The Experts below are selected from a list of 216 Experts worldwide ranked by ideXlab platform

Isabelle Durandzaleski - One of the best experts on this subject based on the ideXlab platform.

  • effectiveness and efficiency of tele expertise for improving access to retinopathy screening among 351 neonates in a Secondary Care Center an observational controlled before after study
    PLOS ONE, 2018
    Co-Authors: Marie Moitry, Kevin Zarca, Michèle Granier, Marie-stéphanie Aubelle, Nathanaël Charrier, Brigitte Vacherot, G. Caputo, Maroua Mimouni, Pierre-henri Jarreau, Isabelle Durandzaleski
    Abstract:

    In France, Secondary Care hospitals encounter difficulties to adhere to retinopathy of prematurity (ROP) screening guidelines. Our objective was to assess the effectiveness and efficacy of a tele-expertise program for ROP screening in neonatal intensive Care units without on-site ophthalmologists. We evaluated the impact of a tele-expertise program funded by the Paris Region Health Authority in a Secondary Care Center general hospital of the Paris Region (CHSF), where there was previously no on-site ophthalmologist. We performed an observational, controlled before-after study, with a university tertiary Care Center with on-site ophthalmologists (Port-Royal) as the control group. Recruitment and data collection for both periods took place from 1 January 2012 to 31 December 31 2012, and from 1 January 2014 to 31 March 2015. The primary endpoint was the percentage of compliance with screening guidelines, Secondary endpoints included pain scores and costs. Over the two periods, at total of 351 infants were recruited in the CHSF. Implementation of the tele-expertise resulted in an absolute +57.3% increase in the proportion of examinations realized in accordance with guidelines (3.8% during the "before" period and 61.1% during the "after" period, p<0.001). As compared with the control group, the proportion of infants appropriately screened improved (57.5% versus 43.1%, p = 0.002); median pain score on the acute pain rating scale for neonates during examination was significantly higher (median score 5.5/10, range [2.5–5.7] versus 2.0/10, range [1.0–3.1], p = 0.002). Screening rates in the control group remained unchanged. The average cost per examination increased from €337 in the "before" period to €353 in the "after period" in the tele-expertise group. The implementation of tele-expertise for ROP screening in the CHSF medical Center resulted in a major improvement of access to Care with a small cost increase. The issue of pain control during examination with tele-expertise should be further addressed.

Marie Moitry - One of the best experts on this subject based on the ideXlab platform.

  • Effectiveness and efficiency of tele-expertise for improving access to retinopathy screening among 351 neonates in a Secondary Care Center: An observational, controlled before-after study.
    PLOS ONE, 2018
    Co-Authors: Marie Moitry, Kevin Zarca, Michèle Granier, Marie-stéphanie Aubelle, Nathanaël Charrier, Brigitte Vacherot, G. Caputo, Maroua Mimouni, Pierre-henri Jarreau, Isabelle Durand-zaleski
    Abstract:

    In France, Secondary Care hospitals encounter difficulties to adhere to retinopathy of prematurity (ROP) screening guidelines. Our objective was to assess the effectiveness and efficacy of a tele-expertise program for ROP screening in neonatal intensive Care units without on-site ophthalmologists. We evaluated the impact of a tele-expertise program funded by the Paris Region Health Authority in a Secondary Care Center general hospital of the Paris Region (CHSF), where there was previously no on-site ophthalmologist. We performed an observational, controlled before-after study, with a university tertiary Care Center with on-site ophthalmologists (Port-Royal) as the control group. Recruitment and data collection for both periods took place from 1 January 2012 to 31 December 31 2012, and from 1 January 2014 to 31 March 2015. The primary endpoint was the percentage of compliance with screening guidelines, Secondary endpoints included pain scores and costs. Over the two periods, at total of 351 infants were recruited in the CHSF. Implementation of the tele-expertise resulted in an absolute +57.3% increase in the proportion of examinations realized in accordance with guidelines (3.8% during the "before" period and 61.1% during the "after" period, p

  • effectiveness and efficiency of tele expertise for improving access to retinopathy screening among 351 neonates in a Secondary Care Center an observational controlled before after study
    PLOS ONE, 2018
    Co-Authors: Marie Moitry, Kevin Zarca, Michèle Granier, Marie-stéphanie Aubelle, Nathanaël Charrier, Brigitte Vacherot, G. Caputo, Maroua Mimouni, Pierre-henri Jarreau, Isabelle Durandzaleski
    Abstract:

    In France, Secondary Care hospitals encounter difficulties to adhere to retinopathy of prematurity (ROP) screening guidelines. Our objective was to assess the effectiveness and efficacy of a tele-expertise program for ROP screening in neonatal intensive Care units without on-site ophthalmologists. We evaluated the impact of a tele-expertise program funded by the Paris Region Health Authority in a Secondary Care Center general hospital of the Paris Region (CHSF), where there was previously no on-site ophthalmologist. We performed an observational, controlled before-after study, with a university tertiary Care Center with on-site ophthalmologists (Port-Royal) as the control group. Recruitment and data collection for both periods took place from 1 January 2012 to 31 December 31 2012, and from 1 January 2014 to 31 March 2015. The primary endpoint was the percentage of compliance with screening guidelines, Secondary endpoints included pain scores and costs. Over the two periods, at total of 351 infants were recruited in the CHSF. Implementation of the tele-expertise resulted in an absolute +57.3% increase in the proportion of examinations realized in accordance with guidelines (3.8% during the "before" period and 61.1% during the "after" period, p<0.001). As compared with the control group, the proportion of infants appropriately screened improved (57.5% versus 43.1%, p = 0.002); median pain score on the acute pain rating scale for neonates during examination was significantly higher (median score 5.5/10, range [2.5–5.7] versus 2.0/10, range [1.0–3.1], p = 0.002). Screening rates in the control group remained unchanged. The average cost per examination increased from €337 in the "before" period to €353 in the "after period" in the tele-expertise group. The implementation of tele-expertise for ROP screening in the CHSF medical Center resulted in a major improvement of access to Care with a small cost increase. The issue of pain control during examination with tele-expertise should be further addressed.

Cennet Yildiz - One of the best experts on this subject based on the ideXlab platform.

  • a survey of concordance of anticoagulant therapy administration in atrial fibrillation according to guidelines a Secondary Care Center experience
    Journal of the American College of Cardiology, 2013
    Co-Authors: Abdulmelik Yildiz, Cennet Yildiz
    Abstract:

    PRO). Approaches to autonomic activity modulation included atrial sympathetic ganglia ablation and pulmonary veins isolation. Renal artery ablation (RAA) was performed in presence of resistant hypertension. Results: Autonomic regulation of circulation was characterized by decrease in parasympathetic and increase in sympathetic influence on the heart, particularly, in patients with diurnal paroxysmal AF. At the same time, arterial baroreflex magnitude was significantly higher in patients with AF related to enhanced sympathetic activation in comparison with control. Ablation of atrial sympathetic ganglia was accompanied by reduction of AF recurrence rate. However, this effect was less evident in comparison with the effect of pulmonary veins isolation. Moreover, HRV restoration in 3 months after ablation of sympathetic ganglia indicates the nondurable effect of this procedure. In the end, baroreflex restoration after RAA observed before may be an important mechanism of not only BP lowering but also reduction of AF paroxysms rate. Conclusion: Disorders of autonomic regulation of circulation is an important mechanism of arrhythmogenesis, so its modulation can be used in patients with AF as a therapeutic strategy.

Augusto Gallino - One of the best experts on this subject based on the ideXlab platform.

  • abstract 18196 excellent incorporation of endovascular aneurysm repair after telementoring program in a Secondary Care Center
    Circulation, 2012
    Co-Authors: Alessandra Pia Porretta, Mario Alerci, Marcello Di Valentino, Rolf Wyttenbach, Marcel Bogen, Adriano Guerra, Luigi Inglese, Ludwig K Von Segesser, Augusto Gallino
    Abstract:

    BACKGROUND Telemedicine is a developing application which enhances mentoring and technical support for medical operators. Endovascular aneurysm repair (EVAR) represents a minimally invasive approac...

  • Telementoring during endovascular treatment of abdominal aortic aneurysms: a prospective study.
    Journal of Endovascular Therapy, 2005
    Co-Authors: Marcello Di Valentino, Mario Alerci, Marcel Bogen, Ludwig K Von Segesser, Fabio Sartori, Paolo Tutta, Bettina Marty, Augusto Gallino
    Abstract:

    PURPOSE: To explore the use of telementoring for distant teaching and training in endovascular aortic aneurysm repair (EVAR). METHODS: According to a prospectively designed study protocol, 48 patients underwent EVAR: the first 12 patients (group A) were treated at a Secondary Care Center by an experienced interventionist, who was training the local team; a further 12 patients (group B) were operated by the local team at their Secondary Center with telementoring by the experienced operator from an adjacent suite; and the last 24 patients (group C) were operated by the local team with remote telementoring support from the experienced interventionist at a tertiary Care Center. Telementoring was performed using 3 video sources; images were transmitted using 4 ISDN lines. EVAR was performed using intravascular ultrasound and simultaneous fluoroscopy to obtain road mapping of the abdominal aorta and its branches, as well as for identifying the origins of the renal arteries, assessing the aortic neck, and monitoring the attachment of the stent-graft proximally and distally. RESULTS: Average duration of telementoring was 2.1 hours during the first 12 patients (group B) and 1.2 hours for the remaining 24 patients (group C). There was no difference in procedural duration (127+/-59 minutes in group A, 120+/-4 minutes in group B, and 119+/-39 minutes in group C; p=0.94) or the mean time spent in the ICU (26+/-15 hours in group A, 22+/-2 hours in group B, and 22+/-11 hours for group C; p=0.95). The length of hospital stay (11+/-4 days in group A, 9+/-4 days in group B, and 7+/-1 days in group C; p=0.002) was significantly different only for group C versus A (p=0.002). Only 1 (8.3%) patient (in group A: EVAR performed by the experienced operator) required conversion to open surgery because of iliac artery rupture. This was the only conversion (and the only death) in the entire study group (1/12 in group A versus 0/36 in groups B + C, p=0.31). CONCLUSIONS: Telementoring for EVAR is feasible and shows promising results. It may serve as a model for development of similar projects for teaching other invasive procedures in cardiovascular medicine.

Andrea E Cavanna - One of the best experts on this subject based on the ideXlab platform.

  • video ambulatory eeg in a Secondary Care Center a retrospective evaluation of utility in the diagnosis of epileptic and nonepileptic seizures
    Epilepsy & Behavior, 2016
    Co-Authors: Andrew Lawley, Francesco Manfredonia, Andrea E Cavanna
    Abstract:

    The development and optimization of protocols using simultaneous video recording alongside long-term electroencephalography (EEG), such as ambulatory EEG (AEEG), expanded the range of available techniques for the investigation of paroxysmal clinical events. In particular, video-AEEG has received increasing attention over the last few years because of its potential to further improve diagnostic utility in the differential diagnosis between epileptic and nonepileptic seizures. We retrospectively evaluated 88 video-AEEG studies in order to assess the diagnostic utility of video-AEEG in 87 patients consecutively referred to a neurophysiology department. Typical clinical events occurred during 55 studies (62.5%). In 26 of these, at least one event was also clearly seen on video recording, contributing to a confident diagnosis. Clinical events were classified according to three diagnostic categories: epileptic seizures (6 studies, 6.8%), physiologic nonepileptic events (13 studies, 14.8%), or psychogenic nonepileptic seizures (36 studies, 40.9%). Of the studies with an event not recorded on video, a confident diagnosis could be reached in 55.2% of cases. The main reason for unsuccessful video recording was failure to activate the camcorder by the patient or Carer. We found an overall diagnostic utility of 67.0%, which confirms the findings of previous reports evaluating the diagnostic yield of AEEG. Implementation of video-AEEG protocols in a Secondary Care Center appears to have high diagnostic utility, particularly for patients with psychogenic nonepileptic seizures. Our findings prompt further research into the potential applications of video-AEEG, in consideration of important implications for successful patient management and healthCare resource allocation.