Browsing by Author "Glisenti, Fulvio"
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- ItemAssessment of prehospital chest pain using telecardiology.(2002-09-09) Scalvini, Simonetta; Zanelli, Emanuela; Conti, Claudia; Volterrani, Maurizio; Pollina, Riccardo; Giordano, Amerigo; Glisenti, Fulvio; ,Two hundred general practitioners were equipped with a portable electrocardiograph which could transmit a 12 lead electrocardiogram ECG via a telephone line A cardiologist was available 24 h a day for an interactive teleconsultation In a 13 month period there were 5073 calls to the telecardiology service and 952 subjects with chest pain were identified The telecardiology service allowed the general practitioners to manage 700 cases 74 themselves further diagnostic tests were requested for 162 patients 17 and 83 patients 9 were sent to the hospital emergency department In the last group a cardiological diagnosis was confirmed in 60 patients and refuted in 23 Seven patients in whom the telecardiology service failed to detect a cardiac problem were hospitalized in the subsequent 48 h The telecardiology service showed a sensitivity of 97 4 a specificity of 89 5 and a diagnostic accuracy of 86 9 for chest pain Telemedicine could be a useful tool in the diagnosis of chest pain in primary care
- ItemBoario Home Care Project: an Italian telemedicine experience.(2003-12-03) Scalvini, Simonetta; Volterrani, Maurizio; Giordano, Amerigo; Glisenti, FulvioThe use of telemedicine appears particularly promising in cardiovascular disease because the cost effectiveness ratio of an early tailored intervention in terms of life saving and functional recovery is demonstrated Boario Home Care project was born in 1998 with the aim of applying the new models of disease management and the new technology on the territory In the first phase the project was to realize a telematic network for the General Practitioners in a mountain territory In the second phase the project was extended to the regional and then national territory and the number of enrolled GPs increased In the third phase that is nowadays the structure of the Service Center has been implemented with new broad band technologies HDLS and with an innovative teleworking model has been adopted for the professional figures involved Four different types of services are now available General Practitioners Home Telenursing for chronic patients Tele diagnosis for palpitations and Call Center Services for hospitals In conclusion Boario Home Care project has reached its maturity and many results even if we can consider them preliminary in the field of Telemedicine Boario Home Care project won e health Awards with the honourable mention and it was presented at the eHealth 2003 ICT for Health in Brussels Belgium
- Item[Cardiac event recorder yields more diagnoses than 24-hour Holter monitoring in patients with palpitations].(2004-04-30) Scalvini, Simonetta; Zanelli, Emanuela; Martinelli, Giovanna; Marchina, Lucia; Giordano, Amerigo; Glisenti, FulvioBACKGROUND Palpitations are a common symptom that sometimes results from a substantial cardiac arrhythmia A 24 hour Holter monitoring is usually used but the yield of this instrument is low in patients whose symptoms occur infrequently The aim of this study was to compare the diagnostic yield and the cost effectiveness of transtelephonic event recorder TER with those of Holter monitoring in patients with intermittent palpitations METHODS Three hundred and ten patients with intermittent palpitations were allocated to the study and randomly assigned to receive a TER or 24 hour Holter monitoring TER was given to patients until recording was obtained while symptoms occurred or was used at most for 7 days At enrollment a basal trace was recorded Patients with palpitations recorded the one lead ECG trace and sent it by phone fixed or mobile to the telemedicine call center where a trained nurse compared the trace with the basal one and checked the patient s symptoms The cardiologist reported on line all the traces sent in the presence of an arrhythmic event and stored and forwarded all the other traces Standard methods were used for Holter recording and reading RESULTS Patients with palpitations during the examination were 119 76 8 in the group of TER and 74 47 8 in the Holter group p Under 0 000 with an efficacy increase of 29 for TER In symptomatic patients there were no differences between the two groups about the presence or absence of arrhythmias checked in the ECG traces the time necessary to make a presence absence diagnosis of arrhythmias was 2 97 2 74 days with the event recorder The total cost of 155 tests made with Holter was altogether 9605 35 Euro costs per test 61 97 Euro while the one of TER was 6019 2 Euro cost par test 38 83 Euro The cost effectiveness analysis was 129 80 Euro for Holter and 50 57 Euro for TER with a saving of 79 23 Euro for every diagnosis made CONCLUSIONS TER allows to detect intermittent palpitations in real time it is more useful and effective than Holter moreover this effectiveness was also confirmed by the cost analysis in which TER resulted less expensive
- ItemCentenary of tele-electrocardiography and telephonocardiography - where are we today?(2005-10-21) Scalvini, Simonetta; Glisenti, FulvioTelecardiology applications can be categorized as pre hospital in hospital and post hospital The major purpose of pre hospital 12 lead electrocardiographic diagnosis is the early detection of acute myocardial infarction with ST segment elevation and the communication of that information to the receiving emergency physician before the arrival of the patient In hospital telecardiology is used between small hospitals in rural regions and main hospitals Telemedicine here has the potential to improve access to echocardiography diagnoses in the intensive care unit emergency room and newborn nursery In some centres urgent echocardiography is performed during weekends evenings and overnight to assess ventricular function ischaemia pericardial effusion valvular disease and heart donor status Post hospital applications include teleconsulting between GPs and specialists home telenursing for chronic cardiac diseases and the diagnosis of arrhythmias Telecardiology is one of the fastest growing fields in telemedicine There is already a significant quantity of published clinical data with some randomized multi centre trials to answer the most important questions definitively Telecardiology in some fields such as emergency and chronic care undoubtedly improves the quality of health care and helps to contain rising costs Telecardiology has yet to reach maturity but the evidence to date indicates that it has made a good start
- ItemChronic heart failure home-based management with a telecardiology system: a comparison between patients followed by general practitioners and by a cardiology department.(2006-08-03) Scalvini, Simonetta; Zanelli, Emanuela; Paletta, Laura; Benigno, Massimo; Domeneghini, Diego; De Giuli, Federica; Giordano, Amerigo; Glisenti, FulvioA group of patients with chronic heart failure CHF were followed by general practitioners GPs with a telecardiology system and a second group of patients were followed by a home based telemonitoring HBT protocol with medical and nursing supervision The 212 GP patients were older than the 226 HBT patients mostly women with CHF secondary to chronic hypertension less self sufficient and with a non optimized therapy The mean number of telephone calls was 2 6 per patient in the GP group and 16 6 per patient in the HBT group PUnder0 001 These preliminary data suggest the applicability and the efficacy of both management models for CHF patients
- ItemIncidence of atrial fibrillation in an Italian population followed by their GPs through a telecardiology service.(2005-02-02) Scalvini, Simonetta; Piepoli, Massimo; Zanelli, Emanuela; Volterrani, Maurizio; Giordano, Amerigo; Glisenti, FulvioAtrial fibrillation AF is the most common sustained cardiac tachyarrhythmia and is often an occasional diagnosis in the absence of known cardiac disease The aim of this study is to describe an Italian patient population with AF followed by their General Practitioners GPs using a telecardiology service
- ItemA pilot study of nurse-led, home-based telecardiology for patients with chronic heart failure.(2004-04-07) Scalvini, Simonetta; Zanelli, Emanuela; Volterrani, Maurizio; Martinelli, Giovanna; Baratti, Doriana; Buscaya, Osvaldo; Baiardi, Paola; Glisenti, Fulvio; Giordano, AmerigoWe assessed the feasibility of home based telecardiology for patients with chronic heart failure CHF Seventy four CHF patients were enrolled into a programme of telephone follow up and single lead electrocardiography ECG monitoring The patients transmitted their ECG data by fixed telephone line to a receiving station where a nurse was available for an interactive teleconsultation Patients were followed up for a mean SD of 307 108 days 1467 calls were analysed 213 ad hoc consultations and 1254 scheduled consultations A total of 124 cardiovascular events were recorded Modifications to therapy were suggested in response to 119 calls hospital admissions were suggested for 13 patients further investigations for 7 and a consultation with the patient s general practitioner for 13 No action was taken after 1330 calls Twenty two ECG abnormalities were recorded In 63 patients receiving the beta blocker carvedilol the mean dosage increased from 36 to 42 mg In the previous year there were 1 8 hospitalizations per patient while in the follow up period there were 0 2 hospitalizations per patient Following up CHF patients using a nurse led telecardiology programme seems to be feasible and useful
- Item[Technological and organizational aspects].(2006-02-27) Glisenti, Fulvio
- ItemTelemedicine: the role of specialist second opinion for GPs in the care of hypertensive patients.(2011-05-23) Scalvini, Simonetta; Rivadossi, Francesca; Comini, Laura; Muiesan, Maria Lorenza; Glisenti, FulvioTo evaluate the feasibility of a second opinion consultation in supporting general practitioners GPs during the daily diagnosis and therapeutic management of patients with essential hypertension
- ItemWireless-accessible sensor populations for monitoring biological variables.(2008-04-23) Mazzù, Marco; Scalvini, Simonetta; Giordano, Amerigo; Frumento, Enrico; Wells, Hannah; Lokhorst, Kees; Glisenti, FulvioThe current health care infrastructure is generally considered to be inadequate to meet the needs of an increasingly older population We have investigated the feasibility of a passive in home monitoring system based on wireless accessible sensor populations WASP In an EU funded project we have identified the system architecture and the sensors required to gather data from elderly patients by continuous monitoring Data from biological variables heart rate accelerometers body temperature and galvanic skin response and everyday habits body position movements will be transmitted to a central monitoring centre A Body Sensor Network worn by the patient and able to communicate with a personal mobile hub and an Ambient Sensor Network a number of wireless sensors incorporated into the patient s home are envisaged The system will be tested by using it in the telemedicine activities of the Health Telematic Network which manages home help projects for elderly patients