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Quaresma AB, Guedes LR, Barros JRD, Baima JP, Imbrizi M, Zerôncio MA, Kotze PG, Flores C. STRUCTURAL EVALUATION OF INFLAMMATORY BOWEL DISEASE COMPREHENSIVE CARE UNITS IN BRAZIL. Arq Gastroenterol 2024; 61:e23166. [PMID: 38511798 DOI: 10.1590/s0004-2803.24612023-166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 03/22/2024]
Abstract
BACKGROUND The most efficient way to prevent complications from inflammatory bowel disease (IBD) is to provide patients with optimized care. Nonetheless, in Brazil, there is no validated methodology for evaluating health services recognized as comprehensive care units (CCU), making it difficult to assess the quality of care provided. OBJECTIVE To understand the current scenario, map the distribution of centers and identify strengths and weaknesses, considering local and regional characteristics. METHODS The study was carried out in three phases. Initially, the Brazilian Organization for Crohn's disease and colitis (GEDIIB) developed 22 questions to characterize CCU in Brazil. In the second phase, all GEDIIB members were invited to respond to the survey with the 11 questions considered most relevant. In the last phase, an interim analysis of the results was performed, using the IBM SPSS Statistics v 29.0.1.0 software. Descriptive statistics were used to characterize the center's profile. The chi-square test was used to compare categorical variables. RESULTS There were 53 responses from public centers (11 excluded). Most centers were concentrated in the Southeastern (n=22/52.4%) and only 1 (2.4%) in the Northern region of Brazil. Thirty-nine centers (92.9%) perform endoscopic procedures, but only 9 (21.4%) have access to enteroscopy and/or small bowel capsule endoscopy. Thirty-three centers (78.6%) offer infusion therapy locally, 26 (61.9%) maintain IBD patient records, 13 (31.0%) reported having an IBD nurse, 34 (81.0%) have specific evidence-based protocols and only 7 (16.7%) have a patient satisfaction methodology. In the private scenario there were 56 responses (10 excluded). There is also a concentration in the Southeastern and Southern regions. Thirty-nine centers (84.8%) have access to endoscopic procedures and 19 perform enteroscopy and/or small bowel capsule endoscopy, more than what is observed in the public environment. Infusion therapy is available in 24 centers (52.2%). Thirty-nine centers (84.8%) maintain a specific IBD patient database, 17 (37%) have an IBD nurse, 36 (78.3%) have specific evidence-based protocols, and 22 (47. 8%) apply a patient satisfaction methodology. CONCLUSION IBD CCU in Brazil were mainly located in the Southeastern and Southern regions of the country. Most centers have dedicated multidisciplinary teams and IBD specialists. There is still a current need to improve the proportion of IBD nurses in IBD care in Brazil. BACKGROUND •In Brazil, there is no validated methodology for evaluating health services recognized as comprehensive care units (CCU), making it difficult to assess the quality of care provided. BACKGROUND •Most CCU were concentrated in the Southeast region and only one (2.4%) in the Northeast region of Brazil. This pattern follows the epidemiological trends of IBD in the country. BACKGROUND •There is still difficulty in accessing enteroscopy and/or small bowel capsule endoscopy in the public health system. BACKGROUND •Most centers have dedicated multidisciplinary teams and IBD specialist doctors. BACKGROUND •There is still a current need to improve the proportion of nurses treating IBD in Brazil.
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Affiliation(s)
- Abel Botelho Quaresma
- Universidade do Oeste de Santa Catarina, Joaçaba, SC, Brasil
- Pontifícia Universidade Católica do Paraná, Programa de Pós-Graduação em Ciências da Saúde, Curitiba, PR, Brasil
| | - Ludmila Resende Guedes
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Instituto Alfa de Gastroenterologia, Belo Horizonte, MG, Brasil
- Hospital Mater Dei, Belo Horizonte, MG, Brasil
| | | | - Júlio Pinheiro Baima
- Universidade Nove de Julho, Bauru, SP, Brasil
- Hospital das Clínicas de Botucatu, Botucatu, SP, Brasil
| | | | | | - Paulo Gustavo Kotze
- Pontifícia Universidade Católica do Paraná, Programa de Pós-Graduação em Ciências da Saúde, Curitiba, PR, Brasil
| | - Cristina Flores
- Centro de Doenças Inflamatórias Intestinais do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Giannini EG, Testa T, Grillo F, Mastracci L, Arrigo S, Cai P, Paolino S, Burlando M, Pisciotta L, Formisano E, Cittadini G, Copello F, Tuo S, Bodini G. Institution of an interdisciplinary IBD centre is associated with improved healthcare utilisation. Eur J Clin Invest 2023:e14143. [PMID: 38041605 DOI: 10.1111/eci.14143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/11/2023] [Accepted: 11/26/2023] [Indexed: 12/03/2023]
Abstract
Despite the institution of an interdisciplinary Inflammatory Bowel Disease (IBD) centre is encouraged, how it may improve patient care is still unknown. In a 5-year period following organisation of an IBD centre, hospitalisations per patient/year decreased (0.41-0.17) and patients on biologics increased (7.7%-26.7%). Total number of hospitalisations (-18.4%) and length of hospitalisation (-29.4%) improved compared with a preceding 5-year period. These findings suggest that institution of an interdisciplinary IBD centre is associated with improved healthcare utilisation.
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Affiliation(s)
- Edoardo G Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Tommaso Testa
- Surgery Unit, Department of Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federica Grillo
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Anatomic Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Luca Mastracci
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Anatomic Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Serena Arrigo
- Pediatric Gastroenterology and Endoscopy, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Piero Cai
- Clinical Psychology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Sabrina Paolino
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Martina Burlando
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Dermatology Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Livia Pisciotta
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Dietetics and Clinical Nutrition Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Elena Formisano
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Dietetics and Clinical Nutrition Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Giuseppe Cittadini
- Oncologic and Interventional Radiology Unit, Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Copello
- Accounting and Management Control Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Sabrina Tuo
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giorgia Bodini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Echarri A, Pérez-Calle JL, Calvo M, Molina G, Sierra-Ausín M, Morete-Pérez MC, Manceñido N, Botella B, Cano N, Castro B, Martín-Rodríguez D, Sánchez-Ortega Y, Corsino P, Cañas M, López-Calleja AM, Nos P, Muñiz J. Should Inflammatory Bowel Disease Clinicians Provide Their Patients with e-Health Resources? Patients' and Professionals' Perspectives. Telemed J E Health 2023; 29:1504-1513. [PMID: 36576850 PMCID: PMC10589484 DOI: 10.1089/tmj.2022.0425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/20/2022] [Accepted: 10/31/2022] [Indexed: 12/29/2022] Open
Abstract
Introduction: The internet is emerging as a source of information for patients with inflammatory bowel disease (IBD). However, it is not always reliable and may cause anxiety. We aim to assess patients' information habits and patients' and professionals' perceptions of a national website integrated as an educational resource for the IBD unit. Methods: Patients aged 18-65 years, comfortable with the internet, and attending follow-ups at participating IBD units (March-June 2019) and their professionals were invited to evaluate a recommended website through an online survey. Results: Three hundred eighty-nine patients and 95 professionals completed the survey. The internet (n = 109; 27.4%) was the second preferred source of information after the health care team (n = 229; 57.5%). Eighty percent of patients searched the internet for information on their disease and 28.6% did so at least once a week (n = 114), especially newly diagnosed ones (<2 years). Patients valued a website recommended by their professional (n = 379; 95.2%) and endorsed by the National Working Group (n = 377; 94.7%). They would attend online educational initiatives on the website (n = 279; 70.1%) and complete periodical surveys to improve its usefulness (n = 338; 84.9%). According to IBD professionals, this type of website is the best patient source of supplementary information (n = 76; 80%) and they "prescribe" it to most patients (67.0 ± 25.2%), especially the newly diagnosed patients (52.7 ± 26.5%). It effectively integrates routine face-to-face education (n = 95; 100%). Conclusions: Patients of IBD units, especially newly diagnosed ones, appreciate a trusted e-Health resource to back up professional information. The favorable opinion of patients and professionals will allow its use in training interventions.
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Affiliation(s)
- Ana Echarri
- IBD Unit. Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Spain
| | - José L. Pérez-Calle
- IBD Unit. Gastroenterology, Hospital Universitario Fundación Alcorcón, Spain
| | - Marta Calvo
- IBD Unit. Gastroenterology, Hospital Universitario Puerta de Hierro, Majalahonda, Spain
| | - Gema Molina
- IBD Unit. Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Spain
| | | | | | - Noemí Manceñido
- IBD Unit. Gastroenterology, Hospital Universitario Infanta Sofía, San Sebastian de los Reyes, Spain
| | - Belén Botella
- IBD Unit. Gastroenterology, Hospital Universitario Infanta Cristina, Parla, Spain
| | - Noelia Cano
- IBD Unit. Gastroenterology, Hospital Universitario de Leon, Spain
| | - Beatriz Castro
- IBD Unit. Gastroenterology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | - Pilar Corsino
- IBD Unit. Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Mercedes Cañas
- IBD Unit. Gastroenterology, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Pilar Nos
- IBD Unit. Gastroenterology, Hospital Universitario La Fe, Valencia, Spain
- CIBEREHD, Madrid, Spain
| | - Javier Muñiz
- Departamento de Ciencias de la Salud e INIBIC, A Coruña, Spain
- Universidad de A Coruña, CIBERCV, A Coruña, Spain
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Tan F, Deng Y, Guo J, Zhou Z, Luo H. Effect of mesalazine combined with probiotics on inflammation and immune function of patients with inflammatory bowel disease. Am J Transl Res 2022; 14:8234-8242. [PMID: 36505287 PMCID: PMC9730058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/17/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine the effects of mesalazine combined with probiotics on inflammation and immune function of patients with inflammatory bowel disease (IBD). METHODS In this retrospective study, a total of 116 patients with IBD treated in Renmin Hospital of Wuhan University from September 2018 to September 2021 were enrolled and divided into a control group (n=55, treated with mesalazine alone) and a research group (n=61, treated with mesalazine combined with probiotics) according to the treatment regimen. The two groups were compared in the levels of inflammatory factors, immune factors, adverse reactions, clinical efficacy and improvement of patients' disease condition before and after treatment. Logistic regression was used to analyze the independent risk factors of infection in patients with IBD at 6 months after admission. RESULTS The research group showed a significantly higher the total effective rate than the control group (P<0.05), and there was no notable difference between the two groups in the incidence of adverse reactions (P>0.05). In addition, compared with the control group, the research group showed significantly lower levels of immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM), Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and had significantly lower scores of clinical activity index (CAI) and endoscopic activity index (EAI) after treatment (all P<0.05). Higher IgG, IgM, IL-6, CRP and EAI levels at admission were independent risk factors for infection in patients with IBD. CONCLUSION Mesalazine combined with probiotics can substantially improve the disease condition of patients with IBD, improve their immune ability and reduce their inflammation level, with a good safety profile.
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Affiliation(s)
- Feifei Tan
- Department of Gastroenterology, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China,Department of Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China
| | - Yinzhi Deng
- Department of Gastroenterology, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China,Department of Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China
| | - Jinkun Guo
- Department of Gastroenterology, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China,Department of Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China
| | - Zhongyin Zhou
- Department of Gastroenterology, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China,Department of Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China
| | - Hesheng Luo
- Department of Gastroenterology, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China,Department of Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan UniversityWuhan 430060, Hubei, China
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Liu L, Liu Y, Gao XZ, Zhang X. An Immersive Human-Robot Interactive Game Framework Based on Deep Learning for Children’s Concentration Training. Healthcare (Basel) 2022; 10:healthcare10091779. [PMID: 36141391 PMCID: PMC9499163 DOI: 10.3390/healthcare10091779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
In order to alleviate bottlenecks such as the lack of professional teachers, inattention during training processes, and low effectiveness in concentration training, we have proposed an immersive human–robot interactive (HRI) game framework based on deep learning for children’s concentration training and demonstrated its use through human–robot interactive games based on gesture recognition. The HRI game framework includes four functional modules: video data acquisition, image recognition modeling, a deep learning algorithm (YOLOv5), and information feedback. First, we built a gesture recognition model containing 10,000 pictures of children’s gestures, using the YOLOv5 algorithm. The average accuracy in recognition trainingwas 98.7%. Second, we recruited 120 children with attention deficits (aged from 9 to 12 years) to play the HRI games, including 60 girls and 60 boys. In the HRI game experiment, we obtained 8640 sample data, which were normalized and processed.According to the results, we found that the girls had better visual short-term memory and a shorter response time than boys. The research results showed that HRI games had a high efficacy, convenience, and full freedom, making them appropriate for children’s concentration training.
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Affiliation(s)
- Li Liu
- College of Digital Technology and Engineering, Ningbo University of Finance and Economics, Ningbo 315175, China
| | - Yangguang Liu
- College of Finance and Information, Ningbo University of Finance and Economics, Ningbo 315175, China
- Correspondence:
| | - Xiao-Zhi Gao
- School of Computing, University of Eastern Finland, 70210 Kuopio, Finland
| | - Xiaomin Zhang
- College of Digital Technology and Engineering, Ningbo University of Finance and Economics, Ningbo 315175, China
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