-572 G/C single nucleotide polymorphism of interleukin-6 and sepsis predisposition in chronic renal disease

Single nucleotide polymorphisms (SNPs) of interleukin (IL)-6 are associated with the development of chronic renal disease (CRD). Their impact for sepsis in the field of CRD was investigated. One control cohort of 115 patients with CRD without infection and another case cohort of 198 patients with CRD and sepsis were enrolled. Genotyping at the −174 (rs1800795) and −572 positions of IL-6 (rs1800796) was done by restriction fragment length polymorphism. Circulating IL-6 was measured by an enzyme immunoassay. The GG genotype of rs1800796 was more frequent among cases (78.3 %) than controls (62.6 %). No difference in the genotype frequencies of rs1800795 between cases and controls were found. Odds ratio for sepsis was 2.07 (95%CI 1.24–3.44, p = 0.005) with the GG genotype of rs1800796, which was confirmed by logistic regression analysis taking into consideration the presence of chronic comorbidities. All-cause mortality until day 28 was similar between patients with the GG genotype and the GC/CC genotypes of rs1800796, but death caused from cardiovascular events not-related with infection was more frequent with the GG genotype (14.6 % vs 2.4 %, p = 0.031). Circulating IL-6 was greater among patients of the GC/CC genotypes of rs1800796 and multiple organ dysfunction (p = 0.013). The GG genotype of rs1800796 predisposes to sepsis in CRD and to 28-day mortality by sepsis-unrelated cardiovascular phenomena.

High efficiency video coding for ultrasound video communication in m-health systems

Emerging high efficiency video compression methods and wider availability of wireless network infrastructure will significantly advance existing m-health applications. For medical video communications, the emerging video compression and network standards support low-delay and high-resolution video transmission, at the clinically acquired resolution and frame rates. Such advances are expected to further promote the adoption of m-health systems for remote diagnosis and emergency incidents in daily clinical practice. This paper compares the performance of the emerging high efficiency video coding (HEVC) standard to the current state-of-the-art H.264/AVC standard. The experimental evaluation, based on five atherosclerotic plaque ultrasound videos encoded at QCIF, CIF, and 4CIF resolutions demonstrates that 50% reductions in bitrate requirements is possible for equivalent clinical quality.

Atherosclerotic plaque ultrasound video encoding, wireless transmission, and quality assessment using H.264

We propose a unifying framework for efficient encoding, transmission, and quality assessment of atherosclerotic plaque ultrasound video. The approach is based on a spatially varying encoding scheme, where video-slice quantization parameters are varied as a function of diagnostic significance. Video slices are automatically set based on a segmentation algorithm. They are then encoded using a modified version of H.264/AVC flexible macroblock ordering (FMO) technique that allows variable quality slice encoding and redundant slices (RSs) for resilience over error-prone transmission channels. We evaluate our scheme on a representative collection of ten ultrasound videos of the carotid artery for packet loss rates up to 30%. Extensive simulations incorporating three FMO encoding methods, different quantization parameters, and different packet loss scenarios are investigated. Quality assessment is based on a new clinical rating system that provides independent evaluations of the different parts of the video (subjective). We also use objective video-quality assessment metrics and estimate their correlation to the clinical quality assessment of plaque type. We find that some objective quality assessment measures computed over the plaque video slices gave very good correlations to mean opinion scores (MOSs). Here, MOSs were computed using two medical experts. Experimental results show that the proposed method achieves enhanced performance in noisy environments, while at the same time achieving significant bandwidth demands reductions, providing transmission over 3G (and beyond) wireless networks.

eEmergency health care information systems

In this paper we provide an overview of the way that information and communication technologies have been used for emergency healthcare support. The paper provides a literature review of case studies exploring information systems for monitoring signals, images, medical videos, as well as information protocols used during emergency health care support, and describes future trends. We anticipate that eEmergency systems can significantly improve the delivery of healthcare during emergency cases. However, the monitoring and evaluation of these systems and especially their use in daily practice still remains a goal to be achieved.

Robust and efficient ultrasound video coding in noisy channels using H.264

In this paper we define diagnostic Regions of Interest (ROIs) for carotid ultrasound medical video, which we then use as input for Flexible Macroblock Ordering (FMO) slice encoding. We extend the FMO concept by enabling variable quality slice encoding, tightly coupled by each region's diagnostic importance. Redundant Slices (RS) utilization increases compressed video's resilience over error prone transmission mediums. We evaluate our scheme on a series of five (5) carotid ultrasound videos at QCIF and CIF resolutions, for packet loss rates up to 30%. Quality assessment based on a clinical rating system that provides for independent evaluations of the different parts of the video (subjective), as well as PSNR ratings (objective), shows that encoded videos attain enhanced diagnostic performance under noisy environments, while at the same time achieving significant bandwidth demands reductions.

An overview of recent end-to-end wireless medical video telemedicine systems using 3G

Advances in video compression, network technologies, and computer technologies have contributed to the rapid growth of mobile health (m-health) systems and services. Wide deployment of such systems and services is expected in the near future, and it's foreseen that they will soon be incorporated in daily clinical practice. This study focuses in describing the basic components of an end-to-end wireless medical video telemedicine system, providing a brief overview of the recent advances in the field, while it also highlights future trends in the design of telemedicine systems that are diagnostically driven.

Wireless medical ultrasound video transmission through noisy channels

Recent advances in video compression such as the current state-of-the-art H.264/AVC standard in conjunction with increasingly available bitrate through new technologies like 3G, and WiMax have brought mobile health (m-Health) healthcare systems and services closer to reality. Despite this momentum towards m-Health systems and especially e-Emergency systems, wireless channels remain error prone, while the absence of objective quality metrics limits the ability of providing medical video of adequate diagnostic quality at a required bitrate. In this paper we investigate different encoding schemes and loss rates in medical ultrasound video transmission and come to conclusions involving efficiency, the trade-off between bitrate and quality, while we highlight the relationship linking video quality and the error ratio of corrupted P and B frames. More specifically, we investigate IPPP, IBPBP and IBBPBBP coding structures under packet loss rates of 2%, 5%, 8% and 10% and derive that the latter attains higher SNR ratings in all tested cases. A preliminary clinical evaluation shows that for SNR ratings higher than 30 db, video diagnostic quality may be adequate, while above 30.5 db the diagnostic information available in the reconstructed ultrasound video is close to that of the original.