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Pessoa D, Rocha BM, Strodthoff C, Gomes M, Rodrigues G, Petmezas G, Cheimariotis GA, Kilintzis V, Kaimakamis E, Maglaveras N, Marques A, Frerichs I, Carvalho PD, Paiva RP. BRACETS: Bimodal repository of auscultation coupled with electrical impedance thoracic signals. Comput Methods Programs Biomed 2023; 240:107720. [PMID: 37544061 DOI: 10.1016/j.cmpb.2023.107720] [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] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Respiratory diseases are among the most significant causes of morbidity and mortality worldwide, causing substantial strain on society and health systems. Over the last few decades, there has been increasing interest in the automatic analysis of respiratory sounds and electrical impedance tomography (EIT). Nevertheless, no publicly available databases with both respiratory sound and EIT data are available. METHODS In this work, we have assembled the first open-access bimodal database focusing on the differential diagnosis of respiratory diseases (BRACETS: Bimodal Repository of Auscultation Coupled with Electrical Impedance Thoracic Signals). It includes simultaneous recordings of single and multi-channel respiratory sounds and EIT. Furthermore, we have proposed several machine learning-based baseline systems for automatically classifying respiratory diseases in six distinct evaluation tasks using respiratory sound and EIT (A1, A2, A3, B1, B2, B3). These tasks included classifying respiratory diseases at sample and subject levels. The performance of the classification models was evaluated using a 5-fold cross-validation scheme (with subject isolation between folds). RESULTS The resulting database consists of 1097 respiratory sounds and 795 EIT recordings acquired from 78 adult subjects in two countries (Portugal and Greece). In the task of automatically classifying respiratory diseases, the baseline classification models have achieved the following average balanced accuracy: Task A1 - 77.9±13.1%; Task A2 - 51.6±9.7%; Task A3 - 38.6±13.1%; Task B1 - 90.0±22.4%; Task B2 - 61.4±11.8%; Task B3 - 50.8±10.6%. CONCLUSION The creation of this database and its public release will aid the research community in developing automated methodologies to assess and monitor respiratory function, and it might serve as a benchmark in the field of digital medicine for managing respiratory diseases. Moreover, it could pave the way for creating multi-modal robust approaches for that same purpose.
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Affiliation(s)
- Diogo Pessoa
- University of Coimbra Centre for Informatics and Systems of the University of Coimbra, Department of Informatics Engineering, 3030-290 Coimbra, Portugal.
| | - Bruno Machado Rocha
- University of Coimbra Centre for Informatics and Systems of the University of Coimbra, Department of Informatics Engineering, 3030-290 Coimbra, Portugal
| | - Claas Strodthoff
- Department of Anesthesiology, and Intensive Care Medicine, University Medical Center Schleswig-Holstein Campus Kiel, Kiel 24105, Schleswig-Holstein, Germany
| | - Maria Gomes
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Guilherme Rodrigues
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Georgios Petmezas
- 2nd Department of Obstetrics and Gynaecology, The Medical School, 54124 Thessaloniki, Greece
| | | | - Vassilis Kilintzis
- 2nd Department of Obstetrics and Gynaecology, The Medical School, 54124 Thessaloniki, Greece
| | - Evangelos Kaimakamis
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital of Thessaloniki, 57010 Pilea Hortiatis, Greece
| | - Nicos Maglaveras
- 2nd Department of Obstetrics and Gynaecology, The Medical School, 54124 Thessaloniki, Greece
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal; Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Inéz Frerichs
- Department of Anesthesiology, and Intensive Care Medicine, University Medical Center Schleswig-Holstein Campus Kiel, Kiel 24105, Schleswig-Holstein, Germany
| | - Paulo de Carvalho
- University of Coimbra Centre for Informatics and Systems of the University of Coimbra, Department of Informatics Engineering, 3030-290 Coimbra, Portugal
| | - Rui Pedro Paiva
- University of Coimbra Centre for Informatics and Systems of the University of Coimbra, Department of Informatics Engineering, 3030-290 Coimbra, Portugal
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Lavrentieva A, Kaimakamis E, Voutsas V, Bitzani M. An observational study on factors associated with ICU mortality in Covid-19 patients and critical review of the literature. Sci Rep 2023; 13:7804. [PMID: 37179397 PMCID: PMC10182846 DOI: 10.1038/s41598-023-34613-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
The novel pandemic caused by SARS-CoV-2 has been associated with increased burden on healthcare system. Recognizing the variables that independently predict death in COVID-19 is of great importance. The study was carried out prospectively in a single ICU in northern Greece. It was based on the collection of data during clinical practice in 375 adult patients who were tested positive for SARS-CoV-2 between April 2020 and February 2022. All patients were intubated due to acute respiratory insufficiency and received Invasive Mechanical Ventilation. The primary outcome was ICU mortality. Secondary outcomes were 28-day mortality and independent predictors of mortality at 28 days and during ICU hospitalization. For continuous variables with normal distribution, t-test was used for means comparison between two groups and one-way ANOVA for multiple comparisons. When the distribution was not normal, comparisons were performed using the Mann-Whitney test. Comparisons between discrete variables were made using the x2 test, whereas the binary logistic regression was employed for the definition of factors affecting survival inside the ICU and after 28 days. Of the total number of patients intubated due to COVID-19 during the study period, 239 (63.7%) were male. Overall, the ICU survival was 49.6%, whereas the 28-day survival reached 46.9%. The survival rates inside the ICU for the four main viral variants were 54.9%, 50.3%, 39.7% and 50% for the Alpha, Beta, Delta and Omicron variants, respectively. Logistic regressions for outcome revealed that the following parameters were independently associated with ICU survival: wave, SOFA @day1, Remdesivir use, AKI, Sepsis, Enteral Insufficiency, Duration of ICU stay and WBC. Similarly, the parameters affecting the 28-days survival were: duration of stay in ICU, SOFA @day1, WBC, Wave, AKI and Enteral Insufficiency. In this observational cohort study of critically ill COVID-19 patients we report an association between mortality and the wave sequence, SOFA score on admission, the use of Remdesivir, presence of AKI, presence of gastrointestinal failure, sepsis and WBC levels. Strengths of this study are the large number of critically ill COVID-19 patients included, and the comparison of the adjusted mortality rates between pandemic waves within a two year-study period.
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Affiliation(s)
- Athina Lavrentieva
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
| | - Evangelos Kaimakamis
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece.
| | - Vassileios Voutsas
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
| | - Militsa Bitzani
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
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3
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Kontou P, Kotoulas SC, Kalliontzis S, Synodinos-Kamilos S, Akritidou S, Kaimakamis E, Anisoglou S, Manika K. Evaluation of Pain Scales and Outcome in Critically Ill Patients of a Greek ICU. J Pain Palliat Care Pharmacother 2023; 37:34-43. [PMID: 36512684 DOI: 10.1080/15360288.2022.2149668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The purpose of the study was to evaluate painful procedures in ICU patients and to investigate their effect as well as the role of analgesia in the outcome. We measured pain level and vital signs before, during and after potentially painful procedures by using the Behavioral Pain Scale (BPS) and the Critical Care Pain Observation Tool (CPOT). We analyzed the correlation of these measurements and of analgesia with the outcome. Twenty-eight patients were subjected to 160 stimuli. There were statistically significant differences in pain scores and most vital signs between the different timepoints (before-during, during-after). Most of them were significantly correlated with each other. Physiotherapy proved to be the most painful procedure. Regarding the outcome, the administration of extra analgesia predicted less days of mechanical ventilation (p = 0.015) and of ICU stay (p = 0.016). The higher change in BPS was correlated with more days of mechanical ventilation [B (95% CI) = 3.640 (1.001-6.280), p = 0.007] and of ICU stay [B (95% CI) = 3.645 (1.035-6.254), p = 0.006]. The higher change in CPOT and the nonuse of extra analgesia were related to increased mortality [OR (95% CI) = 1.492 (1.107-2.011), p = 0.009 and OR (95% CI) = 2.626 (1.013-6.806), p = 0.047]. Increased pain in ICU patients was successfully assessed by the BPS and CPOT and correlated to worse outcomes, which the administration of extra analgesia might improve.
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Tabah A, Buetti N, Staiquly Q, Ruckly S, Akova M, Aslan AT, Leone M, Conway Morris A, Bassetti M, Arvaniti K, Lipman J, Ferrer R, Qiu H, Paiva JA, Povoa P, De Bus L, De Waele J, Zand F, Gurjar M, Alsisi A, Abidi K, Bracht H, Hayashi Y, Jeon K, Elhadi M, Barbier F, Timsit JF, Pollock H, Margetts B, Young M, Bhadange N, Tyler S, Ledtischke A, Finnis M, Ledtischke A, Finnis M, Dwivedi J, Saxena M, Biradar V, Soar N, Sarode V, Brewster D, Regli A, Weeda E, Ahmed S, Fourie C, Laupland K, Ramanan M, Walsham J, Meyer J, Litton E, Palermo AM, Yap T, Eroglu E, Attokaran AG, Jaramillo C, Nafees KMK, Rashid NAHA, Walid HAMI, Mon T, Moorthi PD, Sudhirchandra S, Sridharan DD, Haibo Q, Jianfeng X, Wei-Hua L, Zhen W, Qian C, Luo J, Chen X, Wang H, Zhao P, Zhao J, Wusi Q, Mingmin C, Xu L, Yin C, Wang R, Wang J, Yin Y, Zhang M, Ye J, Hu C, Zhou S, Huang M, Yan J, Wang Y, Qin B, Ye L, Weifeng X, Peije L, Geng N, Hayashi Y, Karumai T, Yamasaki M, Hashimoto S, Hosokawa K, Makino J, Matsuyoshi T, Kuriyama A, Shigemitsu H, Mishima Y, Nagashima M, Yoshida H, Fujitani S, Omori K, Rinka H, Saito H, Atobe K, Kato H, Takaki S, Hasan MS, Jamaluddin MFH, Pheng LS, Visvalingam S, Liew MT, Wong SLD, Fong KK, Rahman HBA, Noor ZM, Tong LK, Azman AH, Mazlan MZ, Ali S, Jeon K, Lee SM, Park S, Park SY, Lim SY, Goh QY, Ng SY, Lie SA, Kwa ALH, Goh KJ, Li AY, Ong CYM, Lim JY, Quah JL, Ng K, Ng LXL, Yeh YC, Chou NK, Cia CT, Hu TY, Kuo LK, Ku SC, Wongsurakiat P, Apichatbutr Y, Chiewroongroj S, Nadeem R, Houfi AE, Alsisi A, Elhadidy A, Barsoum M, Osman N, Mostafa T, Elbahnasawy M, Saber A, Aldhalia A, Elmandouh O, Elsayed A, Elbadawy MA, Awad AK, Hemead HM, Zand F, Ouhadian M, Borsi SH, Mehraban Z, Kashipazha D, Ahmadi F, Savaie M, Soltani F, Rashidi M, Baghbanian R, Javaherforoosh F, Amiri F, Kiani A, Zargar MA, Mahmoodpoor A, Aalinezhad F, Dabiri G, Sabetian G, Sarshad H, Masjedi M, Tajvidi R, Tabatabaei SMN, Ahmed AK, Singer P, Kagan I, Rigler M, Belman D, Levin P, Harara B, Diab A, Abilama F, Ibrahim R, Fares A, Buimsaedah A, Gamra M, Aqeelah A, AliAli AM, Homaidan AGS, Almiqlash B, Bilkhayr H, Bouhuwaish A, Taher AS, Abdulwahed E, Abousnina FA, Hdada AK, Jobran R, Hasan HB, Hasan RSB, Serghini I, Seddiki R, Boukatta B, Kanjaa N, Mouhssine D, Wajdi MA, Dendane T, Zeggwagh AA, Housni B, Younes O, Hachimi A, Ghannam A, Belkhadir Z, Amro S, Jayyab MA, Hssain AA, Elbuzidi A, Karic E, Lance M, Nissar S, Sallam H, Elrabi O, Almekhlafi GA, Awad M, Aljabbary A, Chaaban MK, Abu-Sayf N, Al-Jadaan M, Bakr L, Bouaziz M, Turki O, Sellami W, Centeno P, Morvillo LN, Acevedo JO, Lopez PM, Fernández R, Segura M, Aparicio DM, Alonzo MI, Nuccetelli Y, Montefiore P, Reyes LF, Reyes LF, Ñamendys-Silva SA, Romero-Gonzalez JP, Hermosillo M, Castillo RA, Leal JNP, Aguilar CG, Herrera MOG, Villafuerte MVE, Lomeli-Teran M, Dominguez-Cherit JG, Davalos-Alvarez A, Ñamendys-Silva SA, Sánchez-Hurtado L, Tejeda-Huezo B, Perez-Nieto OR, Tomas ED, De Bus L, De Waele J, Hollevoet I, Denys W, Bourgeois M, Vanderhaeghen SFM, Mesland JB, Henin P, Haentjens L, Biston P, Noel C, Layos N, Misset B, De Schryver N, Serck N, Wittebole X, De Waele E, Opdenacker G, Kovacevic P, Zlojutro B, Custovic A, Filipovic-Grcic I, Radonic R, Brajkovic AV, Persec J, Sakan S, Nikolic M, Lasic H, Leone M, Arbelot C, Timsit JF, Patrier J, Zappela N, Montravers P, Dulac T, Castanera J, Auchabie J, Le Meur A, Marchalot A, Beuzelin M, Massri A, Guesdon C, Escudier E, Mateu P, Rosman J, Leroy O, Alfandari S, Nica A, Souweine B, Coupez E, Duburcq T, Kipnis E, Bortolotti P, Le Souhaitier M, Mira JP, Garcon P, Duprey M, Thyrault M, Paulet R, Philippart F, Tran M, Bruel C, Weiss E, Janny S, Foucrier A, Perrigault PF, Djanikian F, Barbier F, Gainnier M, Bourenne J, Louis G, Smonig R, Argaud L, Baudry T, Dessap AM, Razazi K, Kalfon P, Badre G, Larcher R, Lefrant JY, Roger C, Sarton B, Silva S, Demeret S, Le Guennec L, Siami S, Aparicio C, Voiriot G, Fartoukh M, Dahyot-Fizelier C, Imzi N, Klouche K, Bracht H, Hoheisen S, Bloos F, Thomas-Rueddel D, Petros S, Pasieka B, Dubler S, Schmidt K, Gottschalk A, Wempe C, Lepper P, Metz C, Viderman D, Ymbetzhanov Y, Mugazov M, Bazhykayeva Y, Kaligozhin Z, Babashev B, Merenkov Y, Temirov T, Arvaniti K, Smyrniotis D, Psallida V, Fildisis G, Soulountsi V, Kaimakamis E, Iasonidou C, Papoti S, Renta F, Vasileiou M, Romanou V, Koutsoukou V, Matei MK, Moldovan L, Karaiskos I, Paskalis H, Marmanidou K, Papanikolaou M, Kampolis C, Oikonomou M, Kogkopoulos E, Nikolaou C, Sakkalis A, Chatzis M, Georgopoulou M, Efthymiou A, Chantziara V, Sakagianni A, Athanasa Z, Papageorgiou E, Ali F, Dimopoulos G, Almiroudi MP, Malliotakis P, Marouli D, Theodorou V, Retselas I, Kouroulas V, Papathanakos G, Montrucchio G, Sales G, De Pascale G, Montini LM, Carelli S, Vargas J, Di Gravio V, Giacobbe DR, Gratarola A, Porcile E, Mirabella M, Daroui I, Lodi G, Zuccaro F, Schlevenin MG, Pelosi P, Battaglini D, Cortegiani A, Ippolito M, Bellina D, Di Guardo A, Pelagalli L, Covotta M, Rocco M, Fiorelli S, Cotoia A, Rizzo AC, Mikstacki A, Tamowicz B, Komorowska IK, Szczesniak A, Bojko J, Kotkowska A, Walczak-Wieteska P, Wasowska D, Nowakowski T, Broda H, Peichota M, Pietraszek-Grzywaczewska I, Martin-Loeches I, Bisanti A, Cartoze N, Pereira T, Guimarães N, Alves M, Marques AJP, Pinto AR, Krystopchuk A, Teresa A, de Figueiredo AMP, Botelho I, Duarte T, Costa V, Cunha RP, Molinos E, da Costa T, Ledo S, Queiró J, Pascoalinho D, Nunes C, Moura JP, Pereira É, Mendes AC, Valeanu L, Bubenek-Turconi S, Grintescu IM, Cobilinschi C, Filipescu DC, Predoi CE, Tomescu D, Popescu M, Marcu A, Grigoras I, Lungu O, Gritsan A, Anderzhanova A, Meleshkina Y, Magomedov M, Zubareva N, Tribulev M, Gaigolnik D, Eremenko A, Vistovskaya N, Chukina M, Belskiy V, Furman M, Rocca RF, Martinez M, Casares V, Vera P, Flores M, Amerigo JA, Arnillas MPG, Bermudez RM, Armestar F, Catalan B, Roig R, Raguer L, Quesada MD, Santos ED, Gomà G, Ubeda A, Salgado DM, Espina LF, Prieto EG, Asensio DM, Rodriguez DM, Maseda E, De La Rica AS, Ayestaran JI, Novo M, Blasco-Navalpotro MA, Gallego AO, Sjövall F, Spahic D, Svensson CJ, Haney M, Edin A, Åkerlund J, De Geer L, Prazak J, Jakob S, Pagani J, Abed-Maillard S, Akova M, Aslan AT, Timuroglu A, Kocagoz S, Kusoglu H, Mehtap S, Ceyhun S, Altintas ND, Talan L, Kayaaslan B, Kalem AK, Kurt I, Telli M, Ozturk B, Erol Ç, Demiray EKD, Çolak S, Akbas T, Gundogan K, Sari A, Agalar C, Çolak O, Baykam NN, Akdogan OO, Yilmaz M, Tunay B, Cakmak R, Saltoglu N, Karaali R, Koksal I, Aksoy F, Eroglu A, Saracoglu KT, Bilir Y, Guzeldag S, Ersoz G, Evik G, Sungurtekin H, Ozgen C, Erdoğan C, Gürbüz Y, Altin N, Bayindir Y, Ersoy Y, Goksu S, Akyol A, Batirel A, Aktas SC, Morris AC, Routledge M, Morris AC, Ercole A, Antcliffe D, Rojo R, Tizard K, Faulkner M, Cowton A, Kent M, Raj A, Zormpa A, Tinaslanidis G, Khade R, Torlinski T, Mulhi R, Goyal S, Bajaj M, Soltan M, Yonan A, Dolan R, Johnson A, Macfie C, Lennard J, Templeton M, Arias SS, Franke U, Hugill K, Angell H, Parcell BJ, Cobb K, Cole S, Smith T, Graham C, Cerman J, Keegan A, Ritzema J, Sanderson A, Roshdy A, Szakmany T, Baumer T, Longbottom R, Hall D, Tatham K, Loftus S, Husain A, Black E, Jhanji S, Baikady RR, Mcguigan P, Mckee R, Kannan S, Antrolikar S, Marsden N, Torre VD, Banach D, Zaki A, Jackson M, Chikungwa M, Attwood B, Patel J, Tilley RE, Humphreys MSK, Renaud PJ, Sokhan A, Burma Y, Sligl W, Baig N, McCoshen L, Kutsogiannis DJ, Sligl W, Thompson P, Hewer T, Rabbani R, Huq SMR, Hasan R, Islam MM, Gurjar M, Baronia A, Kothari N, Sharma A, Karmakar S, Sharma P, Nimbolkar J, Samdani P, Vaidyanathan R, Rubina NA, Jain N, Pahuja M, Singh R, Shekhar S, Muzaffar SN, Ozair A, Siddiqui SS, Bose P, Datta A, Rathod D, Patel M, Renuka MK, Baby SK, Dsilva C, Chandran J, Ghosh P, Mukherjee S, Sheshala K, Misra KC, Yakubu SY, Ugwu EM, Olatosi JO, Desalu I, Asiyanbi G, Oladimeji M, Idowu O, Adeola F, Mc Cree M, Karar AAA, Saidahmed E, Hamid HKS. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study. Intensive Care Med 2023; 49:178-190. [PMID: 36764959 PMCID: PMC9916499 DOI: 10.1007/s00134-022-06944-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/23/2022] [Indexed: 02/12/2023]
Abstract
PURPOSE In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. METHODS We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. RESULTS 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. CONCLUSIONS HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.
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Affiliation(s)
- Alexis Tabah
- Intensive Care Unit, Redcliffe Hospital, Brisbane, Australia. .,Queensland Critical Care Research Network (QCCRN), Brisbane, QLD, Australia. .,Queensland University of Technology, Brisbane, QLD, Australia. .,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Niccolò Buetti
- Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Université de Paris, INSERM, IAME UMR 1137, 75018, Paris, France
| | | | - Stéphane Ruckly
- Université de Paris, INSERM, IAME UMR 1137, 75018, Paris, France.,ICUREsearch, Biometry, 38600, Fontaine, France
| | - Murat Akova
- Department of Infectious Diseases, Hacettepe University School of Medicine, Ankara, Turkey
| | - Abdullah Tarik Aslan
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Marc Leone
- Department of Anesthesiology and Intensive Care Unit, Hospital Nord, Aix Marseille University, Assistance Publique Hôpitaux Universitaires de Marseille, Marseille, France
| | - Andrew Conway Morris
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.,Division of Immunology, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, Cb2 1QP, UK.,JVF Intensive Care Unit, Addenbrooke's Hospital, Cambridge, Hills Road, Cambridge, CB2 0QQ, UK
| | - Matteo Bassetti
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy
| | - Kostoula Arvaniti
- Intensive Care Unit, Papageorgiou University Affiliated Hospital, Thessaloníki, Greece
| | - Jeffrey Lipman
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Nimes University Hospital, University of Montpellier, Nimes, France.,Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Ricard Ferrer
- Intensive Care Department, SODIR-VHIR Research Group, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Haibo Qiu
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Nanjing Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - José-Artur Paiva
- Intensive Care Medicine Department, Centro Hospitalar Universitário Sao Joao, Porto, Portugal.,Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal.,Infection and Sepsis ID Group, Porto, Portugal
| | - Pedro Povoa
- NOVA Medical School, New University of Lisbon, Lisbon, Portugal.,Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark.,Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, CHLO, Lisbon, Portugal
| | - Liesbet De Bus
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Jan De Waele
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Farid Zand
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohan Gurjar
- Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
| | - Adel Alsisi
- ICU Department, Prime Hospital, Dubai, United Arab Emirates.,Critical Care Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khalid Abidi
- Medical ICU, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Hendrik Bracht
- Central Interdisciplinary Emergency Medicine, University Hospital Ulm, Ulm, Germany
| | - Yoshiro Hayashi
- Department of Intensive Care Medicine, Kameda General Hospital, Kamogawa, Japan
| | - Kyeongman Jeon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - François Barbier
- Service de Médecine Intensive-Réanimation, Centre Hospitalier Régional d'Orléans, 14, avenue de L'Hôpital, 45100, Orléans, France
| | - Jean-François Timsit
- Université Paris-Cité, INSERM, IAME UMR 1137, 75018, Paris, France.,Medical and Infectious Diseases Intensive Care Unit, AP-HP, Bichat-Claude Bernard University Hospital, 46 Omdurman maternity hospitalrue Henri Huchard, 75877, Paris Cedex, France
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5
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Siasios P, Arvaniti K, Zachrou E, Poulopoulou A, Pisanidou P, Vasileiadou G, Kaimakamis E, Georgopoulou A, Renta F, Lathyris D, Veroniki F, Geka E, Soultati I, Argiriadou E, Apostolidou E, Amoiridou P, Ioannou K, Kouras L, Mimitou I, Stokkos K, Flioni E, Pertsas E, Sileli M, Iasonidou C, Sourla E, Pitsiou G, Vyzantiadis TA. COVID-19-Associated Pulmonary Aspergillosis (CAPA) in Northern Greece during 2020-2022: A Comparative Study According to the Main Consensus Criteria and Definitions. J Fungi (Basel) 2023; 9:jof9010081. [PMID: 36675902 PMCID: PMC9863007 DOI: 10.3390/jof9010081] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 01/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has emerged as an important complication among patients with acute respiratory failure due to SARS-CoV-2 infection. Almost 2.5 years since the start of the COVID-19 pandemic, it continues to raise concerns as an extra factor that contributes to increased mortality, which is mostly because its diagnosis and management remain challenging. The present study utilises the cases of forty-three patients hospitalised between August 2020 and February 2022 whose information was gathered from ten ICUs and special care units based in northern Greece. The main aim was to describe the gained experience in diagnosing CAPA, according to the implementation of the main existing diagnostic consensus criteria and definitions, and present the different classification of the clinical cases due to the alternative algorithms.
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Affiliation(s)
- Panagiotis Siasios
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence:
| | - Kostoula Arvaniti
- ICU, “Papageorgiou” General Hospital of Thessaloniki, 56403 Thessaloniki, Greece
| | - Evangelia Zachrou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Aikaterini Poulopoulou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Pinelopi Pisanidou
- ICU, “Papageorgiou” General Hospital of Thessaloniki, 56403 Thessaloniki, Greece
| | - Georgia Vasileiadou
- First ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Evangelos Kaimakamis
- First ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Athina Georgopoulou
- First ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Foteini Renta
- ICU, “G. Gennimatas” General Hospital of Thessaloniki, 54635 Thessaloniki, Greece
| | - Dimitrios Lathyris
- ICU, “G. Gennimatas” General Hospital of Thessaloniki, 54635 Thessaloniki, Greece
| | - Foteini Veroniki
- First ICU, “AHEPA” University General Hospital of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Geka
- First ICU, “AHEPA” University General Hospital of Thessaloniki, 54636 Thessaloniki, Greece
| | - Ioanna Soultati
- Second ICU, “AHEPA” University General Hospital of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Argiriadou
- Second ICU, “AHEPA” University General Hospital of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Apostolidou
- ICU, “Bodossakio” General Hospital of Ptolemaida, 50200 Ptolemaida, Greece
| | - Pinelopi Amoiridou
- ICU, “Bodossakio” General Hospital of Ptolemaida, 50200 Ptolemaida, Greece
| | | | - Leonidas Kouras
- ICU, “Mamatsio” General Hospital of Kozani, 50100 Kozani, Greece
| | - Ioanna Mimitou
- ICU, “Mamatsio” General Hospital of Kozani, 50100 Kozani, Greece
| | | | - Elliniki Flioni
- ICU, “Agios Pavlos” General Hospital of Thessaloniki, 55134 Thessaloniki, Greece
| | - Evangelos Pertsas
- ICU, “Agios Pavlos” General Hospital of Thessaloniki, 55134 Thessaloniki, Greece
| | - Maria Sileli
- Second ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Christina Iasonidou
- Second ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Evdokia Sourla
- Respiratory Failure Unit, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Georgia Pitsiou
- Respiratory Failure Unit, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
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6
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Athanasiou N, Baou K, Papandreou E, Varsou G, Amfilochiou A, Kontou E, Pataka A, Porpodis K, Tsiouprou I, Kaimakamis E, Kotoulas S, Katsibourlia E, Alexopoulou C, Bouloukaki I, Panagiotarakou M, Dermitzaki A, Charokopos N, Pagdatoglou K, Lamprou K, Pouriki S, Chatzivasiloglou F, Nouvaki Z, Tsirogianni A, Kalomenidis I, Katsaounou P, Vagiakis E. Association of sleep duration and quality with immunological response after vaccination against severe acute respiratory syndrome coronavirus-2 infection. J Sleep Res 2022; 32:e13656. [PMID: 35670298 PMCID: PMC9348328 DOI: 10.1111/jsr.13656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/07/2022] [Accepted: 05/07/2022] [Indexed: 02/03/2023]
Abstract
Growing evidence suggests that sleep could affect the immunological response after vaccination. The aim of this prospective study was to investigate possible associations between regular sleep disruption and immunity response after vaccination against coronavirus disease 2019 (COVID-19). In total, 592 healthcare workers, with no previous history of COVID-19, from eight major Greek hospitals were enrolled in this study. All subjects underwent two Pfizer-BioNTech messenger ribonucleic acid (mRNA) COVID-19 vaccine BNT162b2 inoculations with an interval of 21 days between the doses. Furthermore, a questionnaire was completed 2 days after each vaccination and clinical characteristics, demographics, sleep duration, and habits were recorded. Blood samples were collected and anti-spike immunoglobulin G antibodies were measured at 20 ± 1 days after the first dose and 21 ± 2 days after the second dose. A total of 544 subjects (30% males), with median (interquartile range [IQR]) age of 46 (38-54) years and body mass index of 24·84 (22.6-28.51) kg/m2 were eligible for the study. The median (IQR) habitual duration of sleep was 6 (6-7) h/night. In all, 283 participants (52%) had a short daytime nap. In 214 (39.3%) participants the Pittsburgh Sleep Quality Index score was >5, with a higher percentage in women (74·3%, p < 0.05). Antibody levels were associated with age (r = -0.178, p < 0.001), poor sleep quality (r = -0.094, p < 0.05), insomnia (r = -0.098, p < 0.05), and nap frequency per week (r = -0.098, p < 0.05), but after adjusting for confounders, only insomnia, gender, and age were independent determinants of antibody levels. It is important to emphasise that insomnia is associated with lower antibody levels against COVID-19 after vaccination.
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Affiliation(s)
- Nikolaos Athanasiou
- First Intensive Care Unit (ICU) DepartmentEvaggelismos Hospital, National and Kapodistrian University of AthensAthensGreece,Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece
| | - Katerina Baou
- Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece,4 Pulmonary DepartmentSotiria General Hospital of Chest Diseases of AthensAthensGreece
| | - Eleni Papandreou
- Department of Critical CareO Agios Dimitrios, General Hospital of ThessalonikiThessalonikiGreece
| | - Georgia Varsou
- Sleep LaboratorySismanogleio Amalia Phlemink General HospitalAthensGreece
| | | | - Elisavet Kontou
- Immunology‐Histocompatibility DepartmentEvaggelismos General HospitalAthensGreece
| | - Athanasia Pataka
- Respiratory Failure UnitAristotle University of Thessaloniki George Papanikolaou HospitalThessalonikiGreece
| | - Konstantinos Porpodis
- Pulmonary Department‐Oncology UnitGeorge Papanikolaou General Hospital, Aristotle University of ThessalonikiThessalonikiGreece
| | - Ioanna Tsiouprou
- Pulmonary DepartmentAristotle University of Thessaloniki, George Papanikolaou General HospitalThessalonikiGreece
| | - Evangelos Kaimakamis
- 1st Intensive Care UnitGeorge Papanikolaou General Hospital, Aristotle University of ThessalonikiThessalonikiGreece
| | | | - Evgenia Katsibourlia
- Department of Immunology – HistocompatibilityGeorge Papanikolaou HospitalThessalonikiGreece
| | | | - Izolde Bouloukaki
- Primary Health Care Center of KastelliSleep Disorders Center, Department Of Thoracic Medicine, University Of CreteHeraklionGreece
| | | | | | | | | | - Kallirroi Lamprou
- Pulmonary DepartmentGeneral Oncologic Hospital Of AthensAthensGreece
| | - Sofia Pouriki
- Intensive Care UnitSotiria General Hospital of Chest Diseases of AthensAthensGreece
| | | | - Zoi Nouvaki
- Intensive Care UnitGeneral Hospital of Nikaia – Peiraia Agios PanteleimonAthensGreece
| | | | - Ioannis Kalomenidis
- First Intensive Care Unit (ICU) DepartmentEvaggelismos Hospital, National and Kapodistrian University of AthensAthensGreece,Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece
| | - Paraskevi Katsaounou
- First Intensive Care Unit (ICU) DepartmentEvaggelismos Hospital, National and Kapodistrian University of AthensAthensGreece,Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece
| | - Emmanouil Vagiakis
- First Intensive Care Unit (ICU) DepartmentEvaggelismos Hospital, National and Kapodistrian University of AthensAthensGreece,Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece
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7
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Rocha BM, Pessoa D, Cheimariotis GA, Kaimakamis E, Kotoulas SC, Tzimou M, Maglaveras N, Marques A, de Carvalho P, Paiva RP. Detection of squawks in respiratory sounds of mechanically ventilated COVID-19 patients. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:512-516. [PMID: 34891345 DOI: 10.1109/embc46164.2021.9630734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Mechanically ventilated patients typically exhibit abnormal respiratory sounds. Squawks are short inspiratory adventitious sounds that may occur in patients with pneumonia, such as COVID-19 patients. In this work we devised a method for squawk detection in mechanically ventilated patients by developing algorithms for respiratory cycle estimation, squawk candidate identification, feature extraction, and clustering. The best classifier reached an F1 of 0.48 at the sound file level and an F1 of 0.66 at the recording session level. These preliminary results are promising, as they were obtained in noisy environments. This method will give health professionals a new feature to assess the potential deterioration of critically ill patients.
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8
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Pessoa D, Rocha BM, Cheimariotis GA, Haris K, Strodthoff C, Kaimakamis E, Maglaveras N, Frerichs I, de Carvalho P, Paiva RP. Classification of Electrical Impedance Tomography Data Using Machine Learning. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:349-353. [PMID: 34891307 DOI: 10.1109/embc46164.2021.9629961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Patients suffering from pulmonary diseases typically exhibit pathological lung ventilation in terms of homogeneity. Electrical Impedance Tomography (EIT) is a non- invasive imaging method that allows to analyze and quantify the distribution of ventilation in the lungs. In this article, we present a new approach to promote the use of EIT data and the implementation of new clinical applications for differential diagnosis, with the development of several machine learning models to discriminate between EIT data from healthy and nonhealthy subjects. EIT data from 16 subjects were acquired: 5 healthy and 11 non-healthy subjects (with multiple pulmonary conditions). Preliminary results have shown accuracy percentages of 66% in challenging evaluation scenarios. The results suggest that the pairing of EIT feature engineering methods with machine learning methods could be further explored and applied in the diagnostic and monitoring of patients suffering from lung diseases. Also, we introduce the use of a new feature in the context of EIT data analysis (Impedance Curve Correlation).
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9
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Villafuerte D, Aliberti S, Soni NJ, Faverio P, Marcos PJ, Wunderink RG, Rodriguez A, Sibila O, Sanz F, Martin‐Loeches I, Menzella F, Reyes LF, Jankovic M, Spielmanns M, Restrepo MI, Aruj PK, Attorri S, Barimboim E, Caeiro JP, Garzón MI, Cambursano VH, Ceccato A, Chertcoff J, Cordon Díaz A, de Vedia L, Ganaha MC, Lambert S, Lopardo G, Luna CM, Malberti AG, Morcillo N, Tartara S, Pensotti C, Pereyra B, Scapellato PG, Stagnaro JP, Shah S, Lötsch F, Thalhammer F, Anseeuw K, Francois CA, Van Braeckel E, Vincent JL, Djimon MZ, Nouér SA, Chipev P, Encheva M, Miteva D, Petkova D, Balkissou AD, Yone EWP, Ngahane BHM, Shen N, Xu JF, Rico CAB, Buitrago R, Paternina FJP, Ntumba JMK, Carevic VV, Jakopovic M, Jankovic M, Matkovic Z, Mitrecic I, Jacobsson MLB, Christensen AB, Heitmann Bødtger UC, Meyer CN, Jensen AV, El-Said Abd El-Wahhab I, Morsy NE, Shafiek H, Sobh E, Abdulsemed KA, Bertrand F, Brun‐Buisson C, Montmollin ED, Fartoukh M, Messika J, Tattevin P, Khoury A, Ebruke B, Dreher M, Kolditz M, Meisinger M, Pletz MW, Hagel S, Rupp J, Schaberg T, Spielmanns M, Creutz P, Suttorp N, Siaw-Lartey B, Dimakou K, Papapetrou D, Tsigou E, Ampazis D, Kaimakamis E, Bhatia M, Dhar R, D'Souza G, Garg R, Koul PA, Mahesh PA, Jayaraj BS, Narayan KV, Udnur HB, Krishnamurthy SB, Kant S, Swarnakar R, Limaye S, Salvi S, Golshani K, Keatings VM, Martin-Loeches I, Maor Y, Strahilevitz J, Battaglia S, Carrabba M, Ceriana P, Confalonieri M, Monforte AD, Prato BD, Rosa MD, Fantini R, Fiorentino G, Gammino MA, Menzella F, Milani G, Nava S, Palmiero G, Petrino R, Gabrielli B, Rossi P, Sorino C, Steinhilber G, Zanforlin A, Franzetti F, Carone M, Patella V, Scarlata S, Comel A, Kurahashi K, Bacha ZA, Ugalde DB, Zuñiga OC, Villegas JF, Medenica M, van de Garde E, Mihsra DR, Shrestha P, Ridgeon E, Awokola BI, Nwankwo ON, Olufunlola AB, Olumide S, Ukwaja KN, Irfan M, Minarowski L, Szymon S, Froes F, Leuschner P, Meireles M, Ravara SB, Brocovschii V, Ion C, Rusu D, Toma C, Chirita D, Dorobat CM, Birkun A, Kaluzhenina A, Almotairi A, Bukhary ZAA, Edathodu J, Fathy A, Enani AMA, Mohamed NE, Memon JU, Bella A, Bogdanović N, Milenkovic B, Pesut D, Borderìas L, Garcia NMB, Cabello Alarcón H, Cilloniz C, Torres A, Diaz-Brito V, Casas X, González AE, Fernández‐Almira ML, Gallego M, Gaspar‐García I, Castillo JGD, Victoria PJ, Laserna Martínez E, Molina RMD, Marcos PJ, Menéndez R, Pando‐Sandoval A, Aymerich CP, Rello J, Moyano S, Sanz F, Sibila O, Rodrigo‐Troyano A, Solé‐Violán J, Uranga A, van Boven JFM, Torra EV, Pujol JA, Feldman C, Yum HK, Fiogbe AA, Yangui F, Bilaceroglu S, Dalar L, Yilmaz U, Bogomolov A, Elahi N, Dhasmana DJ, Feneley A, Hancock C, Hill AT, Rudran B, Ruiz‐Buitrago S, Campbell M, Whitaker P, Youzguin A, Singanayagam A, Allen KS, Brito V, Dietz J, Dysart CE, Kellie SM, Franco‐Sadud RA, Meier G, Gaga M, Holland TL, Bergin SP, Kheir F, Landmeier M, Lois M, Nair GB, Patel H, Reyes K, Rodriguez‐Cintron W, Saito S, Soni NJ, Noda J, Hinojosa CI, Levine SM, Angel LF, Anzueto A, Whitlow KS, Hipskind J, Sukhija K, Totten V, Wunderink RG, Shah RD, Mateyo KJ, Noriega L, Alvarado E, Aman M, Labra L. Prevalence and risk factors for
Enterobacteriaceae
in patients hospitalized with community‐acquired pneumonia. Respirology 2019; 25:543-551. [PMID: 31385399 DOI: 10.1111/resp.13663] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. METHODS We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. RESULTS Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. CONCLUSION This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.
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Affiliation(s)
- David Villafuerte
- Division of Pulmonary Diseases and Critical Care MedicineUniversity of Texas Health – San Antonio San Antonio TX USA
- Division of Pulmonary Diseases and Critical Care MedicineSouth Texas Veterans Health Care System San Antonio TX USA
| | - Stefano Aliberti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoRespiratory Unit and Cystic Fibrosis Adult Center Milan Italy
- Department of Pathophysiology and TransplantationUniversity of Milan Milan Italy
| | - Nilam J. Soni
- Division of Pulmonary Diseases and Critical Care MedicineUniversity of Texas Health – San Antonio San Antonio TX USA
- Division of Pulmonary Diseases and Critical Care MedicineSouth Texas Veterans Health Care System San Antonio TX USA
| | - Paola Faverio
- Cardio‐Thoracic‐Vascular Department, University of Milan Bicocca, Respiratory UnitSan Gerardo Hospital, ASST di Monza Monza Italy
| | - Pedro J. Marcos
- Servicio de Neumología, Instituto de Investigación Biomédica de A Coruña (INIBIC)Complejo Hospitalario Universitario de A Coruña (CHUAC) Sergas Universidade da Coruña (UDC) A Coruña Spain
| | - Richard G. Wunderink
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of MedicineNorthwestern University Chicago IL USA
| | - Alejandro Rodriguez
- Hospital Universitari Joan XXIII, Critical Care MedicineRovira and Virgili University and CIBERes (Biomedical Research Network of Respiratory Disease) Tarragona Spain
| | - Oriol Sibila
- Servei de Pneumologia, Departamento de Medicina, Hospital Santa Creu i Sant PauUniversitat Autònoma de Barcelona Barcelona Spain
| | - Francisco Sanz
- Pulmonology DepartmentConsorci Hospital General Universitari de Valencia Valencia Spain
| | | | - Francesco Menzella
- Department of Cardiac‐Thoracic‐Vascular and Intensive Care Medicine, Pneumology UnitIRCCS – Arcispedale Santa Maria Nuova Reggio Emilia Italy
| | - Luis F. Reyes
- Department of MicrobiologyUniversidad de la Sabana Bogota Colombia
| | - Mateja Jankovic
- School of Medicine, Clinic for Respiratory DiseasesUniversity Hospital Center Zagreb, University of Zagreb Zagreb Croatia
| | - Marc Spielmanns
- Internal Medicine Department, Pulmonary Rehabilitation and Department of Health, School of MedicineUniversity Witten‐Herdecke, St. Remigius‐Hospital Leverkusen Germany
| | - Marcos I. Restrepo
- Division of Pulmonary Diseases and Critical Care MedicineUniversity of Texas Health – San Antonio San Antonio TX USA
- Division of Pulmonary Diseases and Critical Care MedicineSouth Texas Veterans Health Care System San Antonio TX USA
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10
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Aliberti S, Cook GS, Babu BL, Reyes LF, H Rodriguez A, Sanz F, Soni NJ, Anzueto A, Faverio P, Sadud RF, Muhammad I, Prat C, Vendrell E, Neves J, Kaimakamis E, Feneley A, Swarnakar R, Franzetti F, Carugati M, Morosi M, Monge E, Restrepo MI. International prevalence and risk factors evaluation for drug-resistant Streptococcus pneumoniae pneumonia. J Infect 2019; 79:300-311. [PMID: 31299410 DOI: 10.1016/j.jinf.2019.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/05/2019] [Accepted: 07/06/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Streptococcus pneumoniae is the most frequent bacterial pathogen isolated in subjects with Community-acquired pneumonia (CAP) worldwide. Limited data are available regarding the current global burden and risk factors associated with drug-resistant Streptococcus pneumoniae (DRSP) in CAP subjects. We assessed the multinational prevalence and risk factors for DRSP-CAP in a multinational point-prevalence study. DESIGN The prevalence of DRSP-CAP was assessed by identification of DRSP in blood or respiratory samples among adults hospitalized with CAP in 54 countries. Prevalence and risk factors were compared among subjects that had microbiological testing and antibiotic susceptibility data. Multivariate logistic regressions were used to identify risk factors independently associated with DRSP-CAP. RESULTS 3,193 subjects were included in the study. The global prevalence of DRSP-CAP was 1.3% and continental prevalence rates were 7.0% in Africa, 1.2% in Asia, and 1.0% in South America, Europe, and North America, respectively. Macrolide resistance was most frequently identified in subjects with DRSP-CAP (0.6%) followed by penicillin resistance (0.5%). Subjects in Africa were more likely to have DRSP-CAP (OR: 7.6; 95%CI: 3.34-15.35, p<0.001) when compared to centres representing other continents. CONCLUSIONS This multinational point-prevalence study found a low global prevalence of DRSP-CAP that may impact guideline development and antimicrobial policies.
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Affiliation(s)
- Stefano Aliberti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, and University of Milan, Department of Pathophysiology and Transplantation, Milan Italy
| | - Grayden S Cook
- Division of Pulmonary Diseases & Critical Care Medicine, The University of Texas Health Science Centre at San Antonio, San Antonio, TX, USA
| | - Bettina L Babu
- Division of Pulmonary Diseases & Critical Care Medicine, The University of Texas Health Science Centre at San Antonio, San Antonio, TX, USA; Division of Pulmonary Diseases & Critical Care Medicine, South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA
| | - Luis F Reyes
- Department of microbiology, Universidad de la Sabana, Bogota, Colombia
| | - Alejandro H Rodriguez
- Critical Care Medicine, Hospital Universitari Joan XXIII, Rovira & Virgili University and CIBERes (Biomedical Research Network of Respiratory disease), Tarragona, Spain
| | - Francisco Sanz
- Pulmonology Department, Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | - Nilam J Soni
- Division of Pulmonary Diseases & Critical Care Medicine, The University of Texas Health Science Centre at San Antonio, San Antonio, TX, USA; Division of Pulmonary Diseases & Critical Care Medicine, South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA
| | - Antonio Anzueto
- Division of Pulmonary Diseases & Critical Care Medicine, The University of Texas Health Science Centre at San Antonio, San Antonio, TX, USA; Division of Pulmonary Diseases & Critical Care Medicine, South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA
| | - Paola Faverio
- Cardio-Thoracic-Vascular Department, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Monza, Italy
| | | | - Irfan Muhammad
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi-74800, Pakistan
| | - Cristina Prat
- Microbiology Department, Hospital Universitari Germans Trias i Pujol. Institut d'Investigació Germans Trias i Pujol, Badalona, Spain. Universitat Autònoma de Barcelona. CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | | | - Joao Neves
- Serviço de Medicina, Centro Hospitalar do Porto, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal
| | | | - Andrew Feneley
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Fabio Franzetti
- Department of Biomedical and Clinical Sciences, Division of Infectious Diseases, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy
| | - Manuela Carugati
- Department of Biomedical and Clinical Sciences, Division of Infectious Diseases, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy
| | - Manuela Morosi
- Department of Biomedical and Clinical Sciences, Division of Infectious Diseases, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy
| | - Elisa Monge
- Department of Biomedical and Clinical Sciences, Division of Infectious Diseases, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy
| | - Marcos I Restrepo
- Division of Pulmonary Diseases & Critical Care Medicine, The University of Texas Health Science Centre at San Antonio, San Antonio, TX, USA; Division of Pulmonary Diseases & Critical Care Medicine, South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA.
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11
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Rocha BM, Filos D, Mendes L, Serbes G, Ulukaya S, Kahya YP, Jakovljevic N, Turukalo TL, Vogiatzis IM, Perantoni E, Kaimakamis E, Natsiavas P, Oliveira A, Jácome C, Marques A, Maglaveras N, Pedro Paiva R, Chouvarda I, de Carvalho P. An open access database for the evaluation of respiratory sound classification algorithms. Physiol Meas 2019; 40:035001. [PMID: 30708353 DOI: 10.1088/1361-6579/ab03ea] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Over the last few decades, there has been significant interest in the automatic analysis of respiratory sounds. However, currently there are no publicly available large databases with which new algorithms can be evaluated and compared. Further developments in the field are dependent on the creation of such databases. APPROACH This paper describes a public respiratory sound database, which was compiled for an international competition, the first scientific challenge of the IFMBE's International Conference on Biomedical and Health Informatics. The database includes 920 recordings acquired from 126 participants and two sets of annotations. One set contains 6898 annotated respiratory cycles, some including crackles, wheezes, or a combination of both, and some with no adventitious respiratory sounds. In the other set, precise locations of 10 775 events of crackles and wheezes were annotated. MAIN RESULTS The best system that participated in the challenge achieved an average score of 52.5% with the respiratory cycle annotations and an average score of 91.2% with the event annotations. SIGNIFICANCE The creation and public release of this database will be useful to the research community and could bring attention to the respiratory sound classification problem.
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Affiliation(s)
- Bruno M Rocha
- Department of Informatics Engineering, Centre for Informatics and Systems (CISUC), University of Coimbra, Coimbra, Portugal. Author to whom any correspondence should be addressed
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12
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Mendes L, Vogiatzis IM, Perantoni E, Kaimakamis E, Chouvarda I, Maglaveras N, Tsara V, Teixeira C, Carvalho P, Henriques J, Paiva RP. Detection of wheezes using their signature in the spectrogram space and musical features. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2015:5581-4. [PMID: 26737557 DOI: 10.1109/embc.2015.7319657] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this work thirty features were tested in order to identify the best feature set for the robust detection of wheezes. The features include the detection of the wheezes signature in the spectrogram space (WS-SS) and twenty-nine musical features usually used in the context of Music Information Retrieval. The method proposed to detect the signature of wheezes imposes a temporal Gaussian regularization and a reduction of the false positives based on the (geodesic) morphological opening by reconstruction operator. Our dataset contains wheezes, crackles and normal breath sounds. Four selection algorithms were used to rank the features. The performance of the features was asserted having into account the Matthews correlation coefficient (MCC). All the selection algorithms ranked the WS-SS feature as the most important. A significant boost in performance was obtained by using around ten features. This improvement was independent of the selection algorithm. The use of more than ten features only allows for a small increase of the MCC value.
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13
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Rocha BM, Filos D, Mendes L, Vogiatzis I, Perantoni E, Kaimakamis E, Natsiavas P, Oliveira A, Jácome C, Marques A, Paiva RP, Chouvarda I, Carvalho P, Maglaveras N. Α Respiratory Sound Database for the Development of Automated Classification. Precision Medicine Powered by pHealth and Connected Health 2018. [DOI: 10.1007/978-981-10-7419-6_6] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Mendes L, Vogiatzis IM, Perantoni E, Kaimakamis E, Chouvarda I, Maglaveras N, Henriques J, Carvalho P, Paiva RP. Detection of crackle events using a multi-feature approach. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:3679-3683. [PMID: 28269092 DOI: 10.1109/embc.2016.7591526] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The automatic detection of adventitious lung sounds is a valuable tool to monitor respiratory diseases like chronic obstructive pulmonary disease. Crackles are adventitious and explosive respiratory sounds that are usually associated with the inflammation or infection of the small bronchi, bronchioles and alveoli. In this study a multi-feature approach is proposed for the detection of events, in the frame space, that contain one or more crackles. The performance of thirty-five features was tested. These features include thirty-one features usually used in the context of Music Information Retrieval, a wavelet based feature as well as the Teager energy and the entropy. The classification was done using a logistic regression classifier. Data from seventeen patients with manifestations of adventitious sounds and three healthy volunteers were used to evaluate the performance of the proposed method. The dataset includes crackles, wheezes and normal lung sounds. The optimal detection parameters, such as the number of features, were chosen based on a grid search. The performance of the detection was studied taking into account the sensitivity and the positive predictive value. For the conditions tested, the best results were obtained for the frame size equal to 128 ms and twenty-seven features.
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15
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Damialis A, Kaimakamis E, Konoglou M, Akritidis I, Traidl-Hoffmann C, Gioulekas D. Estimating the abundance of airborne pollen and fungal spores at variable elevations using an aircraft: how high can they fly? Sci Rep 2017; 7:44535. [PMID: 28300143 PMCID: PMC5353600 DOI: 10.1038/srep44535] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 08/17/2016] [Accepted: 02/10/2017] [Indexed: 01/21/2023] Open
Abstract
Airborne pollen and fungal spores are monitored mainly in highly populated, urban environments, for allergy prevention purposes. However, their sources can frequently be located outside cities’ fringes with more vegetation. So as to shed light to this paradox, we investigated the diversity and abundance of airborne pollen and fungal spores at various environmental regimes. We monitored pollen and spores using an aircraft and a car, at elevations from sea level to 2,000 m above ground, in the region of Thesssaloniki, Greece. We found a total of 24 pollen types and more than 15 spore types. Pollen and spores were detected throughout the elevational transect. Lower elevations exhibited higher pollen concentrations in only half of plant taxa and higher fungal spore concentrations in only Ustilago. Pinaceae and Quercus pollen were the most abundant recorded by airplane (>54% of the total). Poaceae pollen were the most abundant via car measurements (>77% of the total). Cladosporium and Alternaria spores were the most abundant in all cases (aircraft: >69% and >17%, car: >45% and >27%, respectively). We conclude that pollen and fungal spores can be diverse and abundant even outside the main source area, evidently because of long-distance transport incidents.
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Affiliation(s)
- Athanasios Damialis
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Germany - German Research Center for Environmental Health, Augsburg, Germany.,CK-CARE, Christine Kühne - Center for Allergy and Research and Education, Davos, Switzerland.,Department of Ecology, School of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelos Kaimakamis
- 1st Pulmonary Department, "G. Papanikolaou" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Maria Konoglou
- 1st Pulmonary Department, "G. Papanikolaou" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Akritidis
- Internal Medicine Department, "G. Gennimatas" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Claudia Traidl-Hoffmann
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Germany - German Research Center for Environmental Health, Augsburg, Germany.,CK-CARE, Christine Kühne - Center for Allergy and Research and Education, Davos, Switzerland
| | - Dimitrios Gioulekas
- Pulmonary Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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16
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Lasarow L, Vogt B, Mendes L, Chouvarda I, Perantoni E, Kaimakamis E, Weiler N, Paiva RP, Maglaveras N, Frerichs I. Inhomogenität der regionalen Ventilationsverteilung während der forcierten Inspiration gemessen mittels elektrischer Impedanztomografie bei COPD-Patienten. Pneumologie 2017. [DOI: 10.1055/s-0037-1598566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L Lasarow
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - B Vogt
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - L Mendes
- Faculty of Sciences and Technology, University of Coimbra
| | - I Chouvarda
- Laboratory of Medical Informatics, Aristotle University of Thessaloniki
| | - E Perantoni
- General Hospital of Thessaloniki 'g. Papanikolaou'
| | - E Kaimakamis
- General Hospital of Thessaloniki 'g. Papanikolaou'
| | - N Weiler
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - RP Paiva
- Faculty of Sciences and Technology, University of Coimbra
| | - N Maglaveras
- Laboratory of Medical Informatics, Aristotle University of Thessaloniki
| | - I Frerichs
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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17
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Sobnath DD, Philip N, Kayyali R, Nabhani-Gebara S, Pierscionek B, Vaes AW, Spruit MA, Kaimakamis E. Features of a Mobile Support App for Patients With Chronic Obstructive Pulmonary Disease: Literature Review and Current Applications. JMIR Mhealth Uhealth 2017; 5:e17. [PMID: 28219878 PMCID: PMC5339437 DOI: 10.2196/mhealth.4951] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 01/17/2016] [Accepted: 08/20/2016] [Indexed: 01/12/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a serious long-term lung disease in which the airflow from the lungs is progressively reduced. By 2030, COPD will become the third cause of mortality and seventh cause of morbidity worldwide. With advances in technology and mobile communications, significant progress in the mobile health (mHealth) sector has been recently observed. Mobile phones with app capabilities (smartphones) are now considered as potential media for the self-management of certain types of diseases such as asthma, cancer, COPD, or cardiovascular diseases. While many mobile apps for patients with COPD are currently found on the market, there is little published material on the effectiveness of most of them, their features, and their adoption in health care settings. Objectives The aim of this study was to search the literature for current systems related to COPD and identify any missing links and studies that were carried out to evaluate the effectiveness of COPD mobile apps. In addition, we reviewed existing mHealth apps from different stores in order to identify features that can be considered in the initial design of a COPD support tool to improve health care services and patient outcomes. Methods In total, 206 articles related to COPD management systems were identified from different databases. Irrelevant materials and duplicates were excluded. Of those, 38 articles were reviewed to extract important features. We identified 214 apps from online stores. Following exclusion of irrelevant apps, 48 were selected and 20 of them were downloaded to review some of their common features. Results Our review found that out of the 20 apps downloaded, 13 (65%, 13/20) had an education section, 5 (25%, 5/20) consisted of medication and guidelines, 6 (30%, 6/20) included a calendar or diary and other features such as reminders or symptom tracking. There was little published material on the effectiveness of the identified COPD apps. Features such as (1) a social networking tool; (2) personalized education; (3) feedback; (4) e-coaching; and (5) psychological motivation to enhance behavioral change were found to be missing in many of the downloaded apps. Conclusions This paper summarizes the features of a COPD patient-support mobile app that can be taken into consideration for the initial design of an integrated care system to encourage the self-management of their condition at home.
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Affiliation(s)
- Drishty D Sobnath
- Digital Media for Health, Medical Information and Network Technology, Faculty of Science, Engineering and Computing, Kingston University London, Surrey, United Kingdom
| | - Nada Philip
- Digital Media for Health, Medical Information and Network Technology, Faculty of Science, Engineering and Computing, Kingston University London, Surrey, United Kingdom
| | - Reem Kayyali
- Digital Media for Health, Medical Information and Network Technology, Faculty of Science, Engineering and Computing, Kingston University London, Surrey, United Kingdom
| | - Shereen Nabhani-Gebara
- Digital Media for Health, Medical Information and Network Technology, Faculty of Science, Engineering and Computing, Kingston University London, Surrey, United Kingdom
| | - Barbara Pierscionek
- Digital Media for Health, Medical Information and Network Technology, Faculty of Science, Engineering and Computing, Kingston University London, Surrey, United Kingdom
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18
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Kaimakamis E, Karavidopoulou V, Kilintzis V, Stefanopoulos L, Papageorgiou V. Development/Testing of a Monitoring System Assisting MCI Patients: The European Project INLIFE. Stud Health Technol Inform 2017; 242:583-586. [PMID: 28873856] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INLIFE is a project cofounded from the European Union aiming in prolonging independent living of elderly people with cognitive impairment based on open, seamless ICT services supporting communication, daily activities, providing health services and professional care to the elderly. The main innovation stems from ICT solutions offering 19 different services adapted on specific characteristics elderly people with mild cognitive impairment, early and later stages of Dementia, cognitive impairment and co-morbid condition, as well as their formal and informal caregivers. All services have different focus areas and are incorporated into a unified system based on cloud architecture implemented in patients of 6 European countries, including Greece. More than 1200 patients, caregivers and healthcare providers participate in the pilot testing of the project. Primary parameter for assessing the effectiveness of the interventions is their impact on the quality of life of the elderly patients and their caregivers, contributing to prolonging independent living of the affected. A special digital platform has been developed in the Greek pilot site aiming to adapt and monitor all the implemented applications. This includes a medical decision support system that receives biosignals from patients and interaction interfaces in which all participants are involved. Recruitment and patients' participation has already started in the pilot site of Thessaloniki for the services that are to be tested in Greece.
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Affiliation(s)
- Evangelos Kaimakamis
- 1st Intensive Care Unit, General Hospital "G. Papanikolaou", Thessaloniki, Greece
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19
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Kayyali R, Odeh B, Frerichs I, Davies N, Perantoni E, D’arcy S, Vaes AW, Chang J, Spruit MA, Deering B, Philip N, Siva R, Kaimakamis E, Chouvarda I, Pierscionek B, Weiler N, Wouters EFM, Raptopoulos A, Nabhani-Gebara S. COPD care delivery pathways in five European Union countries: mapping and health care professionals' perceptions. Int J Chron Obstruct Pulmon Dis 2016; 11:2831-2838. [PMID: 27881915 PMCID: PMC5115685 DOI: 10.2147/copd.s104136] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND COPD is among the leading causes of chronic morbidity and mortality in the European Union with an estimated annual economic burden of €25.1 billion. Various care pathways for COPD exist across Europe leading to different responses to similar problems. Determining these differences and the similarities may improve health and the functioning of health services. OBJECTIVE The aim of this study was to compare COPD patients' care pathway in five European Union countries including England, Ireland, the Netherlands, Greece, and Germany and to explore health care professionals' (HCPs) perceptions about the current pathways. METHODS HCPs were interviewed in two stages using a qualitative, semistructured email interview and a face-to-face semistructured interview. RESULTS Lack of communication among different health care providers managing COPD and comorbidities was a common feature of the studied care pathways. General practitioners/family doctors are responsible for liaising between different teams/services, except in Greece where this is done through pulmonologists. Ireland and the UK are the only countries with services for patients at home to shorten unnecessary hospital stay. HCPs emphasized lack of communication, limited resources, and poor patient engagement as issues in the current pathways. Furthermore, no specified role exists for pharmacists and informal carers. CONCLUSION Service and professional integration between care settings using a unified system targeting COPD and comorbidities is a priority. Better communication between health care providers, establishing a clear role for informal carers, and enhancing patients' engagement could optimize current care pathways resulting in a better integrated system.
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Affiliation(s)
- Reem Kayyali
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
| | - Bassel Odeh
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
| | - Inéz Frerichs
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Nikki Davies
- Chest Clinic and Research and Development, Croydon University Hospital, Croydon, UK
| | - Eleni Perantoni
- Pulmonary Clinic, AHEPA University Hospital, Thessaloniki, Greece
| | - Shona D’arcy
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anouk W Vaes
- Research and Education, CIRO – Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands
| | - John Chang
- Chest Clinic and Research and Development, Croydon University Hospital, Croydon, UK
| | - Martijn A Spruit
- Research and Education, CIRO – Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands
| | | | - Nada Philip
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
| | - Roshan Siva
- Chest Clinic and Research and Development, Croydon University Hospital, Croydon, UK
| | | | | | - Barbara Pierscionek
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
| | - Norbert Weiler
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Emiel FM Wouters
- Research and Education, CIRO – Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands
| | | | - Shereen Nabhani-Gebara
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
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Lavrentieva A, Depetris N, Kaimakamis E, Berardino M, Stella M. Monitoring and treatment of coagulation abnormalities in burn patients. an international survey on current practices. Ann Burns Fire Disasters 2016; 29:172-177. [PMID: 28149244 PMCID: PMC5266232] [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] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/04/2016] [Indexed: 06/06/2023]
Abstract
The magnitude of coagulation abnormalities, and the definition and treatment of coagulopathy in burn patients are inadequately understood and continue to be discussed in the literature. We aimed to analyse physicians' views on monitoring and treating coagulation abnormalities in burn patients. A total of 350 questionnaires were distributed electronically to burn ICU physicians. Participation was voluntary and anonymous. Responses were analysed electronically and comparisons were made according to the region of the ICU or the specialty of the physician. Of the 350 questionnaires distributed, 55 (15.7%) were returned. The majority of burn specialists consider sepsis-induced coagulopathy to be the most frequent coagulopathy in burn patients, and 74.5% declare that they do not use any specific definition/scoring system in their department to detect coagulopathy. The majority of specialists (70.8%) use standard coagulation tests. The most frequent indications for plasma transfusion are massive bleeding (32.8%) and Disseminated Intravascular Coagulation syndrome treatment (20%). The main specific factors reported in our study are cryoprecipitate (23.2%) and fibrinogen concentrate (18.9%). 21.1% of respondents state that they do not use any specific coagulation factor substitution in burn patients. Specific coagulation factor substitution is not a routine practice. The low response rate precludes the generalization of our results.
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Affiliation(s)
| | - N. Depetris
- Anaesthesia and ICU - Orthopaedic and Trauma Centre A.O., Città della Salute e della Scienza, Turin, Italy
| | - E. Kaimakamis
- Burn ICU, Papanikolaou Hospital, Thessaloniki, Greece
| | - M. Berardino
- Anaesthesia and ICU - Orthopaedic and Trauma Centre A.O., Città della Salute e della Scienza, Turin, Italy
| | - M. Stella
- Burn Centre - Orthopaedic and Trauma Centre A.O., Città della Salute e della Scienza, Turin, Italy
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21
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Kayyali R, Savickas V, Spruit MA, Kaimakamis E, Siva R, Costello RW, Chang J, Pierscionek B, Davies N, Vaes AW, Paradiso R, Philip N, Perantoni E, D'Arcy S, Raptopoulos A, Nabhani-Gebara S. Qualitative investigation into a wearable system for chronic obstructive pulmonary disease: the stakeholders' perspective. BMJ Open 2016; 6:e011657. [PMID: 27580831 PMCID: PMC5013515 DOI: 10.1136/bmjopen-2016-011657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To ascertain the stakeholders' views and devise recommendations for further stages of the Wearable Sensing and Smart Cloud Computing for Integrated Care to Chronic Obstructive Pulmonary Disease (COPD) Patients with Co-morbidities (WELCOME) system development. This system aims to create a wearable vest to monitor physiological signals for patients concerned incorporating an inhaler adherence monitoring, weight, temperature, blood pressure and glucose metres, and a mobile health application for communication with healthcare professionals (HCPs). DESIGN A study of qualitative data derived from focus groups and semistructured interviews. SETTING 4 participating clinical sites in Greece, the UK, Ireland and the Netherlands. PARTICIPANTS Purposive sampling was used to recruit 32 patients with COPD with heart failure, diabetes, anxiety or depression, 27 informal carers and 23 HCPs from 4 European Union (EU) countries for focus groups and interviews. RESULTS Most patients and HCPs described the WELCOME system as 'brilliant and creative' and felt it gave a sense of safety. Both users and HCPs agreed that the duration and frequency of vest wear should be individualised as should the mobile application functions. The parameters and frequency of monitoring should be personalised using a multidisciplinary approach. A 'traffic light' alert system was proposed by HCPs for abnormal results. Patients were happy to take actions in response. CONCLUSIONS WELCOME stakeholders provided valuable views on the development of the system, which should take into account patient's individual comorbidities, circumstances and concerns. This will enable the development of the individualised system in each member state concerned.
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Affiliation(s)
- Reem Kayyali
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
| | - Vilius Savickas
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
| | - Martijn A Spruit
- Department of Research and Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
| | | | - Roshan Siva
- Chest Clinic and Research and Development, Croydon University Hospital, Croydon, UK
| | | | - John Chang
- Chest Clinic and Research and Development, Croydon University Hospital, Croydon, UK
| | - Barbara Pierscionek
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
| | - Nikki Davies
- Chest Clinic and Research and Development, Croydon University Hospital, Croydon, UK
| | - Anouk W Vaes
- Department of Research and Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
| | - Rita Paradiso
- Research and Development, Smartex s.r.l, Pisa, Italy
| | - Nada Philip
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
| | - Eleni Perantoni
- Chest Clinic and Research and Development, Croydon University Hospital, Croydon, UK
| | - Shona D'Arcy
- RCSI Education & Research Centre, RCSI, Dublin, Ireland
| | | | - Shereen Nabhani-Gebara
- Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK
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22
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Vogt B, Mendes L, Chouvarda I, Perantoni E, Kaimakamis E, Becher T, Weiler N, Tsara V, Paiva RP, Maglaveras N, Frerichs I. Influence of torso and arm positions on chest examinations by electrical impedance tomography. Physiol Meas 2016; 37:904-21. [PMID: 27200486 DOI: 10.1088/0967-3334/37/6/904] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Electrical impedance tomography (EIT) is increasingly used in patients suffering from respiratory disorders during pulmonary function testing (PFT). The EIT chest examinations often take place simultaneously to conventional PFT during which the patients involuntarily move in order to facilitate their breathing. Since the influence of torso and arm movements on EIT chest examinations is unknown, we studied this effect in 13 healthy subjects (37 ± 4 years, mean age ± SD) and 15 patients with obstructive lung diseases (72 ± 8 years) during stable tidal breathing. We carried out the examinations in an upright sitting position with both arms adducted, in a leaning forward position and in an upright sitting position with consecutive right and left arm elevations. We analysed the differences in EIT-derived regional end-expiratory impedance values, tidal impedance variations and their spatial distributions during all successive study phases. Both the torso and the arm movements had a highly significant influence on the end-expiratory impedance values in the healthy subjects (p = 0.0054 and p < 0.0001, respectively) and the patients (p < 0.0001 in both cases). The global tidal impedance variation was affected by the torso, but not the arm movements in both study groups (p = 0.0447 and p = 0.0418, respectively). The spatial heterogeneity of the tidal ventilation distribution was slightly influenced by the alteration of the torso position only in the patients (p = 0.0391). The arm movements did not impact the ventilation distribution in either study group. In summary, the forward torso movement and the arms' abduction exert significant effects on the EIT waveforms during tidal breathing. We recommend strict adherence to the upright sitting position during PFT when EIT is used.
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Affiliation(s)
- B Vogt
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Campus Kiel, Kiel, Germany
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23
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Kaimakamis E, Tsara V, Bratsas C, Sichletidis L, Karvounis C, Maglaveras N. Evaluation of a Decision Support System for Obstructive Sleep Apnea with Nonlinear Analysis of Respiratory Signals. PLoS One 2016; 11:e0150163. [PMID: 26937681 PMCID: PMC4777493 DOI: 10.1371/journal.pone.0150163] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 02/10/2016] [Indexed: 12/12/2022] Open
Abstract
Introduction Obstructive Sleep Apnea (OSA) is a common sleep disorder requiring the time/money consuming polysomnography for diagnosis. Alternative methods for initial evaluation are sought. Our aim was the prediction of Apnea-Hypopnea Index (AHI) in patients potentially suffering from OSA based on nonlinear analysis of respiratory biosignals during sleep, a method that is related to the pathophysiology of the disorder. Materials and Methods Patients referred to a Sleep Unit (135) underwent full polysomnography. Three nonlinear indices (Largest Lyapunov Exponent, Detrended Fluctuation Analysis and Approximate Entropy) extracted from two biosignals (airflow from a nasal cannula, thoracic movement) and one linear derived from Oxygen saturation provided input to a data mining application with contemporary classification algorithms for the creation of predictive models for AHI. Results A linear regression model presented a correlation coefficient of 0.77 in predicting AHI. With a cutoff value of AHI = 8, the sensitivity and specificity were 93% and 71.4% in discrimination between patients and normal subjects. The decision tree for the discrimination between patients and normal had sensitivity and specificity of 91% and 60%, respectively. Certain obtained nonlinear values correlated significantly with commonly accepted physiological parameters of people suffering from OSA. Discussion We developed a predictive model for the presence/severity of OSA using a simple linear equation and additional decision trees with nonlinear features extracted from 3 respiratory recordings. The accuracy of the methodology is high and the findings provide insight to the underlying pathophysiology of the syndrome. Conclusions Reliable predictions of OSA are possible using linear and nonlinear indices from only 3 respiratory signals during sleep. The proposed models could lead to a better study of the pathophysiology of OSA and facilitate initial evaluation/follow up of suspected patients OSA utilizing a practical low cost methodology. Trial Registration ClinicalTrials.gov NCT01161381
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Affiliation(s)
- Evangelos Kaimakamis
- Lab of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
- * E-mail: ;
| | - Venetia Tsara
- Sleep Unit, Pulmonary Department, General Hospital “G. Papanikolaou,” Thessaloniki, Greece
| | - Charalambos Bratsas
- Lab of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lazaros Sichletidis
- Pulmonary Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Nikolaos Maglaveras
- Lab of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
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24
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Lavrentieva A, Depetris N, Kaimakamis E, Stella M, Berardino M. Perioperative use of specific coagulation factors in burn patients. an international survey. Intensive Care Med Exp 2015. [PMCID: PMC4796388 DOI: 10.1186/2197-425x-3-s1-a854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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25
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Porpodis K, Konoglou M, Zarogoulidis P, Kaimakamis E, Kontakiotis T, Papakosta D, Zervas V, Katsikogiannis N, Courcoutsakis N, Mitrakas A, Touzopoulos P, Karanikas M, Zarogoulidis K, Markopoulou A. Pulmonary thromboendarterectomy after treatment with treprostenil in a chronic thromboembolic pulmonary hypertension patient: a case report. Int J Gen Med 2011; 4:767-72. [PMID: 22114523 PMCID: PMC3219765 DOI: 10.2147/ijgm.s26494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In recent years, there has been a major advance in the treatment of pulmonary hypertension. New medications are continually added to the therapeutic arsenal. The prostanoids are among the first agents used to treat pulmonary hypertension and are currently considered the most effective. This case study describes a 63-year-old man who was diagnosed with chronic thromboembolic pulmonary hypertension and successfully treated with subcutaneously administered treprostenil for 6 months before a successful pulmonary thromboendarterectomy. Treatment of chronic thromboembolic pulmonary hypertension often requires a multidisciplinary approach before surgery. Further evaluation of prostanoids is needed to define their role and time of initiation of medical therapy in these patients.
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Affiliation(s)
- Konstantinos Porpodis
- Pulmonary Department, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece
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26
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Lavrentieva A, Papadopoulou S, Kaimakamis E, Ioannidou A, Hadzipoulidis D, Bitzani M. O17.5 Diagnostic and predictive value of procalcitonin in septic burn ICU patients. Burns 2011. [DOI: 10.1016/s0305-4179(11)70049-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Bratsas C, Bamidis P, Kehagias DD, Kaimakamis E, Maglaveras N. Dynamic composition of semantic pathways for medical computational problem solving by means of semantic rules. IEEE Trans Inf Technol Biomed 2011; 15:334-343. [PMID: 21335316 DOI: 10.1109/titb.2010.2091645] [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] [Indexed: 05/30/2023]
Abstract
This paper presents a semantic rule-based system for the composition of successful algorithmic pathways capable of solving medical computational problems (MCPs). A subset of medical algorithms referring to MCP solving concerns well-known medical problems and their computational algorithmic solutions. These solutions result from computations within mathematical models aiming to enhance healthcare quality via support for diagnosis and treatment automation, especially useful for educational purposes. Currently, there is a plethora of computational algorithms on the web, which pertain to MCPs and provide all computational facilities required to solve a medical problem. An inherent requirement for the successful construction of algorithmic pathways for managing real medical cases is the composition of a sequence of computational algorithms. The aim of this paper is to approach the composition of such pathways via the design of appropriate finite-state machines (FSMs), the use of ontologies, and SWRL semantic rules. The goal of semantic rules is to automatically associate different algorithms that are represented as different states of the FSM in order to result in a successful pathway. The rule-based approach is herein implemented on top of Knowledge-Based System for Intelligent Computational Search in Medicine (KnowBaSICS-M), an ontology-based system for MCP semantic management. Preliminary results have shown that the proposed system adequately produces algorithmic pathways in agreement with current international medical guidelines.
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Affiliation(s)
- Charalampos Bratsas
- Lab of Medical Informatics, Medical School, Aristotle University of Thessaloniki, Greece.
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28
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Kaimakamis E, Bratsas C, Sichletidis L, Karvounis C, Maglaveras N. Screening of patients with Obstructive Sleep Apnea Syndrome using C4.5 algorithm based on non linear analysis of respiratory signals during sleep. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2009:3465-9. [PMID: 19964987 DOI: 10.1109/iembs.2009.5334605] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AIM To classify patients with possible diagnosis of Obstructive Sleep Apnea Syndrome (OSAS) into groups according to the severity of the disease using a decision tree producing algorithm based on nonlinear analysis of 3 respiratory signals instead of the use of full polysomnography. PATIENTS-METHODS Eighty-six consecutive patients referred to the Sleep Unit of a Pulmonology Department underwent full polysomnography and their tests were manually scored. Three nonlinear indices (Largest Lyapunov Exponent-LLE, Detrended Fluctuation Analysis-DFA and Approximate Entropy-APEN) were extracted from two respiratory signals (nasal cannula flow-F and thoracic belt-T). The oxygen saturation signal (SpO(2)) was also selected. The above measurements provided data to the C4.5 algorithm using a data mining application. RESULTS Two decision trees were produced using linear and nonlinear data from 3 respiratory signals. The discrimination between normal subjects and sufferers from OSAS presented an accuracy of 84.9% and a recall of 90.3% using the variables age, sex, DFA from F and Time with SpO(2)<90% (T90). The classification of patients into severity groups had an accuracy of 74.2% and a recall of 81.1% using the variables APEN from F, DFA from F and T90. CONCLUSION It is possible to have reliable predictions of the severity of OSAS using linear and nonlinear indices from only two respiratory signals during sleep instead of performing full polysomnography. The proposed algorithm could be used for screening patients suspected to suffer from OSAS.
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Affiliation(s)
- Evangelos Kaimakamis
- Lab of Medical Informatics, Medical School, Aristotle University of Thessaloniki, Greece.
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29
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Tsara V, Kaimakamis E. Response to “CPAP and quality of life: A still unresolved issue”. Sleep Med 2010. [DOI: 10.1016/j.sleep.2009.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Bratsas C, Koutkias V, Kaimakamis E, Bamidis PD, Pangalos GI, Maglaveras N. KnowBaSICS-M: an ontology-based system for semantic management of medical problems and computerised algorithmic solutions. Comput Methods Programs Biomed 2007; 88:39-51. [PMID: 17719123 DOI: 10.1016/j.cmpb.2007.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 05/29/2007] [Accepted: 06/27/2007] [Indexed: 05/16/2023]
Abstract
In this paper, an ontology-based system (KnowBaSICS-M) is presented for the semantic management of Medical Computational Problems (MCPs), i.e., medical problems and computerised algorithmic solutions. The system provides an open environment, which: (1) allows clinicians and researchers to retrieve potential algorithmic solutions pertinent to a medical problem and (2) enables incorporation of new MCPs into its underlying Knowledge Base (KB). KnowBaSICS-M is a modular system for MCP acquisition and discovery that relies on an innovative ontology-based model incorporating concepts from the Unified Medical Language System (UMLS). Information retrieval (IR) is based on an ontology-based Vector Space Model (VSM) that estimates the similarity among user-defined MCP search criteria and registered MCP solutions in the KB. The results of a preliminary evaluation and specific examples of use are presented to illustrate the benefits of the system. KnowBaSICS-M constitutes an approach towards the construction of an integrated and manageable MCP repository for the biomedical research community.
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Affiliation(s)
- Charalampos Bratsas
- Lab of Medical Informatics, Faculty of Medicine, Aristotle University of Thessaloniki, P.O. Box 323, Thessaloniki 54124, Greece.
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31
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Bratsas C, Koutkias V, Kaimakamis E, Bamidis P, Maglaveras N. Ontology-based vector space model and fuzzy query expansion to retrieve knowledge on medical computational problem solutions. Annu Int Conf IEEE Eng Med Biol Soc 2007; 2007:3794-3797. [PMID: 18002824 DOI: 10.1109/iembs.2007.4353158] [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] [Indexed: 05/25/2023]
Abstract
Medical Computational Problem (MCP) solving is related to medical problems and their computerized algorithmic solutions. In this paper, an extension of an ontology-based model to fuzzy logic is presented, as a means to enhance the information retrieval (IR) procedure in semantic management of MCPs. We present herein the methodology followed for the fuzzy expansion of the ontology model, the fuzzy query expansion procedure, as well as an appropriate ontology-based Vector Space Model (VSM) that was constructed for efficient mapping of user-defined MCP search criteria and MCP acquired knowledge. The relevant fuzzy thesaurus is constructed by calculating the simultaneous occurrences of terms and the term-to-term similarities derived from the ontology that utilizes UMLS (Unified Medical Language System) concepts by using Concept Unique Identifiers (CUI), synonyms, semantic types, and broader-narrower relationships for fuzzy query expansion. The current approach constitutes a sophisticated advance for effective, semantics-based MCP-related IR.
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Affiliation(s)
- Charalampos Bratsas
- Lab. of Medical Informatics, Medical School, Aristotle University of Thessaloniki, 54124, P.O. Box 323, Thessaloniki, Greece.
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