[Will telemonitoring be adopted by patients with chronic heart failure?]

BACKGROUND

Remote Patient Management for chronic heart failure (CHF) is gaining increasing importance in health care. Telemonitoring is defined as daily measuring of health parameters by the patient and their transmission to a telemedical centre. The adherence of this action by the patient can be considered as a measure for RPM adoption.

METHODS

The randomized controlled clinical trial TIM-HF (NCT 00543881) was conducted between 2008 and 2010 with 710 CHF patients with the primary endpoint total mortality for a mean follow-up of 21.5 ± 7.2 months. The non-prespecified analysis of adherence to daily measuring of ECG, blood pressure, weight and self-assessment was focused on sociodemographic and disease-related factors of the 354 RPM patients.

RESULTS

The mean adherence to telemonitoring was more than 80% (absolute adherence: 81.8 ± 22.8%, relative adherence: 88.9 ± 21.5%). From the beginning of treatment 6.5% of the patients (23/354) have shown an adherence below average. The high adherence of the majority of the patients was stable for the entire study duration and irrespective of age, sex, severity of the disease and the presence of mild to moderate depression.

CONCLUSION

A high adherence can be achieved by individual training of the patient regarding the handling of his disease, the use of telemedical devices and an easy-to-use telemonitoring system. The majority of the informed self-determined CHF patients NYHA class II/III are adopting telemonitoring and are adherent in the long term.

[Contralateral inguinal metastasis from testicular seminoma]

We report the case of a 42-year-old patient with contralateral inguinal seminoma metastasis. He had a history of prior bilateral open inguinal hernia repair and scrotal vasectomy. Staging CT revealed no further lymphoma or organ metastases. After discussion of adjuvant treatment options and contacting a referral centre for testicular cancer, adjuvant treatment was performed with 3 cycles of cisplatin, etoposide and ifosfamide. The development of the contralateral inguinal metastasis is most likely caused by the prior inguinal and scrotal surgery, whereas a primary atypical retrograde metastatic route can't be ruled out. Physical examination of the inguinal lymph nodes should be performed in all patients with testicular cancer and prior inguinal and scrotal surgery.

Towards Imaging with Polycrystalline Mercuric Iodide Semiconductor Detectors

Preparation of polycrystalline mercuric iodide very thin (1 μm) films using laser ablation and thick films (100–600μm), using hot pressing, hot wall vapor deposition and screen printing methods, fabricated as radiation detector plates are briefly described. X-ray diffraction, photoluminescence and optical microscopic measurements as well as response to nuclear radiation will be given. Finally, recent results obtained with a large area imaging pixel detector will be shown.

Comparison Between Cadmium Zinc Telluride Crystals Grown in Russia and in the Ukraine

A comparative analysis of different Cd1−xZnxTe (CZT) crystals grown by a vertical high pressure Bridgman (VHPB) method is reported. The results of several analytical techniques, such as triple axis x-ray diffraction (TAD), rocking curves, low temperature photoluminescence (PL), scanning electron microscopy (SEM), and proton induced x-ray emission (PIXE) are discussed. Segregated carbon inclusions were identified by SEM and energy dispersive x-ray fluorescence (EDXRF), and the results are interpreted in terms of constitutional supercooling of the solidifying CZT melt. The carbon inclusions significantly decrease the resistivity, and in some cases, the noise is too large for the fabrication of radiation detectors. Combining these results with other measurements reported by our research team [1], we identify correlations between the growth and the defects identified in these CZT crystals.

Replacement of monochromator and proportional gas counter by mercuric iodide detector in X-ray powder diffraction

Low-resolution and therefore low-cost mercuric iodide detectors have successfully been applied to replace the combination of a graphite monochromator and a proportional gas radiation counter used in X-ray diffractometers. The mercuric iodide detector requires a lower DC bias of only 200 V rather than the 1500 V bias needed for the proportional gas counter. The much better stopping power of HgI2 allows higher counting efficiency and therefore a better signal-to-noise ratio. Results are shown for X-ray powder diffractions of polycrystalline cubic silicon and tetragonal HgI2.