Medical Center For Treatment Research Articles

The relationship between corona disease anxiety and sleep disturbances and suicidal ideation in medical staff: The mediating role of resiliency and cognitive flexibility: A cross-sectional study.

Medical staff have experienced anxiety, sleep disturbances, and suicide due to the COVID-19 epidemic. Thus, this study examined the relationship between corona disease anxiety, sleep problems, and suicidal ideation in medical staff and how resiliency and cognitive flexibility mediate it. This descriptive-analytical cross-sectional study examined medical staff. In 2022, participants were affiliated with Hamadan University of Medical Sciences, Iran educational and treatment centers. Sampling was done at primary COVID-19 treatment centers. Data was collected using validated instruments. Ethics were observed during data collecting. Path analysis was employed to test hypotheses. Analysis showed significant positive relationships between Corona disease anxiety and sleep disturbances (p = 0.001, β = 0.438) and suicidal ideation (p = 0.001, β = 0.310). Conversely, negative and significant associations were identified between resiliency and cognitive flexibility with sleep disturbances and suicidal ideation. The study illustrates how medical staff's psychological health is linked to COVID-19. High Corona disease anxiety causes sleep disturbances and suicidal thoughts. Resilience and cognitive flexibility modulated Corona disease anxiety, sleep problems, and suicidal thoughts. The comprehensive study focuses on medical staff mental health issues, suggesting targeted solutions.

Gout (ICD 10: M10): a retrospective analysis of the data from the histopathological arthritis register of the DGORh

Gout is considered to be the most common inflammatory arthritis worldwide. The histopathological arthritis register of the German Society for Orthopedic Rheumatology (DGORh) was founded in 2018. The aim of this register is asystematic collection of histopathological data on joint pathologies. As part of amaster's thesis in medicine at the Sigmund Freud Private University (Vienna, Austria) the data on gout cases were retrospectively analyzed. The objective of this analysis was to determine the prevalence of gout, the localizations of gout in the musculoskeletal system and the sensitivity of clinical gout diagnostics. In cooperation with the Medical Treatment Center for Histology, Cytology and Molecular Diagnostics in Trier, Germany (MVZ-HZMD-Trier GmbH; Germany), tissue samples from 190 different orthopedic clinics and practices were analyzed and 7595 datasets were collected and stored in an arthritis register created by the DGORh. All gout cases stored between 1 January 2018 and 20 January 2020 were eligible for retrospective analysis (N = 102). The prevalence of gout was calculated at 1.34%. Of 108 histopathologically confirmed urate crystal depositions and gout granulomas, 76were found in the lower extremities (70.37%), 30in the upper extremities (27.78%) and 2 in the spinal joints (1.85%). The sensitivity of clinical gout diagnostics could be determined at 73.53%. Gout affects different anatomical regions with the first metatarsophalangeal joint being the main localization site. The sensitivity of clinical gout diagnostics was determined at 73.53%. These results emphasize the importance of histopathology in gout diagnostics.

Therapeutic plasma exchange for neonatal hepatic failure

We report a case of therapeutic plasma exchange in a neonate with fulminant liver failure. A six-day old, 2800-gram baby was referred to our medical center for evaluation and treatment of fulminant hepatic failure. The working diagnosis at admission was gestational alloimmune liver disease, and therapeutic plasma exchange was proposed. A double volume plasma exchange was successfully performed, using the Spectra Optia apheresis system, primed with packed red blood cells. Access was obtained via a radial artery catheter and a peripheral intravenous line. On hospital D-14 a diagnosis of E3 deficiency was confirmed, and disease-specific therapy was started. Automated TPE using peripheral arterial and venous catheters may be safely performed in neonates, and should be considered in the treatment of a variety of disorders including neonatal fulminant hepatic failure.

Factors associated with survival of patients with advanced lung cancer and long travel distances

Patients with advanced cancer sometimes travel to locations that have the treatment that they need. We explored the prognostic factors of survival in patients with advanced lung cancer who travel long distances in Taiwan. We obtained data from the National Taiwan University Hospital (NTUH) Integrated Medical Database. Patients who received a diagnosis of stage IV lung cancer from 2010 to 2019 and were treated in NTUH and its Hsinchu and Yunlin branches were enrolled. Factors associated with survival were analyzed using a Cox hazard regression model. In total, 6178 patients with stage IV lung cancer were enrolled. Young age, female sex, smaller primary tumor size, better performance, and non-squamous cell non-small cell histology were independently associated with longer survival. Treatment in medical centers and long travel distances (>50km) were associated with longer survival in the univariate analysis but not in the multivariate analysis (hazard ratio [HR]: 1.04, p=0.361; HR: 0.99, p=0.775, respectively). Participation in clinical trials was associated with longer survival in the univariate (HR: 0.53, p<0.001) and multivariate analyses (HR: 0.62, p<0.001). For the 1144 patients in the Hsinchu area, enrolment in clinical trials was an independent prognostic factor (HR: 0.72, p=0.040), whereas treatment in medical centers was not (HR: 0.95, p=0.635). Long travel distances and treatment in medical centers were not independently associated with survival for patients with advanced lung cancer. Enrolment in clinical trials was an independent prognostic factor.

Outcome of deep venous thrombosis and pulmonary embolism in COVID-19 cancer patients vs non-cancer patients.

e24066 Background: COVID-19 is associated with an increased incidence of venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Multiple mechanisms including COVID-19-induced endothelial dysfunction, cytokine storm, complement activation, and hypoxia lead to the activation of the coagulation cascade. Of note, VTE is the most common presentation of cancer-associated thrombosis. It is associated with worsened prognosis and mortality in both COVID-19 patients and cancer patients. Some studies indicated that comparing to COVID-19 non-cancer population, COVID-19 cancer patients have a higher risk of developing VTE. Methods: This retrospective cohort study identified 1,306 adult patients admitted to the tertiary medical center for COVID-19 treatment from 2020 to 2021, including 38 active cancer patients and 1268 non-cancer patients. Skin cancers were excluded. All patients received anticoagulant for VTE prophylaxis. The primary outcome of interest was the VTE incidence. Results: There was no significant difference in baseline demographics between groups. 35 non-cancer COVID-19 patients developed DVT (2.76%), while one patient had DVT in the cancer group (2.63%); for PE, 25 non-cancer patients were found to have PE (1.97%), while one cancer patient was diagnosed with PE (2.63%). There were no statistical differences in DVT and PE incidences between the COVID-19 cancer group and the non-cancer group during hospitalization. However, the cancer group was found to have older age (P &lt; 0.001), higher D-dimer (P = 0.024) level, and more severe thrombocytopenia (P &lt; 0.001). The COVID-19 cancer group revealed significantly higher in-hospital mortality (36.84%) comparing to the non-cancer group (14.98%) (P &lt; 0.001). Conclusions: Our study revealed no differences in the incidence of PE and DVT between the COVID-19 cancer population and the COVID-19 non-cancer population; COVID-19 cancer patients experienced significantly higher mortality comparing to COVID-19 non-cancer patients. This highlights the importance of having larger-scale studies in the future to assess different outcomes in patients with malignancy and COVID-19.

Island Hopping Transfer for Major Trauma Treatment and 5G Smart Ambulance

&lt;p&gt;成大醫院急診部在2019年提出「特殊傷病患跳島策略」，縮短運送時間，透過連結院前救護和院後治療的方式，讓患者在短時間內得到初步評估和穩定生命跡象，並且安全轉送至醫學中心接受適切治療。自2020年起，已有55位生命徵象不穩定的重大傷病患透過此轉診模式由偏鄉地區轉診至成大，其中有43位存活離開急診並接受後續療。2022年成大急診部與遠傳電信合作，推出2.0版本的跳島策略，透過5G科技導入智慧救護，包括視訊通訊、遠程監控、智慧救護車和智慧穿戴等，提高到院前的醫療品質和效率。期待已此模式當成一個＂pilot study＂；讓5G通訊技術在未來的緊急醫療中扮演更重要的角色，造福更多的病人。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;In 2019, the National Cheng Kung University (NCKU) Hospital Department of Emergency Medicine proposed an &amp;ldquo;island hopping&amp;rdquo; strategy for patients with special injuries to shorten patient transportation time. Specifically, through the coordination of prehospital care and posthospital treatment, patients can be assessed and stabilized t an early stage within a short time and transferred safely to a medical center for appropriate treatment. Since 2020, 55 critically injured patients with unstable vital signs have been referred to NCKU Hospital from remote areas through this transfer model, with 43 of them discharged from the emergency department alive and receiving follow-up treatment. In 2022, NCKU Hospital Department of Emergency Medicine collaborated with FarEastone Telecom in formulating Version 2.0 of the island hopping strategy, which incorporates smart emergency care through the use of 5G technology to facilitate the implementation of video communication, remote monitoring, smart ambulances, and smart wearable devices. The smart emergency care model improves the quality and efficiency of prehospital care. This model shall constitute a pilot study for incorporating 5G communication technology as a key instrument for emergency medicine to benefit more patients.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Regional multidisciplinary team approach to the management of placenta accreta spectrum disorder

Objective Patients with suspected placenta accreta spectrum (PAS) disorder are often referred to specialized medical centers for antepartum management and definitive treatment via cesarean hysterectomy. In 2019, our institution formed the only multidisciplinary team for the management of PAS within two of the largest counties in California. The purpose of this study was to evaluate the effects of the multidisciplinary team on patient volume and surgical outcomes for patients with PAS. Methods This was a single center retrospective cohort study, based in the only tertiary referral center within two of the largest counties in California. Patients who underwent cesarean hysterectomy for suspected PAS from January 2014 to April 2021 were included and divided into two groups, based on management by the multidisciplinary team from January 2019 and onward or routine care prior to that time. The outcomes of interest were quantitative blood loss, total units of packed red blood cell transfusion, referral volume, and diagnostic accuracy as well as ICU admission, bladder injury, and postoperative length of stay. Furthermore, we wanted to determine if patient’s distance to the hospital impacted outcomes. Normally distributed variables were compared between groups using the t-test. Categorical variables were compared between the two groups using the chi square test. Results A total of 114 patients were included in the cohort, 59 patients were from January 2014 to December 2018 and 55 patients were from January 2019 to April 2021. Since the establishment of the multidisciplinary center, there was a 2.5-fold increase in the total patient volume (0.8 case/month to 2 cases/month) and a 2.8-fold increase in the referred patient volume. Patients undergoing cesarean hysterectomy since the establishment of the multidisciplinary team had less quantitative blood loss (1500 mL vs 2000 mL, p = .005) and required less units of packed red blood cell transfusion (2 vs 4 units, p < .001). In addition, blood loss of ≥2000 mL decreased from 57.6% to 38.2% (p = .04) and diagnostic accuracy improved from 35.6% to 83.6% (p < .001). Furthermore, we found that patient distance to the hospital did not significantly impact surgical outcomes. Conclusions Since the establishment of the multidisciplinary team, our center experienced an increase in PAS volume and was able to demonstrate a statistically significant improvement in patient outcomes.

Dynamic indicators of the use of puncture method for the treatment of acute maxillary sinusitis in healthcare institutions of the city of Moscow

According to the statistical forms medical and preventive treatment centres (MPTC), the analysis of dynamic indicators of the treatment of patients with acute sinusitis (AS) in outpatient polyclinic centers (OPC) and ENT hospitals in Moscow for the period from 2017 to 2021 was carried out. The total number of visits to an otorhinolaryngologist in the OPC in Moscow for 2017-2021 amounted to 6 834 952 patients, including 245 172 patients with AS (3.6%).The total number of hospitalizations in the departments of otorhinolaryngology for the same period amounted to 184 735 patients, including 12 906 patients with AS (7%).The number of patients with AS who was consulted by an otorhinolaryngologist from 2017 to 2021 decreased by 18.2%, which can be explained by a change in the routing of patients with mild form of AS to general practitioners. An analysis of the dynamic indicators of maxillary sinus punctures carried out in the medical and preventive treatment centres (MPTC) in Moscow during the period from 2017 to 2021 showed that there was a redistribution of this manipulation from ENT hospitals to the OPC. At the same time, the proportion of patients requiring puncture treatment in the OPC for 2017-2019 was stable and amounted to 9.3%. However, since 2020, there has been an increase in this indicator by more than 2 times (21.7%), which probably indicates an increase in the treatment of patients with moderate forms of AS in the OPC. The frequency of maxillary sinus punctures that were performed in ENT hospitals in 2017-2019 amounted to 83.5%, in 2020-2021 decreased to 63.4%. The average number of maxillary sinus punctures per patient in ENT hospitals from 2017 to 2019 was 13.3. Since 2020, this value has decreased by about 2 times and has become equal to 8.5. The decrease in the number of maxillary sinus punctures that were performed in ENT hospitals is probably due to the fact that patients with severe and complicated forms of acute sinusitis hospitalized from 2020 to 2021 required more radical surgical treatment.

Trends among a population of neonatal abstinence syndrome patients in Huntington, West Virginia

Neonatal abstinence syndrome (NAS) represents a serious emotional toll for the families of affected children and represents a significant financial burden for healthcare providers. Historically, patients living in rural regions, such as Appalachia, have limited access to healthcare facilities. The goal of this study was to increase understanding of the population served by a medical treatment center for NAS patients in Huntington, West Virginia in the hopes of better meeting the needs of these patients and their families. A clinical records review was conducted using the charts from 122 NAS patients that returned for followup clinic appointments at Lily’s Place, a non-profit NAS center in Huntington, between the years of 2015 and 2019. Factors examined in this study included number of visits to the clinic, drugs used by patient mothers, developmental milestones reached, medical issues observed during clinic visits, medical issues common among patient mothers, insurance status, and plans for care developed during each visit. The mean number of visits to the clinic per patient was 1.92. Opioids were found to be the most commonly misused class of drugs among the mothers of patients. Over one third of patient mothers were positive for hepatitis C. Medicaid was the most common insurance for patients and their parents/guardians. Many patients demonstrated a delay in reaching developmental milestones for their age group. Common patient symptoms included muscle and/or joint tightness, torticollis, and tremors. Many patient visits required a demonstration of stretches/exercises for the patient’s guardian to perform on the patient and most patient visits resulted in referrals to additional developmental support services. The results of this study indicate important trends among NAS patients and their families in West Virginia and, potentially, in the wider United States.

Fractures of the Proximal Ulna: A Spectrum of Injuries and Outcomes.

The purpose of this study is to assess the effect of radial head/ neck injury in association with proximal ulna fractures. Between 2006 and 2020, 107 patients presented to our academic medical center for treatment of a proximal ulna fracture and were enrolled into an IRB-approved database. Radiographs, injury details, and surgical interventions were retrospectively reviewed. Patients were classified as having an isolated proximal ulna fracture (PU), a PU fracture with an associated radial head dislocation (M-D), or a Monteggia fracture with an associated radial head fracture (M-V). Clinical and functional outcomes were assessed at follow-up to determine what differences exist between fracture patterns. Statistics were generated using Chi-squared tests for categorical variables and one-way ANOVA tests for numerical variables. While all patients ultimately healed, time to radiographic healing in the PU cohort was shorter at 3.57 ± 1.7months when compared to the M-V cohort (5.67 ± 3.8months) (p < 0.05). At follow-up, patients in the M-V cohort had poorer elbow pronation and supination when compared to the PU and M-D cohorts (p < 0.05). Patients within the PU cohort had fewer complications than those in the M-D and M-V cohorts (p < 0.05). No differences were found between the three cohorts in regard to rates of reoperation, non-union, wound infection, and nerve compression (p > 0.05). The Monteggia fracture with a concomitant radial head/neck fracture is a more disabling injury pattern when compared to an isolated proximal ulna fracture and Monteggia fracture without an associated radial head/neck fracture.

How can infectious medical waste be forecasted and transported during the COVID-19 pandemic? A hybrid two-stage method

The COVID-19 pandemic has caused an unforeseen collapse of infectious medical waste (IMW) and an abrupt smite of the conveying chain. Hospitals and related treatment centers face great challenges during the pandemic because mismanagement may lead to more severe life threats and enlarge environmental pollution. Opportune forecasting and transportation route optimization, therefore, are crucial to coping with social stress meritoriously. All related hospitals and medical waste treatment centers (MWTCs) should make decisions in perspective to reduce the economic pressure and infection risk immensely. This study proposes a hybrid dynamic method, as follows: first to forecast confirmed cases via infectious disease modeling and analyze the association between IMW outflows and cases; next to construct a model through time-varying factors and the lagging factor to predict the waste quantity; and then to optimize the transportation network route from hospitals to MWTCs. For demonstration intentions, the established methodology is employed to an illustrative example. Based on the obtained results, in finding the process of decision making, cost becomes the common concern of decision-makers. Actually, the infection risk among publics has to be considered simultaneously. Therefore, realizing early warning and safe waste management has an immensely positive effect on epidemic stabilization and lifetime health.

PRE-EXPOSURE PROPHYLAXIS (PREP) OF HIV INFECTION – A CRUCIAL TOOL FOR REDUCING THE BURDEN UPON THE PUBLIC HEALTH

HIV is a major global public health problem.The increased access to effective prevention, diagnosis and treatment transformed HIV-infection intoa manageable chronic health condition.Our purpose was to assess the effectiveness of oral pre-exposure prophylaxis (PrEP) of HIV-infection. Material and Methods: CheckPoint Sofia (former Sexual Health Centre – Sofia) is a medical center for consultations, prevention, diagnosis and treatment of sexually transmitted infections (STI’s) and HIV/AIDS. A retrospective study was conducted on 410 consulted males (HIV-seronegative) (October 2020 to August 2022). Results: The mean age was 32±7.6 years (18-57 years) with prevalent ages &lt;30 and 30-40 years (42% and 47%, respectively); Bulgarian citizens 90%, MSM (97%). The clients’ profile revealed active sporting (38%), past STI’s (26%), vaccinated for HBV (54%). No one of the subjects had chronic kidney disease and mandatory investigations of renal functions at starting of PrEP revealed mean levels of urea and creatinine 4.9±1.42 mmol/L and 78±18.2 µmol/L, respectively. On demand regimen (2+1+1 tablets) of PrEP was preferred at 91% and 15% switched to everyday receiving before an increased risk. After starting of PrEP, 55% of the subjects were tested voluntary and no one was positive for HIV, HBV, and HCV. The once reported side effect was transitory diarrhea (in 5%) after the start of PrEP. It is notable that the increased STI’s (syphilis, chlamydia and gonorrhea – 10%, 6% and 5%, respectively) – fact in accordance with global trends. Conclusion: PrEP is an effective prevention of HIV infectionand deserves budgetary finance. The increase of STI’s requires concrete preventive implementations.

Trends Among a Population of Neonatal Abstinence Syndrome Patients in Huntington, West Virginia

Neonatal abstinence syndrome (NAS) represents a serious emotional toll for the families of affected children and represents a significant financial burden for healthcare providers. Historically, patients living in rural regions, such as Appalachia, have limited access to healthcare facilities. The goal of this study was to increase understanding of the population served by a medical treatment center for NAS patients in Huntington, West Virginia in the hopes of better meeting the needs of these patients and their families.

A New Modified Video Solution System for Neuroendoscopic Procedures

Background and Aim: Today, neuroendoscopic surgery is gaining popularity because of its minimal damage to normal structures, fewer complications, and excellent clinical results. Using an endoscope and related instruments, surgeons can perform complex surgeries through small incisions, especially for minimally invasive spinal and brain surgeries. Neuroendoscopic systems are currently costly and not portable. Our new video solution is portable at a lower cost and can display and record images in 4K resolution. Methods and Materials/Patients: We modified the GoPro Hero 6 camera to serve our purpose. By detaching the original camera lens and its front part and replacing the removed parts with a new design, we made a C-mount camera that can connect to a standard C-mount coupler and various common scopes. For color correction, we used an IR-cut filter in front of the camera sensor. Results: By changing some parts of the camera and connecting it to a C-mount coupler and a scope lens, we made a small, portable neuroendoscope that displays and records images in clear, sharp, high resolution, with a high frame rate. Conclusion: The modified GoPro camera can be used as an alternative and unexpansive neuroendoscope system for education or treatment in medical centers in developing countries.

Pattern of Neurological Manifestations in Patients Referred to the Neurology Clinic of a Reference Military Hospital

Background: The field of neurology encompasses a wide range of disease types, and recognizing the most common manifestations of these diseases, particularly in subgroups, is critical for improving appropriate diagnostic and therapeutic measures. Objectives: The purpose of this study was to determine the frequency of common manifestations of neurological diseases in patients referred to a military hospital’s internal neurology clinic. Methods: This was a cross-sectional descriptive study of patients referred to the internal neurology clinic of a reference military hospital, Tehran, Iran in 2020. The sampling was done at random using a checklist. Finally data was analyzed by using SPSS software. Results: Women made up the majority of patients in 336 samples 182 (54.2 %) versus 154 (45.8 %). The patients’ average age was 49.5±16.5 years, with 28.3 % (n=95) being elderly. The three most common complaints raised by patients were headache, movement disorder, and sensory disorder, accounting for 29.5%, 27.7%, and 27.7% of complaints, respectively. Seventeen patients (5.1%) also mentioned other issues, with anger, anxiety, depression, and nausea being the most common complaints. Conclusion: Headache, movement disorder, and sensory disorder are the most common neurological disorders referred to a military hospital. Because of the high prevalence of these issues, it is necessary to establish specialized clinics and conduct additional research to determine the most common types of sensory and movement disorders, as well as the most effective methods of prevention and treatment in medical centers.

Dynamics of endocrine and metabolic changes among patients with coronary artery disease, type 2 diabetes mellitus and metabolic syndrome while treating with telmisartan

Dynamics of endocrine and metabolic changes among patients with coronary artery disease, type 2 diabetes mellitus and metabolic syndrome while treating with telmisartan

The Treatment of Postural Orthostatic Tachycardia Syndrome in Adolescents in an Interdisciplinary Treatment Program: Preliminary Outcomes

Importance: Estimates suggest that 1% of all teens struggle with Postural Orthostatic Tachycardia Syndrome. It can be a devastating condition for the adolescents who do not respond to the currently available pharmacologic and non-pharmacologic interventions. Preliminary data suggests that intensive interdisciplinary treatment may provide an effective intervention that can return these youth to normal functioning including full-time attendance at school, as well as reduce orthostatic symptoms, and psychological distress. Objective: To determine the effectiveness and durability of a 3-week interdisciplinary treatment in adolescents with Postural Orthostatic Tachycardia Syndrome in improving orthostatic symptoms, functioning, and psychological distress. Design: Patients diagnosed with Postural Tachycardia Syndrome admitted to an interdisciplinary treatment program were assessed at admission, discharge and 3-month follow-up to determine presence and severity of orthostatic symptoms, as well as functional status including return to school, and depression. Setting: An intensive interdisciplinary treatment program in a tertiary hospital outpatient setting. Participants: Forty-five adolescents ages 12-18 with confirmed diagnoses of Postural Tachycardia Syndrome referred to a tertiary medical center for interdisciplinary treatment. Intervention: A 3-week intensive outpatient interdisciplinary rehabilitation program with significant parental involvement based on a cognitive-behavioral model. Main Outcome and Measure(s): Self-reported orthostatic symptoms were assessed with the Compass 31; level of functioning was assessed with the Functional Disability Index, depressive symptoms were assessed with the Center for Epidemiological Studies-Depression for Children, and self-reported school attendance was assessed. Results: Significant improvements were observed and maintained at the end of treatment and at 3-month follow-up on measures of orthostatic symptoms, physical functioning, and psychological distress. At admission, 32% of patients had completed high school or were attending school full-time. At 3-month follow-up, 90% were either attending school full-time or had completed their schooling. Keywords: Postural Orthostatic Tachycardia Syndrome, POTS, interdisciplinary treatment, adolescents.

Segment Based Compressive Sensing (SBCS) of Color Images for Internet of Multimedia Things Applications

Telemedicine is one of the IoMT applications transmitting medical images from hospital to remote medical centers for diagnosis and treatment. To share this multimedia content across internet, storage and transmission become a challenge because of its huge volume. New compression techniques are being continuously introduced to circumvent this issue. Compressive sensing (CS) is a new paradigm in signal compression. Block based compressive sensing (BCS) is a standard and commonly used technique in color image compression. However, BCS suffers from block artifacts and during transmission, mistakes can be introduced to affect the BCS coefficients, degrading the reconstructed image’s quality. The performance of BCS at low compression ratios is also poor. To overcome these limitations, without dividing the image into blocks, the image matrix is considered as a whole and compressively sensed by segment based compressive sensing (SBCS). This is a novel strategy that is offered in this article, for efficient compression of digital color images at low compression ratios. Metrics of performance The peak signal to noise ratio (PSNR), the mean structural similarity index (MSSIM), and the colour perception metric delta E are computed and compared to those obtained using block-based compressive sensing (BBCS). The results show that SBCS performs better than BBCS.

Towards a Blockchain-based Medical Test Results Management System

The role of test results in the diagnosis and treatment of patients’ diseases at medical facilities cannot be ignored. Patients must have a series of tests that are related to their symptoms. This can be repeated as many times as possible, depending on the type of disease and treatment. Seriously, in the cases where the patients lose their medical test record (i.e., patient’s medical history), the diagnosis is difficult due to the lack of information about the medical history as well as the symptoms/complications in the previous treatments. Storing this treatment information in medical centers can address risks related to user failure (e.g., loss of medical test records and wet/fire documents). However, users face a bit of difficulty when they change to other medical centers for medical examination and treatment since the data is stored locally, and difficult to share this with others. Current solutions focus on empowering users (i.e., patients) to share medical information related to disease treatment. However, the main barrier to these approaches is the knowledge of the users. They must embrace some background in terms of the technologies, risks, and rights they may share with treatment facilities. To solve this problem, we propose a Blockchain-based medical test result management system where all information is stored and verified by the stakeholder. The data will be stored decentralized and updated throughout the treatment process. We implement a proof-of-concept based on the Hyperledger Fabric platform. To demonstrate the effectiveness of the proposed system, we conduct evaluation methods based on three main tasks of the system: initializing, accessing, and updating data on six different scenarios (i.e., increasing in size of processing requests). The evaluation based on Hyperledger Caliper helped us to have a deeper analysis of the proposed model.

Healed common bile duct perforation after biliary stent placement

A 54-year-old man presented to a local hospital with common bile duct (CBD) stones and obstructive jaundice. Accordingly, the patient underwent ERCP, endoscopic sphincterotomy followed by endoscopic papillary balloon dilation, and stone extraction. After the procedures, he had right upper quadrant abdominal pain. Contrast-enhanced CT of the abdomen revealed perforation of the CBD and bile leakage (A). Consequently, the patient was referred to the medical center for further treatment and immediately underwent percutaneous drainage for bile peritonitis.