TELECOMMUNICATIONS CONVERTER FOR VISUALIZATION AND NAVIGATION SYSTEM IN LOW-INVASIVE MEDICAL MANIPULATIONS

The article highlights the progress of information and telecommunication technologies as a basis for studying modern medical diagnostics, where digital technologies are widely used. Digital medical images can be easily analyzed, stored, and transmitted over telecommunica-tions channels. Most manufacturers support the DICOM medical standard which contains complete, but in many cases redundant, information. There is considered the process of developing a cross-platform telecommunications converter of medical images for the system of visualization and navigation in low-invasive medical manipulations. The popular medical image format DICOM is considered in detail. An algorithm for converting data from the DICOM format into standard graphic files has been developed. The results of the converter operation are analyzed in the case of such characteristics as compression, signal-to-noise level and compression rate.

Are commercial Tweets Truthful About Loosely Regulated Substance Such as CBD? (Preprint)

UNSTRUCTURED Background: This study analyzes differences in the terms and sentiments regarding CBD expressed by commercial and personal users on Twitter. It demonstrates that in the absence of official clinical trial information, data from social networks can be used by public health and medical researchers to assess public claims about loosely-regulated substances like CBD: for example, by comparing the medical conditions targeted by those selling CBD against the medical conditions patients commonly treat with CBD. Objective: The objective of this study is to provide a framework for public health and medical researchers to use to analyze the consumption and marketing of unregulated substances. Specifically we examined cannabidiol (CBD), which is a substance that is often being presented to the public as medication despite complete evidence of efficacy and safety. Methods: We collected 567,850 tweets by searching Twitter with the Tweepy Python package using the terms CBD and cannabidiol. We trained two binary text classifiers to create two corpora of 156,080 personal use and 158,014 commercial/sales. Using medical, standard, and slang dictionaries, we identified and compared the most frequently occurring medical conditions, symptoms, side effects, body parts, and other substances referenced in both corpora. Results: We found references to medically relevant terms that were unique to either personal or commercial CBD tweet classes, as well as medically relevant terms that were common in both classes. In addition, to assess popular claims about the efficacy of CBD as a medical treatment circulating on Twitter, we performed sentiment analysis via the VADER model on the personal CBD tweets. We calculated the average sentiment scores for both personal and commercial CBD tweets referencing at least one of 17 medical conditions/symptoms, and observed an overall positive sentiment in both personal and commercial CBD tweets. We observed negative sentiment conveyed in personal CBD tweets referencing autism, while noticing it was being marketed multiple times as a treatment of autism within commercial CBD tweets. Conclusion: Our proposed framework provides a tool for public health and medical researchers to analyze the consumption and marketing of unregulated substances on social networks. Our analysis showed that that most users of CBD are satisfied with it in regards to the condition it that it is being advertised for, with the exception of autism.

Implementation of electronic stethoscope for online remote monitoring with mobile application

The stethoscope is a piece of medical standard equipment that isused by a physician for an initial examination of the patient. Generally, the stethoscopeis used for auscultating sounds which are generated by the workings of organ systems such as cardiac, lung or digestive. In the present condition with the growing number of the patient population, it has an impact on the burden of hospitals and medical practitioners. So that treatment is not optimal, especially patients who need continuous monitoring. Thus it needs a system that can work dynamically, flexibly and remotely based. This paper focuses on the implementation of the electronic stethoscope which is integrated with a mobile phone as the modality of online data transmission through the internet network. The prototype of an electronic stethoscope uses condenser mic, pre-amplifier, wide bandpass filter (20 Hz-1 KHz) and audio amplifier. The maximum gain is 28.63 dB in the 20 Hz-690 Hz frequency range. The signal output can be connected to the android mobile through the jacked phone to be stored in MP3 format and then sent to the cloud server for further monitoring and analysis. The application called “Steder” supports realtime communication between patient and physician for medical check-up, consultation, and discussion activities.

Koch’s time for COVID-19 and the other major epidemics of the 21st century

Koch’s postulates are classical medical standard followed by researchers all over the world to identify a new pathogen for an emerging infectious disease (EID). In this article, we put forward a new concept of Koch’s time for a new pathogen (KTNP), which stands for the time from the first case of attention of an EID to the first complete genome of the new pathogen in a public domain, to quantify the response of EIDs. Shortening KTNP expedites development of detection kits and/or devices world-wide. The KTNP of five EIDs occurred in this century are calculated respectively. The results demonstrated that KTNP is continuously shortening and Koch’s time for COVID-19 is 15 days.

Fetal Pain: The Science Behind Why It Is the Medical Standard of Care

Despite pain as the fifth vital sign in adult and pediatric care, many still dismiss the fact that immature human beings (whether a fetus, a preterm, or term baby) are capable of being affected by pain. Studies have demonstrated that avoiding, minimizing, and treating pain in babies, particularly when premature, improves their outcomes. Informed by the evidence, treating neonatal pain has become the medical standard of care for physicians in neonatology and anesthesiology. This article provides a brief overview of relevant publications that explain the clinical evolution that has led to the treatment of neonatal pain. This article also examines three arguments against the existence of fetal pain and presents evidence that refutes them. Informed by the research, a revised definition of pain is offered.

A Qualitative Comparison of the Covex Respirator with Face Shield Versus the N95 Respirator

In March 2020, the World Health Organization declared the novel coronavirus (COVID-19) outbreak a worldwide pandemic. The pandemic led to concerns of shortages regarding healthcare-related resources, including personal protective equipment (PPE), ventilators, and more. The uniquely designed COVEX respirator with face shield was engineered and manufactured by Augustine Surgical, Inc. to combat the PPE shortage. The novel COVEX mask is an “all-in-one” face shield and filter with a Viral Filtration Efficiency (VFE) greater than 99%. A standard respirator qualitative fit test was completed on the COVEX respirator as well as the current medical standard 3M N95 respirator. Fit test studies comparing the two masks yielded similar outcomes. The COVEX respirator had a qualitative fit test pass rate of 96.6% and the 3M N95 respirator had a pass rate of 93.3% (n=30). Participants also reported other variables comparing the comfort and fit of each mask, which is described further in the discussion. The COVEX respirator with face shield passed a standardized qualitative fit test at a rate similar to the current medical standard N95 respirator. Our results suggest that the COVEX mask may be a viable PPE option in the future.

Medical standard as a historical component on the way of clinical audit

Aim - the search, analysis and systematization of historical facts concerning the formation and evo-lution of the world medical standartization; severance of its certain long-standing models for the optimization of settling and introduction of the existing, and future analogs, particularly, in the clinical audit format. Material and Methods. In order to study the medical standard as a historical component the fol-lowing methods were used: bibliographic, historical, analytical and methods of systematization and comparison. Results and Discussion. As a result of the conducted research the main historical events in the world development of the medical standartization starting from 1500 up till nowadays were col-lected. In order to study the evolution of the medical standartization, the analysis of the normative documents that have regulated the process of standartization, especially the Doctor's statute(s) in Russia, Minimal standard of the medical equipment and works of the American college of surgeons, was carried out. The scientific works that initiated the introduction of the clinical audit in the Health Care system in Ukraine, Turkey, the USA and Great Britain were throroughly analyzed. Conclusions. The improvement of quality as to rendering the medical aid is a job priority in the health care systems in many countries. For that reason, the search for its optimization was and is still retrieved for many centuries. The territorial formation of medical standartization is associated with England, Russia and the USA, but the occurrence of clinical audit is connected with Ukraine, Turkey, the USA and Great Britain. The foundations of the medical standardization was lauched in 1500 year, while the clinical audit - in 1854 year. The medical standartization is a reflection of the history of development of the organization of health care system, that's why the expertness (knowl-edge) of historical stages concerning the setting and the introduction of medical standartization may give a new impulse in its improvement and development under present-day conditions of reforma-tion in the medical sphere in Ukraine. The earlier beginning of implementation of the medical stan-dartization in the health care system in different countries makes it possible to actualize its introduc-tion into the clinical audit format, that, in its turn, allows to improve the quality of rendering the medical aid. Key words: medical standartization, clinical audit, quality of medical aid

508 Puerperal thrombosis on mitral valve prothesis

Introduction Replacement of a diseased heart valve with a prosthetic heart valve exchanges the native disease for prosthesis-related complications. Valve thrombosis can occur in mechanical prosthetic valves. The significant morbidity and mortality associated with this condition permits rapid diagnostic evaluation. A combination of transthoracic and transoesophageal echocardiography (TEE) is required to assess the haemodynamic effect of thrombosis, leaflet motion and thrombus size. Mechanical valves offer excellent haemodynamic performance and long-term durability, but the need for anticoagulation increases maternal and foetal mortality and morbidity, and the risk of major cardiac events during pregnancy. Case report A 23-year-old gravida 0 woman was admitted to the emergency obstetric care. At the age of 18 months, she underwent valve replacement surgery in the mitral position (St. Jude Medical Standard size 25mm), this requires use of warfarin after surgery. Although she was advised otherwise; the patient became pregnant. She had an increased risk of maternal cardiovascular complications [Modified World Health Organization classification (mWHO) III] and obstetrics complications. The warfarin treatment was discontinued, and it was started low molecular weight heparin (LMWH) 100IU, twice daily subcutaneously, on gestation 36 week. The last administration was 2 days before the admission (>48h before delivery). So, on gestation week 39, she was admitted to the department of Obstetrics. Then, as cardiotocography showed decreased foetal heart rate, an emergency caesarean section was performed. A healthy baby was delivered. After delivery, we perform an immediate two-dimensional transthoracic echocardiography (2D TTE), as there was a high-risk of valve thrombosis, and it showed an apparent normal prosthetic excursion but a high mean pressure gradient (25mmHg) – elevated transprosthetic gradient. It was not well visualized the occlude motion of the mechanical valve by 2D TTE, so we perform a TEE to answer the clinical question, if there was a dysfunction due to an acute process (i.e. thrombus). It revealed an obstruction – reduced mobility of one disc and elevated velocities by CW doppler (30mmHg), and a presence of thrombus (1.3X0.8mm). The anticoagulation with intravenous UFH was started immediately, but anticoagulation failed, and she underwent valve replacement surgery (St. Jude Medical standard size 27mm. Conclusion Our patient had a very-high risk of complications maternal cardiovascular complications - WHO risk classification III - because the risk of valve thrombosis is markedly increased during pregnancy. The risk is lower with adequate dosing of anticoagulant therapy, but our patient was not which increased the risk of thrombosis. Finally, it is important to notice that it is recommended to manage pregnancy in women with mechanical valves in a centre with a pregnancy heart team. Abstract 508 Figure. Valve thrombosis

Breast Cancer With Brain Metastases: Perspective From a Long-Term Survivor

The purpose of this essay is to inform others that it is possible to survive breast cancer with brain metastases. The second author is the subject patient and a long-term survivor of systemic metastatic breast cancer with numerous brain metastases (corresponding to 8% survivor group). We credit her survival to a combination of (1) medicine as practiced by an excellent oncologist with whom we developed a partnership to manage the patient’s health, (2) our informed exploration of the available scientific knowledge including a review of scientific research articles that go beyond conventional care, and (3) the patient’s supplementation with numerous repurposed drugs and other substances reported to have antitumor properties. Alongside her conventional treatment (the medical standard of care), it seems likely that this supplementation has been a key factor in the patient’s long-term survival. We also point out that the lack of follow-up magnetic resonance imaging brain scans for early detection of brain metastases poses substantial risks for patients with HER2+ metastatic breast cancer in non–central nervous system locations. Thus, we suggest that research be conducted on such early detection for possible inclusion in the recommendations for the medical standard of care. Finally, medical doctors and also patients with backgrounds in biological science may wish to consider potential options and advantages of repurposed drugs and other substances reported in scientific publications when the medical standard of care has limited options for advanced cancer and other severe chronic health conditions. However, any efforts along this line by patients should be in collaboration with their medical doctors.

Evaluating Manual Mappings of Russian Proprietary Formats and Terminologies to FHIR

Background Evaluating potential data losses from mapping proprietary medical data formats to standards is essential for decision making. The article implements a method to evaluate the preliminary content overlap of proprietary medical formats, including national terminologies and Fast Healthcare Interoperability Resources (FHIR)—international medical standard. Methods Three types of mappings were evaluated in the article: proprietary format matched to FHIR, national terminologies matched to the FHIR mappings, and concepts from national terminologies matched to Systematized Nomenclature of Medicine–Clinical Terms (SNOMED CT). We matched attributes of the formats with FHIR definitions and calculated content overlap. Results The article reports the results of a manual mapping between a proprietary medical format and the FHIR standard. The following results were obtained: 81% of content overlap for the proprietary format to FHIR mapping, 88% of content overlap for the national terminologies to FHIR mapping, and 98.6% of concepts matching can be reached from national terminologies to SNOMED CT mapping. Twenty tables from the proprietary format and 20 dictionaries were matched with FHIR resources; nine dictionaries were matched with SNOMED CT concepts. Conclusion Mapping medical formats is a challenge. The obtained overlaps are promising in comparison with the investigated results. The study showed that standardization of data exchange between proprietary formats and FHIR is possible in Russia, and national terminologies can be used in FHIR-based information systems.