Selected eHealth Applications in Cyprus from the Training Perspective

Objectives: In this paper a review of selected eHealth applications in Cyprus is presented linked with their success or failure based on their training activities.

Methods: The eHealth systems presented and their training activities include an update of the health information system (HIS) in the public hospitals, a medical system for emergency telemedicine (AMBULANCE and EMERGENCY-112 projects), a home monitoring system for cancer patients (DITIS), a satellite-based network in healthcare applications (EMISPHER and HEALTHWARE projects), and the training activities of the Cyprus Society of Medical Informatics. Different methodologies for training were used ranging from classical approaches like train the trainers, using demo cases followed by personal training, group training, and workshops, to more recent methodologies based on eLearning sessions including teleconsultations.

Results: The training was carried out successfully in all cases. However, not all eHealth systems were put into practice successfully, mainly for reasons not related to training.

Conclusions: It is anticipated that this paper will promote the importance of these applications and their training activities as well as help in the spin off of others thus enabling the offering of a better service to the citizen.

Selected eHealth applications in Cyprus from the training perspective

OBJECTIVES

In this paper a review of selected eHealth applications in Cyprus is presented linked with their success or failure based on their training activities.

METHODS

The eHealth systems presented and their training activities include an update of the health information system (HIS) in the public hospitals, a medical system for emergency telemedicine (AMBULANCE and EMERGENCY-112 projects), a home monitoring system for cancer patients (DITIS), a satellite-based network in healthcare applications (EMISPHER and HEALTHWARE projects), and the training activities of the Cyprus Society of Medical Informatics. Different methodologies for training were used ranging from classical approaches like train the trainers, using demo cases followed by personal training, group training, and workshops, to more recent methodologies based on eLearning sessions including teleconsultations.

RESULTS

The training was carried out successfully in all cases. However, not all eHealth systems were put into practice successfully, mainly for reasons not related to training.

CONCLUSIONS

It is anticipated that this paper will promote the importance of these applications and their training activities as well as help in the spin off of others thus enabling the offering of a better service to the citizen.

Von Willebrand factor in patients evolving Q-wave versus non-Q-wave acute myocardial infarction

We assessed the changes in plasma von Willebrand factor level concentration in 10 patients with Q-myocardial infarction and in six patients with non-Q-myocardial infarction who did not receive thrombolytic treatment. Concentrations of von Willebrand factor antigen were measured by an enzyme-linked immunoassay method in plasma samples obtained twice daily for 4 consecutive days. In patients with Q-wave myocardial infarction, a significant rise in von Willebrand factor antigen levels (P < 0.05) occurred after admission and persisted for 3 days. No significant changes were found in plasma concentration of fibrinogen. In conclusion, von Willebrand factor antigen levels were greater in patients with Q-wave compared to patients with non-Q-wave myocardial infarction.

t-Plasminogen activator and von Willebrand factor in patients with unstable angina

We investigated whether the clinical evolution of symptoms in patients admitted with unstable angina is associated with changes in t-plasminogen activator antigen (t-PA) and von Willebrand (vW) factor levels. Concentrations of vW factor antigen and t-PA antigen were measured by an enzyme-linked immunoassay method in 10 patients who became clinically stable within 24 h of admission and remained so for 5 days. A significant rise in morning t-PA plasma level occurred 24 h after the admission (15.15 +/- 2.1 ng/ml, P < 0.05), whereas the vW factor remained unchanged. No significant changes were found in the night concentration in t-PA and vW factor during the 5 day period. Thus t-PA level is significantly raised 24 h after admission in patients with unstable angina who stabilize in response to medical treatment.

Effects of ketanserin on epicardial coronary arteries after coronary angioplasty in patients with stable angina

Previous studies have demonstrated the development of vasoconstriction immediately after percutaneous coronary angioplasty (PTCA), distal to the dilated stenosis, presumably resulting from endothelial injury. We have investigated the role of 5-HT2 receptors in mediating vasomotor changes in proximal and distal coronary segments and coronary stenoses, immediately after successful PTCA in patients with chronic stable angina. We compared the effects of the intracoronary infusion of 1 mg ketanserin (5-HT2 receptor antagonist) on proximal and distal coronary arterial segments immediately after PTCA in both vessels subjected to PTCA and control vessels. Coronary diameters, before and after angioplasty and after ketanserin administration, of proximal and distal segments and coronary stenoses were measured by computerized quantitative coronary angiography (CAAS system) in 12 patients (10 male, two female; mean age 54 +/- 6 years) with stable angina subjected to PTCA. After coronary angioplasty, vasoconstriction was observed in the segment distal to the dilated stenosis but not in the distal segments of control vessels (-0.12 +/- 0.04 and -0.02 +/- 0.02 mm respectively; P < 0.05). After ketanserin infusion significant dilatation was found in the distal segments of both PTCA vessels and control vessels, but the dilatation was greater in the PTCA vessels (P < 0.05). No significant changes were found in the proximal segments of either PTCA or control vessels, or at the PTCA site. In conclusion, the vasoconstriction distal to the site of PTCA is mediated, at least in part, via 5-HT2 receptors.

The morphology and electrophysiology of the neurones of the paired pedal ganglia of Lymnaea stagnalis (L.)

1. A morphological and electrophysiological map of the identifiable neurones and neuronal clusters of the paired pedal ganglia has been prepared. 2. Neuronal morphology was investigated using the fluorescent dye, Lucifer Yellow CH, whilst electrophysiological properties were studied using conventional intracellular recording techniques and the phase plane technique. 3. The paired pedal ganglia are largely symmetrical and giant neurones usually have contralateral homologues. 4. Neuronal clusters are also paired, but minor asymmetries, both of identifiable neurones and neuronal clusters have been found to exist. 5. These asymmetries are thought to be related to asymmetries of body form. 6. Most of the individually identifiable neurones possess obligatory axon branches which are invariant from one preparation to the next, but variant branches also occur. 7. Within the neuronal clusters, morphology appears to be more variable. 8. Individually identifiable neurones and neuronal clusters were characterized electrophysiologically according to the criteria of action potential shape, spontaneous activity pattern, electrical coupling and common synaptic inputs. 9. Homologous pairs of neurones usually have similar electrophysiological properties, as do those within clusters. 10. A number of wide-acting synaptic inputs have been identified on neurones of the pedal, buccal, visceral and parietal ganglia.

The effect of small and moderate doses of d-amphetamine on hunger, mood, and arousal in man

In rats, low doses of d-amphetamine (d-amp) increase rather than decrease food intake. A double-blind study was carried out in nine healthy female subjects to compare the effects of a low (1 mg) and a moderate (10 mg) dose of d-amp and placebo on hunger, mood and arousal. Each subject participated in three experimental sessions, 1 week apart, when they received either 1 mg d-amp, 10 mg d-amp or placebo, according to a random double-blind design. Visual analogue rating scales for hunger, mood and arousal were completed prior to drug administration and at 30-min intervals for 4 h. A questionnaire relating to sleep pattern and side effects was completed the morning after each experimental session. d-Amp (10 mg) produced a significant reduction in hunger ratings as compared with placebo at 2 h and 2.5 h after administration, while 1 mg d-amp had no significant effect on hunger. Mood and arousal were only slightly elevated by 10 mg d-amp, and not at all by 1 mg.