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1.
BMJ Case Rep ; 13(2)2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32071124

RESUMO

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide with an estimated 17.5 million deaths annually, according to the World Health Organization (WHO). CVD prevention efforts have the potential to prevent the majority of these deaths by supporting guideline-directed medical therapy (GDMT) and lifestyle modification. Mobile health (mHealth) has the potential to address this gap, but has limited evaluation in clinical studies to date. We present the case of a middle-aged patient of low socioeconomic status, with multiple comorbidities, and no prior smartphone experience, who suffered an acute myocardial infarction (MI) and was given the Corrie intervention while hospitalised. The patient demonstrated improvement in lifestyle modification, adherence to GDMT and post-MI recovery through 2.4 years follow-up. This case supports (1) the potential of mHealth interventions to enhance patient experience and outcomes, (2) intuitive design for adoption and improvement in end user experience and (3) the capability of mHealth to reach and empower underserved patients.


Assuntos
Aplicativos Móveis , Monitorização Fisiológica/instrumentação , Infarto do Miocárdio/terapia , Prevenção Secundária/instrumentação , Telemedicina , Doenças Cardiovasculares/prevenção & controle , Feminino , Humanos , Pessoa de Meia-Idade , Smartphone , Sobreviventes
2.
J Thorac Cardiovasc Surg ; 151(2): 385-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26432722

RESUMO

OBJECTIVE: Mitral valve surgery is increasingly performed through minimally invasive approaches. There are limited data regarding the cost of minimally invasive mitral valve surgery. Moreover, there are no data on the specific costs associated with mitral valve surgery. We undertook this study to compare the costs (total and subcomponent) of minimally invasive mitral valve surgery relative to traditional sternotomy. METHODS: All isolated mitral valve repairs performed in our health system from March 2012 through September 2013 were analyzed. To ensure like sets of patients, only those patients who underwent isolated mitral valve repairs with preoperative Society of Thoracic Surgeons scores of less than 4 were included in this study. A total of 159 patients were identified (sternotomy, 68; mini, 91). Total incurred direct cost was obtained from hospital financial records. RESULTS: Analysis demonstrated no difference in total cost (operative and postoperative) of mitral valve repair between mini and sternotomy ($25,515 ± $7598 vs $26,049 ± $11,737; P = .74). Operative costs were higher for the mini cohort, whereas postoperative costs were significantly lower. Postoperative intensive care unit and total hospital stays were both significantly shorter for the mini cohort. There were no differences in postoperative complications or survival between groups. CONCLUSIONS: Minimally invasive mitral valve surgery can be performed with overall equivalent cost and shorter hospital stay relative to traditional sternotomy. There is greater operative cost associated with minimally invasive mitral valve surgery that is offset by shorter intensive care unit and hospital stays.


Assuntos
Procedimentos Cirúrgicos Cardíacos/economia , Doenças das Valvas Cardíacas/economia , Doenças das Valvas Cardíacas/cirurgia , Custos Hospitalares , Tempo de Internação/economia , Valva Mitral/cirurgia , Esternotomia/economia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/métodos , Análise Custo-Benefício , Cuidados Críticos/economia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Cuidados Pós-Operatórios/economia , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/terapia , Esternotomia/efeitos adversos , Esternotomia/métodos , Fatores de Tempo , Resultado do Tratamento
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