Analysis of Medical Tourism for Cardiovascular Diseases

Increasing costs of treatments have led to the apparition of the medical tourism. Patients in high-income countries seek to solve their health problems in developing countries where the cost of medical treatment is much lower. This cost difference has led to the medical tourism industry that is currently estimated with an annual growth rate of about 20%. Cardiovascular diseases are a leading cause of death worldwide. The high cost of treating these diseases cause many patients to seek treatment options abroad. This paper presents an analysis of the medical tourism industry highlighting the factors that led to its development, barriers to medical tourism, and the economic impact of this industry. Although Romania has highly appreciated doctors it hasn’t achieved yet the high level of other developing countries where medical tourism is more intense. Spa tourism is still far from Romania’s potential in this area due to the very small investments and the lack of necessary infrastructure. Using statistical and econometric techniques we examined key health indicators in Romania showing the lack of correlation between the prevalence of cardiovascular diseases, the development of the endowment of the health system in Romania, expenditures on health care and evolution of the number of foreign tourists coming to Romania to treat these diseases. We used statistical data series provided by N.S.I. that were processed using Eviews. We also tested whether there is a causal relationship in the Granger sense between the percentage of GDP allocated to the health care system and the number of nights spent by foreign tourists in resorts in Romania or the number of arrivals of foreign tourists

Importance of NT-pro BNP in the Prevention of Heart Failure, Left Ventricular Systolic Dysfunction and Cardiovascular Events

Objective: The importance of the NT-proBNP value in detecting patients at risk of developing heart failure (HF) and its importance in guiding medical management to prevent the development of HF. Material and methods: The study is a prospective study and includes 314 patients who was presented at the Bagdasar-Arseni Emergency Hospital for cardiology consultation, by appointment, for a period of 3 years. The inclusion criteria were as follows: essential hypertension (diagnosed more than 5 years before), diabetes mellitus (insulin-deficient or under treatment with oral ant diabetics diagnosed more than 5 years before), ischemic heart disease, mild or moderate valvulopathy (mild or moderate mitral regurgitation and large or moderate aortic stenosis) and permanent or paroxysmal atrial fibrillation. Exclusion criteria were as follows: a previous diagnosis of heart failure or left ventricular systolic dysfunction, and the presence of signs or symptoms of heart failure at the time of enrollment in the study. Patients were randomized into 2 groups, a control group and a intervention group. Patients in the intervention group were managed according to the NT-proBNP value, and patients in the control group received the conventional intervention. Patients were monitored for 3 years and the following objectives were pursued: new diagnosis of heart failure, systolic or diastolic dysfunction of the left ventricle and hospitalization for cardiovascular pathology. Results: After 3 years, in the control group there were 40 patients (25.5%) who developed HF, compared to 28 patients (17.8%) in the intervention group. In the control group, 60 patients (38.2%) were diagnosed with left ventricular systolic dysfunction, compared to 43 patients (27.4%) in the intervention group. Regarding left ventricular diastolic dysfunction, in the control group there were 98 patients (62.4%), and in the intervention group there were 80 patients (51.0%). Also, the rate of hospitalizations for cardiovascular pathology was higher in the control group, 56 patients (35.7%), compared to 33 patients (21.0%) in the intervention group. Discussions: The incidence of heart failure, left ventricular systolic or diastolic dysfunction, or hospitalizations for cardiovascular events, was lower in the intervention group, in which patients were managed according to the NT-proBNP value, compared to patients in the control group who received conventional intervention. Conclusions: The NT-proBNP biomarker may be useful in the medical management of patients for the prevention of heart failure

The Implications of Cardiovascular Home Monitoring Rehabilitation - Mobile Applications as Optimum Solutions for the Future

This paper examines the home monitoring system used in our Department of Cardiology in the Future Internet Social Technological Alignment in Healthcare (FI-STAR) project - a project focused on secondary prevention in cardiology (www.fi-star.eu). The system used is composed of bluetooth capable medical devices that collect vital parameters though CardioStar application (an application that was developed in collaboration with computer engineers. The collected data are transmitted in real time to a central server in our hospital, where there is a continuous supervision of the parameters. We evaluated this system in order to prove its use in reducing the cardiovascular risk and increasing the adherence to the life-style changes. This paper presents the analysis of the MAST (Model for Assessment of Telemedicine) evaluation - which is the best way of evaluation for the telemedicine solutions - from the professional point of view. The questionnaires of evaluation were performed anonymous on a online platform. The application passed successfully the MAST evaluation, demonstrating that the developed telemedicine system designed for our cardiac patients fulfills its purpose in the secondary prevention

FI-STAR Online Personalised Cardiac Rehabilitation Solution

Background: Advanced disease prevention solutions using telemedicine are vital for the future in order to decrease the burden produced by the cardio-vascular diseases. This solutions need to ensure more accessibility, high performance and good data privacy. Material and Method: Study groups consist of 48 acute myocardial infarction patients: 24 home monitored using telemedicine and 24 control group performing unmonitored rehabilitation. The process will have two phases: the inpatient period will be common (5-7 days) and the outpatient period (7 weeks). The monitored group will receive a set of Bluetooth capable monitoring devices at discharge, a blood pressure device, a cardio watch, a pulsoxymeter, an ECG chest strap and a Smartphone with the application installed. The application that will be built from scratch will contain the nutritional, medical and physical activity plan and also has monitoring and treatment adjustment functions by the medical personnel Results: Before hospital discharge and at the end of the program all patients will perform an ECG treadmill test, which summed with other medical investigations, will quantify the cardiac fitness level and their improvement. Also using a MAST personalized model there will be assessed a set of performance indicators. Conclusions: The Online Cardiac rehabilitation solution will be a light and secure software, built using Specific Enablers, technology created as generic enablers in the FI-WARE project. This is hoped to offer more patient independence, improve their cardiac fitness and quality of life and reduces the high cost that cardiovascular disease brings to the medical system

FI-STAR Online Personalised Cardiac Rehabilitation Solution

Background:&#x0D; Advanced disease prevention solutions using telemedicine are vital for the future in order to decrease the burden produced by the cardio-vascular diseases. This solutions need to ensure more accessibility, high performance and good data privacy.&#x0D; Material and Method:&#x0D; Study groups consist of 48 acute myocardial infarction patients: 24 home monitored using telemedicine and 24 control group performing unmonitored rehabilitation. The process will have two phases: the inpatient period will be common (5-7 days) and the outpatient period (7 weeks). The monitored group will receive a set of Bluetooth capable monitoring devices at discharge, a blood pressure device, a cardio watch, a pulsoxymeter, an ECG chest strap and a Smartphone with the application installed. The application that will be built from scratch will contain the nutritional, medical and physical activity plan and also has monitoring and treatment adjustment functions by the medical personnel &#x0D; Results: Before hospital discharge and at the end of the program all patients will perform an ECG treadmill test, which summed with other medical investigations, will quantify the cardiac fitness level and their improvement. Also using a MAST personalized model there will be assessed a set of performance indicators.&#x0D; Conclusions: The Online Cardiac rehabilitation solution will be a light and secure software, built using Specific Enablers, technology created as generic enablers in the FI-WARE project. This is hoped to offer more patient independence, improve their cardiac fitness and quality of life and reduces the high cost that cardiovascular disease brings to the medical system.</jats:p

Minimal Individual Haemostasis (Mih) - Feasibility in Conventional and Distal Trans-Radial Approach

Abstract There is a growing use of trans-radial catheterisation for angiography and percutaneous interventions. The advantages of trans-radial over traditional femoral access include a decrease in the incidence of access site bleeding complications and improved patient comfort and recovery. Ensuring short haemostasis, which controls arterial bleeding after transracial interventions, but at the same time maintains radial arterial flow, appears to be the most important factor in reducing peri-procedural complications, especially radial artery occlusion (RAO). We evaluated the technical feasibility of our gradual deflation haemostasis method in a population of patients treated by both conventional and distal trans-radial approach, within 1 month period. A feasibility assessment was performed for 101 patients to assess whether our hemostasis technique could be performed safely. We concluded that our technique is feasible after trans-radial approach, in both categories of access, conventional or distal. The rate of peri-procedural complications was low and related to the type of approach used, with more positive results on the distal trans-radial approach.</jats:p