Clinical Interventions Following Escalations from a Continuous Respiratory Monitoring Service in Patients With Chronic Obstructive Pulmonary Disease.

Background: Continuous respiratory monitoring can support integrated care for chronic obstructive pulmonary disease (COPD) patients, by coupling them with remote clinical personnel who triage patients in coordination with their health care providers. When deploying such services, there remains uncertainty surrounding outcomes when at-risk patients are proactively identified and escalated for provider evaluation. This study presents findings from a service deployed in a real-world COPD cohort by analyzing the clinical interventions made during in-person and telehealth pulmonary outpatient visits following remote escalations.

Use of Remote Cardiorespiratory Monitoring is Associated with a Reduction in Hospitalizations for Subjects with COPD.

Background: Chronic obstructive pulmonary disease (COPD) is prevalent and results in high healthcare resource utilization. The largest impact on health status and proportion of healthcare costs in COPD are related to hospitalizations for acute exacerbations. Accordingly, the Centers for Medicare & Medicaid Services have advocated for remote patient monitoring (RPM) to aid in chronic disease management.

Early identification and treatment of COPD exacerbation using remote respiratory monitoring.

Remote patient monitoring (RPM) is increasingly more accessible and accurate. The optimal utilization of RPM requires medical conditions which have predictive physiologic changes and effective outpatient therapies. Respiratory rate elevation has been shown to be predictive of impending chronic obstructive pulmonary disease (COPD) exacerbation and treatment often focuses on home-based medical therapies.

Post-acute care management of a patient with COVID-19 using remote cardiorespiratory monitoring.

Hospital discharge planning can be complex and hospital space is often limited. Patients, including those with COVID-19, can have prolonged symptoms after discharge and often require ongoing monitoring. Furthermore, prolonging hospital stays primarily for monitoring can expose patients to iatrogenic and infectious risks.

Early Identification of COVID-19 Infection Using Remote Cardiorespiratory Monitoring: Three Case Reports.

Background: The adoption of remote patient monitoring (RPM) in routine medical care requires increased understanding of the physiologic changes accompanying disease development and the proactive interventions that will improve outcomes.

Objective: The aim of this study is to present three case reports that highlight the capability of RPM to enable early identification of viral infection with COVID-19 in patients with chronic respiratory disease.

Methods: Patients at a large pulmonary practice who were enrolled in a respiratory RPM program and who had contracted COVID-19 were identified.

Heterogeneity in combined pulmonary fibrosis and emphysema.

Background: Combined pulmonary fibrosis and emphysema (CPFE) is a unique disorder described in several case series of upper lobe emphysema associated with lower lobe fibrosis. Patients with this entity have relatively preserved lung volumes and spirometry but marked reductions in diffusing capacity on pulmonary function testing. Smoking appears to be the predominant risk factor for this disorder.

Scaphoid fractures: dorsal versus volar approach.

Twenty-six patients with scaphoid fractures were treated with internal fixation using a cannulated differential pitch compression screw. Sixteen patients underwent a dorsal approach (group 1) 10 patients a volar approach (group 2). Average time from injury to surgery was 6.

Politano-leadbetter ureteroneocystostomy. A 30-year experience.

Purpose: We evaluated the results and complications of children with reflux treated with the Politano-Leadbetter ureteroneocystostomy. In particular, we evaluated pre- and postoperative renal parenchymal scarring and the late development of hypertension.

Materials And Methods: From 1965 through 1996, 666 children (814 renal units) were reimplanted by nine urologists.

Ectopic refluxing ureter entering a seminal vesicle cyst associated with ipsilateral renal dysplasia.

The unusual case of a 10-month-old infant with an ectopic refluxing ureter entering into a seminal vesical cyst associated with ipsilateral renal dysplasia is described. The embryology, differential diagnosis, and therapy are discussed.

Prepubic urethrectomy with urethral stripping.

Purpose: Prepubic urethrectomy is a simple, safe alternative to perineal urethrectomy. The lithotomy position can be avoided and, thus, operative time and risk of deep venous thrombosis are decreased. We developed a simple modification because of difficulty in dissecting the bulbous urethra.

A possible ontogenic etiology for idiopathic left varicocele.

A total of 659 consecutive patients underwent venography for the evaluation of idiopathic left varicocele before sclerotherapy. In 484 cases no valves of the left spermatic vein could be demonstrated, while 172 patients demonstrated competent valves or absent insertions of the left spermatic vein at the typical point on the left renal vein plus retrograde flow over persistent intercardinal anastomoses. Stenosis of the renal vein occurred in 103 patients (15.

[Observations on the formation of the secondary venous system of the abdominal cavity with special reference to idiopathic left-sided varicocele].

Based on 1,778 radiologic investigations of vena cava inferior, left renal vein and left spermatic vein the anomalies due to incorrect transformations from the first to the second abdominal venous system are presented. A persistent vena cardinalis posterior could be demonstrated in two cases. Varicoceles were seen with and without insufficient valves of the spermatic vein and venous outflow obstruction of the renal vein, respectively.

Out-patient sclerotherapy of idiopathic left-sided varicocele in children and adults.

Between 1983 and 1989, 334 patients with idiopathic left-sided varicocele were referred for transfemoral sclerotherapy; 323 were adults and 11 were children. The standard site of injection of the sclerosing solution (Varicocid-Natriummorrhuat 55 mg, Benzylalkohol 20 mg) was the mid-portion of the spermatic vein. The upper third was injected only in cases where the catheter could not be negotiated further (e.

[Radiological findings in renal capsular tumors (author's transl)].

Renal capsular tumors are rare. Preoperative diagnostic is based on radiology. Typical urographical findings are marginal impression and dislocation of the entire kidney without deformation of renal pelvis and calices.

[Computer tomography in the investigation of renal trauma (author's transl)].

Two patients with blunt renal injuries (Hodges grade I and II), and two further patients with spontaneous renal and/or retroperitoneal hemorrhage, were studied with excretory urography, isotope scanning, ultrasound, angiography, and computerized tomography. The most important additional information provided by the CT scan was the disclosure of small parenchymal lacerations, as well as the presence and extent of perirenal hematomas. These abnormalities could also be monitored with CT studies during the healing phases.

[Considerations regarding the differential diagnosis during the angiography of non-functioning kidneys (author's transl)].

Utilizing selective renal arteriograms and phlebograms in 7 patients, the differential diagnostic difficulties in separating poorly vascularized tumors from inflammatory lesions are discussed. Retrograde studies either offered no help, or could technically not be accomplished; arteriography proved equivocal in most cases. However, renal phlebography was found to be quite helpful, in that a non-visualized or reduced opacification of the intrarenal venous system, along with irregular extrinsic venous impressions, spoke more for a malignant tumor.

Renal phlebography in diagnosis of poorly vascularized renal malignancies.

Eight cases are presented to demonstrate the value and limitations of renal phlebography in the diagnosis of poorly vascularized renal malignancies. Because of the easier compressibility of the thinner venous channels, malignant tumors may cause more pronounced phlebographic changes than seen in corresponding arteriographic studies. Changes include venous compression and amputation, tumor thrombus, and venous neovascularity.

Selective renal phlebography in the diagnosis of renal pelvic and ureteric varices.

4 cases are presented in order to demonstrate the efficacy of renal phlebography in the diagnosis of renal pelvic and ureteric varices. It is believed that this simple procedure should also be used as a supplement to renal angiography in cases of unexplained gross haematuria and/or persistent renal colic.

Carcinoma in the defunctionalized bladder: report of a case and review of the literature.

There are few reports in the literature of carcinoma developing in the post-diversionary bladder. The sixth such case is reported and the pertinent literature is reviewed. All cases of carcinoma in defunctionalized bladders have been associated with chronic inflammation of the bladder and all tumors became apparent within 4 years of diversion.

Segmental replacement of the ureter using Sparks' mandrils. An experimental study.

Segmental ureteral replacement with free autogenous fibroelastic Dacron tube grafts in three dogs was unsuccessful during preliminary trials. However, a proliferation of urothelium, smooth muscle, and blood vessels throughout the length of the grafts was demonstrated, providing an encouraging potential for further investigations. Technical refinements are suggested that may provide for improved success with experimental ureteral replacement.

Renal phlebography: an aid in the diagnosis of the absent or non-functioning kidney.

There are clinical situations that may preclude the use of retrograde pyelography and renal arteriography in the differential diagnosis of the absent, dysgenetic and non-functioning kidney. At times these procedures are non-diagnostic. We present 8 cases to demonstrate the efficacy of selective renal phlebography as an aid in the diagnosis of these entities.

Retroperitoneal teratoma.

Retroperitoneal teratoma is the third most common primary retroperitoneal neoplasm of childhood ranking behind neuroblastoma and nephroblastoma. Ten per cent of these tumors are malignant. Two cases of benign retroperitoneal teratoma are reported, and the first description of the angiographic appearance of such a tumor is presented.