MP07-06 TELEMEDICINE AND HOME MONITORING OF BLADDER FUNCTION FOR MANAGEMENT OF URINARY TRACT INFECTION IN NEUROGENIC BLADDER & SPINAL CORD INJURY
Notice bibliographique
Résumé
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (MP07)1 Apr 2019MP07-06 TELEMEDICINE AND HOME MONITORING OF BLADDER FUNCTION FOR MANAGEMENT OF URINARY TRACT INFECTION IN NEUROGENIC BLADDER & SPINAL CORD INJURY Lynn Stothers*, Emily Deegan, Alex Kavanagh, Blayne Welk, and Mark Nigro Lynn Stothers*Lynn Stothers* More articles by this author , Emily DeeganEmily Deegan More articles by this author , Alex KavanaghAlex Kavanagh More articles by this author , Blayne WelkBlayne Welk More articles by this author , and Mark NigroMark Nigro More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555090.56812.9cAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Urinary tract infection (UTI) is a serious complication of neurogenic bladder (NB), is associated with resistant organisms and causes autonomic dysreflexia & reduced quality of life. UTI diagnosis in NB is difficult due to sensory changes prohibiting reports of traditional LUTS. Near Infrared spectroscopy (NIRS) has previously reported diagnostic capabilities in pediatric UTI. Objective: examine telemedicine with home monitoring of bladder parameters including NIRS for early UTI diagnosis & symptom reduction. METHODS: Prospective cohort study (NLUTD with recurrent UTI). Subjects served as their own controls x 6 months run in then completed adaptive telemedicine. Measures at 3 time points in clinic included: Neurogenic Bladder Symptom Score (NBSS), SF–36 and Qualiveen–30, urine culture & bladder NIRS. Home-monitoring telemedicine conducted monthly x 6 months including BP, temperature, & urinalysis. A subset of 7 conducted home bladder NIRS for tissue saturation index (TSI%) during natural filling & x 30 min. post emptying. Asymptomatic urine cultures obtained at 3 time points & with symptomatic UTI had bacteria frozen for genetic analysis. RESULTS: N=62; 75% male, 25% female (median 49 & 46 yrs respectively) SCI 87% (ASIA 64%, B 20%, C 9%, D 3.7%, E 2%), MS 7%, spina bifida 5%, other injury 13%; median time since injury 16 yrs. Bladder management: CIC 64%, indwelling cath 29%, spontaneous voiding 7%. 2 used adaptive mouth technology to operate telemedicine independently. 190 urine cultures revealed 135 isolates; 18 strains, antimicrobial resistance (AMR) in 54%. 324 visits demonstrated 91% compliance. 7 SCI subjects completed home NIRS independently capturing TSI%. Urinary incontinence (UI) showed statistically significant reduction on NBSS following telemedicine (p=0.02). CONCLUSIONS: Subjects on telemedicine with home monitoring experienced a significant reduction in UI & high compliance with visits even in high tetraplegia. Home monitoring of blood pressure and acquisition of bladder NIRS was feasible. Telemedicine can improve NB management and increase healthcare access. Bladder NIRS in the SCI population is feasible and could provide an adjunctive method for early UTI detection in this population with high AMR. Source of Funding: Rick Hansen Foundation Vancouver, Canada; London, Canada; Vancouver, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e92-e92 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lynn Stothers* More articles by this author Emily Deegan More articles by this author Alex Kavanagh More articles by this author Blayne Welk More articles by this author Mark Nigro More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,441 | 0,177 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».