This paper presents a novel health monitoring system for Parkinson's disease (pd) patients called help (Home-based Empowered Living for Parkinson's disease patients). The help system has been specifically designed and implemented as a health monitoring system in order to optimize treatment and improve quality of life of people with Parkinson's. This is a challenging goal due to the difficulty in establishing a closed-loop system that is able to detect the outcomes of treatment and react accordingly. In a similar way to diabetes treatment where the plasma glucose level can be measured and can be used to regulate drug doses, the help system's approach aims to estimate pd symptoms and to adjust the dose of medication in order to reduce symptoms. The proposed health monitoring system is composed of several components: a body sensor & actuator network managed by a smartphone, a remote monitoring platform for doctors and clinical professionals as well as a telecommunication and service infrastructure. The real advantage derives from having constant medical control without dramatically modifying daily life. The help system is going to be evaluated in several cities during the first part of 2012 under daily living conditions with pd patients.Keywords: Parkinson's Disease, Body Sensor and Actuator Network, Health Monitoring System, Ambient Assisted Living ResumenEn este trabajo se presenta un nuevo sistema de vigilancia de la salud para pacientes con la enfermedad de Parkinson (ep), pacientes llamados help (Fortaleciendo la vida en el hogar de pacientes con la enfermedad Parkinson). El sistema de ayuda ha sido específicamente diseñado e implementado como un sistema de vigilancia de la salud con el fin de optimizar el tratamiento y mejorar la calidad de vida de las personas con Parkinson. Este es un objetivo difícil debido a la dificultad del establecimiento de un sistema de circuito cerrado que es capaz de detectar los resultados del tratamiento y reaccionar en consecuencia. Es una manera similar al tratamiento de la diabetes donde el nivel de glucosa en plasma se puede medir y se puede utilizar para regular las dosis de medicamentos; el enfoque del sistema
Background: Tocilizumab has been proposed as a treatment for the new disease COVID-19, however, there is not enough scientific evidence to support this treatment. The objective of this study is to analyze whether the use of tocilizumab is associated with respiratory improvement and a shorter time to discharge in patients with COVID-19 and lung involvement.Methods: Observational study on a cohort of 418 patients, admitted to three county hospitals in Catalonia (Spain). Patients admitted consecutively were included and followed until discharge or up to 30 days of admission. A sub-cohort of patients treated with tocilizumab and a sub-cohort of control patients were identified, matched by a large number of risk factors and clinical variables. Sub-cohorts were also matched by the number of other treatments for COVID-19 that patients received. Increment in SAFI (inspired oxygen fraction / saturation) 48 hours after the start of treatment, and time to discharge, were the primary outcomes. Mortality, which was a secondary outcome, was analyzed in the total cohort, by using logistic regression models, adjusted by confounders.Results: There were 96 patients treated with tocilizumab. Of them, 22 patients could be matched with an equivalent number of control patients. The increment in SAFI from baseline to 48 hours of treatment, was not significantly different between groups (tocilizumab: -0.04; control: 0.09; p=0.636). Also, no difference in time to discharge was found between the two sub-cohorts (logrank test: p=0.472). The logistic regression models, did not show an effect of tocilizumab on mortality (OR 0.99; p=0.990)Conclusions: We did not find a clinical benefit associated with the use tocilizumab, in terms of respiratory function at 48 hours of treatment, or time to discharge.
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