Malacarne Mara, Gobbi Giorgio, Pizzinelli Paolo, Lesma Alessandro, Castelli Alberto, Lucini Daniela, Pagani Massimo
Centro di Ricerca sulla Terapia Neurovegetativa, Dipartimento Scienze Cliniche L. Sacco, Università di Milano, Milan, Italy.
Telemed J E Health. 2009 Jan;15(1):80-6. doi: 10.1089/tmj.2008.0066.
Recent epidemiological evidence indicates that chronic degenerative diseases, notably cardiovascular, represent the major toll in terms of death and of impaired quality of life. Recent estimates indicate that a small increase in financial resources in a number of clinical cases may be sufficient to minimize the consequences of elevated cardiovascular risk per individual. The observation that lifestyle choices, and in particular increased physical exercise, might strongly impact cardiovascular risk, suggests a redesign of preventive strategies, based on the combination of pharmacological and behavioral interventions. Following our recent experience with the INteractive teleConsultation network for worldwide healthcAre Services (INCAS) system, we designed a simpler point-to-point telehealth infrastructure, to be employed in cardiovascular risk reduction programs, predicting a high level of acceptance from the population, at the cost of very limited investment. This model was tested on 181 subjects (ages 18-80 years) in the Italian mountain village of Esino Lario. These subjects underwent a screening test to evaluate arrhythmia and cardiometabolic risks (arrhythmias were found in 14% of subjects, systolic arterial pressure was observed in 43% of subjects above 140 mm Hg, diastolic arterial pressure in 31% above 90 mm Hg). This study demonstrates the feasibility of a scaled-down telehealth application particularly suited to cardiovascular prevention in remote areas, such as in mountain villages.
近期的流行病学证据表明，慢性退行性疾病，尤其是心血管疾病，在死亡和生活质量受损方面造成了主要损失。近期估计显示，在一些临床病例中，少量增加财政资源可能足以将个体心血管风险升高的后果降至最低。生活方式的选择，特别是增加体育锻炼，可能会对心血管风险产生重大影响，这一观察结果表明，应基于药物和行为干预相结合的方式重新设计预防策略。根据我们近期在全球医疗保健服务交互式远程会诊网络（INCAS）系统方面的经验，我们设计了一种更简单的点对点远程医疗基础设施，用于心血管风险降低项目，预计该项目在投资非常有限的情况下会获得民众的高度认可。该模式在意大利埃西诺拉里奥山村的181名受试者（年龄在18至80岁之间）身上进行了测试。这些受试者接受了一项筛查测试，以评估心律失常和心脏代谢风险（14%的受试者发现有心律失常，43%的受试者收缩压高于140毫米汞柱，31%的受试者舒张压高于90毫米汞柱）。这项研究证明了一种缩小规模的远程医疗应用的可行性，该应用特别适用于偏远地区（如山村）的心血管预防。
