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M T Araújo

Publications and source records attributed to M T Araújo.

9 recordsLinked to original sources
PubMed2001

Neurological teleconsultation for general practitioners.

A neurology teleconsulting network was implemented between a university hospital in Lisbon and five nearby health centres. PCs equipped for videoconferencing were installed, connected by ISDN lines at 128 kbit/s. Fifty-three general practitioners (GPs) were surveyed. The survey showed that the GPs had difficulties in using computers, but they had definite intentions to use teleconsultation for neurology cases and 83% of the respondents stated that they would probably use the technique. During the study, 90 neurology teleconsultations took place over 55 weeks. The average consultation rate was 1.6 teleconsultations per week (SD 1.3, range 0-6). The conferences lasted 10-45 min. Longer teleconsultations were mainly due to technical difficulties in using computers on the part of users with a low level of computer literacy. The patients were 42 males and 46 females, with a mean age of 38 years (SD 20, range 1-84); two patients were discussed twice. The benefits consisted mainly of advice on patient medication, diagnosis and the prevention of unnecessary specialist consultations or laboratory examinations. Doctor-doctor teleconsultation allows the rapid resolution of queries which otherwise cause stress to patients and increase the cost and complexity of care.

Adolescent↗
PubMed2000

General practitioners and neurotelemedicine.

Predicting attitudes towards teleconsultation systems and intentions of use is crucial at the beginning of the implementation phase, due to the critical role of human factors in its acceptance and continuous utilisation. The main objective of this study was to assess and understand GP's attitudes and intentions towards using the teleconsultation system in Neurology, implemented in Lisbon, between Hospital de Santa Maria/Neurology Outpatient Clinic and the Health Care Centers of its Health Unit. The final aim is the promotion of a wide acceptance and utilisation of the system, through the development of adequate communication strategies. A predictive model "Theory of Reasoned Action" was chosen as method. It was operated with the application of a questionnaire to a sample of 53 GP's, developed from the results of a content analysis of 10 interviews. A total of 44 GP's stated that, probably they will use the system, 5 were neutral and 4 probably will not use it. The responses were submitted to factor and multiple regression analysis. Attitude was determined by only one factor "Accessibility and Quality" (b = 0.486; p = 0.007) from the 5 factors obtained. The intention variance was explained in 26.9% by the attitude and subjective norm. However, only the attitudinal factor (b = 0.469; p = 0.002) contributes significantly to its explanation with no significant influence from the subjective norm. GP's intentions towards using the system are very positive. Nevertheless, there are significant differences between the centers that are participating and not participating in the project. Communication strategies envisaging dissemination and generalised acceptance and utilisation should focus on accessibility and quality of care aspects.

Adult↗
PubMed1995

Exaggerated Bezold-Jarisch reflex in the hypertension induced by inhibition of nitric oxide synthesis.

The present study was designed to investigate the role of cardiopulmonary reflex, more specifically the Bezold-Jarisch reflex, in experimental hypertension induced by chronic administration of Nw-nitro-L-arginine methyl ester (L-NAME) (0.5 mg/ml) added to the drinking water for 6 days. The study was performed in male Wistar rats (200-350 g), 9 animals per group. L-NAME ingestion caused a significant increase in resting mean arterial pressure (MAP: 182 +/- 4 mmHg) and heart rate (HR: 447 +/- 20 bpm) when compared to untreated rats (MAP: 112 +/- 3 mmHg and HR: 355 +/- 10 bpm). Cardiopulmonary receptors were chemically stimulated with bolus injections of 5-hydroxytryptamine (5-HT, 4-10 micrograms/kg, iv) followed by measuring the falls in diastolic arterial pressure (DAP) and HR in conscious and freely moving animals. As expected, the responses to intravenous injections of 5-HT consisted of a dose-dependent reduction in HR (from 26 +/- 14 to 175 +/- 25 bpm) and DAP (from 7 +/- 4 to 39 +/- 3 mmHg) in the control rats. Both bradycardia and diastolic hypotension were significantly accentuated in the L-NAME animals (approximately 30%). These data suggest that, in contrast to other models of hypertension, in the present one caused by inhibition of nitric oxide synthesis, the Bezold-Jarisch reflex is exaggerated. This neural dysfunction could be related to changes in the cardiac vagal efferent or effector.

Animals↗
PubMedDate not supplied

[Teleconsulta en neurology in a health unit: preliminary approach].

This paper begins by discussing the influence of neurological diseases in the practice of general practitioners. A thorough review of the literature allows us to conclude that the frequency of neurological complaints in general practice varies between 7% and 15% and that complaints of sleep disorders reach about 26% in those cases. However, general practitioners do not refer all these neurological cases to a neurologist. They screen the cases and refer only 9% of all observed patients. Next, we briefly analyse the impact of telemedicine in general practice. Given this technique's novelty, we present a predictive model for the utility of teleconsultation, which we are currently developing and testing. We then summarise the current status of general practitioners' referrals to our hospital's neurological outpatient clinic, given previous measures that targeted waiting list reduction and adequate referral. After this overview, we present our methodology, which includes the development and implementation of the technologies needed for teleconsultation and the discussion and application of medical protocols for clinical data, benefits and costs. Simultaneously, we investigated the real need for teleconsultation in Neurology according to the literature and to several, more or less optimistic, models of acceptance. Based on this method, teleconsultation began its regular operation in July 1998. We discuss the result of the first 14 weeks of operation. We observed that referral developed according to calculated predictions and that there were clear advantages regarding diagnostics, medication, exam requests, cost avoidance and patient trips to the central hospital. The data collected predicts that this method is useful, efficient and able to substantially reduce costs.

Algorithms↗