Picture: REUTERS
Picture: REUTERS

PATIENTS, doctors and specialised nurses at the University of California, Los Angeles, are using iPads to help track symptoms and care, and to communicate with each other in real-time about disease management.

"Using a tablet (such as) an iPad helps us to reach out and interact with patients during their daily lives and routines, so we can intervene early, if needed," says Dr Daniel Hommes, professor of medicine at the university, and director of the Centre for Inflammatory Bowel Diseases.

"We want patients to feel that carrying the iPad is like having a doctor in their back pockets," says Hommes.

Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases of the digestive and intestinal tracts, that affect millions of people of all ages around the world.

Symptoms include abdominal pain, diarrhoea, loss of appetite and weight loss.

Studies show that close monitoring, early intervention and educational programmes aimed at better managing these diseases have a profound effect on patients’ quality of life, work and relationships. This approach also significantly lowers health costs.

Hommes says the new programme allows patients to check in with their medical team via the iPad. The device is interactive, and asks patients questions to gauge how they’re doing in areas of disease activity, quality of life and their work productivity.

Patients’ answers are instantly transmitted wirelessly to doctors and nurses for review. The iPad also provides traffic reports that patients can monitor when they head to their clinic appointments.

Depending on patient responses, doctors and nurses can intervene in a number of ways, from offering prescriptions for new medication, making an appointment for an office visit, to helping the patient psychologically cope with the anxiety and isolation that can occur when dealing with a chronic disease.

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•Tiny space-age probes that can see inside single living cells are increasingly being used to diagnose illness in hard-to-reach areas of the body.

Because these devices are comparatively new, US researcher Dr Michel Kahaleh says specialists who are starting to use them might interpret what they see in different ways.

Kahaleh, chief of endoscopy at the Centre for Advanced Digestive Care and professor of clinical medicine at Weill Cornell Medical College, and his research team discovered this when they sent six specialists at five medical institutions recorded videos taken by a probe-based confocal laser endomicroscopy deep inside 25 patients with abnormally narrowed bile ducts.

The study, published in Digestive Diseases and Sciences recently, shows "poor" to "fair" agreement on the clinical significance of what the doctors saw in the videos — cancer, a benign condition or simple inflammation. To use this "amazing technology" properly, doctors need to come up with a standard way of interpreting what the videos reveal, he says.

"We can see detail that was unimaginable a decade ago — this breakthrough is born for the bile duct and those tiny tubes and complicated organ structures that no one has ever been able to visualise before."

When physicians are certain of what they are seeing, they will be able to " avoid unnecessary surgery whenever possible", he says.

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