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FAQ
What
is telemedicine?
Telemedicine means providing medical information and services through
telecommunication networks.
Personal telemedicine is the transmission of medical data by a patient
from a remote location to a medical call center and to the
patient’s doctor via telephone line.
What is the main use of TensioCare home-tele-BP monitoring?
TensioCare brings physicians and patients a powerful partnership to
combat hypertension: complete and reliable reporting, detailed readings
and depth analysis,
TensioCare’s main use is to increase patient compliance, and
to reach the target BP-level.
Has TensioCare also alarm function?
Yes. Treshold level can be set: when BP readings exceed this level
TensioCare system alarms the doctor immediately.
Can TensioDay run on Windows NT/2000/XP?
Yes.TensioDay supports Windows NT/2000/XP.Actually a higher version
than Windows 98 is preferred.
Can TensioDay send files through email?
Yes.TensioDay is capable of sending patient report via email.
Please contact us with any further questions conserning TensioMed
products.
What is the Arteriograph for?
The Arteriograph is a new Hungarian world patent that can be a turning
point in the early diagnosis of the arteriosclerosis.
Who were the members of the research team creating this result?
The TensioMed TM Arteriograph was made by a research consortium lead by
dr. Illyés, Miklós (TensioMed Ltd) having the
following
partner instituts:
Research Institute for Technical Physics and Material Science of the
Hungarian Academy of Science - prof. Dr. Gyulai, József,
Member
of the Academy
Semmelweis Medical University, Institute for Human Physiology
– prof. Dr. Kollai, Márk
Semmelweis Medical University Clinic of Internal Medicine No.
I. – prof. Dr. De Châtel, Rudolf
St. Imre Hospital belonging to the capital, Department of Internal
Medicine, No. I. – prof. Dr. Farsang, Csaba
What is the new measuring method that makes the subject of the patent?
The newly discovered measuring method used in the Arteriograph is based
on the fact that dr. Illyés, Miklós and Mr.
Béres,
József have found out the information content of the signs
appearing in the brachial artery during the oscillometric measurement,
carrying in themselves information regarding the atherosclerosis. The
diagnose is valid not only for the brachial artery, but for the whole
arterial system.
What does the device measure? What is „Arterial
stiffness”?
The Arteriograph examines the "age of the artery" that is the stiffness
of the arteries growing from strength to strength together with aging.
The state when the flexibility of the arteries is lessening and they
are becoming stiffer and stiffer progressively is expressed in the
professional literature uniformly as "arterial stiffness".
What does the „Pulse Wave Velocity (PWV)” and
the „Augmentation index (AIx)” mean?
At present, the aortic pulse wave velocity (PWV) and the so-called
augmentation index (AIx) are used mostly for the non-invasive
examination of the arterial stiffness.
In clinical practice, the pulse wave velocity (further on the PWV) is
generally understood as the PWV of the aorta, because this is where the
lessening of the flexibility of the vessel wall caused by the
atherosclerosis is present first of all. The aortic PWV can be
determined on the basis of the time difference of the pulse waves
appearing on the art. carotis and on the art. femoralis, as well as on
the basis of the velocity measured by the determination of the distance
between these two points, on the basis of the formula v=s/t.
The augmentation index, given in percents, (further on the AIx), is
defined as the pressure difference between the first (P1), the early,
(induced by the heart systole) and the second (P2), the late
(appearing because of the reflection of the first pulse wave) systolic
peaks, divided by the pulse pressure.
AIx(%) = (P2 - P1) / PP × 100
How are these parameters related to the condition of the vascular
system?
The stiffer the wall of the aorta (atherosclerosis), the higher the PWV
value is. Value above 12 m/s is unambiguously accepted as pathologic,
because it has been proved that the survival rate with patients having
PWV value above this limit will significantly grow worse.
The AIx, first of all, gives information on the resistance of the
arterioles. The higher the percentage value of the AIx, the stronger
the resistance of the arterioles (resistance vessels). Peripheral
resistance of the arterioles is essentially influenced by the
endothelium. In case of endothelin dysfunction, the volume of the
nitrogen monoxide (NO) output in the endothelium will decrease, this is
the reason of its vasotonic effect, the peripheral resistance will grow
(further on TPR = Total Peripheral Resistance).
What stage of the vascular and circulatory disturbances can these
parameters be connected to?
The atherosclerosis can already be demonstrated with the Arteriograph
in its earliest stage when the endothelin dysfunction is being
developed, because increased AIx values will be measured. The
Arteriograph can also be used to measure the later, macrovascular stage
of the atherosclerosis. In this case the increase of the aortic PWV
value can be observed
Attention! Increased aortic PWV value can also be caused by the
increase of the cardiac output!
What kinds of other methods can be used to determine these parameters?
Besides invasive methods, the PWV and AIx values can also be measured
with the so-called applanation tonometry These devices can
mutually be characterized with the facts that their practical
application is complicated, time consuming and needs specially educated
professionals. These devices are applied mostly in special
cardiological research laboratories.
It can be said of the Arteriograph that it is a methodological turning
point, because with its simplicity and quickness, it offers a method
for a practicing physician to apply as a routine screening.
How did the validation of the Arteriograph take place?
On the one hand, the validation of the Arteriograph was made against an
invasive method at the Clinic of Cardiology of the Pécs
Medical
University, where the pulse wave given by a cannula inserted
into
the art. brachialis, and the wave given by the Arteriograph were
compared. It was demonstrated that the results gained by the
Arteriograph were totally the same as the intraarterial pulse waves
gained with the invasive method.
The PWV and the AIx values measured by the Arteriograph were also
validated to other, non-invasive measurement methods (Complior,
SphygmoCor). Both parameters show very close correlation (P = 0,8) with
the results measured with the above mentioned methods.
How is an examination taking place? What kind of qualification is
necessary to perform the examination?
The examination is fully automated and computerized. The task of the
operator is only to put the measuring cuff properly and to print out
the findings. Measuring with the Arteriograph will not necessitate any
special medical knowledge.
In the same time, it must be emphasized that the evaluation of the
findings and their proper interpreting in conjunction with
the
whole clinical condition is unambiguously the task of the physician!
What do the findings of the examination contain?
The Arteriograph, necessitating only a 2 minutes’ duration of
measuring, will provide with the following parameters:
Systolic blood pressure (SBP)
Diastolic blood pressure (DBP)
Mean arterial pressure (MAP)
Pulse pressure (PP)
Augmentation index (AIx)
Augmentation index normalized to heart rate 80/min (AIx80 )
Pulse wave velocity on the aorta (PWV)
Length of cardiac cycle in msec (Period)
Systolic area index (SAI)*
Diastolic area index (DAI)*
*The last two parameters give information on the perfusion pressure
state of the coronaries.
The measured AIx and PWV values are automatically evaluated by the
device according as they fall within the optimum, normal , elevated or
pathologic range of values.
What is to be done with patients showing elevated or pathologic values?
In case of patients showing elevated or pathologic values, a thorough
survey of all the other risk factors is indicated even if these
examinations showed negative results in the recent past.
Attention! It can lead to false negative results if the patient is
under strong effect of vasoactive medication (first of all under the
effect of nitrates, ACE-inhibitors).
What are the possibilities of education and consultation for users?
Taking into consideration that with the application of the
Arteriograph, quick information can be obtained on the basic
physiological and pathophysiological processes of the regularities of
the arterial circulation, one day of postgraduate professional course
is held monthly, and at the end of the course, the participants will
receive a diploma certifying their skills in the field of the
application of the Arteriograph.
Besides this, the findings can also be sent to the following e-mail
address for the purpose of consultation: illyesm@tensiomed.com.
In what fields of specialization can the Arteriograph be applied with
successes?
The Arteriograph can provide powerful help for the representatives of
the following specializations during their preventive, diagnostic
interventions as well as when monitoring the effects of therapy:
Family doctors (primary check-up for atherosclerosis, and follow-up of
the treatment)
Professionals working in occupational health (check-ups for
atherosclerosis)
Cardiologists (non-invasive haemodynamical monitoring, research work)
Nephrologists (in case of accelerating atherosclerosis is in connection
with some renal problems)
Diabetologists ( diabetes will accelerate process of aging of the
vessels)
Obstetricians and gynaecologists (the preeclampsia is an endothelial
disease, the menopause is a basic risk factor of atherosclerosis)
Paediatric cardiologists (the atherosclerosis is often detectable
already in young age)
Scientific researchers (in the fields of physiology and pathophysiology)
Experts in pharmacodynamics at pharmaceutical factories (effect of the
given medicament to the TPR, the PWV or to the atherosclerosis)
What references are available on this subject?
Literature available on arterial stiffness nowadays is so large that it
can fill a library. Recommended choice of literature is available for
all who are interested.
Which companies take the device into circulation?
Medexpert Ltd is the exclusive distributor of TensioMed
products
including the Arteriograph. To became a distributor in a foreign
country please contact Medexpert Ldt.
Medexpert, Ltd.
Address: H-1037 Budapest, Törökkő str. 5-7.
Phone: +36-1-250-4490, Fax:+36-1-250-3795
E-mail: arteriograf@medexpert.hu
Web access: www.medexpert.hu
In what assortments can the device be purchased or what is the
reasonable assortment to be bought?
When buying the device, it is advisable to decide whether the installed
or portable version is necessary. The most popular version of the
Arteriograph is the portable one containing an HP notebook in Hungary.
Medexpert Ltd. suggests to buy the Notebook in the country of use
because of the warranty processes and the support. The
TensioMed
programme is available and it can be installed into a suitable computer
and in this way it is able to communicate with the Arteriograph target
computer (containing a previously activated infrared port);
it
can make findings and can handle patient database.
For research tasks, it may be necessary to buy, besides the operation
system, the Microsoft Office programme package as well as the
database handling-converting and statistical target-programmes
developed by the TensioMed.
There are many kinds of colour printers attachable to the device. The
choice must be discussed with professionals. More information can be
found on the actually available assortments of the Arteriograph on our
websites.
To whom is it worth to buy the device?
It worths to buy to anybody working in the professions listed earlier.
According to our experiences, patients need checking up exams performed
by the Arteriograph very much.
What kind of aid can be given by the manufacturer and the distributor
for the users in the form of warranty and over the period of warranty?
Both the manufacturer and the distributors are present in the
international market having ISO qualification working in the system of
quality insurance. Both companies have brand services of their own.
They provide warranty period of 2 years for the basic instrument of the
Arteriograph. This can be done because the valves and pumps built in
the device comply with the highest requirements. Repair under warranty
generally means to replace the device.
Are there any other possibilities to get some more information?
For further help, continuously updated information is provided for our
customers and those who are interested at website
www.medexpert.hu. The new information data come from the
uninterruptedly growing number of customers and as results of the
ever-developing clinical research, which we are pleased to share with
you. Should you have any questions or requests, do not hesitate to
contact Medexpert Ltd. at arteriograf@medexpert.hu.
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