title: Online remote monitoring of patients with differentiated thyroid carcinomas and neuroendocrine tumors treated with high doses of radionuclides.
abstract: BACKGROUND
  Telemedicine could be very useful for patients in remote areas experiencing adverse drug reactions or being in need of sophisticated diagnostic or therapeutic procedures. The aim of this article is to show the experience of our Department of Nuclear Medicine (DNM) in telemonitoring patients with differentiated thyroid carcinomas and neuroendocrine tumors.
  
  
  METHODS
  The DNM at the Clinical Center Kragujevac, Serbia, uses continuous remote monitoring of patients' vital functions, including heart rate, electrocardiogram, respiration rate, blood pressure, and oxygen saturation, as well as video surveillance of the physical isolation area for patients with neuroendocrine tumors (NETs) and some patients with differentiated thyroid carcinomas (DTCs), during administration of radionuclide therapy and for the days following treatment.
  
  
  RESULTS
  The DNM used a telemonitoring system for 156 patients with either DTC or NET who received radionuclide therapy during the last 3 years. There were 32 interventions on patients in the physical isolation area based on changes of the patients' vital functions detected by the telemonitoring system. Twenty-five patients (78%) experienced symptoms, whereas the other seven patients (22%) were symptomless. A responsible physician intervened with treatment of tachycardia (18 cases), hypertension (10 cases), hypotension (2 cases), ventricular extrasystoles (1 case), and ST-segment depression (1 case). After administration of the treatment the health status of the patients was normalized.
  
  
  CONCLUSIONS
  From our experience gained over the past 3 years, this model of organization and supervision with a telemonitoring system of patients receiving radionuclide therapy ensures a high level of safety for the patient, with significant reduction of staff costs.
authors.affiliation: Department of Nuclear Medicine, Clinical Center Kragujevac and Medical Faculty University of Kragujevac, Kragujevac, Serbia. mmatovic@medf.kg.ac.rs
authors.forename: Milovan
authors.initials: M
authors.lastname: Matovic
authors.forename: Slobodan
authors.initials: S
authors.lastname: Jankovic
authors.forename: Marija
authors.initials: M
authors.lastname: Jeremic
authors.forename: Marina
authors.initials: M
authors.lastname: Vlajkovic
authors.forename: Vesna
authors.initials: V
authors.lastname: Matovic
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D020407:Internet / Q000295:instrumentation / Q000458:organization & administration*; D017146:Models, Organizational; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy; D011868:Radioisotopes / Q000627:therapeutic use*; D055771:Serbia; D017216:Telemedicine / Q000379:methods / Q000458:organization & administration*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy
chemical_list: D011868:Radioisotopes