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At least 73 records · Page 4Linked to original sources
PubMed1983

Glycaemic control in pancreatectomized dogs with a wearable artificial endocrine pancreas.

A needle-type glucose sensor has been developed using a platinum electrode covered with immobilized glucose oxidase. Experiments with albumin-saline solution in vitro showed that at 5.5 mmol/l glucose concentration the output current generated was 1.2 +/- 0.4 nA (mean +/- SD). The current increased as a linear function of glucose concentration over the range (0-27.7 mmol/l). The response time to reach 90% of the final plateau value was 16.2 +/- 6.2s. The signal-to-noise ratio of the sensor was 15.8 +/- 2.6 decibels. The temperature coefficient in output was 2.3 +/- 1.0%/degrees C. The current output was not affected significantly by changes in oxygen tension of the solution in the range 25-150 mmHg. In vivo, the output current of sensors inserted into the subcutaneous tissues of dogs was directly related to blood glucose concentrations after oral glucose or meals. Daily checking of the sensors maintained in subcutaneous tissues in five dogs showed that the sensitivity decreased gradually to 87.2 +/- 7.6% at 72 h, and dropped significantly to 57.4 +/- 7.0% of the initial output by 96 h. A wearable artificial endocrine pancreas (18.0 x 17.7 x 7.9 cm, 700 g) was developed, consisting of a needle-type glucose sensor, a microcomputer system and a pump driving mechanism. Three pancreatectomized dogs were fitted with the system by inserting the sensor into subcutaneous tissue. By renewing the sensor every fourth day, the device could maintain the daily glucose variations in diabetic dogs within the range 5-9.5 mmol/l for 7 days.

Animals↗
PubMed2002

[The Wearable Cardioverter Defibrillator (WCD) for the prevention of sudden cardiac death -- a single center experience].

The Wearable Cardioverter Defibrillator (WCD) is an external defibrillator that automatically detects and treats ventricular tachyarrhythmias without the need for assistance from a bystander while at the same time allowing the patient to ambulate freely. The main components of the system are the defibrillator unit and a chest belt with electrodes for arrhythmia detection and therapy delivery. Between December 1998 and October 2001, 84 patients used the device at our institution. The majority of patients had a history of acute myocardial infarction or coronary artery bypass surgery with an increased risk for sudden cardiac death or were awaiting heart transplantation. During a mean follow-up of 116+/-90 days, 7 episodes of ventricular tachyarrhythmias were detected and terminated successfully by the WCD in 5 patients. In 9720 days, there was one inappropriate shock due to oversensing of electrical noise. Four patients died during follow-up; none of them had a cardiac arrest while wearing the device. Five patients were excluded because of irregularities in device use. An ICD was implanted in 24 patients at the end of the follow-up period. The WCD is effective in detecting and treating ventricular tachyarrhythmias in patients with an intermittently increased risk for sudden cardiac death. Further use of the system in larger patient populations is needed to confirm its safety and cost effectiveness.

Aged↗
PubMed2006

Development of a highly responsive needle-type glucose sensor using polyimide for a wearable artificial endocrine pancreas.

To produce a long-life, stable, miniature glucose sensor for a wearable artificial endocrine pancreas (WAEP), we developed a novel microneedle-type glucose sensor using polyimide, designated the PI sensor (outer diameter, 0.3 mm; length, 16 mm), and investigated its characteristics in vitro and in vivo. In the in vitro study, we tested the sensor in 0.9% NaCl solution with varying glucose concentrations and observed an excellent linear relationship between the sensor output and glucose concentration (range: 0-500 mg/100 ml). In in vivo experiments, the PI sensor was inserted into the abdominal subcutaneous tissue of beagle dogs (n = 5), and interstitial fluid glucose concentrations were monitored after sensor calibration. Simultaneously, blood glucose concentrations were also monitored continuously with another PI sensor placed intravenously. The correlation and time delay between subcutaneous tissue glucose (Y) and blood glucose concentrations (X: 30-350 mg/100 ml) were Y = 1.03X + 7.98 (r = 0.969) and 6.6 +/- 1.2 min, respectively. We applied the new WAEP system/PI sensor and an intravenous insulin infusion algorithm developed previously for glycemic control in diabetic dogs. The use of the WAEP system resulted in excellent glycemic control after an oral glucose challenge of 1.5 g/kg (post-challenge blood glucose levels: 176 +/- 18 mg/100 ml at 65 min and 93 +/- 23 mg/100 ml at 240 min), without any hypoglycemia. Thus, we confirmed that our new PI sensor has excellent sensor characteristics in vitro and in vivo. The new WAEP using this sensor is potentially suitable for clinical application.

Administration, Oral↗
PubMed1994

Clinical implantation of the wearable Baxter Novacor ventricular assist system.

Implantation of the wearable Novacor electrically powered left ventricular assist system was performed on March 16, 1993, in a 44-year-old man hospitalized for an acute episode of myocardial decompensation after a 6-year history of dilated cardiomyopathy. He was rehabilitated fully and became ambulatory, awaiting a suitable cardiac graft for 59 days. He is now back to work, enjoying a normal life. This case illustrates the progress made by miniaturization of the external components of the system. General acceptance of the system and psychological adaptation to the new way of life were remarkable.

Adult↗
PubMed1996

Wearable long-term mechanical support for patients with end-stage heart disease: a tenable goal.

Increasing in frequency, and claiming more than 250,000 lives per year, heart failure represents a major public health problem. In spite of newer medical therapies, a significant proportion of patients progress to irreversible end-stage heart disease, for which cardiac transplantation remains the only long term hope. The inability to meet the demand for donor organs has led to the development of left ventricular assist devices as a temporizing measure while awaiting a transplantation. The "bridging to transplantation" experience has firmly established the efficacy of these devices as short-term and medium-term mechanical assistance and has provided valuable lessons applicable to long-term support. Mechanical cardiac assistance technology has dramatically improved and can provide reliable univentricular support with minimal thromboembolic and infectious complications. Although major obstacles remain, the potential benefits are great enough and the morbidity and mortality of end-stage heart disease high enough to warrant the evaluation of wearable left ventricular assist devices for long-term mechanical assistance.

Cardiac Output, Low↗
PubMed1994

Artificial endocrine pancreas and optimal blood glucose regulation in diabetic patients--from bedside-type to wearable-type.

The artificial endocrine pancreas is a feedback control system regulating insulin delivery on a minute-by-minute basis according to the measured blood glucose levels. The bedside-type artificial endocrine pancreas has been proven to be useful not only as a therapeutic tool for diabetes mellitus but also as an elegant research tool for investigating the pathophysiology of the disease. With significant advances in the development of a subcutaneous tissue glucose monitoring system, the wearable-type artificial endocrine pancreas has been applied to diabetic patients. With this system, perfect glycemic control can be obtained for longer periods in ambulatory diabetic patients. The trend in the development of the artificial endocrine pancreas is now directed to implantable devices. Much efforts have been conducted to realize these devices.

Blood Glucose↗
PubMed1990

Development of a potentially wearable glucose sensor for patients with diabetes mellitus: design and in-vitro evaluation.

A potentially wearable glucose sensor was developed, consisting of an oxygen electrode as detector and a dynamic enzyme perfusion system as selector. The selector is a hollow fibre, which can be placed subcutaneously and dialyses glucose from tissue fluid. In this design the problems of enzyme instability and oxygen limitation might be circumvented. The sensor measures glucose reliably for over two weeks, provided a new 10 ml syringe containing a glucose oxidase solution is connected to the system each day.

Biosensing Techniques↗
PubMed1993

On line continuous monitoring of blood lactate in men by a wearable device based upon an enzymatic amperometric lactate sensor.

A wearable device for the continuous measurement of lactate in the blood was constructed by the combination of continuous blood sampling employing a double lumen catheter with an amperometric lactate sensor. In vitro, the lactate sensor turned out to have a linear concentration range between 0 and 15 mmol/l. The response time of the sensor itself amounted to 100 sec, whereas the lag time for blood sampling amounted to 2.2 min. In vivo, the lactate sensor was successfully used for the detection of changes of the blood lactate concentration following strenuous exercise in 7 healthy volunteers, in two cases up to 22 h. In conclusion, the technique of continuous blood sampling by the use of a double lumen catheter in combination with the amperometric lactate sensor is feasible and simplifies frequent blood lactate estimations.

Adolescent↗
PubMed2006

Assessing the physical loading of wearable computers.

Wearable computers enable workers to interact with computer equipment in situations where previously they were unable. Attaching a computer to the body though has an unknown physical effect. This paper reports a methodology for addressing this, by assessing postural effects and the effect of added weight. Using the example of arm-mounted computers (AMCs), the paper shows that adopting a posture to interact with an AMC generates fatiguing levels of stress and a load of 0.54 kg results in increased level of stress and increased rate of fatigue. The paper shows that, due to poor postures adopted when wearing and interacting with computers and the weight of the device attached to the body, one possible outcome for prolonged exposure is the development of musculoskeletal disorders.

Adult↗
PubMed1998

Clinical efficacy of the wearable cardioverter-defibrillator in acutely terminating episodes of ventricular fibrillation.

The findings of our initial study demonstrate for the first time the ability to terminate induced VT/VF reliably (100% of all episodes) by a single, monophasic 230-J shock delivered by the Wearable Cardioverter-Defibrillator (WCD). Although limited by sample size, our data suggest the WCD could be used as a feasible bridge to definitive implantation of an implantable cardioverter-defibrillator in patients in whom risk stratification for sudden death is not completed.

Aged↗
PubMed1982

Wearable artificial endocrine pancrease with needle-type glucose sensor.

Miniaturisation of the bedside artificial endocrine pancreas in necessary to provide a means of restoring physiological glycaemic excursions in diabetic patients in the long term. One of the remaining problems in producing such a sophisticated device is the difficulty in developing a sufficiently small glucose-monitoring system. A needle-type glucose sensor has been developed which is suitable for use in a closed-loop glycaemic control system. The wearable artificial endocrine pancreas, incorporating the needle-type glucose sensor, a computer calculating infusion rates of insulin, glucagon, or both, and infusion pumps, was tested in pancreatectomised dogs: the device produced perfect control of blood glucose for up to 7 days.

Animals↗
PubMed2000

Long-term mechanical circulatory support with the wearable Novacor left ventricular assist system.

OBJECTIVE: As of July 1st 1999, 36 European patients have lived for more than 1 year supported by the Novacor wearable electric left ventricular assist system (LVAS). All were unresponsive to maximum medical therapy, prior to implantation. These patients offer an unique opportunity to evaluate the feasibility of long-term ambulatory mechanical circulatory support as a therapeutic option for patients in profound cardiac failure. METHODS: Data was obtained from the Novacor European Registry. RESULTS: At the time of implantation, median age was 55 (18-67) years. Aetiology was ischemic (9, 25%) or idiopathic (26, 72%) cardiomyopathy, and myocarditis (1, 3%). Median duration of LVAS support was 1.49 (1. 03-4.10) years. Eight recipients had LVAS support times >2 years, of which two were >3 years and one >4 years. The median time spent outside the hospital was 1.27 (0.58-3.83) years, representing 82% of the duration of LVAS support. No mechanical failure was observed during the entire observation period. One pump was replaced electively after 3.67 years due to pump driver wear-out. Twelve patients (33%) are currently on support while 17 were transplanted (14, 39%) or weaned (3, 8%). Seven (19%) patients died after a median of 1.24 years circulatory support. CONCLUSIONS: Experience with long-term Novacor LVAS recipients has demonstrated effective rehabilitation in this group of patients with refractory advanced heart failure. This suggests that LVAS therapy may offer a safe and realistic option for patients for whom no other effective therapy is available. The patient sub-population that would benefit most from this therapy remains to be defined.

Adolescent↗
PubMed2005

Adaptation of a Pocket PC for use as a wearable voice dosimeter.

This article deals with the adaptation of a commercially available Pocket PC for use as a voice dosimeter, a wearable device that measures the vocal dose of teachers or other individuals on the job, at home, and elsewhere during the course of an entire day. An engineering approach for designing a voice dosimeter is described, and design data are presented. Technical issues include transducer selection, dynamic range, frequency response, memory requirements, power requirements, attachment, cables, connections, and data collection. Advantages and disadvantages of the design are discussed.

Electric Stimulation↗
PubMed2003

Clinical efficacy of a wearable defibrillator in acutely terminating episodes of ventricular fibrillation using biphasic shocks.

The Wearable Cardioverter Defibrillator (WCD) automatically detects and treats ventricular tachyarrhythmias without the need for assistance from a bystander, while at the same time allowing the patient to ambulate freely. It represents an alternative to emergency medical services for outpatient populations with a temporary risk of sudden cardiac death. While the original devices used a monophasic truncated exponential waveform for cardioversion/defibrillation shocks, a new, biphasic shock was developed for the next device generation. In 12 patients undergoing electrophysiological testing for ventricular tachyarrhythmias, termination of electrically induced ventricular fibrillation (VF) was attempted via the WCD. In 22 episodes, induced VF was promptly terminated by the first 70 J (n=12) or 100 J (n=10) biphasic shocks. Time between arrhythmia initiation and shock delivery was 22 +/- 6 seconds (70 J) and 21 +/- 6 seconds (100 J) (P=NS). The measured transthoracic impedance was 71 +/- 5 Ohms (64-79 Ohms) for the 70 J shock and 64 +/- 8 Ohms (47-72 Ohms) for the 100 J shock. The present study demonstrates that a single low energy biphasic shock delivered by the WCD, reliably terminates electrically induced VF (100% of episodes). The results of this study suggest that there is an acceptable safety margin to the maximum output of the device (150 J). Despite our promising data, we recommend that programming all shocks for maximum energy output should be done when using the WCD in ambulatory patients.

Ambulatory Care↗
PubMed2006

Investigation of fall-risk using a wearable device with accelerometers and rate gyroscopes.

A clinical tool and an associated test that can assess fall-risk in elderly patients have been designed. The clinical tool was based on a wearable device with accelerometers and rate gyroscopes to identify trunk kinematic parameters. The test was based on a posturography protocol with different constraints and statistical analysis of the kinematic parameters. Statistical clustering based on the Mahalanobis distance was carried out using three groups of 30 subjects (1, age < 65 years; 2, age > or = 65 years and 3, age > or = 65 years and a fall history). The method was statistically validated using three groups of 100 subjects. The test allowed discrimination of elderly subjects with a high fall-risk with high specificity > or = 0.930 and sensitivity > or = 0.939.

Acceleration↗
PubMed1988

A wearable multichannel tactile display of voice fundamental frequency.

This paper describes a wearable sensory aid that provides the deaf with tactually encoded information about intonation. Fundamental frequency is represented as both place and rate of vibration in a linear array of solenoids. Pitch extraction is accomplished through low-pass filtering and peak detection. A microcomputer is used to measure pitch period, which in turn determines which of the solenoids is actuated. By comparing consecutive periods, the system discriminates against random, noise-related inputs. The device is switchable between 1-, 8-, and 16-channel operation. The electronics package is contained in a case that may be worn on a belt. The solenoid array is worn on the forearm. The system is powered by five, rechargeable lithium cells and runs for at least 6 hours between charges. Proposed developments include the incorporation of digital pitch extraction methods and the option to use the spatial output dimension to encode speech parameters other than fundamental frequency.

Deafness↗
PubMed2003

Continuous wear contact lens surface chemistry and wearability.

Continuous wear (CW) contact lenses are defined as lenses composed of hydrogel polymers containing elements other than carbon, hydrogen, oxygen, and nitrogen that enhance oxygen permeability to an extent greater than water alone. Those elements are silicon and fluorine. Silicon is incorporated as siloxanes, and fluorine is used as fluoroalkyl. Despite the water present in CW lenses, they are not wearable without surface modification because of the tendency of siloxanes and fluoroakyls to move in the soft polymers, orient, and become enriched at the surface. Various methods of surface modification are discussed, with emphasis on the plasma technologies used by the two commercial CW lens products, Focus Night & Day and PureVision. Speculation about future directions in surface chemistry are also presented.

Chemical Phenomena↗