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At least 109 records · Page 6Linked to original sources
PubMed1999

PC-based telerehabilitation system with force feedback.

A PC-based orthopedic rehabilitation system was developed for use at home, while allowing for remote monitoring from the clinic. The home rehabilitation station has a Pentium II PC with graphics accelerator, Polhemus tracker, and a novel Multipurpose Haptic Control Interface with its own Pentium board. This interface is used to sample patient's hand positions and to provide resistive forces using the Rutgers Master II (RMII) glove. A library of virtual rehabilitation routines was developed using WorldToolKit software. At the present time, it consists of two physical therapy exercises (DigiKey and Ball) and two functional rehabilitation exercises (Peg Board test and Ball game). All VR exercises allow automatic and transparent patient data collection into an Oracle database. A remote Pentium II PC is connected with the home-based PC over the Internet and an additional video-conferencing connection. The remote computer running Oracle server is used to maintain the patient database, monitor progress and change exercise level of difficulty. This allows for timely patient progress monitoring and repeat evaluations over time from the Clinic. The system will soon start clinical trails at Stanford Medical School, with progress being monitored remotely from Rutgers University. Other rehabilitation haptic interfaces under development include devices for elbow, and knee rehabilitation connected to the Multipurpose Haptic Control Interface.

Computer Graphics↗
PubMed1997

Reduction in the incidence of carbon monoxide exposures in humans undergoing general anesthesia.

BACKGROUND: Carbon monoxide forms via reaction of isoflurane, enflurane, and desflurane with dried CO2 absorbents. The authors hypothesize that interventions by nonphysician support personnel to decrease absorbent drying will decrease the exposure rate of patients to carbon monoxide from anesthetic breakdown. METHODS: In the control group, all anesthetizing personnel were made aware of the factors enabling CO generation from anesthetic breakdown, and prevention techniques were left to the anesthetizing personnel. After data collection was complete, the following interventions were initiated to reduce absorbent drying: Anesthesia technicians and housekeeping personnel were instructed to turn off all anesthesia machines after the last case of the day in each room, and the CO2 absorbent was changed each morning if fresh gas was found flowing. Baralyme was used in all phases of this study. RESULTS: Five cases of intraoperative carbon monoxide exposure occurred among 1,085 (0.46%) first cases in the control group. Postintervention, patient carbon monoxide exposures decreased (P < 0.05), with one exposure among 1,961 (0.051%) first cases in the main operating room. Two exposures among 68 (2.9%) first cases occurred in remote locations (P < 0.001) versus main operating room. Predisposing factors for absorbent drying include the prolonged use of anesthesia machines for monitored anesthesia care, inappropriate drying techniques for expiratory flowmeters, understaffing of support personnel, and anesthesia in remote locations. CONCLUSIONS: These interventions reduced patient exposure to carbon monoxide. Monitoring for carbon monoxide exposures during general anesthesia may be necessary to recognize and end patient exposures that occur despite preventative measures.

Adsorption↗
PubMed2004

Mobile patient monitoring based on impedance-loaded SAW-sensors.

A remotely requestable, passive, short-range sensor network for measuring small voltages is presented. The sensor system is able to simultaneously monitor six small voltages in millivolt-range, and it can be used for Holter-electrocardiogram (ECG) and other biopotential monitoring, or in industrial applications. The sensors are based on a surface acoustic wave (SAW) delay line with voltage-dependent, impedance loading on a reflector interdigital transducer (IDT). The load circuit impedance is varied by the capacitance of the voltage-controlled varactor. High resolution is achieved by developing a MOS-capacitor with a thin oxide, low flat-band voltage, and zero-voltage capacitance in the space-charge region, as well as a high-Q-microcoil by thick metal electroplating. Simultaneous monitoring of multiple potentials is realized by time-division-multiplexing of different sensor signals.

Acoustics↗
PubMed2000

[Information technology of diagnostics of the operator's functional status].

Consideration has been given to the theoretical and applied aspects of regulation of the operator's functional state and its impact on work quality from the standpoint of preparation for and implementation of space mission. Determinations of the reflectory and regulatory functions of the operator's state are given and the neurophysiological mechanism of the latter is characterized. Analyzed were fresh methods of controlling the states of healthy persons and patients subjected to psychogenic depression via remote monitoring of voice, motor activity, etc., and recording of electrical indices (EEG, autonomous functions, etc.). Peculiarities of modifications of errors made by human subjects in identification of masked visual images within the "fatigue--negative emotions" range were investigated.

Affect↗
PubMed1997

Patient and surgeon satisfaction with extremity blockade for surgery in remote locations.

In a practice that may be unique to military health care, extremity nerve blocks are established by anesthesiologists before transporting the patient to a remote clinic for surgery without further monitoring by anesthesia personnel. The safety and acceptance of this practice was assessed through a prospective survey of the surgeons and their patients. Six hundred seventy-seven blocks were performed in a 1-yr period with no adverse events related to this practice. Completed surveys were received from 406 (60%) of the surgeons and 232 (34%) of the patients. Of the blocks performed, 638 (94%) were brachial plexus blocks, with axillary blocks accounting for 87% of the brachial plexus blocks. Of the responding patients, 78% stated that they would be willing to undergo a repeat block. The surgeons were satisfied with the operating conditions in 96% of the cases. This study supports the safety and efficacy of this practice.

Adolescent↗
PubMed1988

Patient anesthesia and monitoring at a 1.5-T MRI installation.

This paper describes the facilities successfully used to provide patient monitoring and anesthesia support in a 1.5-T imaging installation. The requirements for the MRI site for anesthetic gases, shielded power, and radiofrequency ports are outlined. Specific modifications in anesthesia machines, anesthesia cart, laryngoscope, mercury sphygmomanometer, oximeter, and remote blood pressure devices are described. Additional aspects of patient monitoring and support, e.g., electrocardiogram and pressure infusion, are also discussed.

Anesthesiology↗
PubMed2000

Interactive television for an urban adult mental health service: the Guy's Psychiatric Intensive Care Unit Telepsychiatry Project.

We carried out a feasibility study of an interactive television (IATV) system to enhance the provision of psychiatric intensive care services to a remote adult acute psychiatric ward in the same National Health Service mental health trust. The system used videoconferencing equipment connected by ISDN at 128 kbit/s. The system was used for patient referral, assessment and monitoring by staff at the remote site 8 km away.

Adult↗
PubMed2000

Orthopedic rehabilitation using the "Rutgers ankle" interface.

A novel ankle rehabilitation device is being developed for home use, allowing remote monitoring by therapists. The system will allow patients to perform a variety of exercises while interacting with a virtual environment (VE). These game-like VEs created with WorldToolKit run on a host PC that controls the movement and output forces of the device via an RS232 connection. Patients will develop strength, flexibility, coordination, and balance as they interact with the VEs. The device will also perform diagnostic functions, measuring the ankle's range of motion, force exertion capabilities and coordination. The host PC transparently records patient progress for remote evaluation by therapists via our existing telerehabilitation system. The "Rutgers Ankle" Orthopedic Rehabilitation Interface uses double-acting pneumatic cylinders, linear potentiometers, and a 6 degree-of-freedom (DOF) force sensor. The controller contains a Pentium single-board computer and pneumatic control valves. Based on the Stewart platform, the device can move and supply forces and torques in 6 DOFs. A proof-of-concept trial conducted at the University of Medicine and Dentistry of New Jersey (UMDNJ) provided therapist and patient feedback. The system measured the range of motion and maximum force output of a group of four patients (male and female). Future medical trials are required to establish clinical efficacy in rehabilitation.

Adult↗
PubMed1997

Managing patient records and documenting service delivery: the results of a 'best practice' remote area nursing program.

This paper describes a 'best practice' demonstration program for monitoring nursing services in remote locations. A four-phase project involving paper- and computer-based patient information systems was implemented at nursing clinics on islands off the coast of Queensland. Patient demographics, diagnoses and details of health service provision were recorded. Results showed a marked improvement in the detail of patient records over the program period. Monitoring of services also provided useful planning and policy information for company management, while a systematic approach to maintaining patient records addressed several medico-legal issues.

Benchmarking↗
PubMed2000

Virtual reality for relearning daily living skills.

The explosive increase in the power of computers has enabled the creation of fast, interactive 3D environments, sometimes called virtual reality (VR). This technology, often associated with arcade games, is increasingly being used for more serious applications. This paper describes research showing transfer of skills from a virtual environment to the real world. We then describe our VR authoring tool and an application to help cognitively impaired individuals relearn important daily living skills. Additionally we describe the development of a prototype networked system to enable a doctor to monitor remotely the rehabilitation of a group of patients.

Activities of Daily Living↗
PubMed2001

Development of a universal connectivity and data management system.

Point-of-care testing (POCT) is an increasingly popular method of delivering laboratory testing. Management of POCT is challenging given the variety of devices, locations, and staff that need to be coordinated to ensure quality results and meet regulatory guidelines. Electronic capture and transfer of data are preferred for managing POCT, but there is currently no standard method of connecting different devices. Johns Hopkins Medical Institutions (JHMI) developed a common data management system with interfaces to all of its POCT devices. All POCT data are collected in one database and analyzed in a similar fashion. Where data were once collected by carrying laptops to each nursing unit, the POCT devices can now connect directly to the database over the Internet. Algorithms have been created to automate the data analysis and review process. Over the several years that this software has been used, JHMI has experienced improved quality, accuracy, and management of its POCT program. The labor saved by increased automation of data review is refocused on enhancing the performance and scope of the program. Current connectivity and analysis algorithms have future application to remote consultation, management of home self-monitoring patients, and examination of real-time data.

Academic Medical Centers↗
PubMed1999

Can computer autoacquisition of medical information meet the needs of the future? A feasibility study in direct computation of the fine grained electronic medical record.

The project describes feasibility testing of a two-year clinical deployment of an electronic record keeping system for primary care medicine that allowed financial medical management and clinical disease study without the encumbrance of human encoding. The software used an expert system for acquisition of historical information and automatic database encoding of each independent fact. The historical acquisition system was combined with a screen-based physician data entry system to create a fine-grained medical record. Fine-grained data allowed direct computer processing to mimic the ends that presently require human encoding--gatekeeping, disease characterization and remote disease surveillance. The project demonstrated the possibility of real time gatekeeping through direct analysis of data. Detection and characterization of disease states using statistical methods within the database was possible, however, limited in this study because of the large numbers of patient interviews required. The possibilities for remote disease monitoring and clinical studies are also discussed.

Chi-Square Distribution↗
PubMed1986

Electrocardiographic monitoring after electrical injury: necessity or luxury.

It has been common practice to perform routine electrocardiographic (EKG) monitoring of electrically burned patients for the first 24 hours following injury. Is this monitoring necessary, or is it a luxury based on remote probabilities? The records of 48 consecutive patients admitted with high-voltage (greater than 1,000 volts) electrical injuries were reviewed with respect to history of a cardiac event in the field, EKG abnormalities on admission, and the presence of cardiac arrhythmias during the first postinjury day. No serious arrhythmias occurred in any patients who had a normal EKG on admission. It was concluded that routine cardiac monitoring after a high-voltage injury should be individualized based on history of loss of consciousness, documentation of an arrythmia, or an abnormal EKG.

Adolescent↗
PubMed2000

A virtual-reality-based telerehabilitation system with force feedback.

A PC-based orthopedic rehabilitation system was developed for use at home, while allowing remote monitoring from the clinic. The home rehabilitation station has a Pentium II PC with graphics accelerator, a Polhemus tracker, and a multipurpose haptic control interface. This novel interface is used to sample a patient's hand positions and to provide resistive forces using the Rutgers Master II (RMII) glove. A library of virtual rehabilitation routines was developed using WorldToolKit software. At the present time, it consists of three physical therapy exercises (DigiKey, ball, and power putty) and two functional rehabilitation exercises (peg board and ball game). These virtual reality exercises allow automatic and transparent patient data collection into an Oracle database. A remote Pentium II PC is connected with the home-based PC over the Internet and an additional video conferencing connection. The remote computer is running an Oracle server to maintain the patient database, monitor progress, and change the exercise level of difficulty. This allows for patient progress monitoring and repeat evaluations over time. The telerehabilitation system is in clinical trails at Stanford Medical School (CA), with progress being monitored from Rutgers University (NJ). Other haptic interfaces currently under development include devices for elbow and knee rehabilitation connected to the same system.

Computer Graphics↗
PubMed1997

Remote stereotactic visualization for image-guided surgery: technical innovation.

Additional data from imaging sources using computer navigation assistance enables virtual visualization of anatomical structures in three dimensions for stereotactic navigation during an operation. Recent developments in communication technology enable the broadcasting not only of video data, but also of stereotactic navigation data via the network. By telepresence/teleconsulting, the composite images and overlapping graphics (instrument, target structure, landmark, contour) can be seen in connected clinics, with the possibility of interactive graphic assistance. In cranio-maxillofacial surgery, the first surgical teleconsultation in real time via telecommunication of stereotactic data was performed in August 1996. A patient suffering from a post-traumatic deformity following multiple comminuted midface fractures was re-osteotomized with the aid of image-guided surgery using teleconsultation: the intraoperative position achieved could be discussed with different surgeons with regard to symmetry, hard/soft tissue relationships and occlusal details, with the possibility of on-screen planning interaction and real time evaluation of the results, over a distance of 500 km.

Computer Graphics↗
PubMed1996

Assessment of a new transtelephonic portable spirometer.

BACKGROUND: A new portable spirometer, the Spirophone, has been developed that records a subject's blow and can then transmit all the data by telephone to a receiving centre for analysis and comment. Tests of this device were undertaken to determine its accuracy and reliability. METHODS: The performance of the Spirophone was tested using computer generated wave forms, by delivering blows from calibrated syringes at different flows, and by comparing subjects' blows with those recorded with a commercial spirometer. RESULTS: Using computer generated wave forms all lung function indices were accurate to within 1% and blows delivered from calibrating syringes were accurate to within 5%. When subjects performed repeated forced vital capacity (FVC) manoeuvres there were no significant differences between lung function indices recorded with the Spirophone and with a commercial spirometer. With the Spirophone and commercial spirometer in series the FVC and forced expiratory volume in one second (FEV1) were within 5% of each other in nine out of 10 healthy subjects. CONCLUSION: The Spirophone recorded maximal forced expiratory manoeuvres with acceptable accuracy, reliability, and reproducibility, and this system offers the ability to monitor a patient's lung function at a centre remote from the patient.

Asthma↗