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At least 145 records · Page 8Linked to original sources

PubMed2003

Biomonitoring with wireless communications.

Wireless biomonitoring, first used in human beings for fetal heart-rate monitoring more than 30 years ago, has now become a technology for remote sensing of patients' activity, blood pulse pressure, oxygen saturation, internal pressures, orthopedic device loading, and gastrointestinal endoscopy. Technical advances in miniaturization and wireless communications have enabled development of monitoring devices that can be made available for general use by individuals/patients and caregivers. New methods for short-range wireless communications not encumbered by radio spectrum restrictions (e.g., ultra-wideband) will enable applications of wireless monitoring without interference in ambulatory subjects, in home care, and in hospitals.

Accidental Falls↗

PubMedDate not supplied

[Computer-assisted monitoring systems. Use of computer networks and internet technologies].

The automated workplace (AWP) of anesthesiologist developed by the early 1990s provided data collection and processing, viewing of all monitors, and printing of anesthesiological chart (AC). AWP is a subject of continuous modification and adaptation to variable conditions. Computer monitoring including various measuring devises equipped with series interface RS-232 was implemented in Russian Research Center for Surgery. Rapid progress in computer network technologies made it necessary to adapt AWP to operation in computer networks. Since 1999 the computer network has been connected to the Internet. The use of computer technologies, including Internet, provides remote access to AC, thereby providing conditions for remote monitoring. AWP of anesthesiologist can be regarded as an automated control system of the patient state operated by anesthesiologist. Specific features of data processing in AWP are described. The AWP system is planed to be multiprocessor with distributed data flow. The suggested structure of computer network system for surgery rooms meeting the requirements of WWW-technology connected to the Internet is a promising approach to remote monitoring in medicine.

Anesthesia↗

PubMed2005

Peristat: a computer-based perimetry self-test for cost-effective population screening of glaucoma.

PURPOSE: Peristat is a virtual perimetry system that allows self-testing on any standard computer monitor via Internet connection. The sensitivity and specificity of Peristat to detect visual-field defects were compared to standard Humphrey Visual Field Analyzer data. MATERIALS AND METHODS: In this prospective, comparative observational case series, 58 eyes of 33 patients were examined. Semiquantitative analyses compared Peristat and Humphrey Visual-Field scores. The study evaluated patients with an established glaucoma diagnosis, as well as glaucoma suspects who had undergone comprehensive ophthalmologic examinations including prior office perimetry evaluation (Humphrey Field Analyzer). Inclusion criteria were (1) diagnosis or suspicion of glaucoma, (2) BCVA better than 20/200, (3) reliable performance on prior standardized office perimetry, and (4) CDR greater than 0.5. Computer literacy was not required, and more than 40% of the patients tested were computer illiterate, with no previous computer or Internet experience. A total of 58 eyes of 33 patients were tested with the Humphrey and the Peristat systems: 10 eyes of 5 patients without documented glaucomatous field loss and 48 eyes of 23 patients with mild-to-severe scotomas by standard 24-2 office perimetry. A standard computer setup was used with a 17" monitor, and the Peristat system was enabled through a remote connection with a server. RESULTS: All patients completed the Peristat test without difficulty. Testing time varied between 2 and 5 min, tending to be longer with more severe visual-field defects. Test results were reviewed, in a masked fashion, by two glaucoma specialists and one general ophthalmologist. The Peristat demonstrated a high degree of correlation with the Humphrey system. Among the three reviewers, sensitivity ranged from 80% to 83%. In a second subanalysis in which cases with mild defects were excluded, the Peristat's sensitivity increased to 84%-86% while specificity remained between 94% and 97% for all three reviewers. Patients performed the Peristat test with similar facility to their Humphrey test. Fixation losses and test reliability were comparable for both tests. CONCLUSIONS: Peristat is a reliable self-test perimetry system that demonstrates high clinical utility for the detection of visual-field defects from glaucoma. Peristat could be a valuable public health tool for cost-effective screening of glaucoma.

Algorithms↗

PubMed1995

Remote telemetry: new twists for old technology.

Availability of telemetry beds was increased cost-effectively by providing telemetry on medical/surgical units with remote monitoring at designated critical care areas. Guidelines were developed for patient selection, education, clinical policy and procedure. A two-hour inservice was completed by all medical/surgical nurses and after a pilot study the system was implemented on three medical/surgical units.

Cost-Benefit Analysis↗

PubMed2004

Innovative technologies offer new tools for DM in rural and underserved areas.

The possibilities presented by teleconferencing equipment and Internet-based applications are well-known, but scientists are now looking at the value of wearable devices that can transmit specific data regarding body functions such as energy intake and expenditure, and even sleep. The idea is to arm diabetics, the chronically obese, and disease managers with the kind of real-time information that can influence lifestyle choices when they really count.

Algorithms↗

PubMed2006

Remote detection of incessant slow VT with an ICD capable of home monitoring.

In this case report, we present a 57-year-old patient who suffered from incessant slow ventricular tachycardia because of a change in therapy 2 weeks after the implantation of an implantable cardioverter defibrillator (ICD) with Home Monitoring (HM). HM is a fully automatic and wireless system capable of transmitting device data including episode counters. The patient had mild symptoms with only short episodes of dizziness and would not have contacted the primary care centre. Due to HM, the arrhythmia was detected before the next routine follow-up, and the patient was seen the next day. HM made it possible to adjust the dosage of the newly established beta-blocker treatment in an outpatient setting and avoid hospitalization. HM yields the potential for remote detection of arrhythmias in ICD recipients, allowing alterations in device programming or medication.

Defibrillators, Implantable↗

PubMed2003

Self-reported compliance of patients receiving antihypertensive treatment: use of a telemonitoring home care system.

Home monitoring of blood pressure and self-reported drug administration were investigated. Fifty hypertensive patients used a home telemonitoring service for a year. An average of 39% reported that they had followed their prescribed drug intake. Long-term treatment effectiveness was measured as the change in the weekly average morning systolic blood pressure (SBP). Sixteen patients showed a decrease in SBP, 21 no change and 13 a rise in SBP. There was a significant relationship between reported drug intake and variation in daily blood pressure. Groups differed in the magnitude of this effect. Compared with other groups, the difference (3.4 mmHg) between morning and evening SBP was greatest (and significant) in the patients whose blood pressure decreased during the study. Self-reported data using remote home monitoring reveals considerable differences in patterns of compliance with prescribed treatment as well as in the effectiveness of the drug regime.

Blood Pressure↗

PubMed2006

A systematic review of the literature on home monitoring for patients with heart failure.

We conducted a systematic review of the literature for assessing the value of home monitoring for heart failure (HF) patients. The abstracts of 383 articles were read. We excluded those in which either no home monitoring was done or only the technical aspects of the telemedicine application were described. Forty-two studies met the selection criteria. We classified the results into feasibility (technical and institutional) and impact (on the clinical process, on patient health, on accessibility and acceptability of the health system, and on the economy). Evaluating the articles showed that home monitoring in HF patients is viable, given that: (1) it appears to be technically effective for following the patient remotely; (2) it appears to be easy to use, and it is widely accepted by patients and health professionals; and (3) it appears to be economically viable. Furthermore, home monitoring of HF patients has been shown to have a positive impact on: (1) the clinical process, supported by a significant improvement of patient follow-up by adjustment of treatment, diet or behaviour, as well as hospital readmissions and emergency visits reduction; (2) the patient's health, supported by a relevant improvement in quality of life, a reduction of days in hospital, and a decrease in mortality; and (3) costs resulting from the use of health resources.

Aged↗

PubMed1995

Postinfarction ventricular arrhythmias in children.

Because limited information is available on significant arrhythmias after myocardial infarction in pediatric patients, this study was performed to determine the incidence and impact of ventricular tachycardia or fibrillation on the postinfarction course in patients aged 1 day to 16 years. Review of 96 such children showed a wide range of underlying heart disease (56 patients with congenital heart disease, 12 with cardiomyopathy, and 28 with acquired heart disease). Postinfarction ventricular tachycardia/fibrillation occurred commonly (28% of patients with acute myocardial infarction) and early (84% by 2 days after diagnosis). Postinfarction mortality was high in patients with acute myocardial infarction (61%) and appeared to be independent of type of associated heart disease. Ventricular tachycardia/fibrillation was associated with higher mortality rates (approximately 80%) in patients with acute or remote myocardial infarction. The 61 postinfarction survivors were monitored for an average of 4.9 years, and none had significant recurrent ventricular arrhythmias or late sudden death.

Adolescent↗

PubMed2002

ED patient's suicide is wake-up call: are you putting psychiatric patients at risk?

Psychiatric patients require expedited care, quiet areas, and other measures to reduce risks. Restraint use can be reduced by having staff attend a training course. Remember that a psychiatric patient's triage status may change, so monitor for worsening agitation or anxiety. Avoid placing psychiatric patients in a remote area, since they need continuous observation.

Emergency Service, Hospital↗

PubMedDate not supplied

[Criteria of effectiveness and ways of enhancement of emergency medical care to newborns in Saratov oblast].

Basic parameters and problems of development of neonatal care in Saratov oblast are presented. Important part of neonatal care system is pediatric reanimation consulting center which functionally combine neonatal service and pediatric sanitary aviation service. Functionality of center includes rendering of consulting care by "Dynar"--system of remote monitoring by anaesthesiologist-reanimatologist, visits to districts of oblast and patient transportation. Center activities and the training of medical workers of maternity departments, situated on all territory of region contributed to decreasing of infant mortality.

Child Health Services↗

PubMedDate not supplied

[Telemedicine and cardiology].

INTRODUCTION: Telecommunications and information technology provide clinical care at distance by means of telemedicine. Hospitals and other health care facilities use medical telemetry devices for monitoring patients' vital signs. These portable devices are used for measuring patient vital signs such as ECG, blood pressure, heart rate, respiration, capnography (CO2) and other important parameters and then transmit these information to a remote location using a nearby receiver. APPLICATION OF TELEMETRY: Eliminating the need for wired connection with the patient, monitors allow, otherwise bedridden patients to be mobile, which shortens the recovery time. Wireless technology is also useful in the emergency care units, because emergency physicians need not leave their patients while consulting a handheld wireless device. This equipment also enables a paramedic to communicate with emergency physicians for early assessment, well before patients' arrive in hospital. TELEMEDICINE: Certain types of medical telemetry devices may be used in home conditions. Telemetry can provide monitoring and home health care services at distance, using advanced telecommunications and information technology in patients with reasonably stable, but a severe, chronic, difficult condition and caring home environment. This information can enable health-care providers to effectively manage treatment without need for acute emergency treatment and hospitalization. CONCLUSION: Hospitals worldwide are under constant pressure to decrease healthcare cost and to improve treatment outcome. Telemedicine and home health care may be one of the solutions for the problem.

Cardiology↗

PubMed2005

The development of a nonintrusive home-based physiologic signal measurement system.

This paper describes the development of a nonintrusive health-monitoring house system that has been developed for monitoring patients' health status. The system functions unobtrusively and leaves patients free to conduct daily activities. Installed sensors and devices in the house monitor biosignals such as bedside electrocardiogram (ECG), snoring, weight, and movement pattern. The network in the house was constructed using asymmetric digital subscriber line (ADSL) and Bluetooth technologies and it is capable of transmitting monitored signals to the remote hospital server through the home server. The system is found to be effective in monitoring patients' daily activity and health status in a nonconstraining manner.

Adult↗

PubMed1991

Remote frozen section service: a telepathology project in northern Norway.

We discuss the organization of a remote frozen section service in northern Norway. The service is operated by remote control of a motorized video-microscope located at Kirkenes Hospital, at a distance of more than 400 km from the workstation at the University Hospital in Tromsø. The video images of the frozen section are transmitted via a two-way telephone and video telenetwork with a 2 Mbit/s capacity. The images are displayed on monitors and diagnosed by pathologists in Tromsø. To date, 17 patients have been examined by remote frozen section. Correct benign versus malignant diagnoses have been given in all 17 cases compared with final diagnoses based on formalin-fixed and paraffin-embedded material. The average time taken for examining each frozen section was 15 minutes (range, 5 to 30 minutes). In none of the cases was the interpretation of the slides difficult due to deficient quality of the video images. For small hospitals with limited availability of local pathology services and for hospitals with a deficiency of specialists, telepathology may be a worthwhile substitute.

Equipment and Supplies, Hospital↗

PubMed2005

Cardiovascular consequences of weightlessness promote advances in clinical and trauma care.

Cardiovascular adaptations driven by exposure to weightlessness cause some astronauts to experience orthostatic intolerance upon return to Earth. Maladaptations of spaceflight that lead to hemodynamic instability are temporary, and therefore astronauts provide for researchers a powerful model to study cardiovascular dysfunction in terrestrial patients. Orthostatic intolerance in astronauts is linked to changes in the autonomic control of cardiovascular function, and so patients that suffer neurocardiogenic syncope may benefit from a greater understanding of the effects of spaceflight on the autonomic nervous system. In addition, appropriate autonomic compensation is fundamental to the maintenance of stable arterial pressures and brain blood flow in patients suffering traumatic bleeding injuries. The application of lower body negative pressure (LBNP), an experimental procedure used widely in aerospace physiology, induces autonomic and hemodynamic responses that are similar to actual hemorrhage and therefore may emerge as a useful experimental tool to simulate hemorrhage in humans. Observations that standing astronauts and severely injured patients are challenged to maintain venous return has contributed to the development of an inspiratory impedance threshold device that serves as a controlled "Mueller maneuver" and has the potential to reduce orthostatic intolerance in returning astronauts and slow the progression to hemorrhagic shock in bleeding patients. In this review, we focus on describing new concepts that have arisen from studies of astronauts, patients, and victims of trauma, and highlight the necessity of developing the capability of monitoring medical information continuously and remotely. Remote medical monitoring will be essential for long-duration space missions and has the potential to save lives on the battlefield and in the civilian sector.

Adaptation, Physiological↗

PubMed1976

The epidemiology of 2056 remote site infections and 1966 surgical wound infections occurring in 1865 patients: a four year study of 40,923 operations at Rush-Presbyterian-St. Luke's Hospital, Chicago.

Over a 4-year period 40,923 operations and 44,716 surgical admissions were monitored for both community and hospital onset infections. One thousand eight hundred sixty-five patients had 1966 surgical wound infections and 2056 remote infections including 1652 hospital onset and 404 community onset infections. One thousand one hudnred forty-four patients with multiple infections averaged 40 days in the hospital contrasted with 24 days for 721 patients with a single wound infection. The total excess cost of hospitalization for these patients was $951,150. A statistically significant reduction occurred for urinary tract infections, lower respiratory infections and clean and contaminated surgical wound infections. It is suggested that these are all inter-related and a significant reduction in surgical wound infections can be achieved through control of infections at remote sites, particularly those associated with medical devices. The coagulase positive staphylococcus is still the most important single bacterial species in the primary etiology of surgical wound infections. When the gastrointestinal tract is entered or "supra" infecting organisms appear, gram negative bacteria and mixed gram negative and gram positive infections are dominant. Reduction in remote site infections occurring in surgical patients is necessary to reduce the incidence of surgical wound infections, suggest preventive and control measures, and document the effectiveness of such measures.

Adolescent↗

PubMedDate not supplied

Bilateral primary choroidal melanoma treated with bilateral plaque radiotherapy: a report of three cases.

PURPOSE: To report three cases of bilateral primary choroidal melanoma treated with bilateral plaque radiotherapy. METHODS: Retrospective, single-center case series. RESULTS: Case 1: In 1981, a 50-year-old man was diagnosed with a 5-mm-thick choroidal melanoma in the right eye (OD) and treated with plaque radiotherapy. In 1994, a 6.8-mm-thick choroidal melanoma in the left eye (OS) was treated with plaque radiotherapy. Final visual acuity was light perception OD and 20/20 OS at 24 years follow-up. Case 2: In 1983, a 53-year-old woman was diagnosed with a 3.5-mm-thick choroidal melanoma OS and treated with plaque radiotherapy. In 2001, an enlarging 2.5-mm-thick choroidal melanoma OD was treated with plaque radiotherapy. Final visual acuity was 20/30 OD and 20/20 OS at 22 years follow-up. Case 3: In 2001, a 92-year-old man was diagnosed with a 7.9-mm-thick choroidal melanoma OD treated with plaque radiotherapy. In 2003, an enlarging 2.8-mm-thick juxtapapillary choroidal melanoma was treated with plaque radiotherapy. Final visual acuity was 20/70 OD and 20/60 OS at 2.5 years follow-up. No patient showed ocular melanocytosis. Stable tumor regression was achieved in all six eyes. Metastatic disease did not develop in any case over 16 years of follow-up. CONCLUSIONS: Monitoring of both eyes of patients with uveal melanoma is important for the remote possibility of melanoma in the second eye. In these three patients, plaque radiotherapy allowed for preservation of the globes and some vision.

Aged, 80 and over↗

PubMed1992

Pediatric chest imaging.

The highlight of recent articles published on pediatric chest imaging is the potential advantage of digital imaging of the infant's chest. Digital chest imaging allows accurate determination of functional residual capacity as well as manipulation of the image to highlight specific anatomic features. Reusable photostimulable phosphor imaging systems provide wide imaging latitude and lower patient dose. In addition, digital radiology permits multiple remote-site viewing on monitor displays. Several excellent reviews of the imaging features of various thoracic abnormalities and the application of newer imaging modalities, such as ultrafast CT and MR imaging to the pediatric chest, are additional highlights.

Child↗