The Subjective and Objective Monitoring of Sedation

2017 ◽  
pp. 47-67
Author(s):  
Carla Carozzi ◽  
Dario Caldiroli
Keyword(s):  
Objective Monitoring ◽  
Monitoring Of Sedation

scholarly journals Heart rate variability as a strain indicator for psychological stress for emergency physicians during work and alert intervention: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Beatrice Thielmann ◽  
Robert Pohl ◽  
Irina Böckelmann
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Systematic Reviews ◽  
Web Of Science ◽  
Meta Analysis ◽  
Emergency Physicians ◽  
Inclusion Criteria ◽  
Objective Monitoring ◽  
Prisma Statement ◽  
Health Studies

Abstract Background The workloads of emergency physicians are severe. The prevalence of burnout among emergency physicians is higher than with other physicians or compared to the general population. The analysis of heart rate variability (HRV) is a valid method for objective monitoring of workload. The aim of this paper is to systematically evaluate the literature on heart rate variability as an objective indicator for mental stress of emergency physicians. Methods A systematic literature review examining heart rate variability of emergency physicians in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting systematic reviews was performed. PubMed, Ovid, Cochrane Libary, Scopus, and Web of Science electronic databases were used. The methodological quality was evaluated by using a modified STARD for HRV. Results Two studies matched the inclusion criteria by using HRV between alert intervention and two other studies were considered that used HRV in other question areas. It showed an adaptation of HRV under stress. The studies were not comparable. Conclusions There is a need for occupational health studies that examine strains and stress of emergency physicians. The well-established parasympathetic mediated HRV parameters seem to be suitable parameters to objectify the stress.

scholarly journals Objective monitoring of nasal patency and nasal physiology in rhinitis

2005 ◽  
Vol 115 (3) ◽  
pp. S442-S459 ◽  
Author(s):  
R NATHAN ◽  
R ECCLES ◽  
P HOWARTH ◽  
S STEINSVAG ◽  
A TOGIAS
Keyword(s):  
Nasal Patency ◽  
Objective Monitoring ◽  
Nasal Physiology

Characterizing Circulating Nucleosomes in the Plasma of Dogs with Lymphoma

2021 ◽  
Author(s):  
Christopher Dolan ◽  
Tasha Miller ◽  
Jarvis Jill ◽  
Jason Terrell ◽  
Theresa Kelly ◽  
...  
Keyword(s):  
Fold Increase ◽  
Monitoring Tool ◽  
Treatment Results ◽  
Canine Lymphoma ◽  
Histone Octamer ◽  
Objective Monitoring ◽  
Remission Status ◽  
T Cell Lymphomas ◽  
Healthy Dogs ◽  
Multicentric Lymphoma

Abstract Background: Nucleosomes consist of DNA wrapped around a histone octamer core like beads on a string so that DNA can be condensed as chromatin into chromosomes. Diseases such as cancer or inflammation lead to cell death where chromatin is fragmentated and released as mononucleosomes into the blood. The Nu.QTM H3.1 assay measures total nucleosome concentration in plasma of humans and has been used to detect and identify cancer even at early stages. The objectives of this study were to determine if nucleosome levels could be used to distinguish between healthy dogs and dogs with various stages of lymphoma (LSA) using the Nu.Q™ H3.1 assay. A total of 126 dogs diagnosed with LSA and 134 healthy controls were recruited for this study. Plasma was collected from each dog and stored in K2-EDTA tubes. The LSA patient samples were recruited from TAMU or purchased from various biobanks. All control cases were recruited from TAMU. Samples were also collected longitudinally from 3 dogs undergoing treatment for multicentric lymphoma at TAMU as a pilot study to investigate the pattern of nucleosome concentrations in plasma during treatment. Results: Dogs with LSA had an approximately 7-fold increase in their plasma nucleosome concentrations compared to controls (AUC 87.8%). Nucleosome concentrations increased with cancer stage and dogs with B cell lymphomas had significantly higher nucleosome concentrations than dogs with T cell lymphomas. Nucleosome concentrations from serially monitored patients were elevated at diagnosis and progression with subsequent decreases in nucleosome concentration that corresponded to clinically detectable responses to therapy. Conclusions: The Nu.QTM H3.1 assay was able to reliably detect elevated nucleosome concentrations in the plasma of dogs with LSA. Furthermore, it appears that nucleosomes are useful for differentiating cancer from healthy individuals in canines. Results from serially monitored patients indicate that nucleosomes could be an objective monitoring tool for remission status in canine lymphoma patients.

Discontinuing early prophylaxis in severe haemophilia leads to deterioration of joint status despite low bleeding rates

2016 ◽  
Vol 115 (05) ◽  
pp. 931-938 ◽  
Author(s):  
Annelies Nijdam ◽  
Wouter Foppen ◽  
Piet de Kleijn ◽  
Evelien P. Mauser-Bunschoten ◽  
Goris Roosendaal ◽  
...  
Keyword(s):  
Functional Limitations ◽  
Objective Assessment ◽  
Haemophilia A ◽  
Severe Haemophilia ◽  
On Demand ◽  
Recommended Treatment ◽  
Objective Monitoring ◽  
Joint Health ◽  
Observational Cohort

SummaryProphylaxis is the recommended treatment for children with severe haemophilia A, but whether prophylaxis should be continued in adulthood is still under debate. Previous studies with limited follow-up have suggested that some patients may be able to stop prophylaxis in adulthood, while maintaining good joint health. This single-centre observational cohort study examined patients with severe haemophilia A born 1970–1988 without inhibitor development, and assessed the long-term consequences of discontinuing prophylaxis. Patient-initiated changes in prophylaxis, including all switches to on-demand treatment lasting a minimum of two consecutive weeks, were recorded from the time self-infusion began until the last evaluation. Sixty-six patients were evaluated at a median age of 32.4 years: 26 of patients had stopped prophylaxis for a median of 10 years, 15 had interrupted prophylaxis and 59 had continued prophylaxis. Annual joint bleeding rate (AJBR), Haemophilia Joint Health Score (HJHS-2.1; 0–124 points), radiological Pettersson score (0–78 points) and Haemophilia Activities List score (HAL; 100–0 points) were compared between patients who stopped and patients who continued prophylaxis. Although self-reported bleeding rates and functional limitations were similar in both groups (AJBR: 1.5 vs 1.2 and HAL: 84 vs 84 for those who stopped and continued prophylaxis, respectively), objective assessment of joint status showed increased arthropathy after 10 years of on-demand treatment in patients who stopped prophylaxis compared with those who continued (HJHS: 23 vs. 14 and Pettersson: 16 vs 5, respectively; P< 0.01). These results support continuation of long-term prophylaxis in adults and demonstrate the need for objective monitoring of joint status.Trial registration: Dutch Trial Registry number 3098; UTN U1111–1121–7069.

scholarly journals SPECTRAL ENTROPY FOR ASSESSING THE PATIENT RESPONSIVENESS DURING PROPOFOL/FENTANYL SEDATION IN DAY CARE SURGERIES

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr Shalendra Singh ◽  
Dr Priya Taank
Keyword(s):  
Day Care ◽  
Objective Assessment ◽  
Primary Objective ◽  
Sedation Scale ◽  
Depth Of Anaesthesia ◽  
Anesthetic Care ◽  
Mean Values ◽  
Day Care Surgery ◽  
Monitoring Of Sedation ◽  
Care Surgery

Background: For day care surgery under monitored anesthetic care, precise monitoring of sedation depth facilitates optimization of dosage and prevents adverse complications from over sedation. Conventionally subjective sedation scales, such as the Modified observer’s assessment of alertness/ sedation scale (MOAA/S) have been widely utilized for sedation monitoring. The newer monitoring called entropy is considered to be beneficial for objective assessment with combined use of opioids and hypnotics if applied. The primary objective is to determine measurement of entropy as a marker for measuring depth of anaesthesia. Methods: Two groups P and PF ( with 25 patients each) received either propofol 1mg/kg followed by maintenance infusion of 250 mic/ kg/hr whereas “PF”group received additional single dose of fentanyl 2 mic/kg respectively. The values of response entropy (RE) and state entropy (SE) corresponding to each MOAA/S (5 to 0) were determined. Results: The patient’s demographic profile and clinical characteristics were comparable in both the groups. No difference observed in duration of anaesthesia and surgery in both groups. No difference observed in MOAA/S in both groups.  The results shows a highly significant differences in the observed means of SE, RE, MAP and HR with considerably higher mean values in group P (p<0.0001). However other parameter such as SPO2, ETCO2 and RR were almost comparable in both groups. Conclusion: The mean value of SE and RE in group P and PF indicates that deeper plane of anaesthesia is observed in PF group. It is concluded that in assessing the level of hypnosis during intra-operative sedation in MAC, entropy corresponds to MOAA/S and increases or decreases proportionately depending upon increase or decrease level of sedation. Hence from these results it is proposed that entropy monitoring is a reliable monitoring index of anaesthesia depth in MAC. Keywords: Entropy, Propofol, Sedation, Day care surgery, Observer’s assessment of alertness/ sedation scale, Monitored anaesthesia Care

scholarly journals Discrepancies Exist between Exercise Prescription and Dose in Elite Women’s Basketball Pre-Season

Sports ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. 70
Author(s):  
Craig Staunton ◽  
Daniel Wundersitz ◽  
Brett Gordon ◽  
Michael Kingsley
Keyword(s):  
Relative Intensity ◽  
Exercise Intensity ◽  
Exercise Prescription ◽  
Training Session ◽  
Basketball Players ◽  
Warm Up ◽  
Objective Monitoring ◽  
Women's Basketball ◽  
Exercise Dose ◽  
Objectively Measured

This study assessed the influence of exercise prescription on the objectively measured exercise dose in basketball. Intensity (RPE) and volume (sRPE) were prescribed by a professional coach on a drill-by-drill basis during pre-season training for nine elite basketball players. Training drills were classified by prescribed intensity (easy-moderate, moderate-hard, hard–very hard, and very hard-maximal) and type (warm-up, skill-development, offensive- and defensive-technical/tactical, or match-simulation). Exercise intensity was objectively quantified using accelerometry-derived average net force (AvFNet) and time spent in accelerometry-derived relative intensity zones. The volume of exercise (exercise dose) was objectively quantified using accumulated impulse (AvFNet × duration). Relationships between prescribed volume and exercise dose were explored by correlations between sRPE and drill-by-drill accumulation of sRPE (dRPE) with impulse. Very hard-maximal drill intensity was greater than hard-very hard (p = 0.011), but not moderate-hard (p = 0.945). Very hard-maximal drills included the most time performing Supra-maximal intensity (>100% V ˙ O2R) efforts (p < 0.001), suggesting that intensity prescription was based upon the amount of high-intensity exercise. Correlations between impulse with sRPE and dRPE were moderate (r = 0.401, p = 0.197) and very-large (r = 0.807, p = 0.002), respectively, demonstrating that the coach misinterpreted the accumulative effect of drill volume over an entire training session. Overall, a mismatch existed between exercise prescription and exercise dose. Objective monitoring might assist coaches to improve precision of exercise prescription.

scholarly journals Cigarette Smoking Detection with An Inertial Sensor and A Smart Lighter

Sensors ◽  
2019 ◽  
Vol 19 (3) ◽  
pp. 570 ◽  
Author(s):  
Volkan Senyurek ◽  
Masudul Imtiaz ◽  
Prajakta Belsare ◽  
Stephen Tiffany ◽  
Edward Sazonov
Keyword(s):  
Cigarette Smoking ◽  
Inertial Sensor ◽  
Smoking Behavior ◽  
Measurement Unit ◽  
Support Vector ◽  
Svm Classifier ◽  
Free Living ◽  
Objective Monitoring ◽  
In The Wild ◽  
Detection Of Smoking

In recent years, a number of wearable approaches have been introduced for objective monitoring of cigarette smoking based on monitoring of hand gestures, breathing or cigarette lighting events. However, non-reactive, objective and accurate measurement of everyday cigarette consumption in the wild remains a challenge. This study utilizes a wearable sensor system (Personal Automatic Cigarette Tracker 2.0, PACT2.0) and proposes a method that integrates information from an instrumented lighter and a 6-axis Inertial Measurement Unit (IMU) on the wrist for accurate detection of smoking events. The PACT2.0 was utilized in a study of 35 moderate to heavy smokers in both controlled (1.5–2 h) and unconstrained free-living conditions (~24 h). The collected dataset contained approximately 871 h of IMU data, 463 lighting events, and 443 cigarettes. The proposed method identified smoking events from the cigarette lighter data and estimated puff counts by detecting hand-to-mouth gestures (HMG) in the IMU data by a Support Vector Machine (SVM) classifier. The leave-one-subject-out (LOSO) cross-validation on the data from the controlled portion of the study achieved high accuracy and F1-score of smoking event detection and estimation of puff counts (97%/98% and 93%/86%, respectively). The results of validation in free-living demonstrate 84.9% agreement with self-reported cigarettes. These results suggest that an IMU and instrumented lighter may potentially be used in studies of smoking behavior under natural conditions.

scholarly journals iRECIST: how to do it

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Thorsten Persigehl ◽  
Simon Lennartz ◽  
Lawrence H. Schwartz
Keyword(s):  
Working Group ◽  
Checkpoint Inhibitors ◽  
Therapy Response ◽  
Response Assessment ◽  
Main Body ◽  
Response Patterns ◽  
Objective Monitoring ◽  
Oncologic Patients ◽  
Cytotoxic Therapies ◽  
Near Future

Abstract Background iRECIST for the objective monitoring of immunotherapies was published by the official RECIST working group in 2017. Main body Immune-checkpoint inhibitors represent one of the most important therapy advancements in modern oncology. They are currently used for treatment of multiple malignant diseases especially at advanced, metastatic stages which were poorly therapeutically accessible in the past. Promising results of recent studies suggest that their application will further grow in the near future, particularly when used in combination with chemotherapy. A challenging aspect of these immunotherapies is that they may show atypical therapy response patterns such as pseudoprogression and demonstrate a different imaging spectrum of adverse reactions, both of which are crucial for radiologists to understand. In 2017 the RECIST working group published a modified set of response criteria, iRECIST, for immunotherapy, based on RECIST 1.1 which was developed for cytotoxic therapies and adapted for targeted agents. Conclusion This article provides guidance for response assessment of oncologic patients under immunotherapy based on iRECIST criteria.

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