scholarly journals Multimodal nocturnal seizure detection in a residential care setting

Neurology ◽  
2018 ◽  
Vol 91 (21) ◽  
pp. e2010-e2019 ◽  
Author(s):  
Johan Arends ◽  
Roland D. Thijs ◽  
Thea Gutter ◽  
Constantin Ungureanu ◽  
Pierre Cluitmans ◽  
...  
Keyword(s):  
Heart Rate ◽  
Care Setting ◽  
Interobserver Agreement ◽  
False Negative ◽  
Seizure Detection ◽  
Device Performance ◽  
Upper Arm ◽  
Reliable Detection ◽  
Residential Care Setting ◽  
Nocturnal Seizures

ObjectiveTo develop and prospectively evaluate a method of epileptic seizure detection combining heart rate and movement.MethodsIn this multicenter, in-home, prospective, video-controlled cohort study, nocturnal seizures were detected by heart rate (photoplethysmography) or movement (3-D accelerometry) in persons with epilepsy and intellectual disability. Participants with >1 monthly major seizure wore a bracelet (Nightwatch) on the upper arm at night for 2 to 3 months. Major seizures were tonic-clonic, generalized tonic >30 seconds, hyperkinetic, or others, including clusters (>30 minutes) of short myoclonic/tonic seizures. The video of all events (alarms, nurse diaries) and 10% completely screened nights were reviewed to classify major (needing an alarm), minor (needing no alarm), or no seizure. Reliability was tested by interobserver agreement. We determined device performance, compared it to a bed sensor (Emfit), and evaluated the caregivers’ user experience.ResultsTwenty-eight of 34 admitted participants (1,826 nights, 809 major seizures) completed the study. Interobserver agreement (major/no major seizures) was 0.77 (95% confidence interval [CI] 0.65–0.89). Median sensitivity per participant amounted to 86% (95% CI 77%–93%); the false-negative alarm rate was 0.03 per night (95% CI 0.01–0.05); and the positive predictive value was 49% (95% CI 33%–64%). The multimodal sensor showed a better sensitivity than the bed sensor (n = 14, median difference 58%, 95% CI 39%–80%, p < 0.001). The caregivers' questionnaire (n = 33) indicated good sensor acceptance and usability according to 28 and 27 participants, respectively.ConclusionCombining heart rate and movement resulted in reliable detection of a broad range of nocturnal seizures.

Normative Arm and Calf Blood Pressure Values in the Newborn

PEDIATRICS ◽  
1989 ◽  
Vol 83 (2) ◽  
pp. 240-243
Author(s):  
Myung K. Park ◽  
Da-Hae Lee
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mexican Americans ◽  
Newborn Infants ◽  
Coarctation Of The Aorta ◽  
Upper Arm ◽  
Mean Values ◽  
The Right ◽  
Diagnosis Of Hypertension ◽  
Mean Heart Rate

Indirect BP measurement was obtained in the right upper arm in 219 healthy newborn infants with the Dinamap monitor and was compared with values obtained from the calf to establish normative BP values and to help establish a diagnosis of hypertension and coarctation of the aorta in the newborn. There were 174 Mexican-Americans (79.5%), 33 whites (15.0%), and 12 blacks (5.5%). The width of the BP cuff was selected to be 0.4 to 0.5 times the circumference of the extremities. Three supine position readings of BPs and heart rate were obtained from each site and were averaged for statistical analyses. Mean arm BP values (±SD) of the neonate less than 36 hours of age were 62.6±6.9/38.9± 5.7 mm Hg (48.0±6.2 mm Hg). Neonates older than 36 hours had slightly but significantly (P&lt;.05) greater values (4 to 6 mm Hg) than did infants younger than 36 hours of age. Active neonates had values 6 to 10 mm Hg greater than quiet neonates (P&lt;.05). BP values in the calf obtained with the same-sized cuff were almost identical with those obtained from the arm. Differences in consecutively obtained arm and calf BPs (arm values minus calf values) were 1.1±7.7 mm Hg systolic, -0.01 ± 6.2 mm Hg diastolic, and 0.9 ±6.9 mm Hg mean pressures. Mean heart rate (±SD) of neonates less than 36 hours of age was 129.4± 13.2 beats per minute and that of neonates older than 36 hours of age was 139.4± 14.1 beats per minute. These results show the following: (1) arm BPs and calf BPs using the same-sized cuff are almost identical with mean values of approximately 65/ 41 mm Hg (50 mm Hg) in neonates one to three days of age, (2) arm BP of 75/49 mm Hg (59 mm Hg) or greater is in the hypertensive range, and (3) calf BPs that are less than arm BPs by mean + 1 SD (6 to 9 mm Hg) necessitate a thorough investigation for coarctation of the aorta.

scholarly journals A quasi-experimental evaluation of compliant flooring in a residential care setting

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0201290 ◽  
Author(s):  
Johanna Gustavsson ◽  
Carl Bonander ◽  
Finn Nilson
Keyword(s):  
Residential Care ◽  
Experimental Evaluation ◽  
Care Setting ◽  
Quasi Experimental ◽  
Residential Care Setting

Seizure detection using heart rate variability: A prospective validation study

Epilepsia ◽  
2020 ◽  
Vol 61 (S1) ◽  
Author(s):  
Jesper Jeppesen ◽  
Anders Fuglsang‐Frederiksen ◽  
Peter Johansen ◽  
Jakob Christensen ◽  
Stephan Wüstenhagen ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Validation Study ◽  
Seizure Detection

Five New Things: Seizure Detection Devices

2021 ◽  
pp. 10.1212/CPJ.0000000000001044
Author(s):  
Alexandra Carrick Atwood ◽  
Cornelia Natasha Drees
Keyword(s):  
Heart Rate ◽  
Motion Detection ◽  
Electrodermal Activity ◽  
False Positive Rate ◽  
Seizure Detection ◽  
Mechanisms Of Action ◽  
Unexpected Death ◽  
Positive Rate ◽  
Convulsive Seizures ◽  
Electroencephalogram Eeg

ABSTRACT:Purpose: The purpose of this paper is to review seizure detection devices, their mechanisms of action, efficacy and reflecting upon potential improvements for future devices.Recent Findings: There are five main categories of seizure detection devices ([email protected]), these include electroencephalogram (EEG), heart rate detection (HR), electrodermal activity (EDA), motion detection and electromyography (EMG). These devices can be used in combination or in isolation to detect seizures. These devices are high in their sensitivity for convulsive seizures, but low in specificity because of a tendency to detect artifact. Overall, they perform poorly identifying non-convulsive seizures.Summary: Seizure detection devices are currently most useful in detecting convulsive seizures and thereby might help against sudden unexpected death in epilepsy (SUDEP), though they have a high false positive rate. These devices are much less adept at detecting more clinically subtle seizures.

scholarly journals Risk factors for a positive SARS-CoV-2 PCR in patients with common cold symptoms in a primary care setting – a retrospective analysis based on a joint documentation standard

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Johannes Just ◽  
Marie-Therese Puth ◽  
Felix Regenold ◽  
Klaus Weckbecker ◽  
Markus Bleckwenn
Keyword(s):  
Primary Care ◽  
Common Cold ◽  
Odds Ratio ◽  
Care Setting ◽  
Primary Care Setting ◽  
False Negative ◽  
First Grade ◽  
Cross Sectional ◽  
Policy Makers ◽  
Primary Care Patients

Abstract Background Combating the COVID-19 pandemic is a major challenge for health systems, citizens and policy makers worldwide. Early detection of affected patients within the large and heterogeneous group of patients with common cold symptoms is an important element of this effort, but often hindered by limited testing resources, false-negative test results and the lack of pathognomonic symptoms in COVID-19. Therefore, we aimed to identify anamnestic items with an increased/decreased odds ratio for a positive SARS-CoV-2 PCR (CovPCR) result in a primary care setting. Methods We performed a multi-center cross-sectional cohort study on predictive clinical characteristics for a positive CovPCR over a period of 4 weeks in primary care patients in Germany. Results In total, 374 patients in 14 primary care centers received CovPCR and were included in this analysis. The median age was 44.0 (IQR: 31.0–59.0) and a fraction of 10.7% (n = 40) tested positive for COVID-19. Patients who reported anosmia had a higher odds ratio (OR: 4.54; 95%-CI: 1.51–13.67) for a positive test result while patients with a sore throat had a lower OR (OR: 0.33; 95%-CI: 0.11–0.97). Furthermore, patients who had a first grade contact with an infected persons and showed symptoms themselves also had an increased OR for positive testing (OR: 5.16; 95% CI: 1.72–15.51). This correlation was also present when they themselves were still asymptomatic (OR: 12.55; 95% CI: 3.97–39.67). Conclusions Several anamnestic criteria may be helpful to assess pre-test probability of COVID-19 in patients with common cold symptoms.

Accuracy of Heart Rate and Energy Expenditure Estimations of Wrist-Worn and Arm-Worn Apple Watches

2019 ◽  
Vol 2 (3) ◽  
pp. 166-175
Author(s):  
Kayla J. Nuss ◽  
Joseph L. Sanford ◽  
Lucas J. Archambault ◽  
Ethan J. Schlemer ◽  
Sophie Blake ◽  
...  
Keyword(s):  
Heart Rate ◽  
Energy Expenditure ◽  
Exercise Bout ◽  
Criterion Measure ◽  
Maximal Exercise Test ◽  
Upper Arm ◽  
Entire Sample ◽  
Metabolic Cart ◽  
Vigorous Intensity ◽  
Absolute Percent Error

Background: The purpose of this study was to examine the accuracy of heart rate (HR) and energy expenditure (EE) estimated by the Apple Watch Series 1 worn both on the wrist and the upper arm. Methods: Thirty healthy, young adults (15 females) wore the two monitors while participating in a maximal exercise test. Criterion measures were obtained from the Parvo Medics TrueOne 2400 Metabolic Cart and an electrocardiograph. Results: The HR estimations of the arm-worn (AW) Apple Watch had the highest agreement with the electrocardiogram, with mean absolute percent error (MAPE) of <2.5% for the entire sample, for males, and for females, at all exercise intensities. The HR estimations of the wrist-worn Apple Watch had MAPEs ranging from 3.61% (females at very light intensity) to 14.97% (males at very vigorous intensity). When estimating EE for total exercise bout in the entire sample, the arm-worn Apple Watch overestimated EE, with a MAPE of 39.63%, whereas the wrist-worn underestimated EE, with a MAPE of 32.28%. Both the arm- and wrist-worn overestimated EE for females and underestimated EE for males. Conclusion: Wearing the Apple Watch Series 1 on the upper arm versus the wrist improves the MAPE for HR estimations, but does not improve MAPE for the EE calculations when compared to a criterion measure.

Use of Clinical Triage Criteria Decreases Monitored Care Bed Utilization in Gallstone Pancreatitis

2010 ◽  
Vol 76 (10) ◽  
pp. 1147-1149 ◽  
Author(s):  
Arezou Yaghoubian ◽  
Armen Aboulian ◽  
Tony Chan ◽  
Brandon Ishaque ◽  
Dina Wallin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Blood Urea Nitrogen ◽  
Care Setting ◽  
Gallstone Pancreatitis ◽  
Urea Nitrogen ◽  
Period 2 ◽  
Step Down ◽  
Ranson Score

Admission indicators for monitored care in gallstone pancreatitis have been lacking. Recently, we established three criteria for admission to intensive care unit or step down versus ward beds: 1) concomitant cholangitis, 2) heart rate > 110 beats/min, and 3) blood urea nitrogen > 15 mg/dL. The purpose of this study was to determine whether these criteria would be effective in decreasing monitored care bed utilization without adversely affecting outcomes. A retrospective review of all patients with gallstone pancreatitis at a public teaching hospital was performed (2003-2009). A comparison was made of patients before (2003-2005, Period 1) and after (2006-2009, Period 2) establishment of monitored care triage criteria. Over the study period, there were 379 patients. The median Ranson score for both periods was 1. The median ages were 41 and 39, ( P = 0.7). In Period 1, 28 per cent of patients were admitted to the intensive care unit/step down unit versus 12 per cent in Period 2. None of the patients required transfer from the ward to a monitored care setting in Period 2. There were no mortalities in either period. In conclusion, the presence of concomitant cholangitis, heart rate >110, and blood urea nitrogen > 15 are useful and safe triage criteria for admission to a monitored care setting. Use of these criteria significantly decreased monitored care bed utilization and resulted in fewer mis-triages without adversely affecting patient outcomes.

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