clinical monitoring
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2022 ◽  
Vol 28 (2) ◽  
Author(s):  
Ho Quang Chanh ◽  
Huynh Trung Trieu ◽  
Huynh Ngoc Thien Vuong ◽  
Tran Kim Hung ◽  
Tu Qui Phan ◽  
...  
Keyword(s):  

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Casey Ward ◽  
Jon S. Odorico ◽  
Michael R. Rickels ◽  
Thierry Berney ◽  
George W. Burke ◽  
...  

2022 ◽  
pp. 341-359
Author(s):  
Aymen Awad Alian ◽  
Kirk H. Shelley
Keyword(s):  

2021 ◽  
Author(s):  
Anisbed Naranjo Rojas ◽  
Guillermo Molina-Recio ◽  
Luis Angel Perula-de-torres

BACKGROUND Patients with chronic respiratory diseases require oxygen supply in a considerable amount to reduce their symptoms and increase their survival. The development of abilities for the self-management of chronic diseases has been shown to be essential to decrease exacerbation of symptoms. Therefore, the design and development of health mobile applications (apps) that aid in educating and training for disease self-management are cost-effective strategies. OBJECTIVE The purpose of this research was to describe the main characteristics that, according to final users, should be included in a mobile application for monitoring patients prescribed home oxygen therapy. METHODS A participative-qualitative design was used, involving direct participation of patients, caregivers, and healthcare professionals. Focus groups were conducted to identify the needs and perspectives related to the app. A card sorting method was used to determine the contents and basic architecture of the app. RESULTS By means of the focus groups, we could identify nine basic functions of the app for the clinical monitoring of patients under home oxygen therapy. For both profiles, the app structure was determined by identifying the most frequent contents among participants. CONCLUSIONS The implementation of a user-centered design allowed for the detection of the functions, contents, and basic architecture of the app by identifying healthcare professionals and patients’ needs and preferences regarding the self-management and monitoring of home oxygen prescriptions. CLINICALTRIAL Trial Registration: The study is registered in ClinicalTrials.gov: NCT04820790


Sensors ◽  
2021 ◽  
Vol 21 (22) ◽  
pp. 7457
Author(s):  
Liujie Chen ◽  
Tan Xiao ◽  
Ching Tai Ng

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep disorder characterized by repeated pharyngeal collapse with partial or complete obstruction of the upper airway. This study investigates the biomechanics of upper airway collapse of OSASH patients during natural sleep. Computerized tomography (CT) scans and data obtained from a device installed on OSASH patients, which is comprised of micro pressure sensors and temperature sensors, are used to develop a pseudo three-dimensional (3D) finite element (FE) model of the upper airway. With consideration of the gravity effect on the soft palate while patients are in a supine position, a fluid–solid coupling analysis is performed using the FE model for the two respiratory modes, eupnea and apnea. The results of this study show that the FE simulations can provide a satisfactory representation of a patient’s actual respiratory physiological processes during natural sleep. The one-way valve effect of the soft palate is one of the important mechanical factors causing upper airway collapse. The monitoring data and FE simulation results obtained in this study provide a comprehensive understanding of the occurrence of OSAHS and a theoretical basis for the individualized treatment of patients. The study demonstrates that biomechanical simulation is a powerful supplementation to clinical monitoring and evaluation.


Author(s):  
Alexander F. C. Hulsbergen ◽  
Francesca Siddi ◽  
Malia McAvoy ◽  
Benjamin T. Lynch ◽  
Madeline B. Karsten ◽  
...  

OBJECTIVE Postoperative routine imaging is common after pediatric ventricular shunt revision, but the benefit of scanning in the absence of symptoms is questionable. In this study, the authors aimed to assess how often routine scanning results in a change in clinical management after shunt revision. METHODS The records of a large, tertiary pediatric hospital were retrospectively reviewed for all consecutive cases of pediatric shunt revision between July 2013 and July 2018. Postoperative imaging was classified as routine (i.e., in the absence of symptoms, complications, or other direct indications) or nonroutine. Reinterventions within 30 days were assessed in these groups. RESULTS Of 387 included shunt revisions performed in 232 patients, postoperative imaging was performed in 297 (77%), which was routine in 244 (63%) and nonroutine in 53 (14%). Ninety revisions (23%) underwent any shunt-related procedure after postoperative imaging, including shunt reprogramming (n = 35, 9%), shunt tap (n = 10, 3%), and a return to the operating room (OR; n = 58, 15%). Of the 244 cases receiving routine imaging, 241 did not undergo a change in clinical management solely based on routine imaging findings. The remaining 3 cases returned to the OR, accounting for 0.8% (95% CI 0.0%–1.7%) of all cases or 1.2% (95% CI 0.0%–2.6%) of cases that received routine imaging. Furthermore, 27 of 244 patients in this group returned to the OR for other reasons, namely complications (n = 12) or recurrent symptoms (n = 15); all arose after initial routine imaging. CONCLUSIONS The authors found a low yield to routine imaging after pediatric shunt revision, with only 0.8% of cases undergoing a change in management based on routine imaging findings without corresponding clinical findings. Moreover, routine imaging without abnormal findings was no guarantee of an uneventful postoperative course. Clinical monitoring can be considered as an alternative in asymptomatic, uncomplicated patients.


2021 ◽  
Vol 24 (8) ◽  
pp. 246
Author(s):  
Francesca Romano ◽  
Lorenza Rossi ◽  
Irene Raffaldi ◽  
Davide Garelli ◽  
Virna carmellino ◽  
...  

Viper bites are rare but represent a medical emergency that should not be underestimated both in the paediatric and adult population. The clinical presentation can vary from mild symptoms limited to the venom inoculation site to serious cases with extensive tissue involvement and with systemic neurological, haematologic, renal and cardiovascular symptoms. Immediate hospitalization with clinical monitoring is required to promptly undertake the therapy with antivenom serum, when needed, in order to avoid complications related to the venom’s toxicity. In the literature there are no recent and standardised guidelines on viper bite management and treatment. The paper presents a case-series of four children brought to the Emergency Department for viper bite. The peculiarity of the reported cases is that they were all observed in the first 20 days of May 2020, immediately after the end of the lockdown for Covid-19 pandemic. This could be explained by the effect of prolonged lockdown on animal and viper re-expansion in areas with usually larger human presence. The aim of this article is to present the latest literature updates and provide clear and simple indications for the diagnosis, monitoring and therapy of paediatric viper bite to improve its management and prognosis.


2021 ◽  
Vol 11 (11) ◽  
pp. 1101
Author(s):  
Daniel G. E. Thiem ◽  
Paul Römer ◽  
Sebastian Blatt ◽  
Bilal Al-Nawas ◽  
Peer W. Kämmerer

In reconstructive surgery, free flap failure, especially in complex osteocutaneous reconstructions, represents a significant clinical burden. Therefore, the aim of the presented study was to assess hyperspectral imaging (HSI) for monitoring of free flaps compared to clinical monitoring. In a prospective, non-randomized clinical study, patients with free flap reconstruction of the oro-maxillofacial-complex were included. Monitoring was assessed clinically and by using hyperspectral imaging (TIVITA™ Tissue-System, DiaspectiveVision GmbH, Pepelow, Germany) to determine tissue-oxygen-saturation [StO2], near-infrared-perfusion-index [NPI], distribution of haemoglobin [THI] and water [TWI], and variance to an adjacent reference area (Dreference). A total of 54 primary and 11 secondary reconstructions were performed including fasciocutaneous and osteocutaneous flaps. Re-exploration was performed in 19 cases. A total of seven complete flap failures occurred, resulting in a 63% salvage rate. Mean time from flap inset to decision making for re-exploration based on clinical assessment was 23.1 ± 21.9 vs. 18.2 ± 19.4 h by the appearance of hyperspectral criteria indicating impaired perfusion (StO2 ≤ 32% OR StO2Dreference > −38% OR NPI ≤ 32.9 OR NPIDreference ≥ −13.4%) resulting in a difference of 4.8 ± 5 h (p < 0.001). HSI seems able to detect perfusion compromise significantly earlier than clinical monitoring. These findings provide an interpretation aid for clinicians to simplify postoperative flap monitoring.


2021 ◽  
Author(s):  
Matteo Dora ◽  
David holcman

Objective: Electroencephalography (EEG) has become very common in clinical practice due to its relatively low cost, ease of installation, non-invasiveness, and good temporal resolution. Portable EEG devices are increasingly popular in clinical monitoring applications such as sleep scoring or anesthesia monitoring. In these situations, for reasons of speed and simplicity only few electrodes are used and contamination of the EEG signal by artifacts is inevitable. Visual inspection and manual removal of artifacts is often not possible, especially in real-time applications. Our goal is to develop a flexible technique to remove EEG artifacts in these contexts with minimal supervision. Methods: We propose here a new wavelet-based method which allows to remove artifacts from single-channel EEGs. The method is based on a datadriven renormalization of the wavelet components and is capable of adaptively attenuate artifacts of different nature. We benchmark our method against alternative artifact removal techniques. Results: We assessed the performance of the proposed method on publicly available datasets comprising ocular, muscular, and movement artifacts. The proposed method shows superior performances on different kinds of artifacts and signal-to-noise levels. Finally, we present an application of our method to the monitoring of general anesthesia. Conclusions: We show that our method can successfully attenuate various types of artifacts in single-channel EEG. Significance: Thanks to its data-driven approach and low computational cost, the proposed method provides a valuable tool to remove artifacts in real-time EEG applications with few electrodes, such as monitoring in special care units.


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