A MATLAB-BASED GUI FOR REMOTE ELECTROOCULOGRAPHY VISUAL EXAMINATION

In this work, a MATLAB-based graphical user interface is proposed for the visual examination of several eye movements. The proposed solution is algorithm-based, which localizes the area of the eye movement, removes artifacts, and calculates the view trajectory in terms of direction and orb deviation. To compute the algorithm, a five-electrode configuration is needed. The goodness of the proposed MATLAB-based graphical user interface has been validated, at the Clinic of Child Neurology of University Hospital of Ostrava, through the EEG Wave Program, which was considered as “gold standard” test. The proposed solution can help physicians on studying cerebral diseases, or to be used for the development of human-machine interfaces useful for the improvement of the digital era that surrounds us today.

HEALTH FAILURE MODE AND EFFECTS ANALYSIS APPLIED TO HOME MECHANICAL VENTILATION

To use home mechanical ventilation, it is necessary to choose the right target group that can benefit from moving to home care. Moving a patient to home care with home mechanical ventilation involves a number of risks. The aim of this study was to use Health Failure Mode and Effects Analysis (HFMEA) to analyse health risks at a time when a patient is just preparing to move to home care, and a nursing plan is being drawn up. HFMEA was used to analyse health risks. The expert team divided the process of nursing care into 7 parts with other own subprocess, which are 18 in total. Altogether, 41 risks were identified, of which 14 failures were analysed after HFMEA application, potential causes were defined, and their follow-up proposed. According to the results of the method used and the analysis of individual risks, it is necessary to focus on detailed setting of the nursing plan with thorough education of informal caregivers who play an important role in it. The education should be regularly repeated and the check of care itself should be supported by created checklists to confirm the individual steps.

PROTECTIVE ASPECTS IN CONTACTLESS INFRARED THERMOGRAPHY FEVER SCREENING

Main symptoms found in patients with same diseases as for example COVID-19 is febrile. The infrared thermography (IRT) represents a fast measurement in case of screening in public places. One of the limitations of IRT is the resolution of sensor, which has close connection with the distance between camera and ROI. To maximize the effectivity of resolution of the camera is to reduce the distance from the object. The aim of presented study showed the possibility how to protect the camera or medical staff that operates the device against potential infection or contamination from the person with infection. Two protective foils of different thickness (40μm; 9μm) were tested as a barrier between the IRT and the ROI (black body model and human face). Even though the results have shown that the transparent foils decrease linearly the measured value of the temperature, it can be used as a protective barrier between IRT and the object if an appropriate recalculation is done during analysis of IRT images. Results are acceptable in the case of 9μm foil especially. The authors see this possibility as a minor concession from IRT standards but as a great help in health protection. The transparent foil can be used as protective barrier of the infrared camera.

OPTIMIZED CONVECTIVE VOLUME IN ONLINE HEMODIAFILTRATION

Hemodiafiltration (HDF) adds convective elimination of middle molecules (MM), proportional to filtered volume (Vconv) on the top of diffusion-based elimination of small molecules (SM) by conventional hemodialysis (HD). Studies, both observational and randomized controlled ones, performed so far generally indicated positive impact of higher Vconv on all-cause mortality in HDF patients, although the magnitude of Vconv at which HDF becomes apparently superior to HD differed widely among the studies. Also the issue of a suitable anthropometric parameter by which the Vconv should be normalized has not yet been solved. Data from the ESHOL study seems to indicate that patient´s body surface area (BSA) could well be used for this—mortality was decreasing with increasing Vconv/BSA with a bottom plateau starting at about 15 L/m2. We have therefore devised a formula and a graph for determination of Vconv which fulfils the requirement Vconv/BSA= 15. Assuming maximum feasible and safe filtration fraction QF/QB= 0.3, the Vconv actually defines the necessary blood flow (QB) to reach Vconv/BSA= 15 as QB=15·BSA/(0.3·t) (t – session time). It is also possible to check what QB is needed in terms of sufficient diffusion-based transport (target Kt/V) and compare both QB values to see if adequate combined elimination of both SM and MM can be achieved at the same time and under what conditions, respectively.

XANTHENE DYES-MEDIATED IN VITRO PHOTODYNAMIC TREATMENT OF CANCER AND NON-CANCER CELL LINES

Rose bengal and erythrosin B are xanthene dyes mainly known and used as antimicrobial agents, but due to their photodynamic activity they are also potential photosensitizers for cancer photodynamic therapy. The aim of this work is to study a photodynamic efficacy of rose bengal and erythrosin B against human skin melanoma and mouse fibroblast cell lines, compare them with each other and find out their photodynamic properties induced by light emitting diodes with total light dose of 5 J/cm2. To fully identify and understand photodynamic properties of both potentially effective photosensitizers, a set of complex in vitro tests such as cell cytotoxic assay, measurement of reactive oxygen species production, mitochondrial membrane potential change assay, mode of cell death determination or comet assay were made. Although both photosensitizers proved to have similar properties such as increasing production of reactive oxygen species with the higher concentration, predominance of necrotic mode of death or genotoxicity, the more effective photosensitizer was rose bengal because its EC50 was over 20 times lower for both cell lines than in case of erythrosin B.

FIRST EXPERIENCE WITH THE USE OF ICF CLASSIFICATION TO EVALUATE PATIENTS WITH PROGRESSIVE NEUROLOGICAL DISEASE IN RESEARCH

Neurological conditions are associated with a high level of disability, which affects the overall quality of life of patients and their integration in society. As the disease progresses, self-sufficiency and mobility gradually deteriorate. These limitations are made easier by the use of appropriate compensatory aids and the modification of the environment. The sample included a total of 56 patients with neurological diseases—Multiple Sclerosis (41), Parkinson’s disease (14), and Amyotrophic Lateral Sclerosis (1). Women prevailed in the sample, accounting for 73%. The average age of the patients in the sample was 59.4, ranging from 38 to 81 years. Clinical forms of the ICF classification (International Classification of Functioning, Disability and Health) were used to record the information on the functional state of the patients. The most information was obtained from the ICF classification component Restrictions on Activities and Participation. The qualifiers of performance and capacity point out the supportive use of assistance (e.g. adjustment of the environment, compensatory aids) to improve the participation in patient’s life. Through a comprehensive evaluation of the patient's functional health using the ICF classification, we can obtain his/her functional profile. This information can be used when planning the nursing and rehabilitation care.

THE USE OF PACEMAKER DIAGNOSTICS FOR SUPPORTING THE ANTICOAGULATION TREATMENT MANAGEMENT

In this work, the analysis of data on atrial fibrillation (AF) burden from dual chamber pacemakers is used for supporting the anticoagulation treatment management. The aim is to evaluate the benefit of basic diagnostic functions to support oral anticoagulation therapy in patients with atrial fibrillation. These patients have increased risk of thromboembolism. If patients have an implanted pacemaker, the device’s diagnostic features monitor the frequency and duration of atrial fibrillation episodes. This data can then be used for further decisions. Statistical data processing was performed on a group of 117 patients with an implanted dual chamber pacemaker. From these results, we evaluated the benefits of the algorithms. In the whole group, a trend was observed in increase of the AF burden between the two monitored periods. The increase of AF burden occurred in 17 patients, while the decrease occurred in 6 patients only. Using simple logic functions, the numbers of patients with different binary values of the presence of AF, the presence of oral anticoagulation therapy, the risk CHA2DS2-VASc score and the values of AF burden were determined. Thus, in the whole group of patients, the diagnostic functions of the implanted devices contributed to the change in oral anticoagulation therapy for 24% of patients.

UPGRADE OF THE LANGENDORFF APPARATUS USING THE INFRARED THERMO-CONTROL SYSTEM AND AN INTELLIGENT HEATER

Biological experiments involving isolated organs and tissues demand precise temperature monitoring and regulation. An automatic temperature control system was proposed and optimised on real isolated swine hearts and the prototype is described in this work. The traditional Langendorff apparatus consists of a heart holder, a reservoir of perfusion solution flowing to aortic cannula and a heating bath allowing passive heat transfer to the reservoir of perfusion solution. The commercial infrared camera FLIR T62101 was added to this basic set-up and used for very precise monitoring of the temperature kinetic of the organ and connected with an electronic feedback loop, which allowed real-time and precise regulation of heat transfer from the heating bath to the perfusion solution and in turn indirectly to the heart tissue. This provides real time control and active regulation of the myocardial tissue temperature. The infrared camera was tested in several modes and several variants of detection were optimised for ideal measurement of the region of interest of the ex vivo organ. The kinetics of the temperature changes and temperature stability of the tissue were recorded and calibrated by external electronic thermometers (type Pt100, inserted in tissue). The time lapse from the hang-up of the hypo termed organ (30 °C) until optimal warming (37 °C) was less than eight minutes in the final instrument prototype. The final stability of the 37 °C tissue temperature was approved; the temperature fluctuation of left ventricle tissue was characterised as 36.8 ± 0.5 °C. This upgraded traditional instrument could be used in specific preclinical and clinical transplantation and analytical projects in future.

USAGE OF ANESTHESIA INFORMATION MANAGEMENT SYSTEMS IN EUROPEAN COUNTRIES IN 2020 – A SHORT SURVEY

The theoretical aspects and benefits of Anesthesia Information Management Systems (AIMS) are well described in literature already. However, certain existing systems are much less researched with most studies concentrating on the USA. In our study, we sent a link to a Google questionnaire to 403 European hospitals and to 382 European authors who have published in the last five years in a renowned anesthesiologic journal. We have not researched AIMS usage in the Czech Republic, as we have covered this topic in our previous study. We asked responders for information on their AIMS (name, vendor, length of use) or to explain why they do not use one. We received 14 responses from the hospitals and 38 responses directly from the authors. With the return rate of 8 per cent we evaluated our study in qualitative terms. Among the 23 respondents that use AIMS there are 12 different systems including two self-developed systems. A number of these systems have not previously been mentioned in the literature. Most use their systems longer than five years but only three respondents are implementing AIMS at the moment. Both these findings show slower progress in this field than in the USA. Typical reasons given from non-users were financial constraints and inability to recognize benefits of AIMS. Incompatibilities with other medical software and medical devices in use were also mentioned. The heterogeneity of AIMS used and perceived barriers corroborate our previous study from the Czech Republic.

COMPARISON OF END-EXPIRATORY LUNG VOLUME MEASUREMENT BY ELECTRICAL IMPEDANCE TOMOGRAPHY AND NITROGEN WASHOUT METHOD IN PIGS

End-expiratory lung volume (EELV) can be determined using several methods that allow clinically accurate measurements, but it is difficult to apply these methods to the patient's bedside. Electrical impedance tomography (EIT) is offered as another method for measuring EELV. The aim of the study is to compare changes in EELV measured by nitrogen washout method with changes of EELV calculated from the change in end-expiratory lung impedance (EELI) measured by EIT and to determine whether changes in EELV calculated from changes in chest impedance can be used as one of the parameters for EIT data analysis and description. The prospective interventional animal study was performed on ten pigs. The animals received total intravenous anesthesia with muscle relaxation. Mechanical lung ventilation was conducted in the volume-controlled mode. 16-electrode EIT system was used for data acquisition. End-expiratory lung volume was measured by a modified nitrogen wash-in/wash-out technique developed by Olegard et al. The study protocol consisted of the baseline phase, two incremental PEEP steps, two decremental PEEP steps and from normal saline i. v. administration. For each animal, a reference frame (baseline frame) was selected from the initial baseline phase and was used for the reconstruction of EIT images and impedance waveforms. For each breath cycle, tidal variation image was calculated as a difference between the end-inspiratory and the previous end-expiratory EIT image. An equivalent end-expiratory volume change (ΔEELVequiv) was calculated from EELI. The values of ΔEELVequiv were compared with reference EELV data measured by a modified nitrogen wash-in/wash-out technique (ΔEELVmeas). The measured and the estimated changes in EELV were statistically compared and correlation between ΔEELVequiv and ΔEELVmeas was calculated. Statistically significant difference between ΔEELVequiv and ΔEELVmeas was observed only in administration of normal saline bolus. Pearson’s correlation coefficients were 0.29 for increase in PEEP, 0.45 for decrease in PEEP and -0.1 during administration of normal saline bolus. The study showed that during changes in PEEP in the porcine model, there was no linear relationship between ΔEELVequiv and ΔEELVmeas. Although there was no linear relationship between ΔEELVequiv and ΔEELVmeas with changes in PEEP, no statistically significant difference was demonstrated between these two methods, which justifies the use of ΔEELVequiv as a parameter suitable for description and evaluation of EIT data.