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PubMed2003

Accessibility of blood glucose monitoring systems for blind and visually impaired people.

Blindness and visual impairment are prevalent among people with diabetes. Blood glucose monitoring systems (BGMSs) have revolutionized diabetes care, but none of the 30 or so commercially available monitoring systems was designed to be fully accessible to blind and visually impaired persons. Seventeen BGMSs were evaluated for accessible use by people who are blind or visually impaired. Features and functionalities (e.g., operating procedures, user interface design, device specifications, and computer interface capabilities) were examined and tabulated, as was usability and accessibility. A subset of these systems with the highest degree of accessibility was selected and thoroughly examined and tested. Additionally, 12 people who are blind or visually impaired and who were issued BGMSs by their physician or diabetes educator were interviewed and videotaped using their meters. Of the 17 BGMSs, only four had voice output capability, an essential component of accessibility for blind and visually impaired persons. The six BGMSs without voice output that had the largest display fonts were found to have few accessibility features for visually impaired persons. Users indicated that voice output and portability were desired attributes of an accessible BGMS. None of the BGMSs evaluated had all of the required accessibility attributes, including the four systems that had voice output capability. The four systems with voice output were much bulkier and heavier than those that did not have this capability. Recommendations are made for design and development of BGMSs that would increase effective usage by blind and visually impaired persons, including integrating text to speech and streamlining the blood glucose monitoring process.

Blindness↗
PubMedDate not supplied

Method for estimating confidence levels for measurements by blood glucose monitoring systems.

A joint conference on self-monitoring of blood glucose (SMBG) has proposed that all glucose monitoring systems generate values that are within 10% of the actual blood glucose level 100% of the time. To estimate the confidence limits of blood glucose measurements made in a typical university ambulatory care setting and to ascertain whether they met the proposed standard, we performed duplicate determinations of blood glucose using a reflectance meter and applied to the measurements a method for calculating the closeness of measured values to a "true" mean. Based on paired measurements in 100 consecutive diabetic subjects, we were able to show that one measurement would be within 11.9% of a true mean value 95% of the time and within 8.4% of the mean 90% of the time. The 95 and 90% confidence limits for the average of two repeated measurements were calculated to be 8.4 and 5.9%, respectively. Our methodology can be applied to any set of SMBG values to calculate their confidence limits and to determine whether the measurements meet recommended standards.

Blood Glucose Self-Monitoring↗
PubMed2005

Optimal timing for postprandial glucose measurement in pregnant women with diabetes and a non-diabetic pregnant population evaluated by the Continuous Glucose Monitoring System (CGMS).

OBJECTIVE: Using the Continuous Glucose Monitoring System (CGMS; Medtronic Minimed) for a group of pregnant women with and without glucose intolerance, we attempted to answer the following questions: (1) when does the physiological peak of postprandial glucose occur?; (2) do non-diabetic pregnant women and pregnant women with diabetes have different postprandial glucose profiles?; and (3) what is the optimal time for postprandial glucose measurement rated according to clinical outcome? METHODS: We included 53 pregnant women in our study. Based on the criteria of the German Diabetes Association (fasting, 5.0 mmol/L; 1-h, 10.0 mmol/L; 2-h, 8.6 mmol/L) we included 13 women with gestational diabetes, four with type 1 diabetes and 36 non-diabetic pregnant (NDP) women. Gestational and type 1 diabetics were classed as one group: pregnancy complicated by diabetes (PCD). Patients with carbohydrate intolerance underwent dietary counseling in accordance with the recommendations of the American Diabetes Association. Patients received a CGMS for use over 72 h. This was calibrated seven times a day with an Accu-Check. The pre- and postprandial glucose levels were documented at 15-min intervals for 3 h from the beginning of each meal. The postprandial data from the three meals were added. The group was divided according to three clinical outcome parameters: mode of delivery, birth weight percentile, and diabetes-associated complications. RESULTS: Statistically significant differences between groups were found for body mass index, fetal birth weight and oral glucose tolerance test. No significant differences were found for age, parity and gestational age, mode of delivery, and diabetes-associated complications. The sensor provided similar numbers of measurements in both groups (278+/-43 vs. 298+/-73, P = 0.507). The postprandial glucose peak was reached after 82+/-18 min in the non-diabetics vs. 74+/-23 min in the PCD group (not significant). Postprandial glucose values were normally slightly higher in PCD (not significant). We added the postprandial glucose values at each time interval for the three meals for each day. For the sum, there was a significant difference between the measurements at 120 min and at 135 min postprandial (P < 0.05). Dividing the group by clinical outcome showed a significant difference between the postprandial time intervals of 75 min and 105 min (P < 0.05). In addition, the time interval was different from 60 min to 135 min for the mode of delivery and birth weight percentile (P < 0.05). CONCLUSION: The 120-min interval is too long and has a lower correlation to clinical outcome parameters than earlier measurements. Our findings show that the optimal time for testing is between 45 and 120 min postprandial. Based on our practical experience and dietary recommendations, we would prefer a 60-min interval, because patients can calculate this more easily and can have more freedom to eat the recommended number of snacks.

Adult↗
PubMed1987

Monitoring system for adverse events following immunization.

The Monitoring System for Adverse Events Following Immunization (MSAEFI) has collected data from the public sector nationwide on adverse events occurring during the 4-week period following administration of vaccine. From 1979 to 1984, 6483 reports were received. Although rates of reporting have increased throughout the 6-year period, increases were larger for less serious events (209%) than for more serious events (53%). The MSAEFI data have been used to evaluate risk factors for adverse events following immunization, will continue to provide information on the safety of both current and future vaccines and may identify other factors that increase the risks of adverse events following immunization.

Centers for Disease Control and Prevention, U.S.↗
PubMed2001

[Is measuring the depth of anesthesia sensible? An overview on the currently available monitoring systems].

Without any doubt there is an increasing need for accurately measuring depth of anesthesia - from the viewpoint of the anesthesiologist and also of the patient. The ideal monitoring should fulfill the following criteria: It should be applicable for any type of anesthesia (intravenous as well as inhalative anesthesia); the monitor must have an extremely high sensitivity (each patient being awake must be recognized by the device).If the monitor does not have a high sensitivity, the monitor itself might lead to an increasing number of patients being awake during anaesthesia, because the anesthesiologist might rely on the monitor and does not deepen anesthesia while the patient is awake. Specificity is not as important as sensitivity. As incidence of interoperative awareness is low, one must monitor more than 750 patients to recognize only one patient who is awake. Finally, the monitoring device must be economic. If costs are considerably increased by measuring depth of anesthesia in today's climate of cost consciousness, the monitoring has to be restricted to special high risk groups of patients. If monitoring depth of anesthesia will become simple, safe, and economic, each anesthesia should be monitored for its depth, as today each patient needs pulseoxymetry. We try to give an orientation about the available devices for monitoring depth of anesthesia. Since the introduction of BIS interest in measuring depth of anesthesia is growing very dynamically. Due to the dynamic growth we hope that we were able to present an actual and complete overview about the monitoring systems for measuring depth of anesthesia. Until today no monitoring system has proven to fulfill the mentioned criteria. Monitoring of the depth of anesthesia will be based on any processing of the spontaneous EEG or its evoked potentials. Which type of monitoring, entropy, BIS, PSI, or MLAEP will be used in clinical routine will be shown in the future. All available monitors are no predictors, whether depth of anesthesia is sufficient for the next painful surgical stimulus. They can only monitor the anesthetic state at the time of measurement. There is no "golden number" predicting absolutely safely that the patient is in adequate anesthesia. The anesthetist must consider any technique for monitoring of the depth of anesthesia as an additional help in improving care for his patient.

Anesthesia, General↗
PubMed2004

A multi-center study for birth defect monitoring systems in Korea.

The aim of this study was to establish a multi-center birth defects monitoring system to evaluate the prevalence and the serial occurrence of birth defects in Korea. Ten medical centers participated in this program. A trained nurse collected relevant records from delivery units and pediatric clinics in participating hospitals on a monthly basis. We observed 1,537 cases of birth defects among 86,622 deliveries, which included live births and stillbirths. The prevalence of birth defects was 1.8%, and the sex distribution of the birth defect cases was 55.2% male and 41.6% female. The highest proportion of birth defects was in the cardiovascular system (17.5%), followed by birth defects involving in the genitourinary system (15.6%). Chromosomal anomalies were detected 30.0 per 10,000 births. Of these chromosomal anomalies, Down syndrome was most frequently observed. This study led to an establishment of a multi-center active monitoring system for birth defects. To better understand the serial occurrence of birth defects in Korea, it is necessary to increase the number of participating hospitals and to launch on a nation-wide multi-center study.

Child↗
PubMed1989

DMSS--a computer-based diabetes monitoring system.

This paper describes a microcomputer-based decision support system (DSS) for diabetes monitoring. The system's basic functions include a patient management subsystem, an electronic logbook, a nutrition and exercise module, a dictionary for diabetes-related terminology, a diabetic-physician data transfer module and an on-line help capability. DMSS (Diabetes Monitoring Support System) provides a data capturing capability, trend analysis, and nutrition/exercise decision support to improve the monitoring and maintenance of diabetes. It was designed to be used by both a physician and a patient and can also serve as a useful teaching aid for a new diabetic. Its basic advantages lie in its comprehensiveness and flexibility. It is also user-friendly, easy to operate, and does not require any previous computer experience.

Blood Glucose↗
PubMed2006

Development of a coliforms monitoring system using an enzymatic fluorescence method.

A coliforms monitoring system in treated effluent of a wastewater treatment plant has been developed. In order to achieve rapid monitoring within 1 hour, an enzymatic fluorescence method without a culturing process was introduced to this system. It converts the increase rate of fluorescence intensity as enzymatic activity into the number of coliforms instead of converting fluorescence intensity itself. A flow injection analysis is used in this system for automatic measurement. Moreover, it is equipped with the pre-filtering unit to remove the interfering substances in the suspended solids causing deterioration in measurement precision. The good relationship (correlation coefficient of 0.90) between the obtained values using this system and the analysed values using the conventional direct counting method was observed in a test at an existing wastewater treatment plant.

Colony Count, Microbial↗
PubMed1987

Epidemiology of bladder exstrophy and epispadias: a communication from the International Clearinghouse for Birth Defects Monitoring Systems.

A study of infants with bladder exstrophy or epispadias was based on data from ten malformation monitoring systems around the world. The material is derived from nearly 6.3 million births. The recorded prevalence at birth of bladder exstrophy was 3.3 per 100,000 births and of epispadias (without bladder exstrophy) 2.4 per 100,000. The recorded rates of bladder exstrophy did not vary between the monitoring systems, but the rates of epispadias did. Furthermore, nearly all registered infants with epispadias were males. The sex ratio for bladder exstrophy was 1.5:1. Perinatal deaths occurred mainly when other malformations were also present. There was an increased risk in this group of malformations in infants of women aged less than 20 years. At high parity (3+), an increased risk was observed for bladder exstrophy, but there was a decreased risk for epispadias. The birth weight distribution was shifted slightly more to the left in isolated bladder exstrophy than in isolated epispadias, but was considerably shifted to the left when other malformations existed with bladder exstrophy. Most infants with other malformations belonged to the cloacal exstrophy sequence. There was no definite time trend between 1970 and 1985 in the prevalence at birth of bladder exstrophy. The study demonstrates how data from different monitoring registries can be pooled to characterize a rare malformation.

Adult↗
PubMed1981

A modified dose monitoring system in remote afterloading therapy of carcinoma of the uterine cervix using semi-conductor dosimeter.

A dose monitoring system in high dose rate intracavitary remote afterloading therapy of carcinoma of the uterine cervix using semi-conductor dosimeter was developed in July 1979 at our department. During early experience with the above system, extremely high values of mgh as well as high doses to rectum and bladder were encountered in the cases with poor local anatomy or unsuitable application. Solving this problem, such limitations as to the mgh as well as point-A dose were added to the computerized rapid processing system for the pretreatment dose calculation and correction of the treatment parameters to adjust the point-A dose to within +/- 5% of the planned dose. In the majority of the cases treated with Ralstron, this modified dose monitoring system brought considerable success in the optimization of point-A, mgh, rectal and bladder doses, in a simple manner.

Brachytherapy↗
PubMed2006

[Capacity of monitoring system on birth defects during 1990s in China].

OBJECTIVE: To understand the status and capacity of monitoring system on birth defects in China. METHODS: Data regarding 27 groups of birth defects from 57 monitoring programs in World Atlas of Birth Defects (2nd Edition) published by WHO/ICBDMS/EUROCAT/HGP and descriptive analysis by their ranking and contribution were carried out. RESULTS: Both hospital-based (Chinese Birth Defects Monitoring Network, CBDMN) and population-based (Birth Defect Surveillance System in Thirty Counties of Four Provinces, Beijing) monitoring systems showed the same characteristics as below: (1) Not enough groups were monitored, with trisomy 13/18 and congenital heart disease not reported. (2) Prevalence on those 'easily observed' group was high and cleft lip with or without cleft palate in CBDMN ranked 5 among 57 programs, with similar situation in polydactyly. (3) While prevalence rates of internal system and choromosal anomaly were low, CBDMN ranked 56 with Beijing the only non-reported city among all the 57 programs. (4) Unreasonable relationship was seen with prevalence of cleft lip was 5.76,4.02 times higher than that of cleft palate in CBDMN and in Beijing program. Which was 1.58 times of the world's means. Prevalence rates of anencephaly and total anotia/microtia rose 10.39% while spina bifida, hydrocephaly, and gastroschisis had a 4%-5% increase. The prevalence of hypospadias decreased by 4.13% and Down syndrome by 3.02%. CONCLUSION: The capacity of birth defects monitoring, both hospital-based and population-based, was poor in the 1990s, in China.

Capacity Building↗
PubMed2005

A multi-channel continuous water toxicity monitoring system: its evaluation and application to water discharged from a power plant.

A multi-channel continuous water toxicity monitoring system was, after confirming the systems' performance, implemented to samples of water discharged from power plants to detect and classify their toxicity using several recombinant bioluminescent bacteria. Each channel of the system is composed of a series of two mini-bioreactors to enable a continuous operation, i.e., without system interruption due to highly toxic samples. A different recombinant bacterial strain was present in each channel: DPD2540 (fabA::lux CDABE), DPD2794 (recA::luxCDABE), and TV1061 (grpE::luxCDABE), which are induced by cell membrane-, DNA-, and protein-damaging agents, respectively. GC2 (lac::luxCDABE) is a constitutive strain, whose bioluminescence is reduced by an increase in cellular toxicity. Phenol and mitomycin C (MMC) were used for evaluating the system's performance to detect toxic chemicals. These samples were injected into the second mini-bioreactor according to a step or bell-curve manner. The field samples used in this study were obtained from the water discharged from two different power plants in Korea--from a nuclear power plant and a thermo-electronic power plant--and were injected into the second mini-bioreactor to initiate the toxicity test. Each channel showed specific bioluminescent (BL) response profiles due to the toxic compounds present in the water samples. Comparing the BL signals between the standard toxic chemical samples and discharged water samples, the equivalent toxicity of the field water could be estimated. Finally, it was proved that this novel continuous toxicity monitoring system can be used as an alternative tool for the quick monitoring and control of water quality, as well as aid in the setting up of a new monitoring strategy to protect the source of tap water and in the prevention of polluted water discharge.

Alkylating Agents↗
PubMed2004

A real time non-invasive monitoring system for detection of hypovolemic state using RR interval variability in very low frequency ranges.

In offline analysis, very low frequency variability in RR interval and systolic arterial pressure has been reported below 0.1 Hz during head-up tilt (HUT) tests in conditions similar to hypovolemic states in humans. We designed a real time and non-invasive monitoring system of very low frequency RR interval variability to detect the hypovolemic state resulting from internal and external hemorrhages. Eight male Sprague-Dawley rats were subjected to monitoring before (normal state) and after withdrawal of 2 ml blood/100 g body weight over 15 minutes (hypovolemic state). Using one-channel electrocardiogram (ECG), the detection system monitored in real time the very low frequency components of RR interval variability using Fast Fourier Transform (FFT). Temperature mappings of rat abdomen were conducted simultaneously to monitor the hypothermic state after blood withdrawal using a local temperature mapping system with a deep body thermometer. This system demonstrated oscillation of the RR interval at 0.075 +/- 0.015 Hz in real time after blood withdrawal. The deep body temperature decreased significantly from 37.4 +/- 0.9 degrees centigrade to 35.5 +/- 1.2 degrees centigrade (p < 0.05) within 1 hour after blood withdrawal. Our monitoring system appears promising for the detection of hypovolemic state resulting from massive hemorrhage using a one-channel ECG monitor.

Algorithms↗
PubMedDate not supplied

[Personal computer-based computer monitoring system of the anesthesiologist (2-year experience in development and use)].

Creation of computer monitoring systems (CMS) for operating rooms is one of the most important spheres of personal computer employment in anesthesiology. The authors developed a PC RS/AT-based CMS and effectively used it for more than 2 years. This system permits comprehensive monitoring in cardiosurgical operations by real time processing the values of arterial and central venous pressure, pressure in the pulmonary artery, bioelectrical activity of the brain, and two temperature values. Use of this CMS helped appreciably improve patients' safety during surgery. The possibility to assess brain function by computer monitoring the EEF simultaneously with central hemodynamics and body temperature permit the anesthesiologist to objectively assess the depth of anesthesia and to diagnose cerebral hypoxia. Automated anesthesiological chart issued by the CMS after surgery reliably reflects the patient's status and the measures taken by the anesthesiologist.

Anesthesia↗
PubMed2002

Development of a monitoring system for heroin-assisted substitution treatment in Switzerland.

OBJECTIVES: Switzerland introduced heroin-assisted treatment as a routine treatment for drug addicts. As a result the evaluation instruments were changed from a detailed scientific project to a routine monitoring system. The process for developing this monitoring system is described. METHODS: The questionnaires and assessment instruments were restyled with staff of the treatment agencies. Indicators measuring quality of treatment and measures from the future national statistic on the addiction support system were integrated into admission, course and discharge questionnaires. Currently a system for feedback to treatment agencies is being developed. RESULTS: All 21 treatment agencies are participating in the monitoring. Assessment quality is high. CONCLUSIONS: The described monitoring should provide continuous delivery of basic relevant data on patients.

Adult↗
PubMed1995

[A non-invasive portable blood-glucose monitoring system: sampling of suction effusion fluid].

We developed a new portable transcutaneous blood glucose monitoring system using non-invasive collection of suction effusion fluid (SEF) from human skin. A ion sensitive field effect transistor (ISFET) sensor was employed to measure glucose concentration in a very small quantity of the SEF. The system was composed of a couple of portions. One structure was a suction cell, and the other was a main frame. The suction cell included the ISFET glucose sensor, a dilution mechanism, and a sucking interface to human skin. The main frame contained a dilution solution reservoir, a liquid waste reservoir, a fluid pump, a vacuum pump, a micro processor, batteries, and a user interface. The system is self-contained for portable usage during up to 6 hrs monitoring. This system may be the first blood glucose monitoring equipment which does not use blood sampling.

Animals↗
PubMed2005

Reproducibility and reliability of hypoglycaemic episodes recorded with Continuous Glucose Monitoring System (CGMS) in daily life.

AIM: Continuous glucose monitoring may reveal episodes of unrecognized hypoglycaemia. We evaluated reproducibility and reliability of hypoglycaemic episodes recorded in daily life by the Medtronic MiniMed Continuous Glucose Monitoring System (CGMS). METHODS: Twenty-nine adult patients with Type 1 diabetes underwent 6 days of continuous subcutaneous glucose monitoring, applying one CGMS on each side of the abdomen. Blood glucose was measured by HemoCue B-Glucose Analyzers six times daily and two different 4-point calibration sets were generated (set A and B). Using these calibration sets, CGMS raw data were recalibrated generating four different CGMS data sets [left-A (left side of abdomen, calibration set A), left-B, right-A and right-B]. Agreement between CGMS data sets was evaluated during hypoglycaemic events, comparing CGMS readings = 2.2 mmol/l with nadir values from corresponding CGMS data sets. CGMS readings were also compared with independent self-monitored blood glucose (SMBG) values. RESULTS: With hypoglycaemia (CGMS readings = 2.2 mmol/l) in calibration set left-A, values below 3.5 mmol/l were present in 99% (95% CI: 95-100%) of samples in left-B, 91% (95% CI: 84-96%) of samples in right-A, and 90% (95% CI: 83-95%) of samples in right B. In 84% of these episodes (95% CI: 59-96%) independent SMBG values were below 3.5 mmol/l. Difference in duration was observed with a median difference of 20 min; (left-A vs. right-B). CONCLUSION: Hypoglycaemic episodes recorded by CGMS are reproducible and agreement with independent SMBG values is acceptable for retrospective recording of hypoglycaemic events with CGMS.

Blood Glucose Self-Monitoring↗
PubMed2005

[The tuberculosis monitoring system in Moscow].

The existing need for objective assessing methods of different reform strategies in the health care system and of the epidemic situation has resulted in the setting-up of monitoring systems as the most efficient and rapid tool to solve health care problems on the evidence basis provided that the primary data are highly valid. Clinical epidemiological methods with monitoring results kept in mind make it possible to search for the optimum approaches to achieving a qualitative, accessible, and effective program for health care delivered to the population. The tuberculosis monitoring system to be introduced in Moscow can pool an information flow at the urban level, furnishes an opportunity to analyze and assess the activities of a phthisiological service, makes it possible to obtain pooled data on areas, to assess the epidemic situation and tuberculosis-controlling work, and to work out and implement antiepidemic measures.

Adolescent↗