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At least 199 records · Page 11Linked to original sources
PubMed1988

[Non-invasive method of arterial oxygen saturation monitoring in the neonatal intensive care unit (with a review of blood oxygen monitoring methods)].

Recently a new method (pulse oximetry) became available, which enables us to monitor non-invasively the arterial oxygen saturation in neonates. We tested this new method in several premature infants, from the time that oxygen therapy was instituted (IPPV; CPAP), in order to evaluate its potential clinical use. In stable patients we found a better correlation (r = 0.90) between the oxygen saturation measured transcutaneously and that measured in an arterial blood sample that the correlation (r = 0.22) between oxygen tensions measured either transcutaneously or in a blood sample. Although transcutaneous monitoring of the arterial oxygen saturation, especially because it is a continuous process, can be a valuable adjunct in monitoring premature infants who receive extra oxygen, it can not replace the necessity for intermittent blood sampling to determine 'arterial blood gases'. One should also remember that; due to the fact that the position of oxyhemoglobin dissociation curve depends on several factors; the SO2 can not simply be derived from the pO2 or vice versa. Continuous transcutaneous monitoring of oxygen saturation may decrease the frequency with which arterial blood samples for blood gas measurement have to be taken.

Blood Gas Analysis↗
PubMedDate not supplied

[Problems of medical monitoring of patients and requirements for computer monitoring systems].

Medical monitoring of patients is intended for controlling their physiological parameters, providing information to the medical staff as of critical, precritical physiological values, as well as for accumulating information on the patients' condition in time (trends). The existing monitoring systems require further improvement by expanding the types of measuring channels connected to them, providing a definite service, adaptability to a concrete medical institution. The basic orders to develop and produce such systems were got from the leading medical institutions of the Republic of Udmurt. A list of physiological parameters requiring monitoring, specifications of transducer systems and measuring channels (as a table), as well as demands by for channels, as required, records written down into the trend, as results is given. Possible variants of the design and use of computer monitors are provided.

Humans↗
PubMed1998

College of American Pathologists Conference XXXI on laboratory monitoring of anticoagulant therapy: the clinical use and laboratory monitoring of low-molecular-weight heparin, danaparoid, hirudin and related compounds, and argatroban.

OBJECTIVE: To review the role of the laboratory in monitoring therapy with low-molecular-weight heparin, danaparoid, hirudin, and argatroban, as reflected in the medical literature and the consensus opinion of recognized experts in the field. DATA SOURCES: Review of the medical literature and current clinical practice by a panel of 6 international experts in the field of anticoagulant therapy. DATA EXTRACTION AND SYNTHESIS: The experts made an extensive review of the published literature and prepared a draft manuscript, which included preliminary recommendations. The draft manuscript was circulated to participants in the College of American Pathologists Conference XXXI on Laboratory Monitoring of Anticoagulant Therapy prior to the conference. The manuscript and recommendations were then presented at the Conference for discussion. Recommendations were accepted if a consensus of the 26 experts attending the Conference was reached. The results of the discussion were used to revise the manuscript into its final form. CONCLUSIONS: This report reviews the mechanism of action and potential uses of these newer anticoagulant agents. General guidelines for monitoring these agents and 9 specific recommendations for laboratory monitoring of low-molecular-weight heparin and danaparoid are provided, along with citation of the appropriate supporting literature. Issues for which a consensus was not reached at the Conference are also discussed.

Anticoagulants↗
PubMed1976

["Fetal monitoring" within the framework of actual obstetric monitoring].

The introduction of fetal monitoring and its use in high-risk patients was followed in the period 1971-1973 by the first-ever drop in perinatal mortality below 2%. Total monitoring brought about a further reduction in perinatal mortality to 0.95% (1974-1975). This decrease is statistically highly significant. It suggests that among all intensive care methods continuous fetal heart-rate monitoring plays the main contributory role in the early detection of fetal distress. We found that selection of high-risk patients was not sufficient to achieve a drastic reduction in the incidence of acidosis. Only with total fetal monitoring was it possible to effect a significant decrease (from 2.41% to 0.51%) in the number of infants with acidosis (pH less than 7.10).

Acidosis↗
PubMed2000

Continuous electronic heart rate monitoring for fetal assessment during labor.

BACKGROUND: Electronic fetal monitoring (EFM) has been widely adopted. There is debate about its overall effectiveness as well as the relative merits of routine application versus use for high-risk pregnancies only. OBJECTIVES: The objective of this review was to assess the effects of routine continuous electronic fetal monitoring during labour compared with intermittent auscultation. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register, Medline (1966 to 1994), and reference list of relevant articles. We also contacted experts in the field. SELECTION CRITERIA: Randomised trials comparing routine continuous electronic fetal monitoring with intermittent auscultation. DATA COLLECTION AND ANALYSIS: Data were extracted by one reviewer, and their accuracy was confirmed independently by a second person. A single reviewer assessed study quality based on criteria developed by others for randomised controlled trials. Data reported from similar studies were used to calculate a combined risk estimate for each of eight outcomes. MAIN RESULTS: Nine studies involving 18,561 women and their 18,695 infants were included. The trials were of variable quality. A statistically significant decrease was associated with routine continuous EFM for neonatal seizures (relative risk (RR) = 0. 51, confidence interval (CI) = 0.32,0.82). The protective effect for neonatal seizures was only evident in studies with high-quality scores. No significant differences were observed in 1-minute Apgar scores below 4, 1-minute Apgar scores below 7, rate of admissions to neonatal intensive care units, and perinatal death. An increase associated with the use of EFM was observed in the rate of cesarean delivery (RR = 1.41, CI = 1.23,1.61) and operative vaginal delivery (RR = 1.20, CI = 1.11,1.30). REVIEWER'S CONCLUSIONS: The only clinically significant benefit from the use of routine continuous EFM was in the reduction of neonatal seizures. In view of the increase in cesarean and operative vaginal deliveries, the long-term benefit of this reduction must be evaluated in the decision reached jointly by the pregnant woman and her clinician to use continuous EFM or intermittent auscultation during labor.

Cardiotocography↗
PubMed2004

Correlations between the step activity monitor and the DynaPort ADL-monitor.

OBJECTIVE: This study was performed to evaluate correlations between the DynaPort activity of daily living monitor and the step activity monitor. DESIGN: Experimental study with repeated measures. BACKGROUND: Physical activity becomes more important to assess quality of life, e.g. after clinical interventions such as joint replacement surgery. METHODS: Nine subjects wore both devices simultaneously for two days. Limitations and technical problems caused by the devices were assessed by a questionnaire. Correlation coefficients were calculated between parameters derived from both instruments. RESULTS: Only small limitations and problems were reported. Significant correlations were found between the number of steps (step activity monitor) and the percentage of locomotion (DynaPort) (r=0.95), between the number of steps and the physical activity index (DynaPort) (r=0.71) and between the physical activity index and the percentage of locomotion (r=0.76). Wilcoxon-tests between the first and second measurement of each subject did not reveal significant differences but correlation coefficients were poor (r=0.16-0.36). CONCLUSIONS: After one day of simultaneously wearing both devices, the percentage of locomotion can be obtained using only the step activity monitor for additional days. Poor correlations between the first and the second measurements of each subject underline the necessity to record further days to acquire the level of human physical activity.

Activities of Daily Living↗
PubMed2002

Monitoring xenon in the breathing circuit with a thermal conductivity sensor. Comparison with a mass spectrometer and implications on monitoring other gases.

OBJECTIVE: To test the accuracy of a thermal conductivity xenon sensor in vitro and in vivo and to test the effect of xenon on other anesthetic gas analyzers as determined by a mass spectrometry gold standard. METHODS: The xenon concentration was measured with a prototype of a thermal conductivity sensor and a mass spectrometer in vitro and in 6 patients. Further in vitro experiments determined the impact of xenon on the measurements of oxygen, carbon dioxide and desflurane with three commercially available anesthesia gas monitors. RESULTS: In vitro the thermal conductivity sensor and an associated computer, when calibrated against a mass spectrometer using a third order polynomial calibration curve measured the xenon concentration to a 95% confidence limit of -1.2 to +1.8 vol% compared to mass spectrometry. In vivo and under clinical conditions with a mixture of xenon, O2 and CO2 the 95% confidence limit was -2.5 to +1.6 vol% with a mean bias of -0.5 vol% over a concentration range of 20 to 70 vol%. Xenon induced a clinically relevant bias on the measurements of oxygen (up to 5 vol%), carbon dioxide and desflurane (both twofold overestimation) in a Hewlett-Packard M1025B monitor. In contrast there was only a small bias on the measurements of a Drager PM8060 and a Datex AS3 compact monitor, which was statistically significant (oxygen and desflurane) but clinically irrelevant. CONCLUSION: Thermal conductivity is a clinically useful technique to measure xenon in the breathing circuit despite its statistically significant but clinically irrelevant error compared to mass spectrometry. Other gases of interest have to be measured with selected monitors explicitly approved or tested for use with xenon.

Anesthesiology↗
PubMed2001

Home monitoring with the ClearPlan Easy Fertility Monitor for fertility awareness.

Many couples planning a pregnancy have had to gauge the best time for sexual intercourse from subjective indications, e.g. cervical mucus changes, or retrospective information, e.g. temperature and calendar methods. Between women, and within a woman, there are considerable variations in menstrual cycle length and underlying hormonal patterns. Although fertility test kits are available, most still rely on visual interpretation by the user. A new combination of immunochemical testing and computing technology is now available in the ClearPlan Easy Fertility Monitor. This paper describes the features of this accurate, simple-to-use, home-based fertility monitor, which gathers data on hormonal patterns and takes account of the individuality of menstrual cycles in women. These data and information about other events, such as sexual intercourse, can be stored in the monitor and accessed by the couple and their medical professional for retrospective review. The monitor is useful for couples who have just started trying to conceive, or those who have been planning a pregnancy for some time.

Estrone↗
PubMedDate not supplied

Prospective monitoring of minimal residual disease in acute myeloid leukemia with inversion(16) by CBFbeta/MYH11 RT-PCR: implications for a monitoring schedule and for treatment decisions.

Minimal residual disease in patients with acute myeloid leukemia (AML) with inversion(16) can be monitored by CBFbeta/MYH11 RT-PCR. While the association between molecular remission (MR) in bone marrow (BM) and peripheral blood (PB) and long-term clinical remission (CR) seems to be established, there are insufficient data on the kinetics of CBFbeta/MYH11. We have performed a prospective study in order to generate a reasonable and sufficient schedule for PCR-monitoring. 11 patients with AML and inversion (16) in complete hematological remission have been prospectively monitored by CBFbeta/MYH11 RT-PCR in their BM and PB during an observation period of 7 to 67 months (median 32 months). Patients were followed during consolidation chemotherapy with repetitive cycles of high-dose Ara-C and after autologous or allogeneic stem cell transplantation in 2nd CR or refractory AML. MR never coincided with achievement of CR but occurred between 2 and 8 months after hematological remission. All patients in continuous CR were PCR-negative after 1-8 (median 4) months. Two patients relapsed despite MR for 10 to 15 months. Molecular relapse preceded hematological relapse by 3 to 5 months. Three out of four patients who were not in MR after 8 months relapsed. Allogeneic stem cell transplantation was able to eradicate minimal residual disease in 4/4 patients. In 2 patients a temporary reconversion to PCR-positivity was reversed by reduction of immunosuppression. 1 patient did not become PCR-negative until compete withdrawal of immunosuppression. We suggest that BM and PB should be examined after the last consolidation treatment. In case of MR, PB should be examined every 1 to 2 months and BM examination should be done only in case of PCR-positivity in PB in order to confirm the molecular relapse and to identify an impending cytogenetic and/or hematological relapse. CBFbeta/MYH11 RT-PCR monitoring is able to predict relapse 3 to 5 months prior to overt hematological relapse, offers a window of opportunity for preemptive therapy of molecular relapse and confers implications for immunotherapy in the setting of allografting.

Acute Disease↗
PubMedDate not supplied

Liquid-crystal display monitors and cathode-ray tube monitors: a comparison of observer performance in the detection of small solitary pulmonary nodules.

OBJECTIVE: To compare observer performance using liquid-crystal display (LCD) and cathode-ray tube (CRT) monitors in the interpretation of soft-copy chest radiographs for the detection of small solitary pulmonary nodules. MATERIALS AND METHODS: By reviewing our Medical Center's radiologic information system, the eight radiologists participating in this study (three board-certified and five resident) retrospectively collected 40 chest radiographs showing a solitary noncalcified pulmonary nodule approximately 1 cm in diameter, and 40 normal chest radiographs. All were obtained using a storage-phosphor system, and CT scans of the same patients served as the gold standard for the presence of a pulmonary nodule. Digital images were displayed on both high-resolution LCD and CRT monitors. The readers were requested to rank each image using a fivepoint scale (1 = definitely negative, 3 = equivocal or indeterminate, 5 = definitely positive), and the data were interpreted using receiver operating characteristic (ROC) analysis. RESULTS: The mean area under the ROC curve was 0.8901+/- 0.0259 for the LCD session, and 0.8716+/- 0.0266 for the CRT session (p > 0.05). The reading time for the LCD session was not significantly different from that for the CRT session (37.12 and 41.46 minutes, respectively; p = 0.889). CONCLUSION: For detecting small solitary pulmonary nodules, an LCD monitor and a CRT monitor are comparable.

Data Display↗
PubMed1992

[Assessment of construct and content validity of Monitor--an index of the quality of nursing care--and the evaluation of clarity and concreteness of the criteria of Monitor].

The purpose of this study was to test construct and content validity of Monitor and to evaluate if its criteria were clear and concrete. The construct validity was evaluated after reviewing the Finnish nursing literature in order to determine how man is perceived and what are the essential principles of Finnish nursing care. Each of the Monitor criteria was then compared with that view of man and the principles present in the literature. The human needs by Yura and Walsh were examined in order to find out to what extent the Monitor-instrument covers these needs. The content validity and the clarity and concreteness of the criteria were evaluated by experts. The results imply that the physical characteristics of man were prevalent in 76 out of 155 criteria. The essential principles were found in Monitor, but the principles concerning health centricity and patients' independence were found only in 13 out of 155 criteria. The instrument covered 4 human needs by Yura and Walsh totally and 20 in part. The experts rated 151 criteria content valid, 143 concrete and 139 clear in this study. Retesting is needed in the future studies.

Health Services Needs and Demand↗
PubMed2006

Influence of monitor luminance and room illumination on soft-copy reading evaluation with electronically generated contrast-detail phantom: comparison of cathode-ray tube monitor with liquid crystal display.

The influence of monitor brightness and room illumination on soft-copy diagnosis by both cathode-ray tube (CRT) monitor and liquid crystal display (LCD) was evaluated and compared using a contrast-detail phantom. Nine observers (7 radiologists and 2 radiological technicians) interpreted six types of electronically generated contrast-detail phantom images using a 21-inch CRT (2,048x2,560) and a 21-inch LCD (2,048x2,560) under 6 kinds of viewing conditions, i.e. monitor brightness of 330 cd/m2 or 450 cd/m2, and room illumination of 20, 100 or 420 lux at the center of the display. Observers were requested to determine the visible borderline of the objects. Between 330 cd/m2 and 450 cd/m2, no significant difference in the visible area was found under any of the three lighting conditions. However, in two low-contrast phantom images, the visible area on the LCD was significantly larger than that on the CRT, independent of both monitor brightness and room illumination. (p<0.05). The effect of room illumination was not significant, suggesting that the use of LCD at high room illumination is acceptable.

Computers↗
PubMed1986

[Intraoperative monitoring in artificial respiration of premature and newborn infants. II. Monitoring of arterial oxygenation].

Monitoring of adequate arterial oxygenation serves to avoid periods of hypoxaemia and hyperoxaemia with potentially life threatening or organ-damaging sequelae. Basic clinical monitoring, i.e., inspection and auscultation, is mandatory. In all infants, paO2 may be continuously and indirectly monitored by measurement of transcutaneous pO2 (tcpO2). The use of pulse oximetry for non-invasive measurement of arterial oxygen saturation (SaO2) is still undergoing clinical testing. Invasive monitoring of gas exchange is essential in prolonged or intrathoracic interventions as well as in neonates with cardiopulmonary problems. paO2 can be estimated by capillary blood gas analysis; arterial blood gas analysis, however, is required for exact determination of paO2 and of the arterio-cutaneous pO2 gradient (atcDO2). Intraarterial fibre optic determination of oxygen saturation or determination of paO2 with an intraarterial Clark electrode does not appear to be well suited for intraoperative conditions.

Anesthesia, General↗
PubMed2006

Pharmacodynamic monitoring of BAY 43-9006 (Sorafenib) in phase I clinical trials involving solid tumor and AML/MDS patients, using flow cytometry to monitor activation of the ERK pathway in peripheral blood cells.

BACKGROUND: We previously reported a flow cytometry technique to monitor pharmacodynamic effects of the raf kinase inhibitor BAY 43-9006 based on the ability of phorbol ester (PMA) to phosphorylate extracellular-regulated kinase (ERK) in peripheral blood (Chow et al., Cytometry 2001;46:72-78). In this article, we describe its application to phase I trials of BAY 43-9006 in solid tumor and AML/MDS patients. METHODS: The previously described whole blood lysis method was used to monitor BAY 43-9006 effects on peripheral T-cells of solid tumor patients. A modified whole blood fixation protocol was developed for the AML/MDS trial, using the c-kit ligand stem cell factor (SCF) to activate ERK as an alternative to PMA, and incorporating immunophenotypic markers to identify leukemic blasts. RESULTS: At all dose levels of BAY 43-9006 used to treat solid tumor patients, ERK could be activated by PMA in peripheral T-cells and we were not able to show inhibition of raf kinase. A similar effect was seen in the lymphocytes of AML/MDS patients during treatment with BAY 43-9006. However, we found strong inhibition when ERK was activated via c-kit using SCF. Furthermore, normal donor CD34+ve stem cells were much more sensitive to BAY 43-9006 when ERK was activated by SCF, compared to PMA. CONCLUSIONS: These findings support the further development of flow cytometry applications to monitor signal transduction inhibitors during early phase clinical trials.

Aged↗
PubMed1993

Monitoring cerebral oxygenation: experimental studies and preliminary clinical results of continuous monitoring of cerebrospinal fluid and brain tissue oxygen tension.

Cerebral ischaemia is considered to be the central mechanism leading to secondary brain damage in patients with severe head injury. It would therefore seem appropriate to monitor cerebral oxygenation in these patients. The possibilities of continuous monitoring of brain tissue and CSF oxygen tension as parameters for cerebral oxygenation were evaluated. In experimental studies the influence of changed oxygen offer and decreased cerebral perfusion pressure on CSF and brain tissue pO2 were investigated. Fast changes in CSF pO2 were observed in response to decreasing oxygen offer. Slower changes were noted in response to hypo- and hyperventilation. An autoregulatory mechanism regulating CSF pO2 is postulated. Reducing cerebral perfusion pressure decreased both brain tissue and CSF pO2, but in the reperfusion phase after complete ischaemia a dissociation occurred between brain tissue and CSF pO2, CSF pO2 being restored, but brain tissue pO2 remaining low or even decreasing further. From these studies it is concluded that both CSF pO2 and brain tissue pO2 reflect changes in cerebral oxygenation caused by changes in oxygen offer as well as by changes in cerebral blood flow. Brain tissue pO2 is also sensitive to oxygen demand from the tissue. Preliminary studies of continuous monitoring of brain tissue pO2 in patients with severe head injury are reported.

Animals↗
PubMed1985

Computerized monitoring of the EMG and EEG during anesthesia. An evaluation of the anesthesia and brain activity monitor (ABM).

An intraoperative evaluation was made of the electroencephalographic (EEG) and electromyographic (EMG) functions of the Anesthesia and Brain activity Monitor (ABM). This device derives both these measures from a single electrode pair that is typically placed on the mid-forehead and mastoid process. The evaluation consisted of 1) quantifying the zero-crossing frequency (ZXF) of the EEG and mean integrated voltage of both measures (MIVEEG and MIVEMG) that occurred during induction and emergence from general anesthesia in 17 patients and 2) case reports sampled from an additional 41 patients. Alone or combined, variations in these parameters did not consistently accompany changes in the depth or adequacy of anesthesia as determined by standard clinical signs (e.g. heart rate, blood pressure, movement). Interpatient variability in the EEG measures during recovery from anesthesia was so large that neither the absolute value of ZXF nor that of MIVEEG could discriminate between moderate (i.e., maintenance) and light (i.e., emergence) anesthesia. Although MIVEMG uniformly decreased in anesthetized, unparalyzed patients (compared to the pre-operative awake state), noticeable increases during recovery often did not occur until limb movement was observed. Additionally, the common use of neuromuscular blockers made interpretation of low MIVEMG values quite difficult during anesthesia maintenance. However, selected individual case reports illustrated the potential benefit of routine intraoperative, microprocessor-based EEG/EMG monitoring. The single channel EEG/EMG display of the ABM seems sufficient to warn the anesthesiologist of pathologic decreases in cerebral electrical activity. Marked depression of cerebral function is associated with accidental anesthetic overdose, hypoxia or global ischemia. Additionally, the device should be useful for monitoring burst-suppression or isoelectric EEG patterns intentionally produced during barbiturate or isoflurane coma for cerebral protection.

Adolescent↗
PubMed1983

Time series methods in the monitoring of intracranial pressure. Part 1: Problems, suggestions for a monitoring scheme and review of appropriate techniques.

Intracranial hypertension is a dangerous condition and poses a constant threat to patients suffering, for example, a severe head injury. Anticipation of this condition can, however, be difficult. This paper introduces problems that are created in patient management by the pathophysiology of intracranial hypertension and describes methods that have been devised to anticipate the condition, indicating their limitations. A scheme incorporating trend detection and prediction is then suggested for monitoring intracranial pressure (ICP). Several techniques from the fields of time series analysis and control engineering were selected as candidates for the basis of the scheme. These are described and their strengths and weaknesses discussed in the context of the ICP monitoring scheme. The application of time series methods to patient monitoring is reviewed in parallel with these descriptions to indicate the momentum of developments in this area of work. This theoretical background has enabled the direction of further work to be established. In particular it is suggested that adaptive methods are necessary to provide a satisfactory response to significant changes in the measured variable, to avoid repeated alarms and to allow useful short-term predictions of the variable to be made.

Humans↗
PubMed1994

Biological monitoring of hexamethylene diisocyanate by determination of 1,6-hexamethylene diamine as the trifluoroethyl chloroformate derivative using capillary gas chromatography with thermoionic and selective-ion monitoring.

A GC method using a novel derivatization reagent, 2',2',2-trifluoroethyl chloroformate (TFECF), for the derivatization of primary and secondary aliphatic amines with the formation of carbamate esters is presented. The method is based on a derivatization procedure in a two-phase system, where the carbamate ester is formed. The method is applied to the determination of 1,6-hexamethylene diamine (HDA) in aqueous solutions and human urine, using capillary GC. Detection was performed using thermionic specific detection (TSD) and mass spectrometry (MS)-selective-ion monitoring (SIM) using electron-impact (EI) and chemical ionization (CI) with ammonia monitoring both positive (CI)+ and negative ions (CI)-. Quantitative measurements were made in the chemical ionization mode monitoring both positive and negative ions. Tetra-deuterium-labelled HDA (TDHDA; H2NC2H2(CH2)4C2H2NH2) was used as the internal standard for the GC-MS analysis. In CI+ the m/z 386 and the m/z 390 ions corresponding to the [M + 18]+ ions (M = molecular ion) of HDA-TFECF and TDHDA-TFECF were measured; in CI- the m/z 267 and the m/z 271 ions corresponding to the [M - 101]- ions. The overall recovery was found to be 97 +/- 5% for a HDA concentration of 1000 micrograms/l in urine. The minimal detectable concentration in urine was found to be less than 20 micrograms/l using GC-TSD and 0.5 micrograms/l using GC-SIM. The overall precision for the work-up procedure and GC analysis was ca. 3% (n = 5) for 1000 micrograms/l HDA-spiked urine, and ca. 4% (n = 5) for 100 micrograms/l. The precision using GC-SIM for urine samples spiked to a concentration of 5 micrograms/l was found to be 6.3% (n = 10).

Chromatography, Gas↗