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At least 325 records · Page 18Linked to original sources
PubMed1984

[Esophageal function tests: manometry, pH monitoring, pH monitoring combined with manometry and scintigraphy].

Conventional methods for exploration of the esophagus (radiology and fibroscopy) are not sufficiently sensitive to provide a precise diagnosis of minor lesions. New techniques have been developed that enable improved evaluation of the physiopathology of gastro-esophageal reflux and other esophageal motor disorders. These include esophageal manometry, pH monitoring, the association of these two procedures, and finally scintigraphy. Manometry is the most effective method of assessing esophageal motility, and it can assist in the diagnosis of motor disorders related to reflux, of dyskinesias such as in mega-esophagus, and of collagen diseases. The most reliable method for diagnosing gastro-esophageal reflux is by means of pH monitoring. More detailed physiological and physiopathological data can be obtained by combining the two investigational methods. Scintigraphy can sometimes determine the responsibility of pulmonary disorders in the development of reflux.

Collagen Diseases↗
PubMed1984

Cortical evoked potential monitoring. A system for intraoperative monitoring of spinal cord function.

This report describes the intraoperative use of a somatosensory cortical evoked potential system to monitor spinal cord function during 300 orthopedic surgical procedures. This system requires sophisticated equipment and the establishment of normative data but has performed well with no false negatives noted. The most frequent technical problem encountered was the effect of medications and anesthetic agents, some of which impair the evoked response significantly. In this series of 300 cases, three neurologic deficits were documented intraoperatively and confirmed postoperatively. There were four cases in which changes in evoked potentials led to change in operative procedure, with no subsequent neurologic deficit. In the remaining cases, the monitoring indicated no neurologic problems during surgery, and none were noted postoperatively.

Adolescent↗
PubMed1981

Determination of testosterone in plasma from men by gas chromatography/mass spectrometry, with high-resolution selected-ion monitoring and metastable peak monitoring.

Highly specific methods are described for determining testosterone in plasma or serum from men. Extract fractions obtained by selective isolation procedures are converted to tert-butyldimethylsilyl (TBDMS) oximes/TBDMS ethers or methyl oximes/TBDMS ethers and analyzed by gas chromatography/mass spectrometry in the high-resolution selected-ion monitoring or metastable peak-monitoring modes. [2H3]Testosterone and unlabeled 17-epitestosterone are used as the respective internal standards. When we applied the two procedures to analysis of samples of pooled plasma and serum used for external quality assessment of routine assays, the results agreed well. Interlaboratory values for mean concentrations obtained by routine immunoassays (y) consistently exceeded values obtained by our technique (x), although the values closely correlated (r = 0.997; y = 1.008x + 0.564 nmol/L).

Carbon Radioisotopes↗
PubMed1996

[Monitoring nutrition and the quality of the food products in the social-hygiene monitoring system in the Russian Federation].

The results of monitoring of population dietary intake and quality of foods in Russia in last years are discussed. Main problems in dietary intake of population are high animal fat intake and slightly low level of high quality protein intake. Deficits of some vitamins, minerals and dietary fiber intake are also first priority problems in nutrition of population. Monitoring of food safety testify about high frequency of microbial contamination of food and raw food materials especially milk and diary food. These data are used at development of state politics in improving of dietary intake of population.

Adult↗
PubMed1998

Magnetic resonance techniques to monitor the long term evolution of multiple sclerosis pathology and to monitor definitive clinical trials.

Magnetic resonance has provided a literal window on the brain to visualise the actual pathology of MS as it evolves in the living patient. Natural history studies disclosed that MRI visualised pathological activity was seen at 5 to 10x the rate of clinical relapses. Utilising that knowledge, systematic MRI monitoring has been used to supplement clinical monitoring to show the treatment effect in several clinical trials. This chapter explains how MR techniques can be used to further explore the evolution of in vivo pathology both in clinical trials and natural history studies.

Axons↗
PubMed2004

Consciousness monitoring in ventilated patients: bispectral EEG monitors arousal not delirium.

OBJECTIVE: Bispectral index (BIS) is being evaluated as a monitor of consciousness, yet it is unclear what components of consciousness (i.e., arousal vs. content of consciousness) the BIS measures. This study compared BIS levels to well-validated clinical measures of arousal and the presence or absence of delirium. DESIGN: A prospective, blinded, observational cohort study. PATIENTS: 124 mechanically ventilated, adult, medical ICU patients. MEASUREMENTS AND RESULTS: Using BIS 3.4 and BIS-XP 4.0 algorithms, BIS values were calculated immediately prior to clinical assessments. The clinical assessments included the Richmond Agitation-Sedation Scale (RASS) and presence or absence of delirium using the Confusion Assessment Method for the ICU. A total of 484 assessments were collected among 124 patients. BIS-XP values demonstrated greater correlation with RASS than BIS 3.4 ( R(2)=0.36 vs. 0.20), although considerable overlap of BIS-XP scores remained across RASS levels. Median BIS-XP values for delirious and nondelirious observations were 74 and 96, respectively, while BIS 3.4 values were 91 and 96, respectively. However, neither BIS 3.4 nor BIS-XP were significantly associated with delirium after controlling for RASS value. CONCLUSIONS: In comparison with clinical measures of arousal in mechanically ventilated patients, BIS-XP algorithm demonstrated stronger correlation with RASS levels than did BIS 3.4, yet marked overlap across different levels of arousal persist using both algorithms. After controlling for level of arousal, neither BIS-XP nor BIS 3.4 algorithms distinguished between the presence and absence of delirium.

Algorithms↗
PubMed1995

Illi intracranial pressure monitoring and fixation device. A new fixation system for intracranial pressure monitoring in children and adolescents in paediatric neurotraumatology, hydrocephalus and craniofacial surgery.

Fixation and positioning of intracranial pressure (ICP) monitoring devices in small children with very thin skull bones pose serious problems. We present a new ICP fixation device with two movable components compressing the skull bone from in- and outside. This new fixation system, designed by PD Dr. O.E. Illi and licensed by White Spot AG, Surgical Tools and Research, Baar, Switzerland, guarantees far greater stability and reliability than conventional screws or bolts. It is fully compatible with a range of fiberoptic or pneumatic transducer systems. We have applied this new device successfully in 10 patients.

Adolescent↗
PubMedDate not supplied

Postprandial glucose monitoring in type 1 diabetes mellitus: use of a continuous subcutaneous monitoring device.

BACKGROUND: Pre-prandial glucose gives insufficient information on glycemic excursions throughout the day. We aimed to test a continuous subcutaneous glucose-monitoring device (GlucoDay) to describe postprandial glucose changes. METHODS: In 23 T1DM patients, 24-h GlucoDay registrations were started about 14 h before receiving a standard breakfast B and 3 h later lunch L. RESULTS: The 3-min glucose values were computed into parameters describing the postprandial changes after B and L. Two-hour glucose was higher after B (243 +/- 69 vs 180 +/- 79 mg/dL after L, p < 0.0001). Maximum glycemia (313 +/- 105 mg/dL after B and 304 +/- 119 after L, p < 0.0001) was higher and was reached after 78 and 57 min respectively. Three-hour AUC was higher but 30-min AUC was lower after B (5725 +/- 2414 vs 7488 +/- 2208 min mg/dL after L, p = 0.004). Glucose spikes (maximum peak minus fasting plasma glucose) were similar after B and L but the difference between maximum and minimum values was smaller after B (165 +/- 110 vs 219 +/- 115 mg/dL after L, p = 0.020). Duration of hyperglycemic periods >200, 140 or 126 mg/dL were not different after B or L, but time spent at glucose <100 mg/dL was longer after L (p < 0.0001). CONCLUSIONS: These results illustrate the use of subcutaneous glucose registration to characterize postprandial glycemia patterns in T1DM. Application of such methods to evaluate this and other clinical situations in DM can lead to therapeutic and dietary adjustments and ultimately improve glycemic control.

Adult↗
PubMed1989

Intraspinal opioids: implications for monitoring. Monitoring in the intensive care unit is essential.

Patients receiving intraspinal opiates should be monitored in the intensive care unit for at least 24 hours to prevent potentially lethal outcomes. These include respiratory depression caused by sequestration of the morphine in the cerebrospinal fluid and migration of epidural catheters in the subarachnoid or intravascular space. At this time, most hospitals are not equipped or staffed adequately to guarantee the safety of these patients outside the intensive care unit.

Analgesics, Opioid↗
PubMed1989

Comparison of two methods for heparin monitoring: a semi-automated heparin monitoring device and activated clotting time during extracorporeal circulation.

Two methods of heparin monitoring, semi-automated in-vivo heparin protamine titration (HPT) and activated clotting time (ACT), were compared in each of sixteen adult patients undergoing extracorporeal circulation (ECC) for coronary artery bypass surgery. The HPT method determined the initial and maintenance level of heparin for ECC, as well as, the amount of protamine needed for neutralization of heparin. ACT determinations were made in parallel to calculate heparin levels, heparin sensitivity, and protamine requirements. ACT determinations increased from 502 +/- 31 seconds after heparinization to 739 +/- 49 seconds (p less than 0.05) five minutes after the start of ECC. The HPT method determined heparin sensitivity to be 153 +/- 17 secs/mg/kg and this did not change after the institution of ECC. The increase in ACT observed after the start of ECC resulted in an increase in heparin sensitivity from 151 +/- 13 secs/mg/kg initially, to 247 +/- 17 secs/mg/kg after the institution of ECC (p less than 0.01). During ECC, the HPT method reported heparin levels which remained near the initial value of 2.40 +/- 0.12 mg/kg. The ACT method's initial heparin level of 2.66 +/- 0.12 mg/kg rose after the start of ECC to 4.39 +/- 0.55 mg/kg (p less than 0.05). The HPT method adequately predicted protamine requirements, 2.66 +/- 0.15 mg/kg protamine vs. 3.47 +/- 0.14 mg/kg actual dose while the ACT method predicted excess: 5.02 +/- 0.34 mg/kg (p less than 0.01). In-vivo heparin-protamine titration method provided more consistent information during ECC and directed a significantly smaller dose of protamine for heparin neutralization.

Blood Coagulation Tests↗
PubMed1996

Long-term transcutaneous monitoring of oxygen tension and carbon dioxide at 42 degrees C in critically ill neonates: improved performance of the tcpo2 monitor with topical metabolic inhibition.

UNLABELLED: Whereas during the last few years handling of the transcutaneous PO2 (tcPO2) and PCO2 (tcPCO2) sensor has been simplified, the high electrode temperature and the short application time remain major drawbacks. In order to determine whether the application of a topical metabolic inhibitor allows reliable measurement at a sensor temperature of 42 degrees C for a period of up to 12 h, we performed a prospective, open, nonrandomized study in a sequential sample of 20 critically ill neonates. A total of 120 comparisons (six repeated measurements per patient) between arterial and transcutaneous values were obtained. Transcutaneous values were measured with a control sensor at 44 degrees C (conventional contact medium, average application time 3 h) and a test sensor at 42 degrees C (Eugenol solution, average application time 8 h). Comparison of tcPO2 and PaO2 at 42 degrees C (Eugenol solution) showed a mean difference of +0.16 kPa (range +1.60 to -2.00 kPa), limits of agreement +1.88 and -1.56 kPa. Comparison of tcPO2 and PaO2 at 44 degrees C (control sensor) revealed a mean difference of +0.02 kPa (range +2.60 to -1.90 kPa), limits of agreement +2.12 and -2.08 kPa. Comparison of tcPCO2 and PaCO2 at 42 degrees C (Eugenol solution) showed a mean difference of +0.91 (range +2.30 to +0.10 kPa), limits of agreement +2.24 and -0.42 kPa. Comparison of tcPCO2 and PaCO2 at 44 degrees C (control sensor) revealed a mean difference of +0.63 kPa (range 1.50 to -0.30 kPa), limits of agreement +1.73 and -0.47 kPa. CONCLUSION: Our results show that the use of an Eugenol solution allows reliable measurement of tcPO2 at a heating temperature of 42 degrees C; the application time can be prolongued up to a maximum of 12 h without aggravating the skin lesions. The performance of the tcPCO2 monitor was slightly worse at 42 degrees C than at 44 degrees C suggesting that for the Eugenol solution the metabolic offset should be corrected.

Blood Gas Monitoring, Transcutaneous↗
PubMed2000

Central retinal artery color Doppler monitoring versus transcranial Doppler monitoring in cardiac surgery.

We hypothesized that the central retinal artery color Doppler (CRAD) technique can be used as an alternative monitoring method to the conventional transcranial Doppler (TCD) technique which does not consistently provide good signals during cardiopulmonary bypass. This is the first study to compare CRAD with TCD during cardiac surgery. Twenty patients without stroke were examined at the seven preset stages of the two procedures. The maximum flow velocity (Vmax) of the right central retinal artery was measured with a 7.5-MHz Doppler system. The Vmax of the right middle cerebral artery was measured with a TCD system. To estimate the relationship between Vmax and maximum blood pressure (BPmax), CRAD-Vmax (6.6 +/- 2.2 cm/s), TCD-Vmax (44.0 +/-14.8 cm/s), and BPmax (114 +/- 28.5 mmHg) obtained at the initial stage were normalized. The Vmax values of CRAD were successfully obtained, at each of the seven study stages, in all 20 patients. The Vmax values of TCD were obtained at 125 points, and 15 missing values were seen during the stages of cardiopulmonary bypass. CRAD-Vmax was correlated to TCD-Vmax (r = 0.775, P < 0.0001). The normalized values of both TCD- and CRAD-Vmax were correlated to the normalized BPmax (r = 0.766, P < 0.0001) (r = 0.787, P < 0.0001). The accuracy of CRAD was confirmed by the significant correlation with TCD.

Adolescent↗
PubMed2005

Monitoring iodine-129 in air and milk samples collected near the Hanford Site: an investigation of historical iodine monitoring data.

While other research has reported on the concentrations of (129)I in the environment surrounding active nuclear fuel reprocessing facilities, there is a shortage of information regarding how the concentrations change once facilities close. At the Hanford Site, the Plutonium-Uranium Extraction (PUREX) chemical separation plant was operating between 1983 and 1990, during which time (129)I concentrations in air and milk were measured. After the cessation of chemical processing, plant emissions decreased 2.5 orders of magnitude over an 8-year period. An evaluation of (129)I and (127)I concentration data in air and milk spanning the PUREX operation and post-closure period was conducted to compare the changes in environmental levels. Measured concentrations over the monitoring period were below the levels that could result in a potential annual human dose greater than 1 mSv. There was a measurable difference in the measured air concentrations of (129)I at different distances from the source, indicating a distinct Hanford fingerprint. Correlations between stack emissions of (129)I and concentrations in air and milk indicate that atmospheric emissions were the major source of (129)I measured in environmental samples. The measured concentrations during PUREX operations were similar to observations made around a fuel reprocessing plant in Germany. After the PUREX Plant stopped operating, (129)I concentration measurements made upwind of Hanford were similar to the results from Seville, Spain.

Air Pollutants, Radioactive↗
PubMed2001

Continuous ambulatory monitoring of absolute right ventricular pressure and mixed venous oxygen saturation in patients with heart failure using an implantable haemodynamic monitor: results of a 1 year multicentre feasibility study.

BACKGROUND: Implantable sensors that monitor haemodynamics over time may be useful in patients with heart failure. This multicentre study assessed the feasibility of a system that has one sensor measuring absolute pressure and another measuring mixed venous oxygen saturation (SvO(2)). Both sensors were mounted on leads that were implanted in the right ventricle. METHODS: Twenty-one patients with heart failure (NYHA II-III) were included. Comparisons were made to right heart catheterizations at implant and at 2, 6 and 12 months thereafter. Patients underwent several haemodynamic provocations during the catheterizations. RESULTS: Overall, among functioning sensors, the IHM-1 values were highly correlated with reference values for all time points during all provocations, demonstrating high reproducibility and stability (r(2)=0.91, 0.79 and 0.78 for systolic, right ventricular diastolic and SvO(2), respectively). Although IHM-1 underestimated reference pressure values by 4.5 mmHg and SvO(2)by 1.6%, this difference was consistent across provocation and stable over 12 months of follow-up. Twelve of the 21 oxygen sensors failed to function and two pressure sensors had component failures. Preliminary analysis of long-term data revealed haemodynamic patterns that may be key indicators for therapeutic interventions. CONCLUSION: This multicentre feasibility study demonstrated the accuracy and stability of sensors implanted in the right ventricle. The IHM-1, using right ventricular pressures and SvO(2), with improved performance, might be useful in the study of pathophysiological mechanisms and treatment interventions in heart failure.

Adult↗
PubMed2006

Drug monitoring and toxicology: a procedure for the monitoring of oxcarbazepine metabolite by HPLC-UV.

This article describes a rapid high-performance liquid chromatographic (HPLC) method for the measurement of the primary metabolite of oxcarbazepine. Following a simple precipitation step, 10,11,-dihydro-10-hydroxy-5H-dibenzo(b,f)azepine-5-carboxamide is quantitated (5-60 microg/mL) by analysis on an HPLC-UV system. The instrument time is less than 5 min per injection, an improvement over most published methods. The assay's limit of quantitation, linearity, imprecision, and accuracy adequately cover the therapeutic range for appropriate patient monitoring. In comparison to other published methods, this procedure would be of interest to clinical laboratories because it employs a precipitation step for sample preparation, instead of conventional yet time-consuming solid-phase extraction.

Anticonvulsants↗
PubMedDate not supplied

Drug monitoring and toxicology: a procedure for the monitoring of levetiracetam and zonisamide by HPLC-UV.

This article describes a rapid isocratic high-performance liquid chromatographic (HPLC) method for the simultaneous measurement of the anticonvulsants levetiracetam and zonisamide. Monitoring these drugs is important for detecting potentially toxic concentrations, particularly in patients with renal impairment, but no commercial assays are currently available. Following a liquid-liquid extraction, levetiracetam (5-150 microg/mL) and zonisamide (5-80 microg/mL) are quantitated by HPLC-UV. The assay's limit of quantitation, linearity, imprecision, and accuracy adequately cover the therapeutic range of these drugs. The assay should be attractive to clinical laboratories because the run time for quantification of both drugs is approximately 5 min per sample, and no interferences are currently known.

Anticonvulsants↗
PubMed2003

Calibration and evaluation of a transportable in vivo monitoring system for accident monitoring of internal contamination.

A transportable in vivo monitoring system has been constructed and calibrated. The system uses two hyper pure germanium detectors--one for measuring whole body activities, by measuring activity in the torso, and the second for determining activities of radioiodine in the thyroid. The optimum counting geometries have been determined and the system has been calibrated for subjects of different ages and builds. The complete system is transported in two trailers which are pulled by ordinary motor vehicles. The minimum detectable activity (MDA) for 137Cs in whole body for a 10 min counting interval at the 95% confidence level is 200 Bq. The MDA for a count of 131I in thyroid is 20 Bq. The system is capable of detecting activities that are equivalent to a dose of 1 mSv for a wide range of radionuclides.

Body Burden↗
PubMed1995

Challenges in cyclosporine therapy: the role of therapeutic monitoring by area under the curve monitoring.

Cyclosporine has revolutionized the practice of transplantation, but its clinical application has been beclouded by a narrow therapeutic window between immunosuppressive and nephrotoxic concentrations. Marked intra- and interindividual pharmacokinetic differences preclude the use of routine dosing regimens. For example, at the intraindividual level, cyclosporine absorption improves during the first 90 days after institution of therapy. A wide range of demographic factors, namely, age, race, and concomitant drug therapy, as well as individual-specific factors produce unique pharmacokinetic behaviors in any given patient. We introduced a pharmacokinetic strategy for cyclosporine administration almost 10 years ago based on the observation that the best estimate of drug exposure was the area under the concentration-time kinetic curve (AUC) not the trough level. Early studies documented the relation between AUC and the incidence of acute rejection. Subsequent studies revealed that not only is the AUC an important predictor, but so is the consistency of drug absorption over time; namely, patients with variations > 25% among AUC determinations display an increased risk of chronic rejection episodes. Therefore therapeutic drug monitoring plays an important role in the optimal care of patients under cyclosporine therapy.

Cyclosporine↗