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PubMed2005

[Usefulness of continuous glucose monitoring system (CGMS) in monitoring glycaemic profile in small children with diabetes type 1].

BACKGROUND: Improved methods of diabetes therapy result in a near normoglycaemic state in many patients. This leads however unfortunately to more frequent hypoglycaemic incidents. Particularly small children, whose nervous system is not fully mature, are at high risk of central nervous system damage in case of hypoglycaemia. A new method of detail monitoring of glycaemia provides CGMS system. OBJECTIVES: The aim of the study was to compare the glycaemic profile, with high attention to hypoglycaemia in groups of young and older children with diabetes type 1, using CGMS and routine glucose meter. MATERIAL AND METHODS: We studied 32 children with diabetes type 1. Children were divided into groups: group I--small children, n=17 (<7 yrs of age), mean age 5,8 years, with disease duration--2,46 years, with mean HbA1c level--7,22%, and group II--older children, n=15 (>10 years of age), mean age--12 years, with disease duration--3 years, with HbA1c level--7,21%. Continuous glucose monitoring system (CGMS), by MiniMed, was applied in outpatient or hospital conditions, after short training of patient and parents; together with routine glucose meter measurements, 4-8 times/24 hours. In 9 patients from small children group CGMS was repeated after 2 months. RESULTS: Hypoglycaemic incidents detected with CGMS were similar in both groups: 4,6 in I group vs. 4,2 in II group (ns). Hypoglycaemic incidents found with meter were lower in I group--1,6 vs. 2,3 in II group (ns). Mean hypoglycaemic time/24 hour was longer in small children group: 101 min vs. 74 min in group II (p<00,05). In I group we found higher number of hypoglycaemic incidents during the night compared to group II--1,7 vs. 0,8 (p<00,05) and longer duration of night hypoglycaemia: in I group--56 min vs. 32 min in group II (p<00,05). Repeated CGMS study in 9 children from I group revealed decreased mean time of hypoglycaemia/24 hours from 134 min/24 h to 90 min/24 h (p<00,05) and decreased time of night hypoglycaemia from 65 min to 40 min (p<00,05), with a comparable number of hypoglycaemic incidents. Hypoglycaemic incidents found with routine meter measurements in small children were 1,6 vs. 4,6 hypoglycaemia found with CGMS (p<00,05), in the older children group routine measurement found 2,3 hypoglycaemia vs. 4,2 detected with CGMS (ns). CONCLUSIONS: 1. CGMS can be particularly usefull in monitoring glucose profile and detecting hypoglycaemia incidents, mainly nocturnal in small children. 2. CGMS allows to verify meal dose of insulin and to decrease postprandial hyperglycaemia. 3. Modification of insulin therapy on the base of CGMS helps to decrease the time of hypoglycaemia and hyperglycemia, particularly during the night.

Age Factors↗
PubMed1998

Multicenter study of noninvasive monitoring systems as alternatives to invasive monitoring of acutely ill emergency patients.

BACKGROUND: Recent reports showed lack of effectiveness of pulmonary artery catheterization in critically ill medical patients and relatively late-stage surgical patients with organ failure. Since invasive monitoring requires critical care environments, the early hemodynamic patterns may have been missed. Ideally, early noninvasive hemodynamic monitoring systems, if reliable, could be used as the "front end" of invasive monitoring to supply more complete descriptions of circulatory pathophysiology. OBJECTIVES: To evaluate the accuracy and reliability of noninvasive hemodynamic monitoring consisting of a new bioimpedance method for estimating cardiac output combined with arterial BP, pulse oximetry, and transcutaneous PO2 and PCO2; we compared this system of noninvasive monitoring with simultaneous invasive measurements to evaluate circulatory deficiencies in acutely ill patients shortly after hospital admission where invasive monitoring was not readily available. We also preliminarily explored early differences in temporal hemodynamic patterns of survivors and nonsurvivors. DESIGN AND SETTING: Prospective comparison of simultaneous invasive and noninvasive measurements of circulatory function with retrospective analysis of data in university-run county hospitals, university hospitals and affiliated teaching hospitals, and a community private hospital. PATIENTS: We studied 680 patients, including 139 severely injured or hemorrhaging patients in the emergency department (ED), 129 medical (nontrauma) patients on admission to the ED, 274 high-risk surgical patients intraoperatively, and 138 patients recently admitted to the ICU. RESULTS: A new noninvasive impedance device provided cardiac output estimations under conditions in which invasive thermodilution measurements were not usually applied. There were 2,192 simultaneous bioimpedance and thermodilution cardiac index measurements; the correlation coefficient, r = 0.85, r2 = 0.73, p < 0.001. The precision and bias was -0.124+/-0.75 L/min/m2. Both invasive and noninvasive monitoring systems provide similar information and identified episodes of hypotension, low cardiac index, arterial hemoglobin desaturation, low transcutaneous O2, high transcutaneous CO2, and low oxygen consumption before and during initial resuscitation. The limitations of noninvasive systems were described. CONCLUSIONS: Noninvasive monitoring systems gave continuous displays of physiologic data that provided information allowing early recognition of low flow and poor tissue perfusion that were more pronounced in the nonsurvivors. Noninvasive systems may be acceptable alternatives where invasive monitoring is not available.

Adult↗
PubMed2006

Clinical evaluation of the eBsensor hand-held blood glucose monitoring system.

BACKGROUND: Home glucose monitoring system is increasingly recognized as an important tool for glycemic control. We evaluated the clinical performance of the eBsensor glucose monitoring system. METHODS: Fingertip capillary blood glucose concentrations from 282 subjects were measured using eBsensor glucose monitoring system and compared against predicate devices and the Yellow Springs Instruments (YSI) 2300 blood glucose analyzer. Accuracy and precision of the eBsensor glucose monitoring system were assessed using several methods. The comparative study between the eBsensor and 2 currently marketed monitoring systems was performed. RESULTS: The 282 eBsensor readings covered a wide range from 2.6 to 24.4 mmol/l. Deming regression and Pearson correlation analyses showed a linear relationship between the eBsensor readings and the YSI reference method (eBsensor=0.9496 YSI+0.4127 mmol/l; r=0.98). Error Grid analysis demonstrated that 100% of the eBsensor readings in clinically acceptable zones A and B. The CVs for the 6 lots of strips were within the satisfactory interval (<6%). The comparative study showed that the eBsensor readings correlated well with the OneTouch Ultra values (r=0.97) and the Glucocard II values (r=0.97). CONCLUSIONS: eBsensor is a reliable glucose monitoring system which provides high accurate and precise glucose readings over a wide range of glucose concentrations.

Blood Glucose Self-Monitoring↗
PubMed2005

Development of blood extraction system for health monitoring system.

We focus on research to develop a compact human blood sampling device used for the Self Monitoring of Blood Glucose (SMBG). The SMBG comprises: (1) an indentation system using a shape memory alloy (SMA) actuator to force a microneedle through the skin; (2) a micro electrical pumping system to extract blood using a bimorph type piezoelectric microactuator; (3) a biosensor using an enzyme such as glucose oxidase (GOx) to detect and evaluate the amount of glucose in extracted blood. A titanium microneedle the same size as a female mosquito's labium (60 mum outer diameter, 25 mum inner diameter) was produced by the sputter deposition method. The mechanical design of the device was based upon the mosquito's blood sampling mechanism. The blood extraction system worked well. We measured the performance of the principal components: the indentation load for a microneedle of external diameter 100 mum was found to be 0.1 N. The pumping system has an extraction speed of about 2 mul/min for whole blood. This is similar to that achieved by the mosquito.

Biosensing Techniques↗
PubMed1984

[Digital radiation monitoring system with a personal computer].

This paper describes a data processing system of monitors with a personal computer for a radioisotope laboratory. A monitoring system includes 6 area, 6 dust, and 3 gas monitors. Monitor signals through a multiplexer were fed to the personal computer which has analogue ports. Processed data were displayed on a color CRT, stored on a 5 inch mini floppy disk, and printed out as a report. We developed a data processing program with BASIC language. This system largely reduced manpower required to estimate radiation levels in the laboratory. The personal computer has sufficiently enough ability to construct a digital monitoring system for a small radioisotope laboratory.

Computers↗
PubMed2005

[Virulence of Sogatella furcifera field populations to rice varieties: a determination with electronic monitoring system].

With electronic monitoring system (EMS) and honeydew measurement, this paper determined the virulence of Sogatella furcifera field populations in Fuyang County of Zhejiang Province and Changfeng County of Anhui Province. The results showed that in the three EMS recording periods (2, 4 and 6 h), the ratios of phloem ingestion duration to susceptible rice variety TN1 (check) and highly resistant variety RHT were relatively stable. Two hours duration was defined as the shortest period to detect the virulence of S. furcifera field population by EMS. The amounts of honeydew excreted by S. furcifera field population on rice varieties N22, ARC, ADR52 and ND in Fuyang County, which carried the dominant resistance gene Wbph 1, Wbph 2, Wbph 3 and Wbph 5, respectively, were not significantly different from each other, but significantly lower than that on TN1. The durations of phloem ingestion on ARC and ADR52 were not significantly different, but significantly shorter than that on TN1. For the field population in Changfeng County, the amounts of honeydew excreted by S. furcifera did not differ significantly on N22 and ARC or on ADR52 and ND, but the honeydew on the former two rice varieties was significantly more than that on the latter two. The duration of phloem ingestion on ADR52 (22.3 min x 2 h(-1)) was significantly shorter than that on ARC (49.8 min x 2 h(-1)). Therefore, the virulence of S. furcifera field population in Fuyang County had no changes, whereas in Changfeng County, the population showed a definite adaptation to N22 and ARC, displaying the trend of virulence shift. Electronic monitoring system provided a new means for rapidly and accurately detecting the virulence and monitoring its change of S. furcifera field population.

Animals↗
PubMedDate not supplied

A new method to detect systemic inflammatory response syndrome by continuous monitoring system: an experimental study in rats.

A continuous monitoring system was designed for detection of systemic inflammatory response syndrome (SIRS) using spectrum analyser and local temperature mapping system with deep body thermometer. This method demonstrated significant increases of heart and respiratory rates and deep body temperature from normal levels within 120 minutes after lipopolysaccharide administration in rats. Our monitoring system appears promising for clinical detection of SIRS in the early stages to prevent multiple organ failure.

Animals↗
PubMed1997

Considerations for developing a clinical capnogram monitoring system.

Clinical monitoring and diagnostic systems may require the analysis of multiple physiologic signals to generate a diagnosis. The complexity of these systems is formidable for at least two reasons: clinical physiologic signals are noisy, and systems built around multiple signals may fail when any single signal is absent. In view of these limitations, we have been developing a clinical respiratory CO2 waveform (capnogram) diagnostic system. The purpose of this system is to develop a differential diagnosis from a single signal for subsequent evaluation within the context of multiple single-signals. This paper will review the development issues which we have been confronting, and discuss the tools and methods which have been successful.

Adult↗
PubMed2004

[Information system of the Federal Health Monitoring System. An online database offering a wide range of health information].

The information system of the Federal Health Monitoring System (http://www.gbe-bund.de) offers as an online database a wide range of coordinated health information in words and figures. High-performance software tools allow the information to be researched, analyzed flexibly, and downloaded onto the user's own PC for subsequent processing. At present, the core of the information system represents more than 650 million data from more than 100 data sources, combined in sensible indicators. Clearly arranged diagrams, easy-to-understand texts, and precise definitions complete the offer. Documentations contain additional information on more than 200 data sources, features of surveys, methodological questions of surveys, and contact persons.

Databases as Topic↗
PubMed1984

Evaluation of the "Mahalanobis' generalized distance" method of quality control: monitoring system of multivariate data.

The purpose of this article is to evaluate the effectiveness of a monitoring system that utilizes the multivariate data. The system monitors the data of an individual patient by comparing them with his previous data. The Mahalanobis' generalized distance is introduced to measure the difference between the present and previous data. The authors applied this method to several sets of laboratory data, and it was shown to be useful for the monitoring system of laboratory errors. As a practical application, they developed a batch program and introduced it in the daily routine of the computer system. They expect that this method will be employed as a useful monitoring system in clinical laboratories, like the limit and delta checks.

Clinical Laboratory Techniques↗
PubMed1993

Issues in the optimal selection of a cranial nerve monitoring system.

Intraoperative nerve monitoring (IONM) is a safe technique that is of clear clinical value in the preservation of cranial nerves in skull base surgery and is rapidly becoming the standard of care. Available nerve monitoring systems vary widely in capabilities and costs. A well-informed surgeon may best decide on monitoring needs based on surgical case selection, experience, operating room space, availability of monitoring personnel, and cost. Key system characteristics that should be reviewed in the decision-making process include the monitoring technique (electromyography, pressure transducer, direct nerve monitoring, brainstem auditory evoked potential) and the stimulus technique (stimulating parameters, probe selection). In the past, IONM has been primarily employed in posterior fossa and temporal bone surgery, but the value of IONM is being recognized in more skull base and head and neck surgeries. Suggested IONM strategies for specific surgeries are presented.

Journal Article↗
PubMed2006

Rhythm of daily living and detection of atypical days for elderly people living alone as determined with a monitoring system.

We have developed a system for monitoring the health of elderly people living at home. Infrared and other sensor outputs are collected using a monitoring program installed on a personal computer (PC) in the home at a sampling rate of 1 Hz. Once each day, the data are transferred to a server through the Internet using a cable television (TV) connection. An elderly subject was monitored for a 12-day baseline period and completed a daily questionnaire about her activities. This enabled us to identify the rhythm of daily living (sleeping, 23:00-04:59; getting up/breakfast, 05:00-08:59; indoor activities/going out, 09:00-16:59; and dinner/going to bed, 17:00-22:59) and the average outputs from the sensors in the rooms. The subject was then monitored for a further six months. By identifying sensor output counts outside the limits of mean +/- 3SD, we were able to detect atypical days. During the six-month monitoring period, 29 atypical days were detected. We suggest that the monitoring system may be effective in tele-rehabilitation.

Activities of Daily Living↗
PubMed2002

Use of an infrared temperature monitoring system to determine optimal temperature for laser-solder tissue repair.

Thermal damage of tissue is a major concern for all laser tissue repair techniques where the resulting strength of a repair is sensitive to slight alterations in tissue temperature as well as changes in the duration of exposure of the tissue to the laser beam. Too low of a temperature will prevent proper bonding between the surfaces while prolonged exposure of the tissue to the laser beam results in collateral thermal damage and decreased flexibility and strength of the repair. Temperature feedback systems that monitor the surface temperature of the repair site and adjust the laser irradiance accordingly increase the success rate of the technique. Knowledge of an optimal temperature for tissue soldering will also increase the reliability of the technique. The choice of solder material has been another challenge to the reproducibility of strong repairs. The emerging use of solder-doped polymer membranes as surgical adhesives offers numerous advantages over more traditional liquid and solid solders. Poly (L-lactic-co-glycolic acid) (PLGA), when used as a polymer scaffold, is porous enough to absorb serum albumin and can also be doped with various hemostatic and thrombogenic agents to aid tissue healing. An in vitro study was performed to correlate tissue temperature with the tensile strength of repairs formed using the solder-doped polymer membranes. Previous studies by our group indicate that a solder/tissue interface temperature of 65 degrees C is optimal. Using this parameter as a bench mark, laser irradiance was varied and the solder surface and solder/tissue interface temperatures were monitored by an IR temperature monitoring system, designed by the researchers, and a type K thermocouple, respectively.

Animals↗
PubMedDate not supplied

Blood glucose monitoring systems.

Blood glucose monitoring has evolved from a helpful test to an essential part of diabetes treatment. The equipment used for testing also has been changing rapidly, so that today there are numerous monitoring systems on the market representing a wide range of features and prices. The variety makes it confusing for professionals and clients alike to select an appropriate product. The home healthcare nurse is invited to read the companion article, "Monitoring Diabetes Therapy," which is published in this issue, for a discussion of points to consider when choosing a meter. The following chart (Table 1) is designed to assist the home healthcare nurse to identify various meters and to compare features.

Blood Glucose Self-Monitoring↗
PubMed2006

Detection of donor-specific anti-HLA class I and II antibodies using antibody monitoring system.

The antibody monitoring system (AMS, GTI Inc) is a solid enzyme-linked immunosorbent assay (ELISA) crossmatch test for the detection of immunoglobulin G (IgG) antibody to donor-specific solubilized HLA class I and class II antigens. The objective of this study was to compare the results of the AMS assay with donor-specific anti-HLA IgG antibodies (DS-HLA Abs), as determined by ELISA panel reactive antibody (PRA) and the flow cytometric crossmatch test (FCXM). A total of 107 sera were screened for the presence of HLA Abs by ELISA PRA (LAT-M, One-Lambda Inc), the DS-HLA Abs were determined in 34 serum samples (31.8%) by an ELISA panel (LAT class I and class II, One-Lambda Inc) and FCXM. The FCXM and AMS assays were performed with matched lymphocytes from 56 donors. There was a significant degree of concordance (89.7%) between the two tests (P < .001). The sensitivity, specificity, positive predictive value, and negative predictive value of AMS assay to detect DS-HLA Abs was 88.2%, 94.5%, 88.2%, and 94.5%, respectively. The AMS is a simple, objective test, which has several advantages over the cell-based crossmatch test, such as elimination of non-HLA antibody reactivity, elimination of non-donor-specific antibody reactivity, no need for viable cells, and preparation of the donor's HLA antigens in advance. In summary, this study suggested that AMS may be useful as a supportive crossmatch test or as a monitoring test after transplantation to detect class I or class II DS-HLA Abs.

Enzyme-Linked Immunosorbent Assay↗
PubMed1994

Twelve questions to ask about your outcomes monitoring system--Part I.

Outcomes monitoring is an integral part of any decision maker's information resources--the cornerstone of a provider's commitment to quality improvement or of a purchaser's strategy for seeking value. In their eagerness to obtain useful information about provider performance, purchasers and consumers naively may accept flawed evaluations and thereby create perverse incentives for providers that undermine the very qualities they wish to foster. Inaccurate or misleading information about provider performance will lead managers to reward the wrong behavior and so induce more of it. Inaccurate information also can discourage better providers whose performances are not recognized and can lead all providers to distrust and denounce clinical monitoring in general. When these things happen, the great value of outcomes monitoring systems as a tool for quality improvement is lost.

Data Collection↗
PubMed2005

Use of an electronic monitoring system for self-reporting smallpox vaccine reactions.

OBJECTIVES: Tracking vaccine reactions and adverse events during a large-scale vaccination program such as the recent smallpox program or a pandemic flu outbreak will be a challenge. We report on vaccine reaction data collected using a novel telephone- and web-based electronic reporting system. The system was used to monitor vaccinees during the U.S. Army's smallpox vaccination campaign, which was part of the national program to prepare against biological attack. In addition, we report on the time course of events after smallpox vaccination based on the self-reported data and evaluate the validity and reliability of self-reported take information after smallpox vaccination. METHODS: A prospective cohort of subjects receiving the smallpox vaccination volunteered to use an electronic monitoring system to track and report their vaccination reactions. RESULTS: Users made 6.8 +/- 6.2 (mean +/- SD) reports using the electronic monitoring system. The sensitivity and positive predictive value of self-reported takes were high, 98.8% and 99.6%, respectively. The vaccination-site reactions progressed faster for revaccinees than first-time vaccinees. CONCLUSIONS: Simple-to-use telephone/Internet-based technology allowed detailed self-recording of response to smallpox vaccination among outpatients. Self-reports on site appearance were sufficient to determine vaccine takes in most vaccinees. During a mass vaccination event, an electronic monitoring system could facilitate tracking of vaccine reactions, including providing an early warning system for adverse events, and might reduce the burden associated with follow-up visits with healthcare professionals.

Adult↗