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At least 451 records · Page 25Linked to original sources
PubMed2003

The continuous glucose monitoring system is useful for detecting unrecognized hypoglycemias in patients with type 1 and type 2 diabetes but is not better than frequent capillary glucose measurements for improving metabolic control.

OBJECTIVE: To evaluate whether the continuous glucose monitoring system (CGMS; MiniMed, Sylmar, CA) is useful for investigating the incidence of unrecognized hypoglycemias in type 1 and type 2 diabetic patients and for improving metabolic control in type 1 diabetic patients. RESEARCH DESIGN AND METHODS: A total of 70 diabetic subjects (40 type 1 and 30 type 2 subjects) were monitored using the CGMS. The number of unrecognized hypoglycemias was registered. Furthermore, the 40 type 1 diabetic patients whose treatment was modified in accordance with the information obtained from the CGMS were compared with a control group of 35 different type 1 diabetic patients using intensive capillary glucose measurements. HbA(1c) levels were measured before the monitoring period and 3 months later. RESULTS: The CGMS detected unrecognized hypoglycemias in 62.5% of the type 1 diabetic patients and in 46.6% of the type 2 diabetic patients. We found that 73.7% of all events occurred at night. HbA(1c) concentrations decreased significantly in both the group of type 1 diabetic subjects monitored with the CGMS (from 8.3 +/- 1.6 to 7.5 +/- 1.2%, P < 0.01) and the control group (from 8.0 +/- 1.4 to 7.5 +/- 0.8%, P < 0.01). The greatest reduction was observed in the subgroup of patients who started continuous subcutaneous insulin infusion therapy, both in the CGMS-monitored and control groups (from 9.4 +/- 2 to 7.2 +/- 1.4% and from 8.1 +/- 1.8 to 7.1 +/- 0.6%, respectively). CONCLUSIONS: The CGMS is useful for detecting unrecognized hypoglycemias in type 1 and type 2 diabetic subjects; however, it is not better than standard capillary glucose measurements for improving metabolic control of type 1 diabetic subjects, regardless of the therapeutic regimen.

Adult↗
PubMed2006

Continuous glucose monitoring system for early detection of graft dysfunction in allogenic islet transplant recipients.

BACKGROUND: There are no effective indicators of graft dysfunction in islet transplantation. This study evaluated the role of the Continuous Glucose Monitoring System (CGMS) as an early indicator of graft dysfunction in islet transplant recipients. METHODS: In 5 islet allograft recipients, we retrospectively determined the date of graft dysfunction: 3 fasting blood glucose levels >7.8 mmol/L (140 mg/dL) and/or 3 postprandial blood glucose levels >10 mmol/L (180 mg/dL) in 1 week. We then determined 2 time points in respect to graft dysfunction, 5 to 9 months before (time point A) and 2 to 3 months before (time point B). For these 2 time points, we assessed the following: HbA1c, C-peptide (CP), C-peptide glucose ratio (CPGR), 90-minute glucose from mixed meal tolerance test, and percentage of capillary blood glucose levels >7.8 mmol/L (%CBG >7.8) in a 15-day interval (1 week before and after CGMS placement). From the CGMS recordings, we calculated the glucose variability and the percentage of time spent in hyperglycemia >7.8 mmol/L (%HGT >7.8) and >10 mmol/L (%HGT >10). RESULTS: No difference was found between time points A and B for the following parameters: HbA1c, CP, CPGR, 90-minute glucose, %CBG >7.8, and %HGT >10. We observed a statistically significant increase from time point A to time point B in glucose variability (1.1 +/- 0.5 mmol/L to 1.6 +/- 0.6 mmol/L; P = .004), and in the %HGT >7.8 (11 +/- 12% to 22 +/- 18%; P = .036). CONCLUSION: Glucose variability and %HGT >7.8 determined using CGMS are useful as early indicators of graft dysfunction in islet transplant recipients. Further studies with larger sample sizes will help validate these observations.

Adult↗
PubMed1988

Validation of disease diagnoses reported to the National Animal Health Monitoring System from a large Colorado beef feedlot.

Clinical observation and collection of biological specimens from a large beef feedlot (approximately 30,0000 animals) were used to evaluate 6 approaches for validation of a disease reporting system. Data collected during a 12-month period were used to evaluate each approach. A subsample of disease cases reported to the National Animal Health Monitoring System (NAHMS) was compared with the clinical observations of the investigators. Although the agreement between clinical diagnosis by the NAHMS veterinarian and by feedlot health crews was high, the sensitivity and specificity of specific diagnoses varied from 100 to 18% and from 99 to 76%, respectively, which suggests that regular clinical observations by a veterinarian are needed to validate disease diagnoses reported to NAHMS by producers. Subsampling of a group of cattle by means of paired serologic determination of antibodies to infectious bovine rhinotracheitis virus, bovine viral diarrhea virus, bovine respiratory syncytial virus, and parainfluenza-3 virus revealed a high serologic conversion rate to infectious bovine rhinotracheitis, and high levels of preexisting antibody to bovine respiratory syncytial and parainfluenza-3 viruses. It was concluded that the current method of data collection for Colorado feedlots provides an acceptable level of sensitivity and specificity for the program. However, disease events that are not of economic importance to the feedlot operator will be underestimated. If an objective of NAHMS is to develop a base line of animal health conditions, diagnosis of diseases by current methods will be satisfactory. Occasional validation through clinical observations by a veterinarian will suffice to monitor quality of collected data.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Developing GP monitoring systems guided by a soft systems approach.

This paper describes a selected aspect of a research project concerned with 'contracts and competition' in the recently reformed National Health Service. The particular feature highlighted in this paper is the central role played by the general practitioners in the health service as principal sources of the demands made on provider units (particularly hospitals) and, hence, critical determinants of volumes and costs in contracting. A practical outcome of the research has been the development of GP monitoring systems to be used by provider units particularly in the context of marketing-led referral expectations. The approach used to highlight areas of potential GP contract management and monitoring improvements has been a development of soft systems methodology.

Contract Services↗
PubMed2004

Prevalence and characterization of shiga toxin-producing Escherichia coli in swine feces recovered in the National Animal Health Monitoring System's Swine 2000 study.

A study was conducted to determine the prevalence of Shiga toxin-producing Escherichia coli (STEC) in swine feces in the United States as part of the National Animal Health Monitoring System's Swine 2000 study. Fecal samples collected from swine operations from 13 of the top 17 swine-producing states were tested for the presence of STEC. After enrichment of swine fecal samples in tryptic soy broth, the samples were tested for the presence of stx1 and stx2 by use of the TaqMan E. coli STX1 and STX2 PCR assays. Enrichments of samples positive for stx1 and/or stx2 were plated, and colony hybridization was performed using digoxigenin-labeled probes complementary to the stx1 and stx2 genes. Positive colonies were picked and confirmed by PCR for the presence of the stx1, stx2, or stx2e genes, and the isolates were serotyped. Out of 687 fecal samples tested using the TaqMan assays, 70% (484 of 687) were positive for Shiga toxin genes, and 54% (370 of 687), 64% (436 of 687), and 38% (261 of 687) were positive for stx1, stx2, and both toxin genes, respectively. Out of 219 isolates that were characterized, 29 (13%) produced stx1, 14 (6%) produced stx2, and 176 (80%) produced stx2e. Twenty-three fecal samples contained at least two STEC strains that had different serotypes but that had the same toxin genes or included a strain that possessed stx1 in addition to a strain that possessed stx2 or stx2e. The STEC isolates belonged to various serogroups, including O2, O5, O7, O8, O9, OX10, O11, O15, OX18, O20, O57, O65, O68, O69, O78, O91, O96, O100, O101, O120, O121, O152, O159, O160, O163, and O untypeable. It is noteworthy that no isolates of serogroup O157 were recovered. Results of this study indicate that swine in the United States harbor STEC that can potentially cause human illness.

Animals↗
PubMed1989

Orientation Group Monitoring System: an indicator for reversible impairments in cognition during posttraumatic amnesia.

During posttraumatic amnesia (PTA), confusion, attention deficits, impaired memory, disorientation, and inability to process external stimuli often preclude accurate assessment of subtle neurologic changes. The Orientation Group Monitoring System (OGMS) has proven to be a simple, useful strategy for assessing cognitive status. Retrospective analysis of weekly aggregate OGMS scores indicated that a decline in performance of 0.23 or greater is clinically significant. Over a one-year period, 27 patients demonstrated significant decrements in OGMS performance, and in 93% of these instances, the decrease was attributable to a medical problem. Adverse effects of medication was the most common etiology of decreased performance (n = 13). Overwhelmingly, the decline in the OGMS score was the first indication of impaired cognition. This monitoring device is therefore useful as an indicator during PTA of declining cognitive function, warranting further medical evaluation.

Adult↗
PubMed2003

Glycemic control in diabetic CAPD patients assessed by continuous glucose monitoring system (CGMS).

INTRODUCTION: From 20% to 40% of all patients commencing dialysis are diabetic. The quality of glycemic control is an important determinant of outcome. The aims of this study were to investigate the use of the continuous glucose monitoring system (CGMS) to assess overall 24-hour glycemic control and the effects of both nonglucose containing and more biocompatible alternative peritoneal dialysis solutions in insulin-treated continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS: We studied 8 insulin treated diabetic CAPD patients. A CGMS probe was inserted [allowing automatic measurement of interstitial fluid (ISF) glucose every 5 minutes, for a 72-hour period]. The patients were then allowed home with CGMS monitoring to assess the effect on glycemic control of three differing peritoneal dialysis regimes. Phase 1 consisted of three exchanges of 1.36% glucose and one of 3.86% glucose, utilizing a lactate/bicarbonate buffer. Phase 2 was identical but used lactate-buffered fluid alone. Phase 3 utilized a minimally glycemic combination of one amino acid, one icodextrin, and two 1.36% glucose lactate/bicarbonate-containing exchanges. RESULTS: ISF glucose measured by CGMS correlated well with venous glucose measurements (r2 = 0.82, P < 0.0001). There was a statistically significant difference in the mean ISF glucose between all three phases (P < 0.0001). The variation in glycemic control was tighter during phase 3 [mean coefficient of variation (CV) 0.21 +/- 0.03]. CONCLUSION: CGMS appears to be a clinically useful tool to gain additional insights into the glycemic control of diabetic CAPD patients. More biocompatible and nonglucose-containing dialysis fluids seem to be associated with improvements in glycemic control in this group of patients.

Adult↗
PubMedDate not supplied

[Development and experience in clinical use of computer monitoring systems in the cardiology intensive care unit].

To develop national monitor computer systems (MCS) for intensive cardiological care units, which should be reliable, easy-to-use, and cheaper than their foreign analogues is a pressing scientific and practical problem for Russian medical instrument making. The paper presents the results of development of and clinical experience with MCS at the intensive cardiological care unit of the Republican Clinical Cardiology Dispensary in the Republic of Udmurtia (Izhevsk).

Cardiology↗
PubMed2001

Modes of initiation of paroxysmal atrial fibrillation from analysis of spontaneously occurring episodes using a 12-lead Holter monitoring system.

Although new, possibly curative radiofrequency ablation techniques for atrial fibrillation (AF) have been developed in recent years, little is known about the mechanisms of spontaneous onset of AF episodes. Using a 12-lead 24-hour Holter monitoring system, we aimed to characterize such episodes. A total of 297 spontaneous episodes of AF in 33 patients with intermittent AF (mean age of 59 +/- 11 years) were analyzed. Two hundred seventy-six episodes (93%) were initiated by atrial premature complexes (APCs), whereas 19 episodes (6.4%) were preceded by typical atrial flutter and 2 (0.7%) by atrial tachycardia. Based on 12-lead electrocardiographic criteria, the origin of ectopic beats initiating AF was classified in 230 episodes (77.5%) as being of left atrial origin, in 6 episodes (2.0%) as being of right atrial origin and in 40 episodes (13.5%) the exact location could not be determined. In 16 of 23 patients (70%) with multiple episodes of AF, ectopic beats that initiated AF were consistently monomorphic. In the 120 seconds (6.2 APCs/min for a 30-second period) before onset of AF, frequency of ectopic beats increased from 0.8 APCs/min in AF-free intervals to 4.1/min (6.2 APCs/min for a 30-second period), (p = 0.003 and p = 0.016, respectively). In 209 of 254 episodes (82%), AF onset occurred during normal sinus rate (60 to 100 beats/min). Thus, paroxysmal AF is triggered most frequently by monomorphic left APCs. In most AF episodes, the increase in the number of ectopic beats that initiated episodes of AF occurred at a normal sinus rate.

Adult↗
PubMed2005

Accuracy of the modified Continuous Glucose Monitoring System (CGMS) sensor in an outpatient setting: results from a diabetes research in children network (DirecNet) study.

OBJECTIVE: We previously reported the results of an inpatient accuracy study in children with type 1 diabetes using the Continuous Glucose Monitoring System (CGMS, Medtronic MiniMed, Northridge, CA). During the course of that study, a new process was implemented for manufacturing the CGMS sensor. Accuracy from the resulting modified sensor used by only 14 children was significantly better than the original version [median relative absolute difference (RAD), 11% vs. 19%; P < 0.001]. Baseline data from a subsequent outpatient study provide an opportunity to further assess the accuracy of the modified sensor in a much larger sample of children with type 1 diabetes. RESEARCH DESIGN AND METHODS: As part of a randomized trial to assess the utility of the GlucoWatch G2 Biographer (Cygnus, Inc., Redwood City, CA), 200 children with type 1 diabetes were instructed to wear a CGMS for 48-72 h in an outpatient setting at baseline. Glucose measurements from a OneTouch UltraSmart (Lifescan, Inc., Milpitas, CA) home glucose meter were downloaded and used as reference values to calculate accuracy measures. RESULTS: The overall median RAD was 12%. Accuracy was better during hyperglycemia than during hypoglycemia (median RAD, 10% vs. 20%; P < 0.001) and on optimal versus non-optimal days but did not vary significantly by the number of calibrations entered. CONCLUSIONS: These data confirm the improved accuracy previously reported for the modified version of the CGMS sensor.

Blood Glucose↗
PubMed1987

Evaluation of a microprocessor-based portable home monitoring system to measure breathing during sleep.

Study of the epidemiology of disturbances of breathing during sleep was hampered until recently by the need to conduct studies in the laboratory, with attendant inconvenience and limited sample sizes. We assessed the accuracy of a microprocessor-based portable monitoring system (Vitalog PMS-8, Vitalog Corp., CA) to detect and classify episodes of disturbed breathing during sleep in 14 patients with sleep apnea by simultaneously recording oxygenation and thoracoabdominal motion on the portable system and a polygraph. Each patient slept in the laboratory for 1 night. In two subjects, the portable system failed to record thoracoabdominal signals. In the remaining subjects, the portable system detected 78% of 2,340 episodes of disturbed breathing, but the recorded information was not sufficient to allow confident classification into central or obstructive events. The positive predictive value of disturbed breathing detected by the portable system was 64%, Respiratory disturbance indices (RDI) computed from the polygraph and portable records were correlated (r = 0.70; p less than 0.01), and all patients with sleep apnea were correctly diagnosed by the portable system. The portable system overestimated arterial oxygen saturation (SaO2) recorded by an ear oximeter (Biox IIA, Ohmeda, CO) but the error was less than 10% of the true value at SaO2 greater than 60%. Seven normal subjects were studied while awake to examine the accuracy of volume measurements made by the portable system and the system's ability to detect paradoxical thoracoabdominal motion of various degrees. Absolute measurement of tidal volume was inaccurate, but detection rate of paradoxical thoracoabdominal motion was excellent (97%). We conclude that the portable system is sufficiently sensitive to allow detection of patients with breathing disorders during sleep, but further developments are necessary before the system can be relied on for accurate classification of apneas and hypoventilation.

Adult↗
PubMed2004

Prevalence and correlates of nonadherence to antiretroviral therapy in a population of HIV patients using Medication Event Monitoring System.

Nonadherence to antiretroviral therapy (ART) jeopardizes good clinical outcome in people living with HIV. In a single-center prospective study, prevalence and correlates of nonadherence were investigated in 43 patients on ART. Nonadherence was assessed using Medication Event Monitoring System (MEMS), self-report and collateral report of treating physicians. Based on MEMS data, median taking adherence, dosing adherence, and timing adherence was 98% (interquartile range [IQR] = 5.3), 91.5% (IQR = 18), and 86% (IQR = 31.5), respectively. The median number of drug holidays per 100 days was 0.8 (IQR = 4.8). The prevalence of nonadherence measured by MEMS was 40%. Self-reported nonadherence and collateral report of nonadherence by physicians varied from 5% to 41% and 24% to 28%, respectively. Patients were categorized as adherent or nonadherent based on a clinically validated algorithm derived from MEMS parameters. Nonadherent patients used significantly more escaping coping strategies (p = 0.003) and planned problem solving strategies (p = 0.049), were prescribed significantly more antiretroviral medications (p = 0.02) and were significantly longer on ART (p = 0.04) than adherent patients. Identified correlates of nonadherence may help clinicians in detecting patients with HIV at risk for nonadherence and can support the development of adherence enhancing interventions.

Adaptation, Psychological↗
PubMed1997

[The development of CTTM-1000 distant electrocardiogram central ambulatory monitoring system].

This article introduces a new electrocardiogam telephone transmitting and central ambulatory monitoring (receiving) system, and a device used for monitoring and transmitting the user's electrocardiogram. We also give some detailed discussion about the real time the flow display of ECG, and the signal preprocessing method based on the design of optimum FIR linear phase digital filter for the detection of QRS complexes.

Electrocardiography, Ambulatory↗
PubMed1993

A community education monitoring system: methods from the Stanford Five-City Project, the Minnesota Heart Health Program and the Pawtucket Heart Health Program.

Understanding the process of behavior change interventions is critical to achieving campaign effectiveness and successful program replication. The present article presents a community education monitoring system (CEMS) using data from the Stanford Five-City Project (FCP), the Minnesota Heart Health Program (MHHP) and the Pawtucket Heart Health Program (PHHP). CEMS records the number and type of intervention activities, outcome objectives, targets of change (individual, organizational or environmental), channel(s) of dissemination and proportion of programs funded by the community. These data illustrate (1) the application of theory for each project, (2) data-based program administration, (3) feedback for revising programs and (4) type of reach or 'dose' information obtained from intervention monitoring. Process evaluations such as CEMS provide critical links between field realities and evaluation outcomes. This type of evaluation develops standards for measuring program reach and allows comparisons with other programs. CEMS also illustrates how programs enact theory. Validation studies are critical to the continued successful use of CEMS. The first step, however, is to develop a uniform way of describing complex multichannel behavior change programs. CEMS in a refined form should prove invaluable to health promotion program planners whether in research or service settings.

Behavior Therapy↗
PubMed2006

A comprehensive particulate matter monitoring system and dosimetry-based ambient particulate matter standards.

A numerical particulate matter (PM) measurement model is developed to characterize and evaluate PM sampling methods. Simulations are conducted using the model to evaluate currently widely used PM samplers, including Federal Reference Method (FRM) samplers. The simulations show that current PM samplers are very vulnerable to both changes in measurement target (i.e., natural variability of particle size distribution) and the sampler's design, manufacturing, and operating conditions, potentially resulting in significant errors in the monitoring data. The numerical model is used in conjunction with two types of commercially available PM monitoring devices to form a Comprehensive Particulate Matter Monitoring System (CPMMS). The first type of device can be any mass-based PM monitor with a well-defined sampling efficiency curve. The second type of device is one capable of measuring particle size distribution with a reasonably good relative accuracy between size categories but not necessarily accurate in measuring absolute mass concentrations. This study shows that CPMMS can produce much higher quality PM monitoring data than the current PM samplers under the same conditions. In addition, unlike past and current PM monitoring data such as total suspended particulates, coarse PM (PM10), fine PM (PM2.5), etc., the CPMMS monitoring data will survive changes in PM regulatory definition. A new concept, dosimetry-based PM metrics and standards, is proposed to define ambient PM level based on the deposition fraction of particles in the human respiratory tract. The dosimetry-based PM metrics is more meaningful because it correlates the ambient PM level with the portion that can be deposited in the respiratory tract without an arbitrary cutoff particle diameter. CPMMS makes dosimetry-based PM metrics and standards feasible.

Air Pollutants↗
PubMed2005

Why do women stop breastfeeding? Findings from the Pregnancy Risk Assessment and Monitoring System.

OBJECTIVE: We examined breastfeeding behaviors, periods of vulnerability for breastfeeding cessation, reasons for breastfeeding cessation, and the association between predelivery intentions and breastfeeding behaviors. STUDY DESIGN: Using 2 years (2000 and 2001) of data from the Pregnancy Risk Assessment and Monitoring System we assessed the percentage of women who began breastfeeding, continued for < 1 week, continued for 1 to 4 weeks, and continued for > 4 weeks and their reasons for not initiating or stopping. Predelivery breastfeeding intentions of women and their relationship with subsequent breastfeeding behaviors were examined also. RESULTS: We found that 32% of women did not initiate breastfeeding, 4% started but stopped within the first week, 13% stopped within the first month, and 51% continued for > 4 weeks. Younger women and those with limited socioeconomic resources were more likely to stop breastfeeding within the first month. Reasons for cessation included sore nipples, inadequate milk supply, infant having difficulties, and the perception that the infant was not satiated. Women who intended to breastfeed, thought they might breastfeed, or had ambivalent feelings about breastfeeding were more likely to initiate breastfeeding and to continue through the vulnerable periods of early infancy than were those who did not plan to breastfeed. CONCLUSIONS: Our findings indicate a need to provide extensive breastfeeding support after delivery, particularly to women who may experience difficulties in breastfeeding.

Adult↗
PubMed2004

Continuous radioactivity monitoring systems. From the pre-history of radioprotection to the future of radioecology.

The first significant quantities of artificial radioactivity appeared in the environment around the end of the 1940s. They were gigantic and their metrology very quickly seemed to be essential for sanitary and military reasons. In the 1950s, the first continuous monitoring systems of "fall out" were created. They were neither automatic nor sensitive and radioprotection of the environment was not a concern only for simple public information. Since then, radioecology, technology and evolution of our mentality have completely modified our way of thinking. Thus, from the 1980s up to the dawn of the new millennium, the gap between the performances of metrology laboratories and certain aspects of direct measurement has almost disappeared. 1986 certainly contributed a lot to the concept of surveillance networks and alarm systems, emphasising that the major advantage of these is the fact that they are operational, the minute before the accident.

Environmental Monitoring↗