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PubMed2001

Oral health during pregnancy: an analysis of information collected by the pregnancy risk assessment monitoring system.

BACKGROUND: Little is known about the use of dental services during pregnancy. Yet research suggests that a pregnant woman's oral health and her pregnancy outcome may be associated. METHODS: Four states collected oral health data a part of the Pregnancy Risk Assessment Monitoring System, or PRAMS, in 1998. PRAMS is an ongoing, population-based survey designed to obtain information from mothers who recently delivered live-born infants about their experiences and behaviors before, during and immediately after pregnancy. RESULTS: Reports of dental care use during pregnancy ranged from 22.7 to 34.7 percent. In three states, 12.2 percent to 25.4 percent of respondents reported having a dental problem and of these, 44.7 percent to 54.9 percent went for care. Among mothers reporting a dental problem, prenatal care, or PNC, insurance through public funding and late PNC entry were significantly associated with their not getting dental care. CONCLUSIONS: Most mothers did not go for dental care during their pregnancy; among those who reported having problems, one-half did not get dental care. PRACTICE IMPLICATIONS: Attention toward the oral health needs of pregnant women is warranted. A coordinated effort from the dental and obstetric communities to establish guidelines could benefit maternal oral health and perinatal outcomes.

Adolescent↗
PubMed2002

Enhancing the sensitivity of a two-stage continuous toxicity monitoring system through the manipulation of the dilution rate.

Optimization of the dilution rates has been studied to provide an enhanced sensitivity to toxicity by several recombinant bioluminescent Escherichia coli strains, TV1061 (grpE::luxCDABE), DPD2794 (recA::luxCDABE) and DPD2540 (fabA::luxCDABE), in the two-stage continuous toxicity monitoring system. It was found that the sensitivity of both TV1061 and DPD2794 to a pulse injection of phenol and mitomycin C increased with a decrease in the dilution rate. The sensitivity, however, for all the strains to step injections of the toxic chemicals was found to increase with an increase in the dilution rate up to a certain dilution rate and then decreased, mainly due to the rapid washing out of the injected chemicals. The response kinetics of the strains were explained by evaluating the mode of action of the recombinant bioluminescent bacteria to toxicity with the dilution rate, the operating parameter of minibioreactors under consideration in this study.

Bacterial Proteins↗
PubMed1996

Augmentation of parasympathetic nerve function in patients with extrinsic bronchial asthma--evaluation by coefficiency of variance of R-R interval with modified long-term ECG monitoring system.

Patients with bronchial asthma (BA) have evidence of increased vagal cholinergic tone. Although the cardiovascular-respiratory tests used in the past might have been biased by concomitant chest disease, coefficiencies of variance of the R wave to R wave (RR) interval (CVR-R) on electrocardiogram (ECG) have been applied to many diseases as a method of functional evaluation of the parasympathetic nerve system. In 24 hour recordings of ECG (Holter ECG), continuous values of CVR-R have been determined for each one-minute period with a recently developed long-term ECG monitoring system. To examine functional augmentation of parasympathetic nerve in patients with BA, we applied this system in the present study to determine the alteration of parasympathetic nerve function during an inhaled methacholine provocation test in 14 patients and 7 healthy subjects. CVR-R values were calculated from the collection of a 24-hour electrocardiogram. Bronchial response, which was measured by methacholine inhalation, was evaluated with the baseline value of respiratory resistance (Rrs-cont), the cumulative dose producing a 35% decrease in respiratory conductance (PD35Grs) and the minimum cumulative dose required to start to decrease respiratory conductance from baseline (Dmin). The serum concentrations of epinephrine and norepinephrine were measured at the basal and double-increased levels of respiratory resistance during the inhalation test. The increased values of CV(R-R) in asthmatic patients were intimately associated with augmented respiratory resistance. The disparity of CV(R-R) values (delta CV) during the resistance levels from basal to double in the asthmatic group was significantly greater than that in the control group. The absolute change of CV(R-R) values in the asthmatic group was significantly larger than that in the control group. There was a significant correlation between delta CV and Dmin (r = 0.536, p < 0.05), and between delta CV and PD35Grs (r = 0.552, p < 0.05). The serum concentrations of epinephrine and norepinephrine were not significantly different during the methacholine inhalation provocation test. We conclude that alteration of the values of CV(R-R), which were calculated with a modified long-term ECG recording system, may reflect the change of parasympathetic nerve function and the severity of bronchial hyperreactivity, and this system can be a useful non-invasive method for evaluation of increased vagal tone in patients with bronchial asthma.

Adult↗
PubMed2002

Correlates of self-reports of being very depressed in the months after delivery: results from the Pregnancy Risk Assessment Monitoring System.

OBJECTIVE: This study identified correlates of self-reports of being very depressed in the months after delivery in a population-based sample of women. METHODS: We analyzed data on 14,609 recent mothers from the Centers for Disease Control and Prevention's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS). The sample included mothers who delivered a live birth in Colorado, New York State, and North Carolina from 1996 (New York only) to 1999. We assessed risk factors for self-reports of being very depressed in the months after delivery using logistic regression. RESULTS: Overall, 5.9% (95% CI = 5.3, 6.4) of new mothers reported being very depressed in the months after delivery. Women who reported that their pregnancy was a "very hard time" or "one of the worst times of my life" had the highest prevalence of reporting being very depressed in the months after delivery (24.9%, 95% CI = 21.3, 28.5) and, when all risk factors were adjusted for simultaneously, were 4.6 times (95% CI = 3.1, 6.3) more likely to report being very depressed in the months after delivery than other women. Other significant risk factors for self-reports of being very depressed in the months after delivery included experiencing partner-associated stress (OR = 1.9, 95% CI = 1.5, 2.5), physical abuse during pregnancy (OR = 1.6, 95% CI = 1.1, 2.4), and not breast-feeding (OR = 1.4, 95% CI = 1.1, 1.8). CONCLUSIONS: The highest prevalence for self-reports of being very depressed in the months after delivery was in women who reported that their pregnancy was a "very hard time" or "one of the worst times of my life." Clinicians need to be aware of the needs of some women for mental health services both during and after pregnancy.

Adult↗
PubMed2003

Neonatal screening and monitoring system in Taiwan.

Neonatal screening in Taiwan started as a pilot program in 1981. The coverage rate increased to 90% in 1990, and is currently more than 99%. Five diseases are covered in the screening program including congenital hypothyroidism, phenylketonuria, homocystinuria, galactosemia, and glucose-6-phosphate dehydrogenase deficiency. A monitoring system was established at the same time to ensure correct diagnosis and treatment for positive cases. Neonatal screening is not compulsory by law in Taiwan, but the government is very concerned about it. New tests for neonatal screening have recently been included as pilot programs. Parents of the newborns have to pay for these tests, for which informed consent has to be given. These additional tests include screening for congenital adrenal hyperplasia and tandem mass screening. The results of these pilot programs will be offered to the government for policy decision-making in the future.

Congenital Hypothyroidism↗
PubMed2003

Evaluation of a continuous glucose monitoring system in diabetic dogs.

The generation of a blood glucose curve is important for assessing the response to insulin therapy in diabetic dogs. Disadvantages of this technique include patient discomfort and the potential for missing transient hypo- or hyperglycaemic episodes. The aim of the current study was to evaluate a continuous glucose monitoring system (CGMS) for use in diabetic dogs. Interstitial fluid glucose concentrations were recorded in 10 diabetic dogs, every five minutes for up to 48 hours, using a subcutaneous sensor attached to the CGMS device. Blood glucose concentrations were measured simultaneously using a glucometer. The correlation between interstitial fluid and blood glucose values was 0.81 (P < 0.01). The largest discrepancies between the two sets of data were seen during the one- to three-hour period following feeding, suggesting that postprandial hyperglycaemia might not be reflected in the interstitial fluid. The authors conclude that the CGMS is a potentially valuable tool in the management of canine diabetic patients.

Animals↗
PubMed2005

Validation of the Continuous Glucose Monitoring System (CGMS) by the use of two CGMS simultaneously in pregnant women with type 1 diabetes mellitus.

BACKGROUND: In pregnant women with type 1 diabetes tight glycemic control reduces perinatal complications. Intensive observation of glucose profiles is essential in the achievement of tight glycemic control. The recent availability of the Continuous Glucose Monitoring System (CGMS, Minimed, Sylmar, CA) creates the opportunity to obtain more complete glucose profiles. This study was aimed at evaluating the accuracy of the CGMS in pregnant women with type 1 diabetes. METHODS: Five pregnant women with type 1 diabetes were asked to use two CGMS devices simultaneously. The simultaneously measured glucose levels were analyzed using the Pearson correlation, the mean absolute difference, and Bland-Altman analysis. Second, the percentage of concordance of paired data in the hypoglycemic, normoglycemic, or hyperglycemic range was calculated. RESULTS: The correlation coefficient between simultaneously measured data was 0.94 (P < 0.001). The mean absolute difference was 1.1 +/- 0.8 mmol/L. Bland-Altman analysis shows that 95% of the data pairs have a difference < or = 1.74 mmol/L. Almost 80% of the data pairs could be classified in the same glucose range. In 81% of the non-concordant pairs, one glucose value was classified in the hypoglycemic range and one in the normoglycemic range. CONCLUSIONS: This study shows that the reproducibility of the CGMS in pregnant women with type 1 diabetes is adequate. This indicates that the CGMS is a useful tool in the management of type 1 diabetes in pregnant women. However, the CGMS should only be used as a supplementary method of daily glucose level measurement as a small degree of error, mainly in the hypoglycemic range, is present.

Blood Glucose↗
PubMed2006

Assessment of the perioperative hemodynamics and right ventricular performance of lung cancer patients using a continuous cardiac output monitoring system: comparison between video-assisted thoracic surgery and muscle-sparing thoracotomy.

PURPOSE: This prospective study was conducted to assess the influences of hemodynamics and right ventricular (RV) performance after lobectomy by video-assisted thoracic surgery (VATS) and that by muscle-sparing thoracotomy (MST) using a continuous cardiac output (CCO) monitoring system. SUBJECTS AND METHODS: Between October 2002 and April 2004, 16 patients (VATS, 8; MST, 8) who underwent lobectomy with mediastinal lymphadenectomy were enrolled in this study. Changes in hemodynamics and RV performance were evaluated preoperatively and for 36 hours postoperatively. RESULTS: There were significant differences in operative blood loss (BL) and postoperative maxCPK/m(2) between VATS and MST groups. Postoperative values were expressed as a percentage of the preoperative values. For 36 hours perioperatively, the mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP) and total pulmonary resistance index (TPRI) decreased to greater extents in the VATS group than in the MST group. There were no significant differences between the two groups in RV performance including the continuous cardiac index (CCI), RV ejection fraction (RVEF), RV end-diastolic volume index (RVEDVI) and RV stroke index (SI) postoperatively. CONCLUSION: Considering our previous report about postoperative RV performance using the VATS procedure and posterolateral thoracotomy procedure, this study suggests that pulmonary resection using either VATS or MST could be employed as minimally invasive surgery.

Aged↗
PubMedDate not supplied

Drug information systems, early warning, and new drug trends: can drug monitoring systems become more sensitive to emerging trends in drug consumption?

Drug Information Systems (DIS) are called upon to provide an early warning of emerging trends in drug use. However, little theoretical attention is directed toward exploring conceptual issues in this area. In this paper a typology of existing DIS is offered. Among the features that distinguish DIS are their structure (human network or organization systems) and the range of information sources used. Indicators of drug use can be placed on a continuum of sensitivity ranging from leading edge indicators to lagged indicators. Sensitivity implies volatility as sensitive indicators also react to fluctuations that do not become trends. DIS conventionally are largely reliant upon lagged indicators. What is required are DIS that combine a critical information processing function with the ongoing systematic collection of data from a range of data sources.

Data Collection↗
PubMed2000

The introduction of a routine monitoring system in primary care for patients with a first episode of cardiovascular disease.

A study at a group general practice in the English midlands found that health promotion advice had not been routinely provided to some patients with cardiovascular disease and stroke. The purpose of this project therefore was to introduce a monitoring system to ensure that health promotion issues were covered systematically with patients following a first episode of cardiovascular disease. Patients with a first episode of a relevant condition would be identified by an automated search on the practice database, and contacted by the health visitor. A checklist would ensure that all appropriate issues were covered. The system was easily introduced at the practice and no difficulties were experienced with its administration. A total of 62 patients were seen during the year. A substantial number of secondary prevention issues were addressed through advice and information leaflets. The project was felt to be a useful addition to care by the workers involved. Although some of the issues may have been addressed in routine care, early organized nurse contact ensures systematic coverage and early referrals where necessary, as well as potential psychological benefit to patients.

Adult↗
PubMedDate not supplied

A pacemaker monitoring system.

The use of cardiac pacemaker technology has greatly decreased the morbidity and mortality caused by certain cardiac arrhythmias. Its use, however, has not been without complications, including broken or dislodged pacemaker leads, failure of the pacemaker to sense the QRS complex, and cardiac arrhythmias. This paper presents a straightforward and inexpensive monitoring system which detects four specific pacemaker failure states.

Equipment Failure↗
PubMed2006

1,5-anhydroglucitol and postprandial hyperglycemia as measured by continuous glucose monitoring system in moderately controlled patients with diabetes.

OBJECTIVE: Postprandial hyperglycemia is often inadequately assessed in diabetes management. Serum 1,5-anhydroglucitol (1,5-AG) drops as serum glucose rises above the renal threshold for glucose and has been proposed as a marker for postprandial hyperglycemia. The objective of this study is to demonstrate the relationship between 1,5-AG and postprandial hyperglycemia, as assessed by the continuous glucose monitoring system (CGMS) in suboptimally controlled patients with diabetes. RESEARCH DESIGN AND METHODS: Patients with type 1 or type 2 diabetes and an HbA(1c) (A1C) between 6.5 and 8% with stable glycemic control were recruited from two sites. A CGMS monitor was worn for two consecutive 72-h periods. Mean glucose, mean postmeal maximum glucose (MPMG), and area under the curve for glucose above 180 mg/dl (AUC-180), were compared with 1,5-AG, fructosamine (FA), and A1C at baseline, day 4, and day 7. RESULTS: 1,5-AG varied considerably between patients (6.5 +/- 3.2 mug/ml [means +/- SD]) despite similar A1C (7.3 +/- 0.5%). Mean 1,5-AG (r = -0.45, P = 0.006) correlated with AUC-180 more robustly than A1C (r = 0.33, P = 0.057) or FA (r = 0.38, P = 0.88). MPMG correlated more strongly with 1,5-AG (r = -0.54, P = 0.004) than with A1C (r = 0.40, P = 0.03) or FA (r = 0.32, P = 0.07). CONCLUSIONS: 1,5-AG reflects glycemic excursions, often in the postprandial state, more robustly than A1C or FA. 1,5-AG may be useful as a complementary marker to A1C to assess glycemic control in moderately controlled patients with diabetes.

Deoxyglucose↗
PubMed2006

Comparison of esophageal acid exposure at 1 cm and 6 cm above the squamocolumnar junction using the Bravo pH monitoring system.

The aim of this study was to assess the quantitative differences of acid exposure at 1 cm and 6 cm above the squamocolumnar junction (SCJ) using two radiotelemetry pH capsules affixed to the esophageal mucosa. Ten normal subjects and 10 endoscopy-negative gastroesophageal reflux disease (GERD) patients without hiatus hernia (ages 20-54, 12 male) were studied for a 24-h period using the Bravo pH monitoring system. pH capsules were placed 1 cm and 6 cm above the SCJ. Interpretable data for at least 14 h was obtained in 18 of the 20 subjects (9 normal, 9 GERD). Two failures occurred secondary to early capsule dislodgement. Median esophageal acid exposure was significantly increased at 1 cm above the SCJ compared to 6 cm above the SCJ during the total, upright and postprandial time periods in both normal and GERD subjects. During a 2 h postprandial period the esophageal acid exposure was 8-fold greater in GERD subjects and 5-fold greater in normal subjects 1 cm above the SCJ compared to 6 cm above the SCJ. Confident measurement of esophageal acid exposure at a fixed position 1 cm above the SCJ is feasible with the Bravo system. Acid exposure was significantly higher 1 cm above the SCJ compared to 6 cm above the SCJ in both GERD patients and controls. These findings suggest that measurement of acid exposure 1 cm above the SCJ may improve accuracy of pH monitoring by detecting acid reflux events confined to the distal esophagus.

Adult↗
PubMed1989

Predicting relapse in schizophrenia: the development and implementation of an early signs monitoring system using patients and families as observers, a preliminary investigation.

Recognition of prodromal symptoms of schizophrenia offers the potential of early intervention to avert relapse and re-hospitalization (Carpenter & Heinrichs, 1983). The present study investigated how a strategy to detect prodromal signs might be effectively applied in the clinical setting. A standard monitoring system was developed involving completion of a new early signs scale (ESS) measuring changes in key symptoms phenomenologically (self-report) and behaviourally (observer report). The ESS was subject to rigorous psychometric evaluation and tested in a prospective pilot investigation. The ESS reliably identified early signs and predicted relapse with an overall accuracy of 79%. Several different patterns of relapse were identified. Observer reports compensated for loss of insight in some patients. In two cases where early signs indices were detected, prompt increases in medication appeared to arrest relapse and avert readmission. The ESS offers itself as a reliable, valid and administratively feasible measure and demonstrates considerable potential as a cost-effective procedure for secondary prevention.

Adult↗
PubMed2026

National Antimicrobial Resistance Monitoring System: Three Decades of Advancing Public Health Through Integrated Surveillance of Antimicrobial Resistance.

Antimicrobial resistance (AMR) occurs when bacteria and other microorganisms adapt in ways that make medicines less effective, causing infections that are harder to treat and more likely to spread. According to the Centers for Disease Control and Prevention (CDC), AMR infections affect millions of Americans each year and contribute to thousands of deaths (CDC, 2019). After three decades of operation, the U.S. National Antimicrobial Resistance Monitoring System (NARMS) stands as a model of sustained, collaborative public health surveillance. What began in 1996 as an effort to track resistance in Salmonella and E. coli O157 has evolved into a One Health surveillance network monitoring AMR across the farm-to-fork continuum. Through a partnership among CDC, the Food and Drug Administration (FDA), the U.S. Department of Agriculture (USDA), state and local health departments, and universities, NARMS has become the backbone of foodborne AMR surveillance in the United States. The past decade has been particularly transformative. NARMS explored new sampling to include companion animals, minor livestock, aquaculture, surface water, and wildlife. Whole-genome sequencing (WGS) revolutionized the program's capabilities, enabling timely identification of emerging pathogens and revealing how resistance genes spread. Near real-time public dashboards make NARMS data accessible to researchers, clinicians, regulators, and policymakers. NARMS data shape decisions about new animal drug approvals, guide stewardship programs, and inform clinical treatment guidelines nationwide. As NARMS enters its fourth decade with a 2026-2030 strategic plan, the program will leverage artificial intelligence and metagenomics while expanding surveillance to fill remaining gaps ensuring this vital system continues to protect the food supply and both human and animal health from AMR.

Antimicrobial Resistance (AMR)↗
PubMed2006

Novel real-time monitoring system for human cytomegalovirus-infected cells in vitro that uses a green fluorescent protein-PML-expressing cell line.

Promyelocytic leukemia (PML) bodies are discrete nuclear foci that are intimately associated with many DNA viruses. In human cytomegalovirus (HCMV) infection, the IE1 (for "immediate-early 1") protein has a marked effect on PML bodies via de-SUMOylation of PML protein. Here, we report a novel real-time monitoring system for HCMV-infected cells using a newly established cell line (SE/15) that stably expresses green fluorescent protein (GFP)-PML protein. In SE/15 cells, HCMV infection causes specific and efficient dispersion of GFP-PML bodies in an IE1-dependent manner, allowing the infected cells to be monitored by fluorescence microscopy without immunostaining. Since a specific change in the detergent solubility of GFP-PML occurs upon infection, the infected cells can be quantified by GFP fluorescence measurement after extraction. With this assay, the inhibitory effects of heparin and neutralizing antibodies were determined in small-scale cultures, indicating its usefulness for screening inhibitory reagents for laboratory virus strains. Furthermore, we established a sensitive imaging assay by counting the number of nuclei containing dispersed GFP-PML, which is applicable for titration of slow-growing clinical isolates. In all strains tested, the virus titers estimated by the GFP-PML imaging assay were well correlated with the plaque-forming cell numbers determined in human embryonic lung cells. Coculture of SE/15 cells and HCMV-infected fibroblasts permitted a rapid and reliable method for estimating the 50% inhibitory concentration values of drugs for clinical isolates in susceptibility testing. Taken together, these results demonstrate the development of a rapid, sensitive, quantitative, and specific detection system for HCMV-infected cells involving a simple procedure that can be used for titration of low-titer clinical isolates.

Anticoagulants↗
PubMed2005

Strength and endurance training lead to different post exercise glucose profiles in diabetic participants using a continuous subcutaneous glucose monitoring system.

BACKGROUND: Although both strength training (ST) and endurance training (ET) seem to be beneficial in type 2 diabetes mellitus (T2D), little is known about post-exercise glucose profiles. The objective of the study was to report changes in blood glucose (BG) values after a 4-month ET and ST programme now that a device for continuous glucose monitoring has become available. MATERIALS AND METHODS: Fifteen participants, comprising four men age 56.5 +/- 0.9 years and 11 women age 57.4 +/- 0.9 years with T2D, were monitored with the MiniMed (Northridge, CA, USA) continuous glucose monitoring system (CGMS) for 48 h before and after 4 months of ET or ST. The ST consisted of three sets at the beginning, increasing to six sets per week at the end of the training period, including all major muscle groups and ET performed with an intensity of maximal oxygen uptake of 60% and a volume beginning at 15 min and advancing to a maximum of 30 min three times a week. RESULTS: A total of 17,549 single BG measurements pretraining (619.7 +/- 39.8) and post-training (550.3 +/- 30.1) were recorded, correlating to an average of 585 +/- 25.3 potential measurements per participant at the beginning and at the end of the study. The change in BG-value between the beginning (132 mg dL(-1)) and the end (118 mg dL(-1)) for all participants was significant (P = 0.028). The improvement in BG-value for the ST programme was significant (P = 0.02) but for the ET no significant change was measured (P = 0.48). Glycaemic control improved in the ST group and the mean BG was reduced by 15.6% (Cl 3-25%). CONCLUSION: In conclusion, the CGMS may be a useful tool in monitoring improvements in glycaemic control after different exercise programmes. Additionally, the CGMS may help to identify asymptomatic hypoglycaemia or hyperglycaemia after training programmes.

Aged↗
PubMed1991

The Pregnancy Risk Assessment Monitoring System: design, questionnaire, data collection and response rates. PRAMS Working Group.

The birth certificate, the primary tool for population-based surveillance of the condition of infants at birth and maternal status during pregnancy, provides little data about maternal behaviour during pregnancy. To collect data on maternal behaviours that influence pregnancy outcome, we implemented the Pregnancy Risk Assessment Monitoring System in seven states. For this population-based surveillance, new mothers were sampled from birth certificates 2 to 6 months after delivery and contacted by mail; follow-up of nonrespondents was by telephone. Participants completed a 10-page questionnaire. Stratification permitted over-sampling of women with adverse pregnancy outcomes. Among 10,563 women sampled during 1988 and 1989, stratum-specific response rates ranged from 30% to 89%. In 11 of the 28 strata, response rates were greater than 70%. Response rates varied considerably between states. Rates were lower for Black mothers, mothers of low birthweight infants, unmarried mothers and mothers with less than 12 years of education. Active refusal to participate and undelivered mail occurred infrequently. Mail and telephone surveillance of new mothers can yield adequate response rates in selected population groups. Trials of alternative approaches to enhancing response among Black and disadvantaged mothers, such as additional mailings or post-partum in-hospital recruitment, are needed.

Black or African American↗