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At least 487 records · Page 27Linked to original sources
PubMed2004

Cyclic changes in glycemia assessed by continuous glucose monitoring system during multiple complete menstrual cycles in women with type 1 diabetes.

Many women with diabetes notice changes in glucose control perimenstrually. To describe the pattern of changes in glucose control throughout the complete menstrual cycle, and the reproducibility of these changes, we performed a pilot study evaluating glycemic profiles continuously for three cycles in four women with type 1 diabetes. All participants had hemoglobin A1c <7.5% and regular menstrual periods off oral contraceptives. They used Medtronic MiniMed (Northridge, CA) Continuous Glucose Monitoring System (CGMS) devices continuously for three complete menstrual cycles, checked capillary glucose measurements six times daily, changed their own sensors every 3 days, and were seen seven times per menstrual cycle to download data and draw blood. Prolonged monitoring was safely carried out over three consecutive menstrual cycles. We observed two different patterns of glycemic control in relation to the menstrual cycle in these women. The first pattern, seen in two women, was characterized by increased frequency of hyperglycemia in the luteal phase. One of these women also had a hyperglycemic peak in the follicular phase. In the other two women, no characteristic cycle-related pattern was noted. The glucose profiles appeared reproducible between cycles in all women, but varied between women. Thus the menstrual cycle has a reproducible effect on glucose control in a subset of women with type 1 diabetes. Prolonged use of continuous glucose monitoring was safe in the subjects studied, and is the first method clinically available to monitor glucose control over prolonged periods in individuals with diabetes.

Adolescent↗
PubMed1992

[The effect of acebutolol and metoprolol on noninvasive ambulatory blood pressure monitoring system in essential hypertension].

We compared the antihypertensive effects of acebutolol and metoprolol during 2-4 weeks of treatment in patients with mild to moderate essential hypertension. Acebutolol (n = 12) significantly decreased conventionally measured blood pressure from 173/100 mmHg to 148/86 mmHg (p less than 0.005), and metoprolol (n = 11) decreased it from 164/106 mmHg to 138/87 mmHg (p less than 0.01). Based on data derived from automated 24-hour ambulatory blood pressure monitoring, both drugs significantly decreased the blood pressure in the early morning (5:00-10:00). Moreover, in the metoprolol group, there were significant falls in day-time blood pressure (7:30-19:30) and night-time blood pressure (23:00-7:00). In contrast, acebutolol showed significant antihypertensive effect on day-time blood pressure, but not effect on night-time blood pressure. The study confirmed the efficacy and character of metoprolol and acebutolol. We must choose an effective beta-blocker when using an automated 24-hour ambulatory blood pressure monitoring system to get adequate blood pressure reduction for the whole 24 hours.

Acebutolol↗
PubMed2005

Tools for evaluation of impact associated with MSW incineration: LCA and integrated environmental monitoring system.

The identification of significant pollutants emitted from the contamination source is the first step in evaluating the impact associated with anthropic activity. Municipal solid waste (MSW) incinerators are still generally perceived as great pollutant sources, in particular due to their gaseous emissions from the stack, which constitute the major effluent from the plant. In this work a life cycle assessment and an integrated environmental monitoring system were applied together, in order to obtain complete information about the incineration process and its environmental impact. The former is a proven methodology, but its application to waste management systems constitutes a relatively new field of application with a great developmental potential. The contribution of the incineration process to the different environmental impact categories was investigated, finding many avoided impacts due to energy recovery. The latter is an innovative approach that allows a remarkable understanding of impact due to a contamination source; interesting correlations were found between heavy metals both in gas emissions and in natural matrices in the surroundings.

Air Pollutants↗
PubMed1982

Computerized administrative monitoring system for interns and residents.

During the last decade, the role of the government and the professional corporations in approving graduate programmes, licensing interns and residents and requesting statistical information has expanded greatly. The result has been a dramatic increase in administrative workload. At McGill University, the response of the Faculty of Medicine was the introduction of a Computerized Administrative Monitoring System (CAMS) for interns and residents, which provides immediate access, via a video display terminal, to any applicant's or trainee's information file. CAMS also provides timely reports on the status of administrative requirement for both the specialty programmes and the interns and residents assigned to them. The design and implementation of CAMS on the central university time-sharing computer system is described. Some measures of the effort of design, implement and run the system are included, along with an indication of the benefits to the clerical and medical staff who administer the 40 specialty programmes and some 1000 medical trainees.

Computers↗
PubMed1989

[A blindness prevention monitoring system and its application].

The authors conducted a survey of blindness and low vision in the population of 49,770 in Zhong Ning County of Ningxia Province and opened up blindness prevention and treatment with emphasis on cataract. Sight was restored to 88% of the curable blind, bringing down the rate of blindness from 0.24% to 0.14%. A blindness prevention monitoring system of 4 levels was established and its application and significance in the prevention of blindness explored.

Blindness↗
PubMedDate not supplied

[The use of the capture- recapture method in evaluating the epidemiological meningococcal disease monitoring system in Tenerife, Spain (1999-2000)].

BACKGROUND: Meningococcal Disease is mainly monitored passively on the Canary Islands, the regular Compulsory Disease Notification channels being used. The objective of this study includes describing the qualitative and quantitative aspects of this system and evaluating the exhaustiveness, by means of the capture-recapture system, of three information sources. METHODS: This study covers the 1999-2001 period in Tenerife. The information was gathered from three sources: the Compulsory Disease Notification System, the Microbiology Laboratories and the hospital Minimum Basic Data Set. The Evaluation Protocols of the Monitoring System of the Atlanta Centers of Disease Control and Prevention were used. A log-linear model was used for estimating the number of cases. The calculations of the exhaustiveness and the 95% confidence intervals were done in the SPSS10 statistics package. RESULTS: The system was found to have an 84.9% sensitivity, and an 80.4% positive predictive value. The delay in notification (timeliness) fell within the 0.5-13-day range, averaging 3 days. The system was found to have a 76.6% overall acceptability. The exhaustiveness value was 98.1%. CONCLUSIONS: This disease is being monitored well, with a degree of sensitivity which would be revealing of a good notification level, also confirmed by its exhaustiveness. Although the positive predictive value is high, this could be indicative of the expeditious starting of antibiotic treatment which would hinder microbiological confirmation. The system is timely, affording the possibility of measures being taken for fast intervention.

Adolescent↗
PubMed2005

Continuous glucose monitoring system signals the occurrence of marked postprandial hyperglycemia in the elderly.

BACKGROUND: The aim of this study was to ascertain whether dysglycemic episodes occur in institutionalized elderly persons and, if that is the case, to determine whether such episodes are related to meal patterns. Another objective was to investigate the feasibility of subcutaneous (s.c.) glucose measurements in the elderly using a Medtronic MiniMed (Sylmar, CA) continuous glucose monitoring system (CGMS). METHODS: Nine nursing home residents (74-95 years old) without known diabetes or other metabolic disorders were included. The s.c. glucose level was measured for 3 days with the Medtronic MiniMed CGMS. Capillary blood glucose was measured four times daily with a Glucometer Elite device (Bayer, Leverkusen, Germany). Body mass index and basal metabolic rate were calculated, and food intake was recorded. RESULTS: The s.c. glucose level fluctuated noticeably over time; 22.5% of the values recorded during the 3-day period were > or = 8 mmol/L, and values < 3.5 mmol/L were rarely seen. A marked (> 5 mmol/L) and short-term (2-4 h) increase in s.c. glucose was seen after a meal. The mean capillary blood glucose concentration was 7.5 +/- 1.8 mmol/L. Capillary blood glucose > or = 8 mmol/L was recorded on 32.5% of the measurement occasions, and no values were < 3.5 mmol/L. The s.c. glucose values agreed with corresponding capillary blood glucose levels (mean r = 0.75; range 0.43-0.86). Five participants consumed less energy than recommended according to their age, weight, and physical activity level. CONCLUSIONS: Postprandial hyperglycemia frequently occurs in elderly people living in nursing homes. The CGMS is convenient to use to detect hyperglycemia in this age group.

Aged↗
PubMed2002

Assessment of activities of daily living with an ambulatory monitoring system: a comparative study in patients with chronic low back pain and nonsymptomatic controls.

OBJECTIVE: The aim of this study was twofold: (1) to investigate whether differences in activities of daily living exist between patients with chronic low back pain (CLBP) and nonsymptomatic controls; (2) to investigate the day-to-day variability in daily activities. DESIGN: Physical activities were measured over a 24-hour period with an ambulant monitoring system. SETTING: Measurements were carried out in the subject's own environment. SUBJECTS: Forty-seven CLBP patients and 10 nonsymptomatic controls participated in this study. RESULTS: On group level, CLBP patients show a lower activity pattern compared with controls, especially during the evening. This is reflected in a lower walking step frequency during the day and evening, more lying time during the day and a lower physical activity level, less standing time and more lying time during the evening. The day-to-day variability in activity pattern is high and similar for both the patient and control group. CONCLUSION: The lower activity level especially found during the evening might indicate that patients need all their capacity to perform the tasks imposed during the day and as a consequence have less capacity left for their leisure time, in general the evening. This suggests the existence of an imbalance between the patient's physical capacity and the imposed environmental load. The large but similar day-to-day variability in activity pattern, which does not support the clinical findings of 'bad days' in CLBP patients, suggests the need for repeated measures.

Activities of Daily Living↗
PubMed2005

Optimal insulin pump dosing and postprandial glycemia following a pizza meal using the continuous glucose monitoring system.

BACKGROUND: We attempted to identify an optimal insulin pump meal bolus by comparing postprandial sensor glucose values following three methods of insulin pump meal bolusing for a consistent pizza meal. RESEARCH DESIGN AND METHODS: Twenty-four patients with type 1 diabetes participated in a study to compare postprandial glucose values following three meal bolus regimens for a consistent evening pizza meal. Each participant utilized the following insulin lispro regimens on consecutive evenings, and glucose values were tracked by the Continuous Glucose Monitoring System (CGMS, Medtronic MiniMed, Northridge, CA): (a) single-wave bolus (100% of insulin given immediately); (b) 4-h dual-wave bolus (50% of insulin given immediately and 50% given over a 4-h period); and (c) 8-h dual-wave bolus (50% of insulin given immediately and 50% given over a 8-h period). Total insulin bolus amount was kept constant for each pizza meal. RESULTS: Divergence in blood glucose among the regimens was greatest at 8-12 h. The 8-h dual-wave bolus provided the best glycemic control and lowest mean glucose values (singlewave bolus, 133 mg/dL; 4-h dual-wave bolus, 145 mg/dL; 8-h dual-wave bolus, 104 mg/dL), leading to a difference in mean glucose of 29 mg/dL for the single-wave bolus versus the 8-h dual-wave bolus and 42 mg/dL for the 4-h dual-wave bolus versus the 8-h dual-wave bolus. The lower mean glucose in the 8-h dual-wave bolus was not associated with any increased incidence of hypoglycemia. CONCLUSIONS: Use of a dual-wave bolus extended over an 8-h period following a pizza meal provided significantly less postprandial hyperglycemia in the late postprandial period (8-12 h) with no increased risk of hypoglycemia.

Adult↗
PubMed2001

Preventive counseling during prenatal care: Pregnancy Risk Assessment Monitoring System (PRAMS).

BACKGROUND: Prenatal care provides an opportunity for counseling about behaviors and experiences that increase the likelihood of adverse maternal and fetal outcomes. OBJECTIVE: To document (1) prevalence of preventive health counseling during prenatal care, (2) prevalence of women in higher need of counseling about specific health concerns, and (3) whether women in higher need for counseling were more likely than women in lower need to have received counseling. METHODS: Analysis of the Pregnancy Risk Assessment Monitoring System (PRAMS), a state-specific, population-based, random sample of postpartum women, was performed by using data from 14 states for births during 1997 or 1998, for a total of 24,620 participants. Outcome measures included report of preventive health counseling during prenatal visits by specific topic as well as behaviors and experiences about cigarette use, alcohol use, breast-feeding, partner violence, and preterm labor. RESULTS: The percentage of women that report preventive counseling during prenatal care is relatively high (> or =75%) for 9 of 13 topics. However, the percentage of women that report counseling is relatively low (<75%) for partner violence, seat belt use, illegal drug use, and human immunodeficiency virus (HIV) risk. Except for counseling about cigarette and alcohol use, women in higher need, compared with women in lower need, for three other health topics were not significantly more likely to receive counseling. CONCLUSIONS: Preventive health counseling for partner violence, seat-belt use, illegal drug use, and risk of HIV could be increased across prenatal settings. Counseling should involve assessment of risks, with focused counseling related to those risks.

Adolescent↗
PubMed1995

Determining the appropriate level of care. An analysis of factors affecting the staff's overall needs assessments, using data collected through the ASIM monitoring system.

For the purpose of evaluating the validity of the staff's overall needs assessment in terms of the 'appropriate level of care' as a measurement of resource needs--with particular emphasis on the need for institutional resources--an analysis was made concerning the relation of the assessment to various other factors. In the analysis, we used data collected in a survey undertaken in Solna municipality on November 1, 1991 according to the ASIM monitoring system. It was found by multiple regression analysis, that the 'appropriate level of care' was closely related to the client's degree of disability, age, and actual level of care. On the other hand, variables describing the client's social situation--marital status, single-living, informal social support, standard and accessibility of housing--bore no relation to the assessment of need for institutional care. Chiefly because of the close relation to the actual level of care it was concluded that the staff's overall assessment of 'appropriate level of care' should be used with a degree of caution as measure of the need for institutional resources, since it would tend to overrate that need. A more systematic needs assessment procedure is required in order to provide the municipal authorities with unbiased estimates of institutional resource needs.

Aged↗
PubMed2006

United States multicenter clinical usage study of the STAN 21 electronic fetal monitoring system.

OBJECTIVE: The fetal electrocardiogram system for electronic fetal monitoring (EFM) (STAN S21, Neoventa Medical, Moelndal, Sweden) has led to improved perinatal outcomes in other countries. We aimed to assess the ability of United States (US) obstetricians to use this system appropriately for intrapartum care. STUDY DESIGN: A prospective nonrandomized trial was conducted in 6 sites. Enrollment required a singleton vertex fetus, >36 weeks' gestation, with indications for direct fetal monitoring during first stage of labor. Appropriate use was measured by negative predictive value (NPV) of nonintervention for fetuses with nonreassuring fetal heart rate (FHR) patterns, normal STAN readings, and normal neonatal outcomes with umbilical cord arterial pH >7.12; and percent agreement (PA) for intervention decisions with 3 STAN experts who conducted retrospective case reviews blinded to outcome. RESULTS: Five hundred and thirty patients were enrolled. An NPV of 95.2% was achieved while PA between investigators and STAN experts was 84%, and 90%, for intervention and nonintervention, respectively. No fetus with metabolic acidosis requiring intervention was missed by US clinicians. CONCLUSION: US clinicians used the STAN system appropriately in a manner similar to that of experienced STAN users.

Acidosis↗
PubMed2002

Brace monitoring system for the treatment of scoliosis.

Determining the efficacy of brace treatment for AIS has been hampered by poor data on the wear pattern of those children prescribed this treatment. Although there is some information on brace compliance, there is very little on how well the brace is secured and the resulting loads imposed on the trunk. The purpose of this study was to determine the daily brace wear pattern of adolescents prescribed Boston braces. The brace monitoring system consists of a force transducer and a microcomputer unit. A force transducer was placed in the lining of the Boston brace. The microcomputer unit was carried while the brace was worn. The force imposed by the brace pad during daily activity was recorded at 1 minute intervals over a period of 3 to 14 days. The samples were stored by the microcomputer. Five subjects (3F;2M; age: 14+/-2 years) who were to wear the brace full time were studied. The subjects adjusted their braces to a prescribed level of tightness as indicated by a light on the microcomputer. Overall compliance, compliance during school days, and forces imposed by the brace were analysed. The force provided by the Boston brace varies considerably during daily activity. Overall brace compliance was lower than expected, with 2 of 5 subjects wearing their brace infrequently. The compliance rate during school time was not different than during the rest of the study period. Peer pressure at school did not appear to affect brace compliance.

Adolescent↗
PubMed2003

Sex pheromone of horse-chestnut leafminer Camneraria ohridella and its use in a pheromone-based monitoring system.

Gas chromatography combined with electroantennographic detection (GC-EAD), electroantennography (EAG), and wind-tunnel and field experiments were used to reinvestigate the composition of Cameraria ohridella (Lepidoptera, Gracillariidae, Lithocolletinae) sex pheromone. The GC-EAD experiments showed one EAD-active area corresponding to the major pheromone component. (8E,10Z)-tetradeca-8,10-dienal. The EAG experiments proved that (9E)-tetracedecenal and stereoisomers of (8E,10Z)-tetradeca-8,10-dienal exhibited significant electrophysiological activity and could, therefore, be considered as possible minor pheromone components. However, wind-tunnel and field experiments demonstrated that none of these compounds affect the efficacy of the main pheromone component. A monitoring system based on (8E,10Z)tetradeca-8,10-dienal was developed and used to study the flight activity of C. ohridella.

Animals↗
PubMed2005

Interoperability as a quality label for portable & wearable health monitoring systems.

Advances in ICT promising universal access to high quality care, reduction of medical errors, and containment of health care costs, have renewed interest in electronic health records (EHR) standards and resulted in comprehensive EHR adoption programs in many European states. Health cards, and in particular the European health insurance card, present an opportunity for instant cross-border access to emergency health data including allergies, medication, even a reference ECG. At the same time, research and development in miniaturized medical devices and wearable medical sensors promise continuous health monitoring in a comfortable, flexible, and fashionable way. These trends call for the seamless integration of medical devices and intelligent wearables into an active EHR exploiting the vast information available to increase medical knowledge and establish personal wellness profiles. In a mobile connected world with empowered health consumers and fading barriers between health and healthcare, interoperability has a strong impact on consumer trust. As a result, current interoperability initiatives are extending the traditional standardization process to embrace implementation, validation, and conformance testing. In this paper, starting from the OpenECG initiative, which promotes the consistent implementation of interoperability standards in electrocardiography and supports a worldwide community with data sets, open source tools, specifications, and online conformance testing, we discuss EHR interoperability as a quality label for personalized health monitoring systems. Such a quality label would support big players and small enterprises in creating interoperable eHealth products, while opening the way for pervasive healthcare and the take-up of the eHealth market.

Biomedical Technology↗
PubMed1991

Economic evaluation of drug prescription monitoring systems in the extra-hospital environment.

Drugs expenditure accounts for a significant and rising share of public health expenditure (from 14% in 1980 it has now reached 17% approximately). Many efforts have been made to contain its expansion through tickets (co-payments), formularies, price policies, etc., but overall results have been unsatisfactory. The main cause for this failure may be found in the approach adopted, virtually excluding the evaluation of rational use of drugs. Economic evaluation of drug prescription, comparing cost per DDD, assessing both cost/effectiveness ratios and the monitoring system's efficiency, may contribute to a better control of drug expenditure.

Cost-Benefit Analysis↗
PubMed1994

Value of routine pressure monitoring system changes after 72 hours of continuous use.

OBJECTIVE: To assess the infection potential of not routinely changing invasive monitoring kits and associated plasticware. DESIGN: A prospective, observational study of microbiological contamination of a cohort of pressure monitoring infusion systems. SETTING: Adult intensive care units in a university tertiary care center. PATIENTS: Patients who had invasively monitored arterial, central venous, or pulmonary artery catheters in place for > or = 96 hrs without a change to the system were entered into the study. INTERVENTIONS: Fluid samples were obtained from the proximal stopcock of the monitoring kits every 24 hrs, beginning with a sample at 72 hrs and continuing until either the plasticware or catheter was changed or discontinued. Fluid samples were placed in tryptic soy broth and spread on blood agar plates within 24 hrs. MEASUREMENTS AND MAIN RESULTS: Of 451 intervals in which the system remained unviolated for > or = 96 hrs except for sampling, no positive cultures were found. Of the 333 monitoring kits/lines in the study, four cultures became positive within 48 hrs of a violation of the system (flush bag change). Positive cultures were obtained from two different patients, one patient having positive fluid cultures from arterial, central venous, and pulmonary arterial kits. This bacterial growth would not have been eliminated with routine system changes as it occurred within a 48-hr timeframe. CONCLUSIONS: Invasive hemodynamic pressure monitoring systems including tubing and plasticware need not be changed routinely as these changes may cause a higher incidence of contamination due to increased violations of the systems.

Adult↗
PubMed2005

Implementing hygiene monitoring systems in hospital laundries in order to reduce microbial contamination of hospital textiles.

As textiles sent to hospital laundries contain many types of pathogenic organisms, it is important that laundering not only has an appropriate cleaning effect but also has a satisfactory disinfecting effect. Critical to this process is the maintenance of an appropriate hygiene level in the clean area of laundries in order to prevent recontamination of textiles from manual handling when ironing, folding, packing etc. The aims of this study were to evaluate the hygienic state of a hospital laundry, to introduce continuous sanitary measures, and to introduce a continuous hygiene monitoring system with an infection control programme. Two systems for evaluating hospital laundry hygiene were combined: HACCP principles (hazard analysis and critical control points) and RAL-GZ 992 standards (quality assurance standard for textile care of hospital laundry). Evaluation of the hygienic state of the hospital laundry was carried out by evaluating the number and types of micro-organisms present at the critical control points throughout the whole laundering process, using RODAC agar plates for surface sampling and the pour plate method for investigating water samples. The initial examination showed that the sanitary condition of the laundry did not reach the required hygiene level. Therefore, fundamental sanitation measures were instituted and the examination was repeated. Results were then satisfactory. The most important critical control point was the chemothermal laundering efficiency of the laundering process. To prevent micro-organisms spreading into the entire clean working area, it is important that, in addition to regular sanitary measures such as cleaning/disinfecting all working areas, technical equipment and storage shelves etc., regular education sessions for laundry employees on proper hand hygiene is undertaken and effective separation of the clean and dirty working areas is achieved.

Bedding and Linens↗