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PubMed2001

Comparison between direct ion storage and thermoluminescence dosimetry individual monitoring systems, and Internet reporting.

A new electronic direct ion storage (DIS) dosemeter allows accumulated personal dose equivalent Hp(d) at depths of 10 mm and 0.07 mm to be monitored in a few seconds by inserting the dosemeter into a local reader without deleting the accumulated dose. The DIS system meets general requirements on individual monitoring of hospital personnel using ionising radiation. It differs greatly from off-line thermoluminescence dosimetry systems and offers many additional benefits. The non-volatile reading takes only 5 s, is taken as often as needed, and the data are collected into a dose database, where background radiation is subtracted. Individual personnel doses are reported in Intranet as well as on the Internet at regular intervals to the National Regulatory Authorities.

Air Pollutants, Radioactive↗
PubMedDate not supplied

[Space-time water monitoring system at the Iriklinsk hydroelectric power station].

The Microbiosensor B 17677 F test system was applied to make a space-time monitoring of the biotoxicity of water used for production and everyday purposes at the Iriklinsk hydroelectric power station (IHEPS) and to identify the leading causes determining the biotoxicity of tested samples. There were seasonal variations in the biotoxicity with the maximum in spring and with minimum in winter and spring and a relationship of the spring rise in the biotoxicity to water pH changes. There was also an association of the certain values of the biotoxicity of industrial water with the concentration of petroleum products that are major pollutants at the IHEPS. The datum points that characterize the maximum level of technogenic exposure were identified.

Catchment Area, Health↗
PubMed1989

Efficacy of a new needleless insulin delivery system monitoring of blood glucose fluctuations and free insulin levels.

A new insulin delivery system Vitajet has been invented which involves a high-pressure spring and obviates the use of needle injections. To study its efficacy we compared blood glucose fluctuations, integrated glycemia, free insulin and total free insulin concentrations in six insulin-dependent diabetics. After obtaining a steady state of carbohydrate metabolism overnight by feedback control through the artificial endocrine pancreas (AEP) Biostator, the patients received their usual morning and evening doses of insulin by either conventional injection or Vitajet in random order. Blood glucose levels were significantly lower after Vitajet than conventional injections (p less than 0.04) between 10 a.m. and 4 p.m., but the difference disappeared from 4 p.m. onwards. The areas under the curve (AUCs) of glucose fluctuations were lower after Vitajet (28036 +/- 4655 vs 31086 +/- 2310 mg. min% mean +/- SEM, p less than 0.01). AUCs for free insulin concentrations (microU.min/ml) were close: 39286 +/- 4510 (Vitajet) vs 30597 +/- 3575 (conventional). It is concluded that Vitajet constitutes an efficient needleless route for administering insulin pulses.

Adolescent↗
PubMed1993

Comparison of stationary vs ambulatory 24-hour pH monitoring systems in diagnosis of gastroesophageal reflux disease.

Twenty-four-hour intraesophageal pH monitoring is presently considered the most reliable diagnostic test for gastroesophageal reflux. Prolonged esophageal pH measurements can be obtained in hospitalized patients with a stationary technique and in ambulant outpatients by means of a portable device; however, there have been no studies that have examined whether the two approaches provide a similar diagnostic accuracy. We performed a prospective study to compare stationary and ambulatory pH-metry in the diagnosis of gastroesophageal reflux. Seventy-seven control subjects and 178 patients with proven gastroesophageal reflux disease were randomized to either ambulant or static pH-metry, which was performed with standard pH electrodes, sensors, and recorders. Reflux events (intraesophageal pH < 4.0) analyzed were: number of episodes; total, upright, and supine reflux time; number of episodes lasting > 5 min; and duration of the longest episode. A composite score of all reflux events according to DeMeester was also calculated. The limits of normality were defined as the 95th percentiles of the control groups. Both controls and patients assigned to either pH monitoring method were comparable. Of 255 studies attempted, 243 (95%) were completed successfully. The results showed similar median values of reflux events for the two control groups and for the two patients groups. Percent total reflux time provided a good separation between normal and abnormal reflux, with a sensitivity of 0.92 for static pH-metry and 0.68 for the ambulant procedure (respective 95th percentiles, 3.4 and 4.6).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

Cortical spreading depression recorded from the human brain using a multiparametric monitoring system.

The number of parameters (i.e., EEG or ICP-intracranial pressure) routinely monitored under clinical situations is limited. The brain function analyzer described in this paper enables simultaneous, continuous on-line monitoring of cerebral blood flow (CBF) and volume (CBV), intramitochondrial NADH redox state, extracellular K+ concentrations, DC potential, electrocorticography and ICP from the cerebral cortex. Brain function of 14 patients with severe head injury (GCS < or = 8), who were hospitalized in the neurosurgical or general intensive care unit was monitored using this analyzer. Leao cortical spreading depression (SD) has been reported in many experimental animals but not in the human cerebral cortex. In one of the patients monitored, spreading depression was observed. This is the first time that spontaneous repetitive cortical SD cycles have been recorded from the cerebral cortex of a patient suffering from severe head injury. Typical SD cycles appeared 4-5 h after the beginning of monitoring this patient. During the first 3-4 cycles the responses of this patient were very similar to the responses to SD recorded in normoxic experimental animals. Electrocorticography was depressed whereas extracellular K+ levels increased. The metabolic response to spreading depression was characterized by oxidation of intramitochondrial NADH concomitant to a large increase in CBF. During brain death, an ischemic depolarization, characterized by decrease in CBF and an irreversible increase in extracellular K+, was recorded.

Brain↗
PubMed2006

A clinical monitoring system for clozapine.

OBJECTIVE: To describe a framework for the initiation and ongoing monitoring of patients on clozapine, and detail support materials that can be used in clinical settings, including general practice, to support this process. CONCLUSIONS: A framework is described. Clozapine has a special place in the management of treatment-resistant schizophrenia. However, it has certain side-effects that require its use to be carefully evaluated on an individual patient basis, and encompass excellent documentation and discussion with all relevant parties. Comprehensive longitudinal monitoring is required.

Antipsychotic Agents↗
PubMed1993

An acoustical guidance and position monitoring system for endotracheal tubes.

A prototype instrument to guide the placement and continuously monitor the position of an endotracheal tube (ETT) was developed. An incident audible sound pulse is introduced into the proximal ETT and detected as it travels down the ETT via a miniature microphone located in the wall. This pulse is then emitted from the tube tip into the airways and the reflected signal from the airways is detected by the microphone. A well defined reflection arises from the point where the total cross sectional area of the airways increases rapidly, and the difference in timing between detection of the incident pulse and this reflection is used to determine ETT position or movement. This reflection is not observed if the ETT is erroneously placed in the esophagus. The amplitude and polarity of an additional reflection that occurs at the ETT tip is used to estimate the cross-sectional area of the airway in which the ETT is placed. This combined information allows discrimination between tracheal and bronchial intubation and can be used to insure an adequate fit between the ETT and trachea. The instrument has proven extremely reliable in multiple intubations in eight canines and offers the potential to noninvasively and inexpensively monitor ETT position in a continuous manner.

Animals↗
PubMed2002

Empirical evaluation of a hybrid intelligent monitoring system using different measures of effectiveness.

The validation of a software product is a fundamental part of its development, and focuses on an analysis of whether the software correctly resolves the problems it was designed to tackle. Traditional approaches to validation are based on a comparison of results with what is called a gold standard. Nevertheless, in certain domains, it is not always easy or even possible to establish such a standard. This is the case of intelligent systems that endeavour to simulate or emulate a model of expert behaviour. This article describes the validation of the intelligent system computer-aided foetal evaluator (CAFE), developed for intelligent monitoring of the antenatal condition based on data from the non-stress test (NST), and how this validation was accomplished through a methodology designed to resolve the problem of the validation of intelligent systems. System performance was compared to that of three obstetricians using 3450 min of cardiotocographic (CTG) records corresponding to 53 different patients. From these records different parameters were extracted and interpreted, and thus, the validation was carried out on a parameter-by-parameter basis using measurement techniques such as percentage agreement, the Kappa statistic or cluster analysis. Results showed that the system's agreement with the experts is, in general, similar to agreement between the experts themselves which, in turn, permits our system to be considered at least as skillful as our experts. Throughout our article, the results obtained are commented on with a view to demonstrating how the utilisation of different measures of the level of agreement existing between system and experts can assist not only in assessing the aptness of a system, but also in highlighting its weaknesses. This kind of assessment means that the system can be fine-tuned repeatedly to the point where the expected results are obtained.

Artificial Intelligence↗
PubMed2003

Closed-loop glucose control in critically ill patients using continuous glucose monitoring system (CGMS) in real time.

A study was conducted to determine if continuous subcutaneous glucose monitoring (from MiniMed CGMS) could be used in real-time to control blood sugar level (BSL) in patients with critical illness. A closed-loop control system was constructed to use CGMS in a real-time manner, coupled with a proportional integral (PI) control algorithm based on a sliding scale approach, for automatic intravenous infusion of insulin to patients. A total of five subjects with high BSL (> 10 mmol/L) participated in formal studies of the closed-loop control system. Subjects were recruited from critically ill patients in the intensive care unit (ICU) after informed consent was obtained. Error grid analysis showed that 64.6% of the BSL readings as determined in real time using CGMS sensor, when compared to conventional BSL measurements on blood drawn from an arterial line, was clinically accurate (i.e., < 20% deviation from glucometer value). In the five patients who underwent closed-loop control, the controller managed to control only one patient's glycaemia without any manual intervention. Manual intervention was required due to the real-time sensor reading deviating more than 20% from the glucometer value, and also as a safety mechanism. Test on equality of mean and variance for BSL attained prior to, during, and post trial showed that the controller's performance was comparable to manual control. We conclude that the automatic sliding scale approach of closed-loop BSL control is feasible in patients in intensive care. More work is needed in the refinement of the algorithm and the improvement of real-time sensor accuracy.

Algorithms↗
PubMed1989

Development and application of a system for monitoring drug abuse: the Malaysian experience.

Monitoring systems are useful epidemiological instruments for assessing the problem of drug abuse. The rapid growth of the drug dependence problem in Malaysia led to increased awareness of the need for a system for continuous monitoring of the situation. Preliminary work on the design of an appropriate monitoring system was initiated in 1976. A fully integrated national reporting system was established in 1978, linking all public services and agencies coming into contact with drug-dependent persons, including law enforcement agencies, drug abuse treatment and rehabilitation centres, and social and welfare institutions. The information system included a mechanism for systematic gathering, processing, analysing and presenting essential data on the prevention, control and management of drug abuse problems. It also included reporting on drug-related events, such as hospitalizations and arrests, as well as data on known drug-dependent persons and new cases of dependence. The system has been used for routine monitoring of the extent, trends, patterns and other characteristics of drug abuse problems in Malaysia, providing basic information for policy-making and programme planning. On the basis of data generated by the system, it was estimated that the prevalence rate of drug-dependent persons per 100,000 population increased from 84.3 in 1976 to 754.6 in 1986. It was estimated that there were 119,001 drug-dependent persons in Malaysia in 1986.

Drug and Narcotic Control↗