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At least 649 records · Page 36Linked to original sources
PubMed2004

A telehomecare model for optimizing rehabilitation outcomes.

For telehealth to become an accepted component of rehabilitation, a scientific base verifying that telehealth improves outcomes must be developed. A conceptual framework based on theory and empirical findings is necessary for this area of inquiry to flourish. Most academic curricula possess such an educational pillar, which serves to help prepare professionals to practice in the new arena, and scholars to perform quality research. Currently, the authors are involved in developing areas of the biomedical engineering and nursing curricula at Marquette University to address key areas of telerehabilitation. This paper outlines the conceptual framework for these curricular areas. The conceptual framework is derived from three areas that modulate each other, and ultimately impact the outcomes of telerehabilitation. These areas are rehabilitative biosystems, human-technology interfaces, and behavioral compliance. Each can be viewed from the context of an optimization process, and the model can be applied to help identify the weak link for a given telerehabilitative approach under study. Examples of how the model can be used to frame telerehabilitation research are presented, with a special focus on designing home-based solutions for two societal challenges of large scope and great need-stroke and cardiac rehabilitation. The authors conclude that the proposed framework can be used to conceptualize, understand, and optimize the key components of a telerehabilitative process and to analyze alternative approaches for optimizing outcomes.

Home Care Services↗
PubMed2005

Accelerometers in rehabilitation medicine for older adults.

Recent technological developments have led to the production of inexpensive, miniature accelerometer sensors with potential for use in a clinical setting. These sensors can provide reliable information on mobility and objective measurement of gait. They are currently used mainly in a research setting; however, with recent advances, incorporation into clinical practice is possible. For illustrative purposes this paper describes some current applications of accelerometers in gait and balance evaluation, falls risk assessment and mobility monitoring. Accelerometers provide quantitative measures of gait, they are capable of identifying specific gait changes in older adults and in fallers and can be used to objectively quantify ambulatory activity levels. Accelerometers have many potential uses in monitoring of patients in rehabilitation. They provide an added objective and quantitative dimension to gait analysis when combined with clinical assessment. They have the potential in the future to stratify falls risk facilitating early initiation of appropriate therapeutic intervention, thus reducing further falls. The challenge facing clinicians and biomedical engineers is to further harness this technology making it part of everyday clinical practice.

Acceleration↗
PubMed1991

Practical application of determinants of cell behaviour.

During the last fifteen years there has been considerable innovation and development of techniques which can be used to study cell biology and behaviour. These include immunocytochemistry, monoclonal antibody technology, molecular biology and biomedical engineering resulting in advanced flow and image cytometric systems. The volume of research results emerging from basic scientists, pathologists and clinicians relative to these techniques is ever increasing. This generation of data demonstrates the immense interest in the potential of these methods to provide useful information of biological and clinical importance. Breast cancer is one area that has received such attention because of its frequency in western countries and its exhibition of a wide spectrum of clinical behaviour. An acceptance that conservation techniques of surgery and radiotherapy are safe alternatives to mastectomy and developments of chemotherapeutic schedules have now provided the patient, surgeon and oncologist with realistic choices of treatment. The question now being asked by many groups is whether this choice can be influenced appropriately by a knowledge of molecular processes which are present, or that have occurred, and which may influence the tumour cell.

Breast Neoplasms↗
PubMed1992

The European ST-T database: standard for evaluating systems for the analysis of ST-T changes in ambulatory electrocardiography.

The project for the development of the European ST-T annotated Database originated from a 'Concerted Action' on Ambulatory Monitoring, set up by the European Community in 1985. The goal was to prototype an ECG database for assessing the quality of ambulatory ECG monitoring (AECG) systems. After the 'concerted action', the development of the full database was coordinated by the Institute of Clinical Physiology of the National Research Council (CNR) in Pisa and the Thoraxcenter of Erasmus University in Rotterdam. Thirteen research groups from eight countries provided AECG tapes and annotated beat by beat the selected 2-channel records, each 2 h in duration. ST segment (ST) and T-wave (T) changes were identified and their onset, offset and peak beats annotated in addition to QRSs, beat types, rhythm and signal quality changes. In 1989, the European Society of Cardiology sponsored the remainder of the project. Recently the 90 records were completed and stored on CD-ROM. The records include 372 ST and 423 T changes. In cooperation with the Biomedical Engineering Centre of MIT (developers of the MIT-BIH arrhythmia database), the annotation scheme was revised to be consistent with both MIT-BIH and American Heart Association formats.

Algorithms↗
PubMed1992

Endovascular surgery for peripheral arterial occlusive disease. A critical review.

Endovascular surgery is a new multidisciplinary field that applies the recently innovated techniques of angioscopy, intraluminal ultrasound, balloon angioplasty, laser, mechanical atherectomy, and stents. This field can be defined as a diagnostic and therapeutic discipline that uses catheter-based systems to treat vascular disease. As such, it integrates the subspecialties of vascular surgery, interventional radiology, interventional cardiology, and biomedical engineering for the common purpose of improving arterial hemodynamics. Endovascular surgery offers many potential benefits: long incisions are replaced with a puncture wound, the need for postoperative intensive care is significantly reduced, major cardiac and pulmonary complications from general anesthesia are side stepped, and the dollar savings could be dramatic as the need for intensive care unit and in-hospital stay diminishes. Despite these technological advancements, endovascular surgery is still in its infancy and currently has limited applications. This review provides an updated summary of endovascular surgery today and addresses some of the obstacles still preventing its widespread use.

Angioplasty, Balloon↗
PubMed1977

An implantable electromagnetic sound source for speech production.

Our goal is to provide laryngectomized cancer patients with a method of speech rehabilitation as an alternative to esophageal speech when required. With the cooperation of otolaryngologists, biomedical engineers, and speech therapists, an implantable electromagnetic sound source for voice production has been produced. It is biocompatible, durable, and functional in animal experimentation. A small, carefully selected clinical trial will soon begin.

Animals↗
PubMed1997

Continuous noninvasive measurement of cerebral arterial and venous oxygen saturation at the bedside in mechanically ventilated neonates.

OBJECTIVES: To test the practicablity of a new spectrophotometric method using pulse oximetric techniques in combination with special filters for the noninvasive determination of cerebral arterial and venous oxygen saturation and oxygen extraction in neonatal intensive care unit patients. The spectrophotometer used three different wavelengths at a sampling rate of 100 Hz. DESIGN: Clinical evaluation of a new method and comparison with previously published data. SETTING: Design and construction of the special spectrophotometer at the Biomedical Engineering Laboratory of the Swiss Federal Institute of Technology. Measurements in the neonatal intensive care unit of the University Hospital, Zurich, Switzerland. PATIENTS: Convenience sample of 15 clinically stable newborn infants, who were mechanically ventilated and receiving supplemental oxygen. Median gestational age was 29 5/7 wks (range 26 3/ 7 to 36 0/7), median birth weight was 1555 g (720 to 2500), median postnatal age was 4 days (1 to 10). INTERVENTIONS: The emitter and receiver were placed on the forehead near the sagittal sinus, between 2 and 2.8 cm apart, and the pulsating light attenuations (arterial and venous pulse waves) were recorded. MEASUREMENTS AND MAIN RESULTS: Arterial and venous pulse waves were satisfactory in 10 of 15 infants. Mean cerebral arterial oxygen saturation was 89.9 +/- 5.4% (SD), mean cerebral venous oxygen saturation was 73.0 +/- 8.9%, and mean cerebral oxygen extraction was 16.9 +/- 11.7%. A linear regression analysis demonstrated a significant correlation between mean PCO2 and venous oxygen saturation (slope 1.0%/torr, p < .05) and between mean PCO2 and cerebral oxygen extraction (slope -1.3%/torr, p < .05). CONCLUSION: This new method has the potential for monitoring continuously, noninvasively, and simultaneously cerebral arterial and venous oxygen saturation and oxygen extraction in mechanically ventilated preterm infants.

Blood Gas Analysis↗
PubMedDate not supplied

Fabrication of total-contact burn masks by use of human body topography and computer-aided design and manufacturing.

Total-contact burn masks are used to treat scar tissue hypertrophy of the face. The mask should conform very closely to the contours of the face and provide evenly distributed pressure. The mask is worn continually throughout wound maturation. Lack of fit because of an inability to obtain exact facial contours by use of an alginate material diminishes the effectiveness of the mask. A multidisciplinary team representing physical therapy, CAD/CAM (computer-aided design and computer-aided manufacturing), biomedical engineering, and prosthetics has advanced the method of developing total-contact burn masks by use of human body electronic imaging, computer graphics, and numerically controlled milling processes. High-resolution surface scanning and CAD/CAM have been used successfully to accurately fabricate three such masks. The methodology and preliminary results from use of these state-of-the-art techniques are described in this article.

Burns↗
PubMedDate not supplied

Telephone biotelemetry.

This paper is concerned with telephone biotelemetry, such as in the transmission of ECGs or EEGs through telephone networks. It briefly describes the applications of biotelemetry and some research activities in the field. Spectral characteristics and bandwidths of ECG and EEG, and some methods for transmitting these physiological signals through telephone lines are discussed. Shortcomings in the existing telephone biotelemetry systems are identified and some possible solutions to these problems are investigated. The paper is written as a tutorial article directed primarily at clinical engineers, biomedical equipment technicians and other health-care professionals who are interested in the subject.

Electrocardiography↗
PubMedDate not supplied

A computer system for biomedical equipment maintenance reporting.

Biomedical equipment maintenance and repair activities involve an increasing amount of paperwork and report generation. A computer system is described that collects the necessary data on-line for accuracy and efficiency. The system can generate various reports relating to repair history, spare parts usage and preventive maintenance scheduling. It is implemented on a time-sharing minicomputer, and can reduce substantially the time spent by biomedical engineers in documenting their activities.

Computers↗
PubMedDate not supplied

ECG/respiration monitor calibrator.

This paper describes an ECG/Respiration monitor calibrator used by the Biomedical Staff to check such units quickly, inexpensively and accurately. The calibrator can be constructed by the Biomedical Engineering Staff in one day for a parts cost of less than fifty dollars. Once the calibrator is connected to the patient cable of an ECG/Respiration monitor, the calibrator will generate concurrently a calibrated rate and amplitude ECG-pulse and respiration waveform.

Calibration↗
PubMed2001

2001: Things to come.

THIS ARTICLE DISCUSSES elements in the definition of modernity and emerging futurism in neurological surgery. In particular, it describes evolution, discovery, and paradigm shifts in the field and forces responsible for their realization. It analyzes the cyclical reinvention of the discipline experienced during the past generation and attempts to identify apertures to the near and more remote future. Subsequently, it focuses on forces and discovery in computational science, imaging, molecular science, biomedical engineering, and information processing as they relate to the theme of minimalism that is evident in the field. These areas are explained in the light of future possibilities offered by the emerging field of nanotechnology with molecular engineering.

Forecasting↗
PubMed1999

Digital videomicroscopy and image analysis with automatic classification for detection of thin melanomas.

The aim of our investigation was to evaluate the usefulness of a system composed of a digital videomicroscope equipped with a dedicated program for the quantitative characterization of various parameters of the clinically significant features of pigmented skin lesion (PSL) images, forming the basis for automatic differentiation of naevi and thin melanomas. In total 424 naevi and 37 melanomas (including 23 thinner than 0.75 mm) were considered. All the digital images were acquired, framed and analysed using the DBDermo-MIPS program (Biomedical Engineering Dell'Eva-Burroni), which calculates different parameters related to the geometry, the colour distribution and the internal pattern of the lesion. We also assessed the efficacy of an automatic classifier, trained for 100% sensitivity using a subset of PSL images (59 naevi and 19 melanomas), on a test set including 365 naevi and 18 melanomas thinner than 0.75 mm. Significant differences between values from benign and malignant PSLs were observed for most of the numerical parameters. Values from the training set underwent elaboration by means of multivariate discriminant analysis, enabling the identification of variables that are important for distinguishing between the groups in order to develop a procedure for predicting group membership for new cases (test set) in which group membership is undetermined. Going on the training set data, a threshold score was established, enabling each melanoma to be attributed to the right group. When the same threshold value was employed for discriminating between benign and malignant lesions in the test set, all the melanomas were correctly classified, whereas 30 out of the 365 benign lesions were attributed to the wrong group. Thus the specificity of the system reached 92%, whereas the sensitivity was 100%. Our data suggest that elaboration of videomicroscopic images by means of dedicated software improves diagnostic accuracy for thin melanoma. Since elaboration of an image requires only 60s using our system, all the parameter data are available in real time and can be immediately examined by the classifier, providing an instant aid to clinical diagnosis.

Databases, Factual↗
PubMed2002

Investigation of capacitor failures in an automated external defibrillator.

Over the past 2 years, the Canadian Medical Devices Bureau has received a number of reports of capacitor failures on the high voltage board of an automated external defibrillator. Twenty-five cases of broken capacitor leads were found during routine preventive maintenance by the biomedical engineering staff of the institutions reporting the incidents. The Bureau has carried out a laboratory investigation to determine the effect of missing capacitors on the energy delivered by the defibrillator and to assess whether these capacitor failures represent a significant risk to patients. Our findings indicate that the automated external defibrillator will not perform acceptably with two broken capacitors. They further suggest that, during preventive maintenance, operators should use a defibrillator analyser to measure the delivered energy output rather than using the internal energy measurement circuit within the automated external defibrillator.

Canada↗
PubMedDate not supplied

Comparative fixation of tibial plateau fractures using alpha-BSM, a calcium phosphate cement, versus cancellous bone graft.

OBJECTIVES: To compare the compressive strength of a bone substitute material (alpha-BSM) to cancellous bone when used to fill a defect void in a cadaver model of a Schatzker II split depression fracture of the lateral tibial plateau. DESIGN: Randomized, paired design. SETTING: Biomedical engineering laboratory. PATIENTS: Twenty-six human tibias were harvested from 13 cadavers. Three pairs of tibia fractured during preparation and were excluded. The remaining 10 matched pairs were randomized to fixation by using the bone substitute material or cancellous bone. INTERVENTION: A split depression fracture of the lateral tibial plateau was created in each tibia by using reproducible methods. This fracture was stabilized with a stainless steel L-plate and screws and either alpha-BSM or cancellous bone to fill the defect void. MAIN OUTCOME MEASUREMENTS: Stiffness of the elevated fragment in compression, total depression of the joint at 1000 N. RESULTS: The alpha-BSM bone substitute displayed significantly greater stiffness than cancellous bone constructs in Schatzker II split depression fractures of the lateral tibial plateau (P < 0.0001). Plateau defects displaced significantly less at 1000 N when using alpha-BSM in comparison to cancellous bone (P < 0.0001). CONCLUSIONS: In this cadaveric study, alpha-BSM is an effective bone substitute compared with cancellous bone graft for stabilizing split depression fractures of the lateral tibial plateau.

Bone Cements↗
PubMed2004

Detecting and controlling unstable periodic orbits that are not part of a chaotic attractor.

A method for controlling unstable periodic orbits (UPOs) that have not been controllable before is presented. The method is based on detecting UPOs that are situated outside the skeleton of a chaotic attractor. The main idea is to exploit flexible parts of the attractor, which under weak external perturbations allow variable excursions of the trajectory away from its originally determined path. After the perturbation, the trajectory of the autonomous system seeks its path back to the chaotic attractor and reveals additional UPOs that are otherwise not used by the system. It is shown that these UPOs can be controlled as easily as the UPOs that form the basic chaotic attractor. The effectiveness of the proposed method is demonstrated on two different chaotic systems with very distinct response abilities to external perturbations. Additionally, some applications of the method in the fields of laser technology, information encoding, and biomedical engineering are discussed.

Journal Article↗
PubMed1997

Registration of head volume images using implantable fiducial markers.

In this paper, we describe an extrinsic-point-based, interactive image-guided neurosurgical system designed at Vanderbilt University, Nashville, TN, as part of a collaborative effort among the Departments of Neurological Surgery, Computer Science, and Biomedical Engineering. Multimodal image-to-image (II) and image-to-physical (IP) registration is accomplished using implantable markers. Physical space tracking is accomplished with optical triangulation. We investigate the theoretical accuracy of point-based registration using numerical simulations, the experimental accuracy of our system using data obtained with a phantom, and the clinical accuracy of our system using data acquired in a prospective clinical trial by six neurosurgeons at four medical centers from 158 patients undergoing craniotomies to resect cerebral lesions. We can determine the position of our markers with an error of approximately 0.4 mm in X-ray computed tomography (CT) and magnetic resonance (MR) images and 0.3 mm in physical space. The theoretical registration error using four such markers distributed around the head in a configuration that is clinically practical is approximately 0.5-0.6 mm. The mean CT-physical registration error for the phantom experiments is 0.5 mm and for the clinical data obtained with rigid head fixation during scanning is 0.7 mm. The mean CT-MR registration error for the clinical data obtained without rigid head fixation during scanning is 1.4 mm, which is the highest mean error that we observed. These theoretical and experimental findings indicate that this system is an accurate navigational aid that can provide real-time feedback to the surgeon about anatomical structures encountered in the surgical field.

Brain Diseases↗
PubMed1997

Biomedical information technology: medicine and health care in the digital future.

Advancements in medicine and health care are being significantly influenced by the exploding information technology developments. The IEEE Transactions on Information Technology in Biomedicine will address the applications and the infrastructure innovations that would harness biomedical and health care programs in the 21st century.

Biomedical Engineering↗