Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MONITORING SYSTEMS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,387 records · Page 77Linked to original sources
PubMed1993

Chronobiology in cardiology.

In these years, circadian periodicity in the onset of myocardial ischemia, myocardial infarction, sudden cardiac death and ischemic stroke has been confirmed by several investigators. There has also been reported that there exists a significant circadian rhythm in ventricular arrhythmias in patients with myocardial infarction. These recent advances in chronocardiology depend on a development of a high quality built-in A/D converter in ambulatory ECG monitoring system and a remarkably developed sophisticated software. One of the most current topics in recent years is heart rate (HR) variability. As an index of HR variability, RR50 is frequently estimated by the cosine fitting technique. Next, we analyzed the so-called Lorenz plot for another index of HR variability, that is preceding R-R intervals and coupling intervals were plotted sequentially every 3 hours on the abscissa and ordinate, respectively. Finally, we investigated HR variability by power spectral analysis of R-R intervals both by the maximum entropy method and the fast Fourier transform. Mainly, in this paper, we introduced current topics in HR variability, but recent advances in ambulatory blood pressure (BP) monitoring system are also strikingly remarkable. Our newly developed monitoring system of physical activity donated quite a few informations evaluating episodic changes of HR and BP. This device was also useful for finding out the difference between the individual life styles, such as the eveningness versus morningness. In conclusion, these very recent advances in ambulatory monitoring system should be really available for the clinical practice from this time onward.

Adult↗
PubMed1993

Clinical performance of a blood gas monitor: a prospective, multicenter trial.

OBJECTIVE: To prospectively assess the clinical performance of a fluorescent optode-based blood gas monitoring system that is designed to perform arterial pH, PCO2, and PO2 measurements as frequently as clinically required without violating the integrity of the arterial catheter tubing system or permanently removing blood from the patient. DESIGN: A prospective, multicenter study to compare modern blood gas analyzer measurements with the coinciding measurements of the blood gas monitoring system. SETTING: Four intensive care units (ICUs) in academic centers with varying patient populations, blood gas measurement routines, and blood gas laboratory facilities. PATIENTS: Adult ICU patients (n = 117), with appropriately functioning radial arterial catheters in place, who were assessed as likely to require multiple arterial blood gas measurements for > or = 2 days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 117 patients had 1,341 concurrent blood gas analyzer and monitor measurements of arterial pH, PCO2, and PO2 over a 1- to 4-day period. The range of values were 7.14 to 7.64 for arterial pH, 19 to 98 torr (2.5 to 13.0 kPa) for PaCO2, and 38 to 413 torr (5.1 to 54.9 kPa) for PaO2. Linear regression analysis of the optode-based monitor compared with the electrode-based blood gas analyzer demonstrated r2 values of .85 for pH, .92 for PCO2, and .94 for PO2. Comparative statistical analyses for bias (mean difference between analyzer and monitor) and precision (standard deviation of the mean difference [+/- SD] between analyzer and monitor) were respectively:-0.004 and +/- 0.027 for pH; -0.8 torr (-0.11 kPa) and +/- 2.4 torr (0.32 kPa) for PCO2; -2.2 torr (-0.31 kPa) and +/- 8.7 torr (1.2 kPa) for PO2. CONCLUSIONS: Clinical performance of this fluorescent, optode-based blood gas monitoring system demonstrates stability, consistency, and accuracy comparable to modern blood gas analyzers. This system withstood the normal abuse and rigors of clinical conditions common to the ICU while reliably performing in critically ill patients for up to 80 hrs. Use of the device did not significantly alter the function or longevity normally expected from a 20-gauge radial artery catheter. We submit that this blood gas monitoring system can replace the use of blood gas analyzers for ICU patients with indwelling arterial catheters.

Adolescent↗
PubMedDate not supplied

A clinic-based system for monitoring the quality of techniques for the diagnosis of gonorrhea.

The author describes a clinic-based system that monitors the quality of techniques for diagnosis of gonorrhea by continuous comparison of the results of gram-strained smears of urethral and cervical specimens with the corresponding cultures. Discrepant results are immediately reviewed. During a two-year period, the system detected two defects in culture incubation, visual defects in a laboratory technician, and three unexplained reductions in cultural sensitivity. The system motivates clinicians and laboratory technicians to maintain a high level of quality control. In 11,474 comparisons of urethral smear and culture results, there was agreement in 96.9% while the smear alone was positive in 1.6% and the culture alone in 1.5%. Review of positive-smear-negative-culture discrepancies indicated that most smears judged "false-positive" were so classified on the basis of false-negative cultures. In study of 1,331 women, the endocervical smeras identified 60% (273/455) of those with positive culture discrepancies. Many of these may have represented false-negative cultures.

Clinical Laboratory Techniques↗
PubMed2000

Five years of the system of monitoring the environmental impact on population health of the Czech Republic.

The data collected in the System of monitoring the environmental impact on population health of the Czech Republic in 1994-1998 were obtained routinely and in a stabilized manner in six subsystems: health consequences and risks related to air pollution, drinking water quality, noise, human dietary exposure, human exposure to toxic pollutants from the environment and monitoring of the health status and evaluation of selected indicators of demographic and health statistics. They represent a useful and comprehensive background for providing objective information on the health status of the Czech population and on pollution of different components of the environment in the Czech Republic. The results obtained in the period 1994-1998 show that no critical situation needing urgent countermeasures to be taken appeared in the localities monitored. However, some results are indicative of the necessity to take certain remedial measures to maintain all population exposure burdens as low as reasonably possible from the economical and social points of view. Generally, the admissible limit values and exposure limits are exceeded only sporadically in some localities while for most contaminants monitored only very low values compared to the limits can be found and such situations are mostly considered as non-systematic changes.

Adult↗
PubMed1997

System of monitoring the environmental impact on population health of the Czech Republic.

The data collected in the System of monitoring the environmental impact on population health of the Czech Republic in 1994 and 1995 were obtained routinely and in a stabilized manner in six subsystems: health consequences and risks related to air pollution, drinking water quality, noise, human dietary exposure, human exposure to toxic pollutants from the environment and the monitoring of the health state and evaluation of selected indicators of demographic and health statistics. They represent a useful and comprehensive background for providing objective information on the health status of the Czech population and on pollution of different components of the environment in the Czech Republic to other countries in Europe and worldwide to facilitate their commercial and cultural contacts. The results of the calendar year 1995 show that no critical situation needing urgent countermeasures to be taken appeared in the localities monitored. However, some results are indicative of the necessity to take certain remedial measures to maintain all population exposure burdens as low as reasonably possible from the economical and social points of view. The set of problems was identified as important also in 1994. Generally, the limit values and exposure standards are exceeded only sporadically in some localities while for most contaminants monitored only very low values compared to the admissible limits can be found.

Adolescent↗
PubMed1989

OVERSEER: a prototype expert system for monitoring drug treatment in the psychiatric clinic.

This paper describes the development of OVERSEER: a prototype knowledge-based system that monitors the drug treatment of psychiatric patients in real time. Using treatment protocols developed by the expert clinician, OVERSEER monitors the drug treatment process and issues alerts when standard clinical practices are not followed or when laboratory results are abnormal. Written in Prolog, OVERSEER is designed to interface directly with the hospital's database, and, thereby, utilizes all available pharmacy and laboratory data. Moreover, unlike the interactive expert systems developed for the psychiatric clinic, OVERSEER does not require extensive data entry by the clinician. Consequently, the chief benefit of OVERSEER's monitoring approach is the unobtrusive manner in which it evaluates psychopharmacological treatment and provides information regarding patient management to the hospital.

Drug Therapy, Computer-Assisted↗
PubMed1985

A routine system for monitoring perinatal deaths in Scotland.

Since 1983 the monitoring of perinatal deaths in Scotland has been incorporated into the established data collection system which monitors maternal and child health in Scotland. This paper describes the transition from a research project to the routine system and the extension of the data collection to include paediatric and pathological findings. This information is provided by local co-ordinators in active clinical practice. Baseline data are obtained from the routine maternity discharge document (SMR 2). A summary of the findings for the first 4 years of the study, 1977, 1979, 1980 and 1981 is presented, including information about birthweight and gestation-specific perinatal mortality rates; perinatal mortality rates by time of death in relation to labour and singleton and multiple perinatal mortality rates by the obstetric complication preceding the death.

Birth Weight↗
PubMed2001

Towards a national system for monitoring the quality of hospital-based stroke services.

BACKGROUND AND PURPOSE: We sought to evaluate a system for monitoring the quality of hospital-based stroke services that uses routinely collected case fatality data, adjusted for case mix, as well as simple measures of the process of stroke care. METHODS: We compared the process of care and case fatality after stroke between 5 Scottish hospitals (A through E) during 1995-1997. We retrospectively identified 2724 patients with acute stroke using routine discharge data and obtained case mix and process of care data from the medical record. We ascertained case fatality by record linkage and adjusted for case mix using a simple, externally validated regression model. RESULTS: Crude case fatality varied by 21 deaths per 100 admissions between the 5 hospitals. After adjustment, case fatality still differed significantly (P=0.047), with 5 to 7 more deaths per 100 admissions at Hospital A than at Hospitals B through E. There were major shortcomings in the specialization and organization of care, the use of CT scanning, and the completeness of documentation at Hospital A compared with the other hospitals. There were smaller, but clinically important, differences in care between Hospitals B through E but no significant differences in adjusted case fatality. CONCLUSIONS: Once adjusted for important prognostic variables, routinely collected case fatality data might identify hospitals with major shortcomings in the processes of stroke care. More moderate, but still clinically important, variations in stroke care can only be identified by monitoring the process of care directly.

Aged↗
PubMed1986

A control system for monitoring the performance of leukocyte strip tests.

The control system described here is used to monitor the performance of urinary reagent-strip tests for leukocytes. The presence of leukocyte esterase in the urine is used as a marker for leukocytes in urine. The control system is based on sonicated leukocytes, isolated from whole blood. The esterase activity of this sonicate is determined by spectrophotometry with the N-tosyl-L-alanine ester of 5-phenyl-3-hydroxypyrrole as substrate. The assay result is used to determine the amount of sonicate needed to prepare buffered esterase-containing solutions. Such control solutions mimic leukocytic urines and are stable for 6 h at room temperature. The variability of the control system was tested by preparing it five times in a day on five separate days. The overall CV for Leukostix Reagent Strips (Ames Division, Miles Laboratories, Inc.) when tested with these solutions and analyzed with a reflectance spectrophotometer was 8%; for visual readings it was 10%. The overall CV for Chemstrip LN Reagent Strips (Biodynamics, Indianapolis, IN) was 10%.

Cell Separation↗
PubMedDate not supplied

Statistical process control methods for expert system performance monitoring.

The literature on the performance evaluation of medical expert system is extensive, yet most of the techniques used in the early stages of system development are inappropriate for deployed expert systems. Because extensive clinical and informatics expertise and resources are required to perform evaluations, efficient yet effective methods of monitoring performance during the long-term maintenance phase of the expert system life cycle must be devised. Statistical process control techniques provide a well-established methodology that can be used to define policies and procedures for continuous, concurrent performance evaluation. Although the field of statistical process control has been developed for monitoring industrial processes, its tools, techniques, and theory are easily transferred to the evaluation of expert systems. Statistical process tools provide convenient visual methods and heuristic guidelines for detecting meaningful changes in expert system performance. The underlying statistical theory provides estimates of the detection capabilities of alternative evaluation strategies. This paper describes a set of statistical process control tools that can be used to monitor the performance of a number of deployed medical expert systems. It describes how p-charts are used in practice to monitor the GermWatcher expert system. The case volume and error rate of GermWatcher are then used to demonstrate how different inspection strategies would perform.

Evaluation Studies as Topic↗
PubMed2001

Multicenter experiences with a single lead electrode for dual chamber ICD systems.

Monitoring of atrial signals improves the accuracy in identifying supraventricular tachyarrhythmias to prevent inappropriate therapies in patients with implantable ICDs. Since difficulties due to the additional atrial lead were found in dual chamber ICD systems with two leads, the authors designed a single pass VDD lead for use with dual chamber ICDs. After a successful animal study, the prototype VDD lead (single coil defibrillation lead with two additional fractally coated rings for bipolar sensing in the atrium) was temporarily used in 30 patients during a German multicenter study. Atrial and ventricular signals were recorded during sinus rhythm (SR), atrial flutter, AF, and VT or VF. The implantation of the lead was successful in 27 of 30 patients. Mean atrial pacing threshold was 2.5 +/- 0.9 V/0.5 ms, mean atrial impedance was 213 +/- 31 ohms. Atrial amplitudes were greater during SR (2.7 +/- 1.6 mV) than during atrial flutter (1.46 +/- 0.3 mV, P < 0.05) or AF (0.93 +/- 0.37 mV, P < 0.01). During VF atrial "sinus" signals had significantly (P < 0.01) lower amplitudes (1.4 +/- 0.52 mV) than during SR. The mean ventricular sensing was 13.3 +/- 7.9 mV and mean ventricular impedance was 577 +/- 64 ohms. Defibrillation was successful with a 20-J shock in all patients. In addition, 99.6% of P waves could be detected in SR and 84.4% of flutter waves during atrial flutter. During AF, 56.6% of atrial signals could be detected without modification of the signal amplifier. In conclusion, a new designed VDD dual chamber lead provides stable detection of atrial and ventricular signals during SR and atrial flutter. Reliable detection of atrial signals is possible without modification of the ICD amplifier.

Aged↗
PubMedDate not supplied

[Experience in introducing monitoring computer systems in anesthesiology and intensive care units].

The paper describes the author's experience in practically using a monitoring computer system at the Anesthesiology, Resuscitation and Intensive Care Unit, Republican Clinical Hospital No.1, in Izhevsky Udmurtia. The system enables physicians, primarily anesthesiologists-reanimatologists to automate their work. It also allows the problem of routine accounting and report documentation to be solved.

Anesthesiology↗
PubMed2006

Evaluation of invasive and noninvasive hemodynamic monitoring in trauma patients.

OBJECTIVES: The aim of this study was to compare a recently developed and improved noninvasive hemodynamic monitoring system with the conventional invasive monitoring by pulmonary artery catheterization (PAC) in acute emergency trauma patients. METHODS: In a large, university-run, inner city public hospital, we monitored 993 trauma patients noninvasively; 262 of these were simultaneously monitored with both noninvasive hemodynamic and invasive PAC monitoring. The noninvasive monitoring was begun shortly after admission to the emergency department and the invasive PAC monitoring was started in the operating room, or as soon as the patient arrived in the intensive care unit. Noninvasive monitoring included cardiac index (CI) by the IQ or Physio Flow bioimpedance device, together with mean arterial blood pressure, heart rate, pulse oximetry (SapO2), transcutaneous oxygen (PtcO2), and carbon dioxide (PtcCO2) tensions. We compared CI by simultaneous measurements with both invasive and noninvasive methods 907 times in 262 patients. RESULTS: The CI by thermodilution (CItd) correlated well with simultaneous measurements with the bioimpedance (CIbi), r2 = 0.915, r2 = 0.84, p < 0.001. The bias and precision of simultaneous measurements was -0.070 +/- 0.47 L/min/m2; agreement was considered satisfactory. In the initial resuscitation period of both monitoring systems, the CI, mean arterial blood pressure, SapO2, and tissue perfusion (reflected by invasive DO2 and VO2, and by noninvasive PtcO2/FiO2 ratio) were higher in survivors than in nonsurvivors, whereas heart rate values were higher in the nonsurvivors. We concluded that noninvasive hemodynamic monitoring provided a feasible, safe, inexpensive, accurate, continuous, on-line real-time graphic displays that are equivalent to the essential features of invasive pulmonary artery catheter monitoring.

Adult↗
PubMed1992

A computerized information system for monitoring and evaluating substance misuse services.

A computerized, comprehensive information system for the managerial monitoring and evaluation of local substance misuse service delivery is presented. It is based on a model which comprises basic elements of service provision such as, client caseload, time management and workload, work and client satisfaction, in both quantitative and qualitative terms. Findings from its initial implementation in a community drug team and drug dependency units in one of the London District Health Authorities are discussed. The possibility of using this evaluation package by drug and alcohol agencies themselves for the purpose of self-evaluation and monitoring as well as quality assurance is also discussed.

Journal Article↗
PubMedDate not supplied

Dialysis water treatment systems and monitoring in Italy: results of a national survey.

BACKGROUND: The risks connected with dialysis fluid contamination are well established. Epidemiological studies have demonstrated just how difficult it is to obtain permanently satisfactory quality standards. Therefore, dialysis centers must have effective and regular quality control programs, particularly with the growing and widespread use of online convective dialysis treatments. Considering this, we conducted a national survey of water treatment systems and monitoring in Italian dialysis centers. METHODS: Two independent questionnaires were prepared and distributed in 1999 and 2001. The questions were designed to acquire information on structural and procedural elements. Responses to similar questions from both questionnaires were analyzed together. RESULTS: Responses to questionnaires were received from 148 centers (17% of dialysis centers in Italy). In accordance with the European Best Practice Guidelines (EBPG) published recently concerning dialysis fluid purity, in the majority of centers (97%) the water treatment system consisted of at least pre-treatment and reverse osmosis (RO) modules. However, only one stage RO module was implemented (71%), there was a water storage tank (65%) and water pipe distribution loop was made of sanitary polyvinyl chloride (85%). Analysis of procedural elements--the timing and type of disinfection procedures used for the waterline system and monitors, the timing and type of water treatment quality control procedures--revealed a striking variability among centers in terms of the types and frequency of checks performed. CONCLUSIONS: Taking into account the EBPG, this survey revealed both bright and dark spots, calling for a national initiative aimed at defining a standard periodicity of loop disinfection, points in the water pipe line to be tested, and the frequency and type of tests.

Disinfection↗
PubMedDate not supplied

Using a monitored dosage system.

Traditional methods of administering medicines in nursing and residential homes have varied in standard throughout the UK. Monitored dosage systems have the potential to remedy this by making drug administration easier, safer, more hygienic and quicker. This article describes the use of one such system.

Drug Packaging↗