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PubMed2006

Real time remote monitoring of air pollutants and their online transmission to the web using internet protocol.

Recent advances in both information and sensor technologies have enabled the development of Real Time Remote Monitoring (RTRM) capabilities for environmental management. An online and real time remote monitoring system for air pollution has been designed and installed at a traffic police station at Punjagutta in Hyderabad, India. The system is optimized using electrochemical sensors and a real time particulate matter analyzer. The system also monitors meteorological parameters such as temperature, humidity, rainfall, barometric pressure, wind speed and wind direction. The system periodically monitors both pollution and meteorological parameters at pre- programmed intervals of [Formula: see text] hr during peak periods and 1 hr during non peak periods of the day and continuously uploads to a predestinated web site (www.appcb.org/home.htm) using File Transfer Protocol. The web site renders a quick, simple and graphical display of air pollution levels and meteorological parameters and their significance to humans. The present paper highlights design considerations of a pollution monitoring system, system hardware and software requirements and practical limitations and future directions for real time remote monitoring of air pollution.

Air Pollutants↗
PubMed2006

Monitoring morphological and vegetation changes and flow events in dryland river channels.

Monitoring of impacts of floods in river valleys of dryland regions has become important with the onset and threats of desertification and is likely to become even more vital with predictions of increased effects of climate and land use change. It is also needed in order to conform to requirements of the EU Water Framework Directive. Monitoring in such regions sets particular challenges. This paper explains a system of low-cost monitoring of changes in morphology, vegetation and sediment cover in channels and valley floors of ephemerally flowing streams. It has been applied in SE Spain for 10 years and has proved very effective. In particular, the use of simple crest-stage recorders for measuring flow height and the use of real-time differential GPS for rapid and accurate survey and for relocating points have proved very valuable. Part of the monitoring is focused on the interaction of plants and channel processes. Small changes in and around vegetation associated with flow events have been detected by a combination of quadrat surveys and cross-profiling of the channel. A range of flow events has been measured over the period of monitoring, demonstrating their differing effects and the varying sensitivity and responsiveness of different sites. The sporadic occurrence of flood events in such an environment means that a strategy of monitoring several sites and of continuation over many years has great benefits.

Disasters↗
PubMed2006

A critical analysis of Illinois' fish mercury monitoring program, 1974-1998.

Mercury contamination in fish is a serious public health concern that contrasts with other health benefits of eating fish. Like most US states, Illinois has monitored fish mercury contamination for decades to warn the public of mercury exposure risks by consuming fish. Has this monitoring program been effective in detecting public mercury exposure risks? I analyzed fish mercury contamination data from Illinois inland lakes (1974-1998; > 2,300 samples, 18 fish species, 149 lakes) and found that: (a) sampling and analyses have been severely limited since 1985; (b) sampling effort varied widely among lakes and species, and (c) trends and spatial patterns were confused by this variability. As a result of a severely limited and nonstrategic monitoring program, public mercury exposure risks via Illinois fish consumption remain unclear, despite much effort over many years. Illinois monitors fewer fish per angler than many US states, but is not alone in this regard. Illinois should resurrect and redesign its fish contaminant monitoring program to one that strategically and systematically assesses human mercury exposure risk. Other US states and nations may also benefit from similar retrospective examinations of monitoring programs intended to protect public health.

Animals↗
PubMed2004

Validation of a noninvasive blood pressure monitoring device in normotensive and hypertensive pediatric intensive care patients.

OBJECTIVE: To evaluate the performance and to define limitations of a noninvasive blood pressure monitoring device in the critically ill pediatric population. METHOD: Patients were included in the study if they were admitted to the Pediatric Intensive Care Unit, were between the ages of 1 month and 18 years with wrist circumferences of > or =10 cm, and had an indwelling arterial line. Patients were excluded if their systolic blood pressure differed by > or =7.5% between their upper extremities. The measurements were collected simultaneously with those from an arterial line by a computer interfaced with the noninvasive blood pressure monitoring system and the patient's monitor. Heart rates were calculated from the recorded pulse waveforms of the arterial lines. Comparison analyses were performed via bias and precision plots of the blood pressure and heart rate data in addition to calculation of Pearson's correlation coefficients and concordance correlation coefficients. As a nonparametric method of comparison, the proportion of measurements that differed by greater than 10% was calculated. Results. Blood pressures and heart rates of 20 patients between the ages of 12 months and 17 years were monitored by a noninvasive blood pressure monitor for 30 min per patient. This data collection resulted in 2015 data points for each blood pressure and heart rate for comparison of methods. Concordance correlation coefficients were the following: systolic blood pressure, 0.93; diastolic blood pressure, 0.93; mean blood pressure, 0.94; and heart rate, 0.85. CONCLUSIONS: The noninvasive blood pressure monitor is capable of producing an accurate blood pressure measurement every 12-15 heartbeats in addition to providing a pulse waveform and digital display of the heart rate. Our study showed good agreement between the methods in the normotensive and hypertensive critically ill pediatric population with a wrist circumference limitation defined at > or =11 cm.

Adolescent↗
PubMed2006

Non-contact respiratory monitoring system using a ceiling-attached microwave antenna.

Using a microwave antenna attached to the room ceiling, we conducted non-contact monitoring of respiratory chest wall motions of subjects in bed and covered by a soft comfortable bedding, to measure the vital signs of patients under nursing care in a welfare institution. Long-term vital sign monitoring using electrodes places a heavy burden on monitored individuals. Our non-contact respiratory monitoring system comprises a 1,215 MHz-microwave radar (LDR-1), antenna box attached to the ceiling, and personal computer with analyzing software. The system was tested on eight healthy volunteers (mean age, 25 years; range, 21-44 years) and eight elderly volunteers with some disorders (mean age, 69 years; range, 66-75 years). Respiratory rates of subjects measured using this system correlated with rates measured using respiration sensors (r=0.97, P<0.001 for healthy volunteers, r=0.98, P<0.0001 for elderly volunteers). The system could monitor subtle changes in respiratory rate, and monitoring respiratory rate increases caused by disorders such as pneumonia will be possible.

Adult↗
PubMed2006

The value of home blood pressure monitoring.

Home blood pressure (BP) monitoring has become popular and acceptable. The value of home BP monitoring has been recognized, because it has some potential advantages over office BP. Home BP monitoring is more accurate and reproducible, has a better prognostic value, and increases patients' compliance with treatment. Home BP monitoring should be performed with an adequate device, following a standardized procedure. The automated arm-cuff-oscillometric devices are recommended currently, and home BP should be measured at least twice daily, in the morning and in the evening. Home BP monitoring has revealed the phenomena of "white-coat hypertension," "masked hypertension," and "morning hypertension," and it is useful for their management. In the future, home BP monitoring will be an essential aspect of clinical practice.

Blood Pressure Monitoring, Ambulatory↗
PubMed1981

The effect of electronic fetal monitoring on the incidence of cesarean section.

In an attempt to elucidate the effect of electronic fetal monitoring on cesarean section rates, a review was made of the experience before and that during the 7 years after the initiation of fetal monitoring at Vanderbilt University Hospital. When a comparison was made of the cesarean section rates in the 3 years prior to fetal monitoring with those over the subsequent 2 years, no change was observed, thus indicating that, in experienced hands, a liberal use of fetal monitoring in low-risk and high-risk patients does not necessarily cause a rise in the overall incidence of cesarean sections. During this time, the neonatal mortality rate fell approximately fourfold. On the basis of this study, the belief is that a liberal attitude toward delivery by cesarean section for patients with breech presentations and other high-risk conditions contributed more to the rise in cesarean sections at Vanderbilt University Hospital than did electronic fetal monitoring. With proper education of the clinician and correct interpretation of the findings, electronic fetal monitoring need not increase cesarean section rates, but rather should allow for a more accurate description of intrapartum life.

Cesarean Section↗
PubMed1987

The efficacy of intrapartum electronic fetal monitoring.

With basic methodologic criteria as a framework, this report assesses the quality of the seven randomized controlled clinical trials conducted in five countries to compare a policy of routine electronic fetal monitoring with a policy of fetal heart rate monitoring by auscultation. One trial found a statistically significant decrease in the occurrence of neonatal seizures in the electronic fetal monitoring group. The trials demonstrated no other statistically significant benefit associated with the use of electronic fetal monitoring, but most reported significant increases in the rates of abdominal and vaginal operative deliveries associated with electronic fetal monitoring. Taken together, the seven trials provide valuable information about the routine use of intrapartum electronic fetal monitoring; they do not demonstrate that it is a useful screening procedure for all women in labor.

Australia↗
PubMed1990

Patient-recorded domiciliary fetal monitoring.

Domiciliary fetal monitoring via a telephone link has been in clinical use at the Royal Free Hospital for 2 years, during which time 858 traces of 134 patients who were moderately at risk have been transmitted to the hospital. All recognized abnormal heart rate patterns were detected during the study period. In seven patients obstetric intervention took place on the basis of the domiciliary fetal monitoring recording and subsequent hospital monitoring. There were no intrauterine or neonatal deaths, and there was no overall increase in obstetric operative intervention. There appeared to be a significant reduction in the inconvenience suffered by the patient and her family, compared with conventional monitoring. Fetal heart recordings performed solely by the patient were of a high quality and reduced the demand on midwifery resources. To allow this only 3 hours of midwifery time daily was required and no additional demands on obstetric staff were made. It is anticipated that domiciliary fetal monitoring, performed by patients, will become an essential and established service throughout the United Kingdom (and probably Europe) as the principal means of monitoring fetal well-being.

Adult↗
PubMed1995

Comparison of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation in detecting fetal acidemia at birth.

OBJECTIVE: Our purpose was to compare continuous intrapartum electronic fetal heart rate monitoring with intermittent auscultation for detecting fetal acidemia at birth. STUDY DESIGN: Data from a previously published randomized trial of electronic fetal heart rate monitoring versus intermittent auscultation were analyzed to identify any differences between the two methods in detecting fetal acidemia at birth. Fetal acidemia at birth was defined as the presence of cord blood arterial pH < 7.15. RESULTS: A total of 1419 patients with umbilical cord blood acid-base measurements were identified, 739 in the electronic FHR monitoring group and 680 in the auscultation group. Electronic FHR monitoring had significantly better sensitivity (97% vs 34%, p < 0.001), lower specificity (84% vs 91%, p < 0.001), higher positive predictive value (37% vs 22%, p < 0.05), and higher negative predictive value (99.5% vs 95%, p < 0.001) in detecting fetal acidemia at birth. In addition, electronic FHR monitoring was significantly better in detecting all types of acidemia: metabolic (95.5% vs 26.5%, p < 0.001), mixed (95% vs 37.5%, p < 0.001), and respiratory (100% vs 41.5%, p < 0.001). CONCLUSION: These data suggest that electronic FHR monitoring is superior to intermittent auscultation in detecting fetal acidemia at birth.

Acidosis↗
PubMed1995

Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey.

Neurologic deficits were compared to somatosensory evoked potential (SEP) spinal cord monitoring in a survey of spinal orthopedic surgeons. Experienced SEP spinal cord monitoring teams had fewer than one-half as many neurologic deficits per 100 cases compared to teams with relatively little monitoring experience. Experienced SEP monitoring teams also had fewer neurologic deficits than were seen in previous surveys of this group. Definite neurologic deficits, despite stable SEPs (false negative monitoring), occurred during surgery in only 0.063% of patients. Factors independently associated with fewer neurologic deficits also included the surgeon's years of experience in orthopedic surgery and the use of the wake-up test. Other technical survey results are also presented here. These results confirm the clinical efficacy of experienced SEP spinal cord monitoring for prevention of neurologic deficits during spinal surgery such as for scoliosis.

Electric Stimulation↗
PubMed1989

Miniature electronic blood pressure monitor compared with a blind-reading mercury sphygmomanometer in pregnancy.

The use of electronic blood pressure monitors is increasing, but they have received little evaluation in pregnancy. We compared an electronic monitor (Nissei D-175 Digital Monitor) with a London School of Hygiene blind-reading mercury sphygmomanometer in clinical conditions in 41 patients in the third trimester. In 141 comparisons, the electronic monitor read systolic pressures that were 16.53 mmHg higher on average than the mercury sphygmomanometer, the limits of agreement being from -9.13 mmHg to +42.19 mmHg. For diastolic pressures, the electronic monitor read 9.71 mmHg higher on average than the mercury sphygmomanometer, the limits of agreement being from -16.97 mmHg to +36.39 mmHg. The coefficient of repeatability was similar for both instruments with systolic and diastolic readings. As much caution should be exercised with the use of the electronic monitor in late pregnancy as with the mercury sphygmomanometer, and practitioners should be aware of the marked differences that can occur between instruments.

Blood Pressure Determination↗
PubMed1993

Should we monitor peak expiratory flow rates or record symptoms with a simple diary in the management of asthma?

BACKGROUND: Various means of monitoring asthma severity have been proposed to reduce morbidity and mortality rates. We compared two means of assessing asthma flare-ups: monitoring peak expiratory flow rate (PEFR) and keeping a symptom diary. METHODS: This was a crossover randomized study. After a 2-week baseline period during which spirometry and PC20 methacholine were assessed, subjects were asked to record either PEFRs or to keep a symptom diary morning and evening for 6 months; a second baseline assessment separated the two periods. Subjects were asked to contact the study coordinator if the following occurred: (1) in the period of PEFR monitoring, daily fluctuations in PEFR were > 20% or the absolute value fell to < 80% of baseline or both occurred; (2) in the period of symptom diary monitoring there were nocturnal symptoms or a persistence of morning dyspnea after inhaled bronchodilator or a reduction in the duration of effect of the bronchodilator or it was impossible to go to work or school or all occurred. In that case they were asked to come to the hospital to confirm the flare-up through investigation for significant changes in FEV1 or PC20 or both. Forty subjects completed a 6-month symptom diary or PEFR recording period respectively, and 20 completed both. RESULTS: A total of 31 exacerbations were reported in 28 different subjects; three subjects had two flare-ups. Thirteen of 19 (69%) flare-ups were confirmed during the symptom diary period and 9 of 12 (75%) during PEFR monitoring. Nocturnal awakenings and morning falls in PEFR > or = 20% were the most frequent occurrences. CONCLUSIONS: We conclude that a simple symptom diary may be as useful as serial PEFR monitoring in documenting asthmatic flare-ups.

Adult↗
PubMed1988

Space Station atmospheric monitoring systems.

A technology assessment study on atmospheric monitoring systems was performed by Battelle Columbus Division for the National Aeronautics and Space Administration's John F. Kennedy Space Center under Contract No. NAS 10-11033. In this assessment, the objective was to identify, analyze, and recommend systems to sample and measure Space Station atmospheric contaminants and identify where additional research and technology advancements were required. To achieve this objective, it was necessary to define atmospheric monitoring requirements and to assess the state of the art and advanced technology and systems for technical and operational compatibility with monitoring goals. Three technical tasks were defined to support these needs: Definition of Monitoring Requirements, Assessment of Sampling and Analytical Technology, and Technology Screening and Recommendations. Based on the analysis, the principal candidates recommended for development at the Space Station's initial operational capability were: (1) long-path Fourier transform infrared for rapid detection of high-risk contamination incidences, and (2) gas chromatography/mass spectrometry utilizing mass selective detection (or ion-trap) technologies for detailed monitoring of extended crew exposure to low level (ppbv) contamination. The development of a gas chromatography/mass spectrometry/matrix isolation-Fourier transform infrared system was recommended as part of the long range program of upgrading Space Station trace-contaminant monitoring needs.

Air Conditioning↗
PubMed1993

Complications of intracranial pressure monitoring in fulminant hepatic failure.

In patients with fulminant hepatic failure, brain oedema and the resulting intracranial hypertension often lead to death; intracranial pressure (ICP) monitoring may therefore be valuable. However, there is uncertainty about the hazards of implanting ICP monitoring devices. We carried out a survey of complications associated with ICP monitoring among centres performing liver transplantation in the USA (n = 262 patients). Epidural transducers were the most commonly used devices and had the lowest complication rate (3.8%); subdural bolts and parenchymal monitors (fibreoptic pressure transducers in direct contact with brain parenchyma and intraventricular catheters) were associated with complication rates of 20% and 22%, respectively. Fatal haemorrhage occurred in 1% of patients undergoing epidural ICP monitoring, whereas subdural and intraparenchymal devices had fatal haemorrhage rates of 5% and 4%. Thus, in the setting of fulminant hepatic failure, epidural transducers may be the safest choice for ICP monitoring, even though they are known to be less precise than the other devices.

Adult↗
PubMed1995

Noninvasive assessment of speed and stability of infarct-related artery reperfusion: results of the GUSTO ST segment monitoring study. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

OBJECTIVES: The ST segment monitoring substudy of the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial compared the speed and stability of ST segment recovery among four thrombolytic strategies for acute myocardial infarction. BACKGROUND: Rapid resolution of ST segment elevation has been suggested as a noninvasive marker of infarct-related artery patency. We expected that patients treated with accelerated recombinant tissue-type plasminogen activator (rt-PA) would show a quicker recovery than that of other patients but that those treated with streptokinase would show greater stability of recovery. METHODS: ST segment monitoring was initiated in 1,067 patients within 30 min of the start of thrombolysis and continued for > 18 h with the use of a three-channel continuous vectorcardiographic monitor, a 12-lead continuous electrocardiographic (ECG) monitor or a three-channel (V2, V5, aVF) Holter ambulatory ECG monitor. RESULTS: Time to 50% recovery could be assessed in 618 patients and was similar in the four treatment groups: median 45 min with streptokinase/subcutaneous heparin, 45 min with streptokinse/intravenous heparin, 42 min with accelerated rt-PA and 47 min with combination therapy (p = 0.7). No significant difference among the thrombolytic regimens was shown with the three monitors used. Time to initiation of ST segment analysis was directly related to time to 50% recovery (p = 0.0001) and was its best predictor in a multiple regression model. ST segment elevation recurred equally in each treatment group (approximately 36%, p = 0.9) but was significantly more common in patients with a patent infarct-related artery (p = 0.033) or a low ejection fraction (p = 0.001). CONCLUSIONS: The greater 90-min patency seen with accelerated rt-PA in the angiographic substudy did not correlate with a shorter time to 50% ST segment recovery, possibly because of technical limitations and study design. The similar rates of recurrent ischemia (as assessed by ST elevation) among the regimens support the similar infarction and reocclusion rates seen in the main trial and angiographic substudy.

Drug Therapy, Combination↗
PubMedDate not supplied

Evaluation of a respiratory rate monitor in postsurgical patients.

STUDY OBJECTIVE: To evaluate the clinical use of a cardiorespiratory rate monitor in patients receiving epidural opioids following major surgery. DESIGN: For 6 hours during the night following surgery, patients were continuously monitored with a cardiorespiratory rate monitor and a pulse oximeter, as well as by an in-room observer. SETTING: Postoperative surgical ward at a university hospital. PATIENTS: Eight ASA physical status I and II patients ages 30 to 76 years. INTERVENTIONS: Any bradypneic, hypoxemic, bradycardic, or tachycardic event was confirmed by the observer and recorded. MEASUREMENTS AND MAIN RESULTS: The cardiorespiratory rate monitor accurately identified true bradypneic episodes in five of the eight patients. There were no false-positive alarms. The respiratory rate monitor and the pulse oximeter identified one episode of hypoxemia. There were no episodes of bradycardia or tachycardia. CONCLUSIONS: The cardiorespiratory rate monitor is useful in patients at risk for bradypnea following surgery.

Adult↗
PubMed1992

A method for the simultaneous and continuous monitoring of vascular tone and protein leakage in the synovium.

A technique has been developed to monitor changes in synovial vascular tone and leakage of macromolecules, two of the cardinal features of inflammation. The technique permits not only quantitative sequential measurements of the leakage of 125I-albumin from the circulation into the synovium, but also semiquantitative continuous monitoring of the leakage changes. It allows simultaneous continuous monitoring of changes in synovial vascular tone as well. Vascular protein leakage was monitored semiquantitatively by measuring the radioactivity of 125I-albumin in synovial perfusate when passed through a flow cell consisting of a plastic tubing coil situated inside the well of a gamma detector. Quantitative measurements were provided by collecting and counting the synovial perfusate for 125I-albumin. Synovial vascular tone was monitored continuously by measurement of the change in joint radiation emitted by in vivo-labelled 99m-Tc erythrocytes. The in vivo labelling procedure yielded an 86% +/- 9% labelling efficiency. The degree of erythrocyte labelling was stable throughout the course of the experiment. Using this technique, the abilities of histamine to induce changes in synovial vascular tone and protein leakage were examined. Intraarticular infusion of 1 ng/mL histamine produced a 61% +/- 24% increase in synovial vascular blood volume, but did not significantly increase 125I-albumin leakage above that produced by Krebs solution alone. Higher concentrations produced a concentration-related increase in the leakage of 125I-albumin, which was not accompanied by appreciable increases in synovial vascular blood volume above the basal line. The simultaneous and continuous monitoring provided by this technique has revealed an apparent dissociation between vascular tone and vascular protein leakage in response to intraarticular histamine.

Animals↗