Biomedical sciences instrumentation
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Medical technologies move from research and development through manufacturing and marketing into the healthcare delivery system. Within the healthcare delivery system, hospitals rely heavily on medical technologies (and the medical devices they enable) to provide diagnosis, treatment, and monitoring in patient care. Managing these devices from acquisition through application in patient care is a formidable task. ⋯ They must do so within a highly regulated and cost-constrained environment. This paper describes the challenges hospitals face and the strategies they employ in their efforts to achieve cost-effective medical technology management. The role of clinical engineering is discussed.
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Mechanical ventilators are routinely used to care for patients who cannot adequately breath on their own. Management of mechanical ventilation often involves a careful watch of the patient's arterial blood-oxygen tension and requires frequent adjustment of ventilation parameters to optimize the therapy. This situation lends itself as a candidate for closed-loop control. ⋯ The results of a small clinical trial indicated that the system maintained control of the patient's therapy nearly 84% of the time. During the remainder of this time, the controller was interrupted primarily for suctioning, PaO2 sensor calibration or replacement. The response of the closed-loop controller was found to be appropriate, reliable and safe in patients with ARDS.
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Our long-term goal is to formulate and assess functional methodologies to enhance recovery of locomotor function in human subjects after incomplete Spinal Cord Contusion Injury (iSCI). This methodology could consist of locomotor training by active treadmill walking. Here, we present kinematic analysis of limb movements in rats with iSCI that have undergone treadmill-walking training. ⋯ The treadmill training eventually led to recovery of coordinated locomotor function after 7 weeks, albeit with deformities in gait. This recovery of locomotor function occurred in spite of significant loss of axonal connections between the brain and the spinal lumbar segments at site of injury (assessed by histology after terminal data collection). The results suggest that functional recovery of locomotion could be an activity dependent process.
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Most clinicians learned the art and science of auscultation using an acoustic stethoscope. While many models of electronic stethoscopes have been marketed over the years, none of them seem to do a very good job of emulating the most common forms of acoustic stethoscopes available. This paper is an appeal to biomedical circuit designers to learn more about the acoustics of commonly used stethoscopes and to develop an appropriate group of circuits which would emulate them much like music synthesizers can emulate almost any musical instrument. The implications are for creative designers to move toward a rational and acceptable design for both personal physician use and for telemedicine.
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A wearable device for monitoring multiple physiological signals (polysomnograph) usually includes multiple wires connecting sensors and the monitoring device. In order to integrate information from intelligent sensors, all devices must be connected to a Personal Area Network (PAN). This system organization is unsuitable for longer and continuous monitoring, particularly during the normal activity. ⋯ We present our prototype implementation of Wireless Intelligent SEnsor (WISE) based on a very low power consumption microcontroller and a DSP-based personal server. In future we expect all components of WISE integrated in a single chip for use in a variety of new medical applications and sophisticated human computer interfaces. Existing growth of wireless infrastructure will allow a range of new telemedical applications that will significantly improve the quality of health care.