Journal of medical engineering & technology
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Comparative Study
Auditing the technology used to measure blood pressure.
Patient management requires accurate blood pressure measurement, but there is concern about the accuracy of the equipment. Makes and types of sphygmomanometers and sizes of their associated cuffs used in hospital wards and outpatient departments were recorded and calibration checked. Half the sphygmomanometers were oscillometric, 32% aneroid and 18% mercury. ⋯ Many oscillometric devices had no evidence of compliance with validation standards. Sphygmomanometers and their cuffs and hoses should be regularly checked. Clinical staff can carry out many of the checks.
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Comparative Study
A comparison of photoplethysmography and ECG recording to analyse heart rate variability in healthy subjects.
Measures of heart rate variability (HRV) are widely used to assess autonomic nervous system (ANS) function. The signal from which they are derived requires accurate determination of the interval between successive heartbeats; it can be recorded via electrocardiography (ECG), which is both non-invasive and widely available. However, methodological problems inherent in the recording and analysis of ECG traces have motivated a search for alternatives. ⋯ Comparison of 5-minute recordings demonstrated a very high degree of correlation in the temporal and frequency domains and in nonlinear dynamic analyses between HRV measures derived from PPG and ECG. Our results confirm that PPG provides accurate interpulse intervals from which HRV measures can be accurately derived in healthy subjects under ideal conditions, suggesting this technique may prove a practical alternative to ECG for HRV analysis. This finding is of particular relevance to the care of patients suffering from peripheral hyperkinesia or tremor, which make fingertip PPG recording impractical, and following clinical interventions known to introduce electrical artefacts into the electrocardiogram.
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Surface heating modalities are commonly used in physical therapy and physical medicine for increasing circulation, especially in deep tissues, to promote healing. However, recent evidence seems to indicate that in people who are overweight, heat transfer is impaired by the subcutaneous fat layer. The present investigation was conducted on 10 subjects aged 22-54 years, whose body mass index averaged 25.8+/-4.6. ⋯ The results of the experiments showed that for heating modalities that are maintained in skin contact for long periods of time, such as dry heat packs (in place for 6 hours), subcutaneous fat did not impair the change in deep muscle temperature. In contrast, when rapid heat modalities were used, such as the hydrocollator and the whirlpool (15 minutes of sustained skin contact), the transfer of heat from the skin to deep muscle was significantly impaired in people with thicker subcutaneous fat layers. We observed that the greater the impairment in heat transfer to muscle from skin covered by body fat, the warmer the skin temperature increase during the modality.
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A new hybrid two-stage electrocardiogram (ECG) signal compression method based on the modified discrete cosine transform (MDCT) and discrete wavelet transform (DWT) is proposed. The ECG signal is partitioned into blocks and the MDCT is applied to each block to decorrelate the spectral information. Then, the DWT is applied to the resulting MDCT coefficients. ⋯ The results showed that the proposed method provides low bit-rate and high quality of the reconstructed signal. It offers average compression ratio (CR) of 21.5 and PRD of 5.89%, which would be suitable for most monitoring and diagnoses applications. Simulation results show that the proposed method compares favourably with various state-of-the-art ECG compressors.
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This study was performed to assess the value of electrical impedance tomography (EIT) as an indicator of tidal (V(T)) and end expiratory lung volume (EELV). ⋯ Tidal and end-expiratory changes in pulmonary impedance reflect corresponding changes in lung volume, but the increasing underestimation with increasing lung volume should be taken into account in the analysis of EIT data.