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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: New trends in physiological time series analysis are described. The discussed topics concern: parametric methods including their multi-channel version, non-linear formalism, artificial neural networks and wavelet analysis. The parametric methods which have been used mainly in EEG analysis are making their way into other fields. In their multi-channel version autoregressive models furnish information about the intrinsic relationship between signals. The chaotic formalism have brought new insight into the mechanisms of physiological processes. Nevertheless, in the description of physiological time series parameters estimated by means of non-linear formalism should be used with care. Artificial neural networks are becoming a popular method…of time series classification. They are especially suitable in case of noisy and incomplete data. Interesting application of neural networks can be foreseen in the problems where not only classification but also control are involved. Wavelet analysis is a new method which makes possible the simultaneous estimation of signal frequency and localization in time with the accuracy superior to any previously known method. The method is especially suitable for the analysis of fast-varying non-stationary signals.
Keywords: Time series analysis, Parametric methods, Multichannel analysis, Chaos, Artificial neural networks, Wavelet analysis
Abstract: Pressure infusion devices (PID) are used in trauma hospitals and in military applications to enhance rapid fluid replacement of hypovolemic shocked patients. This work presents a simple inexpensive technique for evaluation of the performance characteristics of pressure infusors. Pressure-volume and volume-time curves of pneumatic and spring-activated infusors have been derived for pressurized infusion with various output resistances. Three indices of performance are suggested for evaluation of pressure infusors: the energy of discharge fluid from the bag, efficiency index and time required to empty 50% of the bag.
Abstract: Several studies have suggested that the Valsalva maneuver may predispose potential lethal arrhythmias in patients with coronary artery disease, since this maneuver induces diminished coronary flow. On the other hand some studies have suggested that the Valsalva maneuver abruptly reduces determinants of cardiac oxygen demand, relieving angina pectoris. In order to study the variations of the myocardial oxygen supply–demand relation, during different applications of the maneuver, a mathematical model of the human cardiovascular system is presented. The model has been submitted to an evaluation process allowing the inclusion of a number of additional refinements to the mathematical model structures, and…the obtaining of a reduced model in order to improve the computer time and parameter estimation of the simulation. The simulated output variables of the model correlate well with in vivo data obtained from ten patients with typical exertional angina pectoris studied during cardiac catheterization. The evaluation of the cardiac catheterization data has allowed the differentiation of two subsets of patients by the identification of two different coronary controllers. Computer simulation has permitted the analysis of the relative influences of the intrathoracic and intraabdominal pressure variations on the cardiovascular variables. Depending on the coronary control of the patients, the simulation results have shown that the myocardial oxygen supply–demand relation, calculated during the simulation of high intrathoracic pressures, long duration Valsalva maneuvers, or two consecutive maneuvers, gets values higher or lower than unity. These results suggest, respectively, beneficial or detrimental cardiac effects on the patients.
Abstract: Bed chest X-rays carried out in an Intensive Care Unit (ICU) are an important means of patient monitoring. To get the starting points for standardization of the documentation of X-ray findings, we examined course and contents of the daily X-ray conference in an ICU. We video-taped the conferences and registered its vocabulary. Mean entire duration to comment on the X-rays of one patient was 150 s. On an average, discussion between radiologist and anaesthetist lasted 40 s, dictation of findings 50 s. Sorting and viewing the X-rays took 60 s. Main disruptions were related to non-availability of X-rays and…clinical patient data. Clinical information reported during the discussion is rarely mentioned in the dictated findings.
Keywords: Diagnostic X-ray, Documentation, Information systems, Intensive care units
Abstract: A new method for treatment of urinary stress incontinence is described. Through a vaginal plug the pelvic floor muscles receive a series of electric stimulations which are triggered by an increase of abdominal pressure, detected by an inbuilt pressure sensor. In this study the best parameters for the stimuli are determined during three successive coughs, which are the most common course of urine loss.