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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: BACKGROUND: The volleyball game has a high complexity and thus entails a lot of strain to the players. Due to this high and different training and competition strain comprehensive and individual training plans should be developed with competing training objectives in order to prevent injuries. OBJECTIVE: The aim of the study was to analyse prospectively over six seasons the acute and overuse injuries of a German male professional volleyball team. METHODS: The study included 34 male national league players from season the 2007/08 to 2012/13. All players received a sport medicine examination and…a functional diagnosis before each season. Based on the results the players received an individual training plan. RESULTS: The players suffered 186 injuries. The prevalence of acute injuries was 1.94 per player and overuse injuries 0.64 per player. The incidence of acute injuries was 3.3/1000 h volleyball and overuse injuries 1.08/1000 h volleyball. The largest number of injuries was found in the spine. The players had most likely minor injuries. The players had significantly fewer injuries in their second season (1.92) than in their first season (3.25; p= 0.004). CONCLUSION: It could be concluded that volleyball is a sport with a relative low prevalence of injuries compared to other team sports. The prevalence of injury is 2.58 per player. Due to an injury a player dropped out 16.91 days per season. An individual training program seems to reduce the incidence of injury.
Abstract: BACKGROUND: The spinal canal stenosis is a common disease in elderly. The thecal sac narrowing is considered as the anatomical cause for the disease. There is evidence that the anatomical proportions of the lumbar spinal canal are influenced by postural changes. The liquor volume shift during these postural changes is a valuable parameter to estimate the dynamic qualities of this disease. OBJECTIVE: The aim of this human cadaver study was the determination of intrathecal fluid volume changes during the lumbar flexion and the extension. A special measuring device was designed and built for the study to…investigate this issue under controlled conditions. METHODS: The measuring apparatus fixed the lumbar spine firmly and allowed only flexion and extension. The dural sac was closed water tight. The in vitro changes of the intrathecal volumes during the motion cycle were determined according to the principle of communicating vessels. Thirteen human cadaver spines from the Institute of Anatomy were examined in a test setting with a continuous adjustment of motion. The diagnosis of the lumbar spinal stenosis was confirmed by a positive computer tomography prior testing. The volume changes during flexion and extension cycles were measured stepwise in a 2 degree distance between 18° flexion and 18° extension. Three complete series of measurements were performed for each cadaver. RESULTS: Two specimens were excluded because of fluid leaks from further investigation. The flexion of the lumbar spine resulted in an intrathecal volume increase. The maximum volume effects were seen in the early flexion positions of 2° and 4°. The spine reclination resulted in a volume reduction. The maximum extension effect was seen between 14° and 16°. CONCLUSION: According to our results, remarkable volume effects were seen in the early movements of the lumbar spine especially for the flexion. The results support the concept of the spinal stenosis as a dynamic disease and allow a better understanding of the pathophysiology of this nosological entity. Under clinical aspects our data support the value of a body upright position under avoiding of extended spinal inclination and reclination.
Abstract: BACKGROUND: Cannulated screws (4.0 mm) provide inter-fragmentary compression and stability to fractures. A guide wire is used to define the screw trajectory and hold the fracture fragment while the screw is being inserted. The cannulated shaft typically accommodates a 1.25 mm guide pin. Since the guide pin is very slender and undergoes elastic deformation during insertion, there is a high probability of pin breakage. METHODS: The authors have devised a new way to place the 4.0 mm cannulated screws in a manner that prevents the intraoperative complication of guide wire breakage. For this technique,…predrilling was achieved using a 2.0 mm K-wire which was subsequently replaced with a 1.25 mm guide pin under the protection of sleeve. 4.0 mm cannulated screws were then inserted into a defined trajectory over the guide pin. RESULTS: Using the technique, over 20 patients were managed in our department over a period of two years without any complications. CONCLUSION: We have observed that patients treated with this method experience short operation time, combined with good clinical outcome and we recommend its use in cases where cannulated screw use is warranted.
Abstract: BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) using free tendon grafts has become a widespread treatment option for patellofemoral instability. As the numbers of cases gradually grow, so do the reports of possible peri- and postoperative complications following this procedure. OBJECTIVE: The present review summarizes all known complications of MPFL reconstruction with regard to postoperative outcome and seeks to highlight possible pitfalls that may occur during treatment. CONCLUSIONS: MPFL reconstruction generally has to be regarded as a safe procedure today due to low patellar re-dislocation rates. Complication rates however are not…trivial owing to the complexity of the underlying pathology. Complications can arise from graft fixation or femoral tunnel placement. Postoperative flexion deficits and medial knee pain have been described as predominant complaints. Anatomical preconditions as the grade of trochlear dysplasia, axis or torsion of the lower extremity have to be considered in search of causes for possible graft failure as well as in the thorough preoperative planning of the procedure.
Abstract: BACKGROUND: The sheath is a crucial piece of equipment during endoscopic third ventriculostomy (ETV). However, the normally used metal sheath can not provide clear images around the tube. OBJECTIVE: We developed a new transparent sheath (TS) in order to overcome the inherent disadvantages of the metal sheath (MS). MATERIAL AND METHODS: Between August 2010 and February 2013, a total of 120 hydrocephalus patients received ETV in our hospital. Patients were retrospectively divided into two groups, the transparent sheath group (TSG) and metal sheath group (MSG). The success rate of the first puncture,…the operative time and the incidence of complications were used to compare the efficiency between transparent sheath and metal sheath. RESULTS: There were 32 patients in the TSG and 88 patients in the MSG. The success rate of the first puncture was 100% in the TSG and 87.5% in the MSG, respectively (p= 0.036). The operative time of the TSG was significant shorter than the MSG (p= 0.001). While the incidence of complications was similar between the two groups (p= 0.757). CONCLUSIONS: Compared with the tranditional metal sheath, the newly developed transparent sheath for ETV is more efficient and showed lower risk. This may be explained by the better surgical view of the whole puncture channel provide by the TS.
Abstract: BACKGROUND: Urinary incontinence mostly affects infants, the elderly, and the disabled. However, no diaper is equipped with an effective immediate reminder feature that signifies when changing is needed. OBJECTIVE: This study proposes eco-diapers containing metallic fibers, such that eco-diapers and sensors are combined to transmit a signal when changing is necessary. METHODS: Polyester multifilaments serve as the warp yarn and water absorbent cotton fibers (witvarying finesses of 5, 10, 20, 30, and 40 counts) as the weft yarns to form five woven fabric types. A stereomicroscope is used and the optical contact…angle is measured to determine the optimal parameters for the structure. RESULTS: Obtain the optimal cotton fiber finesse is determined, the influence of the finesse of the metallic fibers on resistance is then examined. The yielded optimal parameters are then integrated to manufacture a wearable sensor, which is then combined with the woven fabrics to develop intelligent diapers. CONCLUSION: A health care system needs a new paradigm, that is, wearable computing is very attractive and extensively examined. The use of metallic fabric can solve complicated wires, and it does not affect the wearing comfort. It will help solve the problem of lacking medical human resources.
Abstract: BACKGROUND/AIM: Penetrating injuries to the oral cavity involving a toothbrush are relatively common among children. Sometimes general anesthesia is recommended. Although the handle prevents adequate mask ventilation in the induction of anesthesia, it is unknown what is the best tool to cut it preventing complications. The aim of this study was to evaluate the optimal tool to cut off the toothbrush handle. MATERIALS AND METHODS: Six anesthesiologists participated in this study. We attached a triaxial acceleration sensor to the tip of the toothbrush to virtually measure force toward the wound. Each participant cut off the…handle of the toothbrush using 3 tools: Gluck rib shears (GRS: cutting horizonal); Sklar Coryllos rib shears (SCRS: cutting vertical); and an ultrasonic scalpel (USS). Acceleration and time required to cut the toothbrush were measured. Each anesthesiologist evaluated the usability of each tool on a 5-point scale. RESULTS: The USS showed the longest mean time (GRS, 1.78 ± 1.01 s; SCRS, 7.30 ± 4.58 s; USS, 28.13 ± 13.41 s), lowest 3-dimensional acceleration (GRS, 2.15 ± 0.69 G; SCRS, 2.13 ± 0.57 G; USS, 1.01 ± 1.07 G), and highest mean score for usability. CONCLUSION: The USS appeared preferable to rib shears for cutting off toothbrush handles, even though it takes longer.
Abstract: BACKGROUND: The reliability of a triaxial accelerometer in measuring the head excursion during typing task among occupational typists has not been reported so far. OBJECTIVE: This study aimed to investigate the intra-rater reliability of triaxial accelerometer measurement of head excursion. METHODS: The triaxial accelerometer measurements were taken to measure head excursion of 8 participants typing in the computer. The intra-rater reliability such as intraclass correlation coefficient, standard error of measurements and coefficient of variation was calculated. The Bland-Altman plot was performed to strengthen the study result. RESULTS:…The analysis of the results showed that the intra-rater reliability of triaxial accelerometer was high with intraclass correlation coefficient (2,1) of 0.986, standard error of measurements (1.05 Hz) and coefficient of variation (3.2%) for two trials of measurements. The Bland-Altman reported an acceptable agreement between the two measurements taken using the triaxial accelerometer to measure head excursion. CONCLUSIONS: The triaxial accelerometer is a simple, objective and useful technology to measure head excursion among the occupational typists.
Keywords: Accelerometer, head excursion, neck movement, reliability, measurement