Mechanomyography signals in spastic muscle and the correlation with the modified Ashworth scale.

The modified Ashworth scale (MAS) is the most widely used measurement technique to assess levels of spasticity. In MAS, the evaluator graduates spasticity considering his/her subjective analysis of the muscular endurance during passive stretching. Therefore, it is a subjective scale. Mechanomyography (MMG) allows registering the vibrations generated by muscle contraction and stretching events that propagate through the tissue until the surface of the skin. With this in mind, this study aimed to investigate possible correlations between MMG signal and muscle spasticity levels determined by MAS. We evaluated 34 limbs considered spastic by MAS, including upper and lower limbs of 22 individuals of both sexes. Simultaneously, the MMG signals of the spastic muscle group (agonists) were acquired. The features investigated involved, in the time domain, the median energy (MMGME) of the MMG Z-axis (perpendicular to the muscle fibers) and, in the frequency domain, the median frequency (MMGmf). The Kruskal-Wallis test (p<;0.001) determined that there were significant differences between intergroup MAS spasticity levels for MMGme. There was a high linear correlation between the MMGme and MAS (R2=0.9557) and also a high correlation as indicated by Spearman test (ρ=0.9856; p<;0.001). In spectral analysis, the Kruskal-Wallis test (p = 0.0059) showed that MMGmf did not present significant differences between MAS spasticity levels. There was moderate linear correlation between MAS and MMGmf (R2=0.4883 and Spearman test [ρ = 0.4590; p <; 0.001]). Between the two investigated features, we conclude that the median energy is the most viable feature to evaluate spasticity due to strong correlations with the MAS.

Treatment for neuropathic pain and chronic inflammation using LASER in animal models.

The ST36 (Zusanli) acupuncture point is used to treat inflammatory processes, pain and gastrointestinal disturbs. For this reason, the aim of the present study was to evaluate the antinociceptive effect of Low-level Laser Treatment (LLLT) on ST36 acupoint using models of chronic nociception and inflammation. Male Swiss mice were treated with LLLT on ST36 30 minutes before the mechanical allodynia (von Frey) performed on the partial sciatic nerve ligation (PSNL) method and Complete Freund's Adjuvant (CFA). The results demonstrated that application of LLLT on ST36 inhibited the mechanical allodynia response induced by PSNL and CFA, with total reversion at 30 minutes after application. Long-term treatment of animals with LLLT on the same acupoint, once a day, also reduced the PNSL and CFA-induced mechanical allodynia response during 8 days of treatment. As conclusion, the results demonstrated that photonic stimulus on ST36 with LLLT produces antinociceptive effect in chronic models of nociception and inflammation. These findings suggest that LLLT may constitute an important therapeutic alternative to control chronic pain.

A new virtual instrument for estimating punch velocity in combat sports.

For improving the performance in combat sport, especially percussion, it is necessary achieving high velocity in punches and kicks. The aim of this study was to evaluate the applicability of 3D accelerometry in a Virtual Instrumentation System (VIS) designed for estimating punch velocity in combat sports. It was conducted in two phases: (1) integration of the 3D accelerometer with the communication interface and software for processing and visualization, and (2) applicability of the system. Fifteen karate athletes performed five gyaku zuki type punches (with reverse leg) using the accelerometer on the 3rd metacarpal on the back of the hand. It was performed nonparametric Mann-Whitney U-test to determine differences in the mean linear velocity among three punches performed sequentially (p <0.05). The maximum velocities measured varied in the range of 10 and 10.2 m/s and the mean velocities from 6 to 6.8 m/s. There was no difference on the mean velocity for the tested punches. The VIS demonstrated regularity and proper functionality for assessing punches in combat sport.

Proposta de Sistema de Informação para Atenção Farmacêutica baseado no Método Dáder / Proposal of an Information System for Pharmaceutical Care based on Dader Method

A característica principal do Acompanhamento Farmacoterapêutico, um dos macrocomponentes da Atenção Farmacêutica, é a documentação sistemática de informações para solução dos Problemas Relacionados aos Medicamentos (PRM). Essa documentação é feita, com frequência, de forma não automatizada e com o preenchimento de fichas manuais catalogadas em arquivos, o que dificulta a sua organização e torna o processo de recuperação dos dados exaustivo e complicado, limitando a sua aplicação no cotidiano. Uma maneira de minimizar estes problemas é utilizar um sistema de informação para dinamizar esse processo, facilitar o acesso aos dados da terapia e melhorar a comunicação entre o médico e a equipe de saúde responsável pelo paciente. Este artigo apresenta, portanto, o desenvolvimento de um sistema para Atenção Farmacêutica baseado no método Dáder, denominado Farmatools. Esse sistema tem como objetivo informatizar o método Dáder, facilitando o acompanhamento farmacoterapêutico, otimizando o tempo de visita e melhorando a recuperação de informação e a comunicação entre os profissionais de saúde. O Farmatools visa melhorar o acesso à informação, diminuindo a inacessibilidade e a perda das informações.

These registrations are often not automated, but done by filling manual forms, that are cataloged. Over time, with the increase in attendances, there is an increase in the number of forms (amount of paper), making the recovery data process extensive and complicated, thereby, its application in daily life. One way to minimize these problems is to use an information system to improve the process and facilitate the data access recorded during the visits, improving communication with the doctor and the health care team responsible for the patient. This paper presents Farmatools, anelectronic system for pharmaceutical care based on Dader Method. The system aims to automate the Dader method, facilitating the pharmaceutical monitoring, reducing visit time, improving the information retrieval, as well as the communication between health professionals. Furthermore, Farmatools avoid the pharmaceutical paper records of patients accumulation, the inaccessibility of them and the loss of information.

Subword-based semantic retrieval of clinical and bibliographic documents.

OBJECTIVES: The increasing amount of electronically available documents in bibliographic databases and the clinical documentation requires user-friendly techniques for content retrieval. METHODS: A domain-specific approach on semantic text indexing for document retrieval is presented. It is based on a subword thesaurus and maps the content of texts in different European languages to a common interlingual representation, which supports the search across multilingual document collections. RESULTS: Three use cases are presented where the semantic retrieval method has been implemented: a bibliographic database, a department EHR system, and a consumer-oriented Web portal. CONCLUSIONS: It could be shown that a semantic indexing and retrieval approach, the performance of which had already been empirically assessed in prior studies, proved useful in different prototypical and routine scenarios and was well accepted by several user groups.

Method for automatic detection of wheezing in lung sounds.

The present report describes the development of a technique for automatic wheezing recognition in digitally recorded lung sounds. This method is based on the extraction and processing of spectral information from the respiratory cycle and the use of these data for user feedback and automatic recognition. The respiratory cycle is first pre-processed, in order to normalize its spectral information, and its spectrogram is then computed. After this procedure, the spectrogram image is processed by a two-dimensional convolution filter and a half-threshold in order to increase the contrast and isolate its highest amplitude components, respectively. Thus, in order to generate more compressed data to automatic recognition, the spectral projection from the processed spectrogram is computed and stored as an array. The higher magnitude values of the array and its respective spectral values are then located and used as inputs to a multi-layer perceptron artificial neural network, which results an automatic indication about the presence of wheezes. For validation of the methodology, lung sounds recorded from three different repositories were used. The results show that the proposed technique achieves 84.82% accuracy in the detection of wheezing for an isolated respiratory cycle and 92.86% accuracy for the detection of wheezes when detection is carried out using groups of respiratory cycles obtained from the same person. Also, the system presents the original recorded sound and the post-processed spectrogram image for the user to draw his own conclusions from the data.

Method for automatic detection of wheezing in lung sounds

The present report describes the development of a technique for automatic wheezing recognition in digitally recorded lung sounds. This method is based on the extraction and processing of spectral information from the respiratory cycle and the use of these data for user feedback and automatic recognition. The respiratory cycle is first pre-processed, in order to normalize its spectral information, and its spectrogram is then computed. After this procedure, the spectrogram image is processed by a two-dimensional convolution filter and a half-threshold in order to increase the contrast and isolate its highest amplitude components, respectively. Thus, in order to generate more compressed data to automatic recognition, the spectral projection from the processed spectrogram is computed and stored as an array. The higher magnitude values of the array and its respective spectral values are then located and used as inputs to a multi-layer perceptron artificial neural network, which results an automatic indication about the presence of wheezes. For validation of the methodology, lung sounds recorded from three different repositories were used. The results show that the proposed technique achieves 84.82% accuracy in the detection of wheezing for an isolated respiratory cycle and 92.86% accuracy for the detection of wheezes when detection is carried out using groups of respiratory cycles obtained from the same person. Also, the system presents the original recorded sound and the post-processed spectrogram image for the user to draw his own conclusions from the data.

Influência da frequência estimulatória envolvida nos efeitos analgésicos induzidos por eletroacupuntura em cervicalgia tensional / Influence of the stimulating frequency involved in analgesic effects induced by electroacupuncture for neck pain due to muscular tension

Objetivo: Avaliar a influência da frequência estimulatória envolvida na analgesia induzida por eletroacupuntura em cervicalgia. Métodos: Comparou-se o desempenho da analgesia produzida em 2Hz, 100Hz, 1000Hz, 2500Hz e um grupo só com acupuntura, sem estímulo elétrico, avaliado por meio de algometria de pressão, Escala Visual Analógica (EVA) e frequência cardíaca. Utilizou-se um estimulador elétrico microprocessado, com forma de pulso em padrão pulsado, monofásico, retangular, balanceado assimétrico, comfase secundária em exponencial decrescente, com período de estimulação de 4 segundos e repouso de 3 segundos. A amostra contou com 66 voluntários com cervicalgia tensional, idade média de 33,67±9,97 anos, 89,5% do gênero feminino e 10,5% do masculino. Resultados: Não houve diferenças entre os grupos para as variáveis nota atribuída à dor pela EVA e frequência cardíaca, sendo que em todos os grupos houve melhoras analgésicas. No entanto, quando comparado o comportamento antes-depois, por meio da algometria de pressão, para um mesmo indivíduo, dentro de seu próprio grupo, houve vantagens analgésicas para o uso de 2500Hz (p=0,006 para a base da região occiptal; p=0,003 para o trapézio direito; e p=0,013 para o trapézio esquerdo), seguido de 100Hz(p=0,035, p=0,016 e p=0,038, para as mesmas regiões, respectivamente). Conclusão: Recomenda-se preferencialmente a aplicação de 2500Hz e 100Hz em eletroacupuntura para analgesia em cervicalgia tensional.

Objective: To assess the influence of the stimulating frequency involved in analgesia induced by electroacupuncture for neck pain. Methods: The performance of the analgesia produced by 2Hz, 100Hz, 1000Hz and 2500Hz was compared with a group withacupuncture alone (without electrical stimulation), by means of pressure algometry, a visual analog scale (VAS) and heart rate. We used an electrical stimulator with a microprocessor yielding standard, single-phase, rectangular and asymmetrical balanced pulsed waveforms with a secondary phase decreasing exponentially. Stimulation periods were 4s, and resting periods were 3s. The sample included 66 volunteers with neck pain due to muscular tension, mean age 33.67±9.97 years, 89.5% female and 10.5% male. Results: There were no differences between the groups regarding the variables of degree of pain (according to the VAS) and heart rate, and all groups presented analgesic improvement. However, when comparing pressure algometry findings for the same individual before and after the treatment, within the same group, we found analgesic advantages in using 2500Hz (p=0.006 for the base of the occipital region, p=0.003 for the right trapezius and p=0.013 for the left trapezius), followed by 100Hz (p=0.035, p=0.016 and p=0.038 for thesame regions, respectively). Conclusion: We preferentially recommend 2500Hz and 100Hz applications of electroacupuncture for analgesia of neck pain due to muscular tension.

Comparison of two knowledge bases on the detection of drug-drug interactions.

This paper describes a drug ordering decision support system that helps with the prevention of adverse drug events by detecting drug-drug interactions in drug orders. The architecture of the system was devised in order to facilitate its use attached to physician order entry systems. The described model focuses in issues related to knowledge base maintenance and integration with external systems. Finally, a retrospective study was performed. Two knowledge bases, developed by different academic centers, were used to detect drug-drug interactions in a dataset with 37,237 drug prescriptions. The study concludes that the proposed knowledge base architecture enables content from other knowledge sources to be easily transferred and adapted to its structure. The study also suggests a method that can be used on the evaluation and refinement of the content of drug knowledge bases.

Design, implementation and evaluation of a clinical decision support system to prevent adverse drug events.

Adverse drug events are known to be a major health problem worldwide. It is estimated that the annual costs related to these events in the United States are greater than the total costs with cardiovascular disease care. Decision support systems that assist drug ordering have demonstrated to be a powerful tool to prevent prescription errors and adverse drug events. On the other hand, some issues related to the development, implementation, configuration, and evaluation of these decision support systems still need further research. This paper presents the development and evaluation of a decision support system prototype that helps with the prevention of adverse drug events by detecting drug-drug interactions in drug orders. The structure of the system tries to solve some of the problems described by the literature, such as integration with hospital information systems, adaptability to local needs, and knowledge base maintenance. The proposed model has shown to be an effective method for representing drug-drug interactions. The prototype was evaluated by a retrospective study using a dataset with 37.237 prescriptions. The system was able to detect 10.044 (27.0%) orders containing one or more drug-drug interactions. Among these interactions, 6.4% had high severity. In a future study, it is intended to apply the developed system in a real-time on-line environment, evaluating the benefits achieved in terms of improvement in medical practice and patient outcomes.

A solution for linearity, stability and frequency bandwidth in PAM electrocutaneous stimulators' isolation interface.

This paper introduces a novel method to isolate low-level from high-voltage circuits and/or channels of PAM electrocutaneous stimulators in neuromuscular electrical stimulation (NMES). The method avoids problems of linearity and polarization stability of optocouplers and narrow bandwidth of isolation amplifiers. Its main parameters are: carrier frequency of rectangular pulses up to 1 MHz and maximum modulating signal (elliptical or triangular envelopes) of 50 kHz. The circuit has low drift, high-voltage isolation, low-power consumption, requires few components, is battery-operated and ideal for microcomputer interface-based applications.

Proposta de abertura de curso de engenharia elétrica com ênfase em biomédica / Proposal of opening course of electric engineering with emphasis in biomedical

Na busca de soluçöes para resolver o problema de formaçäo de pessoal em engenharia biomédica, propöe-se a abertura de um curso de engenharia elétrica, ênfase biomédica. A estrutura curricular segue a Reso. 48/76 do CFE, abrangendo uma carga horária total de 4605 ha assim discriminada: 4 por cento em matérias exidas por legislaçäo específica, 10 por cento em formaçäo geral, 26 por cento em formaçäo profissional geral e 60 por cento em formaçäo básica. As principais matérias da área biomédicas säo: Medicina Básica, Instrumentaçäo Biomédica, Bioengenharia, Reabilitaçäo, Engenharia Hospitalar, Informática Médica e Estágio Supervisionado

Electrotactile stimulator for artificial proprioception.

With the goal of investigating artificial proprioception elicited by electrical stimulation, we have developed a tactile phi phenomenon-based stimulator. This two-channel microprocessed pulse amplitude modulation system generates two different envelope waveforms (triangular and elliptical) and allows programming and visualizing of its main parameters: pulse with (0.1-10 ms), pulse frequency (0.1-10 kHz), modulation frequency (0.3-10 Hz), current intensity (up to 20 mA), and the amplitude modulation index (0-100%). In vivo experiments with 5 normal persons have shown that it is possible to elicit a moving fused phantom image with good resolution. A triangular envelope is good for straight line sensations while the elliptical one is more comfortable and has better resolution for all kinds of moving images.