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1.
Sensors (Basel) ; 21(9)2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-34063000

RESUMO

Decision-making is an important part of human life and particularly in any engineering process related to a complex product. New sensors and actuators based on MEMS technologies are increasingly complex and quickly evolving into products. New biomedical implanted devices may benefit from system engineering approaches, previously reserved to very large projects, and it is expected that this need will increase in the future. Here, we propose the application of Model Based Systems Engineering (MBSE) to systematize and optimize the trade-off analysis process. The criteria, their utility functions and the weighting factors are applied in a systematic way for the selection of the best alternative. Combining trade-off with MBSE allow us to identify the more suitable technology to be implemented to transfer energy to an implanted biomedical micro device.


Assuntos
Sistemas de Liberação de Medicamentos , Próteses e Implantes , Engenharia Biomédica , Engenharia , Humanos , Tecnologia sem Fio
2.
Sensors (Basel) ; 21(9)2021 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-34063296

RESUMO

Implantable antennas are mandatory to transfer data from implants to the external world wirelessly. Smart implants can be used to monitor and diagnose the medical conditions of the patient. The dispersion of the dielectric constant of the tissues and variability of organ structures of the human body absorb most of the antenna radiation. Consequently, implanting an antenna inside the human body is a very challenging task. The design of the antenna is required to fulfill several conditions, such as miniaturization of the antenna dimension, biocompatibility, the satisfaction of the Specific Absorption Rate (SAR), and efficient radiation characteristics. The asymmetric hostile human body environment makes implant antenna technology even more challenging. This paper aims to summarize the recent implantable antenna technologies for medical applications and highlight the major research challenges. Also, it highlights the required technology and the frequency band, and the factors that can affect the radio frequency propagation through human body tissue. It includes a demonstration of a parametric literature investigation of the implantable antennas developed. Furthermore, fabrication and implantation methods of the antenna inside the human body are summarized elaborately. This extensive summary of the medical implantable antenna technology will help in understanding the prospects and challenges of this technology.


Assuntos
Próteses e Implantes , Ondas de Rádio , Humanos , Miniaturização , Tecnologia sem Fio
3.
Sensors (Basel) ; 21(10)2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-34063416

RESUMO

In this article, the design of an efficient wireless power transfer (WPT) system using antenna-based topology for the applications in wearable devices is presented. To implement the wearable WPT system, a simple circular patch antenna is initially designed on a flexible felt substrate by placing over a three-layer human tissue model to utilize as a receiving element. Meanwhile, a high gain circular patch antenna is also designed in the air environment to use as a transmitter for designing the wearable WPT link. The proposed WPT system is built to operate at the industrial, scientific and medical (ISM) band of 2.40-2.48 GHz. In addition, to improve the power transfer efficiency (PTE) of the system, a metamaterial (MTM) slab built with an array combination of 3 × 3 unit cells has been employed. Further, the performance analysis of the MTM integrated system is performed on the different portions of the human body like hand, head and torso model to present the versatile applicability of the system. Moreover, analysis of the specific absorption rate (SAR) has been performed in different wearable scenarios to show the effect on the human body under the standard recommended limits. Regarding the practical application issues, the performance stability analysis of the proposed system due to the misalignment and flexibility of the Rx antenna is executed. Finally, the prototypes are fabricated and experimental validation is performed on several realistic wearable platforms like three-layer pork tissue slab, human hand, head and body. The simulated and measured result confirms that by using the MTM slab, a significant amount of the PTE improvement is obtained from the proposed system.


Assuntos
Dispositivos Eletrônicos Vestíveis , Tecnologia sem Fio , Cabeça , Humanos
4.
Bull World Health Organ ; 99(5): 381-387A, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33958826

RESUMO

In the context of declining economic growth, now exacerbated by the coronavirus disease 2019 pandemic, Papua New Guinea is increasing the efficiency of its health systems to overcome difficulties in reaching global health and development targets. Before 2015, the national health information system was fragmented, underfunded, of limited utility and accessed infrequently by health authorities. We built an electronic system that integrated mobile technologies and geographic information system data sets of every house, village and health facility in the country. We piloted the system in 184 health facilities across five provinces between 2015 and 2016. By the end of 2020, the system's mobile tablets were rolled out to 473 facilities in 13 provinces, while the online platform was available in health authorities of all 22 provinces, including church health services. Fractured data siloes of legacy health programmes have been integrated and a platform for civil registration systems established. We discuss how mobile technologies and geographic information systems have transformed health information systems in Papua New Guinea over the past 6 years by increasing the timeliness, completeness, quality, accessibility, flexibility, acceptability and utility of national health data. To achieve this transformation, we highlight the importance of considering the benefits of mobile tools and using rich geographic information systems data sets for health workers in primary care in addition to the needs of public health authorities.


Assuntos
Sistemas de Informação Geográfica/organização & administração , Sistemas de Informação em Saúde/organização & administração , Vigilância em Saúde Pública/métodos , Tecnologia sem Fio/organização & administração , /epidemiologia , Coleta de Dados , Programas Governamentais , Sistemas de Informação em Saúde/economia , Humanos , Papua Nova Guiné/epidemiologia
5.
Sensors (Basel) ; 21(9)2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33919143

RESUMO

The growing aging of the world population is leading to an aggravation of diseases, which affect the autonomy of the elderly. Wireless body sensor networks (WBSN) are part of the solutions studied for several years to monitor and prevent loss of autonomy. The use of optical wireless communications (OWC) is seen as an alternative to radio frequencies, relevant when electromagnetic interference and data security considerations are important. One of the main challenges in this context is optical channel modeling for efficiently designing high-reliability systems. We propose here a suitable optical WBSN channel model for tracking the elderly during a walk. We discuss the specificities related to the model of the body, to movements, and to the walking speed by comparing elderly and young models, taking into account the walk temporal evolution using the sliding windowing technique. We point out that, when considering a young body model, performance is either overestimated or underestimated, depending on which windowing parameter is fixed. It is, therefore, important to consider the body model of the elderly in the design of the system. To illustrate this result, we then evaluate the minimal power according to the maximal bandwidth for a given quality of service.


Assuntos
Caminhada , Tecnologia sem Fio , Idoso , Humanos , Monitorização Fisiológica , Reprodutibilidade dos Testes
6.
Proc Natl Acad Sci U S A ; 118(19)2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33893178

RESUMO

Capabilities in continuous monitoring of key physiological parameters of disease have never been more important than in the context of the global COVID-19 pandemic. Soft, skin-mounted electronics that incorporate high-bandwidth, miniaturized motion sensors enable digital, wireless measurements of mechanoacoustic (MA) signatures of both core vital signs (heart rate, respiratory rate, and temperature) and underexplored biomarkers (coughing count) with high fidelity and immunity to ambient noises. This paper summarizes an effort that integrates such MA sensors with a cloud data infrastructure and a set of analytics approaches based on digital filtering and convolutional neural networks for monitoring of COVID-19 infections in sick and healthy individuals in the hospital and the home. Unique features are in quantitative measurements of coughing and other vocal events, as indicators of both disease and infectiousness. Systematic imaging studies demonstrate correlations between the time and intensity of coughing, speaking, and laughing and the total droplet production, as an approximate indicator of the probability for disease spread. The sensors, deployed on COVID-19 patients along with healthy controls in both inpatient and home settings, record coughing frequency and intensity continuously, along with a collection of other biometrics. The results indicate a decaying trend of coughing frequency and intensity through the course of disease recovery, but with wide variations across patient populations. The methodology creates opportunities to study patterns in biometrics across individuals and among different demographic groups.


Assuntos
/fisiopatologia , Frequência Cardíaca , Taxa Respiratória , Sons Respiratórios , Tecnologia sem Fio , Biomarcadores , Humanos , Monitorização Fisiológica
7.
Sensors (Basel) ; 21(8)2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33923716

RESUMO

In this study, we developed a new type of wireless transmission system for use in partially implantable hearing aids. This system was designed for miniaturization and low distortion, and features direct digital modulation. The sigma-delta output, which has a high SNR due to oversampling and noise shaping technology, is used as the data signal and is transmitted using a wireless transmission system to the implant unit through OOK without restoration as an audio signal, thus eliminating the need for additional circuits (i.e., LPF and a reference voltage supply circuit) and improving the ease of implantation and reliability of the circuit. We selected a carrier frequency of 27 MHz after analysis of carrier attenuation by human tissue, and designed the communication coil with reference to both the geometry and required communication distance. Circuit design and simulation for wireless transmission were performed using Multisim 13.0. The system was fabricated based on the circuit design; the size of the device board was 13 mm × 13 mm, the size of the implanted part was 9 mm × 9 mm, the diameter of the transmitting/receiving coil was 26 mm, and the thicknesses of these coils were 0.5 and 0.3 mm, respectively. The difference (error) between the detected and simulation waveforms was about 5%, and was thought to be due to the tolerances of the fabricated communication coil and elements (resistors, capacitors, etc.) used in the circuit configuration of the system. The number of windings was reduced more than 9-fold compared to the communication coil described by Taghavi et al. The measured THD was <1% in the frequency band from 100 Hz to 10 kHz, thus easily meeting the standard specification for hearing aids.


Assuntos
Auxiliares de Audição , Desenho de Equipamento , Humanos , Miniaturização , Próteses e Implantes , Reprodutibilidade dos Testes , Tecnologia sem Fio
8.
Nat Med ; 27(4): 727-735, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33737750

RESUMO

Errors in medication self-administration (MSA) lead to poor treatment adherence, increased hospitalizations and higher healthcare costs. These errors are particularly common when medication delivery involves devices such as inhalers or insulin pens. We present a contactless and unobtrusive artificial intelligence (AI) framework that can detect and monitor MSA errors by analyzing the wireless signals in the patient's home, without the need for physical contact. The system was developed by observing self-administration conducted by volunteers and evaluated by comparing its prediction with human annotations. Findings from this study demonstrate that our approach can automatically detect when patients use their inhalers (area under the curve (AUC) = 0.992) or insulin pens (AUC = 0.967), and assess whether patients follow the appropriate steps for using these devices (AUC = 0.952). The work shows the potential of leveraging AI-based solutions to improve medication safety with minimal overhead for patients and health professionals.


Assuntos
Inteligência Artificial , Preparações Farmacêuticas/administração & dosagem , Autoadministração , Adolescente , Adulto , Idoso , Humanos , Sistemas de Infusão de Insulina , Pessoa de Meia-Idade , Nebulizadores e Vaporizadores , Curva ROC , Tecnologia sem Fio , Adulto Jovem
9.
Mutat Res ; 863-864: 503310, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33678242

RESUMO

Time varying magnetic fields (MFs) are used for the wireless power-transfer (WPT) technology. Especially, 85 kHz band MFs, which are included in the intermediate frequency (IF) band (300 Hz - 10 MHz), are commonly used WPT system for charging electric vehicles. Those applications of WPT technology have elicited public concern about health effects of IF-MF. However, existing data from health risk assessments are insufficient and additional data are needed. We assessed the genotoxic effects of IF-MF exposure on erythroid differentiation in mice. A high-intensity IF-MF mouse exposure system was constructed to induce an average whole-body electric field of 54.1 V/m. Blood samples were obtained from male mice before and after a 2-week IF-MF exposure (1 h/day, total: 10 h); X-irradiated mice were used as positive controls. We analyzed the blood samples with the micronucleus (MN) test and the Pig-a mutation assay. No significant differences were seen between IF-MF-exposed and sham-exposed mice in the frequencies of either MN or Pig-a mutations in mature erythrocytes and reticulocytes. IF-MF exposure did not induce genotoxicity in vivo under the study conditions (2.36× the basic restriction for occupational exposure, 22.9 V/m, in the International Commission on Non-Ionizing Radiation Protection (ICNIRP) guidelines). The absence of significant biological effects due to IF-MF exposure supports the practical application of this technology.


Assuntos
Dano ao DNA , Exposição Ambiental/efeitos adversos , Campos Magnéticos/efeitos adversos , Tecnologia sem Fio , Animais , Masculino , Camundongos
10.
PLoS One ; 16(3): e0245900, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33711025

RESUMO

The coronavirus pandemic has seen a marked rise in medical disinformation across social media. A variety of claims have garnered considerable traction, including the assertion that COVID is a hoax or deliberately manufactured, that 5G frequency radiation causes coronavirus, and that the pandemic is a ruse by big pharmaceutical companies to profiteer off a vaccine. An estimated 30% of some populations subscribe some form of COVID medico-scientific conspiracy narratives, with detrimental impacts for themselves and others. Consequently, exposing the lack of veracity of these claims is of considerable importance. Previous work has demonstrated that historical medical and scientific conspiracies are highly unlikely to be sustainable. In this article, an expanded model for a hypothetical en masse COVID conspiracy is derived. Analysis suggests that even under ideal circumstances for conspirators, commonly encountered conspiratorial claims are highly unlikely to endure, and would quickly be exposed. This work also explores the spectrum of medico-scientific acceptance, motivations behind propagation of falsehoods, and the urgent need for the medical and scientific community to anticipate and counter the emergence of falsehoods.


Assuntos
/patologia , Decepção , /virologia , Campos Eletromagnéticos , Fraude/estatística & dados numéricos , Humanos , Revelação da Verdade , Vacinação , Tecnologia sem Fio
11.
Sensors (Basel) ; 21(4)2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33671364

RESUMO

Recording human gestures from a wearable sensor produces valuable information to implement control gestures or in healthcare services. The wearable sensor is required to be small and easily worn. Advances in miniaturized sensor and materials research produces patchable inertial measurement units (IMUs). In this paper, a hand gesture recognition system using a single patchable six-axis IMU attached at the wrist via recurrent neural networks (RNN) is presented. The IMU comprises IC-based electronic components on a stretchable, adhesive substrate with serpentine-structured interconnections. The proposed patchable IMU with soft form-factors can be worn in close contact with the human body, comfortably adapting to skin deformations. Thus, signal distortion (i.e., motion artifacts) produced for vibration during the motion is minimized. Also, our patchable IMU has a wireless communication (i.e., Bluetooth) module to continuously send the sensed signals to any processing device. Our hand gesture recognition system was evaluated, attaching the proposed patchable six-axis IMU on the right wrist of five people to recognize three hand gestures using two models based on recurrent neural nets. The RNN-based models are trained and validated using a public database. The preliminary results show that our proposed patchable IMU have potential to continuously monitor people's motions in remote settings for applications in mobile health, human-computer interaction, and control gestures recognition.


Assuntos
Gestos , Redes Neurais de Computação , Dispositivos Eletrônicos Vestíveis , Mãos , Humanos , Movimento (Física) , Tecnologia sem Fio , Punho , Articulação do Punho
12.
Sensors (Basel) ; 21(5)2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33652644

RESUMO

A textile patch antenna is an attractive package for wearable applications as it offers flexibility, less weight, easy integration into the garment and better comfort to the wearer. When it comes to wearability, above all, comfort comes ahead of the rest of the properties. The air permeability and the water vapor permeability of textiles are linked to the thermophysiological comfort of the wearer as they help to improve the breathability of textiles. This paper includes the construction of a breathable textile rectangular ring microstrip patch antenna with improved water vapor permeability. A selection of high air permeable conductive fabrics and 3-dimensional knitted spacer dielectric substrates was made to ensure better water vapor permeability of the breathable textile rectangular ring microstrip patch antenna. To further improve the water vapor permeability of the breathable textile rectangular ring microstrip patch antenna, a novel approach of inserting a large number of small-sized holes of 1 mm diameter in the conductive layers (the patch and the ground plane) of the antenna was adopted. Besides this, the insertion of a large number of small-sized holes improved the flexibility of the rectangular ring microstrip patch antenna. The result was a breathable perforated (with small-sized holes) textile rectangular ring microstrip patch antenna with the water vapor permeability as high as 5296.70 g/m2 per day, an air permeability as high as 510 mm/s, and with radiation gains being 4.2 dBi and 5.4 dBi in the E-plane and H-plane, respectively. The antenna was designed to resonate for the Industrial, Scientific and Medical band at a specific 2.45 GHz frequency.


Assuntos
Têxteis , Dispositivos Eletrônicos Vestíveis , Tecnologia sem Fio , Radiação Eletromagnética , Desenho de Equipamento
13.
Nat Commun ; 12(1): 1968, 2021 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-33785751

RESUMO

Wireless battery free and fully implantable tools for the interrogation of the central and peripheral nervous system have quantitatively expanded the capabilities to study mechanistic and circuit level behavior in freely moving rodents. The light weight and small footprint of such devices enables full subdermal implantation that results in the capability to perform studies with minimal impact on subject behavior and yields broad application in a range of experimental paradigms. While these advantages have been successfully proven in rodents that move predominantly in 2D, the full potential of a wireless and battery free device can be harnessed with flying species, where interrogation with tethered devices is very difficult or impossible. Here we report on a wireless, battery free and multimodal platform that enables optogenetic stimulation and physiological temperature recording in a highly miniaturized form factor for use in songbirds. The systems are enabled by behavior guided primary antenna design and advanced energy management to ensure stable optogenetic stimulation and thermography throughout 3D experimental arenas. Collectively, these design approaches quantitatively expand the use of wireless subdermally implantable neuromodulation and sensing tools to species previously excluded from in vivo real time experiments.


Assuntos
Neuroestimuladores Implantáveis , Fenômenos Fisiológicos do Sistema Nervoso , Optogenética/instrumentação , Aves Canoras/fisiologia , Telemetria/instrumentação , Tecnologia sem Fio/instrumentação , Animais , Encéfalo/fisiologia , Optogenética/métodos , Nervos Periféricos/fisiologia , Reprodutibilidade dos Testes , Telemetria/métodos
14.
Biosens Bioelectron ; 180: 113139, 2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-33714161

RESUMO

Optogenetics is a cutting-edge tool in neuroscience that employs light-sensitive proteins and controlled illumination for neuromodulation. Its main advantage is the ability to demonstrate causal relationships by manipulating the activity of specific neuronal populations and observing behavioral phenotypes. However, the tethering system used to deliver light to optogenetic tools can constrain both natural animal behaviors and experimental design. Here, we present an optically powered and controlled wireless optogenetic system using near-infrared (NIR) light for high transmittance through live tissues. In vivo optogenetic stimulations using this system induced whisker movement in channelrhodopsin-expressing mice, confirming the photovoltaics-generated electrical power was sufficient, and the remote controlling system operated successfully. The proposed optogenetic system provides improved optogenetic applications in freely moving animals.


Assuntos
Técnicas Biossensoriais , Optogenética , Animais , Luz , Camundongos , Neurônios , Próteses e Implantes , Tecnologia sem Fio
15.
J Biomed Inform ; 116: 103731, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33711539

RESUMO

BACKGROUND: Worldwide pandemic situations drive countries into high healthcare costs and dangerous conditions. Hospital occupancy rates and medical expenses increase dramatically. Real-time remote health monitoring and surveillance systems with IoT assisted eHealth equipment play important roles in such pandemic situations. To prevent the spread of a pandemic is as crucial as treating the infected patients. The COVID-19 pandemic is the ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: We propose a surveillance system especially for coronavirus pandemic with IoT applications and an inter-WBAN geographic routing algorithm. In this study, coronavirus symptoms such as respiration rate, body temperature, blood pressure, oxygen saturation, heart rate can be monitored and the social distance with 'mask-wearing status' of persons can be displayed with proposed IoT software (Node-RED, InfluxDB, and Grafana). RESULTS: The geographic routing algorithm is compared with AODV in outdoor areas according to delivery ratio, delay for priority node, packet loss ratio and bit error rate. The results obtained showed that the geographic routing algorithm is more successful for the proposed architecture. CONCLUSION: The results show that the use of WBAN technology, geographic routing algorithm, and IoT applications helps to achieve a realistic and meaningful surveillance system with better statistical data.


Assuntos
/epidemiologia , Monitoramento Epidemiológico , Sistemas de Informação Geográfica , Internet das Coisas , Pandemias/estatística & dados numéricos , Algoritmos , Simulação por Computador , Humanos , Máscaras/estatística & dados numéricos , Informática Médica , Software , Telemedicina , Tecnologia sem Fio
16.
J Surg Oncol ; 123(5): 1345-1352, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33621378

RESUMO

BACKGROUND AND OBJECTIVES: Post-discharge oncologic surgical complications are costly for patients, families, and healthcare systems. The capacity to predict complications and early intervention can improve postoperative outcomes. In this proof-of-concept study, we used a machine learning approach to explore the potential added value of patient-reported outcomes (PROs) and patient-generated health data (PGHD) in predicting post-discharge complications for gastrointestinal (GI) and lung cancer surgery patients. METHODS: We formulated post-discharge complication prediction as a binary classification task. Features were extracted from clinical variables, PROs (MD Anderson Symptom Inventory [MDASI]), and PGHD (VivoFit) from a cohort of 52 patients with 134 temporal observation points pre- and post-discharge that were collected from two pilot studies. We trained and evaluated supervised learning classifiers via nested cross-validation. RESULTS: A logistic regression model with L2 regularization trained with clinical data, PROs and PGHD from wearable pedometers achieved an area under the receiver operating characteristic of 0.74. CONCLUSIONS: PROs and PGHDs captured through remote patient telemonitoring approaches have the potential to improve prediction performance for postoperative complications.


Assuntos
Assistência ao Convalescente/normas , Neoplasias/cirurgia , Alta do Paciente , Avaliação de Resultados da Assistência ao Paciente , Medidas de Resultados Relatados pelo Paciente , Complicações Pós-Operatórias/fisiopatologia , Tecnologia sem Fio/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Humanos , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Adulto Jovem
17.
Sensors (Basel) ; 21(3)2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33540831

RESUMO

Emotion recognition is of great importance for artificial intelligence, robots, and medicine etc. Although many techniques have been developed for emotion recognition, with certain successes, they rely heavily on complicated and expensive equipment. Skin potential (SP) has been recognized to be correlated with human emotions for a long time, but has been largely ignored due to the lack of systematic research. In this paper, we propose a single SP-signal-based method for emotion recognition. Firstly, we developed a portable wireless device to measure the SP signal between the middle finger and left wrist. Then, a video induction experiment was designed to stimulate four kinds of typical emotion (happiness, sadness, anger, fear) in 26 subjects. Based on the device and video induction, we obtained a dataset consisting of 397 emotion samples. We extracted 29 features from each of the emotion samples and used eight well-established algorithms to classify the four emotions based on these features. Experimental results show that the gradient-boosting decision tree (GBDT), logistic regression (LR) and random forest (RF) algorithms achieved the highest accuracy of 75%. The obtained accuracy is similar to, or even better than, that of other methods using multiple physiological signals. Our research demonstrates the feasibility of the SP signal's integration into existing physiological signals for emotion recognition.


Assuntos
Inteligência Artificial , Emoções , Pele , Algoritmos , Humanos , Modelos Logísticos , Tecnologia sem Fio
18.
Int J Med Sci ; 18(6): 1415-1422, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33628098

RESUMO

Objective: SARS-CoV-2 (originally named COVID-2019) pneumonia is currently prevalent worldwide. The number of cases has increased rapidly but the auscultatory characteristics of affected patients and how to use it to predict who is most likely to survive or die are not available. This study aims to describe the auscultatory characteristics and its clinical relativity of SARS-CoV-2 pneumonia by using a wireless stethoscope. Material and methods: A cross-sectional, observational, single-center case series of 30 consecutive hospitalized patients with confirmed SARS-CoV-2 pneumonia at Leishenshan Hospital in Wuhan, China, were enrolled from March 9 to April 5, 2020. Clinical, laboratory, radiological, treatment data and lung auscultation were collected and analyzed. Lung auscultation was acquired by a wireless electronic stethoscope. Auscultatory characteristics of the moderate, severe, and critically ill patients were compared. Results: Kinds of crackles including fine crackles and wheezing were heard and recorded in these patients. Velcro crackles were heard in most critically ill patients (6/10). Besides, patients with Velcro crackles were all dead (6/6). There was no positive lung auscultatory finding in the moderate group and little positive lung auscultatory findings (4/10) in the severe group. Conclusion: Velcro crackles can be auscultated by this newly designed electronic wireless stethoscope in most critically ill patients infected by SARS-CoV-2 and predicts a poor prognosis. Moderate and severe patients without positive auscultatory findings may have a better prognosis.


Assuntos
Auscultação/métodos , Pulmão/diagnóstico por imagem , Pneumonia/diagnóstico por imagem , Pneumonia/virologia , Tecnologia sem Fio , Idoso , Estudos de Casos e Controles , China , Estado Terminal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estetoscópios
19.
Nutr Metab Cardiovasc Dis ; 31(2): 650-657, 2021 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-33594987

RESUMO

BACKGROUND AND AIMS: Continuous glucose monitoring improves glycemic control in diabetes. This study compared the accuracy of the Dexcom G5 Mobile (Dexcom, San Diego, CA) transcutaneous sensor (DG5) and the first version of Eversense (Senseonics,Inc., Germantown, MD) implantable sensor (EVS). METHODS AND RESULTS: Subjects with type 1 diabetes (T1D) and using EVS wore simultaneously DG5 for seven days. At day 3, patients were admitted to a clinical research center (CRC) to receive breakfast with delayed and increased insulin bolus to induce glucose excursions. At CRC, venous glucose was monitored every 15 min (or 5 min during hypoglycemia) for 6 h by YSI 2300 STAT PLUS™ glucose and lactate analyzer. At home patients were requested to perform 4 fingerstick glucose measurements per day. Eleven patients (9 males, age 47.4 ± 11.3 years, M±SD) were enrolled. During home-stay the median [25th-75th percentile] absolute relative difference (ARD) over all CGM-fingerstick matched-pairs was 11.64% [5.38-20.65]% for the DG5 and 10.75% [5.15-19.74]% for the EVS (p-value = 0.58). At CRC, considering all the CGM-YSI matched-pairs, the DG5 showed overall smaller median ARD than EVS, 7.91% [4.14-14.30]% vs 11.4% [5.04-18.54]% (p-value<0.001). Considering accuracy during blood glucose swings, DG5 performed better than EVS when glucose rate-of-change was -0.5 to -1.5 mg/dL/min, with median ARD of 7.34% [3.71-12.76]% vs 13.59% [4.53-20.78]% (p-value<0.001), and for rate-of-change < -1.5 mg/dl/min, with median ARD of 5.23% [2.09-15.29]% vs 12.73% [4.14-20.82]% (p-value = 0.02). CONCLUSIONS: DG5 was more accurate than EVS at CRC, especially when glucose decreased. No differences were found at home.


Assuntos
Automonitorização da Glicemia/instrumentação , Glicemia/metabolismo , Diabetes Mellitus Tipo 1/diagnóstico , Transdutores , Tecnologia sem Fio/instrumentação , Adulto , Biomarcadores/sangue , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/terapia , Desenho de Equipamento , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento
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