Sports medicine and rehabilitation : clinical and experimental studies : review articles

• Arak, A. Quality of Life After Coronary Bypass Surgery • Audova, M. Electrotherapy: A Part of Rehabilitation of Hand and Leg Fractured Patients • Eller, A., Tein, T., Pintsaar, A. First experience of arthroscopy: success, difficulties, complications • Jaksman, S., Vedru, J., Vider, J. On the Proper Cuff Pressure for Venous Occlusion • Kaljumäe, Ü., Airaksinen, O., Turunen, H., Hänninen, O. Knee Antagonist Muscle Coactivity During Fatiguing Exercise • Karu, T., Kaljumäe, Ü., Slavin, G., Hänninen, О. Computing Aerobic and Anaerobic Load Periods From Heart Rate Records in Runner • Kullus, R., Laane, E., Saks, K., Pokk, T. Oxygen Uptake and Noninvasive Hemodynamic Assessment in Patients With Coronary Heart Disease • Landõr, A., Karu, T., Ojamaa, M. Standards for Evaluating Morphologic and Physical Capacity Indices in Men • Landõr, A., Täil, S., Ignatjeva, N., Savi, T. Fittness, Physical Activity and Serum Cholesterol of Men of Different Age Groups • Maaroos, J. Children in Competitive Sports • Ojamaa, M., Viigimaa, M., Ulst, K., Altraja, E. Myocardial Perfusion Imaging and Coronary Angiography in the Diagnosis of Coronary Artery Disease • Vedru, J. Electrical Impedance Methods for the Measurement of Stroke Volume in Man: State of Arthttp://tartu.ester.ee/record=b1077866~S1*es

Blood Glucose Predictor

For my senior project, I perform data analysis using statistical methods to determine body metrics that correlate with blood glucose levels. Working with Dr. Tina Smilkstein, I take repeat measurements from 6 different volunteers to establish trends in bodily metric data. The data taken includes weight, body fat, pulse rate, VO2, blood glucose, blood pressure, hours slept, and quality of sleep. Using these values, I use the program MiniTab to view results. A few examples of correlations with blood glucose found in this project are: Systolic blood pressure for females had a regression line of 124.0 -0.3366*Blood Pressure. This indicates a negative correlation, meaning as blood pressure rose, blood glucose dropped. For males, the line equation is 59.47 + 0.2962*Blood Pressure, indicating a positive correlation. In the case of diastolic blood pressure, male data was quite scattered graphically, indicating the line of best fit is not an accurate representation of blood glucose. For females, the line is 111.9 – 0.3565*Blood Pressure (diastolic). This again indicates a negative correlation. In the case of weight, both lines graphically followed the data points. For males, the regression line is 162.6 – 0.342*Weight. For females, it is 103.2- 0.1525*Weight. The rest of the correlations and data is found in the contents of the report. Leveraging the results of this research, patients can potentially input their information into a webpage that predicts whether or not they must prick their finger to view actual blood glucose. While this tool may provide an interesting learning opportunity, the numerical value provided is not meant to be taken as medical advice. Every individual has different bodily metrics, therefore the value given is for experimentation, not for a 100% accurate measurement. To be sure of your blood glucose, until the technology has improved, always use a Blood Glucose Monitor, since I am not a medical professional. Once perfected, this could lead to saved time, pain, and trouble for the user. For the following data, it reflects 18-24 year old college students without diabetes to establish a baseline

A novel, non-invasive, optical device for the measurement of total haemoglobin and stroke volume, and for the identification of fluid responsiveness – initial clinical evaluation

Haemoglobin is a molecule present in red blood cells and is essential for adequate oxygen delivery to tissues. It is measured frequently in many clinical situations, particularly intraoperatively. Until recently, it was only possible to measure haemoglobin through blood testing which is an invasive process and requires some time to process. Devices have been developed in the last number of years to minimise both the invasiveness and time needed to measure haemoglobin. More recently, devices are available that provide instant or continuous results without requiring blood samples but these have not been universally accepted into clinical practice. Stroke volume is the amount of blood ejected from the heart at each heartbeat, and is one of the determinants of cardiac output (which is also responsible for ensuring adequate tissue oxygen delivery). It varies across many clinical states, particularly following major haemorrhage or reduced cardiac function. The analysis of variations in stroke volume during the respiratory cycle (i.e. between the end of a complete exhalation and the end of the following complete exhalation) has been shown to predict when a patient’s stroke volume could be improved by administering intravenous fluid. Successfully identifying such ‘responders’ can lead to earlier appropriate treatment, and also avoid over-treatment. However, at present the most reliable methods of measuring stoke volume or predicting fluid responsiveness involve the use of invasive devices which have the potential to be harmful. A novel device has been developed which uses the absorbance of red and near-infrared light across a finger tip as the basis for the measurement of both haemoglobin and stroke volume, along with the prediction of fluid responsiveness. This is non-invasive and would allow for the continuous measurement of these physiological parameters, with potential for more efficient and timely treatment.This thesis presents the first clinical evaluation of the two functions of this novel device across three studies. The first study investigated the measurement of haemoglobin by this device across twenty five patients undergoing heart surgery who each underwent four samples. The second study looked into the measurement of haemoglobin in one hundred pregnant women during their twenty- week antenatal clinic visit. In both studies, the results from the device were compared with the standard laboratory method of measurement. The third study investigated the device’s ability to measure stoke volume and to predict fluid responsiveness in twenty patients undergoing heart surgery. The results of these studies showed that the device is currently not suitable for use in clinical practice as a replacement for the more established methods of measurement one each case. Some explanation is offered regarding the poor results

Towards non-contact glucose sensing in aqueous turbid medium at ∼1.1 meters distance

This work demonstrates a non-contact diffuse reflectance approach with a working distance of ∼1.1 meters for the potential of glucose sensing. Non-contact diffuse reflectance over 1.1-1.3 μm was developed according to a center-illumination-area-detection (CIAD) geometry. The modeled response of diffuse reflectance in the CIAD geometry was examined with phantoms by altering independently the size of the collection geometry and the reduced scattering and absorption properties of the medium. When applied to aqueous turbid medium containing glucose control solutions with the cumulative volume varying over three orders of magnitude, a linear relationship expected for the diffuse reflectance as a function of the medium absorption/reduced-scattering property was observed for four conditions of the glucose-medium composition that differed either in the effective glucose concentration or the host medium scattering property. The cumulation of glucose up to 17.8 mg/dL and 8.9 mg/dL in the host medium having the same optical properties resulted in linear regression slopes of 0.0032 and 0.0030, respectively. The cumulation of the glucose up to 17.8 mg/dL in an aqueous host medium that differed two folds in the reduced scattering property caused the linear regression slope to differ between 0.0032 and 0.0019. The R² values of all cases were all greater than 0.987.Electrical & Computer Engineerin

Diseño de un dispositivo electrónico usando la técnica de bioimpedancia para la medición del nivel de glucosa en pacientes diabéticos

El objetivo general del presente trabajo es diseñar un dispositivo electrónico usando la técnica de bioimpedancia para la medición del nivel de glucosa en pacientes diabéticos con el propósito de realizar mediciones de manera continua. La corriente teórica en el presente trabajo es la bioimpedancia porque es una técnica no invasiva, efectiva y no desarrollada en nuestro país que permite determinar el nivel de glucosa en sangre de forma no invasiva. Asimismo, la metodología empleada consiste en el uso de electrodos de bioimpedancia para la captación de la señal de la impedancia eléctrica, esta señal es adquirida y procesada por un circuito amplificador con tierra flotante, luego pasa por un amplificador de instrumentación que permite la identificación de la frecuencia buscada, seguidamente se realiza la convolución y acondicionamiento de la señal para luego ser enviada al microcontrolador, así también, se requirió de ciertos materiales e instrumentos y equipos especializados como un microcontrolador dsPic, módulo Bluetooth, electrodos de bioimpedancia, espectroscopia de impedancia eléctrica y un generador de ondas arbitrarias. Dentro de los resultados esperados están la obtención de la señal de impedancia eléctrica a partir de la aplicación de corrientes de alta frecuencia, la exhibición de los niveles de glucosa en un dispositivo móvil. De otro lado, una conclusión relevante señala que la adquisición de la señal de bioimpedancia de un paciente diabético se realiza en la sección corporal más larga (brazo a pierna) para la obtención de características dieléctricas, y además, debe asegurarse una correcta postura para obtener una óptima medición

Clinical Applications of Electrical Impedance Tomography in Stroke and Traumatic Brain Injury

Electrical Impedance Tomography (EIT) is a medical imaging technology which uses voltage measurements on the boundaries to reconstruct internal conductivity changes. When applied to imaging brain function, EIT is challenged by the unique geometry of the head and the high variability in the conductivities of brain tissue. Stroke and Trau-matic Brain Injury (TBI) are two of the leading causes of death and long-term disability worldwide. It has been suggested that EIT, which is already in clinical use primarily as a means of assessing lung function, could be used as a pre-hospital diagnostic tool for stroke and TBI, and for bedside monitoring for brain injury patients. The main aim of this PhD thesis is to bring the application of EIT in brain injury closer to regular clinical use. Chapter 1 introduces the concepts of EIT, stroke and TBI, and provides a comprehensive review of clinically relevant neuroimaging techniques and the current state of brain EIT. Chapter 2 presents the results of a series of lab experiments designed to investigate the characteristics and mechanisms of drift in measured boundary voltages, which is the key technical barrier to brain monitoring with EIT. Ex-periments were conducted on lab phantoms, vegetable skin, and healthy human subjects. Chapter 3 describes a feasibility study of monitoring for brain injury with EIT over several hours, using noise recorded on real healthy volunteers. This study also compares the performance of different electrode types. Chapter 4 presents a clinical pilot study performed on acute stroke patients. Multi-frequency (MF) EIT data were record-ed on patients and healthy controls to create the first of its kind clinical EIT dataset to be used as a resource for future research for the EIT community. Finally, the ability to identify stroke patients is demonstrated on the clinical EIT dataset

Non-invasive Measurement of Cholesterol in Human Blood by Impedance Technique: an Investigation by Finite Element Field Modelling

The main topic of this work is detection of solid particles suspended in conductive medium and development of methodologies for determining cholesterol levels in human blood non-invasively by electrical impedance technique. The main part of this research is focused on the development of methodologies for numerical finite element (FE) modelling of simplified blood-cholesterol system, representing a real measurement system. This has been done first in 2D, to prove the concept and then in 3D, to take into account all of the effects that would only be present in 3D system as well as taking into account that there is a fully 3D problem in the heart of presented research. The proposed model has been tested in various extreme cases and theoretical and some experimental validations have been carried out to establish a degree of confidence in the modelling methodologies developed. This included novel way of model simplification by introduction of particle coagulation. This method has been proven to be successful replacement of effective conductivity method, used in the past. It has been tested against variation in physiological parameters, such as particle concentration and distribution, and material properties, such as particle ,conductivities. In 3D modelling cases the red blood cells (RBC) have been added to further increase the complexity of the system. Several case studies were used to help analyse which physical parameters of RBC would have the biggest impact on system’s impedance. Results were validated against experimental data where possible. This allowed extension of proposed methodology to non-spherical particles modelling. The other methodology adopted in this work applies to the electrode modelling. All electrodes are modelled as hollows. This tactic has been proven to work. It was validated both theoretically and by comparing computational model results with experiment results (BERG, City University London). In Conclusions, it is discussed that both methodologies can be used outside of current research in electromagnetic simulations of less conductive particles in conductive solvent and in cases where electrode material is not known. Modelling investigations of the simplified blood-cholesterol systems using the 2D and 3D FE modelling methodologies developed in this work have shown that it should be possible to measure cholesterol levels in human blood by impedance technique. Opinion sought from clinical staff highlight that this can potentially improve patient care by minimizing time needed for tests and human error (by shortening the number of people involved in testing). The work also establishes and discusses the need for further work, both theoretical and experimental for development of a measuring device for non-invasive measurement of cholesterol in human blood by impedance technique

Angina Pectoris

Angina is the most common disorder affecting patients with ischemic heart disease. This book provides a thorough review of fundamental principles of diagnosis, pathophysiology and treatment of angina pectoris, representing an invaluable resource not only for cardiologists, but also for general practitioners and medical students