Acoustical and flow characteristics of a cough as an index of pulmonary function in the guinea pig

Human studies indicate that cough sound and flow analysis may be useful for diagnosing pulmonary abnormalities. The purpose of this study was to evaluate an animal model for cough sound and flow analysis. A system was designed to expose guinea pigs to aerosols of citric acid (0.39M) and record resulting coughs at different stages of chemically induced specific airway resistance (sRAW). Coughs were divided into three categories (low sRAW, n = 113; moderate sRAW, n = 143; high sR AW, n = 93). 124 cough sound parameters were derived from the analysis of the sound pressure waves recorded during the cough. A principal component analysis was performed on the acquired data, and the resulting parameters were used to train a single neuron feed-forward back propagation neural network. The classification system was able to correctly discriminate between members of the high and low airway constriction groups with an accuracy of 0.946 and a sensitivity and specificity of 0.893

Models and analysis of vocal emissions for biomedical applications: 5th International Workshop: December 13-15, 2007, Firenze, Italy

The MAVEBA Workshop proceedings, held on a biannual basis, collect the scientific papers presented both as oral and poster contributions, during the conference. The main subjects are: development of theoretical and mechanical models as an aid to the study of main phonatory dysfunctions, as well as the biomedical engineering methods for the analysis of voice signals and images, as a support to clinical diagnosis and classification of vocal pathologies. The Workshop has the sponsorship of: Ente Cassa Risparmio di Firenze, COST Action 2103, Biomedical Signal Processing and Control Journal (Elsevier Eds.), IEEE Biomedical Engineering Soc. Special Issues of International Journals have been, and will be, published, collecting selected papers from the conference

Models and Analysis of Vocal Emissions for Biomedical Applications

The International Workshop on Models and Analysis of Vocal Emissions for Biomedical Applications (MAVEBA) came into being in 1999 from the particularly felt need of sharing know-how, objectives and results between areas that until then seemed quite distinct such as bioengineering, medicine and singing. MAVEBA deals with all aspects concerning the study of the human voice with applications ranging from the newborn to the adult and elderly. Over the years the initial issues have grown and spread also in other fields of research such as occupational voice disorders, neurology, rehabilitation, image and video analysis. MAVEBA takes place every two years in Firenze, Italy. This edition celebrates twenty-two years of uninterrupted and successful research in the field of voice analysis

Short-term Airway Clearance Management in people with stable Bronchiectasis

Introducción La expectoración crónica es uno de los síntomas respiratorios más prevalentes en personas con bronquiectasias y se asocia con un peor estado clínico y un fuerte impacto en la vida social. A pesar de que el uso de técnicas de drenaje de secreciones (DS) y agentes hiperosmolares es recomendado para facilitar el manejo diario de la tos productiva en pacientes con bronquiectasias, la calidad de su evidencia es todavía bajamoderada y su grado de recomendación varía de débil a fuerte. Por este motivo, se requiere evaluar en profundidad nuevos enfoques terapéuticos a corto plazo que faciliten el DS y que no hayan sido investigados hasta la fecha, para poder diseñar futuros ensayos clínicos a largo plazo con mayor nivel de garantía. Por consiguiente, el objetivo de esta tesis fue investigar que enfoque terapéutico a corto plazo facilita en mayor medida el DS en personas adultas diagnosticadas de bronquiectasias en periodo de estabilidad clínica, al igual que averiguar cómo interpretar correctamente los beneficios clínicos de estas intervenciones.Métodos Dos ensayos clínicos aleatorizados y cruzados se llevaron a cabo para comparar la efectividad a corto plazo de tres técnicas espiratorias lentas de DS (drenaje autógeno, espiración lenta con glotis abierta en decúbito infralateral [ETLGOL] y presión espiratoria positiva temporal [TPEP]) y tres soluciones salinas para inhalar (suero hipertónico [SH], suero hipertónico con ácido hialurónico [SH+AH] y suero isotónico [SI]) en personas con bronquiectasias. El objetivo primario en ambos ensayos clínicos fue el peso húmedo de la cantidad de esputo expectorada durante las sesiones. Además, se realizó un análisis ad‐hoc utilizando las muestras de esputo de ambos ensayos clínicos para examinar la fiabilidad de la cantidad de esputo durante 24 horas, así como la diferencia importante mínima (DIM) después de una sesión de DS en bronquiectasias. Finalmente, se examinó mediante un estudio de viabilidad/factibilidad el potencial uso de los ruidos respiratorios adventicios analizados de forma computacional como herramienta de evaluación de los efectos a corto plazo del DS en pacientes con bronquiectasias.Resultados (1) Las técnicas de drenaje autógeno y ELTGOL favorecieron en mayor grado la expectoración durante las sesiones que la técnica TPEP en personas con bronquiectasias en estabilidad clínica; siendo el drenaje autógeno la técnica preferida por los participantes; (2) la solución SH+AH fue tan efectiva como la solución de SH y mejor que la solución de SI facilitandola expectoración; sin embargo presentó un mejor perfil de seguridad que el SH en personas conbronquiectasias en periodo de estabilidad clínica y por esto fue la técnica de elección por los participantes; (3) el peso húmedo de la cantidad de esputo expectorada durante 24 horas presentó una fiabilidad aceptable; sin embargo su nivel de concordancia fue ligeramente amplio, especialmente para niveles de expectoración elevados. Además, se estimó que una reducción de al menos 6,4 g. en la cantidad de esputo expectorada durante las 24 horas posteriores a una intervención de DS, o un cambio relativo de alrededor del ‐17% con respecto al nivel basal, es la DIM; (4) el uso de los ruidos respiratorios adventicios analizados de forma computacional fue una herramienta viable/factible y parece ser que el número de crujidos espiratorios graves es la mejor variable para utilizar en futuros estudios.Conclusión Los hallazgos de esta tesis resaltan cuáles son los enfoques terapéuticos de DS a corto plazo más efectivos en personas con bronquiectasias en periodo de estabilidad clínica. Por lo tanto, el próximo paso es diseñar y realizar ensayos clínicos a largo plazo que analicen los efectos de estos enfoques terapéuticos en personas con bronquiectasias.Background Daily sputum expectoration is one of the most common respiratory symptoms in people with bronchiectasis. It is associated with poor health outcomes and negative impacts on social life. Although the use of airway clearance techniques (ACTs) and hyperosmolar agents is recommended to more easily manage chronic productive cough, the quality of evidence is still low-moderate and the level of recommendation ranges from weak to strong in bronchiectasis. However, there is a need to evaluate in-depth the short-term effects of airway clearance therapeutic approaches that are so far under-investigated in bronchiectasis in order to design optimal long-term future trials in this field. Therefore, the aims of this thesis were to investigate what is the short-term effectiveness of airway clearance therapeutic approaches in adults with clinically stable bronchiectasis and how to correctly interpret the clinical benefits observed after these interventions. Methods Two randomised, three-way crossover trials were conducted to compare the short-term effectiveness of three slow-expiratory ACTs (autogenic drainage, slow-expiration with glottis opened in lateral posture [ELTGOL] and temporary positive expiratory pressure [TPEP]) and three inhaled saline solutions (hypertonic saline [HS], hyaluronic acid + HS [HA + HS] and isotonic saline [IS]) in people with bronchiectasis. Wet sputum weight during sessions was selected as the primary outcome in both trials. Moreover, an ad hoc analysis was performed using the sputum samples of both studies to evaluate the reliability of 24-hour sputum weight and the minimal important difference (MID) after short-term airway clearance sessions in bronchiectasis. Finally, a feasibility study was conducted to examine the potential use of computerised adventitious respiratory sounds (ARS) as an outcome measure to assess the short-term effects of airway clearance sessions in bronchiectasis. <br /

Analysis of Respiratory Sounds: State of the Art

Objective This paper describes state of the art, scientific publications and ongoing research related to the methods of analysis of respiratory sounds. Methods and material Review of the current medical and technological literature using Pubmed and personal experience. Results The study includes a description of the various techniques that are being used to collect auscultation sounds, a physical description of known pathologic sounds for which automatic detection tools were developed. Modern tools are based on artificial intelligence and on technics such as artificial neural networks, fuzzy systems, and genetic algorithms… Conclusion The next step will consist in finding new markers so as to increase the efficiency of decision aid algorithms and tools

European Respiratory Society statement on airway clearance techniques in adults with bronchiectasis

Airway clearance techniques (ACTs) are part of the main management strategy for patients with bronchiectasis. Despite being a priority for patients, accessibility, implementation and reporting of ACTs are variable in clinical settings and research studies. This European Respiratory Society statement summarises current knowledge about ACTs in adults with bronchiectasis and makes recommendations to improve the future evidence base. A task force of 14 experts and two patient representatives (10 countries) determined the scope of this statement through consensus and defined six questions. The questions were answered based on systematic searches of the literature. The statement provides a comprehensive review of the physiological rationale for ACTs in adults with bronchiectasis, and the mechanisms of action along with the advantages and disadvantages of each ACT. Evidence on ACTs in clinical practice indicates that the most frequently used techniques are active cycle of breathing techniques, positive expiratory pressure devices and gravity-assisted drainage, although there is limited evidence on the type of ACTs used in specific countries. A review of 30 randomised trials for the effectiveness of ACTs shows that these interventions increase sputum clearance during or after treatment, reduce the impact of cough and the risk of exacerbations, and improve health-related quality of life. Furthermore, strategies for reducing the risk of bias in future studies are proposed. Finally, an exploration of patients' perceptions, barriers and enablers related to this treatment is also included to facilitate implementation and adherence to ACTs.</p

Development of an Intelligent Real-time Multi-Person Respiratory Illnesses Sensing System using SDR Technology

Respiration monitoring plays a vital role in human health monitoring, as it is an essential indicator of vital signs. Respiration monitoring can help determine the physiological state of the human body and provide insight into certain illnesses. Recently, non-contact respiratory illness sensing methods have drawn much attention due to user acceptance and great potential for real-world deployment. Such methods can reduce stress on healthcare facilities by providing modern digital health technologies. This digital revolution in the healthcare sector will provide inexpensive and unobstructed solutions. Non-contact respiratory illness sensing is effective as it does not require users to carry devices and avoids privacy concerns. The primary objective of this research work is to develop a system for continuous real-time sensing of respiratory illnesses. In this research work, the non-contact software-defined radio (SDR) based RF technique is exploited for respiratory illness sensing. The developed system measures respiratory activity imprints on channel state information (CSI). For this purpose, an orthogonal frequency division multiplexing (OFDM) transceiver is designed, and the developed system is tested for single-person and multi-person cases. Nine respiratory illnesses are detected and classified using machine learning algorithms (ML) with maximum accuracy of 99.7% for a single-person case. Three respiratory illnesses are detected and classified with a maximum accuracy of 93.5% and 88.4% for two- and three-person cases, respectively. The research provides an intelligent, accurate, continuous, and real-time solution for respiratory illness sensing. Furthermore, the developed system can also be deployed in office and home environments