A Novel Low-Cost Sensor Prototype for Nocturia Monitoring in Older People

Indexación: Scopus.This work was supported in part by CORFO - CENS 16CTTS-66390 through the National Center on Health Information Systems, in part by the National Commission for Scientific and Technological Research (CONICYT) through the program STIC-AMSUD 17STIC-03: ‘‘e-MONITOR âĂŞ Chronic Disease: Ambient Assisted Living and vital teleMONOTORing for e-health,’’ FONDEF ID16I10449 ‘‘Sistema inteligente para la gestión y análisis de la dotación de camas en la red asistencial del sector público,’’ and MEC80170097 ‘‘Red de colaboración científica entre universidades nacionales e internacionales para la estructuración del doctorado y magister en informática médica en la Universidad de Valparaíso.’’ The work of V. H. C. de Albuquerque was supported by the Brazilian National Council for Research and Development (CNPq) under Grant #304315/2017-6.Nocturia is frequently defined as the necessity to get out of bed at least one time during the night to urinate, with each of these episodes being preceded and continued by sleep. Several studies suggest that an increase of nocturia is seen with the onset of age, occurring in around 70% of adults over the age of 70. Its appearance is associated with detrimental quality of life for those who present nocturia, since it leads to daytime sleepiness, cognitive dysfunction, among others. Currently, a voiding diary is necessary for nocturia assessment; these are prone to bias due to their inherent subjectivity. In this paper, we present the design of a low-cost device that automatically detects micturition events. The device obtained 73% in sensibility and 81% in specificity; these results show that systems such as the proposed one can be a valuable tool for the medical team when evaluating nocturia. © 2013 IEEE.https://ieeexplore.ieee.org/document/845445

Prediction of nocturia in live alone elderly using unobtrusive in-home sensors

iCity Lab; SHINESeniors; National Research Foundation (NRF) Singapore under the Land and Livability National Innovation Challenge (L2NIC

Lower Urinary Tract Dysfunction

Lower urinary tract dysfunction (LUTD) is an umbrella diagnosis that covers the abnormalities of anatomy and function in the bladder, urethra, and, in men, the prostate. People with LUTD face a number of social, mental, and physical health effects due to the symptoms. Despite the increasing evidence in the assessment and management of lower urinary tract symptoms, it remains a challenge to bridge the gap between research evidence and clinical practice. In this book, each and every one of the authors presents a remarkable work for how to apply the evidence to clinical practice from different aspects. I hope this book is a key for every reader to open the door to LUTD

Does acute hypoxia and high altitude exposure adversely affect cardiovascular performance?

Introduction: The cardiovascular adaptations to high altitude (HA) exposure and its relationship to acute mountain sickness (AMS) are incompletely understood. Aims: This thesis addresses four main hypotheses 1. HA adversely affects biventricular cardiac function leading to an increase in estimated filling pressures which is influenced by the mode of hypoxia. 2. HA exposure leads to myocardial injury that is linked to the development of AMS. 3. HA exposure is associated with a reduction in arterial compliance and an increase in central blood pressure (BP). 4. HA exposure reduces heart rate (HR) variability (HRV) that is linked to AMS an increased risk of cardiac arrhythmias. Methods: This consisted of eight independent studies conducted at terrestrial and ‘simulated’ HA (hypobaric hypoxia [HH] and normobaric hypoxia [NH] Cardiac function and arterial compliance were examined using portable transthoracic echocardiography and pulse contour analysis respectively. Myocardial injury was measured in venous blood by cardiac troponin T (cTnT) quantification. Cardiac inter-beat interval data for HRV analysis was acquired using single lead ECGs and novel finger and patch sensor technologies. Cardiac rhythm was investigated using a novel implantable cardiac monitor. Results: HA exposure was associated with a non-pathological increase in cTnT, and mild diastolic changes without adversely affecting systolic function or ventricular filling pressures. Resting cardiovascular responses were similar with HH, NH and HA, though notable differences emerged with exercise. Resting central BP, HR and BP-augmentation increased at terrestrial HA. HRV fell (eg reduced time-domain measures, increased LF/HF ratios and less chaos) at HA and was consistently different between men and women. Significant HA (>3500m) was associated with the development of tachyarrhythmia (atrial fibrillation and supraventricular tachycardia) and asymptomatic nocturnal bradycardias and pauses (>3.0 seconds). There were no independent predictors of AMS and its severity. Conclusion: HA-related hypoxia induces early sympathetic activation leading to an increase in resting HR and central BP and may be proarrhythmic. Parasympathetic activation with acclimatisation can trigger nocturnal pauses at higher altitudes. HA exposure does not adversely affect cardiac function

Psychoneuroimmunology and Chronic Pain

There is increasing evidence linking chronic pain to altered levels of central nervous system (CNS) inflammation and increased levels of perceived pain, anxiety, depression and sleep disturbance. However the inflammatory molecules responsible for physiologic and psychological components of chronic pain still warrant identification and exploration. Using central inflammation as a paramount factor in the creation and maintenance of chronic pain, this study aimed to investigate and describe the physical and psychological aspects of chronic pain associated with CNS inflammation. Using a cross-sectional correlational design, cerebrospinal fluid (CSF) inflammatory cytokine patterns present in 8 chronic pain participants were compared to inflammatory cytokine patterns present in 30 control CSF samples using multivariate analysis of variance (MANOVA), with analysis of variance (ANOVA) analysis as a follow-up. Levels of depression, anxiety, sleep disturbance and pain were measured in approximately 8 chronic pain patients and correlated to CSF levels of inflammatory cytokines using Pearson’s r, or Spearman’s Rho correlations. Demographic information was also explored for relationships to central inflammation and descriptive statistics were examined for responses. To our knowledge, this is the first study to describe increased CSF levels of Interleukin-8 (IL-8) in a population of majority Failed Back Surgery Syndrome chronic pain patients (F (1, 36) = 14.89, p \u3c 0.001, partial η2 = 0.293). Gender (F (1,6) = 7.782, p = 0.565), socioeconomic status (r = -0.823, p = 0.012) and educational level (r = 0.727, p = 0.041) were also correlated with central levels of inflammation, indicating that central physiologic changes may be related to host sex and psychosocial factors. All participants reported poor sleep quality and took at least one opioid medication, indicating that sleep and opioids may scaffold a portion of the chronic pain paradigm. This study richly describes the dynamic experience of chronic pain through the lens of Psychoneuroimmunology. Incorporating both physiologic and psychological aspects of the disease, this study describes an association between chronic pain, central inflammation, gender, socioeconomic status, opioid medications and poor sleep quality. Thus, the future of pain treatment must consider these aspects when treating patients and look to future studies for possible new treatment options which target these factors

Contribution of Enterococcus faecalis to urinary tract infection

The purpose of this thesis was to increase understanding of enterococcal UTI, in particular, the response of Enterococcus to antibiotic prophylaxis in vitro and in vivo and enterococcal communication with the bladder. We studied the in vitro effects of trimethoprim-sulfamethoxazole (TMP/SMX) and nitrofurantoin, two of the antibiotic treatments used most commonly in the management of both urinary tract infection (UTI) and recurrent UTI (RUTI), on Enterococcus faecalis attachment to urothelial cells. In doing so, we documented nitrofurantoin-induced increases in bacterial attachment at growth inhibitory concentrations of nitrofurantoin, but not TMP/SMX. This increased virulence did not correlate with increased expression of virulence factors but was correlated with increased expression of three putative genes. We then explored whether this corresponded to alterations in bacterial communities throughout antibiotic prophylaxis for paediatric patients with RUTI. Our bacterial culture results indicated uropathogens were present in the urine of children with and without a history of RUTI and that antibiotic prophylaxis induced a transient decrease in uropathogen load. Interestingly, none of our patients were experiencing symptomatic UTI at the time of urine sample collection, yet a significant proportion of midstream urine samples met the clinical threshold for UTI, indicating these patients had asymptomatic bacteriuria (ABU). Further, E. faecalis bacterial load was positively correlated with non-E. coli uropathogens, suggesting some patients may be pre-disposed to polymicrobial UTI. To elucidate mechanisms by which enterococci can mask the host’s perception of UTI, which may also contribute to the polymicrobial nature of E. faecalis UTI, we completed targeted metabolomics of neuroactive molecules in vitro under conditions mimicking the bladder environment. Our results suggest Enterococcus may produce tyramine in the bladder at concentrations that are likely to have a physiological effect on both urothelial cells and cohabiting bacteria. Our data raises questions about the application of nitrofurantoin to enterococcal UTI and the efficacy of antibiotic prophylaxis for RUTI. Further, our clinical and in vitro data suggest E. faecalis may contribute more to polymicrobial UTI than previously thought. Indeed, enterococcal production of tyramine may explain the high incidence of enterococci in not only polymicrobial UTI but also other infections

Effects of circadian rhythm phase alteration on physiological and psychological variables: Implications to pilot performance (including a partially annotated bibliography)

The effects of environmental synchronizers upon circadian rhythmic stability in man and the deleterious alterations in performance and which result from changes in this stability are points of interest in a review of selected literature published between 1972 and 1980. A total of 2,084 references relevant to pilot performance and circadian phase alteration are cited and arranged in the following categories: (1) human performance, with focus on the effects of sleep loss or disturbance and fatigue; (2) phase shift in which ground based light/dark alteration and transmeridian flight studies are discussed; (3) shiftwork; (4)internal desynchronization which includes the effect of evironmental factors on rhythmic stability, and of rhythm disturbances on sleep and psychopathology; (5) chronotherapy, the application of methods to ameliorate desynchronization symptomatology; and (6) biorythm theory, in which the birthdate based biorythm method for predicting aircraft accident susceptability is critically analyzed. Annotations are provided for most citations

Pediatric and Adolescent Nephrology Facing the Future: Diagnostic Advances and Prognostic Biomarkers in Everyday Practice

The Special Issue entitled “Pediatric and adolescent nephrology facing the future: diagnostic advances and prognostic biomarkers in everyday practice” contains articles written in the era when COVID-19 had not yet been a major clinical problem in children. Now that we know its multifaceted clinical course, complications concerning the kidneys, and childhood-specific post-COVID pediatric inflammatory multisystem syndrome (PIMS), the value of diagnostic and prognostic biomarkers in the pediatric area should be appreciated, and their importance ought to increase