Non Invasive Foetal Monitoring with a Combined ECG - PCG System

Although modern ultrasound provides remarkable images and biophysical measures, the technology is expensive and the observations are only available over a short time. Longer term monitoring is achieved in a clinical setting using ultrasonic Doppler cardiotocography (CTG) but this has a number of limitations. Some pathologies and some anomalies of cardiac functioning are not detectable with CTG. Moreover, although frequent and/or long-term foetal heart rate (FHR) monitoring is recommended, mainly in high risk pregnancies, there is a lack of established evidence for safe ultrasound irradiation exposure to the foetus for extended periods (Ang et al., 2006). Finally, high quality ultrasound devices are too expensive and not approved for home care use. In fact, there is a remarkable mismatch between ability to examine a foetus in a clinical setting, and the almost complete absence of technology that permits longer term monitoring of a foetus at home. Therefore, in the last years, many efforts (Hany et al., 1989; Jimenez et al., 1999; Kovacs et al., 2000; Mittra et al., 2008; Moghavvemi et al., 2003; Nagal, 1986; Ruffo et al., 2010; Talbert et al., 1986; Varady et al., 2003) have been attempted by the scientific community to find a suitable alternative

A REVIEW ON MITRAL REGURGITATION: PATHOPHYSIOLOGY, INVESTIGATIONS AND TREATMENT

Background: The retrograde movement of blood from the left ventricle (LV) into the left atrium (LA) through the mitral valve (MV) causes a systolic murmur heard best at the apex of the heart with radiation to the left axilla. MR is the most common valvular anomaly in the globe, affecting around 2% of the population and increasing in incidence with age. This activity examines the diagnosis and treatment of mitral regurgitation, emphasizing the importance of the healthcare team in assessing and treating patients with this illness. Conclusion: The goal of this review article is to identify the etiology and epidemiology of mitral regurgitation medical conditions and emergencies, review the proper history, physical, and evaluation of mitral regurgitation, outline the treatment and management options for mitral regurgitation, and describe interprofessional team strategies for improving care coordination and communication to advance mitral regurgitation and improve outcomes

Efficient method for events detection in phonocardiographic signals

The auscultation of the heart is still the first basic analysis tool used to evaluate the functional state of the heart, as well as the first indicator used to submit the patient to a cardiologist. In order to improve the diagnosis capabilities of auscultation, signal processing algorithms are currently being developed to assist the physician at primary care centers for adult and pediatric population. A basic task for the diagnosis from the phonocardiogram is to detect the events (main and additional sounds, murmurs and clicks) present in the cardiac cycle. This is usually made by applying a threshold and detecting the events that are bigger than the threshold. However, this method usually does not allow the detection of the main sounds when additional sounds and murmurs exist, or it may join several events into a unique one. In this paper we present a reliable method to detect the events present in the phonocardiogram, even in the presence of heart murmurs or additional sounds. The method detects relative maxima peaks in the amplitude envelope of the phonocardiogram, and computes a set of parameters associated with each event. Finally, a set of characteristics is extracted from each event to aid in the identification of the events. Besides, the morphology of the murmurs is also detected, which aids in the differentiation of different diseases that can occur in the same temporal localization. The algorithms have been applied to real normal heart sounds and murmurs, achieving satisfactory results.This work has been supported by Fundación Séneca of Región de Murcia and Ministerio de Ciencia y Tecnología of Spain, under grants PB/63/FS/02 and TIC2003-09400-C04-02, respectively

Reintegrating socially excluded individuals through a social enterprise intervention

This research project reveals participant perceptions of an employment enhancement programme, run by a social enterprise and designed to reintegrate socially excluded individuals into society. The research participants were the social entrepreneur, staff at the social enterprise, the programme attendees and a representative from an external referral agency. Participants engaged in semi-structured interviews with a researcher designed to elicit participant perceptions of the programme. Results of the analysis of the interviews revealed six emergent themes that were interpreted by the researchers as: ‘social mission focus’, ‘heroic social entrepreneur’, ‘social impact’, ‘recidivism’, ‘the programme’ and ‘programme attendees’. Results of the analysis reveal that all research participants reported the programme helped to re-socialise the programme attendees and increased their self-confidence and self-esteem. Participants also believed programme attendees acquired important skills and qualifications in general warehouse activities and forklift truck driving, which would greatly increase their future employability. Programme attendees indicated the ‘real world’ working environment was important to their feelings of success on the programme. Social enterprise staff expressed concerns about potential ‘mission drift’ resulting from the demands of scaling up the logistics business to achieve the ‘double bottom line’