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https://www.readbyqxmd.com/read/27924105/innovating-affordable-neonatal-care-equipment-for-use-at-scale
#1
REVIEW
V Sashi Kumar, V K Paul, K Sathasivam
The care of small and sick neonates requires biomedical technologies, such as devices that can keep babies warm (radiant warmers and incubators), resuscitate (self-inflating bags), track growth (weighing scales), treat jaundice (phototherapy units) and provide oxygen or respiratory support (hoods, continuous positive airway pressure (CPAP) devices and ventilators). Until the 1990s, most of these products were procured through import at a high cost and with little maintenance support. Emerging demand and an informal collaboration of neonatologists, engineers and entrepreneurs has led to the production of good quality equipment of several high-volume categories at affordable cost in India...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/26604837/treatment-of-sleep-disordered-breathing-with-positive-airway-pressure-devices-technology-update
#2
REVIEW
Karin Gardner Johnson, Douglas Clark Johnson
Many types of positive airway pressure (PAP) devices are used to treat sleep-disordered breathing including obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. These include continuous PAP, autoadjusting CPAP, bilevel PAP, adaptive servoventilation, and volume-assured pressure support. Noninvasive PAP has significant leak by design, which these devices adjust for in different manners. Algorithms to provide pressure, detect events, and respond to events vary greatly between the types of devices, and vary among the same category between companies and different models by the same company...
2015: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/26275782/use-of-medical-devices-in-hospice-for-symptom-management
#3
Nidhi Shah, Peter Homel, Jennifer Breznay
BACKGROUND: Home health services in the United States(US) have been on a rise. Hospice patients cope with diverse physical and pain symptoms; medical devices are used for symptom management to improve their quality-of-care at end-of-life. OBJECTIVE: Using the National Home and Hospice Care Survey (NHHCS), the study summarizes medical device use for symptom management and tracks various demographic variables for home hospice patients. METHODS: A cross-sectional analysis of data using the 2007 NHHCS was conducted...
August 14, 2015: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/25980631/assessment-of-right-ventricular-function-in-obstructive-sleep-apnea-syndrome-and-effects-of-continuous-positive-airway-pressure-therapy-a-pilot-study
#4
Antonio Vitarelli, Claudio Terzano, Maurizio Saponara, Carlo Gaudio, Enrico Mangieri, Lidia Capotosto, Mario Pergolini, Simona D'Orazio, Giovanna Continanza, Ester Cimino
BACKGROUND: It is known that obstructive sleep apnea syndrome (OSAS) can affect right ventricular (RV) performance even in the absence of systemic hypertension and other known cardiac or obstructive pulmonary disease. The purpose of the present study was to assess RV function in OSAS using 3-D echocardiography and speckle tracking echocardiography (STE) and evaluate changes after continuous positive airway pressure (CPAP) treatment. METHODS: Thirty-seven patients with OSAS without comorbidities and thirty control subjects were studied using 3-D echocardiography and STE...
July 2015: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/25038522/model-based-estimation-of-loop-gain-using-spontaneous-breathing-a-validation-study
#5
Elnaz Gederi, Shamim Nemati, Bradley A Edwards, Gari D Clifford, Atul Malhotra, Andrew Wellman
Non-invasive assessment of ventilatory control stability or loop gain (which is a key contributor in a number of sleep-related breathing disorders) has proven to be cumbersome. We present a novel multivariate autoregressive model that we hypothesize will enable us to make time-varying measurements of loop gain using nothing more than spontaneous fluctuations in ventilation and CO2. The model is adaptive to changes in the feedback control loop and therefore can account for system non-stationarities (e.g. changes in sleep state) and it is resistant to artifacts by using a signal quality measure...
September 15, 2014: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/24783469/impact-of-continuous-positive-airway-pressure-therapy-on-left-atrial-function-in-patients-with-obstructive-sleep-apnoea-assessment-by-conventional-and-two-dimensional-speckle-tracking-echocardiography
#6
Mustafa Gökhan Vural, Süha Cetin, Hikmet Firat, Ramazan Akdemir, Ekrem Yeter
OBJECTIVE: The objective of this study was to evaluate left atrial (LA) function in patients with obstructive sleep apnoea (OSA) receiving continuous positive airway pressure therapy (CPAP), incorporating two-dimensional speckle-tracking echocardiography (2D-STE). METHODS: Forty-five control and 117 OSA patients were enrolled in the study. They were categorized into mild, moderate and severe OSA groups according to the apnoea-hypopnoea index (AHI). All patients underwent conventional and 2D-STE...
April 2014: Acta Cardiologica
https://www.readbyqxmd.com/read/24647765/a-novel-application-for-assessing-diaphragmatic-function-by-ultrasonic-deformation-analysis-in-noninvasively-ventilated-healthy-young-adults
#7
N Hatam, A Goetzenich, R Rossaint, I Karfis, J Bickenbach, R Autschbach, G Marx, C S Bruells
PURPOSE: Noninvasive pressure support ventilation is intended to relieve the load on respiratory muscles and to prevent exhaustion. This includes continuous positive airway pressure (CPAP) as well as pressure support ventilation (PSV). Speckle tracking echocardiography (STE) allows quantification of tissue deformation by tracing characteristic grayscale patterns, independent of the acquisition angle. The aim of the present study was to assess the applicability of using STE as a way to investigate diaphragm movement using deformation analysis as a parameter for respiratory workload...
December 2014: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/24625233/born-too-soon-care-for-the-preterm-baby
#8
REVIEW
Joy E Lawn, Ruth Davidge, Vinod K Paul, Severin von Xylander, Joseph de Graft Johnson, Anthony Costello, Mary V Kinney, Joel Segre, Liz Molyneux
As part of a supplement entitled “Born Too Soon”, this paper focuses on care of the preterm newborn. An estimated 15 million babies are born preterm, and the survival gap between those born in high and low income countries is widening, with one million deaths a year due to direct complications of preterm birth, and around one million more where preterm birth is a risk factor, especially amongst those who are also growth restricted. Most premature babies (>80%) are between 32 and 37 weeks of gestation, and many die needlessly for lack of simple care...
2013: Reproductive Health
https://www.readbyqxmd.com/read/24146857/impact-of-untreated-obstructive-sleep-apnea-on-left-and-right-ventricular-myocardial-function-and-effects-of-cpap-therapy
#9
Christoph Hammerstingl, Robert Schueler, Martin Wiesen, Diana Momcilovic, Stefan Pabst, Georg Nickenig, Dirk Skowasch
BACKGROUND: Obstructive sleep apnea (OSA) has deteriorating effect on LV function, whereas its impact on RV function is controversial. We aimed to determine the effect of OSA and continuous positive airway pressure (CPAP) treatment on left and right ventricular (LV, RV) function using transthoracic echocardiography (TTE) and 2 dimensional speckle tracking (2D ST) analysis of RV deformation capability. METHODS AND RESULTS: 82 patients with OSA and need for CPAP therapy were prospectively enrolled and underwent TTE at study inclusion and after 6 months of follow up (FU)...
2013: PloS One
https://www.readbyqxmd.com/read/24019236/synchronized-neonatal-non-invasive-ventilation-a-pilot-study-the-graseby-capsule-with-bi-level-ncpap
#10
COMPARATIVE STUDY
Debra J Stern, Michael D Weisner, Sherry E Courtney
OBJECTIVES: (1) To evaluate the Graseby capsule (GC) as a respiratory detection device when compared to respiratory inductance plethysmography (RIP); (2) to evaluate the response to the Graseby signal of a commercially available bi-level nasal CPAP device (BNCPAP) designed for use with the GC; and (3) to assess the performance of the GC/BNCPAP device when fitted on preterm infants. STUDY DESIGN: The study consisted of four parts: (1) The response characteristics of the GC/BNCPAP were assessed without connection to an infant; (2) the respiratory detection of both GC and RIP were compared in six preterm infants (mean 1,242 g, range 900-1,530 g); (3) the GC/BNCPAP was connected in six preterm infants (mean 1,568 g, range 1,040-1,835 g), isolating the BNCPAP and the infant interaction by substituting an artificial "nose" for the infant and assessing performance using inspiratory times (Ti) of 0...
July 2014: Pediatric Pulmonology
https://www.readbyqxmd.com/read/23992588/an-official-american-thoracic-society-statement-continuous-positive-airway-pressure-adherence-tracking-systems-the-optimal-monitoring-strategies-and-outcome-measures-in-adults
#11
Richard J Schwab, Safwan M Badr, Lawrence J Epstein, Peter C Gay, David Gozal, Malcolm Kohler, Patrick Lévy, Atul Malhotra, Barbara A Phillips, Ilene M Rosen, Kingman P Strohl, Patrick J Strollo, Edward M Weaver, Terri E Weaver
BACKGROUND: Continuous positive airway pressure (CPAP) is considered the treatment of choice for obstructive sleep apnea (OSA), and studies have shown that there is a correlation between patient adherence and treatment outcomes. Newer CPAP machines can track adherence, hours of use, mask leak, and residual apnea-hypopnea index (AHI). Such data provide a strong platform to examine OSA outcomes in a chronic disease management model. However, there are no standards for capturing CPAP adherence data, scoring flow signals, or measuring mask leak, or for how clinicians should use these data...
September 1, 2013: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/23699251/effect-of-patient-contact-time-on-continuous-positive-airway-pressure-cpap-compliance-rates-for-patients-diagnosed-with-obstructive-sleep-apnea-osa
#12
Sharon Ngan
SESSION TYPE: Sleep PostersPRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PMPURPOSE: CPAP Therapy is an effectice therapy for OSA. The purpose of this study was to determine patient/therapist contact time would increase patient CPAP compliance.METHODS: Retrospective chart review of patients diagnosed with OSA with the portable monitoring device ARES and treated with CPAP from the Sleep Center opening to February 2012. CPAP compliance data tracked via data download. Patient contact time included a total of 3 sessions: Each session included one on one contact time, education and discussion on OSA...
October 1, 2012: Chest
https://www.readbyqxmd.com/read/23699184/investigating-the-healthy-user-effect-correlating-cpap-use-and-medication-adherence
#13
Paul Dieffenbach, Dawn Bravata, Jared Ferguson, Vincent McClain, Charles Austin, Frederick Struve, Xinli Li, Linda Williams, Jason Sico, Carlos Fragoso, Nicholas Burrus, John Concato, Nancy Kim, H Klar Yaggi
SESSION TYPE: Sleep IIPRESENTED ON: Monday, October 22, 2012 at 04:00 PM - 05:30 PMPURPOSE: Observational data support the use of Continuous Positive Airway Pressure (CPAP) therapy to reduce cardiovascular morbidity and mortality in patients with obstructive sleep apnea. One common critique of these findings is the potential for bias from the "healthy user effect," which postulates that CPAP users may be more compliant with medical co-therapies that predispose them to improved outcomes. To examine the potential for this effect, we performed an analysis of contemporaneous CPAP and cardiovascular medication usage in patients after stroke or transient ischemic attack (TIA)...
October 1, 2012: Chest
https://www.readbyqxmd.com/read/21962612/left-ventricular-torsion-abnormalities-in-patients-with-obstructive-sleep-apnea-syndrome-an-early-sign-of-subclinical-dysfunction
#14
RANDOMIZED CONTROLLED TRIAL
Antonio Vitarelli, Simona D'Orazio, Fiorella Caranci, Lidia Capotosto, Raymond Rucos, Gino Iannucci, Giovanna Continanza, Olga Dettori, Valentina De Cicco, Massimo Vitarelli, Melissa De Maio, Stefania De Chiara, Maurizio Saponara
BACKGROUND: Previous echocardiographic studies using tissue Doppler imaging (TDI) and speckle tracking imaging (STI) have demonstrated that obstructive sleep apnea syndrome (OSAS) patients may develop subclinical left ventricular (LV) systolic and diastolic dysfunction. Our purpose was to evaluate the impact of OSAS on LV torsion dynamics and aortic stiffness by using TDI and STI echocardiography. METHODS: Forty-two patients with OSAS and no comorbidities were studied...
May 25, 2013: International Journal of Cardiology
https://www.readbyqxmd.com/read/20435865/exacerbation-of-sleep-apnoea-by-frequent-central-events-in-patients-with-the-obstructive-sleep-apnoea-syndrome-at-altitude-a-randomised-trial
#15
RANDOMIZED CONTROLLED TRIAL
Yvonne Nussbaumer-Ochsner, Nicole Schuepfer, Silvia Ulrich, Konrad E Bloch
BACKGROUND Many patients with the obstructive sleep apnoea syndrome (OSA) travel to the mountains for recreational and professional activities while temporarily discontinuing continuous positive airway pressure (CPAP) treatment. A study was undertaken to evaluate the hypothesis that altitude would aggravate their hypoxaemia, sleep-related breathing disturbances and impair daytime performance. METHODS Thirty-four patients with OSA of median age 62 years (IQR 57-65), median apnoea/hypopnoea index (AHI) 47.5 events/h (IQR 32...
May 2010: Thorax
https://www.readbyqxmd.com/read/20405469/evaluation-of-the-effect-of-prehospital-application-of-continuous-positive-airway-pressure-therapy-in-acute-respiratory-distress
#16
G Scott Warner
OBJECTIVE: The impact of the use of mask continuous positive airway pressure (CPAP) on patients with acute respiratory distress in the prehospital, rural setting has not been defined. The goal was to test the use of CPAP using the Respironics WhisperFlow CPAP in patients presenting with acute respiratory distress. This was a collaborative evaluation of CPAP involving a rural EMS agency and the regional medical center. Patient outcomes including the overall rate of intubation-both in the field and in the emergency department (ED), and length of stay in the hospital and Intensive Care Unit (ICU) were tracked...
January 2010: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/20199643/new-acoustic-method-for-detecting-upper-airway-obstruction-in-patients-with-sleep-apnoea
#17
COMPARATIVE STUDY
Elaine M Stockx, Peter Camilleri, Elizabeth M Skuza, Thomas Churchward, Julie M Howes, Michael Ho, Timothy McDonald, Nicholas Freezer, Garun Hamilton, Malcolm H Wilkinson, Philip J Berger
UNLABELLED: This article investigates a new acoustic device to assess the behaviour of the upper airway in patients with OSA. Currently there is no simple non-invasive method to perform such measurements. As such this paper describes the device in probing the patency of the airway during sleep and increasing the efficiency of diagnosing OSA. BACKGROUND AND OBJECTIVE: OSA is a common disorder resulting in health and economic burdens. Currently identifying OSA in patients involves expensive techniques that require overnight studies in a laboratory setting with qualified staff...
February 2010: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/20123859/continuous-positive-airway-pressure-ameliorates-sleep-induced-subclinical-left-ventricular-systolic-dysfunction-demonstration-by-two-dimensional-speckle-tracking-echocardiography
#18
Nobuhiko Haruki, Masaaki Takeuchi, Yoshio Kanazawa, Noriko Tsubota, Rie Shintome, Hiromi Nakai, Roberto M Lang, Yutaka Otsuji
AIMS: We hypothesized that continuous positive airway pressure (CPAP) therapy could improve sleep-induced left ventricular (LV) dysfunction in patients with obstructive sleep apnoea syndrome (OSA). The aim of this study was to investigate the effects of CPAP therapy on LV systolic dysfunction during overnight sleep in patients with OSA using two-dimensional speckle-tracking echocardiography (2DSTE). METHODS AND RESULTS: 2D LV short-axis and apical views were acquired before and immediately after overnight sleeping in 32 patients with OSA and normal LV ejection fraction...
May 2010: European Journal of Echocardiography
https://www.readbyqxmd.com/read/19812589/impact-of-prematurity-and-co-morbidities-on-feeding-milestones-in-neonates-a-retrospective-study
#19
S R Jadcherla, M Wang, A S Vijayapal, S R Leuthner
OBJECTIVE: Feeding problems are an important area of neonatal morbidity that requires attention. We defined the feeding milestones related to transition to per oral feeding among premature infants based on gestational (GA) and postmenstrual ages (PMA), and elucidated the co-morbidity variables affecting with these skills. STUDY DESIGN: Feeding progress was tracked during the first hospitalization in a retrospective study involving 186 infants. We measured the age at acquisition of first feedings, maximum gavage feedings and maximum oral feedings...
March 2010: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/19412711/health-care-delivery-in-a-sleep-center
#20
T E Rosenbalm, S Redline, C Rosenberg, A Disch, G McFadden, K P Stohl
This report presents and describes measures developed for the tracking of care provided to patients referred for evaluation to a sleep clinic and center in a U.S. federal health facility. We provide qualitative and quantitative indicators, tracked for a two-year period of time, for system management, information flow, measures of consultation and subsequent identification of apneic activity (Respiratory Disturbance Index > 10) and treatment for sleep apnea, and the satisfaction with diagnostic testing and treatment...
March 1997: Sleep & Breathing, Schlaf & Atmung
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