Autonomic impairment in patients with migraine.

OBJECTIVE: Heart rate variability analysis of electrocardiogram is becoming an increasingly common method to non-invasively evaluate autonomic nervous function. The aim of the study was to investigate cardiac autonomic function in subjects with and without migraine by using 24-hour ambulatory electrocardiographic recordings. PATIENTS AND METHODS: We investigated 27 subjects with migraine (10 with migraine with aura and 17 without aura) during headache free periods and 10 age-matched healthy control subjects. The migraine was diagnosed using the International Classification of Headache Disorders 2nd Edition criteria. Beck Depression and Beck Anxiety Inventory forms were completed by all subjects. Time and frequency-domain of HRV was analyzed for two periods: diurnal and nocturnal. RESULTS: We found an increased frequency of anxiety and depressive symptoms in migraine patients, especially in migraine with aura group. The heart rate variability parameters SDNN, RMSSD, high frequency were decreased and low frequency was increased in migraine patients during night period compared with normal subjects, most affected were migraine with aura patients. During day period we found modification for SDNN, RMSSD and high frequency parameters only in migraine with aura group. CONCLUSIONS: Reduced parasympathetic activity with sympathetic predominance was found in migraine patients during the night period, most affected being migraine with aura patients.

Noninvasive hemodynamic study of the pulmonary circulation.

UNLABELLED: Cardiac catheterization is the reference method for the hemodynamic study of the pulmonary circulation. However, cardiac catheterization is an expensive and invasive method. Echocardiography is a reliable noninvasive alternative method. The purpose of our study was to determine the correlation between echocardiographic and haemodynamic data obtained by cardiac catheterization in patients with pulmonary hypertension. MATERIAL AND METHODS: We conducted a prospective study on 55 subjects diagnosed with pulmonary hypertension. They were examined by echocardiography and cardiac catheterization. The following parameters were measured: systolic, mean and diastolic pulmonary artery pressure and pulmonary vascular resistance. We determined the coefficient of linear correlation (Pearson) between the two methods. RESULTS: The mean pulmonary artery pressure obtained by cardiac catheterization was 48.82 +/- 18.4 mm Hg; the systolic pulmonary artery pressure at cardiac catheterization was 67.86 +/- 22.31 mm Hg; the diastolic pulmonary artery pressure was 32.85 +/- 15.49 mm Hg; the pulmonary resistance was 10.4 +/- 5.14 Wood units. We obtained very good correlation between the two methods for systolic pulmonary artery pressure (r 0.847, p < 0.0001), mean pulmonary artery pressure (r 0.7, p < 0.001), diastolic pulmonary artery pressure (r 0.54, p 0.01) and pulmonary vascular resistance (r 0.82, p < 0.001). CONCLUSIONS: Echocardiography is an excellent method for the hemodynamic study of the pulmonary circulation.

Evaluation of cardiac parameters using electrical impedance plethysmography.

UNLABELLED: Impedance plethysmography is a method for determining changes in body tissue volumes, based on the measurement of electric impedance at the body surface. Because it is a non-invasive and cost-effective method to measure and analyze hemodynamics, it would bring to physiologists very important diagnostic information for the continuous care of critical patients with hemodynamic disorders. METHODS: This study aimed at acquiring non-invasively and at analyzing plethysmografic waves by measuring the electrical impedance. For measurements we built a device that was designed as an injection module with a microcontroller, a programmable waveform generator, and a voltage controlled current source which generates a sinusoidal pulse with adjustable frequency (10-200 kHz) and adjustable intensity. In output, the device delivers an analogical signal representing the variation of the impedance of the explored section. The acquisition of the bioimpedance signal on PC was made easier by the use of a national instrument data acquisition device, the NI USB 6009. RESULTS: The bioimpedance signal processing, the user interface and the display were managed by MATLAB. Sample impedance data for a test subject are presented. From the experimental results, it is shown that the proposed bioimpedance measuring system could provide good performance over the frequency range for central or peripheral territory. CONCLUSION: The clinical importance of these findings is that this method can measure vascular parameters noninvasively, continuously and more conveniently in humans.

[Effect of environmental and individual factors in renal lithiasis]. / Studiu privind influenta factorilor de mediu si individuali in litiaza renala.

The large number of cases with renal lithiasis occurring in the population of the south-east region of Iasi county has determined us to make a study in this region for the identification of environmental and individual factors involved in the etiopathogenesis of this disease. This study is performed to assert the corelation between the clinical and paraclinical patients data with those obtained through water and soil chemical analisys for identification of determinant environmental and individual factors involved in etiopathogenesis of this disease. This study indicates that the environment factors (water, soil) correlated with personal factors, especially the diet and standard of living are the favouring factors of renal lithiasis.

[Changes of spirographic parameters in type 2 diabetes mellitus]. / Modificarile parametrilor spirografici in diabetul zaharat tip 2.

UNLABELLED: Diabetes mellitus (DM), metabolic disease with chronic evolution, affects various organs through its macro- and micro-angiopathic complications which it causes, one of this target organs for diabetes being the lungs. OBJECTIVES: The aim of the study is to evaluate the relationship between type 2 diabetes mellitus and the pulmonary function. MATERIAL AND METHOD: 50 non-smoking patients diagnosed with type 2 DM, without respiratory problems were included in this study. The control group consisted of 50 healthy volunteers with same age and height as those with diabetes. For all patients there were measured: height, weight, body mass index, plasma glucose, serum cholesterol, trigycerides. Then there were determined by computerized spirometry: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), maximal expiratory flow at 50% from vital capacity (MEF50). These patients were re-evaluated after a 3-year period measuring the same parameters. RESULTS: The study has shown a statistically significant decrease of spirographic parameters (FVC, FEV1, PEF, MEF50) in patients with over 5 years of evolution of type 2 DM, by comparison with the control group. The higher the metabolic unbalance, the lower were these parameters. CONCLUSIONS: Type 2 DM has long-term effects and determines disfunctions and deficiencies of various organs. Our study shows that the lung is a target organ for type 2 DM as well.

[Monitoring of the SaO2 and photoplethysmography in chronic disease]. / Monitorizarea saturatiei de oxigen si a pletismogramei in bolile cronice.

UNLABELLED: Non-invasive monitoring of some vital parameters can improve the management of chronic diseases resulting an important increasing of quality of life. Today the high number of the patients, suffering of chronically diseases, put a big pressure to the health system with their demand for homecare monitoring. MATERIAL AND METHOD: In this paper are presented the design of the wearable medical device for long term monitoring of pulse wave and SaO2 using a probe that includes two light emitting diodes (LEDs), one in the visible red spectrum (660 nm) and the other in the infrared spectrum (940 nm). The device stores all the data on SD memory card for post processing. RESULTS: The monitoring device is built using an ultra low power microcontroller that offers the advantage of high integration of some circuits. The custom made electronic boards used for signal acquisition are also included modules for storage device (SD/MMC card). The pulse wave was processed in MATLAB for calculate the second derivative of photoplethysmogram as an indicator of the hardness of the blood vessel. CONCLUSION: The work was focused on design and implementation of an ultra low power wearable device able to acquire the pulse wave, causing minimal discomfort and allowing high mobility.

[Monitoring system for cardiovascular parameters of drivers]. / Sistem de monitorizare a parametrilor cardiovasculari pentru conducatori auto.

UNLABELLED: In the world the road traffic accidents are in the 3rd place at WHO cause-of-death statistics. One of the main causes of these accidents is driving fatigue as results of stress. The aim of this study is to monitoring the heart rate variability for identifying the grade of stress of the drivers. MATERIAL AND METHOD: For this stage of the study we design and build an device that recording the ECG signal and the heart rate. We analysed of line the heart rate variability for determining one possible link between the grade of fatigue and heart rate variability. The device use only two electrodes placed on the steering wheel. RESULTS: We use three categories of subjects: beginner drivers, amateur drivers with more than 3 year experience, and expert drivers. The monitoring is made for 30 minutes in intensive traffic. CONCLUSION: The preliminary results are satisfactory which determine us to continuing the research in this direction.

[Wireless device for monitoring the patients with chronic disease]. / Dispozitiv wireless pentru monitorizarea pacientilor cu afectiuni cronice.

UNLABELLED: Remote monitoring of chronic diseases can improve health outcomes and potentially lower health care costs. The high number of the patients, suffering of chronically diseases, who wish to stay at home rather then in a hospital increasing the need of homecare monitoring and have lead to a high demand of wearable medical devices. Also, extended patient monitoring during normal activity has become a very important target. MATERIAL AND METHOD: In this paper are presented the design of the wireless monitoring devices based on ultra low power circuits, high storage memory flash, bluetooth communication and the firmware for the management of the monitoring device. RESULTS: The monitoring device is built using an ultra low power microcontroller (MSP430 from Texas Instruments) that offers the advantage of high integration of some circuits. The custom made electronic boards used for biosignal acquisition are also included modules for storage device (SD/MMC card) with FAT32 file system and Bluetooth device for short-range communication used for data transmission between monitoring device and PC or PDA. CONCLUSION: The work was focused on design and implementation of an ultra low power wearable device able to acquire patient vital parameters, causing minimal discomfort and allowing high mobility. The proposed wireless device could be used as a warning system for monitoring during normal activity.

[Multi-objective optimization for fuzzy controller in neuro-muscular rehabilitation]. / Optimizare multiobiectiv a controlerelor fuzzy in recuperarea neuro-musculara.

The multi-objective optimization problem could be generally formulated as minimization of vector objectives subject to a number of constraints and bounds. Among the non-derivative problems, genetic algorithms have been proved to be a good solution in addressing ill-posed problem. We applied the multi-objective optimization to fuzzy controller design in order to obtain a optimal solution that is often a compromise between different objectives. The application that are targeted in this paper is the e-health in neuromuscular rehabilitation using electromyographies. Because our application is implemented using a micro-controller with limited capabilities, that is flash memory, computational effort, and the clock frequency, the interest is to design the smallest fuzzy architecture possible in order to accomplish the objectives. The optimal set was used in order to achieves these objectives.

[E-health application for home monitoring of neuro-muscular rehabilitation]. / Aplicatie e-health pentru monitorizarea la domiciliu a recuperarii neuro-musculare.

In many medical fields the recovery of muscular activity or its improvement up to the level of the optimal parameters is required. Apart from the classical solution for rehabilitation (physical exercises) the use of electrical stimulation has become quite frequent of late. The paper presents an interface that detects the electromyographic (EMG) activity, assesses it, and generates appropriate electrical stimuli, by means of a specific type of fuzzy control system, in order to control the dynamics of the EMG. The proposed interface will detect the motion and muscular activity, it will evaluate and generate the electrical stimulus using a fuzzy system tuned by dynamic of motion. The application will transmit e-Health information to the physician via Internet, synthetic, at request using TCP/IP stack and SMS services for wireless communication.