ABSTRACT
The aim of the study was to compare and evaluate virulence in five strains of Klebsiella pneumoniae, including an isolate carrying New Delhi metallo-beta-lactamase-1 (NDM-1). In vivo virulence was assessed using a murine sepsis model and using the nematode Caenorhabditis elegans killing model, and in vitro virulence by assessing various virulence factors. The NDM-1 carrying K. pneumoniae isolate was the most virulent in the murine sepsis model but there was no clear cut correlation to in vitro virulence factors or killing in C. elegans. It is concluded that K. pneumoniae carrying NDM-1 have an intrinsic virulence potential, which in coexistence with its multiresistance could promote and partly explain its epidemiological success.
Subject(s)
Caenorhabditis elegans/physiology , Klebsiella Infections/microbiology , Klebsiella pneumoniae/enzymology , Klebsiella pneumoniae/pathogenicity , beta-Lactamases/genetics , Animals , Anti-Bacterial Agents/pharmacology , Biofilms/growth & development , Body Temperature , Caenorhabditis elegans/microbiology , Drug Resistance, Multiple, Bacterial , Female , Humans , Kaplan-Meier Estimate , Klebsiella pneumoniae/genetics , Klebsiella pneumoniae/isolation & purification , Mice , Mice, Inbred C57BL , Microbial Sensitivity Tests , Models, Animal , Sepsis/microbiology , Virulence/geneticsABSTRACT
OBJECTIVE: To investigate whether epileptic seizures could be predicted or detected by means of spectral analysis of heart rate variability (HRV). METHODS: Six patients with temporal lobe epilepsy (4 females, 2 males) participated in the prospective pilot study while enrolled for video/EEG monitoring (24 h/day, 2-4 days). ECG was continuously recorded and 30 min seizure-sessions (25-30 min pre-seizure to 30 sec-5 min post-seizure onset) and 30 min non-seizure-sessions (day- and night sessions for each patient, as control) were chosen for further HRV-analysis. Low frequency (LF) (0.04-0.15 Hz), High frequencies (HF) (0.15-0.40 Hz), LF/HF, LF/(LF+HF) and reciprocal HF-power was determined using continuous FFT- spectral analysis of 64 R-R interval windowing with maximum overlapping. RESULTS: Six seizures were recorded and analyzed from three patients (2 females, 1 male). All of the analyzed EEG-correlated seizures showed reciprocal HF-power peaks between 10 sec pre seizure-onset and 24 sec post seizure-onset with peak amplitudes 2.96-93.63 times higher than control maximum peak. For the other parameters we could not find significant difference between seizure and non-seizure sessions. CONCLUSION: Specifically high reciprocal HF-power peaks suggest suppressed parasympathetic activity just around seizure-onset time. Seizure detection using HRV-analysis seems to be a promising method for non-invasive seizure detection in the early phase of the clinical event (even preceding the onset).
Subject(s)
Epilepsy, Temporal Lobe/diagnosis , Heart Rate , Seizures/diagnosis , Adult , Electrocardiography , Electroencephalography , Epilepsy, Temporal Lobe/physiopathology , Female , Humans , Male , Middle Aged , Pilot Projects , Prospective Studies , Seizures/physiopathologyABSTRACT
A generic, realtime wireless telemedicine system has been developed that uses the Bluetooth protocol and the general packet radio service for mobile phones. The system was tested on 10 healthy volunteers, by continuous monitoring of their electrocardiograms (ECGs). Under realistic conditions, the system had 96.5% uptime, a data throughput of 3.3 kbit/s, a mean packet error rate of 8.5x10(-3) packet/s and a mean packet loss rate of 8.2x10(-3) packet/s. During 24 h testing, the total average downtime was 66 min and 90% of the periods of downtime were of only 1-3 min duration. Less than 10% of the ECGs were of unacceptable quality. Thus, the generic telemedicine system showed high reliability and performance, and the design may provide a foundation for realtime monitoring in clinical practice, for example in cardiology.
Subject(s)
Cell Phone , Electrocardiography, Ambulatory/instrumentation , Telemedicine/instrumentation , Adult , Electrocardiography, Ambulatory/methods , Equipment Design , Humans , Middle Aged , Reproducibility of Results , Sleep , Telemedicine/methodsABSTRACT
This paper introduces the design and implementation of a generic wireless and Real-time Multi-purpose Health Care Telemedicine system applying Bluetooth protocol, Global System for Mobile Communications (GSM) and General Packet Radio Service (GPRS). The paper explores the factors that should be considered when evaluating different technologies for application in telemedicine system. The design and implementation of an embedded wireless communication platform utilising Bluetooth protocol is described, and the implementation problems and limitations are investigated. The system is tested and its telecommunication general aspects are verified. The results showed that the system has (97.9 +/- 1.3)% Up-time, 2.5 x 10(-5) Bit Error Rate, 1% Dropped Call Rate, 97.4% Call Success Rate, 5 second transmission delay in average, (3.42 +/- 0.11) kbps throughput, and the system may have application in electrocardiography.
