A smart room for hospitalised elderly people: essay of modelling and first steps of an experiment.

We present a study of modelling and the first steps of an experiment of a smart room for hospitalised elderly people. The system aims at detecting falls and sicknesses, and implements four main functions: perception of patient and environment through sensors, reasoning from perceived events and patient clinical findings, action by way of alarm triggering and message passing to medical staff, and adaptation to various patient profiles, sensor layouts, house fixtures and architecture. It includes a physical multisensory device located in the patient's room, and a multi-agent system for fall detection and alarm triggering. This system encompasses a perception agent, and a reasoning agent. The latter has two complementary capacities implemented by sub-agents: deduction of type of alarm from incoming events, and knowledge induction from recorded events. The system has been tested with a few patients in real clinical situation, and the first experiment provides encouraging results which are described in a precise manner.

"Telepsychometry": a remote psychometry consultation in clinical gerontology: preliminary study.

OBJECTIVE: Evaluation of the clinical feasibility of remote psychometric consultation with elderly patients. METHODS: Remote consultation with six women and four men (average age 87) was compared with a standard consultation. An interview and two psychometric tests were used: the Mini-Mental Status Examination (MMSE) and the Clock Face Test (CFT), which were administered by a clinical psychologist and controlled by a psychologist observer who remained in the room with the patient. The experimental setting consisted of two rooms linked by a coaxial cable. Each room was equipped with a camera, television screen, and microphone. The clinician was able to operate the mobile camera in the patient's room by remote control. The clinician was assisted by a computer, which helped to focus on standardized points. A video camera recorded the consultation for documentation purposes. RESULTS: Decreased performance was observed in the remote versus the standard consultation for both tests (MMSE: p = 0.008; CFT: p = 0.006). Physiologic hearing loss may have been responsible for a fall in the patients' attention. CONCLUSION: Remote psychometric consultation can be applied successfully to the psychological examination of elderly patients provided that communication problems are solved.

Impedance rheoplethysmography. The role of estimation of vasodilatory activity.

The activity of a number of vasodilatory drugs was studied, with the help of impedance rheoplethysmography, on the vascular bed of the hind limb of anaesthetized rabbits. The vasodilators under study induce changes in rheoplethysmogram to a more or less important degree. The results were compared with those obtained with electromagnetic flowmetry. This method seems to be useful in the study of vasodilators because it allows to measure their effects and the duration thereof in a non-aggressive way. This method using flowmetry, allows to study in an analytical way those substances' effects on artery, vein and also capillary.

Rheographic assessment of cerebral blood volume and correlations with changes in intracranial pressure.

The authors present a four electrode rheographic technique for simiquantitative continuous measurement of CBV, by examining changes in cerebral tissue impedance induced by changes in blood content of the brain parenchyma. Correlation between the data obtained and ICP measurements permits conclusions regarding the behaviour of the cerebral blood bed. pCO2 regulates CBV, and the phenomenon is reversible according to a hystereris shaped time course in acute experiments. The rebound of ICP after sudden injections of CSF into the cisterna magna is of a vasogenic nature. Changes in CSF volume induce contrary changes in CBV. Pharmacological effects can be studied. The validity of the method is discussed.

[Pulmonary water and thoracic impedance. Evaluation of a measurement technic]. / Eau pulmonaire et impédance thoracique. Evaluation d'une méthode de measure

We measured transthoracic electrical impedance in 17 anesthetized and mechanically ventilated dogs with a four-electrode system. A current (5 KHZ, 50 mu A) is injected and detected at axillary levels. Transthoracic impedance was 67 +/- 14 ohms (S.D.) with insignificant shifts in control animals. Pulmonary edemas were induced by saline and dextrose overloads with large but opposite variations in impedance. Fifty to hundred per cent increases in total lung water content (determined at autopsy) were induced by intravenous injection of alloxan or instillation of endotracheal saline. Significant but small decreases in impedance followed. Validity of experimental pulmonary edemas with or without blood resistivity and pulmonary blood volume changes is discussed.