Incidence of pressure ulcers in intensive care units and direct costs of treatment: Evidence from Iran

Background and objective

Pressure ulcer (PU) is one of the important and frequent complications of hospitalization, associated with high treatment costs. The present study was conducted to determine the incidence of PU and its direct treatment costs for patients in intensive care unit (ICU) in Iran.

脉搏波形采集与辅助诊断系统的设计

在分析现有脉搏信号测量技术及其处理方法的基础上，设计了以AT89S52单片机为下位机，PC机为上位机的脉搏信号采集装置。利用Delphi强大的数据库支持特性和Delphi与Matlab混合编程技术，开发了脉搏信号辅助诊断系统。该系统界面友好，操作简单，数据处理能力强，实现了脉搏信号的采集，脉搏波形的实时显示、回放等功能。通过对临床患者脉搏数据的实际采集和处理，验证了该系统的有效性和实用性。     

两种不同方法测定低水平压力支持通气时气道阻断压与自主呼吸时常规方法测定值的相关性分析

目的 拟比较以两种不同方法测定低水平压力支持通气（pressure support ventilation，PSV）病人的气道阻断压（P0．1）与自主呼吸时常规方法测定值的相关性。方法 12例机械通气病人，断开呼吸机自主呼吸时以常规方法测定P0．1得到P0．1-SB：在PSV水平为5cmH20，以常规方法和按压呼气末暂停键测定P0．1分别得到P0．1-PSV5和P0．1-PSV5eeo．分析后二者与前者之间的相关性。结果 P0．1-SB与P0．1-PSV5之间差异无显著性，P0．1-PSV5ee0分别小于P0．1-SB与P0．1-PSV5，差异有显著性；P0．1-PSV5eeo与P0．1-PSV5和P0．1-SB之间的相关系数均为0．97。结论 按压呼气末暂停键测定PSV水平为5cmH2O的P0．1值与常规方法测定的PSV水平为5cmH2O以及自主呼吸时的测定值相比，其值偏小,但前者与后二者之间具有良好的相关性。     

Implication of the systolic hump in systemic arterial pressure waves

The systolic hump in the aortic blood pressure wave is defined as the aorticresistance component proportional to the aortic blood flow superimposed on the windkessel component. An electrical analogue comprising a series resistance (aortic resistance) plus a resistance (peripheral resistance) and capacitance (aortic compliance) in parallel (i.e. windkessel component) is used for analysis. Curve fitting using the leastsquares method is performed on calculated and measured blood pressure waves from dogs under haemodynamical conditions induced by infusion of three drugs (noradrenaline, isoproterenol and acetylcholine). The curve fitting RMS (root mean square) errors are <3% for blood pressure waves and <30% for blood flow waves, with good agreement between measured and calculated blood flow waveforms. Infusion of noradrenaline and acetylcholine is found to induce a significant decrease and increase in the aortic resistance, respectively. Although only a small fraction of the blood pressure wave, the systolic hump has a marked effect on the systolic pressure waveform.     

A quantitative analysis of valgus torque on the ACL: a human cadaveric study.

The loads needed to elicit a positive pivot shift test in a knee with an anterior cruciate ligament (ACL) rupture have not been quantified. The coupled anterior tibial translation (ATT), coupled internal tibial rotation (ITR), and the in situ force in the ACL in response to a valgus torque, an inherent component of the pivot shift test, were measured in 10 human cadaveric knee specimens. Using a robotic/universal force-moment sensor testing system, valgus torques ranging from 0.0 to 10.0 Nm were applied in nine increments on the intact and ACL-deficient knee in flexion ranging from 0 degrees to 90 degrees. At 15 degrees of knee flexion, the coupled ATT and ITR were significantly increased in the ACL-deficient knee when compared to the intact knee. Coupled ATT increased a maximum of 291% (6.7 mm, p<0.05), while coupled ITR increased a maximum of 85% (5.1 degrees, p<0.05). At 30 degrees, the increases in coupled ATT and ITR were significant at valgus loads of 3.3 Nm and greater with a maximum increase in coupled ATT of 137% (6.3 mm, p<0.05) and a maximum increase in coupled ITR of 38% (3.6 degrees, p<0.05). At 45 degrees, coupled ATT increased significantly (maximum of 69%, 4.4 mm, p<0.05), but only at torques > or =6.7 Nm. The in situ force in the ACL was less than 20 N for all flexion angles when a torque between 3.3 and 5.0 Nm was applied. Low valgus torque elicited tibial subluxation in the ACL-deficient knee with low in situ ACL forces, similar to a positive pivot shift test. Thus, application of a valgus torque may be suitable to evaluate ACL-deficient and ACL-reconstructed knees, since subluxation can be achieved with minimal harm to the ACL graft. This work is important in understanding one load component needed for the pivot shift examination; further studies quantifying other load components are essential for better comprehension of the in vivo pivot shift examination.     

Changes in temporal gait characteristics and pressure distribution for bare feet versus various heel heights

The purpose of this study was to identify changes in temporal gait characteristics and pressure generation across the sole of the foot due to various heel heights in women's dress pumps. Thirty female subjects, aged 18-30 years, volunteered to participate. Subjects were required to have normal gait and to wear comfortably either size 7 or size 9 shoes. Subjects were tested initially in bare feet using electrodynography (Langer Biomechanics Group, 21 East Industry Court, Deer Park, NY 11729-9986) (EDG) at a cadence of ~100 steps/min set by metronome. EDG trials with 4 pairs of shoes were then performed in random order. Shoes were women's dress pumps identical except for heel height. Heel heights were 1.75, 3.12, 5.72 and 8.74 cm. Data were collected over ~ 30 steps and averaged over this period. Data were analyzed using a one-way ANOVA, and changes were only considered significant if the ANOVA identified significant variations bilaterally. Considering temporal gait variables, we concluded that: (1) stance phase was shortened in shoes vs. bare feet but was unaffected by heel height, (2) the percentage of stance spent in weight bearing on the lateral and medial calcaneus decreased above a 3.12 cm heel height, (3) the percentage of stance spent in weight bearing on the first and second metatarsal heads increased in shoes vs. bare feet but was unaffected by heel height, (4) the percentage of stance spent in weight bearing on the fifth metatarsal was less in the 8.74 cm heel than in any other shoe or in bare feet. With regard to pressure variables, we found that: (1) peak pressure under the fifth metatarsal head was inversely related to heel height, (2) pressure under the third metatarsal head peaked earliest in heels greater than 5.72 cm high, and (3) pressure under the medial calcaneus peaked latest in heels greater than 5.72 cm high.     

A simple dual pressure-ejection system and calibration method for brief local applications of drugs and modified salines

We report a minimal method for dual pressure ejection through a single micropipette, which uses standard theta-type glass tubing and a connection through thinned polythene catheters without any sealing. We also describe a simple calibration method using a standard electrometer. The linearity of the ejected volume with respect to pulse duration and to applied pressure was maintained, as measured by the resistivity of ultrapure water after ejection of a saline solution. The method was used to analyse the inhibitory effect of glutamate on crayfish motoneurones with local and reversible applications of low-chloride saline and picrotoxin.     

A New Acceleration Driven Pacemaker: Rate Modulation Versus Normal Sinus Rhythm—Comparison During Treadmill Exercise

The pocing rate response of a new acceleration driven pulse generator (SWING 100, SORIN BIOMEDICA) was compared with simultaneous normal sinus rhythm (NSR) during two different treadmill exercises. This pacemaker has a gravitational acceleration sensor able to discriminate between physical activities and vibrations. Six healthy volunteers (three male, three female; aged 21.7 ± 4,3 years), with the pacemaker strapped to their right infraclavicular area, performed each test three times with different rise response curve (RRC) each time: fast, normal, and slow. The fall response curve used was the same as the rising one during each test. Pacing rates were recorded using the VEGA analyzer (SORIN BIOMEDICA) and compared with simultaneous NSR recorded by a 7-channel ECG recorder (MINGOGRAF 7, SIEMENS), During all tests immediate (within seconds) rapid increase in pacemaker rate was seen up to about 60 seconds, then a slower increase followed thereafter. The mean correlation between pacing rates and NSR during the Bruce tests were 0.7941 ± 0.10, 0.8562 ± 0.14, and 0.8292 ± 0.07; during the discontinous tests 0.7292 ± 0.16, 0.7233 ± 0.10, and 0.7480 ± 0.11 for fast, normal, and slow RRC, respectively. Each 30 seconds, nonsignificant differences were present between pacing rate and NSR during all the discontinuous tests; similar responses were observed only during the first two stages of Bruce tests after which NSR was significantly higher than pacemaker rates. The speed of rise to upper rate was the main difference between the different programs (fast, normal, and slow). The discontinuous tests showed that the pacemaker responds more to speed than to grade. In conclusion, the Swing pacemaker is easy to use and program, fast, reliable, and is able to mimic the normal sinus behavior especially during discontinuous activities.     

基于人工嗅觉的呈香物质识别方法

研究了人工嗅觉在物质识别中的应用，概述了使用模式识别辨别物质气味的基本原理，详细介绍了人工嗅觉系统的硬件设计，算法和软件实现方法，最后使用本系统对不同香气物质进行了识别，取得了较好的结果。