610 Medizin, Gesundheit
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Online measurement of drug concentrations in patient's breath is a promising approach for individualized dosage. A direct transfer from breath- to blood-concentrations is not possible. Measured exhaled concentrations are following the blood-concentration with a delay in non-steady-state situations. Therefore, it is necessary to integrate the breath-concentration into a pharmacological model. Two different approaches for pharmacokinetic modelling are presented. Usually a 3-compartment model is used for pharmacokinetic calculations of blood concentrations. This 3-compartment model is extended with a 2-compartment model based on the first compartment of the 3-compartment model and a new lung compartment. The second approach is to calculate a time delay of changes in the concentration of the first compartment to describe the lung-concentration. Exemplarily both approaches are used for modelling of exhaled propofol. Based on time series of exhaled propofol measurements using an ion-mobility-spectrometer every minute for 346 min a correlation of calculated plasma and the breath concentration was used for modelling to deliver R2 = 0.99 interdependencies. Including the time delay modelling approach the new compartment coefficient ke0lung was calculated to ke0lung = 0.27 min−1 with R2 = 0.96. The described models are not limited to propofol. They could be used for any kind of drugs, which are measurable in patient's breath.
Rats are commonly used in medical research as they enable a high grade of standardization. The exhalome of ventilated rats has not as yet been investigated using an ion mobility spectrometer coupled with a multi-capillary column (MCC-IMS). As a first step, a rat model has to be established to measure potential biomarkers in the exhale with long-term settings, allowing constant and continuous analysis of exhaled air in time series. Therefore, eight animals were anaesthetized, prepared and ventilated for 1 h. A total of 73 peaks were directly detected with the IMS chromatogram. Thirty five of them were assigned to the ventilator system and 38 to the animals. Peak intensity varied within three measurements. The intensity of analytes of individual rats varied by a factor of up to 18. This new model will also enable continuous measurements of volatile organic compounds (VOCs) from rat's breath in long-term experiments. It is hoped that, in the future, variability and progression of VOCs can be monitored in different models of diseases using this set-up.
An operation room is a stressful work environment. Nevertheless, all involved persons have to work safely as there is no space for making mistakes. To ensure a high level of concentration and seamless interaction, all involved persons have to know their own tasks and tasks of their colleagues. The entire team must work synchronously at all times. However, the operation room (OR) is a noisy environment and the actors have to set their focus on their work. To optimize the overall workflow, a task manager supporting the team was developed. Each actor is equipped with a client terminal showing a summary of their own tasks. Moreover, a big screen displays all tasks of all actors. The architecture is a distributed system based on a communication framework that supports the interaction of all clients with the task manager. A prototype of the task manager and several clients have been developed and implemented. The system represents a proof-of-concept for further development. This paper describes the concept of the task manager.
The implementation of a web based portal QA solution will lead to a high acceptance of the staff as the usage of commonly known standard software (e.g. web browser) allows intuitive handling. In the daily use a significant simplification of the workflow and Performance enhancement can be achieved by easy access to the check documents. As the data is now saved in a database it can easily be processed and long-term trends can be displayed. Therefore possible errors can be detected much easier and earlier. By the usage of time stamps and user authentication procedures and user responsibilities are comprehensibly documented. As the software is browser based, integration into an existing software Environment is not critical. As only technical QA data is processed, no further data security measures are necessary. A certification as a medical product is not required.
Telemedicine is becoming an increasingly important approach to diagnostic, treat or prevent diseases. However, the usage of Information Communication Technologies in healthcare results in a considerable amount of data that must be efficiently and securely transmitted. Many manufacturers provide telemedicine platforms without regarding interoperability, mobility and collaboration. This paper describes a collaborative mobile telemonitoring platform that can use the IEEE 11073 and HL7 communication standards or adapt proprietary protocols. The proposed platform also covers the security and modularity aspects. Furthermore this work introduces an Android-based prototype implementation
This paper presents a new European initiative to support the sustainable empowerment of the ageing society. Empowerment in this context represents the capability to have a self-determined, autonomous and healthy life. The paper justifies the need of such an initiative and highlights the role that telemedicine and ambient assisted living can play in this environment.
The workshop aims to discuss leading edge contributions to the interdisciplinary research area of ambient intelligence (AmI) applied to the domains of telemedicine and driving assistance. AmI refers to human centered environments attributed with sensors. The development of AmI in the two application domains of the workshop shares several commonalities: the extensive usage of networked devices and sensors, the design of artificial intelligence algorithms for diagnosis, including recommendation systems and qualitative reasoning or the application of mobile and wireless communication to their distributed systems. Together with the presentation of common aspects of Ambient Intelligence, a further goal of the workshop is to stimulate synergies among both application domains and present examples. The telemedicine domain can benefit from methodologies in designing complex devices, real-time conform system design, audiovisual or computer vision system design used in automotive driving assistance. Furthermore, the automotive domain can benefit from the usercentric view, biometric sensor data design, multi-user data bases for aggregation and diagnosis using big data like used in telemedicine. The German Government supports these research lines in its Hightec-Strategie under the domains “Health and Nutrition” and “Climate and Energy”. In Spain the term “Spanish Program for R&D Challenged Oriented Society – Challenge in energy safe, efficient and clean & Challenge in sustainable transport, smart and integrated” is used. Scientific contributions to the event are peer-reviewed by a suited program committee having members from Germany and Spain. The same committee is serving the JARCA workshop (Jornadas sobre Sistemas cualitativos y sus Aplicaciones en Diagnosis, Robótica e Inteligencia Ambiental - Conference on Qualitative Systems and their Applications in Diagnoses, Robotics and Ambient Intelligence) since 15 years. This workshop is sponsored by the German Academic Exchange Service (DAAD) under contract number 57070010.
Multi-dimensional patient data, such as time varying volume data, data of different imaging modalities, surface segmentations etc. are of growing importance in the clinical routine. For many use cases, it is of major importance to replicate a certain visualization of a data set created on one machine on a different computer using different software tools. Up until now, there exists no standardized methodology for this consistent presentation. We propose an extension of the Digital Imaging und Communications in Medicine (DICOM) called “Multi dimensional Presentation State” and outline scope and first results of the standardization process.