Thais Russomano, MD, MSc (Aerospace Medicine, Wright State University, USA), PhD (Space Physiology, King’s College London, UK). Thais founded and co-ordinates the Microgravity Centre-PUCRS, Brazil, internationally recognized for its space life sciences and eHealth research. She is a Full Professor at PUCRS and Visiting Senior Lecturer at King’s College London. Thais holds international patents, has authored numerous articles and books, and acts as consultant and advisor for space projects. She is an elected member of aerospace academies and associations and involved in space projects as Co-Founder, Corporate Director and Chief Medical Officer of the USA-based International Space Medicine Consortium, Inc. (ISMC)
PUCRS, v. 16, n. 3, jul./set. 2006 109 Digital signal processing in the differential diagnosis of... more PUCRS, v. 16, n. 3, jul./set. 2006 109 Digital signal processing in the differential diagnosis of benign larynx diseases Zwetsch I. C, et al. Aims: To present a new Digital Signal Processing procedure to evaluate voice disorders, specifically those related to the benign larynx diseases. Methods: Recorded acoustic signals of normal and abnormal voices of outpatients subjected to videolaryngoscopy had been digitalized for the study of the alterations in vocal acoustics. Window and cepstral analysis were applied on these signals. Results: Through the observation of the different alterations in the voices, it was possible to develop a set of parameters of analysis that allowed a coherent diagnosis of larynx alterations, based in the cepstral findings. Cases randomly selected, who had not participated of the study, had been identified only through the information of the set of parameters, with 80% of rightness, significantly validating the method. Conclusions: This computing method is ve...
Introduction: Studies were conducted to evaluate cardiopulmonary resuscitation (CPR) in a simulat... more Introduction: Studies were conducted to evaluate cardiopulmonary resuscitation (CPR) in a simulated low gravitational field, such as Mars (hypoG), aimed at providing an insight into the performance of terrestrial CPR.
Background: Current 2010 terrestrial (1G z ) CPR guidelines have been advocated by space agencies... more Background: Current 2010 terrestrial (1G z ) CPR guidelines have been advocated by space agencies for hypogravity and microgravity environments, but may not be feasible. The aims of this study were to (1) evaluate rescuer performance over 1.5 min of external chest compressions (ECCs) during simulated Martian hypogravity (0.38G z ) and microgravity (μG) in relation to 1G z and rest baseline and (2) compare the physiological costs of conducting ECCs in accordance with the 2010 and 2005 CPR guidelines. Methods: Thirty healthy male volunteers, ranging from 17 to 30 years, performed four sets of 30 ECCs for 1.5 min using the 2010 and 2005 ECC guidelines during 1G z , 0.38G z and μG simulations (Evetts-Russomano (ER) method), achieved by the use of a body suspension device. ECC depth and rate, range of elbow flexion, post-ECC heart rate (HR), minute ventilation (V E ), peak oxygen consumption (VO 2 peak) and rate of perceived exertion (RPE) were measured.
ABSTRACT Performance of efficient single-person cardiopulmonary resuscitation (CPR) is vital to m... more ABSTRACT Performance of efficient single-person cardiopulmonary resuscitation (CPR) is vital to maintain cardiac and cerebral perfusion during the 2-4 min it takes for deployment of advanced life support during a space mission. The aim of the present study was to investigate potential differences in upper body muscle activity during CPR performance at terrestrial gravity (+1Gz) and in simulated microgravity (μG). Muscle activity of the triceps brachii, erector spinae, rectus abdominis and pectoralis major was measured via superficial electromyography in 20 healthy male volunteers. Four sets of 30 external chest compressions (ECCs) were performed on a mannequin. Microgravity was simulated using a body suspension device and harness; the Evetts-Russomano (ER) method was adopted for CPR performance in simulated microgravity. Heart rate and perceived exertion via Borg scores were also measured. While a significantly lower depth of ECCs was observed in simulated microgravity, compared with +1Gz, it was still within the target range of 40-50 mm. There was a 7.7% decrease of the mean (±SEM) ECC depth from 48 ± 0.3 mm at +1Gz, to 44.3 ± 0.5 mm during microgravity simulation (p < 0.001). No significant difference in number or rate of compressions was found between the two conditions. Heart rate displayed a significantly larger increase during CPR in simulated microgravity than at +1Gz, the former presenting a mean (±SEM) of 23.6 ± 2.91 bpm and the latter, 76.6 ± 3.8 bpm (p < 0.001). Borg scores were 70% higher post-microgravity compressions (17 ± 1) than post +1Gz compressions (10 ± 1) (p < 0.001). Intermuscular comparisons showed the triceps brachii to have significantly lower muscle activity than each of the other three tested muscles, in both +1Gz and microgravity. As shown by greater Borg scores and heart rate increases, CPR performance in simulated microgravity is more fatiguing than at +1Gz. Nevertheless, no significant difference in muscle activity between conditions was found, a result that is favourable for astronauts, given the inevitable muscular and cardiovascular deconditioning that occurs during space travel.
VETTS SN. Evaluation of a novel basic life support method in simulated microgravity. Aviat Space ... more VETTS SN. Evaluation of a novel basic life support method in simulated microgravity. Aviat Space Environ Med 2011; 82:104 -10.
RR, R USSOMANO T. Three methods of manual external chest compressions during microgravity simulat... more RR, R USSOMANO T. Three methods of manual external chest compressions during microgravity simulation. Aviat Space Environ Med 2014; 85:687 -93.
Aviation Space and Environmental Medicine, May 1, 2006
There is currently no effective method of measuring arterial blood gas tensions in austere enviro... more There is currently no effective method of measuring arterial blood gas tensions in austere environments such as in space or at high altitude. An alternative to direct arterial measurement is the sampling of arterialized earlobe blood, an accurate technique that has been in use in clinical medicine and physiology for more than 50 yr. We, therefore, developed an earlobe arterialized blood (EAB) collector for practical use in extreme environments. The results from the EAB collector were compared with simultaneous samples of blood drawn from the radial artery. Six healthy subjects breathed a gas mixture of 12.8% O2 in N2 during 15 min of 8 degree head-down tilt. The blood samples were analyzed immediately. The mean differences in Po2 between arterialized earlobe and radial artery samples were 0.25 +/- 1.25 mmHg for Po2 and 1.0 +/- 0.75 mmHg for Pco2; neither difference was significant. There was no difference between the pH values obtained by the two techniques. This study suggests that arterialized blood sampled from the earlobe using the EAB collector may provide sufficiently accurate measurements of the Po2, Pco2 and pH of arterial blood for clinical or research use in extreme environments.
Aviation in Focus Journal of Aeronautical Sciences, Nov 13, 2013
Thais RUSSOMANO 3 RESUMO: A exposição aguda à altitude ainda é um grande desafio para atletas de ... more Thais RUSSOMANO 3 RESUMO: A exposição aguda à altitude ainda é um grande desafio para atletas de diferentes modalidades, pois promove importantes alterações fisiológicas no corpo humano. O objetivo desta revisão foi buscar estratégias de atenuação ou tratamentos dos efeitos da exposição aguda à altitude em situações de exercício. Quarenta e um artigos foram incluídos, através de busca a bases de dados. Os demais artigos que complementam essa revisão referem-se à leitura das referências dos artigos base. Dentre as estratégias mais utilizadas estão a aclimatação, o suporte de O2, injeção de Eritropoietina e a nutrição. Um estudo utilizou-se da Pressão Positiva Contínua nas Vias Aéreas (CPAP) para tratamento de edema de pulmão de alta altitude, apresentando resultados promissores. Novos estudos visando à manutenção e à atenuação do desempenho esportivo em altitude devem ser realizados. PALAVRAS-CHAVE: Exercício, altitude, nutrição, aclimatação, CPAP. ABSTRACT: Acute exposure to altitude is still a major challenge for athletes from different sports as it causes important physiological alterations in the human body. The aim of this review was to seek attenuation strategies or treatments for the effects of acute exposure to altitude in exercise situations. Forty-one articles were included following database searches. The other items complementing this review relate to the reading of the references from the base articles. Among the most used strategies are acclimatization, O2 support, erythropoietin injection and nutrition. One study using continuous positive airway pressure (CPAP) for the treatment of high altitude pulmonary edema has shown promising results. Further research aimed at the maintenance and attenuation of sports performance at altitude should be performed.
International Journal of Integrated Care, Jun 7, 2012
The development of telecommunication technologies and the diffusion of its eHealth applicability ... more The development of telecommunication technologies and the diffusion of its eHealth applicability have enabled the implementation of a wide range of telemedicine systems, supporting clinical practices in different regions of the world. Distant and poorer areas of the globe, often characterized by difficult access and hazardous environments, are those that can most benefit from availability of remote consultations. This is due to the high costs associated with the transportation of specialized health teams and medical equipment between major cities and small villages, sometimes essential for the provision of adequate health care. Brazil is a country of continental dimensions with socioeconomic inequalities and uneven distribution of specialized health care, making it an ideal environment for establishment of eHealth initiatives.
The electrocardiogram (ECG) is a time-varying signal reflecting the ionic current flow which caus... more The electrocardiogram (ECG) is a time-varying signal reflecting the ionic current flow which causes the cardiac fibers to contract and subsequently relax. A normal cycle of the ECG represents the electrical activity which occurs with every heartbeat. In this paper we have compared synthetic ECG, obtained from two different models, to the real data obtained from a normal heart. The synthetic data were generated from (i) the Fitzhugh-Nagumo equations and (ii) MCTS dynamical model. Analyzing the recurrence plots we see that neither of the two models represents, with good accuracy, the cardiac dynamic behind the ECG variability patterns. From the asymmetry spectra conjugating the Gradient-Pattern Analysis and Wavelet Db8 decomposition we show that the MCTS dynamical model is close, than the Fitzhugh-Nagumo (FN) description, to the real ECG variability pattern. However, controversially, the Detrended Fluctuation Analysis shows that the FN closest to the real data. Although the Fitzhugh-Nagumo model can capture the electrical characteristics of the heart beat, it is not able to represent the PQRST wave's morphology in detail. In the MCTS dynamical model this limitation is solved taking into account the 3D cycle dynamics explicitly. In the other hand, in both descriptions the structural complexity in the cardiac membrane can be not well represented. Thus, based on the Gradient Spectra methodology, we present a preliminary approach for ECG modeling validation discussing the application of computational tools to assess biomedical signal analysis which is used to classify clinical statistics from both real and synthetic ECG.
If a cardiac arrest occurs in microgravity, the aim of current emergency procedures is to treat t... more If a cardiac arrest occurs in microgravity, the aim of current emergency procedures is to treat the patient using a medical restraint system within 2 min. The patient may require treatment while medical equipment is being deployed. The capability for one person, unaided, to successfully perform cardiopulmonary resuscitation (CPR) is, therefore, of paramount importance. A new technique has been developed whereby the practitioner encircles the thorax of the patient with his/her legs to restrain the patient to allow CPR to be performed in microgravity. Two investigators performed both this method (during parabolic microgravity) and traditional CPR (at +1 Gz) on an instrumented CPR mannequin. The mannequin was modified to ensure accurate chest compression and ventilation measurements during microgravity. The mean (+/-SE) depth and rate of chest compression were 44.0+/-4.99 mm and 68.3+/-17.0 compressions x min(-1) respectively. Although the mean microgravity rate of compression proved significantly less (p < 0.05) than the +1 Gz mean (97.1+/-3.4 compressions x min(-1)), chest compression depth did not differ (p > 0.05) from +1 Gz measures (43.6+/-0.59 mm). The mean (+/-SE) microgravity tidal volume (VT) was 491+/-50.4 ml, which also did not differ (p > 0.05) from +1 Gz values (507.6+/-11.5 ml). Although difficulties in performing this method during parabolic flight primarily affected compression rate, it may be possible to conduct basic life support using this technique in any microgravity environment.
Introdução: A deficiência de médicos em áreas remotas dificulta o diagnóstico e o manejo de doenç... more Introdução: A deficiência de médicos em áreas remotas dificulta o diagnóstico e o manejo de doenças. O Tele-ECG Digital (SED) foi estabelecido objetivando a disponibilização de laudos de eletrocardiogramas através de dois protocolos: o primeiro com transmissão em 'tempo real', destinado ao atendimento emergências cardiológicas; e o segundo, com utilização da Internet, para os casos de avaliação cardiológica não emergencial. Método: O SED foi implantado em dois hospitais da cidade de São Lourenço do Sul -um localizado na zona rural e outro no centro da cidade, e em um posto de saúde da cidade de Turuçu, ambas no RS. O SED inclui um aparelho digital de ECG, um software de telecomunicação, computadores, uma conexão de modem, linha fixa de telefonia e um telefone celular remoto. Resultados: A amostra coletada por 1 ano envolveu as três instituições participantes. No total, foram ABSTRACT Introduction: A lack of medical specialists in remote areas can delay the diagnosis and the management of diseases. A pioneer Tele-ECG Digital System, DES, was established in Brazil to overcome this situation. Method: DES allows electronic data transmission to and interpretation by a remote cardiologist. Hospitals in Sao Lourenco do Sul, and an outpatient unit in Turucu, both in RS state employed the DES, which includes a digital ECG machine, standard computers, a modem connection, internet facilities, telecommunication software and fixed or mobile phones. Results: A total of 1063 tele-ECGs were performed in the three locations in 1 year: 622 via online and 441 via ehealth. The transmission time was 8.1 min for the online and up to 24h and e-health tele-ECGs. The results showed that 71.2% (443 out of 622) of the online tele-ECGs presented important ECGs alterations, including 66 (14.9%) ECGs with acute signs of myocardial ischemia and 39 ECGs (8.8%) with S-T elevation myocardial infarction.
Estudos sobre a eficácia da Telemedicina em diversos países demonstraram que a mesma é um recurso... more Estudos sobre a eficácia da Telemedicina em diversos países demonstraram que a mesma é um recurso que contribui significativamente para a melhoria da qualidade da assistência médica, permitindo a redução do tempo gasto entre o diagnóstico e a terapia e colaborando para a extensão dos serviços médicos especializados e de qualidade aos locais que não os apresentam (ZUNDEL, 1996). Esta surgiu como uma opção inovadora para o diagnóstico e tratamento médico, com o intuito de evitar a necessidade de remoção dos pacientes para avaliações especializadas. Do ponto de vista médico, ela permite que os profissionais da saúde possam oferecer assistência especializada e atualizada, vencendo as restrições de caráter geográfico (BRATTON; CODY, 2000) Na Cardiologia de Urgência e Emergência, tem havido enormes avanços com a transmissão em tempo real de exames, tais como eletrocardiogramas (ECGs) e ecocardiogramas, o que traz inequívocas contribuições para o estabelecimento de diagnósticos rápidos nos casos de maior gravidade (KEREIAKES et al., 1992; WRIGHT, 1998) Motivado pelas demandas em saúde verificadas em visitas assistenciais a localidades remotas como a Região Amazônica de Rondônia (Janeiro de 2007 e 2008) e a Região do Alto Xingu no Mato Grosso (Julho de 2008) e baseando-se nos recentes desenvolvimentos tecnológicos, o Laboratório de Telemedicina do Centro de Microgravidade busca aperfeiçoar métodos e desenvolver sistemas que permitam a distância realizar diagnóstico, segundaopinião e educação continuada em saúde para comunidades desprovidas de profissionais especializados. Desta forma, este projeto de pesquisa objetiva validar as áreas de Telecardiologia e Teledermatologia do sistema desenvolvido pelo Laboratório de Telemedicina.
PUCRS, v. 16, n. 3, jul./set. 2006 109 Digital signal processing in the differential diagnosis of... more PUCRS, v. 16, n. 3, jul./set. 2006 109 Digital signal processing in the differential diagnosis of benign larynx diseases Zwetsch I. C, et al. Aims: To present a new Digital Signal Processing procedure to evaluate voice disorders, specifically those related to the benign larynx diseases. Methods: Recorded acoustic signals of normal and abnormal voices of outpatients subjected to videolaryngoscopy had been digitalized for the study of the alterations in vocal acoustics. Window and cepstral analysis were applied on these signals. Results: Through the observation of the different alterations in the voices, it was possible to develop a set of parameters of analysis that allowed a coherent diagnosis of larynx alterations, based in the cepstral findings. Cases randomly selected, who had not participated of the study, had been identified only through the information of the set of parameters, with 80% of rightness, significantly validating the method. Conclusions: This computing method is ve...
Introduction: Studies were conducted to evaluate cardiopulmonary resuscitation (CPR) in a simulat... more Introduction: Studies were conducted to evaluate cardiopulmonary resuscitation (CPR) in a simulated low gravitational field, such as Mars (hypoG), aimed at providing an insight into the performance of terrestrial CPR.
Background: Current 2010 terrestrial (1G z ) CPR guidelines have been advocated by space agencies... more Background: Current 2010 terrestrial (1G z ) CPR guidelines have been advocated by space agencies for hypogravity and microgravity environments, but may not be feasible. The aims of this study were to (1) evaluate rescuer performance over 1.5 min of external chest compressions (ECCs) during simulated Martian hypogravity (0.38G z ) and microgravity (μG) in relation to 1G z and rest baseline and (2) compare the physiological costs of conducting ECCs in accordance with the 2010 and 2005 CPR guidelines. Methods: Thirty healthy male volunteers, ranging from 17 to 30 years, performed four sets of 30 ECCs for 1.5 min using the 2010 and 2005 ECC guidelines during 1G z , 0.38G z and μG simulations (Evetts-Russomano (ER) method), achieved by the use of a body suspension device. ECC depth and rate, range of elbow flexion, post-ECC heart rate (HR), minute ventilation (V E ), peak oxygen consumption (VO 2 peak) and rate of perceived exertion (RPE) were measured.
ABSTRACT Performance of efficient single-person cardiopulmonary resuscitation (CPR) is vital to m... more ABSTRACT Performance of efficient single-person cardiopulmonary resuscitation (CPR) is vital to maintain cardiac and cerebral perfusion during the 2-4 min it takes for deployment of advanced life support during a space mission. The aim of the present study was to investigate potential differences in upper body muscle activity during CPR performance at terrestrial gravity (+1Gz) and in simulated microgravity (μG). Muscle activity of the triceps brachii, erector spinae, rectus abdominis and pectoralis major was measured via superficial electromyography in 20 healthy male volunteers. Four sets of 30 external chest compressions (ECCs) were performed on a mannequin. Microgravity was simulated using a body suspension device and harness; the Evetts-Russomano (ER) method was adopted for CPR performance in simulated microgravity. Heart rate and perceived exertion via Borg scores were also measured. While a significantly lower depth of ECCs was observed in simulated microgravity, compared with +1Gz, it was still within the target range of 40-50 mm. There was a 7.7% decrease of the mean (±SEM) ECC depth from 48 ± 0.3 mm at +1Gz, to 44.3 ± 0.5 mm during microgravity simulation (p < 0.001). No significant difference in number or rate of compressions was found between the two conditions. Heart rate displayed a significantly larger increase during CPR in simulated microgravity than at +1Gz, the former presenting a mean (±SEM) of 23.6 ± 2.91 bpm and the latter, 76.6 ± 3.8 bpm (p < 0.001). Borg scores were 70% higher post-microgravity compressions (17 ± 1) than post +1Gz compressions (10 ± 1) (p < 0.001). Intermuscular comparisons showed the triceps brachii to have significantly lower muscle activity than each of the other three tested muscles, in both +1Gz and microgravity. As shown by greater Borg scores and heart rate increases, CPR performance in simulated microgravity is more fatiguing than at +1Gz. Nevertheless, no significant difference in muscle activity between conditions was found, a result that is favourable for astronauts, given the inevitable muscular and cardiovascular deconditioning that occurs during space travel.
VETTS SN. Evaluation of a novel basic life support method in simulated microgravity. Aviat Space ... more VETTS SN. Evaluation of a novel basic life support method in simulated microgravity. Aviat Space Environ Med 2011; 82:104 -10.
RR, R USSOMANO T. Three methods of manual external chest compressions during microgravity simulat... more RR, R USSOMANO T. Three methods of manual external chest compressions during microgravity simulation. Aviat Space Environ Med 2014; 85:687 -93.
Aviation Space and Environmental Medicine, May 1, 2006
There is currently no effective method of measuring arterial blood gas tensions in austere enviro... more There is currently no effective method of measuring arterial blood gas tensions in austere environments such as in space or at high altitude. An alternative to direct arterial measurement is the sampling of arterialized earlobe blood, an accurate technique that has been in use in clinical medicine and physiology for more than 50 yr. We, therefore, developed an earlobe arterialized blood (EAB) collector for practical use in extreme environments. The results from the EAB collector were compared with simultaneous samples of blood drawn from the radial artery. Six healthy subjects breathed a gas mixture of 12.8% O2 in N2 during 15 min of 8 degree head-down tilt. The blood samples were analyzed immediately. The mean differences in Po2 between arterialized earlobe and radial artery samples were 0.25 +/- 1.25 mmHg for Po2 and 1.0 +/- 0.75 mmHg for Pco2; neither difference was significant. There was no difference between the pH values obtained by the two techniques. This study suggests that arterialized blood sampled from the earlobe using the EAB collector may provide sufficiently accurate measurements of the Po2, Pco2 and pH of arterial blood for clinical or research use in extreme environments.
Aviation in Focus Journal of Aeronautical Sciences, Nov 13, 2013
Thais RUSSOMANO 3 RESUMO: A exposição aguda à altitude ainda é um grande desafio para atletas de ... more Thais RUSSOMANO 3 RESUMO: A exposição aguda à altitude ainda é um grande desafio para atletas de diferentes modalidades, pois promove importantes alterações fisiológicas no corpo humano. O objetivo desta revisão foi buscar estratégias de atenuação ou tratamentos dos efeitos da exposição aguda à altitude em situações de exercício. Quarenta e um artigos foram incluídos, através de busca a bases de dados. Os demais artigos que complementam essa revisão referem-se à leitura das referências dos artigos base. Dentre as estratégias mais utilizadas estão a aclimatação, o suporte de O2, injeção de Eritropoietina e a nutrição. Um estudo utilizou-se da Pressão Positiva Contínua nas Vias Aéreas (CPAP) para tratamento de edema de pulmão de alta altitude, apresentando resultados promissores. Novos estudos visando à manutenção e à atenuação do desempenho esportivo em altitude devem ser realizados. PALAVRAS-CHAVE: Exercício, altitude, nutrição, aclimatação, CPAP. ABSTRACT: Acute exposure to altitude is still a major challenge for athletes from different sports as it causes important physiological alterations in the human body. The aim of this review was to seek attenuation strategies or treatments for the effects of acute exposure to altitude in exercise situations. Forty-one articles were included following database searches. The other items complementing this review relate to the reading of the references from the base articles. Among the most used strategies are acclimatization, O2 support, erythropoietin injection and nutrition. One study using continuous positive airway pressure (CPAP) for the treatment of high altitude pulmonary edema has shown promising results. Further research aimed at the maintenance and attenuation of sports performance at altitude should be performed.
International Journal of Integrated Care, Jun 7, 2012
The development of telecommunication technologies and the diffusion of its eHealth applicability ... more The development of telecommunication technologies and the diffusion of its eHealth applicability have enabled the implementation of a wide range of telemedicine systems, supporting clinical practices in different regions of the world. Distant and poorer areas of the globe, often characterized by difficult access and hazardous environments, are those that can most benefit from availability of remote consultations. This is due to the high costs associated with the transportation of specialized health teams and medical equipment between major cities and small villages, sometimes essential for the provision of adequate health care. Brazil is a country of continental dimensions with socioeconomic inequalities and uneven distribution of specialized health care, making it an ideal environment for establishment of eHealth initiatives.
The electrocardiogram (ECG) is a time-varying signal reflecting the ionic current flow which caus... more The electrocardiogram (ECG) is a time-varying signal reflecting the ionic current flow which causes the cardiac fibers to contract and subsequently relax. A normal cycle of the ECG represents the electrical activity which occurs with every heartbeat. In this paper we have compared synthetic ECG, obtained from two different models, to the real data obtained from a normal heart. The synthetic data were generated from (i) the Fitzhugh-Nagumo equations and (ii) MCTS dynamical model. Analyzing the recurrence plots we see that neither of the two models represents, with good accuracy, the cardiac dynamic behind the ECG variability patterns. From the asymmetry spectra conjugating the Gradient-Pattern Analysis and Wavelet Db8 decomposition we show that the MCTS dynamical model is close, than the Fitzhugh-Nagumo (FN) description, to the real ECG variability pattern. However, controversially, the Detrended Fluctuation Analysis shows that the FN closest to the real data. Although the Fitzhugh-Nagumo model can capture the electrical characteristics of the heart beat, it is not able to represent the PQRST wave's morphology in detail. In the MCTS dynamical model this limitation is solved taking into account the 3D cycle dynamics explicitly. In the other hand, in both descriptions the structural complexity in the cardiac membrane can be not well represented. Thus, based on the Gradient Spectra methodology, we present a preliminary approach for ECG modeling validation discussing the application of computational tools to assess biomedical signal analysis which is used to classify clinical statistics from both real and synthetic ECG.
If a cardiac arrest occurs in microgravity, the aim of current emergency procedures is to treat t... more If a cardiac arrest occurs in microgravity, the aim of current emergency procedures is to treat the patient using a medical restraint system within 2 min. The patient may require treatment while medical equipment is being deployed. The capability for one person, unaided, to successfully perform cardiopulmonary resuscitation (CPR) is, therefore, of paramount importance. A new technique has been developed whereby the practitioner encircles the thorax of the patient with his/her legs to restrain the patient to allow CPR to be performed in microgravity. Two investigators performed both this method (during parabolic microgravity) and traditional CPR (at +1 Gz) on an instrumented CPR mannequin. The mannequin was modified to ensure accurate chest compression and ventilation measurements during microgravity. The mean (+/-SE) depth and rate of chest compression were 44.0+/-4.99 mm and 68.3+/-17.0 compressions x min(-1) respectively. Although the mean microgravity rate of compression proved significantly less (p < 0.05) than the +1 Gz mean (97.1+/-3.4 compressions x min(-1)), chest compression depth did not differ (p > 0.05) from +1 Gz measures (43.6+/-0.59 mm). The mean (+/-SE) microgravity tidal volume (VT) was 491+/-50.4 ml, which also did not differ (p > 0.05) from +1 Gz values (507.6+/-11.5 ml). Although difficulties in performing this method during parabolic flight primarily affected compression rate, it may be possible to conduct basic life support using this technique in any microgravity environment.
Introdução: A deficiência de médicos em áreas remotas dificulta o diagnóstico e o manejo de doenç... more Introdução: A deficiência de médicos em áreas remotas dificulta o diagnóstico e o manejo de doenças. O Tele-ECG Digital (SED) foi estabelecido objetivando a disponibilização de laudos de eletrocardiogramas através de dois protocolos: o primeiro com transmissão em 'tempo real', destinado ao atendimento emergências cardiológicas; e o segundo, com utilização da Internet, para os casos de avaliação cardiológica não emergencial. Método: O SED foi implantado em dois hospitais da cidade de São Lourenço do Sul -um localizado na zona rural e outro no centro da cidade, e em um posto de saúde da cidade de Turuçu, ambas no RS. O SED inclui um aparelho digital de ECG, um software de telecomunicação, computadores, uma conexão de modem, linha fixa de telefonia e um telefone celular remoto. Resultados: A amostra coletada por 1 ano envolveu as três instituições participantes. No total, foram ABSTRACT Introduction: A lack of medical specialists in remote areas can delay the diagnosis and the management of diseases. A pioneer Tele-ECG Digital System, DES, was established in Brazil to overcome this situation. Method: DES allows electronic data transmission to and interpretation by a remote cardiologist. Hospitals in Sao Lourenco do Sul, and an outpatient unit in Turucu, both in RS state employed the DES, which includes a digital ECG machine, standard computers, a modem connection, internet facilities, telecommunication software and fixed or mobile phones. Results: A total of 1063 tele-ECGs were performed in the three locations in 1 year: 622 via online and 441 via ehealth. The transmission time was 8.1 min for the online and up to 24h and e-health tele-ECGs. The results showed that 71.2% (443 out of 622) of the online tele-ECGs presented important ECGs alterations, including 66 (14.9%) ECGs with acute signs of myocardial ischemia and 39 ECGs (8.8%) with S-T elevation myocardial infarction.
Estudos sobre a eficácia da Telemedicina em diversos países demonstraram que a mesma é um recurso... more Estudos sobre a eficácia da Telemedicina em diversos países demonstraram que a mesma é um recurso que contribui significativamente para a melhoria da qualidade da assistência médica, permitindo a redução do tempo gasto entre o diagnóstico e a terapia e colaborando para a extensão dos serviços médicos especializados e de qualidade aos locais que não os apresentam (ZUNDEL, 1996). Esta surgiu como uma opção inovadora para o diagnóstico e tratamento médico, com o intuito de evitar a necessidade de remoção dos pacientes para avaliações especializadas. Do ponto de vista médico, ela permite que os profissionais da saúde possam oferecer assistência especializada e atualizada, vencendo as restrições de caráter geográfico (BRATTON; CODY, 2000) Na Cardiologia de Urgência e Emergência, tem havido enormes avanços com a transmissão em tempo real de exames, tais como eletrocardiogramas (ECGs) e ecocardiogramas, o que traz inequívocas contribuições para o estabelecimento de diagnósticos rápidos nos casos de maior gravidade (KEREIAKES et al., 1992; WRIGHT, 1998) Motivado pelas demandas em saúde verificadas em visitas assistenciais a localidades remotas como a Região Amazônica de Rondônia (Janeiro de 2007 e 2008) e a Região do Alto Xingu no Mato Grosso (Julho de 2008) e baseando-se nos recentes desenvolvimentos tecnológicos, o Laboratório de Telemedicina do Centro de Microgravidade busca aperfeiçoar métodos e desenvolver sistemas que permitam a distância realizar diagnóstico, segundaopinião e educação continuada em saúde para comunidades desprovidas de profissionais especializados. Desta forma, este projeto de pesquisa objetiva validar as áreas de Telecardiologia e Teledermatologia do sistema desenvolvido pelo Laboratório de Telemedicina.
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