995 resultados para Medical instruments


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The paper discusses maintenance challenges of organisations with a huge number of devices and proposes the use of probabilistic models to assist monitoring and maintenance planning. The proposal assumes connectivity of instruments to report relevant features for monitoring. Also, the existence of enough historical registers with diagnosed breakdowns is required to make probabilistic models reliable and useful for predictive maintenance strategies based on them. Regular Markov models based on estimated failure and repair rates are proposed to calculate the availability of the instruments and Dynamic Bayesian Networks are proposed to model cause-effect relationships to trigger predictive maintenance services based on the influence between observed features and previously documented diagnostics

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Mode of access: Internet.

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Cover title.

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Loose-leaf for updating.

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Item 215

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Em diversos estados do Brasil, foram relatadas epidemias de infecções causadas por micobactérias de crescimento rápido (MCR) desde o ano 2000. A maioria dos casos foi principalmente associada ao clone BRA100 de Mycobacterium massiliense, recentemente renomeada para Mycobacterium abscessus subsp. bolletii, isolado de pacientes submetidos a procedimentos invasivos nos quais os instrumentos médicos não foram adequadamente esterilizados e/ou desinfetados. Sendo as quinolonas uma opção no tratamento de infecções por MCR e sugerida para esquemas terapêuticos para esses surtos, foram avaliadas nesse trabalho as atividades in vitro de quatro gerações de quinolonas para cepas clinicas e de referência de MCR através da microdiluição em caldo. Também foram analisadas as sequências peptídicas das regiões determinantes da resistência a quinolonas (RDRQ) das subunidades A e B da DNA gyrase (GyrA e GyrB) após o seqüenciamento de DNA seguido pela tradução da sequência de aminoácidos. Cinquenta e quatro cepas de M. abscessus subsp bolletii, incluindo o clone BRA100, isoladas em diferentes estados do Brasil, e 19 cepas de referência de MCR foram caracterizadas. Todas as 54 cepas clínicas de M. abscessus subsp. bolletii foram resistentes a todas as gerações de quinolonas e mostraram o mesmo resíduo nas RDRQ, incluindo Ala-83 em GyrA, Arg-447 e Asp-464 em GyrB, descritos como sendo responsáveis por gerar um baixo nível de resistência a quinolonas em micobactérias. Porém, outras espécies de MCR apresentaram diferentes susceptibilidade e padrões de mutações contrários aos classicamente já definidos, sugerindo que outros mecanismos de resistência, diferentes de mutações em gyrA e gyrB também possam estar envolvidos na alta resistência a quinolonas.

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This thesis explores the use of electromagnetics for both steering and tracking of medical instruments in minimally invasive surgeries. The end application is virtual navigation of the lung for biopsy of early stage cancer nodules. Navigation to the peripheral regions of the lung is difficult due to physical dimensions of the bronchi and current methods have low successes rates for accurate diagnosis. Firstly, the potential use of DC magnetic fields for the actuation of catheter devices with permanently magnetised distal attachments is investigated. Catheter models formed from various materials and magnetic tip formations are used to examine the usefulness of relatively low power and compact electromagnets. The force and torque that can be exerted on a small permanent magnet is shown to be extremely limited. Hence, after this initial investigation we turn our attention to electromagnetic tracking, in the development of a novel, low-cost implementation of a GPS-like system for navigating within a patient. A planar magnetic transmitter, formed on a printed circuit board for a low-profile and low cost manufacture, is used to generate a low frequency magnetic field distribution which is detected by a small induction coil sensor. The field transmitter is controlled by a novel closed-loop system that ensures a highly stable magnetic field with reduced interference from one transmitter coil to another. Efficient demodulation schemes are presented which utilise synchronous detection of each magnetic field component experienced by the sensor. The overall tracking accuracy of the system is shown to be less than 2 mm with an orientation error less than 1°. A novel demodulation implementation using a unique undersampling approach allows the use of reduced sample rates to sample the signals of interest without loss of tracking accuracy. This is advantageous for embedded microcontroller implementations of EM tracking systems. The EM tracking system is demonstrated in the pre-clinical environment of a breathing lung phantom. The airways of the phantom are successfully navigated using the system in combination with a 3D computer model rendered from CT data. Registration is achieved using both a landmark rigid registration method and a hybrid fiducial-free approach. The design of a planar magnetic shield structure for blocking the effects of metallic distortion from below the transmitter is presented which successfully blocks the impact of large ferromagnetic objects such as operating tables. A variety of shielding material are analysed with MuMetal and ferrite both providing excellent shieling performance and an increased signal to noise ratio. Finally, the effect of conductive materials and human tissue on magnetic field measurements is presented. Error due to induced eddy currents and capacitive coupling is shown to severely affect EM tracking accuracy at higher frequencies.

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Background: The prevalence of sphincter rupture during childbirth has increased in Sweden from half percent to three percent from 1973 to 1993. Women who undergo planned home birth have sphincter injuries to a smaller extent than women who undergo planned hospital births. Objective: The purpose of this study was to describe women’s experience of the last stages of delivery during planned home birth. Design: Inductive content analysis of 150 randomly selected delivery reports. The delivery reports were gathered as a reply to an open question in a previously conducted survey.Findings: The woman´s confidence in the natural birthing process emerged as the overall theme of the delivery reports. Fourteen subcategories and five categories emerged during the analysis process: experience of support, physical experience, psychological experience, experience of birthplace and birth position and the woman’s awareness during birth. Conclusion: The support from the surrounding people was very important for the women and they felt calm and secure in the home environment. The women often gave birth in a birthing position that led to a reduced risk of perineal tears. Many risk factors for sphincter injuries were eliminated for the women who went thru planned home birth. For example the women often had experiences of prior deliveries and further no medical instruments were used during late stages of delivery in planned home births.

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Includes bibliography

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Pós-graduação em Enfermagem (mestrado profissional) - FMB

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A new methodology is proposed for evaluating the economic development opportunities associated with the different industries making up a country’s economic structure. To this end, neo-Schumpeterian concepts are used to reinterpret the tools afforded by the “product space” literature in an attempt to assess the technological pervasiveness and sophistication of different production sectors. The ultimate objective is to develop a description of today’s techno-productive paradigm and the differential role that the various sectors play in it. An analysis of export data from 113 countries and territories for 2005-2009 indicates that the key sectors in the world economy are: industrial machinery, scientific and medical instruments, and pharmaceuticals. The strong performance of sectors based on mature technologies suggests that key sectors originating in different stages in history can survive and overlap one another, much like geological strata, owing to the persistence of older technological systems.

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Mode of access: Internet.