Results of Electroencephalographic Monitoring during 369 Consecutive Carotid Artery Revascularizations
European Neurology, 1997
A continuous intraoperative EEG monitoring was performed in 369 consecutive carotid artery revasc... more A continuous intraoperative EEG monitoring was performed in 369 consecutive carotid artery revascularizations (CARs) (321 patients) to minimize the intraoperative neurological morbidity. There were 227 carotid endarterectomies and patch graft angioplasty (198 patients), 79 carotid eversion endarterectomies (70 patients) and 58 internal carotid artery reimplantations into the common carotid artery (48 patients). Indications for CARs were TIAs (141, 43.9%), amaurosis fugax (60, 18.6%) and fixed or partial nonprogressing stroke (14, 4.3%). One hundred and six patients (33.1%) were asymptomatic. EEG abnormalities consistent with cerebral ischemia occurred in 97 (26.3%) operations. The indwelling shunt (IS) was used in 73 cases; in the remaining 24 (24.7%), IS was not used on purpose because the surgical procedure was carried out successfully within 5-6 min after the appearance of EEG changes. All patients awoke from the anesthesia without any neurological deficit. Five patients presented with a major stroke within postoperative day 1 and 2, and 1 patient died on postoperative day 10. In 2 of these cases, the intraoperative EEG monitoring was absolutely normal and the IS was not used: the carotid occlusion was due to technical errors. The most striking finding of this series is the absence of false-negative results in continuous EEG monitoring. EEG monitoring appears an available and useful method for the detection of cerebral ischemia secondary to carotid cross-clamping and contributes to put at zero the intraoperative complications of the surgical procedure.
Mobile learning has been receiving increased attention from diverse conferences and publications.... more Mobile learning has been receiving increased attention from diverse conferences and publications. The attention is well deserved because, if correctly implemented, it constitutes an efficient complementary tool to the traditional learning methods. Following this idea, we present PortableLab, a mobile learning system that integrates an application developed for mobile devices with Google Android operating system. PortableLab allows students to analyze several poor quality power supply occurrences. For this, the mobile remote laboratory has to connect to a database server where real-time measured data is stored by a local signal processing module. The mobile application was designed as a complementary mean to the classic laboratory lessons. The developed system is a step forward in the development of mobile learning courses, presenting new contents directed for a 'hot' platform. This paper describes the system, giving special focus on the system's overall infrastructure and the chosen technical solutions for the mobile application implementation, as well as on some preliminary results.
Designing personalized therapeutic serious games for a pervasive assistive environment
Serious games-based therapies are currently gaining massive interest of both computer science and... more Serious games-based therapies are currently gaining massive interest of both computer science and healthcare communities. This paper focuses on the design and use of personalized therapeutic serious games in a pervasive healthcare assistive environment that integrates smart objects such as wheelchairs. The smart objects have embedded sensors to measure physiological parameters. Tablet PCs are being attached to the wheelchairs, serving
can be translated into accurate predictors of health risk, even at an early stage, and can be com... more can be translated into accurate predictors of health risk, even at an early stage, and can be combined with alarm-triggering systems in order to initiate the appropriate actions. The paper presents the design and implementation of a mobile TeleCare system based on a smart wrist-worn device with a nonobtrusive sensing module for cardiac, respiratory and motor activity, a microcontroller platform for primary processing of the data from the sensors and wireless communication using Bluetooth protocol. Advanced data processing, data management, human computing interfacing and data communication are implemented using a smartphone running Android operating system (OS). A Web based health TeleCare information system was implemented being characterized by the following functionalities: data synchronization with the smartphone, advanced data processing and data presentation assuring a comprehensive data analysis and evidence based health management as well as for remote assistance of the patients by doctors and nurses. Experimental results associated with vital signs sensing and the software implementation are included in the paper.
Results of Electroencephalographic Monitoring during 369 Consecutive Carotid Artery Revascularizations
European Neurology, 1997
A continuous intraoperative EEG monitoring was performed in 369 consecutive carotid artery revasc... more A continuous intraoperative EEG monitoring was performed in 369 consecutive carotid artery revascularizations (CARs) (321 patients) to minimize the intraoperative neurological morbidity. There were 227 carotid endarterectomies and patch graft angioplasty (198 patients), 79 carotid eversion endarterectomies (70 patients) and 58 internal carotid artery reimplantations into the common carotid artery (48 patients). Indications for CARs were TIAs (141, 43.9%), amaurosis fugax (60, 18.6%) and fixed or partial nonprogressing stroke (14, 4.3%). One hundred and six patients (33.1%) were asymptomatic. EEG abnormalities consistent with cerebral ischemia occurred in 97 (26.3%) operations. The indwelling shunt (IS) was used in 73 cases; in the remaining 24 (24.7%), IS was not used on purpose because the surgical procedure was carried out successfully within 5-6 min after the appearance of EEG changes. All patients awoke from the anesthesia without any neurological deficit. Five patients presented with a major stroke within postoperative day 1 and 2, and 1 patient died on postoperative day 10. In 2 of these cases, the intraoperative EEG monitoring was absolutely normal and the IS was not used: the carotid occlusion was due to technical errors. The most striking finding of this series is the absence of false-negative results in continuous EEG monitoring. EEG monitoring appears an available and useful method for the detection of cerebral ischemia secondary to carotid cross-clamping and contributes to put at zero the intraoperative complications of the surgical procedure.
Mobile learning has been receiving increased attention from diverse conferences and publications.... more Mobile learning has been receiving increased attention from diverse conferences and publications. The attention is well deserved because, if correctly implemented, it constitutes an efficient complementary tool to the traditional learning methods. Following this idea, we present PortableLab, a mobile learning system that integrates an application developed for mobile devices with Google Android operating system. PortableLab allows students to analyze several poor quality power supply occurrences. For this, the mobile remote laboratory has to connect to a database server where real-time measured data is stored by a local signal processing module. The mobile application was designed as a complementary mean to the classic laboratory lessons. The developed system is a step forward in the development of mobile learning courses, presenting new contents directed for a 'hot' platform. This paper describes the system, giving special focus on the system's overall infrastructure and the chosen technical solutions for the mobile application implementation, as well as on some preliminary results.
Designing personalized therapeutic serious games for a pervasive assistive environment
Serious games-based therapies are currently gaining massive interest of both computer science and... more Serious games-based therapies are currently gaining massive interest of both computer science and healthcare communities. This paper focuses on the design and use of personalized therapeutic serious games in a pervasive healthcare assistive environment that integrates smart objects such as wheelchairs. The smart objects have embedded sensors to measure physiological parameters. Tablet PCs are being attached to the wheelchairs, serving
can be translated into accurate predictors of health risk, even at an early stage, and can be com... more can be translated into accurate predictors of health risk, even at an early stage, and can be combined with alarm-triggering systems in order to initiate the appropriate actions. The paper presents the design and implementation of a mobile TeleCare system based on a smart wrist-worn device with a nonobtrusive sensing module for cardiac, respiratory and motor activity, a microcontroller platform for primary processing of the data from the sensors and wireless communication using Bluetooth protocol. Advanced data processing, data management, human computing interfacing and data communication are implemented using a smartphone running Android operating system (OS). A Web based health TeleCare information system was implemented being characterized by the following functionalities: data synchronization with the smartphone, advanced data processing and data presentation assuring a comprehensive data analysis and evidence based health management as well as for remote assistance of the patients by doctors and nurses. Experimental results associated with vital signs sensing and the software implementation are included in the paper.
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Papers by Marco Guerra