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- Serra, J., et al.
(författare)
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European society of neurogastroenterology and motility guidelines on functional constipation in adults
- 2020
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Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925 .- 1365-2982. ; 32:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Chronic constipation is a common disorder with a reported prevalence ranging from 3% to 27% in the general population. Several management strategies, including diagnostic tests, empiric treatments, and specific treatments, have been developed. Our aim was to develop European guidelines for the clinical management of constipation. Design After a thorough review of the literature by experts in relevant fields, including gastroenterologists, surgeons, general practitioners, radiologists, and experts in gastrointestinal motility testing from various European countries, a Delphi consensus process was used to produce statements and practical algorithms for the management of chronic constipation. Key Results Seventy-three final statements were agreed upon after the Delphi process. The level of evidence for most statements was low or very low. A high level of evidence was agreed only for anorectal manometry as a comprehensive evaluation of anorectal function and for treatment with osmotic laxatives, especially polyethylene glycol, the prokinetic drug prucalopride, secretagogues, such as linaclotide and lubiprostone and PAMORAs for the treatment of opioid-induced constipation. However, the level of agreement between the authors was good for most statements (80% or more of the authors). The greatest disagreement was related to the surgical management of constipation. Conclusions and Inferences European guidelines on chronic constipation, with recommendations and algorithms, were developed by experts. Despite the high level of agreement between the different experts, the level of scientific evidence for most recommendations was low, highlighting the need for future research to increase the evidence and improve treatment outcomes in these patients.
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- Garcia, J, et al.
(författare)
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ECG-based detection of body position changes in ischemia monitoring
- 2003
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Ingår i: IEEE Transactions on Biomedical Engineering. - 1558-2531. ; 50:6, s. 677-685
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this gaper is to analyze and detect changes in body position (BPC) during electrocardiogram (ECG) recording. These changes are often manifested as shifts in the, electrical axis and may be misclassified as ischemic changes during. ambulatory monitoring. We investigate two ECG signal processing methods for detecting BPCs. Different schemes for feature extraction are used (spatial and scalar), while preprocessing, trend postprocessing and detection are identical. The spatial approach is based on VCG loop rotation angles and the scalar approach is based on the Karhunen-Loeve transform (KLT) coefficients. The methods are evaluated on two different databases: a database with annotated BPCs and the STAFF III database with recordings from rest and during angioplasty-induced ischemia but not including BPCs. The angle-based detector results in performance values of detection probability P-D = 95%, false alarm probability P-F = 3% in the BPC database and false alarm rate in the STAFF III database in control ECCs during rest R-F(c) = 2 h(-1) (episodes per hour) and in ischemia recordings during angioplasty R-F(a) = 7 h(-1), whereas the KLT-based detector produces values of P-D = 89%, P-F = 3%, R-F(c) = 4 h(-1), and RF(a) = 11 h-1, respectively. Including information on noise level in the detection process to reduce the number of false alarms, performance values of P-D similar or equal to 90%, P-F similar or equal to 1%, R-F(c) similar or equal to 1 h(-1) and R-F(a) similar or equal to 2 h(-1) are obtained with both methods. It is concluded that reliable detection of BPCs may be achieved using the ECG signal and should work in parallel to ischemia detectors.
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