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Winnipeg, Canada

Rumbolt C.B.C.,University of Manitoba | Hooper D.R.,Riverview Health Center
Muscle and Nerve

Introduction: In patients with clinically diagnosed carpal tunnel syndrome (CTS) the more symptomatic hand may be different from the more severely affected hand on electrodiagnostic testing. This study aims to determine the level of agreement which should be expected between these measures and consequently the level of suspicion for co-occurring pathology which is warranted if there is discordance. Methods: This was a single center retrospective review of 252 patients referred for upper extremity electrodiagnostic evaluation who were diagnosed subsequently with CTS. Comparison was made between the patient's perceived worst side and the more abnormal side on electrodiagnostic studies. Results: We found a significant level of agreement (κ=0.676) between patient symptoms and electrodiagnostic testing when identifying the side with more severe CTS. Conclusions: Discordance between patient perception and electrodiagnostic results regarding which hand is affected more severely in patients with CTS should alert the clinician to possible coexisting nonneurologic pathology and prompt regional musculoskeletal examination as indicated. © 2014 Wiley Periodicals, Inc. Source

Montazeri A.,University of Manitoba | Giannouli E.,University of Manitoba | Moussavi Z.,University of Manitoba | Moussavi Z.,Riverview Health Center
Annals of Biomedical Engineering

In this article, a novel technique for assessment of obstructive sleep apnea (OSA) during wakefulness is proposed; the technique is based on tracheal breath sound analysis of normal breathing in upright sitting and supine body positions. We recorded tracheal breath sounds of 17 non-apneic individuals and 35 people with various degrees of severity of OSA in supine and upright sitting positions during both nose and mouth breathing at medium flow rate. We calculated the power spectrum, Kurtosis, and Katz fractal dimensions of the recorded signals and used the one-way analysis of variance to select the features, which were statistically significant between the groups. Then, the maximum relevancy minimum redundancy method was used to reduce the number of characteristic features to two. Using the best two selected features, we classified the participant into severe OSA and non-OSA groups as well as non-OSA or mild vs. moderate and severe OSA groups; the results showed more than 91 and 83% accuracy; 85 and 81% specificity; 92 and 95% sensitivity, for the two types of classification, respectively. The results are encouraging for identifying people with OSA and also prediction of OSA severity. Once verified on a larger population, the proposed method offers a simple and non-invasive screening tool for prediction of OSA during wakefulness. © 2011 Biomedical Engineering Society. Source

Yadollahi A.,University of Toronto | Yadollahi A.,Toronto Rehabilitation Institute | Yadollahi A.,University of Manitoba | Montazeri A.,University of Manitoba | And 3 more authors.
Annals of Biomedical Engineering

Tracheal respiratory sound analysis is a simple and non-invasive way to study the pathophysiology of the upper airway and has recently been used for acoustic estimation of respiratory flow and sleep apnea diagnosis. However in none of the previous studies was the respiratory flow-sound relationship studied in people with obstructive sleep apnea (OSA), nor during sleep. In this study, we recorded tracheal sound, respiratory flow, and head position from eight non-OSA and 10 OSA individuals during sleep and wakefulness. We compared the flow-sound relationship and variations in model parameters from wakefulness to sleep within and between the two groups. The results show that during both wakefulness and sleep, flow-sound relationship follows a power law but with different parameters. Furthermore, the variations in model parameters may be representative of the OSA pathology. The other objective of this study was to examine the accuracy of respiratory flow estimation algorithms during sleep: we investigated two approaches for calibrating the model parameters using the known data recorded during either wakefulness or sleep. The results show that the acoustical respiratory flow estimation parameters change from wakefulness to sleep. Therefore, if the model is calibrated using wakefulness data, although the estimated respiratory flow follows the relative variations of the real flow, the quantitative flow estimation error would be high during sleep. On the other hand, when the calibration parameters are extracted from tracheal sound and respiratory flow recordings during sleep, the respiratory flow estimation error is less than 10%. © 2012 Biomedical Engineering Society. Source

Lobchuk M.M.,University of Manitoba | Rosenberg F.,Riverview Health Center
Journal of Wound, Ostomy and Continence Nursing

PURPOSE: The purpose of the original mixed-design study was to compare affected individual and family caregiver perceptions of urinary incontinence quality of life in relation to their empathic responses toward one another and to explore their qualitative responses of factors that hinder or facilitate these responses. The aim of this secondary analysis is to report responses shared by affected individuals and family caregivers on how their lives have been impacted by urinary incontinence. DESIGN: Qualitative study with content analysis. SUBJECTS AND SETTING: The sample comprised 13 persons with urinary incontinence and 13 family caregivers. Their mean age was 78 years and the mean age for caregivers was 67 years. Caregivers were mainly the spouses or daughters of affected respondents. Interviews were conducted in participants' homes in Winnipeg, Manitoba, Canada. METHODS: Data were collected via 26 audio-recorded interviews. Content analysis was used to capture major themes arising from the data. RESULTS: Five major themes with respective subthemes highlight how urinary incontinence infl uenced the quality of life of affected individuals and their family caregivers, including (1) life changes, (2) psychological responses and coping, (3) painful responses of others, (4) reticence to seek medical attention, and (5) advice to health care professionals. CONCLUSIONS: Health care professionals should recognize that dealing with urinary incontinence in the home is a "team effort" between affected individuals and family caregivers. Educational efforts need to counter attitudes in care providers who avoid talking about urinary continence and enhance sensitivities toward affected individuals' and family caregivers' ongoing need for control in continence care based on their unique needs and preferences. © 2014 by the Wound, Ostomy and Continence Nurses Society. Source

Friesen M.R.,University of Manitoba | Hamel C.,Riverview Health Center | McLeod R.D.,University of Manitoba
International Journal of Environmental Research and Public Health

This paper reports on the findings of a user trial of a mHealth application for pressure ulcer (bedsore) documentation. Pressure ulcers are a leading iatrogenic cause of death in developed countries and significantly impact quality of life for those affected. Pressure ulcers will be an increasing public health concern as the population ages. Electronic information systems are being explored to improve consistency and accuracy of documentation, improve patient and caregiver experience and ultimately improve patient outcomes. A software application was developed for Android Smartphones and tablets and was trialed in a personal care home in Western Canada. The software application provides an electronic medical record for chronic wounds, replacing nurses' paper-based charting and is positioned for integration with facility's larger eHealth framework. The mHealth application offers three intended benefits over paper-based charting of chronic wounds, including: (1) the capacity for remote consultation (telehealth between facilities, practitioners, and/or remote communities), (2) data organization and analysis, including built-in alerts, automatically-generated text-based and graph-based wound histories including wound images, and (3) tutorial support for non-specialized caregivers. The user trial yielded insights regarding the software application's design and functionality in the clinical setting, and highlighted the key role of wound photographs in enhancing patient and caregiver experiences, enhancing communication between multiple healthcare professionals, and leveraging the software's telehealth capacities. © 2013 by the authors; licensee MDPI, Basel, Switzerland. Source

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