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The paper proposes a telerehabilitation solution for hand Therapy. The proposed solution has two main components: the recovery part itself and the device for recording physiological parameters. We chose to record the heart rate and the EMG signal. To monitor heart rate during recovery exercises, we used a photoplethysmogram (PPG) sensor that picks up the earlobe signal. EMG module connected directly to the electrodes placed on the muscle whose activity is to be monitored for recording the EMG signal. To perform the recovery exercises, we made a game in Unity3D with several levels and degrees of complexity. After completing each level, the patient obtains a score depending on the correctness with which he performed the exercise. Before starting the recovery program, each patient was monitored with a Holter system for 24 hours, and an analysis of heart rate variation was performed. These results are considered a reference for analyzing the rhythm variability performed during the recovery program.

Neurodegenerative diseases and other categories of dementia have a profound impact not only on those diagnosed but also on those close to them and society, and are affecting millions of people worldwide. Various researchers and companies have proposed medical and non-medical products or devices that help these people. The products on the market at the moment, although numerous, are not connected to the needs of patients. Also, most of the existing devices do not sufficiently protect the patient’s data. This study designed a complete system to monitor and record the patient’s locations, heart rate, and patient’s spatial position. Also, this system’s novelty is the function that helps people with dementia in the self-administration of drugs. In this case, they can take care of themselves, and those close to them will always know the location and position of these patients if they took their medication correctly.

The paper proposes a design solution for a low cost device with feedback for upper extremity rehabilitation after a stroke event. Cerebral vascular accident (CVA) or stroke is one of the leading causes of morbidity and mortality worldwide. CVA is the most important cause of long-term disability in Europe, and demographic changes have led to an increase in both incidence and prevalence of this. Most secondary stroke disability is recovered in a few months, but others may persist for life. The rehabilitation should be started as soon as there is a greater chance of recovery in this early stage. Disabilities get worse and remain permanent over time, which is why is recommended the establishment of a rehabilitation program as soon as possible. Today, the use of virtual reality environments allow patients to perform tasks that mimic real life in rehabilitation clinics, but it tends increasingly more in the future these tasks can be done at home, sending data and receiving feedback from doctors. The devices presented in this paper are not only mechanical devices that allow the movement on a certain direction with predetermined effort degree for the patient, possibly controlled by the force of the muscle activity (EMG), but are innovative devices with the possibility to record a full set of biomedical signals. The patient device can record one or more biomedical parameters such as electrocardiography (ECG), heart rate (HR), electromyography (EMG), non-invasive blood pressure (NIBP), oxygen concentration in the blood (SpO2), movement speed and acceleration, angle of motion of a body extremity, torsion, s.a. according to the physician’s prescription and the patient needs. This means that the patient device will be very flexible and can communicate with other medical devices for home use

As medicine and technology have advanced over the millennia, healthcare technology has become more sophisticated and more complex, but its essential role of extending the ability of people to deliver healthcare remains. Over the past hundred years, healthcare has become increasingly reliant on medical technology with clinicians dependent on it for diagnosis and treatment. The appropriate deployment of technology contributes to the improvement in the quality of healthcare, the containment of cost, and to increased access to healthcare services. Within this paper, it was desired to make an overview of the role and situation of the bioengineer in Romania and of the degree of integration in the specialized structures within the management of medical technologies.

The provision of today’s health services depends on a steady increase in the evolution of medical technology. There is no hospital department that has not felt the impact of electronic, mechanical, hydraulic equipment in daily routine. The development of medical technology, the complexity of medical equipment has been rapid, producing a proliferation of growing medical devices. This paper was conducted to provide a comprehensive study evaluating the maintenance and repair program for medical equipment to determine the optimal method for a cost-effective management system and to identify risk factors. When a risk assessment tool is being developed, quantified and implemented, many applications are possible to generate procedure risk monitoring presentations across the institution to implement a technical competence program for biomedical/clinical engineers, technicians and clinicians.

Currently, the complexity of the equipment involves a problem in the training of maintenance professionals, maintenance predictive techniques being similar to medical diagnostic techniques, whenever a symptom that requires tests to diagnose the problem occurs. Total Preventive Maintenance or TPM is a type of maintenance plan used in production and various industrial fields. Overall, this is a theory about how the tools, parts and machinery used for production services are maintained so that life is as increased without incident and as safe. This concept is used to reduce maintenance costs, dead times with the aim of improving and rationalizing production and customer service. The most effective tools for preventive maintenance applications, Infrared Cameras provide the amazing ability to see what other diagnostic tools cannot. Using these cameras to discover hidden issues before they turn into serious situations, help keep your equipment in peak performance, avoiding expensive equipment damage and improving safety. Infrared thermal imaging has been used as a non-destructive and non-direct technique to examine progressive deterioration processes and failure mechanisms of different medical equipment. After the study, we can conclude that thermal imaging has major advantages over other diagnostic techniques because measuring equipment does not emit harmful radiation, thermal scanning does not require direct contact with the object to be analyzed, malfunctions are detected quickly and this procedure can be repeated whenever or needed, allowing real-time analysis.

The paper proposes a solution for monitoring of cardiovascular parameters during rehabilitation after stroke. Stroke is the most important cause of long-term disability in Europe. The effects of stroke can vanish after a short period or can remain for the rest of the life depending on therapeutic program. The system developed for this study is not only therapeutically devices that use virtual reality for rehabilitation exercises but also record one or more biomedical parameters such as: electromyogram (EMG), electrocardiogram (ECG), pulse wave, heart rate (HR), respiration rate or oxygen concentration in the blood (SpO2). These physiological parameters are selected according to the physician’s prescription and the patient needs. It was observed the cardiovascular system status, analyzing the heart rate variability. During therapeutic procedure it was recorded ECG (1 lead) and heart rate variability (HRV) was calculated. The results were used to determine the stress level induced by the rehabilitation program.

In this paper we present a report on the use of thermographic imaging techniques as a monitoring tool in newborn respiratory rate. The basis of this type of monitoring is the processing of real-time thermographic images. This contactless monitoring method it is absolute necessary because it is designed to monitor a very fragile category of patients: premature new born babies. Our biomedical signal of interests it is represented by the spontaneous breaths of the newborn. In the present study we demonstrate that the respiratory rate of the preterm newborn can be monitored based on the analysis of temperature changes that occurs in the anterior nasal area (nostrils).

The paper proposes a solution for monitoring of cardiovascular parameters during home-based hand rehabilitation. The most important cause of long-term disability in Europe is cerebral vascular accident (CVA) or stroke. The effects of stroke can vanish after a short period or can remain for the rest of the life depending on therapeutic program. The system developed for this study is not only therapeutically devices that allow the movement of hand for physical exercises controlled by electromyography (EMG) but also record one or more biomedical parameters such as: electromyogram (EMG), electrocardiogram (ECG), pulse wave, heart rate (HR), temperature, respiration rate, non-invasive blood pressure (NIBP) or oxygen concentration in the blood (SpO2). These physiological parameters are selected according to the physician’s prescription and the patient needs. In this paper it is presented an application that refers to the hand rehabilitation of post-stroke. It was observed the cardiovascular system status, analyzing the heart rate variability. During therapeutic procedure it was recorded ECG (1 lead) and pulse wave (using an ear lobe sensor). After that HRV was calculated for each signal. The results were used to determine the stress level induced by the rehabilitation program.

Often, computer-based education is associated with distance learning in contrast to face-to-face education. The differences between the two educational solutions tend to fade away, influenced by the new forms and educational solutions that are born with technological developments. Although the use of software elements in the study of electronic circuits has been introduced for some time, most applications are limited to providing useful information, formulas or making virtual simulated electrical circuit in ideal conditions. The concept of interfacing elements from classical electronics by making electronic circuits on a breadboard using real components with virtual tools creates a new learning environment with many advantages. A virtual learning environment is a specially designed information space that facilitates the learning process in a traditional way that includes a set of teaching tools designed to improve the learner's educational experience. Learning to use a tool like Educational Laboratory Virtual Instrumentation Suite from National Instruments eliminates the need for bulky equipment in the lab and also allows for the design of customized tools that can be used and reused for specific projects regarding biomedical instrumentation. The active role of the teacher is manifested, in this case, in a different way from the lessons done without computer support. Its presence is discreet, but important; it is the one that sets the time and methods of applying the method as an alternative to classical methods. What is characteristic and very important for these learning environments virtual refers to the active, creative role of learners.

Medical technologies play an important role in diagnosis and treatment of diseases. The diversity of medical devices increases the quality of medical act but, in the same time, increase the risk of adverse events or errors if the medical staff don’t have sufficient experience in using new medical equipment and new treatment procedures. Appropriate education and training of medical staff, including training in the appropriate use of medical equipment, is therefore essential for developing a high quality health care system. For solving this important problem is necessary to provide a replica of the patient care environment and the use of real patient simulators is a key issue. In these simulation centers the medical staff can learn and apply cognitive, psychomotor, and affective skills and instructors can facilitate learning and objectively measure student performance and competency. According to the available budget is two way for creating the clinical environment replica. First is to design a flexible implementation to accommodate multiple environment configurations in a single space and the second is to replicate the environments in which the learners will provide patient care like emergency department, intensive care unit, operating room, patient care unit or clinical examination room. In both situations is necessary to identify equipment typically found in the clinical environments we wish to replicate. Usually the medical equipment are: patient bed, patient monitors, ventilators, anesthesia delivery systems, suction devices, air and oxygen supplies, IV poles, infusion pumps, supply carts, defibrillators. All equipment must match with capabilities of patient simulators. In this paper we present our experience in training more than 500 medical staff in neonatal resuscitation and almost 1000 physicians and nurses in emergency medicine using real patient simulators in clinical simulation laboratory who are working in Medical Bioengineering Faculty from ”Grigore T. Popa” University of Medicine and Pharmacy Iasi.

The EOG signal is based on the potential difference between the cornea and retina (also known as the corneo-retinal potential) and can be measured by using electrodes placed around the eyes. The amplitude of the EOG signal varies between 50 ... 3500 uV. The eye can be seen as a dipole with a positive pole in the retina and the negative one in the cornea. Thus, an electric potential field is created that is changing proportionally with the rotation of the eye. The movements can be assessed from a single eye, but because for a healthy human being the eye movements are coupled, in this paper the signal obtained from both eyes is used. Furthermore, this method allows assessing both vertical and horizontal signal simultaneously. One of the most complex algorithms used to detect steep slopes and peaks within medical signals is the Pan-Tompkins algorithm, but is especially used for ECG signals. This is the reason why the previous studies focused on the detection of the abrupt discontinuities in the EOG signal, from the wavelet transform perspective. In this manner, the points of discontinuity determined by the eye movement will generate high wavelet coefficients, regardless of scale. Starting from previous results regarding different technics used for eye movement investigation and electrooculogram signal (EOG), the paper presents a robust algorithm that is capable of performing real time eye movement detection. This algorithm was implemented in LabVIEW, based on virtual instruments and it was successfully tested in the laboratory of Biomedical Engineering from Technical University of Cluj-Napoca.

In this work we present the results of implementing a new educational system type simulator in a sensitive area, where the practice is quite difficult to realize- neonatology. Neonatology is the latest branch of medicine, drawn from pediatrics that deals with newborn care. High-fidelity simulation is an effective tool in teaching neonatal resuscitation skills to professionals. In this paper we present our experience in medical examining staff using a high fidelity simulator. For the first time in Romania, at the beginning of 2016 a team of medical bioengineering together with teachers from discipline Neonatology at the University of Medicine and Pharmacy "Grigore T. Popa" Iasi, introduces a new practical test within examination for obtaining the title of specialist in neonatology - practical test on the simulator.

Mirror therapy (MT) has been seen to provide encouraging results in hemiparesis treatment. For stroke there are evidence that MT, used like an additional intervention, improves recovery of arm function and a there are a few evidence regarding rehabilitation of lower limb function and pain after stroke. Firm conclusions could not be drawn yet, that’s why the objective of this study is to evaluate the clinical aspects of mirror therapy (MT) interventions after stroke, which patients are likely to benefit most from MT, and how MT should preferably be applied. Co-monitoring blood pressure, HRV, respiratory rate and oxygen saturation can bring valuable information on cardiovascular reactivity in patients after stroke but also on the effectiveness of therapy, as MT. The study will attempt to correlate neurophysiological aspects and hemodynamic using both classical and modern methods of analysis based on nonlinear analysis, less used today. We used a series of additional tests of stimulation the sympathetic and parasympathetic system, to emphasize the influence of those two elements.

The objective of this study was to define a working method for biomedical engineers/ medical engineers to determine realistic maintenance intervals for medical equipment in hospitals. Maintenance period was analyzed for 145 medical equipment, including monitoring and treatment devices. Some indicators were established on the conditions of use of equipment and taking into account the manufacture year of the equipment; the data were analyzed using logistic regression predictors. The average time between failures was determined and was reported to some categories of relevant indicators.

In previous studies our concern was the electromagnetic compatibility in terms of life-supporting medical equipment in intensive care units. Following the results obtained, we decided to intensify our efforts in the field of electromagnetic compatibility trials of medical devices, including raising awareness of the problems of electromagnetic interference. In this work we have studied the influence of the electromagnetic field on infusion pumps / injectomats equipment used in all health facilities, not only intensive care. A very important aspect in this study is that these types of equipment used in administering medication are found in ambulances for example, a medium in which the electromagnetic field is very strong.

Besides medical and pharmacy specialists, the engineering branch has a main role in modern health care, characterized by high medical technology, powerful software programs for data analysis, and top management tools to increase efficiency of the health care system. Among many engineering specialties, bioengineers and biomedical engineers, even if somehow different, have a main common feature: the strong inter-, multi- and transdisciplinarity of their work. The paper analyses some characteristics of the specific education process in both fields, shows their sub-domains of activity, presents opportunities related to designing a career, presents specific aspects of 21 years of medical bioengineering education in Iasi city, Romania, and concludes that medical bioengineering and biomedical engineering belong to the top jobs, with a constant growths in demand.

Anorectal manometry is one way of evaluating the patient's quality of life, as it is an efficient way of assessing the anal function before and after neoadjuvant and/or surgical treatment. It is important to evaluate the function of the anal sphincter, as it can dictate the surgical treatment that is applied to the patient. The main issue that arises is the large variability of results, related to the operator-linked bias, as well as the different types of equipment that are used. Standardization is required. The studies in literature lack homogeneity, as some studies show there is a link between neoadjuvant therapy and anal incontinence, whereas others say there is no relation, while others even show the benefic effect on the short term of neoadjuvant radiation therapy on anal sphincter function. There is also the issue of long-term results and follow-up. In the instance of a "sphincter-saving" intervention, evaluation of the tonicity of the anal sphincter is important, as it can dictate between choosing a colorectal/coloanal anastomosis and realizing a terminal colostomy.

In this paper cardiovascular variability has been evaluated in patients with cerebrovascular accident (CVA), in patients recovering from stroke. In this prime report, more than twenty patients were examined; time-domain and frequency-domain parameters were studied during deep breathing (DB), Valsalva maneuver (VA) and hand grip (HG). After this we compared the HRV obtained in the specific test for each specific patient; we studied also records of different patients with the same injury, in order to estimate the magnitude of the difference. Using standard cardiovascular reflex tests we managed to analyze the heart rate variability in order to demonstrate the influence of the autonomic nervous marking parasympathetic dysfunction and sympathetic predominance in stroke people.

In this paper we presents our experience in training medical staff using high fidelity simulator. We train 500 physicians and nurses from 10 County Hospitals that cover a large area of Romania.

Many researches have been done in the last years upon the various effects of electromagnetic fields (EMF) on biological signals. There are several studies involving subjects who perform various tasks while being exposed to EMF, concluding that some aspects of cognitive function and some distinctive parts of brain physiology may be affected by the exposure to EMF. This paper aims to study the influence of electromagnetic field produced by a medical equipment on the EEG signals processed in real time.

This paper presents a design of medical device for bioelectrical impedance estimation. The hardware required to implement the system is based on a signal generator to provide current, a microcontroller to coordinate the process and a data acquisition board to measure the voltage changes across the analyzed region. The algorithm for calculating the physiological variables was implemented in MATLAB. Sample impedance data for a test subject are also presented.

Medical technology is by now an integral part of health care according to consisting general accepted standards. The Medical Equipment Management Plan defines the mechanisms for interaction and oversight of the medical equipment used in the diagnosis, treatment, and monitoring of patients. The related policies and procedures govern activities from selection and acquisition to incoming inspection and maintenance of medical equipment. The mission is to ensure that equipment used in patient care is safe, available, accurate, and affordable.

Medical equipment risk assessment is part of an overall medical equipment management program for a healthcare facility or system. A complete program includes corrective maintenance or repair, equipment control, asset management, health care technology planning, education, and activities directed toward improving medical device-related patient safety. The purpose of this paper is to provide some guidance lines in establishing and managing a medical equipment quality assurance program and to present some procedures for inspection, maintenance, evaluation, and performance testing for some medical devices. A computerized medical equipment management system is described. The results demonstrate that it is a useful tool in tracking device inventory and maintenance history. Also risk classes have been designed for medical devices based on the time of testing, risk must be identified in relation to patient and staff member. The results of this paper take into consideration the advances in device reliability, reduced preventive maintenance requirements, and internal device surveillance (self test) along with changes in standards.

In this paper we present studies on biological and health effects of electromagnetic fields emphasising the aspects related with measurement of the aggressing electromagnetic fields. A brief review of literature on electromagnetic environment is presented, together with some methods aiming to control and eliminate the electromagnetic interferences on medical instrumentation used in the acquisition of the biological signals (electroencephalography - EEG, electrocardiography - ECG). We performed analysis of electromagnetic fields in order to determine the induced current/field and the specific absorption rate in models of human body and also to correlate the exposure fields with some alterations of the biological signals acquired from a subject laid in various electromagnetic environments. The main goal of this research is to design a method for accurate identification and characterization of the aggressing electromagnetic fields on biological signals and human health.

Hysteresis is often present in strain-stress curves that describe the mechanical properties of the blood vessels. In this paper we propose to use the Maxwell-slip model in order to describe the hysteresis curve in aorta and other blood vessels. An optimization method for parameters of the Maxwell-slip model using variable length genotype adapted for differential evolutionary algorithm is proposed. The experimental results showed a very good approximation of the hysteresis curve using the Maxwell-slip model and the proposed optimization method.

Electrical impedance method has found utility in many fields of medical research, but the old instrumentation can be expensive to use and complicated to build. Advancements in electronic component design and equipment allow a bioimpedance analysis using a simple medical device. The aim of this work is to design a medical device which estimates the blood flow and calculates some hemodynamic parameters on the plethysmographic wave. We designed an equilibrated bridge designed on a small circuit board with connections for power and bioimpedance electrodes. A programmable function generator and an oscilloscope were connected to a computer and were tasked to drive and receive data from the circuit. The alternating - current generator is the current source; a series resistor limits the amount of current that passes through the subject. The frequency of the delivered current is between 20 kHz and 250 kHz. Because the skin impedance increases at higher frequencies, a small amount of energy will be delivered to the patient, that ensuring the safety of the system. The circuit was validated by testing its current output over a range of frequencies and comparing measured values of impedance across a test circuit to expected values. The software receives data and inserts it into a data sheet for analysis.

Today the high number of the patients, suffering of chronically diseases, put a big pressure to the health system with their demand for homecare monitoring. In this paper are presented the design of the wearable medical device for long term monitoring of pulse wave, SpO2 and NIBP. The monitoring device acquiring the signals, store them on local memory and send all the data to a central station were the data are processed. The pulse wave was processed for calculate the second derivative of photoplethysmogram as an indicator of the hardness of the blood vessel [1]. The work was focused on design and implementation of an ultra low power wearable device able to acquire the pulse wave, causing minimal discomfort and allowing high mobility

The rapid development of medical technology in the fields of medical diagnosis and therapy (including rehabilitation and functional adaptation) establish of complex interdisciplinary undergraduate programs initially described as Biological and Medical Engineering, Biomedical Engineering, and Chemical Engineering and currently known as Medical Bioengineering. In Romania are two major directions in this field: bioengineering that are developed in Iasi at University of Medicine and Pharmacy and medical engineering that are implemented in Cluj at Technical University and Bucharest at Politehnica University.

This paper presents the preliminary work made in the framework of the research project SIMPA 11-070. The aim of this project is to develop a medical device for monitoring some vital parameters on patients with chronically diseases (like cardiovascular diseases) that alongside a software application, it provides an integrated solution of monitoring the evolution of the disease in order to optimize the treatment.

The actual status of technological development impose the improvement of quality of life through health services, information and communication systems and environment control more efficient in hospitals. This study want to develop a medical device for monitoring some vital parameters on patients with chronically diseases that alongside a software application, it provides an integrated solution of monitoring the evolution of the disease in order to optimize the treatment. We wish to apply this system for the pregnant women with chronically diseases like diabetes or heart disease.

Remote monitoring of chronic diseases can improve health outcomes and potentially lower health care costs. The present work refers to the data transmittance and processing, as it is to be implemented in an eHealth monitoring system dedicated to pregnant women with chronically diseases. Alongside a software application and correspondent hardware, it provides an integrated solution of monitoring the evolution of the disease in order to optimize the treatment. The system is designed to be an efficient and safe instrument that transfers the data from different measurement devices towards the medical staff in order to keep update the patient’s data and increase the efficiency of the disease management.

Development of industrial cell culture processes needs a good engineering practice and system expertise in achieving a successful integrated process using disposable components. The bioreactors for 3D tissues systems could be an advantageous alternative in terms of low contamination risk, easiness of handling and scaling-up. A careful and strategic design of these equipments provides a better process control and a safe and reproducible production of tissue construct. They can offer the technical means to perform controlled studies aimed to understanding the specific biological, chemical or physical effects. An important problem that has to be solved is the bioreactors scalability of the technology in mammalian systems. A cell line development process, carried on bioreactors, should be well defined and standardized so that areas requiring high-throughput and repetitive work can be identified.

The analysis of chaotic components in movements during hands tremor and more classic analysis of the movements is considered in relation to its application to diagnosis and rehabilitation techniques. Fuzzy methods are used to characterize the movements and to assess their normality. Visual and auditory feedback is provided to help controlling the movements in a rehabilitation system that incorporates elements of virtual reality.