No description available.

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Thesis (MScIng)--University of Stellenbosch, 2005. / Bibliography. Also available via the Internet.

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Thesis (Ph. D.)--Ohio State University, 2005. / Available online via OhioLINK's ETD Center; full text release delayed at author's request until 2006 Aug 15.

Thesis (MScEng (Electrical and Electronic Engineering))--University of Stellenbosch, 2005. / Most of the relevant and severe congenital cardiac malfunctions can be recognized in the neonatal period of a child’s life. The delayed recognition of a congenital heart defect may have a serious impact on the long-term outcome of the affected child. Experienced cardiologists can usually evaluate heart murmurs with a high sensitivity and specificity, although non-specialists, with less clinical experience, may have more difficulty. Although primary care physicians frequently encounter children with heart murmurs most of these murmurs are innocent. The aim of this project is to design an automated algorithm that can assist the primary care physician in screening and diagnosing pediatric patients with possible cardiac malfunctions. Although attempts have been made to automate screening by auscultation, no device is currently available to fulfill this function. Multiple indicators of pathology are nonetheless available from heart sounds and were elicited using several signal processing techniques. The three feature extraction algorithms (FEA’s) developed respectively made use of a Direct Ratio technique, a Wavelet analysis technique and a Knowledge based neural network technique. Several implementations of each technique are evaluated to identify the best performer. To test the performance of the various algorithms, the clinical auscultation sounds and ECG-data of 163 patients, aged between 2 months and 16 years, were digitized. Results presented show that the De-noised Jack-Knife neural network can classify 163 recordings with a sensitivity and specificity of 92 % and 92.9 % respectively. This study concludes that, in certain conditions, the developed automated auscultation algorithms show significant potential in their use as an alternative evaluation technique for the classification of heart sounds in normal (innocent) and pathological classes.

Made available in DSpace on 2016-04-27T13:10:25Z (GMT). No. of bitstreams: 1 Virna Maria Guevara.pdf: 2274504 bytes, checksum: f4a163e1284fcda1b344b0644f21a061 (MD5) Previous issue date: 2014-10-29 / Introduction- The prevalence of congenital cardiovascular disease is of 7 to 10 children in every 1000 live births. The reasons that lead to the referral of a child by primary care physicians are very varied, with cardiac heart murmur being the most common. Amongst other reasons one can find precordial pain, arrhythmia, fatigue, dyspnea, cyanosis, abnormal chest x-ray, abnormal electrocardiogram, medical examination for physical exercise. The present challenge for pediatricians, family physicians and pediatric cardiologists is to develop accurate diagnosis strategies in a cost-effective manner, with the aim of improving the treatment and save resources. Objectives- The objective is to strengthen the network of health care in its primary and secondary levels using cases of Pediatric Cardiology as the strategic condition and develop an interdisciplinary work proposal with the support of a matrix, which optimize the referral system. Material and methods- It is about the exploratory study with descriptive documental analysis from 433 referral letters of patients seen at the Pediatric Cardiology Ambulatory of Policlinic of Sorocaba from January to June 2012, along with the study of the patients medical records. The data collected is quantified using descriptive statistics when relevant. Results- One hundred and sixty-six patients (38,3%) were discharged, 93 with feedback letter of referral (56,0%). Ninetysix (22,2%) missing follow up, 9 of which had confirmed cardiovascular disease, 29 with absence of cardiovascular disease and 58 without a definitive diagnosis of cardiovascular disease. One hundred and seventy-one patients (39,5%) attend follow-ups. Conclusion- With the aim of strengthening the network of health care using recent medical advances, such as telemedicine and the concept of matrix support, as means of exchange, improvement and to save resources and knowledge / Introdução - A prevalência das cardiopatias congênitas está entre sete a dez crianças por 1000 nascidas vivas. Os motivos que levam o médico da atenção primária a encaminhar uma criança ao cardiologista pediátrico são bastante variados, sendo o sopro cardíaco a causa mais frequente. Dentre outros motivos frequentes encontram-se dor precordial, arritmias, cansaço, dispneia, cianose, radiografia de tórax anormal, eletrocardiograma alterado, avaliação para atividade física. O desafio atual dos pediatras, médicos de família e cardiopediatras é desenvolver estratégias de diagnósticos precisos e financeiramente adequados, com o intuito de melhorar o tratamento e racionalizar os recursos. Objetivos - O objetivo é fortalecer a rede de atenção à saúde em seus níveis primário e secundário, utilizando-se dos casos de Cardiologia Pediátrica como condição estratégica e desenvolver uma proposta de trabalho interdisciplinar e de interação com apoio matricial, otimizando o sistema de referência e contrarreferência. Material e método - Trata-se de estudo exploratório com análise documental descritiva das 433 guias de referenciamento de pacientes atendidos no ambulatório de Cardiologia Pediátrica da Policlínica Municipal de Sorocaba, no período de janeiro a junho de 2012, acompanhado do estudo dos prontuários. Os dados obtidos foram quantificados e utilizada a estatística descritiva quando pertinente. Resultados - Cento e sessenta e seis pacientes (38,3%) tiveram alta, 93 com contrarreferência (56,0%) preenchida. Noventa e seis pacientes (22,2%) perderam o seguimento, sendo nove com doença cardiovascular presente, 29 com doença cardiovascular ausente e 58 sem diagnóstico definitivo de doença cardiovascular. Cento e setenta e um pacientes (39,5%) pacientes mantêm seguimento. Conclusão A fim de se fortalecer a rede de atenção à saúde, a utilização de recentes avanços, como a telemedicina e o conceito de apoio matricial se colocam como meios de troca, otimização e racionalização do conhecimento e dos recursos