Auscultation transformed:the ingenious invention of the stethoscope by René Théophile Hyacinthe Laennec

This study delves into the life and significant contributions of René Théophile Hyacinthe Laennec,a prominent French physician of the 19^(th) century,and thoroughly examines his revolutionary creation,the stethoscope.Laennec’s innovative spirit not only revolutionized medical diagnosis during his time but also left a lasting imprint on the broader field of medicine,influencing healthcare for generations.This extensive inquiry covers various aspects,including his historical context,the development of the stethoscope,its profound implications for medical diagnosis,and its enduring impact on the history of medicine.

随钻测压工具StethoScope在渤海油田的应用

在油田开发过程中,地层压力是衡量地层能量的重要指标,合理的地层压力是搞好油田稳定和调整挖潜的重要条件。随着油田的勘探开发,地层能量开始衰减,在很大程度上影响了开发效果,因此及时准确了解地层压力的情况就显的尤为重要介绍了StethoScope工具特点、测压流程及其在渤海油田应用效果分析。

Highly sensitive electronic stethoscope based on non-uniform PVDF curvature structure

Electronic stethoscope is an instrument used for auxiliary determination of patients＇ physical condition by collecting and processing heart sounds and lung sounds.Since traditional electronic stethoscopes have low sensitivity and poor low-frequency response,a novel electronic stethoscope is provided in this paper using curved PVDF clamping structure with non-uniform curvature based on the structure of PVDF and silicone rubber substrate.Theoretical analysis and comparison by means of the corresponding inhomogeneous string vibration model show that sensitivity significantly increases for non-uniform curvature than the uniform one.Furthermore,a new electronic stethoscope pickup is developed based on the optimal parameters at the point of maximum sensitivity of non-uniform curvature.Experiment results show that the sensitivity of the pickup can reach1.7mV/Pa,which increases by 13.3%compared to the one with the structure of uniform curvature PVDF and silicone rubber substrate that has been studied in recent years.Moreover,flat frequency response characteristics can be retained within the frequency band range of 2-2kHz,which covers the frequency response range of cardiopulmonary sound collection,thus provides a strong guarantee for complete acquisition of heart and lung sound signals.

Artificial Intelligence in Medicine:Real Time Electronic Stethoscope for Heart Diseases Detection

Diseases of the cardiovascular system are one of the major causes of death worldwide.These diseases could be quickly detected by changes in the sound created by the action of the heart.This dynamic auscultations need extensive professional knowledge and emphasis on listening skills.There is also an unmet requirement for a compact cardiac condition early warning device.In this paper,we propose a prototype of a digital stethoscopic system for the diagnosis of cardiac abnormalities in real time using machine learning methods.This system consists of three subsystems that interact with each other(1)a portable digital subsystem of an electronic stethoscope,(2)a decision-making subsystem,and(3)a subsystemfor displaying and visualizing the results in an understandable form.The electronic stethoscope captures the patient’s phonocardiographic sounds,filters and digitizes them,and then sends the resulting phonocardiographic sounds to the decision-making system.The decision-making systemclassifies sounds into normal and abnormal using machine learning techniques,and as a result identifies abnormal heart sounds.The display and visualization subsystem demonstrates the results obtained in an understandable way not only for medical staff,but also for patients and recommends further actions to patients.As a result of the study,we obtained an electronic stethoscope that can diagnose cardiac abnormalities with an accuracy of more than 90%.More accurately,the proposed stethoscope can identify normal heart sounds with 93.5%accuracy,abnormal heart sounds with 93.25%accuracy.Moreover,speed is the key benefit of the proposed stethoscope as 15 s is adequate for examination.

Spectral analysis of bowel sounds in intestinal obstruction using an electronic stethoscope

AIM: To determine the value of bowel sounds analysis using an electronic stethoscope to support a clinical diagnosis of intestinal obstruction. METHODS: Subjects were patients who presented with a diagnosis of possible intestinal obstruction based on symptoms, signs, and radiological findings. A 3MTH Littmann Model 4100 electronic stethoscope was used in this study. With the patients lying supine, six 8-second recordings of bowel sounds were taken from each patient from the lower abdomen. The recordings were analysed for sound duration, soundto-sound interval, dominant frequency, and peak frequency. Clinical and radiological data were reviewed and the patients were classified as having either acute, subacute, or no bowel obstruction. Comparison of bowel sound characteristics was made between these subgroups of patients. In the presence of an obstruction, the site of obstruction was identified and bowel calibre was also measured to correlate with bowel sounds. RESULTS: A total of 71 patients were studied during the period July 2009 to January 2011. Forty patientshad acute bowel obstruction (27 small bowel obstruction and 13 large bowel obstruction), 11 had subacute bowel obstruction (eight in the small bowel and three in large bowel) and 20 had no bowel obstruction (diagnoses of other conditions were made). Twenty-five patients received surgical intervention (35.2%) during the same admission for acute abdominal conditions. A total of 426 recordings were made and 420 recordings were used for analysis. There was no significant difference in sound-to-sound interval, dominant frequency, and peak frequency among patients with acute bowel obstruction, subacute bowel obstruction, and no bowel obstruction. In acute large bowel obstruction, the sound duration was significantly longer (median 0.81 s vs 0.55 s, P = 0.021) and the dominant frequency was significantly higher (median 440 Hz vs 288 Hz, P = 0.003) when compared to acute small bowel obstruction. No significant difference was seen between acute large bowel obstruction and large bowel pseudoobstruction. For patients with small bowel obstruction, the sound-to-sound interval was significantly longer in those who subsequently underwent surgery compared with those treated non-operatively (median 1.29 s vs 0.63 s, P < 0.001). There was no correlation between bowel calibre and bowel sound characteristics in both acute small bowel obstruction and acute large bowel obstruction. CONCLUSION: Auscultation of bowel sounds is nonspecific for diagnosing bowel obstruction. Differences in sound characteristics between large bowel and small bowel obstruction may help determine the likely site of obstruction.

An Early Diagnosis of Endocarditis Facilitated by the Electronic Stethoscope

The practice of cardiac auscultation is a critical tool used by physicians to detect alterations in the cardiovascular system. A case of both left and right sided endocarditis initially detected by electronic auscultation in a woman with a history of injection drug use is described. The electronic stethoscope, with the ability to amplify heart sounds, established the presence of both a systolic and diastolic murmur when standard auscultation failed to detect the diastolic component. Urgent standard echocardiography confirmed concurrent tricuspid and aortic valves endocarditis, and the patient was referred for surgical evaluation urgently. The present case demonstrates the value of the electronic stethoscope to amplify murmurs in the early detection of endocarditis. The case presented also serves as a useful reminder that right-sided endocarditis can have important leftsided complications.

StethoScope随钻测压技术在渤海JZS油田的应用

渤海JZS油田主力含油层系为沙二段辫状河三角洲前缘砂泥岩薄互层,由于砂层薄且相变快,地震资料难以分辨,储层连通及动用情况不明,严重制约了油田后续开发。为了解区块储层连通关系,优化井网部署,首次采用StethoScope随钻测压技术进行了地层压力测试。全面介绍了StethoScope随钻测压工具的测压原理、应用流程、测压模式及其在渤海JZS油田优化注采中的应用。测试结果明确了地层动用亏空情况和储层连通关系,为油田后期开发提供了重要依据,同时对StethoScope随钻测压技术在其他区域的推广应用具有一定的借鉴和指导意义。

Characterization and cross-comparison of digital stethoscopes for telehealthremote patient auscultation

Stethoscopes are commonly used to diagnose cardiac and respiratory diseases.The advent of digital stethoscopes added the capability to remotely monitor the cardiorespiratory well-being of patients and facilitate digital remote auscultations for physicians to examine their patients outside of the clinic.To increase the adoption of a hybrid diagnosis between in-person and remote auscultations,it is important to characterize the frequency response of different configurations of digital stethoscopes.A standard testing platform was adopted from the literature and re-validated by seven physicians.Two wearable and two non-wearable digital stethoscopes were investigated.A similarity factor score was used to analyze select time-synchronized acoustic events that achieved high fidelity between stethoscopes.The frequency responses between devices were compared using the correlation coefficient.Two devices reported the highest correlation coefficient of 0.72 and 0.75 in the wearable and non-wearable categories,respectively.The correlation coefficient of the frequency responses between the same pair of devices on the human chest was 0.91.With such a high agreement in the frequency response between the wearable and non-wearable digital stethoscope,it can be concluded that the configuration of digital stethoscope is not a limiting factor of performance,and both are acceptable and desirable for physicians to adopt either configuration in remote delivery of healthcare.

随钻测压技术在绥中36-1油田的应用

绥中36-1油田的开发已进入中高含水期,生产动态资料显示纵向上层间矛盾大、注采不均衡,各个砂体地层压力差异不清楚。油田首次采用随钻测压工具StethoScope进行地层压力测试,介绍该工具工作原理、测试过程及数据质量控制,分析测得的地层压力和流度数据,可将其作为优化泥浆密度、指导采油井合理工作制度、注水井优化各层注水量的依据。

Armarium facilitating angina management post myocardial infarction concomitant with coronavirus disease 2019

The outbreak and spread of coronavirus disease 2019(COVID-19)are not only a disaster of people’s life and health over the world,[1–3]but also the challenge for medical practitioner in clinical management.Owing to many diagnostic instruments are not suitable or convenient to use any more in contagious ward considering the risk of cross infections,such as traditional stethoscope or electrocardiogram(ECG).In this scenarios,wireless and digital equipment are optimal choices for epidemic management in order to exert rapid diagnosis and disease evaluation.Herein,we reported a case of the patient suffering both COVID-19 and myocardial infarction,for which the tele-ECG and wireless stethoscope facilitated the accurate diagnosis and instant management.

Development of laser-based heart sound detection system

In this paper, we demonstrate the prototype of a new stethoscope using laser technology to make the heart-beat signal “visible”. This heartbeat detection technique could overcome the limitation of the acoustic stethoscope brought by the poor ability of human ear to hear low frequency heart sounds. This is important, as valuable information from sub-audio sounds is present at frequencies below the range of human hearing. Moreover, the diagnostic accuracy of the acoustic stethoscope is also very sensitive to noise from immediate environment. In the prototype of laser-based stethoscope, the heartbeat signal is correlated to the optical spot of a laser beam reflected from a thin mirror attached to the patient’s chest skin. The motion of the mirror with the chest skin is generated by the heart sounds. A linear optical sensor is applied to detect and record the motion of the optical spot, from which the heartbeat signal in time-domain is extracted. The heartbeat signal is then transformed to frequency domain through digital signal processing. Both time-domain and frequency-domain signals are analyzed in order to classify different type of heart murmurs. In the prototype of the laser-based stethoscope, we use a heart-sound box to simulate the chest of a human being. The heart-sounds collected from real patients are applied to activate the vibration of the heart-sound box. We also analyze different heart murmur patterns based on the time-domain and frequency-domain heartbeat signals acquired from the optical system.