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91. 发明授权

US08447401B2 Collecting posture information to evaluate therapy 有权
公开(公告)号：US08447401B2
公开(公告)日：2013-05-21
申请号：US12856255
申请日：2010-08-13
申请人： Keith A. Miesel , Kenneth T. Heruth
发明人： Keith A. Miesel , Kenneth T. Heruth
IPC分类号： A61N1/36
CPC分类号： A61B5/4848 , A61B5/103 , A61B5/1116 , A61B5/4082 , A61B5/6825 , A61B5/686 , A61M5/14276 , A61N1/0531 , A61N1/0534 , A61N1/36071 , A61N1/36082 , A61N1/36514 , A61N1/36521 , A61N1/36535 , A61N1/36542 , A61N1/36557 , A61N1/37235
摘要： A medical device delivers a therapy to a patient. Posture events are identified, e.g., a posture of the patient is periodically determined and/or posture transitions by the patient are identified, and each determined posture event is associated with a current therapy parameter set. A value of at least one posture metric is determined for each of a plurality of therapy parameter sets based on the posture events associated with that therapy parameter set. A list of the therapy parameter sets is presented to a user, such as a clinician, for evaluation of the relative efficacy of the therapy parameter sets. The list may be ordered according to the one or more posture metric values to aid in evaluation of the therapy parameter sets. Where values are determined for a plurality of posture metrics, the list may be ordered according to the one of the posture metrics selected by the user.

92. 发明授权

US08317770B2 Systems and methods of identifying catheter malfunctions using pressure sensing 有权
标题翻译：使用压力感测识别导管故障的系统和方法
公开(公告)号：US08317770B2
公开(公告)日：2012-11-27
申请号：US11731355
申请日：2007-03-30
申请人： Keith A. Miesel , Eric J. Panken
发明人： Keith A. Miesel , Eric J. Panken
IPC分类号： A61M31/00 , A61M37/00
CPC分类号： A61M5/16859 , A61M5/14276 , A61M2205/14 , A61M2205/15
摘要： Methods and systems for determining whether a catheter malfunction is present in a catheter by analyzing changes in the pressure of fluids being pumped through the delivery lumen of the catheter. The pressure changes that may be monitored may include, e.g., the peak pressure within the catheter and/or the pressure decay profile. The catheter malfunctions that may be determined using the methods and systems of the invention may include, e.g., leaks, blockages, the presence of gas bubbles, etc.
摘要翻译：通过分析通过导管的输送腔泵送的流体的压力变化来确定导管故障是否存在于导管中的方法和系统。可以监测的压力变化可以包括例如导管内的峰值压力和/或压力衰减曲线。可以使用本发明的方法和系统确定的导管故障可以包括例如泄漏，堵塞，气泡的存在等

93. 发明申请

US20120150258A1 COLLECTING POSTURE AND ACTIVITY INFORMATION TO EVALUATE THERAPY 有权
标题翻译：收集治疗和活动信息以评估治疗
公开(公告)号：US20120150258A1
公开(公告)日：2012-06-14
申请号：US13401348
申请日：2012-02-21
申请人： Keith A. Miesel , Kenneth T. Heruth , Gregory F. Molnar
发明人： Keith A. Miesel , Kenneth T. Heruth , Gregory F. Molnar
IPC分类号： A61N1/372
CPC分类号： A61B5/103 , A61B5/0205 , A61B5/1116 , A61B5/4082 , A61B5/4094 , A61B5/6804 , A61B5/6825 , A61B5/686 , A61N1/0529 , A61N1/0531 , A61N1/0534 , A61N1/36071 , A61N1/36082 , A61N1/36585 , A61N1/37235 , G06F19/00
摘要： A medical device, programmer, or other computing device may determine values of one or more activity and, in some embodiments, posture metrics for each therapy parameter set used by the medical device to deliver therapy. The metric values for a parameter set are determined based on signals generated by the sensors when that therapy parameter set was in use. Activity metric values may be associated with a postural category in addition to a therapy parameter set, and may indicate the duration and intensity of activity within one or more postural categories resulting from delivery of therapy according to a therapy parameter set. A posture metric for a therapy parameter set may indicate the fraction of time spent by the patient in various postures when the medical device used a therapy parameter set. The metric values may be used to evaluate the efficacy of the therapy parameter sets.
摘要翻译：医疗设备，程序员或其他计算设备可以确定一个或多个活动的值，并且在一些实施例中，确定由医疗设备用于递送治疗的每个治疗参数集的姿势度量。当参数组被使用时，基于由传感器产生的信号来确定参数集的度量值。除了治疗参数集之外，活动度量值可以与姿势类别相关联，并且可以指示根据治疗参数集合递送治疗产生的一个或多个姿势类别内的活动的持续时间和强度。用于治疗参数组的姿势度量可以指示当医疗装置使用治疗参数集时患者在各种姿势中花费的时间的分数。度量值可用于评估治疗参数组的功效。

94. 发明授权

US08190251B2 Method and apparatus for the treatment of movement disorders 有权
标题翻译：用于治疗运动障碍的方法和装置
公开(公告)号：US08190251B2
公开(公告)日：2012-05-29
申请号：US11565268
申请日：2006-11-30
申请人： Gregory F. Molnar , Gabriela C. Miyazawa , Keith A. Miesel , Jonathan C. Werder , David L. Carlson , Jonathon E. Giftakis
发明人： Gregory F. Molnar , Gabriela C. Miyazawa , Keith A. Miesel , Jonathan C. Werder , David L. Carlson , Jonathon E. Giftakis
IPC分类号： A61B5/04
CPC分类号： A61N1/36067 , A61B5/048 , A61B5/4082 , A61N1/36003
摘要： A method, apparatus, and system for treating patients suffering from movement disorders having the ability to determine one or more biomarkers indicative of a disease state. In some embodiments, the biomarker may be used as a closed-loop feedback signal to control the delivery of therapy (such as electrical stimulation or drug therapy), and which may also be used as an indication of therapy effectiveness. One embodiment uses electrodes placed in the brain to measure EEG or local field potential (LFP) signals, from which the one or more biomarkers may be determined.
摘要翻译：用于治疗患有运动障碍的患者的方法，装置和系统，其具有确定指示疾病状态的一种或多种生物标志物的能力。在一些实施方案中，生物标志物可以用作闭环反馈信号以控制治疗的递送（例如电刺激或药物治疗），并且其也可以用作治疗有效性的指示。一个实施例使用放置在脑中的电极来测量EEG或局部场电位（LFP）信号，从该信号可以确定一个或多个生物标志物。

95. 发明申请

US20120109099A1 IMPLANTABLE MEDICAL PUMP DIAGNOSTICS 有权
标题翻译：可植入医用泵诊断
公开(公告)号：US20120109099A1
公开(公告)日：2012-05-03
申请号：US12916720
申请日：2010-11-01
申请人： Charles R. Rogers , Irfan Z. Ali , Ronald L. Mezera , Keith A. Miesel , Scott A. Sarkinen , Nicholas R. Whitehead
发明人： Charles R. Rogers , Irfan Z. Ali , Ronald L. Mezera , Keith A. Miesel , Scott A. Sarkinen , Nicholas R. Whitehead
IPC分类号： A61M5/142
CPC分类号： A61M5/16809 , A61M5/14216 , A61M5/14276 , A61M2005/16863 , A61M2005/16868 , A61M2005/16872
摘要： A method of detecting a fault condition within an implantable medical pump comprises delivering therapeutic fluid using a medical pump comprising an actuation mechanism configured to be energized to provide a pump stroke, detecting a property associated with energizing the actuation mechanism, and determining whether the property associated with energizing the actuation mechanism indicates that a fault condition exists with the medical pump.
摘要翻译：检测可植入医疗泵内的故障状况的方法包括使用医用泵递送治疗流体，所述医疗泵包括致动机构，所述致动机构被配置为通电以提供泵行程，检测与致动机构通电相关联的属性，以及确定属性是否相关联通过致动机构通电，指示医疗泵存在故障状况。

96. 发明授权

US08121694B2 Therapy control based on a patient movement state 有权
标题翻译：基于患者运动状态的治疗控制
公开(公告)号：US08121694B2
公开(公告)日：2012-02-21
申请号：US12237799
申请日：2008-09-25
申请人： Gregory F. Molnar , Steven S. Gill , Keith A. Miesel , Mark S. Lent , Timothy J. Denison , Eric J. Panken , Carl D. Wahlstrand , Jonathan C. Werder
发明人： Gregory F. Molnar , Steven S. Gill , Keith A. Miesel , Mark S. Lent , Timothy J. Denison , Eric J. Panken , Carl D. Wahlstrand , Jonathan C. Werder
IPC分类号： A61N1/18
CPC分类号： A61B5/04014 , A61B5/0006 , A61B5/4082 , A61B5/6814 , A61N1/36003 , A61N1/36014 , A61N1/36025 , A61N1/36067 , A61N1/36082
摘要： A movement state of a patient is detected based on brain signals, such as an electroencephalogram (EEG) signal. In some examples, a brain signal within a dorsal-lateral prefrontal cortex of a brain of the patient indicative of prospective movement of the patient may be sensed in order to detect the movement state. The movement state may include the brain state that indicates the patient is intending on initiating movement, initiating movement, attempting to initiate movement or is actually moving. In some examples, upon detecting the movement state, a movement disorder therapy is delivered to the patient. In some examples, the therapy delivery is deactivated upon detecting the patient is no longer in a movement state or that the patient has successfully initiated movement. In addition, in some examples, the movement state detected based on the brain signals may be confirmed based on a signal from a motion sensor.
摘要翻译：基于诸如脑电图（EEG）信号的脑信号检测患者的运动状态。在一些示例中，可以检测指示患者的预期运动的患者的脑的背侧前额叶皮层内的脑信号，以便检测运动状态。运动状态可以包括指示患者打算启动运动，启动运动，尝试启动运动或实际运动的脑状态。在一些示例中，在检测到运动状态时，将运动障碍治疗递送给患者。在一些示例中，在检测到患者不再处于运动状态或患者已成功启动运动时，治疗递送被停用。此外，在一些示例中，可以基于来自运动传感器的信号来确认基于脑信号检测到的运动状态。

97. 发明授权

US08068910B2 Flexible tube sensor for sensing urinary sphincter pressure 有权
标题翻译：柔性管传感器用于感测尿路括约肌压力
公开(公告)号：US08068910B2
公开(公告)日：2011-11-29
申请号：US11116952
申请日：2005-04-28
申请人： Martin T. Gerber , Keith A. Miesel
发明人： Martin T. Gerber , Keith A. Miesel
IPC分类号： A61N1/00
CPC分类号： A61N1/36007 , A61B5/0031 , A61B5/076 , A61B5/202 , A61B5/205 , A61B5/6882
摘要： The disclosure describes a therapeutic sphincter control system with a fluid tube pressure sensor. The system senses sphincter pressure and sends the information to a stimulator that is capable of stimulation therapy to control sphincter contractility, thus reducing unwanted urinary incontinence. Measuring sphincter pressure is accomplished through the use of a fluid-filled tube placed through the sphincter and attached to a module implanted within the bladder. Pressure within the tube is transduced to generate an electrical signal that is sent wirelessly to an implanted stimulator connected to a lead positioned near pelvic floor nerves. An external device may be used to wirelessly send information to the implanted stimulator and inhibit stimulation in order for the patient to empty the bladder. Pressure information and stimulation information may be recorded and reviewed for continued patient monitoring. In addition, the system may only include the pressure sensor to monitor patient pressure information.
摘要翻译：本公开描述了具有流体管压力传感器的治疗括约肌控制系统。该系统感测括约肌压力，并将信息发送到能够刺激治疗的刺激器以控制括约肌收缩力，从而减少不必要的尿失禁。测量括约肌压力是通过使用通过括约肌放置的流体填充管并附接到植入膀胱内的模块来实现的。所述管内的压力被传导以产生电信号，所述电信号被无线地发送到连接到靠近盆底神经的引线的植入刺激器。外部设备可以用于向植入的刺激器无线地发送信息并抑制刺激以使患者清空膀胱。可以记录和审查压力信息和刺激信息以进行持续的患者监测。另外，该系统可能只包括用于监测患者压力信息的压力传感器。

98. 发明授权

US08016776B2 Wearable ambulatory data recorder 有权
标题翻译：可佩戴的卧床数据记录仪
公开(公告)号：US08016776B2
公开(公告)日：2011-09-13
申请号：US11413619
申请日：2006-04-28
申请人： Duane Bourget , Keith A. Miesel , Gregory F. Molnar
发明人： Duane Bourget , Keith A. Miesel , Gregory F. Molnar
IPC分类号： A61B5/103
CPC分类号： A61N1/08 , A61B5/0002 , A61B5/0031 , A61B5/0402 , A61B5/0476 , A61B5/0488 , A61B5/08 , A61B5/1116 , A61B5/1118 , A61B5/112 , A61B5/145 , A61B5/4082 , A61B5/4809 , A61B5/4815 , A61B5/4839 , A61B5/6831 , A61B5/6833 , A61B2560/0223 , A61B2560/0412 , A61B2560/0431 , A61B2562/0219 , A61N1/36021 , A61N1/36071 , A61N1/3702 , G06F19/00 , G06F19/3456 , G06F19/3481 , G16H10/60 , G16H40/63
摘要： A wearable ambulatory data recorder that senses physiological parameters of a patient, and stores physiological parameter data for later retrieval, as well as techniques for using such a wearable ambulatory data recorder, are described. The data recorder includes one or more sensors located on or within a housing. The data recorder may include an adhesive layer for attachment to a patient. In some embodiments, the housing may be within a patch, e.g., bandage, which includes the adhesive layer. The housing may be waterproof. Features of the data recorder such as size, waterproofness, and inclusion of an adhesive may allow the data recorder to be unobtrusively worn by a patient during a variety of daily activities. The data recorder may be for single use and thereafter disposable.
摘要翻译：描述了感测患者的生理参数并存储用于稍后检索的生理参数数据的可穿戴式步行数据记录器，以及使用这种可穿戴式可动态数据记录器的技术。数据记录器包括位于壳体上或壳体内的一个或多个传感器。数据记录器可以包括用于附接到患者的粘合剂层。在一些实施例中，壳体可以在包括粘合剂层的贴片（例如绷带）内。外壳可能是防水的。诸如尺寸，防水性和包含粘合剂的数据记录器的特征可允许数据记录器在各种日常活动期间被患者不佩服地佩戴。数据记录器可以是单次使用的，然后是一次性的。

99. 发明授权

US07957809B2 Closed-loop therapy adjustment 有权
标题翻译：闭环治疗调整
公开(公告)号：US07957809B2
公开(公告)日：2011-06-07
申请号：US11607454
申请日：2006-12-01
申请人： Duane Bourget , Keith A. Miesel
发明人： Duane Bourget , Keith A. Miesel
IPC分类号： A61N1/00
CPC分类号： A61N1/37252 , A61N1/36021 , A61N1/36071 , A61N1/37247
摘要： Techniques for detecting a value of a sensed patient parameter, and automatically delivering therapy to a patient according to therapy information previously associated with the detected value, are described. In exemplary embodiments, a medical device receives a therapy adjustment from the patient. In response to the adjustment, the medical device associates a sensed value of a patient parameter with therapy information determined based on the adjustment. Whenever the parameter value is subsequently detected, the medical device delivers therapy according to the associated therapy information. In this manner, the medical device may “learn” to automatically adjust therapy in the manner desired by the patient as the sensed parameter of the patient changes. Exemplary patient parameters that may be sensed for performance of the described techniques include posture, activity, heart rate, electromyography (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), temperature, respiration rate, and pH.
摘要翻译：描述了用于检测感测到的患者参数的值并根据先前与检测值相关联的治疗信息自动地向患者递送治疗的技术。在示例性实施例中，医疗设备从患者接收治疗调节。响应于调整，医疗设备将感测到的患者参数值与基于调整确定的治疗信息相关联。每当随后检测到参数值时，医疗装置根据相关联的治疗信息递送治疗。以这种方式，当患者的感测参数改变时，医疗设备可以“学习”以患者期望的方式自动调整治疗。可以感测用于执行所述技术的示例性患者参数包括姿势，活动，心率，肌电图（EMG），脑电图（EEG），心电图（ECG），温度，呼吸速率和pH。

100. 发明申请

US20110082522A1 CLOSED-LOOP THERAPY ADJUSTMENT 有权
公开(公告)号：US20110082522A1
公开(公告)日：2011-04-07
申请号：US12966827
申请日：2010-12-13
申请人： Duane Bourget , Keith A. Miesel
发明人： Duane Bourget , Keith A. Miesel
IPC分类号： A61N1/36
CPC分类号： A61N1/37247 , A61N1/36014 , A61N1/36071 , A61N1/37252
摘要： Techniques for detecting a value of a sensed patient parameter, and automatically delivering therapy to a patient according to therapy information previously associated with the detected value, are described. In exemplary embodiments, a medical device receives a therapy adjustment from the patient. In response to the adjustment, the medical device associates a sensed value of a patient parameter with therapy information determined based on the adjustment. Whenever the parameter value is subsequently detected, the medical device delivers therapy according to the associated therapy information. In this manner, the medical device may “learn” to automatically adjust therapy in the manner desired by the patient as the sensed parameter of the patient changes. Exemplary patient parameters that may be sensed for performance of the described techniques include posture, activity, heart rate, electromyography (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), temperature, respiration rate, and pH.

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