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81. 发明授权

US08688221B2 Collecting posture and activity information to evaluate therapy 有权
标题翻译：收集姿势和活动信息以评估治疗
公开(公告)号：US08688221B2
公开(公告)日：2014-04-01
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： A61N1/36
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。

82. 发明授权

US08561460B2 Ratiometric plunger assembly for volume sensing applications 有权
标题翻译：用于体积感应应用的比例式柱塞组件
公开(公告)号：US08561460B2
公开(公告)日：2013-10-22
申请号：US13269088
申请日：2011-10-07
申请人： Keith A. Miesel
发明人： Keith A. Miesel
IPC分类号： G01F17/00 , G01L9/12 , A61M37/00 , A61M31/00
CPC分类号： A61M5/1684 , A61M5/14 , A61M5/14276 , A61M2205/3317 , G01F17/00 , G01F23/14
摘要： A volume sensing system for use in determining a volume of a variable volume reservoir can include a lower plunger that can have a first end adapted to move with a bottom of the reservoir. An upper plunger can be slidable relative to the lower plunger. A lower biasing member can be positioned substantially between a base of the reservoir and the upper plunger, and the upper biasing member can be positioned between the upper plunger and an interference member. The upper biasing member can have a predetermined stiffness relative to the lower biasing member such that upon movement of the lower plunger, the upper plunger can move at a predetermined fraction of the amount of movement of the lower plunger, where the predetermined fraction can be determined at least in part by the predetermined stiffness of the upper biasing member relative to the lower biasing member.
摘要翻译：用于确定可变体积储存器的体积的体积感测系统可以包括下部柱塞，其可以具有适于与储存器的底部一起移动的第一端。上柱塞可相对于下柱塞滑动。下偏压构件可以基本上位于储存器的底部和上柱塞之间，并且上偏压构件可以定位在上柱塞和干涉构件之间。上偏置构件可以具有相对于下偏压构件的预定刚度，使得在下柱塞移动时，上柱塞可以以下柱塞移动量的预定分数移动，其中可确定预定分数至少部分地由上偏置构件相对于下偏置构件的预定刚度。

83. 发明授权

US08337431B2 Collecting activity and sleep quality information via a medical device 有权
标题翻译：通过医疗设备收集活动和睡眠质量信息
公开(公告)号：US08337431B2
公开(公告)日：2012-12-25
申请号：US12351414
申请日：2009-01-09
申请人： Kenneth T. Heruth , Keith A. Miesel
发明人： Kenneth T. Heruth , Keith A. Miesel
IPC分类号： A61B5/103 , A61B5/117
CPC分类号： A61B5/1116 , A61B5/1118 , A61B5/4519 , A61B5/4815 , A61B5/6826 , A61B5/686 , A61N1/36135 , A61N1/36542
摘要： A device, such as an implantable medical device (IMD) or a programming device, determines when a patient is attempting to sleep. When the device determines that the patient is attempting to sleep, the device determines values for one or more metrics that indicate the quality of a patient's sleep based on at least one physiological parameter of the patient. When the device determines that the patient is not attempting to sleep, the device periodically determines activity levels of the patient. Activity metric values may be determined based on the determined activity levels. A clinician may use sleep quality information and patient activity information presented by a programming device to, for example, evaluate the effectiveness of therapy delivered to the patient by the medical device.
摘要翻译：诸如可植入医疗装置（IMD）或编程装置之类的装置确定患者何时试图睡觉。当设备确定患者正在尝试睡眠时，设备基于患者的至少一个生理参数来确定指示患者睡眠质量的一个或多个度量的值。当设备确定患者没有尝试睡眠时，设备周期性地确定患者的活动水平。活动度量值可以基于确定的活动水平来确定。临床医生可以使用由编程设备呈现的睡眠质量信息和患者活动信息，以例如评估由医疗设备递送给患者的治疗的有效性。

84. 发明授权

US08335568B2 Controlling therapy based on sleep quality 有权
标题翻译：基于睡眠质量控制治疗
公开(公告)号：US08335568B2
公开(公告)日：2012-12-18
申请号：US12544727
申请日：2009-08-20
申请人： Kenneth T. Heruth , Keith A. Miesel
发明人： Kenneth T. Heruth , Keith A. Miesel
IPC分类号： A61N1/18
CPC分类号： A61M5/14276 , A61B5/02 , A61B5/04 , A61B5/4815 , A61M5/1723 , A61M2230/06 , A61M2230/63 , A61N1/36071 , A61N1/365 , A61N1/36521 , A61N1/36542 , A61N1/36557
摘要： A medical device, such as an implantable medical device (IMD), determines values for one or more metrics that indicate the quality of a patient's sleep, and controls delivery of a therapy based on the sleep quality metric values. For example, the medical device may compare a sleep quality metric value with one or more threshold values, and adjust the therapy based on the comparison. In some embodiments, the medical device adjusts the intensity of therapy based on the comparison, e.g., increases the therapy intensity when the comparison indicates that the patient's sleep quality is poor. In some embodiments, the medical device automatically selects one of a plurality of therapy parameter set available for use in delivering therapy based on a comparison sleep quality metric values associated with respective therapy parameter sets within the plurality of available therapy parameter sets.
摘要翻译：诸如可植入医疗装置（IMD）的医疗设备确定指示患者睡眠质量的一个或多个指标的值，并且基于睡眠质量量度值控制治疗的递送。例如，医疗设备可以将睡眠质量度量值与一个或多个阈值进行比较，并且基于比较来调整治疗。在一些实施例中，医疗装置基于比较来调整治疗的强度，例如当比较表明患者的睡眠质量差时，增加治疗强度。在一些实施例中，医疗设备基于与多个可用治疗参数组内的各个治疗参数组相关联的比较睡眠质量量度值，自动选择可用于递送治疗的多个治疗参数集中的一个。

85. 发明授权

US08246573B2 Detecting empty medical pump reservoir 有权
标题翻译：检测空的医用泵水箱
公开(公告)号：US08246573B2
公开(公告)日：2012-08-21
申请号：US12768336
申请日：2010-04-27
申请人： Irfan Z. Ali , Keith A. Miesel , Scott L. Kalpin , Scott A. Sarkinen
发明人： Irfan Z. Ali , Keith A. Miesel , Scott L. Kalpin , Scott A. Sarkinen
IPC分类号： A61M31/00 , F04B49/06 , F04B7/00 , A61B5/103
CPC分类号： A61M5/14276 , A61B5/1116 , A61M5/14212 , A61M5/172 , A61M2205/18 , A61M2205/3317 , A61M2205/50
摘要： A medical device system comprises a reservoir configured to store a therapeutic fluid and a medical pump configured to deliver the therapeutic fluid from the reservoir to a patient. The system also comprises a sensor that can detect a characteristic associated with the pump and a processor to determine if the characteristic detected indicates the reservoir is empty or near empty. The characteristic may comprise a property associated with the energization of an actuation mechanism configured to be energized to provide a pump stroke. The characteristic may also comprise a characteristic of a noise made by an actuator within the pump at the end of a pump stroke.
摘要翻译：医疗设备系统包括被配置为存储治疗流体的储存器和被配置为将治疗流体从储存器输送到患者的医用泵。该系统还包括可以检测与泵相关联的特征的传感器和处理器，以确定检测到的特征是否指示储存器为空或接近空。特征可以包括与致动机构的通电相关联的特性，该致动机构配置成被激励以提供泵冲程。特征还可以包括在泵冲程结束时由泵内的致动器产生的噪声的特性。

86. 发明授权

US08118748B2 Implantable capacitive pressure sensor system and method 有权
标题翻译：可植入电容式压力传感器系统及方法
公开(公告)号：US08118748B2
公开(公告)日：2012-02-21
申请号：US11116804
申请日：2005-04-28
申请人： Michael A. Schugt , Keith A. Miesel , Jeremy W. Burdon , Eric H. Bonde
发明人： Michael A. Schugt , Keith A. Miesel , Jeremy W. Burdon , Eric H. Bonde
IPC分类号： A61B5/02
CPC分类号： A61B5/0215 , H01L2224/48227 , H01L2924/15192
摘要： Embodiments of the invention provide systems and methods for an implantable capacitive pressure sensor. Some embodiments of the invention include a capacitive pressure sensor capsule comprising a substrate, a conductive plate functionally coupled to the substrate, a conductive diaphragm spaced from the conductive plate and functionally coupled to the substrate, a lid hermetically sealed against the substrate, and pressure sensing circuitry disposed within a volume generally defined by the lid and the substrate. Embodiments of the invention also include a lead provided with an implantable pressure sensor capsule and a method of manufacturing a capacitive pressure sensor capsule.
摘要翻译：本发明的实施例提供了一种用于可植入电容式压力传感器的系统和方法。本发明的一些实施例包括电容式压力传感器胶囊，其包括基底，功能性地连接到基底的导电板，与导电板隔开并功能耦合到基底的导电隔膜，密封地密封在基底上的盖，以及压力感测设置在通常由盖和基板限定的体积内的电路。本发明的实施例还包括具有可植入压力传感器胶囊的引线和制造电容式压力传感器胶囊的方法。

87. 发明申请

US20120041510A1 FLEXIBLE TUBE SENSOR FOR SENSING URINARY SPHINCTER PRESSURE 有权
标题翻译：柔性管传感器用于感应尿素压力
公开(公告)号：US20120041510A1
公开(公告)日：2012-02-16
申请号：US13279826
申请日：2011-10-24
申请人： Martin T. Gerber , Keith A. Miesel
发明人： Martin T. Gerber , Keith A. Miesel
IPC分类号： A61N1/36
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。

88. 发明申请

US20120035496A1 BLADDER SENSING USING IMPEDANCE AND POSTURE 有权
标题翻译：使用阻力和姿态进行刮板感应
公开(公告)号：US20120035496A1
公开(公告)日：2012-02-09
申请号：US13264023
申请日：2010-04-20
申请人： Timothy J. Denison , Keith A. Miesel
发明人： Timothy J. Denison , Keith A. Miesel
IPC分类号： A61B5/053
CPC分类号： A61N1/36007 , A61B5/053 , A61B5/1116 , A61B5/204 , A61B5/686 , A61B5/6883 , A61B5/7203 , A61B2560/0462 , A61B2562/0219
摘要： This disclosure provides techniques for bladder sensing. In accordance with the techniques described in this disclosure, a device may measure the impedance of a bladder, determine the posture of a patient, and determine a status of the bladder based on the impedance and posture.
摘要翻译：本公开提供了用于膀胱感测的技术。根据本公开中描述的技术，装置可以测量膀胱的阻抗，确定患者的姿势，并且基于阻抗和姿势来确定膀胱的状态。

89. 发明授权

US08083730B2 Implantable therapeutic substance delivery device with reservoir volume sensor 有权
标题翻译：具有储液容量传感器的可植入治疗物质输送装置
公开(公告)号：US08083730B2
公开(公告)日：2011-12-27
申请号：US11413302
申请日：2006-04-28
申请人： Keith A. Miesel
发明人： Keith A. Miesel
IPC分类号： A61K9/22 , A61M37/00 , A61M1/00 , A61M31/00 , G01F17/00
CPC分类号： A61M5/14276 , A61F2/022 , A61M2205/3317 , A61M2205/3379 , A61M2205/3389 , A61M2209/045
摘要： An implantable medical device for delivering a therapeutic substance including a housing and a volume sensor assembly. The housing includes a stationary wall and maintains a reservoir containing the therapeutic substance and including a base wall movable relative to the stationary wall such that reservoir volume is a function of a spacing between the base wall and the stationary wall. The volume sensor assembly includes a cap, a shaft, a target, and circuitry. The cap defines a passage extending from an open end, and is mounted to the stationary wall such that the open end is open relative to a stationary wall inner face. The shaft has a first end attached to the base wall and a second end maintaining the target otherwise movably arranged within the passage. The circuitry generates information indicative of a longitudinal position of the target relative to the cap, and thus of the reservoir volume.
摘要翻译：一种用于输送包括壳体和体积传感器组件的治疗物质的可植入医疗装置。壳体包括固定壁并且保持容纳治疗物质的储存器并且包括相对于静止壁可移动的底壁，使得储存器容积是基壁和固定壁之间的间隔的函数。体积传感器组件包括盖，轴，靶和电路。盖限定了从开口端延伸的通道，并且安装到固定壁，使得开口端相对于固定壁内表面敞开。轴具有附接到基壁的第一端和保持目标的第二端，否则可移动地布置在通道内。电路产生指示靶相对于盖的纵向位置的信息，因此产生储存器容积的信息。

90. 发明申请

US20110313261A1 WEARABLE AMBULATORY DATA RECORDER 有权
标题翻译：耐用的数据记录仪
公开(公告)号：US20110313261A1
公开(公告)日：2011-12-22
申请号：US13217011
申请日：2011-08-24
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 , A61B5/04 , A61B5/00
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动态数据记录器以及用于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。

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