2 resultados para Anomalies du rythme cardiaque foetal
em AMS Tesi di Dottorato - Alm@DL - Università di Bologna
Resumo:
La tesi è incentrata sull'analisi dell'organizzazione retorica della prosa di Giorgio Manganelli, indagando il sistema ritmico attraverso il quale l'autore è in grado di creare un fluire sintattico che sfugge alle classificazioni di genere. Per Manganelli, infatti, il linguaggio è solamente organizzazione di se stesso, e perciò la scrittura ruota attorno a un centro narrativo vuoto, dissimulando l'assenza di necessità. Egli è un retore puntuale dotato di una straordinaria abilità compositiva, che gli consente di mettere in scena l'ambiguità insita nella retorica. Per affrontare questa analisi è stato opportuno avvalersi della critique du rythme ideata da Henri Meschonnic, a partire dalle riflessioni di Emile Benveniste sul concetto eracliteo di ritmo, poiché essa fornisce una prospettiva duttile, dinamica e svincolata da pregiudizi critici. Meschonnic infatti considera il ritmo non come schema metrico ma in quanto organizzazione del senso nel discorso, volto alla signifiance del testo. In quest'ottica si è tentato di costruire un percorso attraverso le opere di Manganelli per descrivere il sistema retorico su cui si fonda la sua scrittura, a partire dai materiali del suo laboratorio (poesie, prose, appunti di diario, scambi epistolari) fino all'ideazione di discorsi pseudo-teologici che si presentano come allegoria stessa della scrittura. Si sono analizzati in particolare la trasposizione letteraria della tecnica musicale della variazione in Nuovo commento (1969), e il ritmo del periodo ipotetico in Rumori o voci (1987), testo emblematico della ricerca di Manganelli sulle potenzialità del linguaggio. Infine la prosa manganelliana è stata messa a confronto con quella di altri importanti autori italiani del Novecento (Pavese, Gadda, Camporesi, Celati), al fine di comparare tra loro diverse organizzazioni ritmiche del linguaggio, e ricollocando così Manganelli al centro del panorama letterario italiano con tutta la sua eversiva marginalità.
Resumo:
Monitoring foetal health is a very important task in clinical practice to appropriately plan pregnancy management and delivery. In the third trimester of pregnancy, ultrasound cardiotocography is the most employed diagnostic technique: foetal heart rate and uterine contractions signals are simultaneously recorded and analysed in order to ascertain foetal health. Because ultrasound cardiotocography interpretation still lacks of complete reliability, new parameters and methods of interpretation, or alternative methodologies, are necessary to further support physicians’ decisions. To this aim, in this thesis, foetal phonocardiography and electrocardiography are considered as different techniques. Further, variability of foetal heart rate is thoroughly studied. Frequency components and their modifications can be analysed by applying a time-frequency approach, for a distinct understanding of the spectral components and their change over time related to foetal reactions to internal and external stimuli (such as uterine contractions). Such modifications of the power spectrum can be a sign of autonomic nervous system reactions and therefore represent additional, objective information about foetal reactivity and health. However, some limits of ultrasonic cardiotocography still remain, such as in long-term foetal surveillance, which is often recommendable mainly in risky pregnancies. In these cases, the fully non-invasive acoustic recording, foetal phonocardiography, through maternal abdomen, represents a valuable alternative to the ultrasonic cardiotocography. Unfortunately, the so recorded foetal heart sound signal is heavily loaded by noise, thus the determination of the foetal heart rate raises serious signal processing issues. A new algorithm for foetal heart rate estimation from foetal phonocardiographic recordings is presented in this thesis. Different filtering and enhancement techniques, to enhance the first foetal heart sounds, were applied, so that different signal processing techniques were implemented, evaluated and compared, by identifying the strategy characterized on average by the best results. In particular, phonocardiographic signals were recorded simultaneously to ultrasonic cardiotocographic signals in order to compare the two foetal heart rate series (the one estimated by the developed algorithm and the other provided by cardiotocographic device). The algorithm performances were tested on phonocardiographic signals recorded on pregnant women, showing reliable foetal heart rate signals, very close to the ultrasound cardiotocographic recordings, considered as reference. The algorithm was also tested by using a foetal phonocardiographic recording simulator developed and presented in this research thesis. The target was to provide a software for simulating recordings relative to different foetal conditions and recordings situations and to use it as a test tool for comparing and assessing different foetal heart rate extraction algorithms. Since there are few studies about foetal heart sounds time characteristics and frequency content and the available literature is poor and not rigorous in this area, a data collection pilot study was also conducted with the purpose of specifically characterising both foetal and maternal heart sounds. Finally, in this thesis, the use of foetal phonocardiographic and electrocardiographic methodology and their combination, are presented in order to detect foetal heart rate and other functioning anomalies. The developed methodologies, suitable for longer-term assessment, were able to detect heart beat events correctly, such as first and second heart sounds and QRS waves. The detection of such events provides reliable measures of foetal heart rate, potentially information about measurement of the systolic time intervals and foetus circulatory impedance.