Detektion neuroaktiver Substanzen durch Modifikation des Aktivitätsmusters neokortikaler Netzwerke auf Multielektrodenarrays – Charakterisierung und Optimierung eines neuronalen Biosensors

In dieser Arbeit wurden kortikale neuronale Netzwerke auf Multielektrodenarrays auf ihre Tauglichkeit als zellbasiertes Biosensorsystem untersucht. Der Schwerpunkt der pharmakologischen Untersuchungen an den ausgereiften kortikalen Netzwerken lag auf dem Einsatz von Substanzen, welche auf den GABAA-Rezeptor einwirken. Die Modifikation des spontan generierten Aktivitätsmusters ließ dabei Rückschlüsse auf die Wirksamkeit und den Wirkungsmechanismus der Testsubstanzen zu. Ferner war in den meisten Fällen eine Diskriminierung der auf den gleichen Rezeptor einwirkenden Substanzen möglich. Die Analyse der Spikerate und verschiedener auf Bursts beruhender Messparameter machte deutlich, dass die Burstrate bei den extrazellulären Ableitungen auf Netzwerkebene den sensitivsten und verlässlichsten Parameter zum Nachweis der Substanzeffekte darstellte. Durch die Verwendung kortikaler Netzwerke unter optimierten Kulturbedingungen und einer auf das System abgestimmten Analysesoftware konnte die Reproduzierbarkeit und Sensitivität im Vergleich zu anderen Studien deutlich verbessert werden. Um die extrazelluläre Signalableitung von einer möglichst geringen Zellanzahl und damit einem überschaubaren zellulären Netzwerk auf Multielektrodenarrays zu ermöglichen, wurden die Oberflächeneigenschaften der Substrate so modifiziert, dass die Lokalisation der Zellsomata und das Auswachsen der Neurite einer geometrischen Kontrolle unterlag. Die kontrollierte Substratbeschichtung des Adhäsionspromotors Poly-D-Lysin in einem triangulären Muster konnte dabei durch die Methode des Mikrokontaktstempelns realisiert werden. Durch das kontrollierte Zellwachstum konnte die extrazelluläre Ableitung von Netzwerken einer geringen Zelldichte über einen Zeitraum von mehreren Wochen ermöglicht werden. Die Untersuchung struktureller und morphogenetischer Eigenschaften, sowie elektrophysiologische Untersuchungen der strukturierten Netzwerke bewiesen, dass die kontrollierte Substratbeschichtung sich nicht negativ auf das Wachstum, die Synaptogenese und die Funktionalität auswirkte.

Análisis de la actividad física competitiva en jugadores de fútbol de un equipo de excelencia

OBJETIVO: Esta tesis doctoral pretende analizar el rendimiento en fútbol desde un punto de vista físico de los jugadores de un equipo de excelencia (EE). Se entiende como EE a un equipo que presenta un prolongado bagaje de éxitos nacionales e internacionales a lo largo de varios años. MÉTODO: Se utilizó el sistema de registro (AMISCO) de la actividad del jugador de fútbol en competición (distancia total recorrida, distancias a distintas velocidades, y número de sprints) analizando a lo largo de seis temporadas continuada la actividad de jugadores de élite (N=2082), siendo 1051 pertenecientes al EE y 1031 a jugadores de los equipos rivales (ER). RSULTADO: El perfil de actividad (distancia total, distancia en distintas velocidades y nº de sprints) de los jugadores del EE muestran valores inferiores al de los jugadores de los ER. De igual forma ocurre en cada una de las partes del partido, el puesto específico de juego de los jugadores en las distintas temporadas analizadas y en los distintos meses de la temporada. El EE registra una mayor actividad (distancia total recorrida en el partido, distancia recorrida en velocidades altas V>17 km/h y nº de Sprints) cuando juega de local a cuando lo hace como visitante. Asimismo EE muestra demandas superiores de exigencia física en la competición europea (Champions League) frente a la Liga en la distancia total recorrida en el partido y a velocidades bajas (V<17 km/h), mientras que apenas muestra diferencias en los indicadores de exigencia física cuando se enfrenta a los equipos rivales de distinto nivel de rendimiento, exceptuando en la distancia recorrida andando (V=01-11 km/h) con diferencias significativas superiores cuando el nivel del oponente es de Máxima dificultad frente a Elevada dificultad (p<.01) o Media dificultad (p<.01). En función del estilo de juego se registran diferencias en la distancia total recorrida en el partido, en velocidades bajas (V<17 km/h) y en el nº de Sprints (V>24 km/h). Por último, el perfil de actividad del EE no se ve influenciado por el efecto de estar sometido a una alta densidad competitiva (jugar un partido entre semana). Se constata como un jugador de un EE está supeditado no sólo a las exigencias del puesto específico sino también está sujeta a las características propias del jugador al desempeñar el rol o función táctica encomendada. Esta influencia es más evidente en jugadores que ocupan puestos específicos avanzados. CONCLUSION: La presente investigación aporta la caracterización de la actividad de los jugadores de un EE frente al perfil de actividad de sus rivales, mostrando un nivel de respuesta específica y diferente, más estable frente a determinadas variables contextuales y donde la exigencia física en el puesto específico se ve condicionada por las características individuales del jugador, todos estos aspectos pueden ayudar a la hora de planificar el entrenamiento en este tipo de equipos. ABSTRACT OBJETIVE: This doctoral thesis aims to analyze the performance in football from a physical point of view on a team of excellence. METHOD: The registration system (AMISCO) activity soccer player in competition (total distance traveled distances at different speeds, and number of sprints) was used to analyze over six seasons continued activity elite players (N = 2082), with 1051 belonging to Team Excellence (EE) and 1031 players from rival teams (ER). RESULT: The competitive physical response of the US players are analyzed and compared with that of ER. The activity profile (total distance, distance at different speeds and number of sprints) of EE players shown below players ER values. The same occurs in each of the parts of the game, the specific game since players analyzed in different seasons and in different months of the season. The EE recorded increased activity (total distance traveled in the match, distance at high speeds V> 17 km / h and sprints number) when playing a local when it does on the road. EE also shows higher demands physical demands in European competition (Champions League) against the League in the total distance traveled in the party and at low speeds (V <17 km / h), while just shows differences in indicators of demand physics when the opposing teams with different levels of performance faces, except in the distance walked (V = 01-11 km / h) with significant differences when higher level Maximum opponent is facing difficulty High difficulty (p < .01) or Medium difficulty (p <.01). Depending on the style of play differences are recognized in the total distance traveled in the party, at low speeds (V <17 km / h) and the number of Sprints (V> 24 km / h). Finally, the activity profile of EE is not influenced by the effect of being subjected to a high competitive density (play a game during the week). It is found as a player on a team of Excellence is subject not only to the requirements of the specific position but is also subject to the characteristics of the player to play the role or function entrusted tactics. This influence is most evident in advanced players who occupy specific positions. CONCLUSION: This research provides the characterization of the activity of EE players versus activity profile of its rivals, showing a level of response specific and different, more stable against certain contextual variables and where the physical demands on the specific position is conditioned by the individual characteristics of the player, all these aspects can help in planning training in this type of equipment.

A GESTÃO EDUCATIVO-CULTURAL PARA A TERCEIRA IDADE. A EXPERIÊNCIA DO SESC PAULISTA

É evidente a vida mais ativa do idoso assim como a necessidade de espaços que possam oferecer momentos de lazer, cultura, interação e estudo por parte deste grupo. Entendendo isto, este trabalho tem o intuito de estudar dentro do SESC paulista o departamento voltado à terceira idade, a chamada GETI (Gerência de Estudos e Programas para Terceira Idade). Procura-se criar uma linha histórica clara que aborda sua criação, estrutura, forma de gestão e principais ações com o idoso. Busca-se o entendimento do SESC como um possível perfil de atividade do Terceiro Setor. A fim de se verificar a eficácia das ações desenvolvidas, o trabalho estuda o modus operandi de três unidades que hoje possuem o chamado TSI (Trabalho Social com o Idoso) por meio do entendimento da forma de elaboração destas ações pelos coordenadores destas unidades e o resultado deste trabalho pelo olhar do idoso freqüentador. A busca de informações e pesquisa deu-se através de dados secundários provenientes de levantamento bibliográfico e documental em fontes públicas, como o próprio acervo do SESC, além de pesquisas recentes sobre o idoso, como a da Fundação Perseu Abramo. Por meio deste levantamento buscouse analisar o programa, sua metodologia, diretrizes e peculiaridades. A fim de se detalhar a análise, trabalhou-se com uma pesquisa qualitativa descritiva que mostrou os aspectos importantes da gestão educativo-cultural para o idoso, além da pesquisa em profundidade com gerentes e coordenadores da GETI e contribuição valiosa de gerontólogos e ex colaboradores do SESC. Para que fosse possível analisar a existência ou não de divergências no entendimento destas ações para o idoso, o autor procurou identificar esta questão por meio da narrativa oral deste público. Desta forma procura-se a compreensão do tema desde a gerência do SESC até seu freqüentador.(AU)

A GESTÃO EDUCATIVO-CULTURAL PARA A TERCEIRA IDADE. A EXPERIÊNCIA DO SESC PAULISTA

É evidente a vida mais ativa do idoso assim como a necessidade de espaços que possam oferecer momentos de lazer, cultura, interação e estudo por parte deste grupo. Entendendo isto, este trabalho tem o intuito de estudar dentro do SESC paulista o departamento voltado à terceira idade, a chamada GETI (Gerência de Estudos e Programas para Terceira Idade). Procura-se criar uma linha histórica clara que aborda sua criação, estrutura, forma de gestão e principais ações com o idoso. Busca-se o entendimento do SESC como um possível perfil de atividade do Terceiro Setor. A fim de se verificar a eficácia das ações desenvolvidas, o trabalho estuda o modus operandi de três unidades que hoje possuem o chamado TSI (Trabalho Social com o Idoso) por meio do entendimento da forma de elaboração destas ações pelos coordenadores destas unidades e o resultado deste trabalho pelo olhar do idoso freqüentador. A busca de informações e pesquisa deu-se através de dados secundários provenientes de levantamento bibliográfico e documental em fontes públicas, como o próprio acervo do SESC, além de pesquisas recentes sobre o idoso, como a da Fundação Perseu Abramo. Por meio deste levantamento buscouse analisar o programa, sua metodologia, diretrizes e peculiaridades. A fim de se detalhar a análise, trabalhou-se com uma pesquisa qualitativa descritiva que mostrou os aspectos importantes da gestão educativo-cultural para o idoso, além da pesquisa em profundidade com gerentes e coordenadores da GETI e contribuição valiosa de gerontólogos e ex colaboradores do SESC. Para que fosse possível analisar a existência ou não de divergências no entendimento destas ações para o idoso, o autor procurou identificar esta questão por meio da narrativa oral deste público. Desta forma procura-se a compreensão do tema desde a gerência do SESC até seu freqüentador.(AU)

Adjustment of conformational flexibility is a key event in the thermal adaptation of proteins

3-Isopropylmalate dehydrogenase (IPMDH, E.C. 1.1.1.85) from the thermophilic bacterium Thermus thermophilus HB8 is homologous to IPMDH from the mesophilic Escherichia coli, but has an approximately 17°C higher melting temperature. Its temperature optimum is 22–25°C higher than that of the E. coli enzyme; however, it is hardly active at room temperature. The increased conformational rigidity required to stabilize the thermophilic enzyme against heat denaturation might explain its different temperature-activity profile. Hydrogen/deuterium exchange studies were performed on this thermophilic-mesophilic enzyme pair to compare their conformational flexibilities. It was found that Th. thermophilus IPMDH is significantly more rigid at room temperature than E. coli IPMDH, whereas the enzymes have nearly identical flexibilities under their respective optimal working conditions, suggesting that evolutionary adaptation tends to maintain a “corresponding state” regarding conformational flexibility. These observations confirm that conformational fluctuations necessary for catalytic function are restricted at room temperature in the thermophilic enzyme, suggesting a close relationship between conformational flexibility and enzyme function.

The chitinase PfCHT1 from the human malaria parasite Plasmodium falciparum lacks proenzyme and chitin-binding domains and displays unique substrate preferences

Within hours after the ingestion of a blood meal, the mosquito midgut epithelium synthesizes a chitinous sac, the peritrophic matrix. Plasmodium ookinetes traverse the peritrophic matrix while escaping the mosquito midgut. Chitinases (EC 3.2.1.14) are critical for parasite invasion of the midgut: the presence of the chitinase inhibitor, allosamidin, in an infectious blood meal prevents oocyst development. A chitinase gene, PgCHT1, recently has been identified in the avian malaria parasite P. gallinaceum. We used the sequence of PgCHT1 to identify a P. falciparum chitinase gene, PfCHT1, in the P. falciparum genome database. PfCHT1 differs from PgCHT1 in that the P. falciparum gene lacks proenzyme and chitin-binding domains. PfCHT1 was expressed as an active recombinant enzyme in Escherichia coli. PfCHT1 shares with PgCHT1 a substrate preference unique to Plasmodium chitinases: the enzymes cleave tri- and tetramers of GlcNAc from penta- and hexameric oligomers and are unable to cleave smaller native chitin oligosaccharides. The pH activity profile of PfCHT1 and its IC50 (40 nM) to allosamidin are distinct from endochitinase activities secreted by P. gallinaceum ookinetes. Homology modeling predicts that PgCHT1 has a novel pocket in the catalytic active site that PfCHT1 lacks, which may explain the differential sensitivity of PfCHT1 and PgCHT1 to allosamidin. PfCHT1 may be the ortholog of a second, as yet unidentified, chitinase gene of P. gallinaceum. These results may allow us to develop novel strategies of blocking human malaria transmission based on interfering with P. falciparum chitinase.

Peroxynitrite-mediated nitration of tyrosine residues in Escherichia coli glutamine synthetase mimics adenylylation: relevance to signal transduction.

Treatment of Escherichia coli glutamine synthetase (GS) with peroxynitrite leads to nitration of some tyrosine residues and conversion of some methionine residues to methionine sulfoxide (MSOX) residues. Nitration, but not MSOX formation, is stimulated by Fe-EDTA. In the absence of Fe-EDTA, nitration of only one tyrosine residue per subunit of unadenylylated GS leads to changes in divalent cation requirement, pH-activity profile, affinity for ADP, and susceptibility to feedback inhibition by end products (tryptophan, AMP, CTP), whereas nitration of one tyrosine residue per subunit in the adenylylated GS leads to complete loss of catalytic activity. In the presence of Fe-EDTA, nitration is a more random process: nitration of five to six tyrosine residues per subunit is needed to convert unadenylylated GS to the adenylylated configuration. These results and the fact that nitration of tyrosine residues is an irreversible process serve notice that the regulatory function of proteins that undergo phosphorylation or adenylylation in signal transduction cascades might be seriously compromised by peroxynitrite-promoted nitration.

A GESTÃO EDUCATIVO-CULTURAL PARA A TERCEIRA IDADE. A EXPERIÊNCIA DO SESC PAULISTA

É evidente a vida mais ativa do idoso assim como a necessidade de espaços que possam oferecer momentos de lazer, cultura, interação e estudo por parte deste grupo. Entendendo isto, este trabalho tem o intuito de estudar dentro do SESC paulista o departamento voltado à terceira idade, a chamada GETI (Gerência de Estudos e Programas para Terceira Idade). Procura-se criar uma linha histórica clara que aborda sua criação, estrutura, forma de gestão e principais ações com o idoso. Busca-se o entendimento do SESC como um possível perfil de atividade do Terceiro Setor. A fim de se verificar a eficácia das ações desenvolvidas, o trabalho estuda o modus operandi de três unidades que hoje possuem o chamado TSI (Trabalho Social com o Idoso) por meio do entendimento da forma de elaboração destas ações pelos coordenadores destas unidades e o resultado deste trabalho pelo olhar do idoso freqüentador. A busca de informações e pesquisa deu-se através de dados secundários provenientes de levantamento bibliográfico e documental em fontes públicas, como o próprio acervo do SESC, além de pesquisas recentes sobre o idoso, como a da Fundação Perseu Abramo. Por meio deste levantamento buscouse analisar o programa, sua metodologia, diretrizes e peculiaridades. A fim de se detalhar a análise, trabalhou-se com uma pesquisa qualitativa descritiva que mostrou os aspectos importantes da gestão educativo-cultural para o idoso, além da pesquisa em profundidade com gerentes e coordenadores da GETI e contribuição valiosa de gerontólogos e ex colaboradores do SESC. Para que fosse possível analisar a existência ou não de divergências no entendimento destas ações para o idoso, o autor procurou identificar esta questão por meio da narrativa oral deste público. Desta forma procura-se a compreensão do tema desde a gerência do SESC até seu freqüentador.(AU)

Positron emission tomography (PET) tumor segmentation and quantification: Development of new algorithms

Tumor functional volume (FV) and its mean activity concentration (mAC) are the quantities derived from positron emission tomography (PET). These quantities are used for estimating radiation dose for a therapy, evaluating the progression of a disease and also use it as a prognostic indicator for predicting outcome. PET images have low resolution, high noise and affected by partial volume effect (PVE). Manually segmenting each tumor is very cumbersome and very hard to reproduce. To solve the above problem I developed an algorithm, called iterative deconvolution thresholding segmentation (IDTS) algorithm; the algorithm segment the tumor, measures the FV, correct for the PVE and calculates mAC. The algorithm corrects for the PVE without the need to estimate camera's point spread function (PSF); also does not require optimizing for a specific camera. My algorithm was tested in physical phantom studies, where hollow spheres (0.5-16 ml) were used to represent tumors with a homogeneous activity distribution. It was also tested on irregular shaped tumors with a heterogeneous activity profile which were acquired using physical and simulated phantom. The physical phantom studies were performed with different signal to background ratios (SBR) and with different acquisition times (1-5 min). The algorithm was applied on ten clinical data where the results were compared with manual segmentation and fixed percentage thresholding method called T50 and T60 in which 50% and 60% of the maximum intensity respectively is used as threshold. The average error in FV and mAC calculation was 30% and -35% for 0.5 ml tumor. The average error FV and mAC calculation were ~5% for 16 ml tumor. The overall FV error was ∼10% for heterogeneous tumors in physical and simulated phantom data. The FV and mAC error for clinical image compared to manual segmentation was around -17% and 15% respectively. In summary my algorithm has potential to be applied on data acquired from different cameras as its not dependent on knowing the camera's PSF. The algorithm can also improve dose estimation and treatment planning.^

Relação entre desempenho funcional e indicadores de doença arterial obstrutiva periférica em idosas

The presence of peripheral arterial disease (PAD) increases the risk and vulnerability to adverse clinical outcomes in the elderly. Like this, we investigated the relationship between functional performance and indicators of PAD in elderly women. METHODS: Cross-sectional study in which 54 elderly were assessed by questionnaire mini mental state examination, Short Phisical Performance Battery (SPPB), ankle-brachial index (ABI), human activity profile (HAP) and Edinburgh questionnaire. Statistical analysis was performed using ANOVA, t test and Pearson correlation. We considered p <0.05 as significance level. RESULTS: The mean age SPPB and ABI were 69.2 (± 6.9) years, SPPB 9.42 (± 2.55) and ABI 1.04 (± 0.14). The prevalence of PAD was 16.3%. There was a significant correlation between ABI and gait speed (r = 0.75, p = 0.001) and between PAH with SPPB (p = 0.001). CONCLUSIONS: It is suggested that the decline in functional performance in older, expressed in gait velocity component of the SPPB, is related to the presence of PAD

Profil d’activité physique des enfants et adolescents diabétiques de type 1

Les patients diabétiques de type 1 (DT1) ont avantage à avoir un bon contrôle glycémique pour réduire les effets négatifs à court et long terme d’un mauvais contrôle glycémique sur leur santé. Pour contrôler leur glycémie, ils doivent prendre de l’insuline, mais il est aussi recommandé qu’ils aient de bonnes habitudes de vie comme une nutrition appropriée et une pratique adéquate d’activité physique. Par contre, les patients DT1 ne suivent généralement pas les recommandations en activité physique et une partie du problème vient de leurs barrières personnelles à un style de vie actif, telle la peur des hypoglycémies. L’utilisation de la pompe comme traitement à l’insuline aide à mieux contrôler la glycémie, plus précisément l’hémoglobine glyquée, que les injections d’insuline, et le dispositif est de plus en plus prescrit chez les enfants et adolescents. Par contre, son impact sur la pratique des activités sédentaire et physique n’est pas encore bien connu. L’objectif de la présente étude est donc de révéler le profil d’activité physique complet, incluant les barrières à l’exercice et les habitudes de vie des parents, des enfants et adolescents DT1, selon leur type de traitement à l’insuline (pompe ou injections). L’étude a été conduite à la clinique d’endocrinologie du Centre hospitalier universitaire de Sainte-Justine (Montréal, Canada). Un questionnaire auto-administré a été complété par 188 patients DT1 âgés de 6 à 17 ans et un de leurs parents. Soixante pourcent des patients étaient des utilisateurs de la pompe à insuline. Il n’y avait pas de différence significative pour aucune des composantes du profil d’activité physique, des habitudes sédentaires et des barrières à l’exercice entre les patients DT1 utilisant les injections et ceux utilisant la pompe. La peur de faire des hypoglycémies était la barrière à l’activité physique principale pour les deux groupes de traitement. Les adolescents dont les parents pratiquaient une plus grande variété d’activités physiques faisaient plus d’activité physique d’intensité moyenne à élevée et passaient moins de temps devant les écrans. En conclusion, le type de traitement n’était pas associé à un style de vie plus sain chez les patients pédiatriques DT1, mais un profil d’activité physique parental varié était le facteur principal d’intérêt pour des habitudes de vie plus saines chez les adolescents DT1.

Profil d’activité physique des enfants et adolescents diabétiques de type 1

Les patients diabétiques de type 1 (DT1) ont avantage à avoir un bon contrôle glycémique pour réduire les effets négatifs à court et long terme d’un mauvais contrôle glycémique sur leur santé. Pour contrôler leur glycémie, ils doivent prendre de l’insuline, mais il est aussi recommandé qu’ils aient de bonnes habitudes de vie comme une nutrition appropriée et une pratique adéquate d’activité physique. Par contre, les patients DT1 ne suivent généralement pas les recommandations en activité physique et une partie du problème vient de leurs barrières personnelles à un style de vie actif, telle la peur des hypoglycémies. L’utilisation de la pompe comme traitement à l’insuline aide à mieux contrôler la glycémie, plus précisément l’hémoglobine glyquée, que les injections d’insuline, et le dispositif est de plus en plus prescrit chez les enfants et adolescents. Par contre, son impact sur la pratique des activités sédentaire et physique n’est pas encore bien connu. L’objectif de la présente étude est donc de révéler le profil d’activité physique complet, incluant les barrières à l’exercice et les habitudes de vie des parents, des enfants et adolescents DT1, selon leur type de traitement à l’insuline (pompe ou injections). L’étude a été conduite à la clinique d’endocrinologie du Centre hospitalier universitaire de Sainte-Justine (Montréal, Canada). Un questionnaire auto-administré a été complété par 188 patients DT1 âgés de 6 à 17 ans et un de leurs parents. Soixante pourcent des patients étaient des utilisateurs de la pompe à insuline. Il n’y avait pas de différence significative pour aucune des composantes du profil d’activité physique, des habitudes sédentaires et des barrières à l’exercice entre les patients DT1 utilisant les injections et ceux utilisant la pompe. La peur de faire des hypoglycémies était la barrière à l’activité physique principale pour les deux groupes de traitement. Les adolescents dont les parents pratiquaient une plus grande variété d’activités physiques faisaient plus d’activité physique d’intensité moyenne à élevée et passaient moins de temps devant les écrans. En conclusion, le type de traitement n’était pas associé à un style de vie plus sain chez les patients pédiatriques DT1, mais un profil d’activité physique parental varié était le facteur principal d’intérêt pour des habitudes de vie plus saines chez les adolescents DT1.

Comparación de un programa de ejercicio intradiálisis frente a ejercicio domiciliario sobre capacidad física funcional y nivel de actividad física

Introducción: El ejercicio durante la hemodiálisis es beneficioso, aunque son pocas las unidades de hemodiálisis que ofrecen un programa de ejercicio adaptado a estos pacientes. Por ello es necesario encontrar alternativas más económicas para realizar ejercicio. El objetivo es comparar los efectos de un programa de ejercicio intradiálisis frente a ejercicio domiciliario, sobre la adherencia al programa, la capacidad física funcional y el nivel de actividad física. Métodos: 17 pacientes en hemodiálisis de un centro de Valencia fueron aleatorizados dividiéndoles en un grupo de ejercicio intradiálisis (n=9) y un grupo domiciliario (n=8). Ambos programas incluían ejercicio aeróbico y de fuerza durante 4 meses. Se valoró una amplia batería de pruebas funcionales (Short Physical Performance Battery, equilibrio monopodal, Timed Up and Go, Sit To Stand to sit test 10 y 60, dinamometría de mano, fuerza de tríceps, 6 minutos marcha) y dos cuestionarios de nivel de actividad física (Human Activity Profile y Physical Activity Scale for Elderly). Resultados: 2 pacientes del grupo intradiálisis y 5 pacientes de ejercicio domiciliario finalizaron el programa y fueron analizados. Se observó un efecto significativo del factor tiempo en el caso del Human Activity Profile (P<.017). En las pruebas funcionales no se encontró ninguna diferencia significativa. En cuanto a la adherencia al ejercicio los pacientes del grupo intradiálisis cumplieron el 92.7% y el grupo domiciliario el 68.7% del total de las sesiones. Conclusiones: En ambos grupos se observa un aumento del nivel de actividad física. Sin embargo, es necesario modificar factores, tanto en el personal sanitario como en los propios pacientes, para conseguir mayor adherencia a los programas de ejercicio.

Positron Emission Tomography (PET) Tumor Segmentation and Quantification: Development of New Algorithms

Tumor functional volume (FV) and its mean activity concentration (mAC) are the quantities derived from positron emission tomography (PET). These quantities are used for estimating radiation dose for a therapy, evaluating the progression of a disease and also use it as a prognostic indicator for predicting outcome. PET images have low resolution, high noise and affected by partial volume effect (PVE). Manually segmenting each tumor is very cumbersome and very hard to reproduce. To solve the above problem I developed an algorithm, called iterative deconvolution thresholding segmentation (IDTS) algorithm; the algorithm segment the tumor, measures the FV, correct for the PVE and calculates mAC. The algorithm corrects for the PVE without the need to estimate camera’s point spread function (PSF); also does not require optimizing for a specific camera. My algorithm was tested in physical phantom studies, where hollow spheres (0.5-16 ml) were used to represent tumors with a homogeneous activity distribution. It was also tested on irregular shaped tumors with a heterogeneous activity profile which were acquired using physical and simulated phantom. The physical phantom studies were performed with different signal to background ratios (SBR) and with different acquisition times (1-5 min). The algorithm was applied on ten clinical data where the results were compared with manual segmentation and fixed percentage thresholding method called T50 and T60 in which 50% and 60% of the maximum intensity respectively is used as threshold. The average error in FV and mAC calculation was 30% and -35% for 0.5 ml tumor. The average error FV and mAC calculation were ~5% for 16 ml tumor. The overall FV error was ~10% for heterogeneous tumors in physical and simulated phantom data. The FV and mAC error for clinical image compared to manual segmentation was around -17% and 15% respectively. In summary my algorithm has potential to be applied on data acquired from different cameras as its not dependent on knowing the camera’s PSF. The algorithm can also improve dose estimation and treatment planning.