963 resultados para ULTRASONOGRAFIA DOPPLER - UTLIZACION
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Abstract Objective To determine if high umbilical artery Doppler (UAD) pulsatility index (PI) is associated with cardio-vascular (CV) risk-factors in children at age 12 years. Methods We studied 195 children at age 12 years who had had in-utero UAD studies performed at 28 weeks gestation. The children were grouped according to whether their umbilical Doppler PI was high (indicating poor feto-placental circulation) or normal. At age 12 years we assessed CV risk factors, including anthropometric measures, blood pressure, pulse wave velocity (a measure of arterial compliance), cardio-respiratory fitness and homocysteine and cholesterol serum levels. Results Compared with children with a normal UAD PI (N=88), the children (N=107) with high UAD PI had higher resting pulse rate (p=0.04), higher pulse wave velocity (p=0.046), higher serum homocysteine levels (p=0.032) and reduced arterial compliance (7.58 v 8.50 m/sec, p=0.029) using univariate analysis. These differences were not present when adjusting for cofounders was modelled. Conclusion High PI on UAD testing in-utero may be associated with increased likelihood of some cardio-vascular risk factors at age 12-years but confounding variables may be as important. Our study raises possible long-term benefits of in-utero UAD measurements.
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A counterintuitive scheme to produce ultracold hydrogen via fragmentation of laser cooled diatomic hydrides is presented where the final atomic H temperature is inversely proportional to the mass of the molecular parent. In addition, the critical density for formation of a Bose-Einstein condensate (BEC) at a fixed temperature is reduced by a factor (mH/mMH)3/2 over directly cooled hydrogen atoms. The narrow Feshbach resonances between a S01 atom and hydrogen are well suited to a tiny center of mass energy release necessary during fragmentation. With the support of ab initio quantum chemistry, it is demonstrated that BaH is an ideal diatomic precursor that can be laser cooled to a Doppler temperature of 26K with just two rovibronic transitions, the simplest molecular cooling scheme identified to date. Preparation of a hydrogen atom gas below the critical BEC temperature Tc is feasible with present cooling technology, with optical pulse control of the condensation process.
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<p>Wavelet entropy assesses the degree of order or disorder in signals and presents this complex information in a simple metric. Relative wavelet entropy assesses the similarity between the spectral distributions of two signals, again in a simple metric. Wavelet entropy is therefore potentially a very attractive tool for waveform analysis. The ability of this method to track the effects of pharmacologic modulation of vascular function on Doppler blood velocity waveforms was assessed. Waveforms were captured from ophthalmic arteries of 10 healthy subjects at baseline, after the administration of glyceryl trinitrate (GTN) and after two doses of N(G)-nitro-L-arginine-methyl ester (L-NAME) to produce vasodilation and vasoconstriction, respectively. Wavelet entropy had a tendency to decrease from baseline in response to GTN, but significantly increased after the administration of L-NAME (mean: 1.60 0.07 after 0.25 mg/kg and 1.72 0.13 after 0.5 mg/kg vs. 1.50 0.10 at baseline, p < 0.05). Relative wavelet entropy had a spectral distribution from increasing doses of L-NAME comparable to baseline, 0.07 0.04 and 0.08 0.03, respectively, whereas GTN had the most dissimilar spectral distribution compared with baseline (0.17 0.08, p = 0.002). Wavelet entropy can detect subtle changes in Doppler blood velocity waveform structure in response to nitric-oxide-mediated changes in arteriolar smooth muscle tone.</p>
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<p>OBJECTIVE: To determine whether an elevated fetal umbilical artery Doppler (UAD) pulsatility index (PI) at 28weeks' gestation, in the absence of fetal growth restriction (FGR) and prematurity, is associated with adverse neurocognitive outcome in children aged 12 years.</p><p>METHODS: Prospective cohort study, comparing children with a normal fetal UAD PI (<90th centile) (n=110) and those with an elevated PI (90th centile) (n=40). UAD was performed at 28, 32 and 34weeks gestation. At 12years of age, all children were assessed under standardised conditions at Queen's University, Belfast, UK to determine cognitive and behavioural outcomes using the British Ability Score-II and Achenbach Child Behavioural Checklist Parent Rated Version under standardised conditions. Regression analysis was performed, controlling for confounders such as gender, socioeconomic status and age at assessment.</p><p>RESULTS: The mean age of follow-up was 12.4years (0.5 SD) with 44% of children male (n=63). When UAD was assessed at 28weeks, the elevated fetal UAD group had lower scores in cognitive assessments of information processing and memory. Parameters included (1) recall of objects immediate verbal (p=0.002), (2) delayed verbal (p=0.008) and (3) recall of objects immediate spatial (p=0.0016). There were no significant differences between the Doppler groups at 32 or 34weeks' gestation.</p><p>CONCLUSIONS: An elevated UAD PI at 28weeks' gestation in the absence of FGR or prematurity is associated with lower scores of declarative memory in children aged 12years. A potential explanation for this is an element of placental insufficiency in the presence of the appropriately grown fetus, which affects the development of the fetal hippocampus and information processing and memory long-term. These findings, however, had no impact on overall academic ability, mental processing and reasoning or overall behavioural function.</p>
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Evaluation of blood-flow Doppler ultrasound spectral content is currently performed on clinical diagnosis. Since mean frequency and bandwidth spectral parameters are determinants on the quantification of stenotic degree, more precise estimators than the conventional Fourier transform should be seek. This paper summarizes studies led by the author in this field, as well as the strategies used to implement the methods in real-time. Regarding stationary and nonstationary characteristics of the blood-flow signal, different models were assessed. When autoregressive and autoregressive moving average models were compared with the traditional Fourier based methods in terms of their statistical performance while estimating both spectral parameters, the Modified Covariance model was identified by the cost/benefit criterion as the estimator presenting better performance. The performance of three time-frequency distributions and the Short Time Fourier Transform was also compared. The Choi-Williams distribution proved to be more accurate than the other methods. The identified spectral estimators were developed and optimized using high performance techniques. Homogeneous and heterogeneous architectures supporting multiple instruction multiple data parallel processing were essayed. Results obtained proved that real-time implementation of the blood-flow estimators is feasible, enhancing the usage of more complex spectral models on other ultrasonic systems.
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The work described here is part of a research program aiming to increase the sensitivity to disease detection using Doppler ultrasound by reducing the effects to the measurement procedure on the estimation of blood velocity and detection of flow disturbance.
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Os sinais de fluxo sanguneo so sinais aleatrios que, alm de variarem de individuo para individuo, variam tambm consoante o ciclo cardaco em anlise. Sendo o diagnstico de patologias cardiovasculares fortemente baseado em sinais de ultrassom Doppler representados em forma de espectrograma, e tendo em considerao que o rudo do tipo speckle parte integrante dos sinais ultrassnicos, torna-se vital a pesquisa de mtodos de eliminao desse tipo de rudo e de caracterizao precisa dos parmetros desses sinais biomdicos por forma a melhorar a qualidade do diagnstico clnico. Com esta tese pretende-se desenvolver uma ferramenta computacional que possibilite a extrao automtica dos parmetros pico sistlico, fim de distole e de outros eventos clinicamente relevantes de sinais Doppler de fluxo sanguneo, com especial ateno ao sinal proveniente da artria cartida. Esta investigao vem na continuidade de um projeto realizado anteriormente no Grupo de Processamento de Sinal Biomdico da Universidade do Algarve, no qual foi desenvolvido um sistema de reduo de rudo de espectrogramas Doppler. Este sistema de remoo de rudo ser aqui aplicado e melhorado. Para a deteo e extrao automtica de parmetros clnicos, foi desenvolvido um algoritmo que recebe um sinal de Doppler e que tem como sada o espectrograma livre de rudo e os valores dos parmetros clnicos calculados. O algoritmo desenvolvido est dividido em trs partes principais. A primeira, consiste na transformada do sinal para os domnios tempo-frequncia para a criao do espectrograma e na aplicao de uma metodologia de remoo do rudo do tipo speckle do espectrograma. A fase seguinte a criao de um sinal bidimensional a partir do espectrograma, o qual criado para possibilitar a sua caraterizao. Por ltimo, desenvolveu-se uma fase dedicada caracterizao do sinal, tendo como principais funes a deteo dos eventos clnicos de pico sistlico, fim de distole, ndice de pulsao, ndice de resistncia e ratio sstole-distole. A refinao de atuao de cada uma das trs partes mencionadas pode ser ajustada pelo utilizador, tendo para o efeito sido desenvolvido uma interface grfica na qual a interao do utilizador com o programa global facilitada. Versatilidade e eficcia do algoritmo desenvolvido foram demonstradas pelos resultados obtidos com trs sinais de Doppler de diferentes origens: um de origem clnica, um sinal de fluxo em artria cartida simulado experimentalmente recorrendo a phantoms, e um sinal de fluxo simulado computacionalmente. Para cada um destes sinais so apresentados os valores das variveis considerados preferenciais para o ajuste ao respetivo sinal e os respetivos espetros de rudo reduzido. Os resultados da extrao automtica dos parmetros clnicos dos trs sinais, comprovou a utilidade clnica do algoritmo desenvolvido.
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This paper compares a carrier tracking scenario when a received Global Positioning System (GPS) signal has low Doppler frequency. It is shown that if the Numerically Controlled Oscillator (NCO) is quantized to 1 bit, the carrier tracking loop is unable to keep track of the incoming signal which leaves the tracking loop oscillating between the upper and lower bounds of the tracking loop bandwidth. One way of overcoming this problem is presented and compared with another existing solution, found in the literature, providing comparative results from the use of real-recorded off the air GPS L1 signals. Results show that the proposed method performs better tracking performance compared with the existing solution which it requires much less hardware complexity.
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Enthesitis is the hallmark of spondyloarthritis and is observed in all subtypes. Namely, a wide information on spondyloarthritis abnormalities, including synovitis, bursitis, tendinitis, enthesitis and cortical bone abnormalities (erosions and enthesophytes), can be efficiently perceived by ultrasound power Doppler. Furthermore, several studies on imaging of enthesis showed that imaging techniques are better than clinical examination to detect pathology at asymptomatic enthesis. Vascularized enthesitis detected by ultrasound power Doppler appears to be a valuable diagnostic tool to confirm spondyloarthritis diagnosis. This article focuses on the validity and reliability of ultrasound enthesitis assessment in the management of spondyloarthritis patients.
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RESUMO: Enthesitis is the hallmark of spondyloarthritis (SpA), and is observed in all subtypes. Wide information on SpA abnormalities, including synovitis, tendinitis and enthesitis, can be efficiently perceived by Doppler ultrasound. Furthermore, several studies on imaging of enthesis showed that imaging techniques are better than clinical examination to detect enthesis alterations; and vascularized enthesitis detected by Doppler ultrasound appears to be a valuable diagnostic tool to confirm SpA diagnosis. However, data published until now concerning entheseal elementary alterations that characterize SpA enthesitis (enthesis inflammatory activity) or enthesopathy (permanent structural changes) reflect rather the authors empiric opinion than a methodological validation process. In this sense it seems crucial to identify elementary entheseal lesions associated with activity or damage, in order to improve monitoring and treatment response in SpA patients. The development of better assessment tools is today a challenge and a need in SpA. The first study of this thesis focused on the analysis of the reliability of inter-lector and inter-ultrasonography equipment of Madrid sonography enthesitis index (MASEI). Fundamental data for the remaining unrolling project validity. In the second and third studies we concerned about two entheseal elemental lesions: erosions and bursa. In literature erosions represent a permanent structural damage, being useful for monitoring joint injury, disease activity and therapeutic response in many rheumatic diseases; and to date, this concept has been mostly applied in rheumatoid arthritis (RA). Unquestionably, erosion is a tissue-related damage and a structural change. However, the hypothesis that we decided to test was if erosions represent a permanent structural change that can only grow and worsen over time, as occurs in RA, or a transitory alteration. A longitudinal study of early SpA patients was undertaken, and the Achilles enthesis was used as a model. Our results strongly suggested that previously detected erosions could disappear during the course of the disease, being consistent with the dynamic behavior of erosion over time. Based on these striking results it seems reasonable to suggest that the new-bone formation process in SpA could be associated with the resolution of cortical entheseal erosion over time. These results could also be in agreement with the apparent failure of anti-tumor necrosis factor (TNF) therapies to control bone proliferation in SpA; and with the relation of TNF-, Dickkopf-related protein 1 (Dkk-1) and the regulatory molecule of the Wnt signaling pathway in the bone proliferation in SpA. In the same model, we then proceeded to study the enthesis bursa. Interestingly, the Outcome Measures in Rheumatology Clinical Trials (OMERACT) enthesopathy definition does not include bursa as an elementary entheseal lesion. Nonetheless, bursa was included in 46% of the enthesis studies in a recently systematic literature review, being in agreement with the concept of synovio-entheseal complex that includes the link between enthesitis and osteitis in SpA. It has been clarified in recent data that there is not only a close functional integration of the enthesis with the neighboring bone, but also a connection between enthesitis and synovitis. Therefore, we tried to assess the prevalence and relevance of the bursa-synovial lesion in SpA. Our findings showed a significant increase of Achilles bursa presence and thickness in SpA patients compared to controls (healthy/mechanical controls and RA controls). These results raise awareness to the need to improve the enthesopathy ultrasonographic definition. In the final work of this thesis, we have explored new perspectives, not previously reported, about construct validity of enthesis ultrasound as a possible activity outcome in SpA. We performed a longitudinal Achilles enthesis ultrasound study in patients with early SpA. Achilles ultrasound examinations were performed at baseline, six- and twelve-month time periods and compared with clinical outcome measures collected at basal visit. Our results showed that basal erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are higher in patients with Doppler signal in enthesis, and even that higher basal ESR, CRP and Ankylosing Spondylitis Disease Activity Score (ASDAS) predicted a higher Doppler signal (an ultrasound alteration accepted as representative of inflammation) six months later. Patients with very high disease activity assessed by ASDAS (>3.5) at baseline had significantly higher Achilles total ultrasound score verified at the same time; and ASDAS <1.3 predicted no Doppler signal at six and twelve months. This seems to represent a connection between classical biomarkers and clinical outcomes associated with SpA activity and Doppler signal, not only at the same time, but also for the following months. Remarkably, patients with inactive disease (ASDAS < 1.3) at baseline had no Doppler signal at six and twelve months. These findings reinforce the potential use of ultrasound related techniques for disease progression assessment and prognosis purposes. Intriguingly, Ankylosing Spondylitis Disease Activity Index (BASDAI) didnt show significant differences between different cut-offs concerning ultrasound lesions or Doppler signal, while verified with ASDAS. These results seem to indicate that ASDAS reflects better than BASDAI what happens in the enthesis. The work herein discussed clearly shows the potential utility of ultrasound in enthesis assessment in SpA patients, and can be important for the development of ultrasound activity and structural damage scores for diagnosis and monitoring purposes. Therefore, local promotion of this technique constitutes a medical intervention that is worth being tested in SpA patients for diagnosis, monitoring and prognosis purposes.
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In this work parameters of Mg-doped GaN samples were studied using positron annihilation spectroscopy and analyzed. It is shown that gallium vacancies exist in an unintentionally doped sample. Next, the sample with higher concentration of Mg and low growth temperature contains vacancy clusters. In case of low concentration of Mg the growth temperature does not affect the formation of defects. Analog electronics can be replaced by a modern digital device. While promising a high quantity of benefits, the performance of these digitizers requires thorough adjustment. A 14-bit two channel digitizer has been tested in order to achieve better performance than the one of a traditional analog setup, and the adjustment process is described. It has been shown that the digital device is unable to achieve better energy resolution, but it is quite close to the corresponding attribute of the available analog system, which had been used for measurements in Mg-doped GaN.
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This study examined factors contributing to the differences in left ventricular mass as measured by Doppler echocardiography in children. Fourteen boys (10.3 0.3 years of age) and 1 1 girls (10.5 0.4 years of age) participated in the study. Height and weight were measured, and relative body fat was determined from the measurement of skinfold thickness according to Slaughter et al. (1988). Lean Body Mass was then calculated by subtracting the fat mass from the total body mass. Sexual maturation was self-assessed using the stages of sexual maturation by Tanner (1962). Both pubic hair development and genital (penis or breast for boys and girls respectively) development were used to determine sexual maturation. Carotid Pulse pressure was assessed by applanation tomometry in the left carotid artery. Cardiac mass was measured by Doppler Echocardiography. Images of cardiac structures were taken using B-Mode and were then translated to M- Mode. The dimensions at the end diastole were obtained at the onset of the QRS complex of the electrocardiogram in a plane through a standard position. Measurements included: (a) the diameter of the left ventricle at the end diastole was measured from the septum edge to the endocardium mean border, (b) the posterior wall was measured as the distance from to anterior wall to the epicardium surface, and (c) the interventricular septum was quantified as the distance from the surface of the left ventricle border to the right ventricle septum surface. Systolic time measurements were taken at the peak of the T-wave of the electrocardiogram. Each measurement was taken three to five times before averaging. Average values were used to calculate cardiac mass using the following equation (Deveraux et al. 1986). Weekly physical activity metabolic equivalent was calculated using a standardize activity questionnaire (Godin and Shepard, 1985) and peakV02 was measured on a cycloergometer. There were no significant differences in cardiovascular mesurements between boys and girls. Left ventricular mass was correlated (p<0.05) with size, maturation, peakV02 and physical activity metabolic equivalent. In boys, lean body mass alone explained 36% of the variance in left ventricular mass while weight was the single strongest predictor of left ventricular mass (R =0.80) in girls. Lean body mass, genital developemnt and physical activity metabolic equivalent together explained 46% and 81% in boys and girls, respectively. However, the combination of lean body mass, genital development and peakV02 (ml kgLBM^ min"') explained up to 84% of the variance in left ventricular mass in girls, but added nothing in boys. It is concluded that left ventricular mass was not statistically different between pre-adolescent boys and girls suggesting that hormonal, and therefore, body size changes in adolescence have a main effect on cardiac development and its final outcome. Although body size parameters were the strongest correlates of left ventricular mass in this pre-adolescent group of children, to our knowledge, this is the first study to report that sexual maturation, as well as physical activity and fitness, are also strong associated with left ventricular mass in pre-adolescents, especially young females. Arterial variables, such as systolic blood pressure and carotid pulse pressure, are not strong determinants of left ventricular mass in this pre-adolescent group. In general, these data suggest that although there is no gender differences in the absolute values of left ventricular mass, as children grow, the factors that determine cardiac mass differ between the genders, even in the same pre-adolescent age.
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Objectif: valuer l'efficacit du dpistage de lhypertension gestationnelle par les caractristiques dmographiques maternelles, les biomarqueurs sriques et le Doppler de l'artre utrine au premier et au deuxime trimestre de grossesse. laborer des modles prdictifs de lhypertension gestationnelle fondes sur ces paramtres. Methods: Il s'agit d'une tude prospective de cohorte incluant 598 femmes nullipares. Le Doppler utrin a t tudi par chographie transabdominale entre 11 +0 13 +6 semaines (1er trimestre) et entre 17 +0 21 +6 semaines (2e trimestre). Tous les chantillons de srum pour la mesure de plusieurs biomarqueurs placentaires ont t recueillis au 1er trimestre. Les caractristiques dmographiques maternelles ont t enregistres en mme temps. Des courbes ROC et les valeurs prdictives ont t utiliss pour analyser la puissance prdictive des paramtres ci-dessus. Diffrentes combinaisons et leurs modles de rgression logistique ont t galement analyss. Rsultats: Parmi 598 femmes, on a observ 20 pr-clampsies (3,3%), 7 pr-clampsies prcoces (1,2%), 52 cas dhypertension gestationnelle (8,7%) , 10 cas dhypertension gestationnelle avant 37 semaines (1,7%). Lindex de pulsatilit des artres utrines au 2e trimestre est le meilleur prdicteur. En analyse de rgression logistique multivarie, la meilleure valeur prdictive au 1er et au 2e trimestre a t obtenue pour la prvision de la pr-clampsie prcoce. Le dpistage combin a montr des rsultats nettement meilleurs compars avec les paramtres maternels ou Doppler seuls. Conclusion: Comme seul marqueur, le Doppler utrin du deuxime trimestre a la meilleure prdictive pour l'hypertension, la naissance prmature et la restriction de croissance. La combinaison des caractristiques dmographiques maternelles, des biomarqueurs sriques maternels et du Doppler utrin amliore l'efficacit du dpistage, en particulier pour la pr-clampsie ncessitant un accouchement prmatur.
