978 resultados para Stroke Volume


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The present study aimed to investigate the presence of corpus callosum (CC) volume deficits in a population-based recent-onset psychosis (ROP) sample, and whether CC volume relates to interhemispheric communication deficits. For this purpose, we used voxel-based morphometry comparisons of magnetic resonance imaging data between ROP (n = 122) and healthy control (n = 94) subjects. Subgroups (38 ROP and 39 controls) were investigated for correlations between CC volumes and performance on the Crossed Finger Localization Test (CFLT). Significant CC volume reductions in ROP subjects versus controls emerged after excluding substance misuse and non-right-handedness. CC reductions retained significance in the schizophrenia subgroup but not in affective psychoses subjects. There were significant positive correlations between CC volumes and CFLT scores in ROP subjects, specifically in subtasks involving interhemispheric communication. From these results, we can conclude that CC volume reductions are present in association with ROP. The relationship between such deficits and CFLT performance suggests that interhemispheric communication impairments are directly linked to CC abnormalities in ROP. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

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Background: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU). This is despite advances in the management of patients with severe sepsis and septic shock including early recognition, source control, timely and appropriate administration of antimicrobial agents, and goal directed haemodynamic, ventilatory and metabolic therapies. High-volume haemofiltration (HVHF) is a blood purification technique which may improve outcomes in critically ill patients with severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used to treat acute kidney injury (AKI) in critically ill patients in the ICU.

Objectives: This review assessed whether HVHF improves clinical outcome in adult critically ill patients with sepsis in an ICU setting.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2011, Issue 7); MEDLINE (1990 to August 2011), EMBASE (1990 to August 2011); LILACS (1982 to August 2011), Web of Science (1990 to August 2011), CINAHL (1982 to August 2011) and specific websites.

Selection criteria: We included randomized controlled trials (RCTs) and quasi-randomized trials comparing HVHF or high-volume haemodiafiltration to standard or usual dialysis therapy; and RCTs and quasi-randomized trials comparing HVHF or high-volume haemodiafiltration to no similar dialysis therapy. The studies involved adults in critical care units.

Data collection and analysis: Three review authors independently extracted data and assessed trial quality. We sought additional information as required from trialists.

Main results: We included three randomized trials involving 64 participants. Due to the small number of studies and participants, it was not possible to combine data or perform sub-group analyses. One trial reported ICU and 28-day mortality, one trial reported hospital mortality and in the third, the number of deaths stated did not match the quoted mortality rates. No trials reported length of stay in ICU or hospital and one reported organ dysfunction. No adverse events were reported. Overall, the included studies had a low risk of bias.

Authors' conclusions: There were no adverse effects of HVHF reported.There is insufficient evidence to recommend the use of HVHF in critically ill patients with severe sepsis and or septic shock except as interventions being investigated in the setting of a randomized clinical trial. These trials should be large, multi-centred and have clinically relevant outcome measures. Financial implications should also be assessed.

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Multiscale micro-mechanics theory is extensively used for the prediction of the material response and damage analysis of unidirectional lamina using a representative volume element (RVE). Th is paper presents a RVE-based approach to characterize the materi al response of a multi-fibre cross-ply laminate considering the effect of matrix damage and fibre-matrix interfacial strength. The framework of the homogenization theory for periodic media has been used for the analysis of a 'multi-fibre multi-layer representative volume element' (M2 RVE) representing cross-ply laminate. The non-homogeneous stress-strain fields within the M2RVE are related to the average stresses and strains by using Gauss theorem and the Hill-Mandal strain energy equivalence principle. The interfacial bonding strength affects the in-plane shear stress-strain response significantl y. The material response predicted by M2 RVE is in good agreement with the experimental results available in the literature. The maximum difference between the shear stress predicted using M2 RVE and the experimental results is ~15% for the bonding strength of 30MPa at the strain value of 1.1%

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A parallel kinematic machine (PKM) topology can only give its best performance when its geometrical parameters are optimized. In this paper, dimensional synthesis of a newly developed PKM is presented for the first time. An optimization method is developed with the objective to maximize both workspace volume and global dexterity of the PKM. Results show that the method can effectively identify design parameter changes under different weighted objectives. The PKM with optimized dimensions has a large workspace to footprint ratio and a large well-conditioned workspace, hence justifies its suitability for large volume machining.

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The two-stroke engine, by its nature is very dependent on the unsteady gas dynamics within an exhaust system. This is demonstrated by the tuning effects on two-stroke engines, which have been well documented. In consideration of current emissions legislation, a two-stroke engine can be fitted with a catalytic converter for the outboard, utility or automotive markets. The catalytic substrate represents a major obstruction to the flow of exhaust gas, which hinders the progression of the main exhausted pulse, and in turn effects the scavenging of the cylinder and ultimately the performance of the engine.

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Recovery of upper limb function after stroke is poor. The acute to subacute phase after stroke is the optimal time window to promote the recovery of upper limb function. The dose and content of training provided conventionally during this phase is however, unlikely to be adequate to drive functional recovery, especially in the presence of severe motor disability. The current study concerns an approach to address this shortcoming, through evaluation of the SMART Arm, a non-robotic device that enables intensive and repetitive practice of reaching by stroke survivors with severe upper limb disability, with the aim of improving upper limb function. The outcomes of SMART Arm training with or without outcome-triggered electrical stimulation (OT-stim) to augment movement and usual therapy will be compared to usual therapy alone.

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The modern stereologic method of vertical sections was applied to the retina as a means of generating unbiased estimates of three-dimensional structure. The method is illustrated with real data on the volume and surface area of the capillary basement membrane from the central retina of the rat. Novel methods of estimating the volume of retina sampled and of creating accurate vertical sections are described. The advantages of using stereologic methods to generate quantitative information on the three-dimensional structure of the retina are discussed and compared to those of previous quantitative methods that provide data on two-dimensional structure only.