Head to head comparison of 2D vs real time 3D dipyridamole stress echocardiography

Real-time three-dimensional (RT-3D) echocardiography has entered the clinical practice but true incremental value over standard two-dimensional echocardiography (2D) remains uncertain when applied to stress echo. The aim of the present study is to establish the additional value of RT-3D stress echo over standard 2D stress echocardiography. We evaluated 23 consecutive patients (age = 65 ± 10 years, 16 men) referred for dipyridamole stress echocardiography with Sonos 7500 (Philips Medical Systems, Palo, Alto, CA) equipped with a phased – array 1.6–2.5 MHz probe with second harmonic capability for 2D imaging and a 2–4 MHz matrix-phased array transducer producing 60 × 70 volumetric pyramidal data containing the entire left ventricle for RT-3D imaging. In all patients, images were digitally stored in 2D and 3D for baseline and peak stress with a delay between acquisitions of less than 60 seconds. Wall motion analysis was interpreted on-line for 2D and off-line for RT-3D by joint reading of two expert stress ecocardiographist. Segmental image quality was scored from 1 = excellent to 5 = uninterpretable. Interpretable images were obtained in all patients. Acquisition time for 2D images was 67 ± 21 sec vs 40 ± 22 sec for RT-3D (p = 0.5). Wall motion analysis time was 2.8 ± 0.5 min for 2D and 13 ± 7 min for 3D (p = 0.0001). Segmental image quality score was 1.4 ± 0.5 for 2D and 2.6 ± 0.7 for 3D (p = 0.0001). Positive test results was found in 5/23 patients. 2D and RT-3D were in agreement in 3 out of these 5 positive exams. Overall stress result (positive vs negative) concordance was 91% (Kappa = 0.80) between 2D and RT-3D. During dipyridamole stress echocardiography RT-3D imaging is highly feasible and shows a high concordance rate with standard 2D stress echo. 2D images take longer time to acquire and RT-3D is more time-consuming to analyze. At present, there is no clear clinical advantage justifying routine RT-3D stress echocardiography use

Robotic neurorehabilitation: a computational motor learning perspective

Conventional neurorehabilitation appears to have little impact on impairment over and above that of spontaneous biological recovery. Robotic neurorehabilitation has the potential for a greater impact on impairment due to easy deployment, its applicability across of a wide range of motor impairment, its high measurement reliability, and the capacity to deliver high dosage and high intensity training protocols

Nonlinear regional economic dynamics: continuous-time specification, estimation and stability analysis

Regional dynamics, Continuous-time econometrics, Generalized Lotka–Volterra system, Local and global stability analysis, O18, O41, C31, C33, C61, C62,

Efeitos da natação sobre a independência funcional de pacientes com lesão medular Efectos de la natación sobre la independencia funcional de pacientes con lesión medular Effects of swimming on the functional independence of patients with spinal cord injury

FUNDAMENTOS E OBJETIVO: O esporte tem um papel fundamental na reabilitação física de pacientes com lesão medular por ampliar as alternativas terapêuticas e favorecer a independência funcional. O estudo tem por objetivo conhecer os efeitos da natação sobre habilidades funcionais de pacientes com lesão medular. MÉTODOS: Foram selecionados 16 pacientes portadores de lesão medular, divididos em dois grupos: experimental e controle. Os grupos foram avaliados por meio da Medida de Independência Funcional (Escala FIM) antes e após o procedimento que consistiu em sessões de natação realizadas duas vezes por semana durante quatro meses. RESULTADOS: Os dois grupos apresentaram mudanças nos cuidados com o corpo, transferências, escore motor total e escore total. O grupo experimental apresentou ganho maior nas transferências, escore motor total e escore total. CONCLUSÃO: A atividade de natação foi efetiva na melhora da condição física, trazendo benefícios motores sobre as habilidades funcionais dos participantes do grupo experimental.<br>FUNDAMENTOS Y OBJETIVO: El deporte tiene un papel fundamental en la rehabilitación física de pacientes con lesión medular por ampliar las alternativas terapéuticas y favorecer la independencia funcional. El estudio tiene por objeto conocer los efectos de la natación sobre las habilidades funcionales de los pacientes con lesión medular. MÉTODOS: Fueron seleccionados 16 pacientes portadores de lesión medular divididos en dos grupos: experimental y control. Los grupos fueron evaluados por medio de la Medida de Independencia Funcional (Escala FIM) antes y después de un procedimiento que consistió en sesiones de natación realizadas dos veces por semana durante cuatro meses. RESULTADOS: Los dos grupos presentaron cambios en los cuidados con el cuerpo, transferencias, puntaje motor total y puntaje total. El grupo experimental presentó ganancia mayor en las transferencias, puntaje motor total y puntaje total. CONCLUSIÓN: La actividad de natación fue efectiva en la mejora de la condición física, trayendo beneficios motores sobre las habilidades funcionales de los participantes del grupo experimental.<br>FUNDAMENTS AND OBJECTIVE: Sports play an important role in the physical rehabilitation of patients with spinal cord injury by broadening the therapeutic alternatives in addition to providing functional independence. The objective of this study is to determining the effects of swimming on the functional capacity of patients with spinal cord injury. METHODS: 16 patients with spinal cord injury were divided into two groups: experimental and control. The assessment of both groups was performed using the Functional Independence Measure (FIM scale) before and after the trial, which consisted of swimming sessions performed twice a week during a period of four months. RESULTS: Both groups demonstrated noticeable gains related to body care, transference, overall and motor scores, even though the experimental group presented greater gains in transference, overall motor score and overall score. CONCLUSION: The swimming activity was effective in improving their physical condition, bringing motor benefits on the functional capacity of participants from the experimental group