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Biomedical subjects

A Pedotti

Publications and source records attributed to A Pedotti.

114 records · Page 7Linked to original sources

Continuous vs intermittent blood pressure measurements in estimating 24-hour average blood pressure.

In the past few years noninvasive automatic blood pressure (BP) recorders have been increasingly used to estimate patients' 24-hour BP more accurately than by one or few isolated measurements. However, these recorders only allow BP to be intermittently measured at intervals between 5 to 30 minutes, which means that the number of values collected over 24 hours (10 to 100) remains a tiny fraction of the thousands of values that occur during the same period. To determine whether this represents a limitation to this approach, BP was recorded intraarterially for 24 hours (Oxford method) in 20 ambulant hypertensive patients. A beat-to-beat analysis of the BP recording was provided by a computer, and the average 24-hour systolic, diastolic, and mean BP values were compared with those obtained by analyzing single BP waves of the same recording at intervals of 5, 10, 15, 30, and 60 minutes. In each subject the average 24-hour BP values obtained by the beat-to-beat analysis closely corresponded to those obtained by the analysis performed at 5-, 10-, 15-, or 30-minute intervals. In most subjects, this was the case also when the analysis was performed at 60-minute intervals. These findings demonstrate that intermittency of measurements does not limit the accurate assessment of true average BP. Indeed, accurate assessment can be achieved at intervals as much as 30 or 60 minutes apart.

Adult↗

[Automatic opto-electronic control of patient position in radiotherapy for breast carcinoma].

INTRODUCTION: We report on the technical and clinical validation of a system for real-time analytical control of patient position at simulation and treatment units in radiotherapy. MATERIAL AND METHODS: The positioning control system uses a technology for motion analysis consisting of an optical component (a pair of TV cameras) and of a unit for real-time image processing. The system can provide real-time (up to 100 times a second) three-dimensional (3D) coordinates of a set of passive markers (small plastic hemispheres, 5 mm O) previously positioned on the patient and located within the field of view of the system's TV cameras. The method for positioning quality control is based on the analytical comparison between the current positions of the set of markers placed on the patient's skin and a corresponding reference pattern, the latter acquired at the end of the simulation procedure or at the first irradiation session. The system was used at the Radiotherapy Division of the European Institute of Oncology for the analytical control of repositioning in three patients submitted to irradiation after conservative surgery (quadrantectomy) for breast cancer. This showed the clinical feasibility of both the technology and the method, and permitted to quantify improvement in patient positioning relative to current repositioning procedures. In particular, the possibility to evaluate the patient's breathing phases allowed to distinguish the different factors (repositioning inaccuracies and cyclic and random patient movements) contributing to global localization errors. RESULTS: This method is independent of physical and geometrical irradiation parameters and permits efficient real-time quantitative control of specific repositioning quality and of actual patient immobility during irradiation. Assessment of the accuracy of conventional repositioning methods based on laser alignment showed a fair performance of the optical centering procedure (with 3D displacements < 5 mm) only for the markers placed close to the skin landmarks used for laser alignment. On the contrary, the markers within the irradiation field but not directly controlled during the repositioning procedure exhibited localization errors > 5 mm; this happened even though the inaccuracies related to patient's breathing movements had been excluded from analysis. Moreover, quantitative assessment of global localization errors confirmed the high influence of breathing movements on the position repeatability and maintenance. In this case, even the markers which were on average well repositioned turned out to be significantly displaced during the radiation dose delivery. CONCLUSIONS: Our results confirm that real-time motion analysis based on opto-electronic techniques can play a crucial role as a means of improving patient positioning and assessing immobility. Thus, the system permits to quantify errors in target volume localization, which permits to adopt suitable countermeasures to reduce uncertainties during actual irradiation. This is a crucial requirement, particularly when the complexity of the irradiation geometry (conformal radiotherapy) or radiation type (hadrontherapy) calls for optimal application of the simulated treatment plan to each actual irradiation session.

Breast Neoplasms↗

Comparative biomechanical evaluation of different wheelchair seat cushions.

The aim of the present study was to perform a comparative biomechanical analysis of four antidecubitus wheelchair cushions. Thirty wheelchair users were considered divided into three groups: paraplegic subjects (with no cutaneous sensation), neurologic subjects (with intact cutaneous sensation), and elderly subjects. The biomechanical evaluation was performed using a piezoresistive sensor matrix system to quantify parameters referred to pressure distribution, seating surface and posture. Dedicated software was developed for the automatic elaboration of the raw data and the computation of the parameters of interest. Differences among cushion types and subject groups were analyzed. An analysis of time-transient behaviors was also performed. Results showed that no significant differences in pressure peak reduction were found among the four cushions. Moreover, no time-transient behavior was shown by any cushions. However, both the location of pressure peaks and posture were dependent on cushion types. Comparison of the three subject groups showed that elderly subjects had the highest mean pressure and the lowest contact surface, while paraplegics presented the highest pressure peaks. This procedure appears indicated for individualizing the prescription of a wheelchair cushion and even for customizing a cushion to induce a specific posture.

Adult↗

Opto-electronic plethysmography.

Recent developments of Opto-Electronic plethysmography allow a noninvasive and accurate measurement of the volume of the chest wall and its different thoraco-abdominal compartments, without any calibration specific on the subject under analysis. OEP provides the complete ventilatory pattern without using any device attached to the subject in any conditions and posture. Combined with pressure and airflow measurements, it can be used to study statics, dynamics and energetics of the chest wall and to estimate possible blood shifts between the thorax and the extremities.

Asthma↗

A 3D kinematic method for evaluating voluntary movements of the cervical spine in humans.

The purpose of this study was to assess the reliability of a 3D kinematic method of evaluating movements of the cervical spine. Range of motion (ROM) of the cervical spine was evaluated in 8 control subjects during flexion-extension, rotation and lateral bending movements. The test was repeated on two separate occasions. The ROM test-retest difference ranged from 1.42 degrees for right axial rotation to 9.11 degrees for left axial rotation. The test showed good reliability, with an intraclass correlation coefficient which was higher than 0.74 in extension movement and excellent in flexion, axial rotation and lateral bending. In conclusion, the method proposed for the 3D kinematic analysis of neck movement proved to be useful and non-invasive and to show good-excellent reproducibility. Furthermore the method is easily applicable in clinical practice to evaluate neck function in cervical spine disorders.

Adult↗