Step-counting accuracy of activity monitors in persons with Down syndrome.

BACKGROUND: Accelerometers and pedometers have been used to monitor the number of steps. However, the evidence on the step-counting accuracy of these devices - especially accelerometers - is limited in persons with Down syndrome (DS). This study therefore examined the accuracy of accelerometers placed on the hip or wrist and of a pedometer with a uni-axial accelerometer mechanism in measuring steps in persons with DS and whether device error is associated with walking speed, height, weight, body mass index, waist circumference, leg length, age or sex. METHOD: Seventeen persons with DS (eight women and nine men; age 33 ± 15 years) walked over-ground for 6 min at their preferred speed. The steps were measured with a hip-worn and a wrist-worn ActiGraph accelerometer using the manufacturer's default (DF) and low-frequency extension (LFE) filters, and with the NL-1000 New Lifestyles pedometer on the hip. Steps were also measured with hand tally which served as the criterion. RESULTS: Absolute percent error was considerable and differed statistically between devices (P = 0.001); however, error improved for accelerometers when LFE was applied (Hip-DF: 31.6 ± 18.8%; Hip-LFE: 9.7 ± 12.8%; Wrist-DF: 32.7 ± 14.2%; Wrist-LFE: 13.6 ± 10.2%; Pedometer: 23.2 ± 22.8%). Bland-Altman plots indicated underestimation of steps for accelerometers and the pedometer. Application of LFE, however, improved the prediction of the accelerometers. The number of steps measured by the hip accelerometer with LFE and by the pedometer did not differ statistically from actual steps. Steps by the remaining methods were significantly lower than hand tally (P ≤ 0.001). Correlations between percent error for each device and walking speed, anthropometry, age or sex ranged between -0.28 and +0.48, and were non-significant, except for age. CONCLUSIONS: The results demonstrated that the pedometer and ActiGraph accelerometers have considerable error in measuring steps of persons with DS. Application of LFE, however, significantly improved the step-counting performance of the Actigraph accelerometers.

Malignant seeding of the needle track during stereotaxic core needle breast biopsy.

Early reports demonstrated the diagnostic advantage of large-core (14-gauge) biopsy over fine-needle aspiration biopsy of nonpalpable lesions of the breast without apparent significant increase in morbidity. A case of malignant seeding of the needle track after a large-core biopsy of a mucinous carcinoma of the breast is documented. The potential for increased risk of tract seeding of malignancy must be considered.

MR imaging and biomedical implants, materials, and devices: an updated review.

Certain ferromagnetic metallic implants, materials, and devices are regarded as contraindications for magnetic resonance imaging, primarily because of the risks associated with their movement or dislodgment. More than 40 publications have reported the ferromagnetic qualities of 261 different metallic objects (aneurysm and hemostatic clips, 32; carotid artery vascular clamps, five; dental devices or materials, 16; heart valve prostheses, 29; intravascular coils, filters, and stents, 14; ocular implants, 12; orthopedic implants, materials, and devices, 15; otologic implants, 56; pellets and bullets, 23; penile implants, nine; vascular access ports, 33; and miscellaneous, 17) on the basis of measurements of deflection forces or attraction during exposure to static magnetic fields at strengths of 0.147-4.7 T. The results of these studies are listed with respect to the specific object tested, the material used to construct the object (if known), whether or not the object was deflected or moved during exposure to the static magnetic field, and the highest static magnetic field strength used for testing the object.