Developing movement therapy application with Microsoft Kinect control for supporting stroke rehabilitation.

The topic of this article and work was to create an application for movement therapy, which can help the rehabilitation of stroke patients. The application makes it possible to make unique exercises for different patients, adapting to the special personal needs. The developed real time gesture analyzing algorithm works in the background of the application, which has not yet spread on the field of medical devices. I deal with one part of this wide field in my dissertation, with the rehabilitation gesture analyzing. The data received from the Kinect sensor is processed by a location based gesture analyzing algorithm, and the results show that the software is suitable for the improvement of the rehabilitation process. It was a key aspect to create a simple interface. I achieved this with the use of the C# language and WPF technology.

[An atypical presentation of atherosclerosis in psoriasis: "Porcelain aorta"]. / Présentation particulière de l'athérome au cours du psoriasis : un cas d'« aorte porcelaine ¼.

BACKGROUND: Several recent epidemiological studies have shown an increase in cardiovascular morbidity and mortality in patients with psoriasis; such increase is greater in the event of severe and early psoriasis. PATIENTS AND METHODS: We report the case of a 42-year-old patient with severe skin psoriasis ongoing since childhood and presenting with porcelain aorta, a little-known sign of atherosclerosis. This is the first publication reporting this association. DISCUSSION: Porcelain aorta results from atherosclerotic calcification of the aortic arch. For long asymptomatic, it can manifest itself in various complications. This observation highlights the importance of cardiovascular risk assessment and of screening for complications thereof in patients presenting psoriasis.

Balloon occlusion versus wedged hepatic venography using iodinated contrast for targeting the portal vein during TIPS.

PURPOSE: To assess the efficacy, safety and gain in procedure time of the technique of balloon occlusion hepatic venography with iodinated contrast used to target the portal vein during TIPS. The technique is assessed versus wedged hepatic venography. MATERIALS AND METHODS: Fifty-eight TIPS were prospectively included. The portal vein was located in 30 cases by the wedged hepatic venography (group 1) and in 28 cases by balloon occlusion hepatic venography (group 2). To compare both techniques a "portogram quality" score was defined using a 5 points scale. The time required to achieve portal puncture was also recorded. The complications of both procedures were assessed and classified in groups as intrahepatic hematoma or intraperitoneal hemorrhage. RESULTS: The right portal vein was visualized in a significantly higher number of patients using balloon than with wedged retrograde venography 71.3% (20/28) versus 13.3% (4/30) respectively (P=0.002). The quality score for the portogram was significantly higher for balloon hepatic venography 2.21 than for wedged hepatic venography 1.07 (P=0.002). The mean time required to puncture the portal vein was significantly shorter when the right branch of the portal vein was visualized 21 min versus 33.5 min (P=0.046). We recorded one intrahepatic hematoma (3.3%) and 4 intraperitoneal hemorrhage (13.3%) secondary to wedged hepatic venography. There were no complications with balloon occlusion hepatic venography (P=0.053). CONCLUSION: The use of balloon occlusion hepatic venography improves the quality of the retrograde portal venography to target the portal vein and decreases procedure time. The balloon technique is also burdened with fewer complications than the standard wedged hepatic venography.

Quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania: learning from mothers' experiences.

BACKGROUND: With a decline of infant mortality rates, neonatal mortality rates are striking high in development countries particularly sub Saharan Africa. The toolkit for high quality neonatal services describes the principle of patient satisfaction, which we translate as mother's involvement in neonatal care and so better outcomes. The aim of the study was to assess mothers' experiences, perception and satisfaction of neonatal care in the hospitals of Kilimanjaro region of Tanzania. METHODS: A cross sectional study using qualitative and quantitative approaches in 112 semi structured interviews from 14 health facilities. Open ended questions for detection of illness, care given to the baby and time spent by the health worker for care and treatment were studied. Probing of the responses was used to extract and describe findings by a mix of in-depth interview skills. Closed ended questions for the quantitative variables were used to quantify findings for statistical use. Narratives from open ended questions were coded by colours in excel sheet and themes were manually counted. RESULTS: 80 mothers were interviewed from 13 peripheral facilities and 32 mothers were interviewed at a zonal referral hospital of Kilimanjaro region. 59 mothers (73.8%) in the peripheral hospitals of the region noted neonatal problems and they assisted for attaining diagnosis after a showing a concern for a request for further investigations. 11 mothers (13.8%) were able to identify the baby's diagnosis directly without any assistance, followed by 7 mothers (8.7%) who were told by a relative, and 3 mothers (3.7%) who were told of the problem by the doctor that their babies needed medical attention. 24 times mothers in the peripheral hospitals reported bad language like "I don't have time to listen to you every day and every time." 77 mothers in the periphery (90.6%) were not satisfied with the amount of time spent by the doctors in seeing their babies. CONCLUSION: Mothers of the neonates play great roles in identifying the illness of the newborn. Mother's awareness of what might be needed during neonatal support strategies to improve neonatal care in both health facilities and the communities.

Cardiac MRI in the diagnosis of complications of myocardial infarction.

The improvement in revascularization techniques and medicine treatment during infarction has substantially reduced mortality during the acute phase of this condition. Since the advent of kinetic sequences and the concomitant development of gadolinium chelates and delayed enhancement sequences, cardiac MRI has become the second-line reference examination for ischemic heart disease. The technique of delayed enhancement with the inversion recovery sequence performed after injection has been validated for numerous indications in ischemic disease. Delayed enhancement sequences make it possible in particular to look for "no-reflow" areas (microvascular obstructions), to quantify the infarction area, and to assess prognosis. MRI also allows us to define the area at risk, that is, the area with edema, and to look for and assess the mechanical complications of the infarction. The aim of this review is to summarize current knowledge about: the pharmacokinetic principles that regulate myocardial enhancement; the different sequences available to acquire delayed enhancement images, and; the value of cardiac MRI in the diagnosis of complications of myocardial infarction.

[Delayed myocardial enhancement: Optimizing the MR imaging protocol]. / Comment j'optimise la technique d'IRM à la recherche d'un rehaussement tardif?

The purpose of this article is to 1) review the basic models characterizing myocardial enhancement on MR and CT, 2) review the main characteristics of available iodinated and Gadolinium-based contrast agents and, 3) review the literature on emerging MR contrast agents to assess myocardial viability. The intensity of enhancement following infarction is the result of two processes: 1) the increased interstitial space (15 + or - 2% in normal myocardium and 80 + or - 3% in necrotic tissue) secondary to cell necrosis and 2) perfusion abnormalities secondary to absent revascularization or impaired microvascularization. The equation described by Kety was used to create models of contrast material kinetics within myocardium or enhancement of the different components of the myocardium (viable myocardium, necrosed myocardium, fibrosis, with no-reflow zone, hibernating or stunned myocardium).