Characterizing head motor disorders to create novel interfaces for people with cerebral palsy: creating an alternative communication channel by head motion.

This paper aims to validate a head mounted inertial interface to characterize disorder movements in people with cerebral palsy (CP). The kinematic patterns extracted from this study will be used to design an alternative communication channel (using head motion) adapted to user's capabilities and limitations. Four people with CP participated (GMFCS level V) and three healthy subjects as reference group. The main outcome measures were divided into 1) Time-domain, 2) Frequency-domain and 3) Spatial domain. Results showed that the inertial interface succeeds assessing the pathological motion. Firstly, the system differentiates between voluntary and involuntary motion in terms of motor control, frequency and range of motion. Secondly some motion disorders such as hypertonia, hypotonia can be identified. These results suggest that people with motor disorders could benefit from the developed inertial system in three fields: 1) diagnosis of motor disorder by means of an objective quantification, 2) physical and cognitive rehabilitation by means of proprioceptive enhancement through visual-motor feedback and 3) functional compensation by means of an inertial person-machine interface for controlling computer and assistive devices (e.g. wheelchairs or walkers).

Paroxysmal atrial fibrillation prevention by pacing in patients with pacemaker indication.

AIMS: The prevent-atrial fibrillation (AF) registry analyses the clinical relevance and usefulness of the four preventive pacing algorithms, available in a family of cardiac stimulators, to prevent atrial fibrillation. METHODS AND RESULTS: This study is a prospective, non-randomized, multicentre registry. Patients are eligible for the registry if they have sick sinus syndrome (SSS) with or without pre-existing atrial fibrillation. The preventive pacing algorithms were programmed for each patient on an individual basis using the diagnostic features of the devices. In the period from April 2000 to April 2001 a total of 68 patients (33 male, 35 female) has been included in the registry in 14 hospitals in Spain. Mean age was 72+/-12 years and the pacemaker indication was SSS in 15 patients (22%) and SSS with paroxysmal AF in 53 patients (78%). The median AF burden for the total group (n=32) was significantly reduced from 3.9 to 1.3% (67%, P=0.034, Wilcoxon signed rank test). The decrease in AF burden was accompanied by a non-significant decrease in the median number of episodes per day from 1.47 to 0.64 (a decrease of 56%). The average atrial pacing % was increased from 72 to 78%. CONCLUSIONS: The prevent-AF registry demonstrated the usefulness of four preventive pacing algorithms in daily clinical practice. During the registry a significant reduction in AF burden and all other endpoints was observed. Dedicated diagnostics were key to adapting the optimal pacing therapy during follow-up.

High torque ultrasonic motors for hand prosthetics: current status and trends.

This paper presents the work carried out at the Instituto de Automática Industrial, in the framework of the EU MANUS project and with the co-operation of the Katholieke Universiteit of Leuven, to develop a specifically designed TWUM for driving our prototype of hand prosthesis. The application of TWUM to prosthetic devices has clear advanteges, namely, noiseless operation, self-braking drive, high torque and low speed characteristics. Here we analyse main actuation advantages, point out main drawbacks of this technology and describe our research in the area of specific design of TWUM for high torque actuation, improved control characteristics and enhanced overall performance. We intend to provide a concurrent approach to the overall actuator design involving electronics, mechanical design as well as improved control strategies having in mind the prosthetic application.

Ovarian endometriosis and clear cell carcinoma, leiomyomatosis peritonealis disseminata, and endometrial adenocarcinoma: an unusual, pathogenetically related association.

A 42 year-old female with a preoperative clinical diagnosis of ovarian cancer underwent laparotomy which revealed leiomyomatosis peritonealis disseminata (LPD) in the peritoneum and omentum and a left ovarian endometriotic cyst associated with a clear cell carcinoma. A grade 1, superfically invasive villoglandular endometrial endometrioid adenocarcinoma was also found. Microscopically, the endometriotic cyst wall contained an extensive peripheral band-like condensation of stromal cells. These cells were strongly positive for alpha inhibin and may have been the hormonal source responsible for the induction of the simultaneous LPD and endometrial adenocarcinoma. It is proposed that endometriosis is not only a precursor of clear cell carcinoma but, through secondary hormonal induction of the surrounding ovarian stroma, may also provide a hormonal stimulus for diverse proliferative processes.

El desarrollo de los gemelos discordantes durante los dos primeros años de vida / The development of discordant twins during the first two years of life

El objetivo de este trabajo es analizar la influencia del bajo peso al nacer en el desarrollo biológico, motor, cognitivo y social de los gemelos discordantes en el peso, mediante un estudio longitudinal realizado al año y a los dos años. Se estudiaron once parejas de gemelos con una discordancia en el peso al nacer 15 por ciento. Se midieron las variables biológicas, neurológicas y psicológicas. Los resultados biológicos indicaron que existían diferencias significativas en el peso, talla y perímetro cefálico entre los gemelos pequeños y los grandes al nacer. La exploración neurológica descartó la existencia de otras patologías. Los datos respecto a las variables psicológicas, medidas con las Escalas Bayley de Desarrollo Infantil, nos indican que en las habilidades motoras las diferencias se mantienen significativas al año y a los dos años, así como en las habilidades cognitivas; y que en Manipulación, Imitación Comprensión y en Vocalización-Socialización se encuentran diferencias significativas al año. Los gemelos pequeños tienen menor atención y desarrollan un mayor grado de hiperactividad que los gemelos grandes al año y a los dos años. Además, se obtuvo una correlación positiva entre el peso y los Índices de Desarrollo Mental (IDM) y Psicomotor (IDP), y una correlación negativa entre la discordancia y el IDM e IDP. En consecuencia, el peso al nacer y una discordancia 15 por ciento en el peso de los gemelos pueden ser indicadores de riesgo, y deben ser tenidos en cuenta para prevenir dificultades en el desarrollo cognitivo, escolar y social de estos niños (AU)

[High risk congenital diaphragmatic hernia. Factors predicting mortality]. / Hernia diafragmática congénita de alto riesgo. Factores predictores de mortalidad.

A retrospective study of patients with high-risk congenital diaphragmatic hernia operated on in our hospital the last 15 years is made in order to establish some predictors involved in the final evolution of the patients. The best prognostic correlation has been demonstrated by preoperatory roentgenogram, Apgar-test and gasometric values 24 hours after surgical repair. A delayed surgical operation is also correlated with a better prognosis in accordance with the suitability of respiratory stabilization of the patient before the stress of surgery or because of a lesser respiratory insufficiency in patients operated on later.

[Neonatal small left colon syndrome (author's transl)]. / Síndrome del colon izquierdo pequeño.

Two cases of neonatal intestinal obstruction, with clinical, radiological and evolutive characteristics typical of the "neonatal small left colon syndrome", are described. Some etiological aspects are commented upon as well as differential diagnosis, which must be done with a certain number of diseases that produce intestinal obstruction in the newborn. Authors consider of great interest the high incidence of this syndrome in children born to diabetic mothers, diagnostic value of barium enema and the usually benign clinical course with very simple therapeutic procedures.