Operator independent left ventricular function monitoring during pharmacological stress echo with the new peak transcutaneous acceleration signal.

BACKGROUND: As the myocardium contracts isometrically, it generates vibrations that can be measured with an accelerometer. The vibration peak, peak endocardial acceleration (PEA), is an index of contractility. OBJECTIVE: To evaluate the feasibility of PEA measured by the cutaneous precordial application of the accelerometer sensor; and to assess the usefulness of PEA monitoring during pharmacological stress echocardiography. DESIGN: Feasibility study. SETTING: Stress echo laboratory. PATIENTS: 34 consecutive patients underwent pharmacological stress (26 with dipyridamole; 8 with dobutamine) and PEA monitoring simultaneously. INTERVENTIONS: A microaccelerometer was positioned in the precordial region and PEA was recorded. Dipyridamole was infused up to 0.84 mg/kg in 10 minutes, and dobutamine up to 40 microg/kg/min in 15 minutes. RESULTS: A consistent PEA signal was obtained in all patients. Overall mean (SD) baseline PEA was 0.26 (0.15) g (g = 9.8 m/s(2)), increasing to 0.5 (0.36) g at peak stress (+0.24 g, 95% confidence interval (CI) 0.14 to 0.34 g; p < 0.01). PEA increased from 0.26 (0.16) to 0.37 (0.25) g in the dipyridamole group (+0.11 g, 95% CI 0.08 to 0.16 g; p < 0.01), and from 0.29 (0.1) to 0.93 (0.37) g in the dobutamine group (+0.64 g, 95% CI 0.37 to 0.91 g; p < 0.01). CONCLUSIONS: Using precordial leads this method offers potential for diagnostic application in the short term monitoring of myocardial function. PEA monitoring is feasible during pharmacological stress and documents left ventricular inotropic response quantitatively in a non-invasive and operator independent fashion.

Echographic investigation in Terson's syndrome.

The authors present the A and B scan echographic images of a patient affected with Terson's syndrome. The images show the possible continuity between the vitreous hemorrhage and the hemorrhage in the optic nerve sheaths.

[Treatment with flicker stimulation of lesions of the visual cortex surface]. / Traitement avec stimulation flicker pour les lésions des aires visuelles corticales.

In this paper, the authors present the results of Flicker stimulation therapy in functional visual deficits secondary to occipital cortex lesions of miscellaneous origins. They formulate the hypothesis that the functional response obtained is subordinate to a variation or an integration of the macular cortical representation seat. Four cases were examined and the results obtained are significant.

[A new hypothesis for the treatment of amblyopia: the flicker stimulator]. / Nouvelle hypothèse de traitement de l'amblyopie: le stimulateur Flicker.

A variety of cells are involved in the pathogenesis of amblyopia : ON, OFF, ON-OFF cells, postsynaptic cells, neurons of striate cortex and the select interest of the macula. The need for stimulation of these cells in treating amblyopia forms the theoretical basis of the Flicker stimulator with red monochromatic light (LED, 655 nm). The authors present a clinical investigation on 35 subjects with anisometropic or strabismic amblyopia, before extensive treatment with classic anti-amblyopic techniques without satisfactory improvement obtaining significant statistical results (p less than 0,001).