He-Ne LLLT inhibits the sensitization increase of nociceptors on the inflammatory process. The analgesic effect seems to involve hyperalgesic mediators instead of peripheral opioid receptors.
We investigated the ability of time-warping-based ECG-derived markers of T-wave morphology changes in time ($$d_{w}$$ d w ) and amplitude ($$d_a$$ d a ), as well as their non-linear components ($${d_w^{{\mathrm{NL}}}}$$ d w NL and $${d_a^{\mathrm{NL}}}$$ d a NL ), and the heart rate corrected counterpart ($$d_{w,c}$$ d w , c ), to monitor potassium concentration ($$[K^{+}]$$ [ K + ] ) changes ($$\Delta [K^+]$$ Δ [ K + ] ) in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). We compared the performance of the proposed time-warping markers, together with other previously proposed $$[K^{+}]$$ [ K + ] markers, such as T-wave width ($$T_w$$ T w ) and T-wave slope-to-amplitude ratio ($$T_{S/A}$$ T S / A ), when computed from standard ECG leads as well as from principal component analysis (PCA)-based leads. 48-hour ECG recordings and a set of hourly-collected blood samples from 29 ESRD-HD patients were acquired. Values of $$d_w$$ d w , $$d_a$$ d a , $${d_w^{\mathrm{NL}}}$$ d w NL , $${d_a^{\mathrm{NL}}}$$ d a NL and $$d_{w,c}$$ d w , c were calculated by comparing the morphology of the mean warped T-waves (MWTWs) derived at each hour along the HD with that from a reference MWTW, measured at the end of the HD. From the same MWTWs $$T_w$$ T w and $$T_{S/A}$$ T S / A were also extracted. Similarly, $$\Delta [K^+]$$ Δ [ K + ] was calculated as the difference between the $$[K^{+}]$$ [ K + ] values at each hour and the $$[K^{+}]$$ [ K + ] reference level at the end of the HD session. We found that $$d_{w}$$ d w and $$d_{w,c}$$ d w , c showed higher correlation coefficients with $$\Delta [K^+]$$ Δ [ K + ] than $$T_{S/A}$$ T S / A —Spearman’s ($$\rho$$ ρ ) and Pearson’s (r)—and $$T_w$$ T w —Spearman’s ($$\rho$$ ρ )—in both SL and PCA approaches being the intra-patient median $$\rho \ge 0.82$$ ρ ≥ 0.82 and $$r \ge 0.87$$ r ≥ 0.87 in SL and $$\rho \ge 0.82$$ ρ ≥ 0.82 and $$r \ge 0.89$$ r ≥ 0.89 in PCA respectively. Our findings would point at $$d_{w}$$ d w and $$d_{w,c}$$ d w , c as the most suitable surrogate of $$\Delta [K^+]$$ Δ [ K + ] , suggesting that they could be potentially useful for non-invasive monitoring of ESRD-HD patients in hospital, as well as in ambulatory settings. Therefore, the tracking of T-wave morphology variations by means of time-warping analysis could improve continuous and remote $$[K^{+}]$$ [ K + ] monitoring of ESRD-HD patients and flagging risk of $$[K^{+}]$$ [ K + ] -related cardiovascular events.
Objective: Chronic kidney disease affects 7 more than 10% of the world population. Changes in serum 8 ion concentrations increase the risk for ventricular ar-9 rhythmias and sudden cardiac death, particularly in end-10 stage renal disease (ESRD) patients. We characterized how 11 T wave amplitude, duration and morphology descriptors 12 change with variations in serum levels of potassium and 13 calcium and in heart rate, both in ESRD patients and in 14 simulated ventricular fibers. Methods: Electrocardiogram 15 (ECG) recordings from twenty ESRD patients undergoing 16 hemodialysis (HD) and pseudo-ECGs (pECGs) calculated 17 from twenty-two simulated ventricular fibers at varying 18 transmural heterogeneity levels were processed to quantify 19 T wave width (T w ), T wave slope-to-amplitude ratio (T S/A ) 20 and four indices of T wave morphological variability based 21 on time warping (d w , d NL w , d a and d NL a ). Serum potassium 22 and calcium levels and heart rate were measured along 23 HD. Results: d NL a was the marker most strongly correlated 24
Objetivos. Verificar o efeito do tratamento hidroterapêutico na funcionalidade e tono de crianças com tetraparesia espástica. Métodos. Foram incluídas seis crianças com tetraparesia espástica e idade entre 2 e 6 anos, e realizada a avaliação do tono pela escala de Ashworth Modificada e da funcionalidade pela aplicação do Pediatric Evaluation of Disability Inventory (PEDI). Os pacientes foram submetidos a 20 sessões de tratamento hidroterapêutico, entre fevereiro e junho de 2006, e após estes foram reavaliados pelos mesmos procedimentos. Para testar a significância antes e após o tratamento foi utilizado o teste não paramétrico de Wilcoxon. Resultados. Não houve diferença dos valores na avaliação do tono pela Escala de Ashworth Modificada antes e após o tratamento hidroterapêutico. Na avaliação através da aplicação do PEDI, ao serem analisados os valores do escore bruto nas três áreas de função, verificou-se diferença estatisticamente significante após o tratamento. Conclusão. Os resultados mostram que a hidroterapia, como tratamento, promove melhora funcional significativa para pacientes com paralisia cerebral e tetraparéticas espásticas na faixa etária estudada.
Objetivo. Comparar a funcionalidade de crianças com Síndrome de Down (SD) e crianças com desenvolvimento típico (DT). Método. Foram avaliadas 68 crianças com SD e 68 com DT (n=136), divididas em 3 subgrupos etários: 6 meses a 23 meses, 24 meses a 59 meses e de 60 meses a 90 meses. Para avaliação, utilizou-se o teste funcional PEDI (Pediatric Evaluation of Disability Inventory). O teste não paramétrico de Mann-Whitney e a correlação de Spearman foram utilizados para análise estatística. Resultados. As crianças SD apresentam escores inferiores às crianças DT nas funções de autocuidado, de mobilidade e de função social em todas as faixas etárias (p <0,05). Os subgrupos de 60 meses a 90meses não apresentaram diferença quanto à função de mobilidade (p=0,081). A renda per capita e escolaridade materna impactaram a funcionalidade do grupo DT na função social (r=0,635) e de autocuidado (r=0,581), mas não impactaram a funcionalidade grupo SD. Conclusão: A função social e de autocuidado na SD diferem do desenvolvimento típico e as funções de mobilidade são compatíveis com o DT por volta do quinto ano de vida. As condições socioeconômicas não impactam a funcionalidade das crianças com SD.>
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