Дисертації з теми "Peripheral vascular diseases Diagnosis"
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-50 дисертацій для дослідження на тему "Peripheral vascular diseases Diagnosis".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте дисертації для різних дисциплін та оформлюйте правильно вашу бібліографію.
Insall, R. L. "Pulse waveforms and transit time from photoelectric plethysmography in the diagnosis of peripheral vascular disease." Thesis, University of Newcastle Upon Tyne, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309069.
Повний текст джерелаOutif, Ahmed M. "Measurement of limb vascular volume using nuclear medicine technique : A new physiological approach to the diagnosis of peripheral arterial occlusive disease." Thesis, University of Bristol, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310638.
Повний текст джерелаSilva, Rita de Cassia Gengo e. "Validação das características definidoras do diagnóstico de enfermagem: perfusão tissular periférica ineficaz em pacientes com doença arterial obstrutiva periférica sintomática." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-26082010-134117/.
Повний текст джерелаINTRODUCTION: The nursing diagnosis Ineffective Peripheral Tissue Perfusion (PTPI) and its defining characteristics (CD) have not yet been validated in patients with peripheral arterial obstructive disease (DAOP) in the lower limbs, through tests that evaluate functional capacity and arterial vascular function. OBJECTIVE: To validate some CD of PTPI in patients with symptomatic DAOP and verify the relevance of these characteristics in determining this nursing diagnosis. METHOD: 65 patients with DAOP were selected (62.2 + 8.1 years; 56.9% male; ankle brachial index - ABI = 0.59 + 0.14), in which PTPI was diagnosed considering the presence of intermittent claudication and ABI <0.90, and 17 control subjects (63.4 + 8.7 years; 41.2% male; ABI = 1.14 + 0.08). All participants were submitted to physical assessment, ABI measurement, evaluation of functional capacity and arteries functional properties. ABI was calculated for each leg, dividing the higher pressure of the ankle by the higher pressure of the arms, whereas the worst ABI was considered. Patients with ABI related to DAOP were split according to the impairment of peripheral circulation. Functional capacity was determined through the six-minute walk test (TC6). Total and pain free distances were recorded. Arteries funcional properties were evaluated in terms of arterial stiffness (C-F PWV and C-R PWV) using the Complior®, and in terms of vascular reactivity using high-resolution ultrasound in basal condition and after reactive hyperemia and sublingual administration of nitrate. Reactive hyperemia promotes endotlhelium dependent vasodilation which is flow mediate (DMF); nitrate is a nitric oxide donor and causes endothelium independent vasodilation. RESULTS: The prevalence of the CD absent or weak peripheral pulses was higher among patients with PTPI compared with control subjects (> 70.0% versus 5.3%, respectively, p < 0.001). Patients with PTPI traveled shorter distances in the TC6 (265.1 + 77.4 versus 354.7 + 42.1 m, p < 0.001), presented higher C-F PWV (12.2 + 4.0 versus 9.6 + 2.2 m/s, p = 0.016), lower FMD (2.7 + 4.2% versus 6.1 + 5.4%, p = 0.014) and lower post nitrate dilation (14.3 + 8.4% versus 20.6 + 10.0%, p = 0.019) than the control group. The individual analysis of CD showed that their presence were associated with reduction in the total and pain free walking distances in TC6, increased C-F PWV, and diminished FMD and post nitrate dilation. The absent or weak dorsalis pedis and/or posterior tibial arterial pulses in the cluster analysis predicted: (1) poor functional capacity, reduction of 61 meters in the total walking distance and 124 meters in the pain free walking distance; (2) higher arterial stiffness, because the average of C-F PWV increased 18%; and (3) greater impairment of vascular reactivity, evidenced by a reduction of 2.6% in the FMD. In addition, alteration in the amplitude of some peripheral pulse or bruit in the left femoral artery increased 1024 times the risk of PTPI. Total and pain free walking distances in the TC6, C-F PWV and the post nitrate dilation were significantly associated with greater impairment of peripheral circulation evaluated through ABI. An increase of 1m of pain free travelled distance reduced the risk of severe (or moderate and severe) impairment of peripheral circulation in 0.8% (CI 95% = 0.985 - 0.998), whereas an increase of 1m/s in the C-F PWV increased the risk by 23.7% (CI 95% = 1.057 - 1.448). CONCLUSION: The CD absent or weak peripheral pulses was the most relevant characteristic determining the nursing diagnosis PTPI because it presented the highest prevalence, was associated with reduced functional capacity, and presented a strong association with arteries functional alteration.
Sigvant, Birgitta. "Epidemiological aspects of peripheral arterial disease." Stockholm : Department of Molecular Medicine and Surgery, Karolinska Institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-670-5/.
Повний текст джерелаEneroth, Magnus. "Amputation for vascular disease prognostic factors for healing, long-term outcome and costs /." Lund : Lund University, Dept. of Orthopedics, Lund University Hospital, 1997. http://catalog.hathitrust.org/api/volumes/oclc/39752358.html.
Повний текст джерелаÖgren, Mats. "Vascular morbidity and mortality in men with non-invasively detected peripheral arterial disease results from the prospective population study "Men born in 1914" /." Lund : Dept. of Community Health Sciences and the Dept. of Clinical Physiology, Malmö General Hospital, Lund University, 1994. http://catalog.hathitrust.org/api/volumes/oclc/39693808.html.
Повний текст джерелаLayman, Hans Richard William. "Tissue Engineering Strategies for the Treatment of Peripheral Vascular Diseases." Scholarly Repository, 2010. http://scholarlyrepository.miami.edu/oa_dissertations/461.
Повний текст джерелаChristman, Sharon Klopfenstein. "Intervention to slow progression of peripheral arterial disease." Connect to this title online, 2003. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1054059524.
Повний текст джерелаTitle from first page of PDF file. Document formatted into pages; contains xiii, 123 p.; also includes graphics (some col.). Includes bibliographical references (p. 114-123). Available online via OhioLINK's ETD Center
Lewis, M. H. "Peripheral arterial disease from aetiology to surgical management." Thesis, University of South Wales, 2013. https://pure.southwales.ac.uk/en/studentthesis/peripheral-arterial-disease-from-aetiology-to-surgical-management(7defd31a-6995-4fc7-9302-2fced42b5982).html.
Повний текст джерелаRichardson, Jim. "Living with peripheral vascular disease a one-person case study : a dissertation [thesis] presented in partial fulfilment of the requirements for the Master of Health Science at Auckland University of Technology, December 2002." Full thesis. Abstract, 2002.
Знайти повний текст джерелаCollins, Patrick William Hugh. "Assessing the severity of lower limb ischaemia and the thrombo-inflammatory response to surgery and exercise in peripheral arterial disease." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources. Restricted contains 3rd party material and therefore cannot be made available electronically until Jan. 1, 2012, 2008. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=53369.
Повний текст джерелаWith: Surgical revascularisation in patients with severe limb ischaemia induces a pro-thrombotic state / P. Collins ... et al. Platelets. 2006: 17(5), 311-317. With: A preliminary study on the effects of exercising to a maximum walking distance on platelet and endothelial function in patients with intermittent claudication / P. Collins ... et. Eur. J. Vasc. Endovasc. Surg. 2006: 31, 266-273. Includes bibliographical references.
Wilson, Alasdair. "The effects of combination antiplatelet therapy on smooth muscle mitogenesis after angioplasty for claudication." Thesis, University of Aberdeen, 2010. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165239.
Повний текст джерелаHou, Xiang-Yu. "Exercise performance and mitochondrial function in peripheral arterial disease." Thesis, Queensland University of Technology, 2002. https://eprints.qut.edu.au/36778/1/36778_Digitised%20Thesis.pdf.
Повний текст джерелаCunningham, Margaret. "Psychological factors associated with walking in patients with Peripheral Arterial Disease." Thesis, University of Stirling, 2010. http://hdl.handle.net/1893/3040.
Повний текст джерелаSanderson, Brad E. "Supervised stationary cycling versus supervised treadmill-walking for periperal arterial disease /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18988.pdf.
Повний текст джерелаMamadu, Hadii M., Timir Paul, Liang Wang, Sreenivas P. Veeranki, Hemang B. Panchal, Arsham Alamian, Pooja Subedi, and Mattew Budoff. "Association Between Multiple Modifiable Risk Factors of Cardiovascular Disease and Hypertension in Rural Appalachia. Arteriosclerosis, Thrombosis and Vascular Biology (ATVB)/Peripheral Vascular Disease (PVD) 2016 Scientific Sessions." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1394.
Повний текст джерелаLee, Kui-Joo. "The detection of double product break point in individuals with peripheral arterial disease." Virtual Press, 2000. http://liblink.bsu.edu/uhtbin/catkey/1178340.
Повний текст джерелаSchool of Physical Education
Al, Talalwah Waseem. "The vascular variability of the iliac system and clinical diagnosis in radiology and neurology." Thesis, University of Dundee, 2013. https://discovery.dundee.ac.uk/en/studentTheses/1aa955a0-1289-4670-b226-0eea5425ae0b.
Повний текст джерелаArreguy-Sena, Cristina. "A trajetória de construção e validação dos diagnósticos de enfermagem: trauma vascular e risco para trauma vascular." Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-04102011-100032/.
Повний текст джерелаAs we investigate the process of the construction of nursing diagnoses (vascular trauma and/or Risk of vascular trauma), we intend to classify, in the first chapter, the types of peripheral surface veins of teenage, adult, and elderly patients, according to the characteristics of a vein that can be punctured for therapeutic and diagnostics purposes, based on the application of the Delphi technique, judged by people from our different professional categories (angiologists, anesthetists, nurses and biochemists). We obtained a C.I. of over 90% for totally adequate/pertinent and less than 10% for moderately adequate/pertinent for the 13 criteria applied: mobility, course, insertion/derivation, caliber, visibility, palpation and localization with reference to the joint, location of the vein with reference to its anatomical structure, regulation of the diameter of the venous course, consistency of the venous course, continuity of the vessel tissue, how easy it is to puncture the vein, and other criteria to be included. In chapter 2, we present the construction of the elements (name, defining features, related factors) of the nursing diagnosis \"vascular trauma\" and of the elements (name, risk factor) of the nursing diagnosis \"risk of vascular trauma\", based on our reading of the existing literature and on our work experience, and the validation of their respective components as in Fhering´s (1986) model, and the adaptation of these to the related factors and risk factors. 60 experts took part. To summarize: of the 18 defining features analyzed, 15 were found to be greater (cut-off point >=0,8) and one smaller (cut-off point >=0,5 and <=0,8); of the 14 related factors analyzed, all met with approval, 11 of them with weighted average scores greater than or equal to 0,8 and of the 51 risk factors analyzed, 8 were approved with scores over 0,5 for situations connected with medication and the manner or intervals of infusion; 4 were approved for situations connected with the intravenous device and the time it remained in the same place of insertion, 5 were approved for situations connected with the individual, his/her habits, standard of communication, lifestyle and sensory-motor ability, and 20 were approved for situations connected with professional decisions, institutional policies and the procedure itself. Finally, in chapter 3, we present the clinical validation of some components of the diagnoses \"vascular trauma\" and \"risk of vascular trauma\", using a group study; our observations were based on 323 people and 427 point of insertion of the intravenous device. The results of the model adjustment test were significant tor a set of nine variables which may be transposed to similar populations. The most prominent of these variables were the time the device remained in one place of insertion and the quality of fixing of the devices (whether they were fixed or loose). Other factors were shown to be relevant only for the population under study.
Walvick, Ronn P. "Magnetic Resonance Imaging of Neural and Pulmonary Vascular Function." Digital WPI, 2010. https://digitalcommons.wpi.edu/etd-dissertations/372.
Повний текст джерелаNi, Chih-Wen. "Discovery of mechanosensitive microrna and messenger RNA in mouse arterial endothelium and in cultured endothelial cells." Diss., Georgia Institute of Technology, 2010. http://hdl.handle.net/1853/34674.
Повний текст джерелаHollabaugh, Kimberly Marie. "Analysis of oxygen uptake kinetics during exercise in subjects with peripheral arterial disease an application of non-linear mixed-effects regression modeling procedures for repeated measurement data /." Oklahoma City : [s.n.], 2010.
Знайти повний текст джерелаAcevedo, Lipes Andrea Milena. "Deep Learning System for the Automatic Classification of Normal and Dysplastic Peripheral Blood Cells as a Support Tool for the Diagnosis." Doctoral thesis, Universitat de Barcelona, 2021. http://hdl.handle.net/10803/671387.
Повний текст джерелаLos especialistas de laboratorio identifican visualmente muchas características morfológicas para identificar las diferentes células normales, así como los tipos de células anormales, cuya presencia en sangre periférica es evidencia de enfermedades graves. Algunas de las desventajas del análisis morfológico visual incluyen que toma mucho tiempo, necesita experiencia para realizar una revisión objetiva de los frotis y es propenso a la variabilidad entre observadores. Además, la mayoría de las descripciones morfológicas se proporcionan en términos cualitativos. Debido a lo expuesto anteriormente, es necesario establecer medidas cuantitativas. El objetivo general de esta tesis es el reconocimiento automático de células normales y células displásicas circulantes en sangre en síndromes mielodisplásicos mediante redes neuronales convolucionales y técnicas de procesamiento digital de imágenes. Para lograr este objetivo, este trabajo comenzó con el diseño y desarrollo de una base de datos Mysql para almacenar información e imágenes de pacientes y el desarrollo de un primer clasificador de cuatro grupos de células, utilizando redes neuronales convolucionales como extractores de características. Luego, se compila un conjunto de datos de alta calidad de alrededor de 17.000 imágenes de células sanguíneas normales y se utiliza para el desarrollo de un sistema de reconocimiento de ocho grupos de células sanguíneas. En este trabajo, comparamos dos enfoques de aprendizaje por transferencia para encontrar el mejor para clasificar los diferentes tipos de células. En la segunda parte de la tesis se desarrolla un nuevo modelo de red neuronal convolucional para el diagnóstico de síndromes mielodisplásicos. Este modelo fue validado mediante prueba de concepto. Se considera uno de los primeros modelos que se han construido para apoyar el diagnóstico. El trabajo final de la tesis es la integración de dos redes convolucionales en un sistema modular para la clasificación automática de células normales y anormales. La metodología y los modelos desarrollados constituyen un paso adelante hacia la implementación de un sistema modular para reconocer automáticamente todos los tipos de células en una configuración real en el laboratorio.
Melo, Michele Nakahara. "Processo de punção de vasos e trauma vascular periférico em uma unidade de pronto atendimento." Universidade Federal de Juiz de Fora (UFJF), 2017. https://repositorio.ufjf.br/jspui/handle/ufjf/5883.
Повний текст джерелаApproved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-10-16T13:30:48Z (GMT) No. of bitstreams: 1 michelenakaharamelo.pdf: 6340172 bytes, checksum: 390b3ea0b5a42d8c811bbac88f7cc6f5 (MD5)
Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-10-16T13:31:14Z (GMT) No. of bitstreams: 1 michelenakaharamelo.pdf: 6340172 bytes, checksum: 390b3ea0b5a42d8c811bbac88f7cc6f5 (MD5)
Made available in DSpace on 2017-10-16T13:31:14Z (GMT). No. of bitstreams: 1 michelenakaharamelo.pdf: 6340172 bytes, checksum: 390b3ea0b5a42d8c811bbac88f7cc6f5 (MD5) Previous issue date: 2017-08-21
Introdução: O uso dos vasos sanguíneos, apesar de ser reconhecido como útil e benéfico à prática clínica, pode causar iatrogenias, efeitos adversos e comprometer a segurança, o tratamento e o conforto dos usuários. As manifestações de alteração no sítio de inserção dos cateteres intravasculares periféricos (CIVPs) ou nas áreas adjacentes são conhecidas como trauma vascular. Objetivo: produzir tecnologia assistencial leve-dura na modalidade de bundle para subsidiar implementação de intervenções de enfermagem sobre o processo de punção de vasos periféricos e a prevenção de trauma vascular numa Unidade de Pronto Atendimento (UPA) a partir de um diagnóstico situacional, com vistas à estruturação do cuidado de enfermagem baseado em evidências. Métodos e técnicas: Foram referenciais: 1) Políticas Públicas em Urgência/Emergência; 2) Processo de punção de vasos periféricos numa UPA; 3) Teoria das Representações Sociais (Abric) e 4) Teoria de Neuman. Pesquisa de método misto (qualiquanti), operacionalizada em procedimentos sequenciais e simultâneos utilizando intervenções complexas, segundo Medical Research Council (MRC). Cenário: UPA de porte III em Minas Gerais. Foram etapas metodológicas: desenvolvimento (revisão integrativa, ambiência, diário de campo, abordagem estrutural das representações sociais); confiabilidade e pilotagem (coorte e diário de campo); avaliação (construção do bundle, processo educativo e diário de campo) e implementação (educação permanente com segmento e monitoramento e diário de campo). Participaram 56 membros da equipe de enfermagem e 228 usuários do Sistema Único de Saúde (SUS) que tiveram suas veias puncionadas avaliadas numa coorte (252). Dados coletados por triangulação de técnicas e métodos (semiológicos, fotográficos, entrevistas, técnicas projetivas, observação participativa e consulta a acervo eletrônico) com apoio do aplicativo Open Data Kit (ODK). Foram utilizados programas EVOC 2000® e SPSS24®, sendo atendidos requisitos éticos/legais de pesquisa envolvendo seres humanos. Resultados: usuários se apresentaram como homens (58,3%), de baixa escolaridade (56,8%), idosos (55,6%) e alocados no setor amarelo (67,1%); incidência de trauma vascular periférico de 62,3% (predominando endurado, edema e dor) documentados por critérios imagéticos. Houve correlação (p-valor= 0,001-0,040) entre sexo, faixa etária, hipertensão, sangue visível e autoavaliação de ter veia difícil de puncionar com a variável de desfecho (trauma vascular). Produziuse tecnologia assistencial leve-dura na modalidade de bundle, alicerçado em diagnóstico situacional e evidências científicas. Foram utilizadas ferramentas tecnológicas/comunicacionais e didático-pedagógicas (vídeo e protocolo) para subsidiar abordagens individuais e grupais. A revisão integrativa delineou acervos sobre tipos/causas de trauma vascular e intervenções compatíveis com usuários de uma UPA, explicitando perfis modificáveis/não modificáveis por intervenções de enfermagem. Elementos simbólicos retrataram respostas humanas dos usuários e profissionais que norteiam demandas de cuidados e lacunas na percepção de como os mesmos concebem, enfrentam, valoram, experienciam a temática e lidam com ela. Concepção coletiva dos profissionais alicerçada numa técnica fragmentada desconectada da relação dialógica sensível e singular que deve presidir qualquer ato profissional. Conclusões/Considerações finais: a complexidade da temática e o distanciamento do enfermeiro de seu protagonismo no direcionamento da atuação da equipe de enfermagem e das atividades assistências/gerenciais possibilitaram negar a hipótese de nulidade de H1 e a hipótese de nulidade de H2. Foram contribuições: diagnóstico situacional, criação do bundle e abordagem educativa. Recomenda-se: investimento institucional em educação permanente da equipe de enfermagem e de materiais apropriados, criação de um protocolo institucional de notificação de eventos adversos e realização de uma coorte após a implementação do bundle e a replicação da investigação em outras UPAs.
Introduction: The use of blood vessels, despite being recognized as useful and beneficial to clinical practice, can cause iatrogenic, adverse effects and compromise the safety, treatment and comfort of the users. The manifestations of change in the insertion site of the peripheral intravascular catheters or adjacent areas are known as vascular trauma. Objectives: to produce light-hard assistance technology in the bundle modality to support the implementation of nursing interventions on the peripheral vessel puncture process and prevent the vascular trauma in an Emergency Department (ED) based on a situational diagnosis, with a view to the structuring of evidence-based nursing care. Methods and techniques: Reference was made to: 1) Public Policies in Emergency; 2) Procedure of puncture of peripheral vessels in a UPA; 3) Theory of Social Representations (Abric) and 4) Theory of Neuman. Mixed-method research, operationalized in sequential and simultaneous procedures using complex interventions, according to the Medical Research Council (MRC). Scenario: UPA of size III in Minas Gerais. There were methodological steps: Development (integrative review, ambience, field diary, structural approach to social representations); Reliability and Piloting (cohort and field diary); Evaluation (bundle construction, educational process and field diary) and Implementation (permanent education with segment and monitoring and field diary). Participants were 56 members of the nursing team and 228 users of the Sistema ùnico de Saúde (SUS) who had their punctured veins evaluated in a cohort (252). Data collected by triangulation of techniques and methods (semiological, photographic, interviews, projective techniques, participatory observation and electronic collection) with the support of the Open Data Kit (ODK), EVOC 2000® and SPSS24® programs were used, and ethical/legal research requirements involving human beings were met. Results: users presented as: men (58.3%), with low schooling (56.8%), elderly (55.6%) and allocated in the yellow sector (67.1%); incidence of peripheral vascular trauma of 62.3% (predominantly enduring, edema and pain) documented by imaging criteria. There was a correlation (p-value = 0.001-0.040) between sex, age, hypertension, visible blood and self-evaluation of having a difficult-to-puncture vein with outcome variable (vascular trauma). Light-hard care technology was developed in bundle modality, based on situational diagnosis and scientific evidence. Technological / communicational and didactic-pedagogical tools (video and protocol) were used to subsidize individual and group approaches. The integrative review delineated collections on types/causes of vascular trauma and interventions compatible with ED users, explaining modifiable/non-modifiable profiles by nursing interventions. Symbolic elements portrayed human responses from users and practitioners who drive care demands and gaps in the perception of how they conceive, confront, value, experience, and deal with the issue. Collective conception of professionals based on a fragmented technique disconnected from the sensitive and singular dialogical relationship that should preside any professional act. Conclusions / final considerations: the complexity of this issue and the distance of the nurses from their role in directing the nursing staff and assisting/management activities made it possible to deny the hypothesis of nullity of H1 and the hypothesis of nullity of H2. Contributions were: situational diagnosis, bundle creation and educational approach. It is recommended: institutional investment in continuing education of the nursing team and appropriate materials, creation of an institutional protocol for reporting adverse events and completion of a cohort after the implementation of the bundle and replication of this research in other EDs.
Sanfins, Milaine Dominici. "Neuropatia auditiva/dessincronia auditiva: um estudo em alunos de três escolas especiais para deficientes auditivos da cidade de São Paulo." Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-19092014-101620/.
Повний текст джерелаIntroduction: Auditory Neuropathy/Auditory Dys-synchrony (AN) is a disorder identified only 20 years ago. Due to diagnosis failure, patients with this disorder were diagnosed as hearing impaired. AN diagnosis was made possible upon the appearance of OAE\'s recordings and its presence in hearing evaluation battery. Therefore, it is possible that some individuals who have been diagnosed as suffering from sensorioneural hearing loss had indeed AN. Purpose: The purpose of this study was to characterize the type and degree of auditory impairment in a population of the hearing impaired in the city of São Paulo; to verify when parents had the suspicious of the hearing impairment and when was the audiological diagnosis done in these individuals; to identify the subjects whose behavioral evaluations are not compatible with the electrophysiological evaluations in order to identify Auditory Neuropathy events and carry out a qualitative study of the cases of subjects with incompatibility of responses in the behavioral and electrophysiological evaluations. Method: 89 hearing impaired individuals from three school for the deaf in the city of São Paulo, and 11 from the Educational Audiology Division of the Medicine School of the University of São Paulo were evaluated in some audiological tests: imitanciometry, audiometer evaluation (AE), otoacoustic emissions (OAE) and Auditory Brainstem Response (ABR). Results: Out of the 100 subjects in this study, 99% presented a sensorioneural hearing loss, and in 50% the predominant degree of auditory loss was profound, one of the subjects was not able to perform AE. The average age of parents suspicion was 15.52 months and the clinical diagnosis was 25.07 months, in all the groups the parents suspicion was prior to the formal diagnosis. Only one subject presented behavioral evaluations incompatible with the electrophysiological, however, in the course of the research the chart was changed, whereas the hearing fluctuation was the most remarkable factor observed. Conclusions: The results suggest that AN is a rare disorder even in the hearing impaired community and alert the need of long term follow up in the cases of suspected disorder
Zerati, Antonio Eduardo. "Prevalência de síndrome metabólica em pacientes com claudicação intermitente e sua correlação com o nível de obstrução arterial." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-18022011-115810/.
Повний текст джерелаINTRODUCTION: The metabolic syndrome consists in a group of cardiovascular risk factors referring to insulin resistance, associated with increased cardiovascular morbidity and mortality. Metabolic syndrome is correlated to several illnesses, especially those associated with atherosclerosis, like peripheral arterial disease. Intermittent claudication is a symptom of an early stage of peripheral arterial disease, and the precocious diagnosis of metabolic syndrome is important for adequate medical treatment, in order to prevent or delay the progression of atherosclerosis. OBJECTIVES: The aim of this cross-sectional study is to determine the prevalence of the metabolic syndrome in patients with intermittent claudication and its correlation with age, gender, localization of arterial obstruction and association with symptomatic coronary artery disease. METHODS AND RESULTS: There were studied 170 consecutive patients with intermittent claudication, determined by physical examination, which revealed absence or weakness of pulses on the limb or limbs that were limiting deambulation, and an ankle-brachial index 0.9. The mean age was 65 years (33-89 years). There were 117 men (68.8%) with mean age of 65.6 years (33 84 years) and 53 women (31.1%) with mean age of 63.7 years (35 89 years). Metabolic syndrome was diagnosed in 98 patients (57.6%), 62 men (63.3%) and 36 women (36.7%). The mean age of patients with metabolic syndrome was 63.5 years, against 67.0 years of patients without metabolic syndrome (P= .027). Considering patients with 65 years old, the metabolic syndrome was present in 46 (48.9%) individuals and in 52 (68.4%) patients below 65 years old (P= .011). CONCLUSIONS: The metabolic syndrome is frequent among patients with intermittent claudication, with a significant higher prevalence in claudicants < 65 years of age. The metabolic syndrome was not correlated with sex and symptomatic coronary artery disease. The metabolic syndrome did not affect any specific arterial segment in claudicant patients
Damiano, Ana Paula. "Efeitos de um programa de exercício físico a curto prazo na claudicação intermitente de pacientes com doença arterial obstrutiva periférica." Universidade do Estado de Santa Catarina, 2008. http://tede.udesc.br/handle/handle/409.
Повний текст джерелаCoordenação de Aperfeiçoamento de Pessoal de Nível Superior
Intermittent claudication (IC) is the main symptom of peripheral arterial occlusive disease (PAOD) and it can severely affect the walking capacity. This study aimed to investigate the effects of a short-course physical exercise program on intermittent claudication of PAOD patients. Twelve out of the 34 recruited subjects were excluded for several reasons. Twenty-two subjects (14 males, mean age 64.4 ± 10.4 years, ankle-brachial index ≤ 0.8) with varied clinical characteristics were included, and all have participated in Programa de Reabilitação de Doenças Vasculares Periféricas do Núcleo de Cardiologia e Medicina do Exercício (NCME) of the CEFID/UDESC. The physical performance was objectively assessed by means of a 6-minute walk test and subjectively assessed by means of the walking impairment questionnaire. The primary walking test was carried out in order to assess the initial and absolute claudication distances, and lasted up to 15 minutes. The final test lasted up to 30 minutes, if necessary. The results showed that 3 out of the 22 participants had no claudication, being able to walk up to one hour without pain. The mean improvement of the initial claudication distance for the 19 remaining participants was 74.15% (67.6 ± 61.4m, p<0.05). Eleven patients (50%) did not report absolute claudication pain during the primary test; 3 patients, with prior absolute claudication pain, completed the final walking test without reporting pain, and the 8 remaining patients, who still reported absolute claudication pain, had a mean improvement of 48.61% (84.3 ± 58.8m, p<0.05) in walking distance. Regarding the distance walked in 6 minutes, the mean improvement of the 22 patients was 17% (41.1 ± 62.5, p<0.05). It was also possible to notice mean improvement (n = 22) of 14.30% (p<0.05) in walking capacity impairment; 17.56% (p<0.05) in walking distance; 4.59% (p=0.258) in walking speed and 5.49% (p=0.468) in stair climbing. In conclusion, a short-course physical exercise program is effective in PAOD and IC patients. Throughout the walking test, the initial and absolute claudication distances and the distance walked in 6 minutes were significantly improved. The walking impairment questionnaire showed considerable improvements related to walking impairment and walking distance, however, concerning walking speed and stair climbing, the improvements were not statistically significant.
A claudicação intermitente (CI) é o principal sintoma da doença arterial obstrutiva periférica (DAOP) e pode comprometer severamente o desempenho de caminhada. O objetivo do estudo foi investigar os efeitos de um programa de exercício físico a curto prazo na claudicação intermitente de pacientes com DAOP. Dos 34 indivíduos selecionados, 12 foram excluídos por diversos motivos. Os 22 incluídos (14 do gênero masculino, média de idade 64,4 + 10,4 anos, índice tornozelo braquial < 0,8), todos participantes do Programa de Reabilitação de Doenças Vasculares Periféricas do Núcleo de Cardiologia e Medicina do Exercício (NCME) do CEFID/UDESC, apresentavam características clínicas heterogêneas. O desempenho físico foi avaliado objetivamente por meio do teste de caminhada de 6 minutos e subjetivamente pelo questionário de dificuldade para caminhar. O teste inicial de caminhada, destinado à avaliação das distâncias de claudicação inicial e absoluta, foi prolongado até 15 minutos e o final, quando necessário, até 30 minutos. Os resultados demonstraram que, dos 22 participantes do estudo, 3 deixaram de sentir a claudicação, caminhando até uma hora no programa de exercícios sem referir dor. Nos 19 pacientes restantes, a melhora média da distância de claudicação inicial foi de 74,15% (67,6 ± 61,4m, p<0,05). Dos 22 pacientes incluídos no estudo, 11 (50%) não apresentaram dor da claudicação absoluta no teste inicial; 3 pacientes, antes com dor da claudicação absoluta, completaram o teste de caminhada final sem essa manifestação e nos restantes (8 pacientes), que ainda apresentavam dor da claudicação absoluta, foi observada melhora média na distância caminhada de 48,61% (84,3 ± 58,8m, p<0,05). Quanto à distância percorrida em 6 minutos, a melhora média dos 22 pacientes foi de 17% (41,1 ± 62,5, p<0,05). Foi ainda constatado melhora média (n = 22) de 14,30% (p<0,05) na dificuldade para caminhar; 17,56% (p<0,05) na distância de caminhada; 4,59% (p = 0,258) na velocidade de caminhada e 5,49% (p = 0,468) na subida de degraus. Conclui-se que um programa de exercício físico a curto prazo é eficiente no tratamento de pacientes com DAOP e CI. Foi possível observar, por meio do teste de caminhada, melhora significativa na distância para claudicação inicial e absoluta e na distância percorrida em 6 minutos. A aplicação do questionário de dificuldade para caminhar demonstrou melhoras significativas relacionadas à dificuldade para caminhar e à distância de caminhada, sendo, entretanto, as melhoras relacionadas à velocidade de caminhada e subida de degraus consideradas estatisticamente não significativas.
Freitas, Dayana. "Risco cardiovascular na hipertensão do avental branco: avaliação do Índice Tornozelo Braquial." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-14012013-155532/.
Повний текст джерелаThe vascular changes are secondary clinical complications of high blood pressure which can compromise the functional capacity and increase the risk of mortality. The Ankle-Brachial Index (ABI) is an instrument used as a marker of peripheral occlusive arterial disease which has attracted broad scientific and clinical interest. According to guidelines for clinical practice, ABI values <=0.9 or >=1.3 are considered pathological and associated with a high incidence of cardiovascular morbidity and mortality. This descriptive and cross-sectional study aimed at identifying cardiovascular risk in white coat hypertension by determining the ABI through the use of automatic oscillometric sphygmomanometers. The study was performed in a municipality located in the northeastern of the state of São Paulo, from August 2010 to June 2011. Participants were divided into normotensive, hypertensive, and white coat hypertensive subjects, classified according to the medical diagnosis and outcome of Ambulatory Blood Pressure Monitoring (ABPM). The variables investigated were: age, color of skin, marital family situation, nationality, level of education, occupation, weight, height, waist circumference, ankle-brachial blood pressure and ABI. The calculation of ABI was performed by the ratio between the higher systolic blood pressure (SBP) of the posterior tibial artery and the highest systolic brachial artery. Descriptive analyzes were performed using the Statistical Package for Social Sciences Statistical Package - SPSS, version 15.0. The analysis of variance (ANOVA) was used for repeated measures and Tukey test for multiple comparisons of means. The degree of linear relationship in the scores of SBP and ABI was verified by using the Pearson correlation coefficient. The results were expressed as means ± standard errors of the mean (SEM), and the differences were considered statistically significant at p<0.05. The study included 135 subjects, 37% normotensive, 37% hypertensive and 26% white coat hypertensive subjects. In all groups, most participants are female, white, live with the spouse, from the state of São Paulo, housewives and have incomplete elementary education. White coat hypertensive subjects have intermediate risk in the analysis of all clinical variables studied. Although no significant difference was found in the analysis of ABI values in the comparison of groups, changes consistent with peripheral occlusive arterial disease and arterial calcification was observed only in the groups with hypertensive and white coat hypertensive subjects. The analysis of the lower ABI value showed that 10% of hypertensive subjects and 5.7% of white- coat hypertensive subjects had ABI<=0.9 and 6% of hypertensive subjects and 11.4% of white-coat hypertensive subjects had ABI>1.3 . There is a negative correlation between SBP and ABI in the groups of hypertensive and white coat hypertensive subjects. These findings relate to the premise that white coat hypertension should not be understood as a benign condition, being characterized by a clinical condition that can lead to established hypertension. The measurement of ABI deserves importance in clinical management of patients and should be a tool for assessing cardiovascular risk valued by professionals in the routine of health services.
VAZQUEZ, JORGE ARTURO. "NERVE FIBER DIAMETER MEASUREMENTS USING HEMATOXYLIN AND EOSIN STAINING AND BRIGHTFIELD MICROSCOPY TO ASSESS THE NOVEL METHOD OF CHARACTERIZING PERIPHERAL NERVE FIBER DISTRIBUTIONS BY GROUP DELAY." DigitalCommons@CalPoly, 2014. https://digitalcommons.calpoly.edu/theses/1293.
Повний текст джерелаSICCHIERI, LETICIA B. "Estudo e caracterização de marcadores ópticos para a aterosclerose." reponame:Repositório Institucional do IPEN, 2016. http://repositorio.ipen.br:8080/xmlui/handle/123456789/26949.
Повний текст джерелаMade available in DSpace on 2016-12-22T16:50:04Z (GMT). No. of bitstreams: 0
O presente trabalho buscou investigar a formação da placa de aterosclerose através de caracterização da autofluorescência do tecido e do plasma na presença de marcadores fluorescentes. Para realizar o estudo, coelhos foram divididos em dois grupos: um grupo controle onde os animais foram submetidos a uma dieta normal e um grupo experimental onde os animais foram submetidos a uma dieta hipercolesterolêmica. Foram realizadas duas experimentações animais: na primeira os animais foram sendo eutanasiados ao longo do experimento e suas artérias foram coletadas. Na segunda os animais foram acompanhados por no máximo 80 dias. Durante o experimento apenas o sangue foi coletado e os animais foram eutanasiados no final do experimento. Dois marcadores fluorescentes foram utilizados no trabalho: o complexo európio-clorotetraciclina (EuCTc) e o corante tioflavina T (ThT). Analisouse inicialmente a fluorescência dos marcadores na presença do plasma dos coelhos tanto para o grupo controle, quanto para o grupo experimental em função dos tempos de dieta. Para o complexo EuCTc observou-se duas bandas de emissão, com excitação em 400 nm, uma característica da clorotetraciclina, em 515 nm e uma em 617 nm característica do íon európio. A análise da banda do íon európio indicou um incremento da banda de emissão do complexo na presença do plasma do grupo experimental em relação ao grupo controle. Para o corante ThT também foi observado um aumento na banda de emissão em 480 nm, com excitação em 413 nm, para o grupo experimental em comparação com o grupo controle. A potencialidade de utilização do complexo EuCTc e EuCTcMg (EuCTc na presença do íon magnésio) para marcação da placa de aterosclerose nas artérias, foi estudada através da análise de microscopia de fluorescência. Observou-se que a emissão do complexo melhora muito a visualização da placa quando comparada com a autofluorescência. Observou-se, através de microscopia de tempo de vida de fluorescência, que há uma transferência de energia entre os fluoróforos presentes na placa e os complexos EuCTc e EuCTcMg. Essa transferência de energia ocasionou em uma diminuição drástica no tempo de vida de fluorescência dos fluoróforos nessa região. Por fim, estudou-se a geração de segundo harmônico do colágeno na placa de aterosclerose, sendo obtidas diferenças na quantidade e organização do colágeno para os diferentes grupos experimentais.
Tese (Doutorado em Tecnologia Nuclear)
IPEN/T
Instituto de Pesquisas Energéticas e Nucleares - IPEN-CNEN/SP
Filho, José Carlos Jucá Pompeu. "Associação dos achados morfofuncionais cardíacos, renais e vasculares com as alterações do índice tornozelo-braço em pacientes hipertensos diabéticos." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-26102015-152333/.
Повний текст джерелаIntroduction: A lot of studies have established strong correlations between the ankle-brachial index (ABI), a marker of subclinical atherosclerosis and cardiovascular prognosis in different populations. However, few studies have assessed the correlation between the values of the ABI and cardiovascular and renal lesions in patients with hypertension and diabetes. Objective: To study the prevalence of cardiac, carotid, renal and retinal morphological and functional changes according to the presence or not of altered ABI values (ABI <= 0.9 or ABI > 1.4) in hypertensive patients with type 2 diabetes. Methods: It was included 99 diabetic hypertensive patients aged between 50 and 80 years. The measurement of the ABI was performed in all patients by validated method and they were classified in Group 1 (normal ABI, n = 49) or group 2 (altered ABI, n = 50). All patients were submitted, up to 6 months, to Doppler echocardiography, carotid ultrasound, color retinography, assessment of glomerular filtration rate (GFR) and 24h albuminuria. Patients were analyzed for the occurrence or not of a composite echocardiographic outcome which included morphological and functional cardiac alterations relevant to clinical practice. Patients in groups 1 and 2 were compared regarding the prevalence of carotid plaques with or without hemodynamic repercussion, TFG < 60 ml/min/m2, 24h albuminuria > 30 mg and the presence or not of retinopathy. Finally, we compared the prevalence of mean frequency of the following end-organ lesions of both groups, considering unit value for each one: left ventricular hypertrophy, hypertensive retinopathy, TFG < 60 ml/min/m2 and internal carotid artery stenosis > 50%. Results: The mean age of the patients was 65.4 ± 7 years, with 61.6% of them female. The presences of elevated levels of systolic blood pressure (153.4 ± 18 versus 170.0 ± 26 mmHg), of 24h albuminuria > 30 mg (55.3% versus 82.6%) and TFG < 60 ml/min/m2 (12.8% vs. 33.3%) were significantly greater (p < 0.05) among the patients of Group 2. The composite echocardiographic outcome was more prevalent in Group 2 (84.0% versus 59.2%, p = 0.006) and the average frequency of subclinical injury of target organs was also greater in patients of Group 2 (0.36 ± 0.31 versus 0.19 ± 0.19; p = 0.001). Binary logistic regression analysis revealed that the ABI was one of the independent predictors of composite echocardiographic outcome (OR = 3.43; IC 95% = 1.07 - 11.0; p = 0.04). From the linear regression analysis it was obtained a final model in which the ABI was one of three independent predictors for the estimation of the average frequency of end-organ damage with ? coefficient = 13.22 (1.81-24.63), besides age and previous myocardial infarction. Conclusion: Our data demonstrates that changed ABI values are associated with higher prevalence of subclinical end-organ lesions, principally changes in echocardiographic parameters, in patients with hypertension and diabetes
Struthers, Kyle Remington. "ISCHEMIA IMPAIRS VASODILATION IN SKELETAL MUSCLE RESISTANCE ARTERY." DigitalCommons@CalPoly, 2011. https://digitalcommons.calpoly.edu/theses/546.
Повний текст джерелаJogerst, Gerald J., Shimin Zheng, Elena V. Frolova, and Mee Young Kim. "Late-Life Depressive Symptoms: An International Study." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/43.
Повний текст джерелаFidelis, Ronald José Ribeiro. "Avaliação da extensão da oclusão arterial na isquemia crônica de membros inferiores: estudo comparativo da ecografia com Doppler colorido e da arteriografia." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-29012007-144331/.
Повний текст джерелаArteriography is an invasive method of imaging the vascular system that allows assessment of the intraluminal characteristics of the arteries. It detects minimal arterial wall changes with intravascular injections of contrast agents. Dispite significant advances in lasts decades, some pitfalls remain in determining the extension of arterial occlusions and the run-off vessels in cases of arterial occlusive disease in the lower extremities (LEAOD). Some authors have already studied the extension of the disease, by arteriography, in patients with femoropopliteal disease; nevertheless, none of them has so far used the Intraoperative Distal Prebypass Arteriography (IDA) as the goldstandard in patients with disease in the aortoiliac territory. This study is a clinical, prospective trial, developed by the Division of Vascular Surgery at the University of Sao Paulo to analyse the pre-operative arteriography (POA) in its capacity of showing the true extension of the arterial occlusion and the run-off vessels in LEAOD. The Duplex Ultrasound Arterial Mapping (DUAM) was also tested in the same situations. Extension of the arterial occlusion was defined as the length between the point where the contrast agent leaves the main vessel, and the point where the contrast come back to it, in the arterial system, the later called Refilling Point (RP). Run-off was defined as the sum of the distal arteries continuous with the RP. All of the patients included in this study were subjected in a determined time interval to a POA, a DUAM and a IDA. Forty seven lower extremities were studied in 33 patients (34 with aortoiliac, and 13 with femoropopliteal disease). POA detected the true RP in 53% of the instances, with a bad reprodutibility of the gold-standard (k = 0,44, P > 0,001). The DUAM detected the RP 74,5%, with a good results reprodutibliity (k = 0,68, P < 0,001). In the assessment of run-off vessels POA and DUAM have detected, respectively, 125 and 167 of the 183 arteries showed in IDA. This disagreement between POA and DUAM was estastistically significant (P = 0,001). The only clinical characteristic associated with the results was the anatomical location of the arterial disease. We concluded that the POA does not identify the true RP and the run-off vessels in the aortoiliac LEAOD. The DUAM showed a good agreement with the IDA, and so it can be considered a good choice to assess the RP and the run-off in aortoiliac and femoropopliteal LEAOD.
Brand, Martin. "Potential novel approaches to risk identification in advanced peripheral arterial disease." Thesis, 2014.
Знайти повний текст джерелаQuigley, Francis G. "Transcutaneous oxygen tension in the assessment of lower limb ischaemia and ulceration." Thesis, 1989. http://hdl.handle.net/2440/110690.
Повний текст джерелаKhalil, Michael. "Development of a Vascular Optical Tomographic Imaging System for the Diagnosis and Monitoring of Peripheral Arterial Disease." Thesis, 2014. https://doi.org/10.7916/D8DF6PCQ.
Повний текст джерела"Serum high-sensitivity C-reactive protein concentration of Chinese chronic-renal-failure patients with atherosclerotic vascular disease or cardiac valve calcification." 2002. http://library.cuhk.edu.hk/record=b5895944.
Повний текст джерелаThesis (M.Sc.)--Chinese University of Hong Kong, 2002.
Includes bibliographical references (leaves 85-93).
Abstracts in English and Chinese.
ACKNOWLEDGEMENTS --- p.4
SUMMARY --- p.5
ABBREVIATIONS --- p.9
LIST OF TABLES --- p.11
LIST OF FIGURES --- p.13
Chapter CHAPTER I --- INTRODUCTION --- p.14
Chapter 1.1 --- The Historical Aspects of C-Reaction Protein --- p.15
Chapter 1.2 --- Biochemistry of CRP --- p.16
Chapter 1.3 --- Physiology of CRP --- p.18
Chapter 1.4 --- Current Clinical Applications of Serum CRP Assay --- p.19
Chapter 1.5 --- Recent Findings of CRP --- p.21
Chapter 1.5.1 --- Pathophysiology of atherosclerosis --- p.22
Chapter 1.5.2 --- A nother atherogenic risk factor: hs- CRP --- p.26
Chapter 1.5.3 --- Can hs-CRP replace other risk factors? --- p.30
Chapter 1.5.4 --- Altering hs-CRP result in medication --- p.32
Chapter 1.6 --- Methods of Measurement of CRP Concentration --- p.33
Chapter 1.7 --- Analytical Considerations in the Measurement of hs-CRP --- p.34
Chapter CHAPTER II --- OBJECTIVES AND SIGNIFICANCE --- p.36
Chapter 2.1 --- Objectives --- p.37
Chapter 2.2 --- Issues and Problems --- p.37
Chapter 2.3 --- Significance and Value of this Study --- p.38
Chapter CHAPTER III --- MA TERIALS AND METHODS I Setting up the serum hs-CRP assay on the Hitachi 911 Analyzer --- p.39
Chapter 3.1 --- Materials --- p.40
Chapter 3.1.1 --- Reagents from Roche Diagnostics --- p.40
Chapter 3.1.2 --- Reagents for the Beckman Coulter Array ® Analyzer --- p.40
Chapter 3.1.3 --- In-house reagents --- p.41
Chapter 3.2. --- Apparatus and Equipment --- p.41
Chapter 3.2.1 --- Hitachi 911 Analyzer --- p.41
Chapter 3.2.2 --- Beckman Coulter Array ® 360 Analyzer --- p.42
Chapter 3.3 --- The Tina-quant a C-Reactive Protein (Latex) Ultrasensitive Assay --- p.42
Chapter 3.3.1 --- Priniciple of the Dual-Radius Enhanced Latex (DuREL´ёØ) technology --- p.42
Chapter 3.3.2 --- Assessment of Analytical Performance --- p.45
Chapter CHAPTER IV --- MA TERIALS AND METHODS II Serum hs-CRP in Chinese chronic-renal-failure patients with atherosclerotic vascular disease or cardiac valve calcification --- p.48
Chapter 4.1 --- Patient Recruitment --- p.49
Chapter 4.2. --- Blood Specimens --- p.49
Chapter 4.3 --- Assay Methods --- p.50
Chapter 4.3.1 --- hs-CRP --- p.50
Chapter 4.3.2 --- TC --- p.50
Chapter 4.3.3 --- TG --- p.51
Chapter 4.3.4 --- HDL-C --- p.51
Chapter 4.3.5 --- LDL-C --- p.52
Chapter 4.3.6 --- Apo A-1 --- p.52
Chapter 4.3.7 --- Apo B --- p.53
Chapter 4.3.8 --- Lp(a) --- p.53
Chapter 4.4 --- Ultrasound measurement of carotid artery inter-media thickness --- p.53
Chapter 4.5 --- Statistical analysis --- p.54
Chapter CHAPTER V --- RESUTLSI Setting up the serum hs-CRP assay on the Hitachi 911 Analyzer --- p.55
Chapter 5.1 --- Imprecision --- p.56
Chapter 5.2 --- Linearity --- p.56
Chapter 5.3 --- Recovery --- p.56
Chapter 5.4 --- Detection Limit --- p.57
Chapter 5.5 --- Carry-over --- p.57
Chapter CHAPTER VI --- RESULTS II Serum hs-CRP in Chinese chronic-renal-failure patients with atherosclerotic vascular disease or cardiac valve calcification --- p.63
Chapter 6.1 --- Patient Recruitment --- p.64
Chapter 6.2 --- Chinese chronic-renal-failure patients with AVD --- p.64
Chapter 6.3 --- Chinese chronic-renal-failure patients with CVC --- p.65
Chapter CHAPTER VII --- DISCUSSION I Performance of the serum hs-CRP assay on the Hitachi 911 Analyzer --- p.75
Chapter 7.1 --- "Imprecision, Detection Limit, Linearity, and Recovery of hs-CRP Assay" --- p.76
Chapter 7.1.1 --- Imprecision --- p.76
Chapter 7.1.2 --- Detection Limit --- p.76
Chapter 7.1.3 --- Linearity --- p.76
Chapter 7.1.4 --- Recovery --- p.77
Chapter 7.2 --- Overall Performance --- p.77
Chapter CHAPTER VIII --- DISCUSSION II Serum hs-CRP in Chinese chronic-renal-failure patients with atherosclerotic vascular disease or cardiac valve calcification --- p.79
Chapter 8.1 --- CAPD Patients --- p.80
Chapter 8.2 --- Serum hs-CRP Concentration of AVD and CVC Patients --- p.81
Chapter 8.3 --- Other risk factors in AVD and CVC Patients --- p.82
Chapter 8.4 --- Conclusion --- p.83
REFERENCES --- p.85
Hsu, Chin-Che, and 許晴哲. "Study of the cutaneous microcirculation in the gangrenous peripheral vascular diseases." Thesis, 1995. http://ndltd.ncl.edu.tw/handle/04735890581589452628.
Повний текст джерелаGunderson, Lisa C. "Physical activity change in peripheral artery disease patients." 2013. http://liblink.bsu.edu/uhtbin/catkey/1739774.
Повний текст джерелаAccess to thesis permanently restricted to Ball State community only.
School of Physical Education, Sport, and Exercise Science
Dzieciuch, Jennifer M. "Decision making of peripheral vascular disease patients threatened with limb loss a research report submitted in partial fulfillment ... Master of Science (Medical-Surgical Nursing) /." 1990. http://catalog.hathitrust.org/api/volumes/oclc/68795151.html.
Повний текст джерела"Plasma homocysteine, atheromatous vascular disease and platelet function." 2002. http://library.cuhk.edu.hk/record=b6073395.
Повний текст джерела"January 2002."
Thesis (Ph.D.)--Chinese University of Hong Kong, 2002.
Includes bibliographical references (p. 219-248).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Mode of access: World Wide Web.
Abstracts in English and Chinese.
Burris, Merrill Jami. "Effects of resistance exercise on functional ability and quality of life in persons with peripheral arterial disease." 2005. http://www.oregonpdf.org.
Повний текст джерелаMaharaj, Rabindranath Ramsuk. "An inter-racial study into the pattern and prevalence of atherosclerotic peripheral vascular disease in the University-based vascular surgical service in Durban." Thesis, 1996. http://hdl.handle.net/10413/8266.
Повний текст джерелаThesis (M.D.)-University of Natal, Durban, 1996.
"Homocysteinaemia (heterozygous state) in the Chinese population." Chinese University of Hong Kong, 1994. http://library.cuhk.edu.hk/record=b5887189.
Повний текст джерелаThesis (M.Sc.)--Chinese University of Hong Kong, 1994.
Includes bibliographical references (leaves 98-106).
LIST OF TABLES
LIST OF FIGURES
ACKNOWLEDGEMENTS
ABSTRACT --- p.1
Chapter CHAPTER ONE --- p.3
Chapter 1.1 --- Introduction --- p.3
Chapter 1.1.1 --- Sources of homocysteine and origins of deficiency or excess in the human body --- p.3
Chapter 1.1.2 --- Homocysteine metabolism --- p.4
Chapter 1.2 --- Causes of and clinical syndromes in homocysteinaemia --- p.12
Chapter 1.2.1 --- Deficiency of cystathionine β-synthase --- p.12
Chapter 1.2.1.1a --- Homozygous homocysteinaemia --- p.13
Chapter 1.2.1.1b --- Heterozygous hyperhomocysteinaemia --- p.17
Chapter 1.2.2 --- "Deficiency of 5, 10 methylenetetrahydrofolate reductase" --- p.20
Chapter 1.2.3 --- Defects of cobalamin synthesis --- p.21
Chapter 1.3 --- Standardised oral methionine load test --- p.23
Chapter 1.4 --- Treatment and prospects for homocysteinaemia --- p.25
Chapter 1.4.1 --- Homozygous homocysteinaemia --- p.25
Chapter 1.4.2 --- Heterozygous homocysteinaemia --- p.27
Chapter 1.5 --- Pathogenesis of vascular disease in homocystinuria --- p.28
Chapter 1.6 --- Aim of the study --- p.30
Chapter CHAPTER TWO --- p.31
Chapter 2.1 --- Patient's criteria --- p.31
Chapter 2.2 --- Control' s criteria --- p.32
Chapter 2.3 --- Exclusion criteria for patients and controls --- p.32
Chapter 2.4 --- The methionine loading test and additional investigations carried out --- p.33
Chapter 2.5 --- Statistics used for data analyses --- p.35
Chapter CHAPTER THREE --- p.38
Chapter 3.1 --- Sample collection --- p.38
Chapter 3.2 --- Analytical methods for homocysteine determination --- p.39
Chapter 3.2.1 --- Cyanide nitroprusside test --- p.39
Chapter 3.2.2 --- Radioenzymic Assays --- p.40
Chapter 3.2.3 --- Gas chromatography - Mass spectrometry --- p.41
Chapter 3.2.4 --- HPLC with Electrochemical detection --- p.42
Chapter 3.2.5 --- HPLC and postcolumn derivatization --- p.43
Chapter 3.2.6 --- "Precolumn derivatization, HPLC and fluorescence detection" --- p.44
Chapter 3.3 --- The method used in this study --- p.47
Chapter 3.3.1 --- Materials --- p.48
Chapter 3.3.2 --- Reagents --- p.49
Chapter 3.3.3 --- Instrumentation --- p.49
Chapter 3.3.4 --- Sample preparation --- p.50
Chapter 3.3.4.1 --- Reduction --- p.50
Chapter 3.3.4.2 --- Derivatization --- p.50
Chapter 3.3.5 --- Chromatographic conditions --- p.51
Chapter 3.3.6 --- Standard preparation --- p.51
Chapter 3.4 --- Method Optimization --- p.52
Chapter 3.4.1 --- Choice of reducing agent --- p.52
Chapter 3.4.1.1 --- Dithiotreitol (DTT) --- p.52
Chapter 3.4.1.2 --- Sodium borohydride --- p.53
Chapter 3.4.2 --- Choice of precipitating reagent --- p.56
Chapter 3.4.3 --- Optimization of chromatographic conditions --- p.56
Chapter 3.4.3.1 --- "Flow rate, temperature and organic composition of mobile phase" --- p.56
Chapter 3.4.3.2 --- pH of the mobile phase --- p.59
Chapter 3.4.4 --- Confirmation of homocysteine peak --- p.60
Chapter 3.5 --- Analysis of results --- p.60
Chapter 3.6 --- Method validation --- p.60
Chapter 3.6.1 --- Linearity --- p.60
Chapter 3.6.2 --- Precision --- p.63
Chapter 3.6.3 --- Recovery --- p.64
Chapter CHAPTER FOUR --- RESULTS --- p.66
Chapter 4.1 --- The pre- and post-methionine loading plasma homocysteine concentrations in patients and controls --- p.66
Chapter 4.2 --- The frequency distributions of hyperhomocysteinaemia in patients and controls --- p.68
Chapter 4.2.1 --- The distributions of homocysteinaemia in patients and controls --- p.68
Chapter 4.2.2 --- The frequency distributions of fasting hyper-homocysteinaemia in patients and controls --- p.68
Chapter 4.2.3 --- The frequency distributions of post-methionine hyperhomocysteinaemia in patients and controls --- p.73
Chapter 4.2.4 --- The frequency distributions of the abnormal methionine tolerance in patients and controls --- p.75
Chapter 4.3 --- "The frequency distributions of hypertension and hyperlipidaemia in controls and, including smoking,in patients without and with hyperhomocysteinaemia" --- p.77
Chapter 4.3.1 --- The frequency distribution of hypertension and hyperlipidaemia in patients and controls --- p.77
Chapter 4.3.2 --- "The frequency distributions of hyper-lipidaemia, hypertension, smoking and gender in patients with vascular disease with and without hyperhomocysteinaemia" --- p.79
Chapter 4.4 --- "The comparison of the age, haematological and biochemical indices and the blood pressure between the patients and controls" --- p.81
Chapter 4.4.1 --- The comparison of the patients' age at presentation and plasma lipids following recovery from the acute episode with those in controls at the time of methionine loading --- p.81
Chapter 4.4.2 --- The comparison of the age at presentation and the plasma lipids in patients with and without hyperhomocysteinaemia --- p.83
Chapter 4.4.3 --- "The comparison of the B12, serum folate and RBC folate in patients and controls at the time of presentation" --- p.84
Chapter 4.4.4 --- "The comparison of the B12, serum folate and RBC folate levels in patients with and without hyperhomocysteinaemia and in controls" --- p.85
Chapter CHAPTER FIVE --- DISCUSSION --- p.87
REFERENCES --- p.98
(11166657), Jacob Monroe. "Leg Heat Therapy to Improve Walking Tolerance and Vascular Function in Patients with Symptomatic Peripheral Artery Disease." Thesis, 2021.
Знайти повний текст джерелаLower extremity peripheral artery disease (PAD) is an increasingly prevalent manifestation of atherosclerosis that substantially limits mobility and increases mortality. Few options currently exists for practical conservative treatment of individuals with PAD. We have previously demonstrated that lower limb heat therapy (HT) can improve leg blood flow and reduce systolic blood pressure in patient with lower extremity PAD. Using three unique clinical trials, we sought to test the hypothesis that repeated exposure to HT would improve walking tolerance and vascular function in patients with lower extremity PAD. In these trials, we have sought to examine the clinical efficacy of HT, the physiological mechanisms which may underpin changes in walking endurance in this population, and also the practicality of employing HT in a home-based setting. The primary finding from these trials was that daily application of leg HT improved walking endurance in patients with lower-extremity PAD. Furthermore, the treatment adherence rate was excellent (<96%) and was not associated with severe adverse events. The changes in walking tolerance were consistently not associated with positive changes in vascular function, suggesting an alternative mechanism should be examined in future studies.
"A randomized study of the effect of hormone replacement therapy on peripheral blood flow in surgically postmenopausal women." 1997. http://library.cuhk.edu.hk/record=b5889286.
Повний текст джерелаThesis (M.Phil.)--Chinese University of Hong Kong, 1997.
Includes bibliographical references (leaves 155-175).
ABSTRACT --- p.1
ACKNOWLEDGMENTS --- p.3
LIST OF TABLES --- p.5
LIST OF FIGURES --- p.7
LIST OF ABBREVIATIONS --- p.8
Chapter I. --- INTRODUCTION --- p.9
Chapter I.A. --- Menopause --- p.9
Chapter I.A.1. --- Definition of the Menopause --- p.9
Chapter I.A.2. --- Pathophysiology of Ovarian Failure --- p.10
Chapter I.B. --- Effects of the Menopause --- p.13
Chapter I B.1. --- Acute Effects --- p.13
Chapter I.B.2. --- Medium Term Effects --- p.14
Chapter I.B.3. --- Chronic Effects --- p.15
Chapter I.B.3.a. --- Osteoporosis --- p.15
Chapter I.B.3.b. --- Coronary Artery Disease (CAD) --- p.17
Chapter I.C. --- Management of the Menopause --- p.19
Chapter I.C.1. --- Hormone Replacement Therapy --- p.21
Chapter I.C.2. --- Oestrogens --- p.22
Chapter I.C.2.a. --- Oral Oestrogens --- p.22
Chapter I.C.3. --- Progestogens --- p.24
Chapter I.C.3.a. --- Combined Oestrogen and Progestogen Therapy --- p.24
Chapter I.C.4. --- Complications and Contraindications to Hormone Replacement Therapy --- p.26
Chapter II. --- LITERATURE REVIEW --- p.34
Chapter II.A. --- Atherosclerosis --- p.35
Chapter II.B. --- Risk Factors for Coronary Artery Disease --- p.37
Chapter II.B.1. --- Age and Sex --- p.38
Chapter II.B.2. --- Age at Menopause --- p.38
Chapter II.B.3. --- Family History --- p.38
Chapter II.B.4. --- Serum Lipids --- p.39
Chapter II.B.5. --- Blood Pressure --- p.39
Chapter II.B.6. --- Smoking --- p.40
Chapter II.B.7. --- Diabetes Mellitus --- p.40
Chapter II.C. --- The Effect of the Menopause on Risk Factors for Coronary Heart Disease --- p.41
Chapter II.C.1. --- The Effect of the Menopause on Lipids and Lipoproteins --- p.41
Chapter II.C.2. --- The Effect of the Menopause on Glucose and Insulin Metabolism --- p.43
Chapter II.C.3. --- The Effect of the Menopause on Coagulation --- p.44
Chapter II.C.4. --- The Effect of the Menopause on the Arterial Wall --- p.45
Chapter II.D. --- The Risk of Coronary Artery Disease After the Menopause --- p.46
Chapter II.D.1. --- The Effect of the Menopause on Peripheral Vascular Disease (PVD) --- p.47
Chapter II.E. --- The Effect of the Hormone Replacement Therapy on Coronary Artery Disease Risk --- p.49
Chapter II.F. --- The Mechanism of Cardioprotection of Oestrogen --- p.63
Chapter II.F.1. --- The Indirect Effect of the Hormone Replacement Therapy on the Cardiovascular System --- p.64
Chapter II.F.1.a. --- The Effect on Lipids and Lipoproteins --- p.64
Chapter II.F.1.b. --- The Effect on Coagulation and Fibrinolysis --- p.66
Chapter II.F.1.c. --- The Effect on Insulin and Glucose Metabolism --- p.67
Chapter II.F.2. --- The Direct Effects of the Hormone Replacement Therapy on the Cardiovascular System --- p.67
Chapter II.F.2.a. --- The Effect of Oestrogen on Vascular Contractility --- p.68
Chapter II.F.2.b. --- The Effect of Oestrogen on Endothelial Dysfunction --- p.69
Chapter II.F.2.C. --- Other Possible Direct Actions of Oestrogen --- p.72
Chapter II.G. --- The Effects of Oestrogen on Blood Flow --- p.73
Chapter III. --- RESEARCH PLAN --- p.78
Chapter III.A. --- Formation of Research Hypothesis --- p.78
Chapter III B. --- Research Hypothesis --- p.80
Chapter III.C. --- Plan of Studies --- p.81
Chapter III.C.1. --- Pilot Study --- p.81
Chapter III.C.2. --- Randomized Controlled Study --- p.81
Chapter IV. --- METHODOLOGY --- p.84
Chapter IV.A. --- Pilot Study --- p.84
Chapter IV.B. --- Study Population --- p.87
Chapter IV.B.1. --- Recruitment of Cases --- p.88
Chapter IV.B.1.a. --- Patients' Consent --- p.88
Chapter IV.B.1.b. --- Method of Recruitment --- p.88
Chapter IV.B.1.e. --- Research Methodology --- p.89
Chapter IV.C. --- Ethical Considerations --- p.90
Chapter IV.D. --- Samples Size Calculation --- p.92
Chapter IV.E. --- Statistical Analysis --- p.93
Chapter IV.F. --- Physical Principles of the Measurement of Peripheral Resistance --- p.94
Chapter IV.F.1. --- The Arterial Analogue Waveform --- p.97
Chapter IV.F.2. --- Peak Systolic Velocity --- p.98
Chapter IV.G. --- Measurement of Pulsatility Index --- p.100
Chapter IV.G.1. --- Establishment of Methodologies Used to Measure Peripheral Blood Flow --- p.105
Chapter IV.G.2. --- Training of the Investigator --- p.107
Chapter IV.H. --- Assay for Serum Oestradiol --- p.108
Chapter IV.H.1. --- Principles --- p.108
Chapter IV.H.2. --- Reagents --- p.109
Chapter IV.H.3. --- Sample Dilution --- p.111
Chapter IV.H.4. --- Calibration --- p.112
Chapter IV.H.5. --- Quality Control --- p.112
Chapter IV.H.6. --- Assay Validation --- p.113
Chapter V. --- RESULTS --- p.115
Chapter V.A. --- Pilot Study --- p.115
Chapter V.B. --- Study Population --- p.118
Chapter V.B.1. --- Characteristics of the Patients at Recruitment --- p.120
Chapter V.B.2. --- Doppler Measurements --- p.123
Chapter V.B.3. --- Pulsatility Index and Serum Oestradiol --- p.135
Chapter VI. --- DISCUSSION --- p.137
Chapter VI.A. --- Overview --- p.132
Chapter VI.A.1. --- The Pilot Study --- p.133
Chapter VI.B. --- Study Population --- p.136
Chapter VI.C. --- Doppler Ultrasound as a Measurement of Vascular Resistance and Blood Flow --- p.142
Chapter VI.C.1. --- Reliability of Doppler Study --- p.143
Chapter VI.D. --- Pulsatility Index and Hormone Replacement Therapy --- p.146
Chapter VI.E. --- Effects of Oestrogen on Pulsatility Index --- p.150
Chapter VI.F. --- Conclusions --- p.152
Chapter VI.G. --- Future Directions --- p.153
REFERENCES --- p.155
APPENDIX1 --- p.176
Kemp, Arika D. "Peripheral Venous Retroperfusion: Implications for Critical Limb Ischemia and Salvage." Thesis, 2014. http://hdl.handle.net/1805/6452.
Повний текст джерелаPeripheral arterial disease is caused by plaque buildup in the peripheral arteries. Standard treatments are available when the blockage is proximal and focal, however when distal and diffuse the same type of the treatment options are not beneficial due to the diseased locations. Restoration of blood flow and further salvaging of the limb in these patients can occur in a retrograde manner through the venous system, called retroperfusion or arteriovenous reversal. Retroperfusion has been explored over the last century, where early side to side artery to venous connections had issues with valve competency prohibiting distal flows, edema buildup, and heart failure. However, more recent clinical studies create a bypass to a foot vein to ensure distal flows, and though the results have been promising, it requires a lengthy invasive procedure. It is our belief that the concerns of both retroperfusion approaches can be overcome in a minimally invasive/catheter based approach in which the catheter is engineered to a specific resistance that avoids edema and the perfusion location allows for valves to be passable and flow to reach distally. In this approach, the pressure flow relations were characterized in the retroperfused venous system in ex-vivo canine legs to locate the optimal perfusion location followed by in-vivo validation of canines. Six canines were acutely injured for 1-3 hours by surgical ligation of the terminal aorta and both external iliac arteries. Retroperfusion was successfully performed on five of the dogs at the venous popliteal bifurcation for approximately one hour, where flow rates at peak pressures reached near half of forward flow (37±3 vs. 84±27ml/min) and from which the slope of the P/F curves displayed a retro venous vasculature resistance that was used to calculate the optimal catheter resistance. To assess differences in regional perfusion, microspheres were passed during retroperfusion and compared to baseline microspheres passed arterially prior to occlusion in which the ratio of retroperfusion and forward perfusion levels were near the ratio of reversed and forward venous flow (0.44) throughout the limb. Decreases in critical metabolites during injury trended towards normal levels post-retroperfusion. By identifying the popliteal bifurication as a perfusion site to restore blood flow in the entirety of the distal ischemic limb, showing reversal of injury, and knowing what catheter resistances to target for further chronic studies, steps towards controlled retroperfusion and thus more efficient treatment options can be made for severe PAD patients.
Lucas, Miguel Nuno Fernandes. "Impacto do exercício físico na prevenção de complicações macrovasculares em pessoas com Diabetes Mellitus tipo 2 : uma revisão sistemática e meta-análise." Master's thesis, 2019. http://hdl.handle.net/10316/89925.
Повний текст джерелаIntrodução: A Diabetes Mellitus (DM) Tipo 2 é um grupo heterogéneo de distúrbios caraterizado por vários graus de insulinorresistência, diminuição da secreção de insulina e aumento da produção de glicose. As complicações macrovasculares da DM são semelhantes a eventos cardiovasculares em não-diabéticos, porém têm uma maior incidência em pessoas com DM. Eventos e mortalidade por doença coronária são até cinco vezes superiores em doentes com DM e o impacto da hiperglicemia crónica nestes casos é pouco claro. O exercício físico diminui a incidência de eventos cardiovasculares na população em geral, contudo, o seu papel nos doentes com DM Tipo 2 não está completamente esclarecido. O objetivo desta revisão sistemática é descrever o impacto do exercício físico, como fator isolado, na prevenção das complicações macrovasculares em pessoas com DM Tipo 2 e sumariar os resultados dos artigos originais publicados nos últimos dez anos.Métodos: Para elaborar esta revisão sistemática foi realizada pesquisa de literatura em dezembro de 2018 na Pubmed e Embase. Foram utilizados termos MeSH e a terminologia Emtree equivalente, com os filtros de “English”, “Portuguese”, “Randomized Controlled Trials” e “Ten years”. Foi feita seleção de artigos por resumos e depois por leitura de texto integral por dois revisores independentes e os resultados finais foram analisados em meta-análise cumulativa.Resultados: Posteriormente à pesquisa de literatura foi realizado screening de 400 artigos. No final, apenas dois artigos foram elegíveis. Nesses dois artigos incluídos na meta-análise (I2 = 46%), o grupo sujeito a intervenção de exercício físico apresenta incidência mais baixa de eventos macrovasculares do que o grupo de controlo, ainda que sem significância estatística (p = 0,310). Contudo, uma meta-análise cumulativa comprova os benefícios do exercício físico na prevenção de eventos macrovasculares (OR = 0,29; p = 0,048). A qualidade ao longo dos estudos foi classificada como moderada.Conclusão: Em períodos de seis a vinte e quatro meses de follow-up, de pessoas com DM Tipo 2, comprovou-se, neste trabalho, a prevenção de eventos macrovasculares num grupo de intervenção por exercício físico, com evidência de qualidade moderada. A informação disponível para o tema deste trabalho foi escassa, pelo que novos estudos longitudinais com follow-up a longo prazo de pessoas com diabetes sem doença cardiovascular aterosclerótica, sujeitos a intervenção por exercício físico, deverão ser realizados.
Introduction: Type 2 Diabetes Mellitus (DM) is a heterogenous group of disorders characterized by various grades of insulin resistance, decrease of insulin secretion and increase of glucose production. Macrovascular complications of DM are similar to cardiovascular events in non-diabetics, however, they have a higher incidence on people with DM. Mortality and events by coronary disease are up to five times higher in patients with DM and the impact of chronic hyperglycaemia is unclear on these cases. Exercise lowers the incidence of cardiovascular events in general population, however its role on patients with Type 2 DM isn’t completely enlightened. The objective of this systematic review is to describe the impact of exercise as a isolated factor, on prevention of macrovascular complications in patients with Type 2 DM and summarize results of original articles published during the last ten years.Methods: To elaborate this systematic review, we performed a literature search on December 2018 on Pubmed and Embase. We used MeSH terms and Emtree equivalent terminology, with the following filters “English”, “Portuguese”, “Randomized Controlled Trials” e “Ten years”. The selection of the studies was done by summaries and after that by reading of the full text by two independent reviewers and the final results were analysed on a cumulative meta-analysis. Results: After the literature search we performed a screening of 400 articles. In the end only two articles were elegible. On these two studies included on meta-analysis (I2 = 46%), the intervention group showed a lower incidence of macrovascular events than the control group, yet without statistical significance (p = 0.310). However, a cumulative meta-analysis demonstrates the benefits of physical exercise in the prevention of macrovascular events (OR = 0.29; p = 0.048). The quality across the studies was classified as moderate.Conclusion: At six weeks and four months of follow up of people with Type 2 DM, the prevention of macrovascular events was proven in an intervention group by exercise therapy, with evidence of moderate quality. There is few information available regarding the subject of this work, suggesting the implementation of new studies with a long term follow-up of people with diabetes, on exercise therapy, without atherosclerotic cardiovascular disease.
Janvier, Marie-Ange. "Optimization and validation of a new 3D-US imaging robot to detect, localize and quantify lower limb arterial stenoses." Thèse, 2010. http://hdl.handle.net/1866/4758.
Повний текст джерелаAtherosclerosis is a disease caused by the accumulation of lipid deposits inducing the remodeling and hardening of the vessel wall, which leads to a progressive narrowing of arteries. These lesions are generally located on the coronary, carotid, aortic, renal, digestive and peripheral arteries. With regards to peripheral vessels, lower limb arteries are frequently affected. The severity of arterial lesions are evaluated by the stenosis degree (reduction > 50.0 % of the lumen diameter) using angiography, magnetic resonance angiography (MRA), computed tomography (CT) and ultrasound (US). However, to plan a surgical therapeutic intervention, a 3D arterial geometric representation is notably preferable. Imaging methods such as MRA and CT are very efficient to generate a three-dimensional imaging of good quality even though their use is expensive and invasive for patients. 3D-ultrasound can be perceived as a promising avenue in imaging for the location and the quantification of stenoses. This non invasive, non allergic (i.e, nephrotoxic contrast agent) and non-radioactive imaging modality offers distinct advantages in convenience, low cost and also multiple diagnostic options to quantify blood flow in Doppler. Since medical robots already have been used with success in surgery and orthopedics, our team has conceived a new medical 3D-US robotic imaging system to localize and quantify arterial stenoses in lower limb vessels. With this new technology, a clinician manually teaches the robotic arm the scanning path. Then, the robotic arm repeats with high precision the taught trajectory and controls simultaneously the ultrasound image acquisition process at even sampling and preserves safely the force applied by the US probe. Consequently, the reconstruction of a lower limb arterial geometry in 3D with this system could allow the location and quantification of stenoses with high accuracy. The objective of this research project consisted in validating and optimizing this 3D-ultrasound imaging robotic system. The reliability of a 3D reconstructed geometry obtained with 2D-US images captured with a robotic system depends considerably on the positioning accuracy and the calibration procedure. Thus, the positioning accuracy of the robotic arm was evaluated in the workspace with a lower limb-mimicking phantom design (article 1 - chapter 3). In addition, a Z-phantom was designed to assure a precise calibration of the robotic system. These optimal methods were used to validate the system for the clinical application and to find the transformation which converts image coordinates of a 2D-ultrasound image into the robotic arm referential. From these results, all objects scanned by the robotic system can be adequately reconstructed in 3D. Multimodal imaging vascular phantoms of lower limb arteries were used to evaluate the accuracy of the 3D representations (article 2 - chapter 4, article 3 - chapter 5). The validation of the reconstructed geometry with this system was performed by comparing surface points with the manufacturing vascular phantom file surface points. The accuracy to localize and quantify stenoses with the 3D-ultrasound robotic imaging system was also determined. These same evaluations were analyzed in vivo to perceive the feasibility of the study.