Relationship between sensory processing patterns and gross motor function of children and adolescents with Down syndrome and typical development: a cross-sectional study.

BACKGROUND: Children and adolescents with Down syndrome (DS) may experience impairments in sensory and motor skills that can be interrelated. The purposes of this study were (i) to compare the sensory processing patterns and gross motor function between children and adolescents with DS and with typical development (TD) and (ii) to explore associations between these areas in both DS and TD groups. METHOD: This cross-sectional study involved a sample size of 25 participants with DS (mean age 10.24 ± 2.04 years) and 25 participants with TD (mean age 10.04 ± 2.82 years). The sensory processing patterns were assessed using the Sensory Profile Second Version questionnaire, and the gross motor function was measured with the Gross Motor Function Measure (GMFM-88) dimensions (D) standing, and (E) walking, running, and jumping. Differences between groups were tested using the Mann-Whitney test, and the relationship between the variables was examined using Spearman's correlation tests, with a significance level set at 5%. RESULTS: Children with DS showed greater difficulties with sensory processing than TD children in Seeker (P < 0.001), Avoider (P < 0.001), Sensitivity (P < 0.001), Registration (P < 0.001), Auditory (P < 0.001), Touch (P = 0.001), Movements (P = 0.001), Oral (P = 0.028), Conduct (P = 0.005), Socioemotional (P < 0.001), and Attentional (P < 0.001) domains. Additionally, children with DS presented lower gross motor function than TD in GMFM-88, standing (P < 0.001) and walking, running, and jumping (P < 0.001). Correlations were found between greater difficulties with sensory processing in Touch and lower gross motor function in walking, running, and jumping for the DS group. CONCLUSION: Our results suggest there are more difficulties in sensory processing patterns and gross motor function in children with DS than in TD. Also, there is a single association between more difficulties in sensory processing and less well-developed motor function in the DS group. Therefore, a comprehensive assessment of all these aspects should be performed in children and adolescents with DS, along with the provision of relevant interventions addressing specific needs.

Proteolysis in Mozzarella cheeses manufactured by different industrial processes.

The objective of the present study was to investigate the influence of stretching temperature, fat content, and time of brining on proteolysis during ripening of Mozzarella cheeses. Seventeen cheese-making experiments (batches) were carried out on an industrial scale on successive days, following the standard procedure with some modifications. Fat content of cheese milk, temperature at the stretching step, and time of brining varied from one batch to another as required by the experimental design, outlined by a surface response model. Proteolysis was assessed during ripening of samples, which was prolonged for at least 3 mo, by means of electrophoresis, nitrogen fractions, and soluble peptide mapping. The amount of soluble nitrogen at pH 4.6 was not significantly different in cheeses obtained by diverse procedures, but it increased during ripening of all samples. This result was coincident with the breakdown of alpha(s1)- and beta-caseins evidenced by electrophoresis, which reached similar extents at late stages of ripening, regardless of the cheese-making process. Multivariate analysis on soluble peptide profiles obtained by liquid chromatography also detected sample grouping according to ripening time, but did not evidence any separation caused by the cheese-making technology. We concluded that the changes in the cheese-making process assayed in this work were insufficient to produce significant differences in proteolysis of the cheeses. Ripening time had more influence on proteolysis of Mozzarella cheeses than any other assayed variable.

[Stress imaging in coronary artery disease: state of the art]. / Stress imaging nella cardiopatia ischemica: stato dell'arte.

To date, several diagnostic tools allow an accurate non-invasive evaluation of coronary artery disease; this is due to the great progress in echocardiographic and nuclear imaging techniques in the last 10 years. The large availability of different stress imaging techniques allows to choose the most appropriate technique for each patient according to the clinical characteristics. This paper presents the state of the art of echocardiographic and nuclear stress imaging for the diagnosis of coronary artery disease and for the prognostic stratification of infarcted patients. Advantages and limits of the different techniques are described rather than putting in competition echo and nuclear cardiology as has often been done in the past. Cardiologists should select among the various techniques on the basis of clinical characteristics of single patients, center's experience and an objective evaluation of economical aspects.

Bilateral neck paragangliomas.

Paragangliomas of the head and neck are rare neoplasms presented as cervical mass, generally bilateral, that arise from chemoreceptors located at the carotid bifurcation (carotid body tumors), along the vagus nerve (vagal paragangliomas), and in the jugular fossa and tympanic cavity (jugulotympanic paragangliomas). They are typically asymptomatic at the beginning, highly vascular, slow-growing and compressing the surrounding anatomic structures. Only radical surgery is the curative treatment for paragangliomas. We present a case of a 62- year-old woman with a diagnosis of bilateral neck paragangliomas where surgical removal was judged burdened by excessive risk because of the size of the tumor.

A method to calculate tissue impedance through a standard bipolar pacing lead.

UNLABELLED: The transthoracic impedance (T) and its variations may be estimated through the measurement of the electrical impedance between the can and the right ventricular coil of a defibrillation lead. This method may allow the monitoring of fluid overload before a heart failure attack. Aim of this study was to validate in vitro a method to calculate T in case of a standard bipolar pacing lead, by performing 3 measurements: standard unipolar impedance from the tip (Zuni-tip); unipolar impedance from the ring (Zuni-ring); standard bipolar impedance (Zbip). The formula we used is derived from the standard equivalent circuit of a pacing system: [Formula: see text] T represents the tissue impedance between the can and the electrodes of the lead. To validate the method we used a saline solution and 3 different pacing leads manufactured by Vitatron (Vitatron BV, Arnhem, The Netherlands): Impulse II (high impedance lead), Crystalline ActFix (screw-in lead), Brilliant S+ (VDD single-lead). The measured values of the saline solution impedance were compared to the values calculated through the formula. RESULTS: The calculated impedance of the solution, evaluated through the proposed formula, is reliable independently of the electrode used and highly correlated to the corresponding measured values (R>0.9). CONCLUSION: Tissue impedance may be calculated from standard unipolar and bipolar impedance measurements with a standard bipolar pacing lead.

Superior vena cava stenosis at site of intersection of two pacing electrodes.

Superior vena cava obstruction is described in a patient with two endocardial pacing electrodes. At necropsy a severe stenosis of the venous lumen was found at the site of intersection of the two catheters. There was no evidence of thrombus formation. Venous wall stenosis is an unusual complication of transvenous pacing and is probably favoured by the presence of two electrodes.

[Measurement of the myocardial stimulation threshold in chronic and acute patients with pacemaker implanted (author's transl)]. / Misura della soglia di elettrostimolazione cardiaca in pazienti portatori di pacemaker, acuti e cronici.

Eighty-two patients, with electrodes implanted for varying periods of time, have been divided into three groups: acute (at implantation); intermediate (3 to 36 months) and chronic (37 to 124 months). In these groups, respectively 28, 26 and 28 myocardial stimulation threshold measurements have been performed. Measurements have been performed with MEEMR (Myocardial Excitation Energy Meter), an instrument deviced and built by the Institute of Elaboration of Information, CNR and University of Pisa. Microjoule has been chosen as unit of measure. More commonly used units of measure, such as threshold current in milliamp, have been calculated from values in microjoules. Mean values was 0.6 muJ in the first group, 6.9 muJ in the second one and 8.3 in the third one. Student test has been performed on such measurements, divided into groups, with the following results: p less than 0.01 between 1st and 2nd group, non significant difference between 2nd and 3rd group, p less than 0.01 between 1st and 3rd group. Such results suggest a trend toward myocardial threshold stabilization over a long period of time, as had already been hypothized by others Authors. Further useful information may be drawn from these data if they are evaluated in relation to a life-time pacemaker, as is nowadays desirable in view of recent progress in circuit technology and energy sources.

[The diagnosis of myocardial infarction in the presence of disorders of ventricular activation for right endoventricular pacing and left bundle branch block (author's transl)]. / La diagnosi di infarto miocardico in presenza di turbe dell'attivazione ventricolare dovute ad elettrostimolazione endocavitaria destra e blocco di branca sinistro.

The Authors have studied the vectocardiogram in left bundle branch block, right endoventricular pacing, myocardial infarction and right endoventricular pacing, myocardial infarction and left bundle branch block. Vectocardiographic loop analysis allows the diagnosis of myocardial infarction both in the presence of endoventricular pacing and in the presence of left bundle branch block.

[Stenosis of superior vena cava at the crossing site of two catheters (author's transl)]. / Stenosi della vena cava superiore nel punto di incrocio di due elettrodi stimolatori.

A case of superior vena cava syndrome is described in a patient with two endocardial pacing electrodes. At autopsy a severe stenosis of the venous lumen was found at the crossing site of the two catheters. There was no evidence of thrombus formation. Venous wall stenosis is an unusual complication of transvenous pacing and is probably favoured by the presence of two electrodes.

Pulsed Doppler verification of atrial contribution to ventricular filling in sequential pacing.

We have used pulsed Doppler to ascertain effective atrial contribution to ventricular filling in sequential pacemaker rhythm. The technique is particularly valuable when electrocardiographic evidence of atrial capture is uncertain.

[A new system for dynamic electrocardiography. First clinical trial]. / Unovo sistema per elettrocardiografia dinamica. Prima esperienza clinica.

The development of a reliable system for analysis of ambulatory ECG recordings, for evaluation of arrhythmias and ST-T segment changes is a great challenge for technology and cardiovascular medicine. Signal superimposition or AVSEP system, conceived by Norman J. Holter, has been widely used and is employed even in recent sophisticated devices for analysis of ambulatory ECG recordings. As an alternative way we have chosen contourography, known since 1966, enhanced by a dynamic and perspective effect (Fig. 1). Figure 2 shows the display mechanism of the ECG signal. Cardiac cycles are continuously sampled, triggered and positioned along the running time axis. The QRS complexes undergo progressive amplitude decrease while "sliding" toward a viewpoint adjustable by the operator (Fig. 3). As memory contains a fixed number of cycles, the latest cycle enters the screen while the oldest falls out. Instead of being superimposed as in AVSEP system, cardiac cycles are displayed separately. In this way it is possible to make comparisons between one cycle and another or among different areas of the ECG tracing. At any instant, the tracing can be stopped, and an intensified area of interest can be recorded on a paper strip in a standard fashion (Fig. 4). A clinical comparison has been performed between this device and two different commercial systems; 25 tapes, 24 hours each, have been separately analyzed by two cardiologists with the Avionics system and 25 with the Pathfinder, and then with the new system. Each operator was not aware of the results of the other one.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical experience with a new dynamic display system for ambulatory ECG recordings.

The authors present the results of clinical experience with a new display for ECG signal presentation in ambulatory ECG monitoring. The new method has been devised by adding to contourography the dynamic effect produced by image movement and the perspective effect produced by pseudo-tridimensional presentation. The system has been developed using a microprocessor, a dynamic memory and an arithmetic unit which sends the signal on a CRT screen. Clinical experience, based upon 150 analyses, demonstrates the new method's marked efficiency in presenting rhythm disturbances and particularly ST-T segment alterations. Clinical validation has been performed comparing the results of 50 tapes analysed both with the new method and with different commercial systems. The new method provides useful information as to ST-T segment in 98% of cases and as to rhythm disturbances in 90%, while commercial systems reveal ST-T alterations in 84% and arrhythmias in 70% This method, being devoid of automaticity, does not yield false positives; dynamic and pseudo-tridimensional visualization of ECG signal allow the operator to perceive with high sensitivity alterations of the observed tracing.

Venous obstruction in permanent pacemaker patients: an isotopic study.

Isotope venography was used to study the venous circulation proximal to the superior vena cava in two groups of pacemaker patients, one with a single endocavitary electrode and the other with multiple pacing catheters. A control group of patients without pacemakers was also studied. Numerous abnormalities were found, especially in the group with multiple electrodes. These findings suggest that venous obstruction is a common complication of endocardial pacing.