Surface Electromyography Study Using a Low-Cost System: Are There Neck Muscles Differences When the Passenger Is Warned during an Emergency Braking Inside an Autonomous Vehicle?

Deaths and serious injuries caused by traffic accidents is a concerning public health problem. However, the problem can be mitigated by the Autonomous Emergency Braking (AEB) system, which can avoid the impact. The market penetration of AEB is exponentially growing, and non-impact situations are expected to become more frequent. Thus, new injury patterns must be analysed, and the neck is particularly sensitive to sudden acceleration changes. Abrupt braking would be enough to be a potential risk for cervical spine injury. There is controversy about whether or not there are differences in cervical behaviour depending on whether passengers are relaxed or contract their muscles before the imminent accident. In the present manuscript, 18 volunteers were subjected to two different levels of awareness during an emergency braking test. Cervical muscles (sternocleidomastoid and trapezius) were analysed by the sEMG signal captured by means of a low-cost system. The differences observed in the muscle response according to gender and age were notable when passengers are warned. Gender differences were more significant in the post-braking phase. When passengers were relaxed, subjects older than 35 registered higher sEMG values. Meanwhile, when passengers contract their muscles, subjects who were younger than or equal to 35 years old experienced an increment in the values of the sEMG signals.

New Procedure for the Kinematic and Power Analysis of Cyclists in Indoor Training.

In this research, the performance and movements of amateur and professional cyclists were analyzed. For this, reflective markers have been used on different parts of the body of the participants in conjunction with sports cameras and a mobile power meter. The trajectories of the markers have been obtained with the software Kinovea and subsequently analyzed using error ellipses. It is demonstrated that the error ellipses help determine movement patterns in the knees, back, and hip. The covariance of the error ellipses can be indicative of the alignment and symmetry of the frontal movement of the knees. In addition, it allows verifying the alignment of the spine and the symmetry of the hip. Finally, it is shown that it is necessary to consider the uncertainty of the power devices since it considerably affects the evaluation of the cyclists' performance. Devices with high uncertainty will demand a greater effort from the cyclist to meet the power required in the endurance test developed. The statistical magnitudes considered help to analyze power and evaluate the cyclists' performance.

Study of the Emergency Braking Test with an Autonomous Bus and the sEMG Neck Response by Means of a Low-Cost System.

Nowadays, due to the advances and the increasing implementation of the autonomous braking systems in vehicles, the non-collision accident is expected to become more common than a crash when a sudden stop happens. The most common injury in this kind of accident is whiplash or cervical injury since the neck has high sensitivity to sharp deceleration. To date, biomechanical research has usually been developed inside laboratories and does not entirely represent real conditions (e.g., restraint systems or surroundings of the experiment). With the aim of knowing the possible neck effects and consequences of an automatic emergency braking inside an autonomous bus, a surface electromyography (sEMG) system built by low-cost elements and developed by us, in tandem with other devices, such as accelerometers or cameras, were used. Moreover, thanks to the collaboration of 18 participants, it was possible to study the non-collision effects in two different scenarios (braking test in which the passenger is seated and looking ahead while talking with somebody in front of him (BT1) and, a second braking test where the passenger used a smartphone (BT2) and nobody is seated in front of him talking to him). The aim was to assess the sEMG neck response in the most common situations when somebody uses some kind of transport in order to conclude which environments are riskier regarding a possible cervical injury.

Is the Use of a Low-Cost sEMG Sensor Valid to Measure Muscle Fatigue?

Injuries caused by the overstraining of muscles could be prevented by means of a system which detects muscle fatigue. Most of the equipment used to detect this is usually expensive. The question then arises whether it is possible to use a low-cost surface electromyography (sEMG) system that is able to reliably detect muscle fatigue. With this main goal, the contribution of this work is the design of a low-cost sEMG system that allows assessing when fatigue appears in a muscle. To that aim, low-cost sEMG sensors, an Arduino board and a PC were used and afterwards their validity was checked by means of an experiment with 28 volunteers. This experiment collected information from volunteers, such as their level of physical activity, and invited them to perform an isometric contraction while an sEMG signal of their quadriceps was recorded by the low-cost equipment. After a wavelet filtering of the signal, root mean square (RMS), mean absolute value (MAV) and mean frequency (MNF) were chosen as representative features to evaluate fatigue. Results show how the behaviour of these parameters across time is shown in the literature coincides with past studies (RMS and MAV increase while MNF decreases when fatigue appears). Thus, this work proves the feasibility of a low-cost system to reliably detect muscle fatigue. This system could be implemented in several fields, such as sport, ergonomics, rehabilitation or human-computer interactions.

Tratamiento de la infección crónica por el virus de la hepatitis C. Factores predictores de respuesta / Treatment of chronic hepatitis C virus infection. A study of best predictors for response

Objetivo: Evaluar la respuesta virológica sostenida (RVS) y los factores predictores de la misma en los pacientes con infección crónica por el virus de la hepatitis C (VHC) tratados con peginterferón alfa-2a y ribavirina. Pacientes: Estudio retrospectivo de 272 pacientes naïve con infección crónica por el VHC tratados durante 24 ó 48 semanas y con seguimiento durante 24 semanas después de retirar el tratamiento. Resultados: De los 272 pacientes, 243 completaron el tratamiento. La RVS en el análisis por intención de tratar fue del 66,5%, y en pacientes tratados 74,5%. En el análisis univariado, la RVS fue mayor en menores de 40 años (84,4%), con carga viral pretratamiento <500.000 UI/ml (86,9%), genotipo no-1 (86,4%), no cirróticos ni precirróticos (76,5%), con respuesta virológica rápida (RVR) (91,4%) y con respuesta virológica precoz (RVP) (83,8%) (p<0.01). El análisis multivariado mostró que solo el genotipo y la RVP influyeron en la RVS. La RVR y el grado de lesión hepática no se incluyeron en el análisis multivariado porque no se dispuso de estas variables en un alto número de pacientes. Los VPP y VPN de la RVR fueron 91,5% y 48,7% respectivamente, de la RVP 83,8% y 95,8% y de la RVP completa 91,3% y 78,7% respectivamente. Conclusiones: La RVS en nuestra serie fue mayor que en otros estudios. Los factores predictores de RVS fueron el genotipo y la RVP. La RVP presentó un alto VPN y la RVP completa un alto VPP(AU)

Objective: The aim of this study was evaluate the rate of sustained viral response (SVR) and the influence of different factors on the SVR in patients with chronic hepatitis C virus (HCV) infection treated with pegylated interferon alfa 2a and ribavirin. Methods: We retrospectively analysed 272 naïve patients with chronic hepatitis C who had been treated for 24 weeks or 48 weeks and had been followed for an additional 6 months thereafter. Results: Out of 272 patients, 243 completed the entire treatment. The overall SVR rate in intent-to-treat analysis was 66.5% and in treated patients was 74.5%. In an univariate analysis, the SVR was associated with age <40 years (84.4%), pre-treatment viral load <500.000 IU/ml (86.9%), non-1 genotype HCV (86.4%), non cirrhosis or pre-cirrhosis (76.5%), rapid virologic response (RVR) (91.4%) and early virologic response (EVR) (83.8%). In the multivariate logistic regression analysis, the presence of an infection caused by a non-1 genotype and to achieve ERV were independent predictors of SVR. The RVR and histological stage of liver disease were not included in the multivariate analysis because these data were not available in most of the patients. The PPV and NVP of RVR were 91.5% and 48.7% respectively, of EVR were 83.8% and 95.8% respectively and of complete EVR were 91.3% and 78.7%, respectively. Conclusions: The SVR was higher than in other studies. The genotype and EVR were independent factors to predict the effect of antiviral therapy. The EVR had a high NPV and the complete EVR a high PPV(AU)

Hepatitis aguda por el virus de la hepatitis C en la población adulta / Acute hepatitis due to hepatitis C virus infection in the adult population

Introducción El conocimiento de la infección aguda por el virus de la hepatitis C (VHC) es importante para diseñar estrategias de prevención y tratamiento efectivas. El objetivo del estudio fue conocer las características clinicoepidemiológicas y la evolución de los pacientes diagnosticados de infección aguda por VHC.MétodosEstudio clinicoepidemiológico descriptivo retrospectivo de los pacientes adultos con infección aguda por VHC diagnosticados entre los años 2000-2008 en nuestro hospital.ResultadosSe diagnosticó a 16 pacientes. La fuente probable de transmisión fue la adicción a drogas por vía parenteral (ADVP) en 4 casos, un accidente sanitario por pinchazo en 3 casos, un procedimiento médico en 3 casos y la vía sexual en 2 casos. En 4 casos la fuente de infección fue desconocida. Ocho pacientes se diagnosticaron por un cuadro clínico sintomático, (3 en los controles por accidente sanitario y en 5 la detección fue casual). Nueve pacientes presentaron síntomas francos y 7 fueron asintomáticos o tuvieron síntomas leves. Los 4 pacientes que recibieron tratamiento se curaron y de los 12 pacientes que no recibieron tratamiento, el 58,3% cronificó. Se observó una mayor tendencia a la cronificación en los pacientes que no presentaron ictericia frente a los que la presentaron (el 85,7 vs. el 16,7%).ConclusionesLos procedimientos médicos siguen siendo un factor de riesgo de adquisición de la infección por el VHC, por lo que es necesaria la búsqueda activa así como insistir en el cumplimiento de las medidas de prevención de transmisión parenteral. Debido al bajo porcentaje de pacientes con ictericia que cronifican, el inicio del tratamiento en estos pacientes podría retrasarse en función de su evolución (AU)

Introduction Knowledge of acute hepatitis C infection (AHC) is important to design effective prevention and treatment strategies. The aim of this study was to determine the clinical and epidemiological features and outcomes of patients diagnosed with AHC.MethodsA retrospective clinical-epidemiological study was carried out in adult patients diagnosed with AHC between 2000 and 2008 in our hospital.ResultsSixteen patients were diagnosed. The most probable source of transmission was intravenous drug abuse in four patients, a percutaneous injury in three healthcare workers, a medical procedure in three patients and sexual contact in two patients. The source of infection was unknown in four patients. Diagnosis was based on acute clinical symptoms in eight patients, follow-up of healthcare injury in three patients and was fortuitous in five patients. Nine patients showed severe symptoms, while seven patients were asymptomatic or had mild symptoms. The four patients who received treatment were cured. Of the 12 patients that did not receive treatment, the disease became chronic in 58.3%. Progression to chronic disease was more frequent in patients without jaundice than in those with jaundice (85.7% vs 16.7%).ConclusionsBecause medical procedures are still a risk factor for hepatitis C infection, active surveillance is required as well as compliance with prevention measures against parenteral transmission. The percentage of patients with jaundice who progress to chronic disease is low and consequently the start of treatment in these patients could be delayed according to their clinical course (AU)

[Acute hepatitis due to hepatitis C virus infection in the adult population]. / Hepatitis aguda por el virus de la hepatitis C en la población adulta.

INTRODUCTION: Knowledge of acute hepatitis C infection (AHC) is important to design effective prevention and treatment strategies. The aim of this study was to determine the clinical and epidemiological features and outcomes of patients diagnosed with AHC. METHODS: A retrospective clinical-epidemiological study was carried out in adult patients diagnosed with AHC between 2000 and 2008 in our hospital. RESULTS: Sixteen patients were diagnosed. The most probable source of transmission was intravenous drug abuse in four patients, a percutaneous injury in three healthcare workers, a medical procedure in three patients and sexual contact in two patients. The source of infection was unknown in four patients. Diagnosis was based on acute clinical symptoms in eight patients, follow-up of healthcare injury in three patients and was fortuitous in five patients. Nine patients showed severe symptoms, while seven patients were asymptomatic or had mild symptoms. The four patients who received treatment were cured. Of the 12 patients that did not receive treatment, the disease became chronic in 58.3%. Progression to chronic disease was more frequent in patients without jaundice than in those with jaundice (85.7% vs 16.7%). CONCLUSIONS: Because medical procedures are still a risk factor for hepatitis C infection, active surveillance is required as well as compliance with prevention measures against parenteral transmission. The percentage of patients with jaundice who progress to chronic disease is low and consequently the start of treatment in these patients could be delayed according to their clinical course.

[Hepatitis B virus genotypes in chronic carriers on the island of Gran Canaria. Clinical and epidemiological characteristics]. / Genotipos del virus de la hepatitis B en portadores crónicos en la isla de Gran Canaria. Características clinicoepidemiológicas.

OBJECTIVE: To investigate the prevalence of hepatitis B virus (HBV) genotypes in Spanish hepatitis B carriers, and to study the differences in epidemiological characteristics, e antigen (HBeAg) seroconversion, serum DNA viral levels (VL) and liver function alterations. METHODS: This study included 108 patients. Genotyping was carried out in 84 with the INNO-LiPA HBV genotyping assay (Innogenetics). RESULTS: There were 41 women and 67 men, with a mean age of 44.1 years. The source of transmission was family contact in 26 patients (24.1%); transfusions in 10 (9.3%); sexual promiscuity in 9 (8.3%), intravenous drug use in 3 (2.8%), health care accident in 2 (1.8%); and unknown causes in 58 (53.7%). Forty patients had chronic hepatitis and 68 (63%) were healthy carriers. The time of evolution of the infection was known in only in 45 patients, and was over 10 years in 42 of them. One hundred patients (92.6%) were HbeAg-negative and 90 (83.3%) had detectable viral DNA. Genotype A was present in 46 (54.8%), D in 20 (23.8%), F in 2 (2,4%), C in 1 (1.2%), A-G coinfection in 7 (8.3%), A-D in 4 (4.8%), D-G in 2 (2,4%), A-C in 1 (1.2%), and A-D-G in 1 (1.2%). There were no significant differences between genotypes. A trend towards an association was found between VL

Genotipos del virus de la hepatitis B en portadores crónicos en la isla de Gran Canaria. Características clinicoepidemiológicas / Hepatitis B virus genotypes in chronic carriers on the island of Gran Canaria. Clinical and epidemiological characteristics

Objetivo. Conocer la distribución de genotipos del virus de la hepatitis B (VHB) de pacientes españoles portadores crónicos y su relación con las características epidemiológicas, la presencia de antígeno e, el nivel sérico del ADN viral (CV) y la alteración de la función hepática. Métodos. Se estudiaron 108 pacientes. El genotipo se realizó en 84 mediante INNO-LiPA HBV Genotyping-Innogenetics. Resultados. De los pacientes, 41 fueron mujeres y 67 hombres, con una edad media de 44,1 años. Las fuentes de transmisión fueron: contacto familiar, 26 pacientes (24,1%); transfusiones, 10 (9,3%); promiscuidad sexual, 9 (8,3%); adicción a drogas parenterales, 3 (2,8%); accidente sanitario, 2 (1,8%) y en 58 (53,7%) se desconocía. Cuarenta pacientes (37%) presentaron una hepatitis crónica (HC) y 68 (63%) eran portadores asintomáticos. Sólo en 45 pacientes se conocía el tiempo de evolución de la infección y en 42 fue mayor de 10 años. Cien pacientes (92,6%) presentaron antígeno e-negativo y 90 (83,3%) tuvieron ADN viral detectable. La distribución de genotipos fue: A, 46 (54,8%); D, 20 (23,8%); F, 2 (2,4%); C, 1 (1,2%), coinfección A-G, 7 (8,3%); A-D, 4 (4,8%); D-G, 2 (2,4%); A-C, 1 (1,2%) y A-D-G, 1 (1,2%). No se observaron diferencias significativas entre genotipos. Se observó una tendencia en el genotipo A a presentar HC cuando la CV ≤ 10 5 copias/ml (28,9% de los casos) frente al genotipo D (7,7%) (p no significativa). Conclusiones. En nuestra área predomina el genotipo A, D y las coinfecciones con G. Observamos una tendencia del genotipo A a producir una mayor actividad inflamatoria cuando la CV ≤ 10 5 copias/ml (AU)

Objective. To investigate the prevalence of hepatitis B virus (HBV) genotypes in Spanish hepatitis B carriers, and to study the differences in epidemiological characteristics, e antigen (HBeAg) seroconversion, serum DNA viral levels (VL) and liver function alterations. Methods. This study included 108 patients. Genotyping was carried out in 84 with the INNO-LiPA HBV genotyping assay (Innogenetics).Results. There were 41 women and 67 men, with a mean age of 44.1 years. The source of transmission was family contact in 26 patients (24.1%); transfusions in 10 (9.3%); sexual promiscuity in 9 (8.3%), intravenous drug use in 3 (2.8%), health care accident in 2 (1.8%); and unknown causes in 58 (53.7%). Forty patients had chronic hepatitis and 68 (63%) were healthy carriers. The time of evolution of the infection was known in only in 45 patients, and was over 10 years in 42 of them. One hundred patients (92.6%) were HbeAg-negative and 90 (83.3%) had detectable viral DNA. Genotype A was present in 46 (54.8%), D in 20 (23.8%), F in 2 (2,4%), C in 1 (1.2%), A-G coinfection in 7 (8.3%), A-D in 4 (4.8%), D-G in 2 (2,4%), A-C in 1 (1.2%), and A-D-G in 1 (1.2%). There were no significant differences between genotypes. A trend towards an association was found between VL ≤ 10 5 copies/mL and the presence of chronic hepatitis in genotype A (28.9%) as opposed to genotype D (7.7%) (p non significant). Conclusions. HBV genotypes A and D, and coinfections with G are predominant in our area. Genotype A showed a tendency to produce greater inflammatory activity when VL was ≤ 10 5 copies/ml (AU)

Diagnóstico por imágenes para alumnos de medicina / Diagnostic imaging for medical students

Métodos de diagnóstico por imágenes. Sistema respiratorio, diafragma y mediastino. Corazón y aorta. Abdomen en general y sistema digestivo. Sistema urinario. Sistema ginecológico y obstetricia. Esqueleto. Cabeza ósea. Sistema nervioso central. Radiología intervencionista

Diagnóstico por imágenes para alumnos de medicina / Diagnostic imaging for medical students

Métodos de diagnóstico por imágenes. Sistema respiratorio, diafragma y mediastino. Corazón y aorta. Abdomen en general y sistema digestivo. Sistema urinario. Sistema ginecológico y obstetricia. Esqueleto. Cabeza ósea. Sistema nervioso central. Radiología intervencionista

Heterotopía de la sustancia gris: diagnóstico por resonancia magnética / Heteropatic gray matter: magnetic resonance imaging

Las anomalías de migración neuronal son malformaciones cerebrales comunes. Estas anomalías son reconocidas habitualmente en pacientes con convulsiones o retardo madurativo. Nosostros analizamos los hallazgos en 12 pacientes con Heterotopías de la sustancia gris (HSG) diagnosticados con RM, sus tipos y los diagnósticos diferenciales

Heterotopía de la sustancia gris: diagnóstico por resonancia magnética / Heteropatic gray matter: magnetic resonance imaging

Las anomalías de migración neuronal son malformaciones cerebrales comunes. Estas anomalías son reconocidas habitualmente en pacientes con convulsiones o retardo madurativo. Nosostros analizamos los hallazgos en 12 pacientes con Heterotopías de la sustancia gris (HSG) diagnosticados con RM, sus tipos y los diagnósticos diferenciales (AU)

Lesiones no palpables de la mama: la técnica radioquirúrgica / Non palpable breast lesions: radiographyc and surgical technic

Se analizan una serie de 206 casos explorados con mamografía y técnica radioquirúrgica (TRQ) de la mama, en pacientes con lesiones no palpables de la glándula. Se identificaron 47 carcinomas (22,8%), todos de tipo ductal, lobulillar o mixto. El 40 por ciento resultaron tumores no infiltrantes. En todos los casos se efectuó linfadenectomía homolateral, no identificándose metástasis ganglionares. La anatomía patológica indicó que 42/45 lesiones medían 10 mm o menos. El 90 por ciento mostró curación clínica, en cinco pacientes (10%) se observaron matástasis a distancia, felleciendo tres. Otras cinco pacientes desarrollaron un cáncer contralateral metacrónico en un lapso mayor de un año. Se describen en detalle: a)la técnica empleada (TRQ); b)los aspectos clínicos y c) los hallazgos mamográficos y anatomopatológicos. Se ofrecen conclusiones destacando el papel de la mamografía, la TRQ así como los aspectos clinicopatológicos del cáncer de mama

Lesiones no palpables de la mama: la técnica radioquirúrgica / Non palpable breast lesions: radiographyc and surgical technic

Se analizan una serie de 206 casos explorados con mamografía y técnica radioquirúrgica (TRQ) de la mama, en pacientes con lesiones no palpables de la glándula. Se identificaron 47 carcinomas (22,8%), todos de tipo ductal, lobulillar o mixto. El 40 por ciento resultaron tumores no infiltrantes. En todos los casos se efectuó linfadenectomía homolateral, no identificándose metástasis ganglionares. La anatomía patológica indicó que 42/45 lesiones medían 10 mm o menos. El 90 por ciento mostró curación clínica, en cinco pacientes (10%) se observaron matástasis a distancia, felleciendo tres. Otras cinco pacientes desarrollaron un cáncer contralateral metacrónico en un lapso mayor de un año. Se describen en detalle: a)la técnica empleada (TRQ); b)los aspectos clínicos y c) los hallazgos mamográficos y anatomopatológicos. Se ofrecen conclusiones destacando el papel de la mamografía, la TRQ así como los aspectos clinicopatológicos del cáncer de mama