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Biomedical subjects

P Bifulco

Publications and source records attributed to P Bifulco.

8 recordsLinked to original sources

An algorithm for the recovery of fetal heart rate series from CTG data.

Cardiotocography (simultaneous recording of fetal heart rate (FHR) and uterine contractions) is one of the most used diagnostic techniques to evaluate fetal well-being and to investigate the functional state of the fetal autonomic nervous system. Recently, great interest has been paid to the variability of the FHR, and its frequency analysis, as a base for a more objective analysis of the cardiotocographic (CTG) tracings. FHR signals are unevenly sampled series. To obtain evenly sampled series, cardiotocographs often use zero-order interpolation. Such process is simple and fast but results unsuitable for frequency analyses because it introduces alterations in the FHR power spectrum. An algorithm for the recovery of the true FHR series out of the zero-order interpolated CTG data was developed and evaluated.

Algorithms↗

Foetal heart rate power spectrum response to uterine contraction.

Cardiotocography is the most diffused prenatal diagnostic technique in clinical routine. The simultaneous recording of foetal heart rate (FHR) and uterine contractions (UC) provides useful information about foetal well-being during pregnancy and labour. However, foetal electronic monitoring interpretation still lacks reproducibility and objectivity. New methods of interpretation and new parameters can further support physicians' decisions. Besides common time-domain analysis, study of the variability of FHR can potentially reveal autonomic nervous system activity of the foetus. In particular, it is clinically relevant to investigate foetal reactions to UC to diagnose foetal distress early. Uterine contraction being a strong stimulus for the foetus and its autonomic nervous system, it is worth exploring the FHR variability response. This study aims to analyse modifications of the power spectrum of FHR variability corresponding to UC. Cardiotocographic signal tracts corresponding to 127 UC relative to 30 healthy foetuses were analysed. Results mainly show a general, statistically significant (t test, p<0.01) power increase of the FHR variability in the LF 0.03-0.2 Hz and HF 0.2-1 in correspondence of the contraction with respect to a reference tract set before contraction onset. Time evolution of the power within these bands was computed by means of time-varying spectral estimation to concisely show the FHR response along a uterine contraction. A synchronised grand average of these responses was also computed to verify repeatability, using the contraction apex as time reference. Such modifications of the foetal HRV that follow a contraction can be a sign of ANS reaction and, therefore, additional, objective information about foetal reactivity during labour.

Autonomic Nervous System↗

Automatic recognition of vertebral landmarks in fluoroscopic sequences for analysis of intervertebral kinematics.

Intervertebral kinematics closely relates to the functionality of the spinal segments. Direct measurement of the intervertebral kinematics in vivo is very problematic. The use of a fluoroscopic device can provide continuous screening of the lumbar tract during patient spontaneous motion, with an acceptable, low X-ray dose. The kinematic analysis is intended to be limited to planar motion. Kinematic parameters are computed from vertebral landmarks on each frame of the image sequence. Landmarks are normally selected manually in spite of the fact that this is subjective, tedious to perform and regarded as one of the major contributors to errors in the computed kinematic parameters. The aim of this work is to present an innovative method for the automatic recognition of vertebral landmarks throughout a fluoroscopic image sequence to provide an objective and more precise quantification of intervertebral kinematics. The recognition procedure is based upon comparing vertebral features in two adjacent frames by means of a cross-correlation index, which is also robust despite the low signal-to-noise ratio of the lumbar fluoroscopic images. To provide a quantitative assessment of this method a calibration model was used which consisted of two lumbar vertebrae linked by a universal joint. The reliability and accuracy of the kinematic measurements have been investigated. The errors are of the order of a millimetre for the localisation of the intervertebral centre of rotation and tenths of a degree for the intervertebral angle. Error analysis suggests that this method improves the accuracy of the intervertebral kinematic calculations and has the potential to automate the selection of anatomical landmarks.

Calibration↗

Relationship between visual acuity and eye position variability during foveations in congenital nystagmus.

Visual acuity in congenital nystagmus has proven to be primarily related to the duration of foveation periods, during which the image of a target falls onto the fovea and eye velocity slows down. It was found that the longer the foveation time the higher the visual acuity. However, the cycle-to-cycle variability of the eye position and velocity during foveation periods also contribute to visual acuity. A high variability of the eye position during the foveations hinders a stable placement of the target image on the centralmost fovea and consequently decreases visual acuity. To investigate the relationship between different nystagmus features and visual acuity, infrared- oculographic and electro-oculographic eye position recordings of 20 patients affected by congenital nystagmus were analysed in different gaze positions. In several patients' recordings, a high variability of the eye position during foveations (i.e. greater than 0.5 degrees) was detected. Correspondingly, low visual acuity was measured, in spite of sufficiently long foveation periods. The standard deviation of eye positions during foveation periods was used to measure this variability and it was found to be correlated to visual acuity, in conjunction with the mean duration of the foveation periods. On the basis of the data analysis, an exponential relationship is proposed to relate visual acuity and the standard deviation of the eye position during foveations.

Adolescent↗

Study of the control strategy of the quadriceps muscles in anterior knee pain.

Anterior knee pain (AKP) is a common pathological condition, particularly among young people and athletes, associated to an abnormal motion of the patella during the bending of the knee and possibly dependent on a muscular or structural imbalance. A lack of synergy in the quadriceps muscles results in a dynamic misalignment of the patella, which in turn produces pain. AKP rehabilitative therapy consists of conservative treatment whose main objective is to strengthen the Vastus Medialis. The aim of this article is to study the quadriceps muscle control strategy in AKP patients during an isokinetic exercise. Analysis of the muscle activation strategy is important for an objective measurement of the knee functionality in that it helps to diagnose and monitor the rehabilitative treatment. Surface electromyography (EMG) from the three superficial muscles of the femoral quadriceps during a concentric isokinetic exercise has been analyzed along with the signals of knee joint position and torque. A group of 12 AKP patients has been compared with a group of 30 normal subjects. Analysis of the grand ensemble average of the EMG linear envelopes in AKP patients reveals significant modifications in Vastus Medialis activity compared to the other quadriceps muscles. In order to study the synergy of the muscles, temporal identifiers have been associated to the EMG linear envelopes. To this end, EMG linear envelope decomposition in Gaussian pulses turned out to be effective and the results highlight an appreciable delay in the activation of the Vastus Medialis in AKP patients. This muscular unbalance can explain the abnormal motion of the patella.

Adolescent↗

Quadriceps muscles activation in anterior knee pain during isokinetic exercise.

The aim of this paper is to study the femoral quadriceps muscles activation in patients suffering from anterior knee pain (AKP) during an isokinetic exercise. AKP is a common pathological condition, associated to an abnormal motion of the patella. It possibly depends on a muscular or structural imbalance. A lack of synergy in the quadriceps muscles results in a dynamic misalignment of the patella, which in turn produces pain. A quantitative analysis of the muscle activation strategy is important for an objective measurement of the knee functionality in that it helps to diagnose and monitor the rehabilitative treatment. Surface electromyography (EMG) from the three superficial muscles of the femoral quadriceps during a concentric isokinetic exercise has been analysed. A group of AKP patients has been compared with a control group of healthy subjects. Ensemble average of the EMG linear envelopes reveals significant modifications in Vastus Medialis activity in AKP patients. In order to quantify the synergy of the muscles, different parameters have been associated to EMG linear envelopes significant features. A decomposition in gaussian pulses and an asymmetry coefficient have been utilised. The results relative to these concise parameters highlight an appreciable delay and a modification in the activation of the Vastus Medialis in AKP patients.

Adolescent↗