Objective: To evaluate the comparative efficacy of 3 antidepressants, each representative of a distinct psychopharmacologic class, in the treatment of depressive disorders associated to Parkinson disease with dementia (PDD). Methods: A group of 23 patients, mean age 72.1, diagnosed with PDD for at least 2 years, who were admitted in our department for a major depressive episode (DSM IV TR), received antidepressant treatment with escitalopram (mean dose 15 mg daily, n=7), duloxetine (mean dose 45 mg daily, n=8) or trazodone (mean dose 150 mg daily, n=8). All patients received treatment for PDD with rivastigmine or donepezil continuously, for at least 12 months. The distribution of patients on the antidepressant treatment was randomized, in a single-blind manner. Patients were evaluated monthly, for 6 months, using Montgomery Asberg Depression Rating Scale, Hamilton Rating Scale for Depression-17 items, Clinical Global Impression-Improvement and Mini Mental Status Examination. Results: Patients treated with duloxetine had the most significant improvement in the depressive symptoms, as the endpoint MADRS (-18.6+/-2.3, p< 0.01), HAMD (-13.2+/-1.1, p< 0.01) and CGI-I (-3.2+/-0.5, p< 0.01) scores reflected. The differences between escitalopram and trazodone didn't reach a significant level but, overall, both improved the depressive symptoms compared to baseline (p< 0.05). The difference between duloxetine and the other two antidepressants became significant after 8 weeks (p< 0.01). The severity of dementia symptoms didn't vary significantly between the three groups at endpoint. Conclusion: Duloxetine had proven itself more efficient than escitalopram and trazodone in the improvement of the depressive symptoms in PDD.
Achieving a high frame rate in echocardiography is highly important for quantifying the short phases of the cardiac cycle that contain valuable information for medical diagnosis. Additionally, the 3D quantitative assessment of the heart would significantly improve the current measurements used in daily clinical routine. Nevertheless obtaining ultrafast images remains a challenge due to the trade-off between the image quality and a high frame rate, especially when volumetric data is acquired. Among the current ultrafast imaging methods, multi-linetransmit imaging (MLT) provides an increased frame rate but in the same time mostly preserves the image quality. In this paper we present the first real-time experimental implementation of the MLT in 3D ultrasound. The results indicate the potential of 3D MLT for achieving high contrast and resolution while increasing the frame rate. This study thus demonstrates the feasibility of 3D MLT in real-time and extends its possible applications to dynamic cardiac imaging.
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There is an increasing interest for sparse 2D arrays as an alternative to full gridded arrays used in commercial systems. This work presents an effective and straightforward solution to perform 3D ultrasound imaging by driving a reduced number of elements of a commercial 2D array. The selection of 128, 192 or 256 elements out of a 32x32 array was based on simulated annealing to produce radiated beam patterns with optimal tradeoff in terms of main lobe width (resolution) and side lobe level (contrast) over a (± 32°) volume. The aim of the present work is to experimentally validate these optimal configurations by performing 3D focused imaging on a phantom. The performance metrics included the lateral resolution and the contrast to noise ratio (CNR), measured on the images obtained by scanning a grayscale phantom. The results show that the optimized 256 elements array performs, as expected, the best among all the compared sparse arrays, presents the same resolution performance as the full array and a-6 dB loss of CNR while using 25% of the active elements.
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