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Sample records for catheterization indications techniques

  1. Superselective catheterization technique in hepatic angiography

    SciTech Connect

    Chuang, V.P.; Soo, C.S.; Carrasco, C.H.; Wallace, S.

    1983-10-01

    The techniques for superselective catheterization of hepatic artery are described. The catheters have five major configurations in various sizes: (1) simple curve, (2) reverse curve, (3) double curve, (4) modified double curve, and (5) hepatic and splenic curves. Since the celiac artery may be directed caudad, horizontally, or cephalad, the techniques vary accordingly. The basic approach of the system described is to tailor the catheter to fit the vascular anatomy. These various techniques have produced a 95% success rate in the hepatic artery catheterization of 1000 patients.

  2. Catheterization.

    ERIC Educational Resources Information Center

    Lewis, Mary Bell; Moseley, James L.

    This module is designed to teach the fundamentals of clean intermittent urinary catheterization for the disabled child, particularly in the school setting. The text includes information on proper hand washing techniques, the supplies needed, suggested settings, and the preparations required before and after the catheter is inserted into the…

  3. [Indications for central veinous catheterism in psychiatric patients (author's transl)].

    PubMed

    König, P; Strickner, M

    1978-03-01

    Based on cases of a Psychiatric Intensive Care Unit specific indications and applications of catheterism of central-veins in these special instances are presented, the psychiatric indications and contraindications for such measures are submitted in addition to those known from other medical fields. The mode of insertion, duration, infusionregimen and rates of complications are reviewed in 102 cases. Two of the common veinous-catheter systems are compared as for practicability. PMID:417008

  4. Paraplegia following cervical epidural catheterization using loss of resistance technique with air: a case report

    PubMed Central

    Chae, Yun Jeong; Park, Hyung Bae; Kim, Chan; Nam, Si Gweon

    2016-01-01

    We report a case of paraplegia without neurologic deficit of upper extremities following cervical epidural catheterization using air during the loss of resistance technique. A 41-year-old woman diagnosed with complex regional pain syndrome had upper and lower extremity pain. A thoracic epidural lead was inserted for a trial spinal cord stimulation for treating lower extremity pain and cervical epidural catheterization was performed for treating upper extremity pain. Rapidly progressive paraplegia developed six hours after cervical epidural catheterization. Spine CT revealed air entrapment in multiple thoracic intervertebral foraminal spaces and surrounding epidural space without obvious spinal cord compression before the decompressive operation, which disappeared one day after the decompressive operation. Her paraplegia symptoms were normalized immediately after the operation. The presumed cause of paraplegia was transient interruption of blood supply to the spinal cord through the segmental radiculomedullary arteries feeding the spinal cord at the thoracic level of the intervertebral foramen caused by the air. PMID:26885305

  5. [Application of ultrasonography in central venous catheterization; access sites and procedure techniques].

    PubMed

    Czyzewska, Dorota; Ustymowicz, Andrzej; Klukowski, Mark

    2016-08-01

    Central venous catheterization is commonly performed in clinical practice. Traditional procedural technique is based on anatomical landmarks, but is associated with a high risk of failure and complications. To decrease their incidence European and American societies recommend application of ultrasonography. Preliminary ultrasonographic examination allows for assessment of local anatomical relations as well as vessel morphology (diameter, patency), while real-time ultrasonography increases chances of successful needle insertion. This paper presents the most common venous access sites and procedure techniques. PMID:27157792

  6. Cardiac Catheterization

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Cardiac Catheterization? Cardiac catheterization (KATH-eh-ter-ih-ZA-shun) is a ... disease. Doctors also can use ultrasound during cardiac catheterization to see blockages in the coronary arteries. Ultrasound ...

  7. Ultrasound-guided catheterization of the portal vein in 11 cows using the Seldinger technique.

    PubMed

    Braun, U; Camenzind, D; Ossent, P

    2003-02-01

    Catheterization of the portal vein using the Seldinger technique [Acta Radiol. (1958) 38, 368] was performed in 11 cows. Ultrasound-guided percutaneous portocentesis, using a 25-cm, 14-gauge steel cannula, was performed from the 10th, 11th or 12th intercostal space on the right side. A stylet was placed through the cannula, which was then removed, and a polyurethane balloon-tipped catheter was advanced over the stylet into the portal vein and sutured to the skin (Seldinger, 1952). Blood samples were collected from the catheter at least once daily. The catheter was removed 9-15 days later when blood could no longer be aspirated. The cows were then slaughtered and a post-mortem examination was performed. During the study, appetite remained normal in nine of 11 cows. In three cows, the general behaviour and demeanour were mildly, but transiently, abnormal. Four cows had leucopoenia. The most frequently encountered problem was occlusion of the catheter, which usually was resolved by flushing with heparinized saline. The most common post-mortem lesion observed was an increase in fibrous connective tissue at the site of cannulation. In nine of 11cows, there was a thrombus in the portal vein at the site of catheterization. Generally, the severity of the lesions was mild. The results of this study demonstrated that ultrasound-guided percutaneous catheterization of the portal vein, using the Seldinger technique, is possible in cows. The catheter may be left in place for collection of blood samples for up to 15 days. PMID:12650501

  8. Percutaneous Treatment of a Primary Pancreatic Hydatid Cyst Using a Catheterization Technique

    PubMed Central

    Karaman, Bulent; Ustunsoz, Bahri; Ugurel, Mehmet Sahin

    2012-01-01

    Primary pancreatic hydatid cysts are rare and its percutaneous treatment and catheterization technique has, to the best of our knowledge, not been published in literature. A 33-year-old male patient who presented with abdominal pain was evaluated by ultrasonography (US) and computed tomography examinations. Both examinations revealed a cyst in the neck of the pancreas. After the administration of albendazole chemoprophylaxis, the patient underwent diagnostic puncture showing high pressure spring water which harbored the scoleces and was treated percutaneously by the catheterization technique. In this technique, first the cyst was punctured, the fluid content aspirated, the radiocontrast material injected to see possible fistulisation, and then re-aspirated. The 20% hypertonic saline solution was injected and re-aspiration was performed to the best of our abilities, followed by the insertion of a catheter for drainage of the remaining non-aspiratable fluid content. At follow-up examination, the cyst was not visible on US after 6 months. There was no evidence of cyst recurrence or dissemination after 18 months at serologic and imaging follow-up. PMID:22438691

  9. Percutaneous treatment of a primary pancreatic hydatid cyst using a catheterization technique.

    PubMed

    Karaman, Bulent; Battal, Bilal; Ustunsoz, Bahri; Ugurel, Mehmet Sahin

    2012-01-01

    Primary pancreatic hydatid cysts are rare and its percutaneous treatment and catheterization technique has, to the best of our knowledge, not been published in literature. A 33-year-old male patient who presented with abdominal pain was evaluated by ultrasonography (US) and computed tomography examinations. Both examinations revealed a cyst in the neck of the pancreas. After the administration of albendazole chemoprophylaxis, the patient underwent diagnostic puncture showing high pressure spring water which harbored the scoleces and was treated percutaneously by the catheterization technique. In this technique, first the cyst was punctured, the fluid content aspirated, the radiocontrast material injected to see possible fistulisation, and then re-aspirated. The 20% hypertonic saline solution was injected and re-aspiration was performed to the best of our abilities, followed by the insertion of a catheter for drainage of the remaining non-aspiratable fluid content. At follow-up examination, the cyst was not visible on US after 6 months. There was no evidence of cyst recurrence or dissemination after 18 months at serologic and imaging follow-up. PMID:22438691

  10. Percutaneous Transhepatic Catheterization of the Portal Vein: A Combined CT- and Fluoroscopy-Guided Technique

    SciTech Connect

    Weimar, Bernd; Rauber, Klaus; Brendel, Mathias D.; Bretzel, Reinhard G.; Rau, Wigbert S.

    1999-07-15

    Combined CT- and fluoroscopy-guided transhepatic portal vein catheterization was performed in 44 patients selected for pancreatic islet cell transplantation. The method allowed catheterization with a single puncture attempt in 39 patients. In four patients two attempts and in one patient four attempts were necessary. One minor hematoma of the liver capsule occurred that required no further treatment. Compared with other methods the average number of puncture attempts was reduced.

  11. Urine culture - catheterized specimen

    MedlinePlus

    Culture - urine - catheterized specimen; Urine culture - catheterization; Catheterized urine specimen culture ... urinary tract infections may be found in the culture. This is called a contaminant. You may not ...

  12. [Plasmapheresis: technique, complications and indications].

    PubMed

    Pruijm, M T; Cherpillod, A; Vogt, B; Burnier, M

    2008-03-01

    Plasmapheresis is an extracorporeal technique used to remove pathogenic macromolecules from the plasma. Plasmapheresis is used to treat neurological, renal, hematological as well as systemic diseases, which explains why many different specialties in medicine can be involved. Plasmapheresis has evolved in forty years into a frequently used, relatively safe procedure. Nowadays a large spectrum of different techniques exists, each with its own possible complications. In this article we will give an overview of these different techniques, their complications and indications, in order to familiarize the reader with this fascinating treatment. PMID:18402016

  13. CT colonography: techniques, indications, findings.

    PubMed

    Mang, Thomas; Graser, Anno; Schima, Wolfgang; Maier, Andrea

    2007-03-01

    Computed tomographic colonography (CTC) is a minimally invasive technique for imaging the entire colon. Based on a helical thin-section CT of the cleansed and air-distended colon, two-dimensional and three-dimensional projections are used for image interpretation. Several clinical improvements in patient preparation, technical advances in CT, and new developments in evaluation software have allowed CTC to develop into a powerful diagnostic tool. It is already well established as a reliable diagnostic tool in symptomatic patients. Many experts currently consider CTC a comparable alternative to conventional colonoscopy, although there is still debate about its sensitivity for the detection of colonic polyps in a screening population. This article summarizes the main indications, the current techniques in patient preparation, data acquisition and data analysis as well as imaging features for common benign and malignant colorectal lesions. PMID:17224254

  14. Clean intermittent self-catheterization in neuro-urology.

    PubMed

    Di Benedetto, P

    2011-12-01

    Neurogenic lower urinary tract dysfunction (NLUTD) is commonly encountered in rehabilitation settings, and is caused by a variety of pathologies. The management of spinal cord injury (SCI) has been the model of reference for the management of other pathologies with NLUTD. The introduction of intermittent catheterization (IC) led to decline in renal related mortality in SCI patients and allowed an improvement of quality of life (QoL) in all neurogenic patients with NLUTD. IC could be sterile, aseptic or clean. Sterile intermittent catheterization (SIC) is the preferred method of bladder drainage in emergency medicine units and during spinal shock in SCI patients, but it is costly and time-consuming. Catheterizations performed in institutions, such as rehabilitation hospitals and nursing homes, are done aseptically. Clean intermittent catheterization (CIC), i.e. self-catheterization (CISC) or third party catheterization, represents the "gold standard" method for bladder emptying in all neuropathic patients with NLUTD: the technique is safe and effective and results in improved kidney and upper urinary tract status, lessening of vesico-ureteral reflux and amelioration of urinary continence. CISC is mandatory in patients with NLUTD secondary to detrusor areflexia/hypocontractility and in patients suffering from neurogenic detrusor overactivity with detrusor external sphincter dyssynergia and high post void residual of urine, often in combination with antimuscarinics/bladder relaxants. The review summarizes the most important aspects of IC and CISC. Attention was focused on the history of urethral catheterization, aims, materials, advantages, indications, and present-day techniques of CISC, emphasizing the importance of teaching in order to perform correctly the catheterization technique. PMID:22222962

  15. Staged urethroplasty: indications and techniques.

    PubMed

    Secrest, Charles L

    2002-05-01

    There is still a place for staged urethroplasty. There are some indications for staged urethral reconstruction such as strictures associated with chronic inflammation, fistula, false passage, urethral stones, urethral diverticula, abscess, failed prior repair, complicated hypospadias, severe trauma, neurologic diseases, extensive BXO strictures and long strictures. Staging a urethroplasty should not be considered a step backwards rather instead we should learn from experience and realize there are some patients who are too complex to reconstruct in a single stage. PMID:12371236

  16. Bladder catheterization, male (image)

    MedlinePlus

    Catheterization is accomplished by inserting a catheter (a hollow tube, often with and inflatable balloon tip) into ... catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable ...

  17. The history of cardiac catheterization.

    PubMed

    Bourassa, Martial G

    2005-10-01

    The evolution of cardiac catheterization has occurred over at least four centuries. One of the first major steps was the description of the circulation of the blood by William Harvey in 1628. The next milestone was the measurement of arterial pressure by Stephen Hales, one century later. However, the 19th century represented the golden age of cardiovascular physiology, highlighted by the achievements of Carl Ludwig, Etienne-Jules Marey and Claude Bernard, among others. Human cardiac catheterization developed during the 20th century. The first right heart catheterization in a human was performed by Werner Forssmann on himself in 1929. Diagnostic cardiac catheterization was introduced by André Cournand and Dickinson Richards in the early 1940s, and selective coronary angiography was described by Mason Sones in the early 1960s. More recently, with the advent of catheter-based interventions, pioneered by Andreas Gruentzig in the late 1970s, there has been considerable progress in the refinement and expansion of these techniques. Currently, the Sones technique is used only infrequently, and coronary angiography and percutaneous coronary intervention rely mainly on percutaneous femoral and percutaneous radial artery approaches. On the occasion of the 50th anniversary of the Montreal Heart Institute, it seems appropriate to highlight the contribution of this institution in these two areas. PMID:16234881

  18. Fallopian Tube Catheterization

    PubMed Central

    Thurmond, Amy Suzanne

    2013-01-01

    Fallopian tube catheterization is used for treatment of infertility caused by proximal tubal occlusion, and has replaced surgical treatment for this condition. More recently, fallopian tube catheterization has been used for tubal sterilization. Interventional radiologists tested numerous methods for tubal occlusion using the rabbit as an animal model. As a result, a tubal device has recently been Food and Drug Administration approved for permanent sterilization using hysteroscopic guidance; it can also be placed fluoroscopically by fallopian tube catheterization as an “off-label” procedure. This is a 5-year continuation and update on a procedure that has been done by interventional radiologists for 25 years; history of the development of fallopian tube catheterization in women has been published in detail in this journal. Highlighted in this article will be description of the basic components needed for fallopian tube catheterization. PMID:24436565

  19. A century of indicator dilution technique.

    PubMed

    Henriksen, Jens H; Jensen, Gorm B; Larsson, Henrik B W

    2014-01-01

    This review imparts the history and the present status of the indicator dilution technique with quantitative bolus injection. The first report on flow measurement with this technique appeared 100 years ago. In 1928, the use of intravascular dyes made possible a widespread application in animals and human during the next decades. Multiple indicators, radioactive tracers, inlet-outlet detection and residue detection were introduced in the 1950s and 1960s, and refined along with the development of indicator kinetics. From the 1970s, a wide clinical use in the study of heart, brain, lungs, liver and kidneys developed, and powerful computers in the 1980s and 1990s accorded the technique a new dimension. Today, the indicator dilution technique, on one hand, is applied in the same way as 100 years ago, on the other hand it forms the basis of quantitative SPECT, positron emission tomography, and dynamic MR scans. The technique still undergoes refinement and elaboration as a lasting concept with a high potential for further development. PMID:23869947

  20. Posterior Cervical Foraminotomy: Indications, Technique, and Outcomes.

    PubMed

    Dodwad, Shah-Jahan M; Dodwad, Shah-Nawaz M; Prasarn, Mark L; Savage, Jason W; Patel, Alpesh A; Hsu, Wellington K

    2016-06-01

    Cervical radiculopathy presents with upper extremity pain, decreased sensation, and decreased strength caused by irritation of specific nerve root(s). After failure of conservative management, surgical options include anterior cervical decompression and fusion, disk arthroplasty, and posterior cervical foraminotomy. In this review, we discuss indications, techniques, and outcomes of posterior cervical laminoforaminotomy. PMID:27187617

  1. Left heart catheterization

    MedlinePlus

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye will be injected into your ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  2. Bladder catheterization, male (image)

    MedlinePlus

    ... kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.

  3. Left heart catheterization

    MedlinePlus

    ... Bonow RO. Cardiac catheterization. In: Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook ... arteriography and intracoronary imaging In: Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook ...

  4. [Salter innominate osteotomy : Indications, surgical technique, results].

    PubMed

    Schulze, A; Tingart, M

    2016-08-01

    The prevalence of congenital hip dysplasia in Germany is 2-4 % and that of hip dislocation is 0.5-1 %. If early therapy is not successful or the hip dysplasia or dislocation is diagnosed too late (children of over 1 year of age) surgical treatment is indicated to increase the femoral coverage. The innominate osteotomy, published by Robert B. Salter 1961, is a worldwide established technique to improve the lateral and ventral coverage of the femoral head in primary or secondary hip dysplasia or dislocation. In this paper we discuss Salter's technique and present indications, the perioperative procedure, operative modifications and operative extensions and demonstrate the anatomical requirements, postoperative biomechanical changes and long-term results. PMID:27351429

  5. Tracheostomy: epidemiology, indications, timing, technique, and outcomes.

    PubMed

    Cheung, Nora H; Napolitano, Lena M

    2014-06-01

    Tracheostomy is a common procedure performed in critically ill patients requiring prolonged mechanical ventilation for acute respiratory failure and for airway issues. The ideal timing (early vs late) and techniques (percutaneous dilatational, other new percutaneous techniques, open surgical) for tracheostomy have been topics of considerable debate. In this review, we address general issues regarding tracheostomy (epidemiology, indications, and outcomes) and specifically review the literature regarding appropriate timing of tracheostomy tube placement. Based on evidence from 2 recent large randomized trials, it is reasonable to wait at least 10 d to be certain that a patient has an ongoing need for mechanical ventilation before consideration of tracheostomy. Percutaneous tracheostomy with flexible bronchoscopy guidance is recommended, and optimal percutaneous techniques, indications, and contraindications and results in high-risk patients (coagulopathy, thrombocytopenia, obesity) are reviewed. Additional issues related to tracheostomy diagnosis-related groups, charges, and procedural costs are reviewed. New advances regarding tracheostomy include the use of real-time ultrasound guidance for percutaneous tracheostomy in high-risk patients. New tracheostomy tubes (tapered with low-profile cuffs that fit better on the tapered dilators, longer percutaneous tracheostomy tubes) are discussed for optimal use with percutaneous dilatational tracheostomy. Two new percutaneous techniques, a balloon inflation technique (Dolphin) and the PercuTwist procedure, are reviewed. The efficacy of tracheostomy teams and tracheostomy hospital services with standardized protocols for tracheostomy insertion and care has been associated with improved outcomes. Finally, the UK National Tracheostomy Safety Project developed standardized resources for education of both health care providers and patients, including emergency algorithms for tracheostomy incidents, and serves as an excellent

  6. Multicenter long-term validation of a minicourse in radiation-reducing techniques in the catheterization laboratory.

    PubMed

    Kuon, Eberhard; Weitmann, Kerstin; Hoffmann, Wolfgang; Dörr, Marcus; Hummel, Astrid; Riad, Alexander; Busch, Mathias C; Felix, Stephan B; Empen, Klaus

    2015-02-01

    Patient radiation exposure in invasive cardiology is considerable. We aimed to investigate, in a multicenter field study, the long-term efficacy of an educational 90-minute workshop in cardiac invasive techniques with reduced irradiation. Before and at a median period of 2.5 months and 2.0 years after the minicourse (periods I, II, and III, respectively) at 5 German cardiac centers, 18 interventionalists documented various radiation parameters for 10 coronary angiographies. The median patient dose area product (DAP) for periods I, II, and III amounted to 26.6, 12.2, and 9.6 Gy × cm(2), respectively. The short-term and long-term effects were related to shorter median fluoroscopy times (180, 138, and 114 seconds), fewer radiographic frames (745, 553, and 417) because of fewer (11, 11, and 10) and shorter (64, 52, and 44 frames/run) runs, consistent collimation, and restriction to an adequate image quality; both radiographic DAP/frame (27.7, 17.3, and 18.4 mGy × cm(2)) and fluoroscopic DAP/second (26.6, 12.9, and 14.9 mGy × cm(2)) decreased significantly. Multivariate analysis over time indicated increasing efficacy of the minicourse itself (-55% and -64%) and minor influence of interventionist experience (-4% and -3% per 1,000 coronary angiographies, performed lifelong until the minicourse and until period III). In conclusion, autonomous self-surveillance of various dose parameters and feedback on individual radiation safety efforts supported the efficacy of a 90-minute course program toward long-lasting and ongoing patient dose reduction. PMID:25579886

  7. Clean intermittent catheterization revisited.

    PubMed

    Lamin, Eliza; Newman, Diane K

    2016-06-01

    Catheterization is the insertion of a hollow flexible tube (called a catheter) to drain the urine from the bladder and is probably one of the oldest urologic procedures, dating back 3000 years. Since 1972, when urologist Dr Jack Lapides described a procedure for performing clean intermittent catheterization, this method of bladder management has become lifesaving for an individual who cannot empty their bladder independently. If the bladder is not emptied regularly, elevated storage pressures can develop which may put the upper tracts at risk of subsequent deterioration. Intermittent catheterization (IC) has become the first-line and preferred method of drainage in patients with neurogenic lower urinary tract dysfunction, as long as dexterity or available caregiver support and body habitus allow access. However, over the past 20 years, an evolution has occurred in the technology of catheters used for IC. But with these advances, so has controversy arisen. This article is a review of the current application of IC, the current technology in catheter material and systems, differences between reusable and one-time, or single-use catheters, the cost benefit of doing IC, and the infectious benefit. PMID:26956983

  8. Oncoplastic breast surgery: indications, techniques and perspectives

    PubMed Central

    Montag, Eduardo; Gemperli, Rolf

    2013-01-01

    Breast-conservation surgery (BCS) is established as a safe option for most women with early breast cancer. Recently, advances in oncoplastic techniques have reduced surgical trauma and thus are capable of preserving the breast form and quality of life. In spite of the most BCS defects can be managed with primary closure, the aesthetic outcome may be unpredictable. Oncoplastic reconstruction may begin at the time of BCS (immediate), weeks (delayed-immediate) or months to years afterwards (delayed). With immediate reconstruction, the surgical process is smooth, since both procedures can be associated in one operative setting. Additionally, it permits wider excision of the tumor, with a superior mean volume of the specimen and potentially reducing the incidence of margin involvement. The oncoplastic techniques are related to volume displacement or replacement procedures including local flaps, latissimus dorsi myocutaneous flap and reduction mammaplasty/masthopexy. Regardless of the fact that there is no consensus concerning the best approach, the criteria are determined by the surgeon’s experience and the size of the defect in relation to the size of the remaining breast. On the basis of our 15-year experience, it is possible to identify trends in types of breast defects and to develop an algorithm for immediate BCS reconstruction on the basis of the initial breast volume, the extent/location of glandular tissue ressection and the remaining available breast tissue. The main advantages of the technique utilized should include reproducibility, low interference with the oncologic treatment and long-term results. Surgical planning should include the patients’s preferences, and chiefly addressing individual reconstructive requirements, enabling each patient to receive an individual “custom-made” reconstruction. PMID:25083476

  9. [Unilateral triangular lumbopelvic stabilization: indications and techniques].

    PubMed

    Hoffmann, M F; Dudda, M; Schildhauer, T A

    2013-11-01

    Operative fixation has become treatment of choice for unstable sacral fractures. Osteosynthesis for these fractures results in loss of reduction in up to 15%. Vertical sacral fractures involving the S1 facet joint (Isler 2 and 3) may lead to multidirectional instability. Multidirectional instability of the posterior pelvic ring and lumbopelvic junction may be stabilized and forces balanced by a so-called lumbopelvic triangular fixation. Lumbopelvic triangular fixation combines vertical fixation between the lumbar vertebral pedicle and the ilium, with horizontal fixation, as an iliosacral screw or a transiliacal plate osteosynthesis. The iliac screw is directed from the posterior superior iliac spine (PSIS) to the anterior inferior iliac spine (AIIS). Thereby, lumbopelvic fixation decreases the load to the sacrum and SI joint and transfers axial loads from the lumbar spine directly onto the ilium. Triangular lumbopelvic fixation allows early full weight bearing and therefore reduces prolonged immobilization. The placement of iliac screws may be a complex surgical procedure. Thus, the technique requires thorough surgical preparation and operative logistics. Wound-related complications may occur. Preexisting Morell-Lavalée lesions increase the risk for infection. Prominent implants cause local irritation and pain. Hardware prominence and pain are markedly reduced with screw head recession into the PSIS. PMID:24233083

  10. MRI Catheterization in Cardiopulmonary Disease

    PubMed Central

    Rogers, Toby; Ratnayaka, Kanishka

    2014-01-01

    Diagnosis and prognostication in patients with complex cardiopulmonary disease can be a clinical challenge. A new procedure, MRI catheterization, involves invasive right-sided heart catheterization performed inside the MRI scanner using MRI instead of traditional radiographic fluoroscopic guidance. MRI catheterization combines simultaneous invasive hemodynamic and MRI functional assessment in a single radiation-free procedure. By combining both modalities, the many individual limitations of invasive catheterization and noninvasive imaging can be overcome, and additional clinical questions can be addressed. Today, MRI catheterization is a clinical reality in specialist centers in the United States and Europe. Advances in medical device design for the MRI environment will enable not only diagnostic but also interventional MRI procedures to be performed within the next few years. PMID:24394821

  11. Translaminar lumbar epidural endoscopy: anatomy, technique, and indications.

    PubMed

    De Antoni, D J; Claro, M L; Poehling, G G; Hughes, S S

    1996-06-01

    This article describes a new technique to achieve access to the epidural space via a direct posterior portal. This minimally invasive technique allows treatment of disc protrusions and extrusions with full visualization and minimal dissection of the paraspinal musculature. Hemostasis, visualization, and triangulation is performed with standard arthroscopic instrumentation. The anatomy of, indications for, and advantages of this techniques are described. PMID:8783828

  12. Radiation Dose Estimation for Pediatric Patients Undergoing Cardiac Catheterization

    NASA Astrophysics Data System (ADS)

    Wang, Chu

    correction factors for the MOSFET organ dose measurements in the following studies. Minor angular dependence (< +/-20% at all angles tested, < +/-10% at clinically relevant angles in cardiac catheterization) was observed. Second, the cardiac dose for common fluoroscopic imaging techniques for pediatric patients in the two age groups was measured. Imaging technique settings with variations of individual key imaging parameters were tested to observe the quantitative effect of imaging optimization or lack thereof. Along with each measurement, the two standard system output indices, the Air Kerma (AK) and Dose-Area Product (DAP), were also recorded and compared to the measured cardiac and skin doses -- the lack of correlation between the indices and the organ doses shed light to the substantial limitation of the indices in representing patient radiation dose, at least within the scope of this dissertation. Third, the effective dose (ED) for Posterior-Anterior and Lateral fluoroscopic imaging techniques for pediatric patients in the two age groups was determined. In addition, the dosimetric effect of removing the anti-scatter grid was studied, for which a factor-of-two ED rate reduction was observed for the imaging techniques. The Clinical Component involved analytical research to develop a validated retrospective cardiac dose reconstruction formulation and to propose the new Optimization Index which evaluates the level of optimization of the clinician's imaging usage during a procedure; and small sample group of actual procedures were used to demonstrate applicability of these formulations. In its entirety, the research represents a first-of-its-kind comprehensive approach in radiation dosimetry for pediatric cardiac catheterization; and separately, it is also modular enough that each individual section can serve as study templates for small-scale dosimetric studies of similar purposes. The data collected and algorithmic formulations developed can be of use in areas of

  13. [Pre-implantation genetic diagnosis: indications, techniques, and results].

    PubMed

    Veiga, A; Boada, M; Barri, P N

    1998-01-01

    The combination of the technique of In Vitro Fertilization (IVF) and molecular genetics has led to the development of Preimplantation Genetic Diagnosis (PGD). Oocyte and embryo biopsy, Fluorescent in situ Hybridization (FISH) and Polymerase Chain Reaction (PCR) allow diagnostic procedures in couples with high risk and also certain IVF couples. We present a review of PGD indications, techniques and results. PMID:9810133

  14. Modified sonourethrography assists urethral catheterization.

    PubMed

    Minagawa, Tomonori; Suzuki, Toshiro; Domen, Takahisa; Yokoyama, Hitoshi; Ishikawa, Masakuni; Hirakata, Shiro; Nagai, Takashi; Nakazawa, Masaki; Ogawa, Teruyuki; Ishizuka, Osamu

    2016-07-01

    Sonourethrography (SUG) is an infrequently used modality to observe the male urethra. We modified SUG to examine the reasons for difficulty in urethral catheterization and to determine a safe approach to resolve these problems. Following retrograde urethral jelly injection, modified SUG (mSUG) was performed in male patients with difficulty in urethral catheterization. mSUG was performed using transcutaneous ultrasonography in patients for whom the catheter became lodged in the penile urethra. In other patients, mSUG was performed using transrectal ultrasonography. We divided the causes of difficult indwelling urethral catheterization into physiological and pathological conditions. With regard to physiological conditions, the urethral catheter became stuck in the bulbous portion, membranous urethra, and prostatic urethra. mSUG distinguished the problematic part of the urethra in real time, and it assisted in overcoming the problem. With regard to pathological conditions, urethral stricture after trauma or surgery was clearly demonstrated in the penile and prostatic portions of the urethra. As with physiological conditions, mSUG images assisted in navigating the catheter through the problematic pathological areas or demonstrated the need to abandon the catheterization. mSUG can visualize the male urethra clearly during urethral catheterization and provide real-time assistance with the procedure. PMID:26847624

  15. Myocardial Perfusion Scintigraphy: Techniques, Interpretation, Indications and Reporting

    PubMed Central

    Fathala, Ahmed

    2011-01-01

    Myocardial perfusion single photon emission-computed tomography (MPS) has been one of the most important and common non-invasive diagnostic cardiac test. Gated MPS provides simultaneous assessment of myocardial perfusion and function with only one study. With appropriate attention to the MPS techniques, appropriate clinical utilization and effective reporting, gated MPS will remain a useful diagnostic test for many years to come. The aim of this article is to review the basic techniques of MPS, a simplified systematic approach for study interpretation, current clinical indications and reporting. After reading this article the reader should develop an understanding of the techniques, interpretation, current clinical indications and reporting of MPS studies. PMID:22048510

  16. Swan-Ganz - right heart catheterization

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003870.htm Swan-Ganz - right heart catheterization To use the sharing features on this page, please enable JavaScript. Swan-Ganz catheterization is the passing of a thin ...

  17. History of Nocturia May Guide Urinary Catheterization for Total Joint Arthroplasty.

    PubMed

    Rana, Sumit; Woolson, Steven T; Giori, Nicholas J

    2016-07-01

    Urinary tract infection is a common complication after total knee arthroplasty (TKA) and can be related to urethral catheterization. This study attempted to determine whether nocturia could be used as an indicator of risk for postoperative urinary retention to limit the need for prophylactic catheterization in men undergoing TKA. A retrospective study was performed in a consecutive series of men undergoing TKA at a single Veterans Affairs medical center. Patients reporting 0 episodes or 1 episode of nocturia per night were not catheterized prophylactically, and patients reporting 2 or more episodes of nocturia each night were catheterized preoperatively. Of 100 consecutive patients, 51 reported no more than 1 episode of nocturia and did not undergo preoperative catheterization. Of these patients, 10 required 1 postoperative straight catheterization for urinary retention. In the 49 patients who were catheterized prophylactically, all catheters were removed on postoperative day 1. Only 1 of these patients required reinsertion of a catheter. No patient in either group was discharged with a catheter or had a urinary tract infection. Previously, the authors' standard protocol was to use a prophylactic urinary catheter for all men after TKA. In this 100-patient cohort, with this new protocol, 41 patients were not catheterized at all and 10 patients had only 1 straight catheterization. In this study, the frequency of nocturia in men undergoing TKA was an effective screening tool that safely reduced the need for an indwelling catheter in 51% of patients. [Orthopedics. 2016; 39(4):e749-e752.]. PMID:27111076

  18. Surface indicator and smoke flow visualization techniques in rotating machinery

    NASA Astrophysics Data System (ADS)

    Joslyn, H. David; Dring, Robert P.

    The surface indicator (ammonia/Ozalid paper) flow visualization technique for turbomachine flow research is presently noted to be especially valuable in the specification of instrumentation arrays in film cooling studies. This method is also useful in interpreting quantitative aerodynamic measurements and in detecting the presence of such three-dimensional phenomena as relative eddies, end-wall secondary flows, tip leakage flows, corner stalls, boundary layer transition and separation, and radial fluid transport. The smoke flow visualization technique can lead to a better understanding of wake-airfoil interaction, thereby furnishing a basis for the assessment of analytical models.

  19. Deep Anterior Lamellar Keratoplasty: Indications, Surgical Techniques and Complications

    PubMed Central

    Karimian, Farid; Feizi, Sepehr

    2010-01-01

    The concept of lamellar keratoplasty (LK) is not new. However, it had been abandoned and largely replaced by the time-honored technique of penetrating keratoplasty (PK) because LK is technically demanding, time consuming and gives suboptimal visual outcomes due to interface irregularity arising from manual lamellar dissection. Recent improvements in surgical instruments and introduction of new techniques of maximum depth of corneal dissection as well as inherent advantages such as preservation of globe integrity and elimination of endothelial graft rejection have resulted in a re-introduction of LK as an acceptable alternative to conventional PK. This review article describes the indications, different techniques, clinical outcomes and complications of deep anterior LK. PMID:20543934

  20. Full Endoscopic Spinal Surgery Techniques: Advancements, Indications, and Outcomes

    PubMed Central

    Yue, James J.; Long, William

    2015-01-01

    Advancements in both surgical instrumentation and full endoscopic spine techniques have resulted in positive clinical outcomes in the treatment of cervical, thoracic, and lumbar spine pathologies. Endoscopic techniques impart minimal approach related disruption of non-pathologic spinal anatomy and function while concurrently maximizing functional visualization and correction of pathological tissues. An advanced understanding of the applicable functional neuroanatomy, in particular the neuroforamen, is essential for successful outcomes. Additionally, an understanding of the varying types of disc prolapse pathology in relation to the neuroforamen will result in more optimal surgical outcomes. Indications for lumbar endoscopic spine surgery include disc herniations, spinal stenosis, infections, medial branch rhizotomy, and interbody fusion. Limitations are based on both non spine and spine related findings. A high riding iliac wing, a more posteriorly located retroperitoneal cavity, an overly distal or proximally migrated herniated disc are all relative contra-indications to lumbar endoscopic spinal surgery techniques. Modifications in scope size and visual field of view angulation have enabled both anterior and posterior cervical decompression. Endoscopic burrs, electrocautery, and focused laser technology allow for the least invasive spinal surgical techniques in all age groups and across varying body habitus. Complications include among others, dural tears, dysesthsia, nerve injury, and infection. PMID:26114086

  1. Identifying indicators through modified Delphi technique in polytechnics system

    NASA Astrophysics Data System (ADS)

    Nashir, Irdayanti Mat; Mustapha, Ramlee; Yusoff, Abdullah

    2015-02-01

    This study aims to examine how the panel has been selected as experts in assessing indicators of innovative instructional leadership (IIL) administrator in polytechnics based on 222 items were obtained through previous studies. A total of eleven people were selected as the expert panels in a study where expert selection criteria based on their background in the leadership. Experts were interviewed separately. Interviews were carried out for a half hour in their offices. The data obtained were analyzed using Atlas Ti. Overall findings indicate experts agree that a total of 188 items and 14 indicators should be maintained in this innovative instructional leadership instruments and next by using Modified Delphi Technique. The instrument will then be analyzed to obtain findings on the perception of lecturers on every administrator innovative instructional leadership in their respective polytechnics.

  2. [Osteosynthesis of the clavicle. Indications, surgical technique, results].

    PubMed

    Lindenmaier, H L; Kuner, E H; Becker, B

    1991-05-01

    The osteosynthesis of the clavicle should be the exception and should only be indicated in the case of complicated fractures. The high rate of pseudoarthrosis given in medical literature, is due to errors in indication, selection of implants and in surgical techniques. Procedures like intramedullar wiring, axial screwing and single cerclage-wire suture are unsuited for osteosynthesis of the clavicle. After osteosynthesis of the clavicle we have found exceptional positive results, with respect to functional, radiological and after subjective evaluation, at a low rate of complication without any consequences occurring in the years to come. These results show, that mainly good or even excellent success can be achieved, at a limited indication, combined with careful surgery and a standardized surgery procedure of osteosynthesis of the clavicle. PMID:1874044

  3. The development of a validated checklist for femoral venous catheterization: preliminary results.

    PubMed

    Riesenberg, Lee Ann; Berg, Katherine; Berg, Dale; Davis, Joshua; Schaeffer, Arielle; Justice, Ellen M; Tinkoff, Glen

    2014-01-01

    Femoral venous catheterization is a common, invasive procedure, which may lead to serious complications. Validated checklists are central to teaching and assessing procedural skills and may result in improved health care quality. The results of the first step of the validation of a femoral venous catheterization checklist are described. A comprehensive literature review of articles published on femoral venous catheterization did not yield a checklist validated by the Delphi method. A modified Delphi technique, involving a panel of 8 interdisciplinary, interinstitutional experts, was used to develop a femoral venous catheterization checklist. The internal consistency coefficient using Cronbach α was .99. Developing a 29-item checklist for teaching and assessing femoral venous catheterization is the first step in the validation process. For this checklist to become further validated, it should be implemented and studied in the simulation and clinical environments. PMID:24045368

  4. A practical approach to difficult urinary catheterizations.

    PubMed

    Ghaffary, Cameron; Yohannes, Amanuel; Villanueva, Carlos; Leslie, Stephen W

    2013-12-01

    Routine placement of transurethral catheters can be challenging in some situations, such as urethral strictures, severe phimosis and false passages. Intravaginal retraction of the urethral meatus can complicate Foley placement in postmenopausal females. In men, blind urethral procedures with mechanical or metal sounds without visual guidance or guidewire assistance are now discouraged due to the increased risk of urethral trauma and false passages. Newer techniques of urethral catheterization including guidewires, directed hydrophilic mechanical dilators, urethral balloon dilation, and direct vision endoscopic catheter systems are discussed, along with the new standardized protocol for difficult transurethral catheter insertions. Suprapubic catheter placement techniques, including percutaneous trocars and the use of the curved Lowsley tractor for initial suprapubic catheter insertion, are reviewed. Prevention and management of common catheter-related problems such as encrustation, leakage, Foley malposition, balloon cuffing and frequent blockages are discussed. PMID:23959835

  5. Catheterization of the Hepatic Artery Via the Left Common Carotid Artery in Rats

    SciTech Connect

    Li Xiao; Wang Yixiang, J.; Zhou Xiangping Guan Yongsong; Tang Chengwei

    2006-12-15

    The commonly used approach for rat hepatic artery catheterization is via the gastroduodenal artery, which is ligated after the procedure. A new method of rat hepatic artery catheterization via the left common carotid artery (LCCA) is described. The LCCA is repaired after catheterization. The catheterization procedures included the following: (1) opening the rat's abdominal cavity and exposing the portion of abdominal aorta at the level of the celiac trunk; (2) separating and exposing the LCCA; inserting a microguidewire and microcatheter set into the LCCA via an incision; after placement into the descending aorta, the microguidewire and microcatheter are maneuvered into the hepatic artery under direct vision; (3) after transcatheter therapy, the catheter is withdrawn and the incision at the LCCA is repaired. This technique was employed on 60 male Sprague-Dawley rats with diethylnitrosamine-induced liver cancer, using a 3F microguidewire and microcatheter set. Selective hepatic artery catheterization was successfully performed in 57 rats. One rat died during the operation and five rats died within 7 days after the procedure. It is envisaged that as experience increases, the catheterization success rate will increase and the death rate will decrease. A new approach for selective hepatic artery catheterization via the LCCA in rats is introduced, which makes repeat catheterization of this artery possible and allows large embolization particles to be delivered by using a 3F catheter.

  6. Propeller Flaps: A Review of Indications, Technique, and Results

    PubMed Central

    D'Arpa, Salvatore; Toia, Francesca; Pirrello, Roberto; Moschella, Francesco; Cordova, Adriana

    2014-01-01

    In the last years, propeller flaps have become an appealing option for coverage of a large range of defects. Besides having a more reliable vascular pedicle than traditional flap, propeller flaps allow for great freedom in design and for wide mobilization that extend the possibility of reconstructing difficult wounds with local tissues and minimal donor-site morbidity. They also allow one-stage reconstruction of defects that usually require multiple procedures. Harvesting of a propeller flap requires accurate patient selection, preoperative planning, and dissection technique. Complication rate can be kept low, provided that potential problems are prevented, promptly recognized, and adequately treated. This paper reviews current knowledge on propeller flaps. Definition, classification, and indications in the different body regions are discussed based on a review of the literature and on the authors' experience. Details about surgical technique are provided, together with tips to avoid and manage complications. PMID:24971367

  7. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications

    PubMed Central

    Halpern, Joshua; Mittal, Sameer; Pereira, Keith; Bhatia, Shivank; Ramasamy, Ranjith

    2016-01-01

    There are several options for the treatment of varicocele, including surgical repair either by open or microsurgical approach, laparoscopy, or through percutaneous embolization of the internal spermatic vein. The ultimate goal of varicocele treatment relies on the occlusion of the dilated veins that drain the testis. Percutaneous embolization offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts. However, the technique demands interventional radiologic expertise and has potential serious complications, including vascular perforation, coil migration, and thrombosis of pampiniform plexus. This review discusses the common indications, relative contraindications, technical details, and risks associated with percutaneous embolization of varicocele. PMID:26658060

  8. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications.

    PubMed

    Halpern, Joshua; Mittal, Sameer; Pereira, Keith; Bhatia, Shivank; Ramasamy, Ranjith

    2016-01-01

    There are several options for the treatment of varicocele, including surgical repair either by open or microsurgical approach, laparoscopy, or through percutaneous embolization of the internal spermatic vein. The ultimate goal of varicocele treatment relies on the occlusion of the dilated veins that drain the testis. Percutaneous embolization offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts. However, the technique demands interventional radiologic expertise and has potential serious complications, including vascular perforation, coil migration, and thrombosis of pampiniform plexus. This review discusses the common indications, relative contraindications, technical details, and risks associated with percutaneous embolization of varicocele. PMID:26658060

  9. Skin testing for allergic diseases: techniques, indications and interpretations.

    PubMed

    Villacorte, G V

    1978-01-01

    Despite significant strides in serologic methodologies, the skin test, when properly done, has remained the single most sensitive and practical assay for specific dermal-bound reaginic antibody. Its value could further be enhanced if and when characterization and standardization of the allergen extracts become a reality. While the technique is simple, the indications and interpretations of allergy skin tests required the expertise of well-trained allergists. A positive skin reaction is no more than a mere supportive laboratory aid in the diagnosis of allergic disease, which is arrived at through a carefully taken detailed history and a meticulously done physical examination. PMID:748833

  10. Intrathecal pain pumps: indications, patient selection, techniques, and outcomes.

    PubMed

    Bolash, Robert; Mekhail, Nagy

    2014-10-01

    Intrathecal drug delivery represents an advanced modality for refractory chronic pain patients as well as intractable spasticity. This article reviews the advantages and indications for intrathecal therapy, as well as recommendations for proper patient selection using a multidisciplinary team to provide a global assessment of the impact of chronic pain on the patient's well-being. The goals and expectations of trialing are discussed alongside advantages and disadvantages of several trialing techniques. A discussion of outcomes is presented for patients with chronic pain due to both malignant and nonmalignant causes. PMID:25240660

  11. The effect of anesthetization and urinary bladder catheterization on renal function of rainbow trout

    USGS Publications Warehouse

    Hunn, J.B.; Willford, W.A.

    1970-01-01

    1. Rainbow trout were anesthetized with MS-222 (Sandoz) or methylpentynol and catheterized. Urine was collected at selected intervals up to 48 hr. 2. Effects of MS-222 anesthesia on urine flow and composition were isolated from the stress of catheterization by re-anesthetizing the fish 18 to 20 hr post catheterization. 3. Urine output patterns were similar following MS-222 or methylpentynol anesthesia and catheterization. Highest urine flows were measured 4 to 8 hr post treatment. The highest urine output after re-anesthetization with MS-222 was observed 2 to 4 hr post-anesthesia. 4. Highest concentrations of Na2+, K+, Ca2+, Cl- and inorganic PO4 in the urine were measured in the first 2 hr after anesthesia and catheterization. 5. Flow rates and chemical composition of urine indicate that "normal" renal function is re-established 12 to 24 hr post-treatment.

  12. [Indications and technique of partial arthrodesis of the carpus].

    PubMed

    Martini, A K

    1992-01-01

    Partial arthrodesis of the carpus has again become a topical method. The technique has been improved and the range of indications has been extended. Fusion of certain areas has indeed been propagated as first-line therapy, for example in lunatum necrosis or as an important additional operation in substitution plastic surgery. Partial arthrodesis of the carpus is intended to eliminate mechanisms which has become pathological whilst preserving the best possible mobility. Partial arthrodesis alters the movement pattern of the individual ossae carpi. Moreover, the pressure in the adjacent joints also rises. The risk of a new pathological process is considerable. Recent publications report on a rapid development of impingement and symptoms. The most frequent partial arthrodeses are discussed. The indications and the direct consequences are critically analysed and explained with reference to examples. Technical details and potential dangers are described. An STT-arthrodesis is indicated for osteoarthritis of these bones. The radio-lunar arthrodesis is recommended for ulnar drifting of the carpus in cases of rheumatoid arthritis. Reconstruction of the central axis with arthrodesis of the capitate-lunate is indicated for pseudarthrosis of the scaphoid with carpal collapse. Other combinations are possible, they cause however greater functional deficits. We recommend a critical analysis of the function of the entire carpus before the operation. Caution is called for when an incipient arthrosis is present in the adjacent joint. Partial arthrodesis of the carpus is rather a temporary solution, since it enables time to be gained. Total arthrodesis is the ultimate resort. PMID:1642031

  13. Percutaneous endoscopic gastrostomy: Indications, technique, complications and management

    PubMed Central

    Rahnemai-Azar, Ata A; Rahnemaiazar, Amir A; Naghshizadian, Rozhin; Kurtz, Amparo; Farkas, Daniel T

    2014-01-01

    Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues

  14. Percutaneous endoscopic gastrostomy: indications, technique, complications and management.

    PubMed

    Rahnemai-Azar, Ata A; Rahnemaiazar, Amir A; Naghshizadian, Rozhin; Kurtz, Amparo; Farkas, Daniel T

    2014-06-28

    Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the "pull" technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues

  15. Per-oral endoscopic myotomy: emerging indications and evolving techniques.

    PubMed

    Minami, Hitomi; Inoue, Haruhiro; Haji, Amyn; Isomoto, Hajime; Urabe, Shigetoshi; Hashiguchi, Keiichi; Matsushima, Kayoko; Akazawa, Yuko; Yamaguchi, Naoyuki; Ohnita, Ken; Takeshima, Fuminao; Nakao, Kazuhiko

    2015-01-01

    Esophageal achalasia is a benign esophageal motility disorder resulting from an impaired relaxation of the lower esophageal sphincter. The principles of treatment involve disruption of the sphincter at the esophagogastric junction. Treatment techniques include balloon dilatation, botulinum toxin injection, and surgical myotomy. In 2008, per-oral endoscopic myotomy (POEM) was introduced by Inoue et al. as an endoscopic myotomy with no skin incision. The procedure has been well accepted and widely applied owing to its minimal invasiveness and high cure rates. Moreover, there have been discussions on wider indications for POEM and new technical developments have been reported. The present article reviews the historical background and present status of POEM, as well as future prospects for its application in the treatment of esophageal achalasia. PMID:25040806

  16. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications.

    PubMed

    Carofino, Brad C; Mazzocca, Augustus D

    2010-03-01

    The anatomic coracoclavicular ligament reconstruction (ACCR) is a surgical procedure to address acriomioclavicular joint instability. The coracoclavicular ligaments are reconstructed using a semitendinosus allograft passed beneath the coracoid and through bone tunnels in the clavicle. The graft is secured with interference screw fixation, and the acromioclavicular joint is retained. Here we describe the authors' surgical technique, indications, and rehabilitation protocol. Also, a preliminary case series of seventeen patients is presented. Patients demonstrated significant improvement in pain levels and function. The mean ASES score increased from 52 preoperatively to 92. The Constant Murley rose from 66.6 to 94.7. There were three failures in this series, and two required revision surgery. PMID:20188267

  17. Venous catheterization with ultrasound navigation

    SciTech Connect

    Kasatkin, A. A. Nigmatullina, A. R.; Urakov, A. L.

    2015-11-17

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient’s exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  18. Venous catheterization with ultrasound navigation

    NASA Astrophysics Data System (ADS)

    Kasatkin, A. A.; Urakov, A. L.; Nigmatullina, A. R.

    2015-11-01

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient's exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  19. Retinal cholesterol emboli during diagnostic cardiac catheterization.

    PubMed

    Blanco, V R; Morís, C; Barriales, V; González, C

    2000-11-01

    Retinal embolism is a highly infrequent complication of cardiac catheterization of thrombotic, lipidic, and calcific etiology. We provide the first reported clinical case of retinal embolism caused by cholesterol crystal without systemic adverse effects as a severe complication of diagnostic cardiac catheterization. Cathet. Cardiovasc. Intervent. 51:323-325, 2000. PMID:11066118

  20. Reducing distress in pediatric cardiac catheterization.

    PubMed

    Naylor, D; Coates, T J; Kan, J

    1984-08-01

    To examine the efficacy of rehearsal in reducing distress in 3- to 6-year-old children undergoing diagnostic cardiac catheterization, 40 children were assigned randomly to the rehearsal preparation procedure or to usual preparation. The rehearsal program involved the use of behavioral rehearsal in the catheterization laboratory, manuals to explain the procedure to the parents, and coloring books to provide parents and children with a vicarious experience of catheterization. Rehearsed patients cried, yelled for mother, complained of pain less, and showed lower rates of motor activity than did control patients. Rehearsed patients also showed less overt regressive, aggressive, and anxiety behaviors at home following the catheterization than did controls. Parents in the rehearsed group showed less anxiety following the catheterization, and negative reactions in children correlated significantly with parental anxiety. Participants' reactions were uniformly more positive in the rehearsed than in the control patients. PMID:6741887

  1. Complications of Cardiac Catheterization in Structural Heart Disease

    PubMed Central

    Lee, Ko Eun; Seo, Yeon Jeong; An, Hyo Soon; Song, Young Hwan; Kwon, Bo Sang; Bae, Eun Jung; Noh, Chung Il

    2016-01-01

    Background and Objectives Cardiac catheterization is used to diagnose structural heart disease (SHD) and perform transcatheter treatment. This study aimed to evaluate complications of cardiac catheterization and the associated risk factors in a tertiary center over 10 years. Subjects and Methods Total 2071 cardiac catheterizations performed at the Seoul National University Children's Hospital from January 2004 to December 2013 were included in this retrospective study. Results The overall complication, severe complication, and mortality rates were 16.2%, 1.15%, and 0.19%, respectively. The factors that significantly increased the risk of overall and severe complications were anticoagulant use before procedure (odds ratio [OR] 1.83, p=0.012 and OR 6.45, p<0.001, respectively), prothrombin time (OR 2.30, p<0.001 and OR 5.99, p<0.001, respectively), general anesthesia use during procedure (OR 1.84, p=0.014 and OR 5.31, p=0.015, respectively), and total procedure time (OR 1.01, p<0.001 and OR 1.02, p<0.001, respectively). Low body weight (OR 0.99, p=0.003), severe SHD (OR 1.37, p=0.012), repetitive procedures (OR 1.7, p=0.009), and total fluoroscopy time (OR 1.01, p=0.005) significantly increased the overall complication risk. High activated partial thromboplastin time (OR 1.04, p=0.001), intensive care unit admission state (OR 14.03, p<0.001), and concomitant electrophysiological study during procedure (OR 3.41, p=0.016) significantly increased severe complication risk. Conclusion Currently, the use of cardiac catheterization in SHD is increasing and becoming more complex; this could cause complications despite the preventive efforts. Careful patient selection for therapeutic catheterization and improved technique and management during the peri-procedural period are required to reduce complications. PMID:27014356

  2. Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes

    SciTech Connect

    Lopez, Anthony James

    2015-08-15

    Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory ‘proof’ of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of women with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world’s population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure.

  3. Assessing the blalock-hanlon atrioseptectomy at cardiac catheterization.

    PubMed

    Clark, E B; Rosenquist, G C

    1977-01-01

    Blalock-Hanlon atrial septectomy (BH) is performed to increase systemic and pulmonary venous mixing at the atrial level. Failure of clinical improvement may be related to inadequate intraatrial communication. A simple catheterization technique employing a balloon catheter is used to assess the presence or absence of the limbus of the foramen ovale following BH, since persistence of the limbus of the fossa ovalis after BH is associated with significantly smaller percentage of communication (atrial communication area/total atrial area). PMID:603909

  4. Septic and technical complications of central venous catheterization. A prospective study of 200 consecutive patients.

    PubMed Central

    Sitzmann, J V; Townsend, T R; Siler, M C; Bartlett, J G

    1985-01-01

    The results of central venous catheterization for total parenteral nutrition were prospectively evaluated in 200 consecutive patients. All catheters were fabricated of polyurethane tubing inserted by the Seldinger technique. Two hundred sixty-three lines were inserted in 200 patients for a total of 4103 days. Major complications occurred in 2.3% patients. Twenty-four per cent of catheters were associated with suspected sepsis; of these, 52% were removed directly and 48% were changed over a guidewire. The total catheter sepsis rate was 5.7%. The incidence of sepsis correlated with the number of attempts to insert the line and with positive skin cultures. These data indicate that: use of the Seldinger technique to insert nonthrombogenic flexible catheters results in lower technical morbidity; the incidence of established infection is much lower than the incidence of suspected sepsis; guidewire change may be performed without risk to the patient or interruption of therapy; sepsis rates can be decreased by reducing the number of attempts to catheterize the subclavian vein; and sepsis rates correlate with positive skin cultures at the insertion site. PMID:3935062

  5. Continuous use of intermittent bladder catheterization - can social support contribute?

    PubMed Central

    Lopes, Marjoyre Anne Lindozo; Lima, Elenice Dias Ribeiro de Paula

    2014-01-01

    Objective to investigate the factors affecting the adequate continuous use of intermittent catheterization and its relation with social support. Method sectional, descriptive and correlational study involving 49 patients with neuropathic bladder caused by spinal cord injury. Results almost all (92%) participants continued the intermittent catheterization, but 46.9% made some changes in the technique. The complications (28.6% of the sample) were mainly infection and vesicolithiasis. There were high scores for social support in relation to people that were part of the patient's social support. Conclusion All of them noticed great support from the family, but not from the society in general. The difficulties were related to the lack of equipment and inadequate infrastructure, leading to changes that increased urologic complications. PMID:25029058

  6. Guide wire migration during femoral vein catheterization.

    PubMed

    Khatami, Mohammad Reza; Abbasi, Rozita; Sadigh, Gelareh

    2010-10-01

    Central vein catheterization is a routine and relatively safe procedure in critically ill patients. Complications with this procedure depend to the site of catheterization and the skill of the operator. In addition to the common complications with femoral vein catheterization there are some rare usually preventable side effects related to guide wire and catheter. In our patient who underwent femoral catheterization for acute hemodialysis, we report migration of guide wire through the systemic circulation from the femoral vein to the jugular vein. This is a very rare complication that is a human error and is totally preventable by doing the procedure by a skilled doctor and considering the standards described for central vein catheter insertion. PMID:20852377

  7. Right Cardiac Catheterization Using the Antecubital Fossa Vein in Korean Patients

    PubMed Central

    Lee, Sang Hyun; Lee, Dae Sung; Lee, Soo Yong; Hwang, Jongmin; Chon, Min Ku; Hwang, Ki Won; Kim, Jeong Su; Park, Yong Huyn; Kim, June Hong

    2016-01-01

    Background and Objectives Right heart catheterization is traditionally performed using a femoral vein approach that involves admission, bed rest, and risks of bleeding and hematoma. Recent studies have confirmed safety of the use of forearm vein for right cardiac catheterization. In the present study, we evaluated the feasibility of right cardiac catheterization via the antecubital fossa vein in Korean patients. Subjects and Methods The medical records of all patients who underwent right heart catheterization at our hospital between January 2003 and December 2014 were reviewed retrospectively. Right cardiac catheterizations via the antecubital fossa vein and the femoral vein were compared in terms of demographic data (age, sex, weight, height, and body mass index), indications for right cardiac catheterization, and procedural and outcome data (initial success rate, procedure time, compression to ambulation time, and complications). Results We reviewed 132 cases (antecubital fossa vein approach, n=37; femoral vein approach, n=95). The demographic data, initial success rate (100% vs. 100%) and procedure time (21.6±16.8 min vs. 25.6±12.6 min, p=0.14) were similar in both groups. The antecubital fossa vein group had a shorter mean compression to ambulation time than the femoral vein group (0.0 min vs. 201.2±48.1 min, p<0.01). No complications were observed in either group. Conclusion Our study indicated the ease of performance of right cardiac catheterization via the antecubital fossa vein. Thus, the antecubital fossa vein can be an alternative access site for right cardiac catheterization in Korean patients. PMID:27014351

  8. Frontofacial Surgery in Children and Adolescents: Techniques, Indications, Outcomes

    PubMed Central

    Britto, J.A.; Greig, A.; Abela, C.; Hearst, D.; Dunaway, D.J.; Evans, R.D.

    2014-01-01

    The techniques of frontofacial surgery are most valuable in the clinical management of complex craniofacial deformity to achieve a range of functional and aesthetic gains in children from infancy to maturity. A variety of complex craniofacial osteotomies that can be used to separate the orbits from the skull base have been described. In addition, the combination of circumorbital release and pterygomaxillary disjunction allows advancement of the orbitomaxillary segment for powerful clinical benefit. For the purpose of this article, the principal frontofacial strategies include the monobloc frontofacial advancement by distraction (MBD), frontofacial bipartition advancement by distraction (BpD), orbital box osteotomy (FFBx), and frontofacial bipartition (FFBp). These techniques are broadly used for two purposes: to allow for the translocation of one or both orbits to correct orbitofacial disproportion (hypertelorism, vertical orbital dystopia, or a combination of both), or to advance the orbitomaxillary segment for orbital volume expansion and protection of the eye in syndromes featuring severe exorbitism (oculo-orbital disproportion). Here we describe aspects of our experience of frontofacial surgery in the Craniofacial Centre at Great Ormond Street Hospital for Children, London, with reference to the principles underpinning frontofacial surgical techniques, their challenges, and their impact on function and aesthetics. PMID:25210505

  9. Idiopathic unilateral hypoplasia of internal jugular vein and coagulopathy: Unusual case for central venous catheterization.

    PubMed

    Nama, Rajnish K; Bhosale, Guruprasad P; Shah, Veena R

    2015-01-01

    Central venous catheterization (CVC) is routinely done procedure in ICU or during surgery for various indications. Right Internal jugular vein (IJV) is preferred vessel among different routes for CVC. Anatomic variations of neck vessels are not uncommon and may increase the complication rate especially in patients with altered coagulation profile. Anatomic landmark technique is commonly used for CVC but not without possibility of complications. Ultrasound (US) guided IJV Cannulation provides high success rate, less access time and lesser complications. Superiority of US over anatomic landmark technique has been established, but use of US in clinical practice is still limited. We report a case of idiopathic unilateral hypoplastic IJV in a patient with altered coagulation profile who required CVC, we also tried to find out the barriers for limited use of US. PMID:26712993

  10. Overview: techniques and indications of LDL-apheresis.

    PubMed

    Bosch, T; Gurland, H J

    1991-01-01

    In recent years, LDL-apheresis has emerged to be an efficient treatment of hyperlipidemia in patients who do not respond sufficiently to diet and lipid lowering drugs. A survey of LDL lowering extracorporeal procedures is presented. Among them, to date 5 procedures have been used clinically on a routine basis: unselective plasma exchange, semi-selective double filtration (including its modifications like thermofiltration and predilution/backflush) and three highly selective LDL-apheresis systems: LDL-adsorption on dextran sulfate coated cellulose beads or anti-apoprotein B-linked sepharose and heparin induced extracorporeal LDL and fibrinogen precipitation (the so-called HELP system). Advantages, limitations and special indications of these commercially available systems are discussed. If atherosclerosis can really be made regress by drastic reduction of elevated serum cholesterol levels as indicated by recent publications, lipid apheresis will no doubt play a major role in attaining this goal. PMID:1751662

  11. [Patent foramen ovale percutaneous closure: indications, techniques and results].

    PubMed

    Aubry, P; Gérardin, B; Juliard, J-M; Tchetche, D; Brochet, E; Etchegoyen, L; Vahanian, A

    2007-12-01

    A patent foramen ovale is almost physiological (15% of the population) but can be associated with some pathological situations in which its closure can be considered. The only medical indication currently accepted is a right-left shunt without elevation of the right pulmonary pressure, whose most famous pattern is the rare platypnea-orthodeoxie syndrome. PFO may be responsible for diving decompression accidents. Before taking the decision of closing a PFO, each situation must be discussed on a case to case basis. In spite of the possible link between some kinds of migraine and PFO, according to current knowledge, there is no evidence of the efficiency of PFO closure in this situation. The secondary prevention of a cryptogenic ischaemic cerebrovascular attack on a young person with a PFO associated to a membranous septum aneurysm, is the most commonly considered indication, but we lack valid data for this indication. The PFO closing procedure is well codified and its success rate is close to 100%, with rare major complications. Residual permeability within the prosthesis ensuring the closure of the PFO decreases gradually to get under 15% after six months. The clinical result is often dramatic when treating right-left shunts. As far as the secondary prevention of cryptogenic ischaemic cerebro vascular attacks in young people is concerned, there might be some clinical benefit, but we are waiting for the results of ongoing randomized and scheduled studies. PMID:17961493

  12. Technique, indications, and results of proximal medial gastrocnemius lengthening.

    PubMed

    Barouk, Pierre

    2014-12-01

    Gastrocnemius proximal lengthening was first performed to correct spasticity in children, and was adapted for the patient with no neuromuscular condition in the late 1990s. Since then, the proximal gastrocnemius release has become less invasive and has evolved to include only the fascia overlying the medial head of the gastrocnemius muscle. The indications for performing this procedure are a clinically demonstrable gastrocnemius contracture that influences a variety of clinical conditions in the forefoot, hindfoot, and ankle. It is a safe and easy procedure that can be performed bilaterally simultaneously, and does not require immobilization of the ankle after surgery. PMID:25456723

  13. Venous Access Ports: Indications, Implantation Technique, Follow-Up, and Complications

    SciTech Connect

    Walser, Eric M.

    2012-08-15

    The subcutaneous venous access device (SVAD or 'port') is a critical component in the care of patients with chronic disease. The modern SVAD provides reliable access for blood withdrawal and medication administration with minimal disruption to a patient's lifestyle. Because of improved materials and catheter technology, today's ports are lighter and stronger and capable of high-pressure injections of contrast for cross-sectional imaging. The majority of SVAD placement occurs in interventional radiology departments due to their ability to provide this service at lower costs, lower, complication rates, and greater volumes. Port-insertion techniques vary depending on the operator, but all consist of catheter placement in the central venous circulation followed by subcutaneous pocket creation and port attachment to the catheter with fixation and closure of the pocket. Venous access challenges occasionally occur in patients with central vein occlusions, necessitating catheterization of collateral veins or port placement in alternate locations. Complications of SVADs include those associated with the procedure as well as short- (<30 days) and long-term problems. Procedural and early complications are quite rare due to the near-universal use of real-time ultrasound guidance for vein puncture, but they can include hematoma, catheter malposition, arrhythmias, and pneumothorax. Late problems include both thrombotic complications (native venous or port-catheter thrombosis) and infections (tunnel or pocket infections or catheter-associated bloodstream infections). Most guidelines suggest that 0.3 infections/1000 catheter days is an appropriate upper threshold for the insertion of SVADs.

  14. [Surgical aspects of indications and techniques for adenomatous polyposis variants].

    PubMed

    Möslein, Gabriela

    2016-08-01

    Due to the advances in molecular genetic diagnostics of adenomatous polyposis variants, identification of patients with a genetic predisposition and their at risk relatives is becoming increasingly important in clinical practice. Precise knowledge of the specific risk profile is gaining significance especially for surgeons and requires a clinically differentiated approach in order to correctly identify the indications for prophylactic surgery. In this article reference will be made to the technical details of the pouch operation rather than the decision-making process per se, since this has become common knowledge for specialized colorectal surgeons. Besides the more commonly known polyposis syndromes, such as familial adenomatous polyposis (FAP), surgeons should nowadays at least be able to clinically distinguish between attenuated and classical variants of FAP, be aware of MUTYH-associated polyposis (MAP) and also the new polyposis syndrome polymerase proofreading-associated polyposis (PPAP). Surgeons should be familiar with the specific indications and extent of surgery for prophylactic organ removal in the lower gastrointestinal tract in order to be able to competently advise patients. PMID:27339646

  15. [Single-port colonic surgery : techniques and indications].

    PubMed

    Vestweber, B; Straub, E; Kaldowski, B; Paul, C; Alfes, A; Haaf, F; Vestweber, K H

    2011-05-01

    Colonic surgery is feasible with the single-port technique using standard laparoscopic instruments. Operative time and complication rates are comparable to conventional standard laparoscopic procedures. Position of instruments (crossed over) and orientation are somewhat different and need to be trained and practiced. In this patient collective 200 colon resections covering the complete spectrum of colonic surgery were done in our department. Of these 120 patients were operated on because of sigma diverticulitis. The average operative time was 149 min whereby 6 patients (5.0%) had to be converted to an open procedure, 12 (10.0%) patients had early complications, of which 6 (5.0%) had minor wound complications which were treated conservatively and 4 (3.3%) patients had late complications (2 stenoses and 2 hernias) during the mean follow-up time of 7.5 months (range 6-14 months). The cosmetic effect was very good and functional results were good. Single-port colon operations are the least invasive procedure available at the moment. PMID:21431623

  16. Bernese periacetabular osteotomy for hip dysplasia: Surgical technique and indications

    PubMed Central

    Kamath, Atul F

    2016-01-01

    For young, active patients with healthy hip cartilage, pelvic osteotomy is a surgical option in to address hip pain and to improve mechanical loading conditions related to dysplasia. Hip dysplasia may lead to arthrosis at an early age due to poor coverage of the femoral head and abnormal loading of the joint articulation. In patients with symptomatic dysplasia and closed triradiate cartilage (generally over age 10), including adolescents and young adults (generally up to around age 40), the Bernese periacetabular osteotomy (PAO) is a durable technique for addressing underlying structural deformity. The PAO involves a modified Smith-Petersen approach. Advantages of the Bernese osteotomy include preservation of the weight-bearing posterior column of the hemi-pelvis, preservation of the acetabular blood supply, maintenance of the hip abductor musculature, and the ability to effect powerful deformity correction about an ideal center of rotation. There is an increasing body of evidence that preservation of the native hip can be improved through pelvic osteotomy. In contrast to hip osteotomy and joint preservation, the role of total hip arthroplasty in young, active patients with correctable hip deformity remains controversial. Moreover, the durability of hip replacement in young patients is inherently limited. Pelvic osteotomy should be considered the preferred method to address correctable structural deformity of the hip in the young, active patient with developmental dysplasia. The Bernese PAO is technically demanding, yet offers reproducible results with good long-term survivorship in carefully selected patients with preserved cartilage and the ability to meet the demands of rehabilitation. PMID:27190755

  17. Bernese periacetabular osteotomy for hip dysplasia: Surgical technique and indications.

    PubMed

    Kamath, Atul F

    2016-05-18

    For young, active patients with healthy hip cartilage, pelvic osteotomy is a surgical option in to address hip pain and to improve mechanical loading conditions related to dysplasia. Hip dysplasia may lead to arthrosis at an early age due to poor coverage of the femoral head and abnormal loading of the joint articulation. In patients with symptomatic dysplasia and closed triradiate cartilage (generally over age 10), including adolescents and young adults (generally up to around age 40), the Bernese periacetabular osteotomy (PAO) is a durable technique for addressing underlying structural deformity. The PAO involves a modified Smith-Petersen approach. Advantages of the Bernese osteotomy include preservation of the weight-bearing posterior column of the hemi-pelvis, preservation of the acetabular blood supply, maintenance of the hip abductor musculature, and the ability to effect powerful deformity correction about an ideal center of rotation. There is an increasing body of evidence that preservation of the native hip can be improved through pelvic osteotomy. In contrast to hip osteotomy and joint preservation, the role of total hip arthroplasty in young, active patients with correctable hip deformity remains controversial. Moreover, the durability of hip replacement in young patients is inherently limited. Pelvic osteotomy should be considered the preferred method to address correctable structural deformity of the hip in the young, active patient with developmental dysplasia. The Bernese PAO is technically demanding, yet offers reproducible results with good long-term survivorship in carefully selected patients with preserved cartilage and the ability to meet the demands of rehabilitation. PMID:27190755

  18. Patent foramen ovale: indications for closure and techniques.

    PubMed

    Taramasso, Maurizio; Nietlispach, Fabian; Maisano, Francesco; Meier, Bernhard

    2016-05-17

    Non-surgical closure of the patent foramen ovale (PFO) has been possible for 40 years and proved safe in probably a million cases performed worldwide. Nonetheless, indications are still restricted as only a few are supported by randomised data. Paradoxical embolism through a PFO causes stroke, myocardial infarction, and visceral or peripheral ischaemia. The PFO is a likely mediator of migraine, diving or high altitude sickness, dyspnoea, and sleep apnoea problems. As untoward effects of a PFO are rare and spaced widely timewise, large cohorts and long follow-ups are required to prove unequivocally that PFO closure is bene-ficial and appropriate in comparison to no treatment or medical therapy. The most compelling respective randomised data have been gathered so far in the realm of secondary prevention of cerebral attacks and migraine. Invariably they showed a numerical advantage of PFO closure with significant difference in sub-analyses. Evidence-based medicine carries a danger of underutilising valuable therapies while accumulating further data. PFO closure is an example. Its documented innocuousness invites a more proactive reflection in upcoming guidelines. At worst, PFO closure may not convey the projected amount of benefit. This even opens the door for primary prevention in some PFOs with high-risk characteristics. PMID:27174117

  19. Coil Embolization Treatment in Pulmonary Artery Branch Rupture During Swan-Ganz Catheterization

    SciTech Connect

    Gottwalles, Yannick; Wunschel-Joseph, Marie-Eve; Hanssen, Michel

    2000-11-15

    Rupture of the pulmonary artery or one of its branches during Swan-Ganz catheterization is a complication that is rare but remains fatal in almost 50% of cases. The risk factors and mechanisms involved in the pathogenesis of this accident have been widely reported. Management is twofold: resuscitation procedures and specific medical or even surgical treatment. We report a case of pulmonary artery rupture occurring during Swan-Ganz catheterization that was treated by coil embolization. This technique, which is quick and simple to use, would appear to be very promising. This is the first case of successful emergency treatment of pulmonary artery rupture using an endovascular technique.

  20. 21 CFR 870.1310 - Vessel dilator for percutaneous catheterization.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vessel dilator for percutaneous catheterization... Vessel dilator for percutaneous catheterization. (a) Identification. A vessel dilator for percutaneous catheterization is a device which is placed over the guide wire to enlarge the opening in the vessel, and which...

  1. Clean Intermittent Catheterization in the School Setting

    ERIC Educational Resources Information Center

    Katrancha, Elizabeth D.

    2008-01-01

    Spina bifida (SB) is a neural tube defect that causes many physical and mental disabilities. Bowel and bladder incontinence is the disability seen most often in these students that requires the school nurse's attention. Clean intermittent catheterization (CIC) provides the student with SB a vehicle to reach a satisfactory level of continence,…

  2. Early ambulation following 6 French diagnostic left heart catheterization: a prospective randomized trial.

    PubMed

    Wood, R A; Lewis, B K; Harber, D R; Kovack, P J; Bates, E R; Stomel, R J

    1997-09-01

    Outpatient cardiac catheterization is frequently performed, but the optimal recovery time after sheath removal has not been defined. Left heart catheterization was performed via the femoral artery utilizing 6 French catheters on 323 outpatients. One hundred thirty-five patients were randomized to ambulate at a mean of 2.5 hr (group 1) after puncture site compression, whereas 188 patients were randomized to ambulate at a mean of 4.1 hr (group 2). Telephone follow-up occurred within 48 hr. A small hematoma (< 5 cm) occurred in 2 (1.6%) patients in group 1 and in 4 (2.4%) patients in group 2. These results indicate that it is safe to ambulate patients 2.5 hr following 6 French diagnostic heart catheterization. PMID:9286529

  3. Myocardial blood flow: Roentgen videodensitometry techniques

    NASA Technical Reports Server (NTRS)

    Smith, H. C.; Robb, R. A.; Wood, E. H.

    1975-01-01

    The current status of roentgen videodensitometric techniques that provide an objective assessment of blood flow at selected sites within the coronary circulation were described. Roentgen videodensitometry employs conventional radiopaque indicators, radiological equipment and coronary angiographic techniques. Roentgen videodensitometry techniques developed in the laboratory during the past nine years, and for the past three years were applied to analysis of angiograms in the clinical cardiac catheterization laboratory.

  4. Complete guidewire retention after femoral vein catheterization.

    PubMed

    Cat, Bahar Gulcay; Guler, Sertac; Soyuduru, Murat; Guven, Ibrahim; Ramadan, Hayri

    2015-01-01

    Central venous catheters (CVCs) are often used for various purposes in the emergency departments (ED). The main uses of CVCs in the EDs are emergent hemodialysis, in situations where peripheral vein catheterization cannot be achieved, and continuous invasive hemodynamic monitoring. The complications related to CVC insertion are usually mechanical and observed in the near term after the procedure. Retained CVC guidewire after catheterization is a rare complication in the published reports and usually related with intra- or postoperative settings and jugular or subclavian vein. The present study reported a young female patient who underwent left femoral vein catheterization 6 months earlier in an intensive care unit of another hospital and was diagnosed with complete guidewire retention in the ED. To the best of the authors' knowledge, this is the first case in published reports with a diagnosis of retained CVC guidewire with retrograde migration into the femoral vein. Surprisingly, the patient developed no thrombotic or embolic complication during this 6-month period. PMID:26657235

  5. Ultrasound-guided central venous catheterization in prone position

    PubMed Central

    Sofi, Khalid; Arab, Samer

    2010-01-01

    Central venous catheterization (CVC) is a commonly performed intraoperative procedure. Traditionally, CVC placement is performed blindly using anatomic landmarks as a guide to vessel position. Real-time ultrasound provides the operator the benefit of visualizing the target vein and the surrounding anatomic structures prior to and during the catheter insertion, thereby minimizing complications and increasing speed of placement. A 22-year-old male underwent open reduction and internal fixation of acetabulum fracture in prone position. Excessive continuous bleeding intraoperatively warranted placement of CVC in right internal jugular vein (IJV), which was not possible in prone position without the help of ultrasound. Best view of right IJV was obtained and CVC was placed using real-time ultrasound without complications. Ultrasound-guided CVC placement can be done in atypical patient positions where traditional anatomic landmark technique has no role. Use of ultrasound not only increases the speed of placement but also reduces complications known with the traditional blind technique. PMID:20668564

  6. [Radiation exposure to personnel in cardiac catheterization laboratories].

    PubMed

    von Boetticher, Heiner; Meenen, Christiane; Lachmund, Jörn; Hoffmann, Wolfgang; Engel, Heinz-Jürgen

    2003-01-01

    Radiation exposure in personnel of cardiac catheterization units is based on local dosimetry during patient investigations. In the present study, dose rates were measured at various heights in representative locations, with and without fixed radiation protection shields in place. To determine the effective dose values, TLD measurements were performed using on Alderson phantom to generate radiation scatter and a second phantom in the position of the cardiologist performing the catheterization. Various types of personal radiation protection garment and fixed shields were considered in the calculations. Our results indicate on one hand that good protective standards can be achieved with effective doses below 1 mSv/year under optimized conditions. On the other hand, inappropriate radiation protection equipment can cause substantial increase of radiation doses. Alone the lack of a thyroid shield increases the effective dose of the cardiologist by a factor of 3. For the personnel, effective doses were generally higher than personal doses by a factor between 1.5 and 4.8 depending on the radiation protection situation. PMID:14732954

  7. Transcervical catheterization and cervical patency during the oestrous cycle in domestic cats.

    PubMed

    Chatdarong, K; Lohachit, C; Ponglowhapan, S; Linde-Forsberg, C

    2001-01-01

    The aims of the present study were to develop a device for vaginal and transcervical catheterization in domestic cats, and to study cervical patency during the various stages of the oestrous cycle. Seventeen queens submitted for routine spaying were included in the study. A vaginal catheter was designed from a urinary catheter for dogs, to fit into the ventral vaginal fornix, and a 3.5 French tomcat catheter was used as an inner transcervical catheter. Cervical patency was studied by infusing 0.5 ml Urografin into the cranial vagina and taking X-rays of the queens after 5 min. The Urografin did not enter the uterus, even in the oestrous queens. Transcervical catheterization was then attempted. The correct placement of the intrauterine catheter was confirmed by injecting green food colour mixed with penicillin G and observing the presence of stain in the uterine horns during surgery. Catheterization was successful in 13 of 17 queens: six of nine in interoestrus, three of three in oestrus, one of two in metoestrus and three of three in the postpartum period. Transcervical catheterization is a non-invasive technique that is likely to improve the success rate of assisted feline reproduction, and is potentially a useful non-surgical technique for diagnosis and therapy of uterine diseases. PMID:11787175

  8. Catheterization of the urethra in female pigs.

    PubMed

    Musk, G C; Zwierzchoniewska, M; He, B

    2015-10-01

    Female pigs are commonly utilized as an animal model for biomedical research and require urethral catheterization. Sixteen pigs were anaesthetized for research purposes and required the placement of a urethral catheter. Post-mortem examination of the vaginas revealed the urethral opening to be consistently halfway from the mucocutaneous junction of the vulva to the cervix. A shallow diverticulum was also observed on the ventral floor of the urethral opening. To optimize conditions for success the pig should be carefully positioned supine, a vaginal speculum and light source should be used, the pig should be adequately anaesthetized, and the anatomy of the vagina should be reviewed. PMID:25977261

  9. Use of structured personality survey techniques to indicate operator response to stressful situations

    SciTech Connect

    Waller, M.A.

    1990-01-01

    Under given circumstances, a person will tend to operate in one of four dominant orientations: (1) to perform tasks; (2) to achieve consensus; (3) to achieve understanding, or (4) to maintain structure. Historically, personality survey techniques, such as the Myers-Briggs type indicator, have been used to determine these tendencies. While these techniques can accurately reflect a person's orientation under normal social situations, under different sets of conditions, the same person may exhibit other tendencies, displaying a similar or entirely different orientation. While most do not exhibit extreme tendencies or changes of orientation, the shift in personality from normal to stressful conditions can be rather dramatic, depending on the individual. Structured personality survey techniques have been used to indicate operator response to stressful situations. These techniques have been extended to indicate the balance between orientations that the control room team has through the various levels of cognizance.

  10. [How to do: central vein catheterization].

    PubMed

    Allgäuer, Sebastian

    2016-03-01

    The cannulation of a central vein is a standard acces to the vascular system of critically ill patients. It can be used for administration of medication and parenteral nutrition, haemodynamic monitoring as well as hemodialsis via Shaldon catheter.The technique of implantation of a central venous catheter is described step by step in this article. Moreover, advantages and disadvantages of the different techniques and puncture sites as well as indications and contraindications are critically discussed regarding the most recent literature. PMID:26939103

  11. Development of a charge adjustment model for cardiac catheterization.

    PubMed

    Brennan, Andrew; Gauvreau, Kimberlee; Connor, Jean; O'Connell, Cheryl; David, Sthuthi; Almodovar, Melvin; DiNardo, James; Banka, Puja; Mayer, John E; Marshall, Audrey C; Bergersen, Lisa

    2015-02-01

    A methodology that would allow for comparison of charges across institutions has not been developed for catheterization in congenital heart disease. A single institution catheterization database with prospectively collected case characteristics was linked to hospital charges related and limited to an episode of care in the catheterization laboratory for fiscal years 2008-2010. Catheterization charge categories (CCC) were developed to group types of catheterization procedures using a combination of empiric data and expert consensus. A multivariable model with outcome charges was created using CCC and additional patient and procedural characteristics. In 3 fiscal years, 3,839 cases were available for analysis. Forty catheterization procedure types were categorized into 7 CCC yielding a grouper variable with an R (2) explanatory value of 72.6%. In the final CCC, the largest proportion of cases was in CCC 2 (34%), which included diagnostic cases without intervention. Biopsy cases were isolated in CCC 1 (12%), and percutaneous pulmonary valve placement alone made up CCC 7 (2%). The final model included CCC, number of interventions, and cardiac diagnosis (R (2) = 74.2%). Additionally, current financial metrics such as APR-DRG severity of illness and case mix index demonstrated a lack of correlation with CCC. We have developed a catheterization procedure type financial grouper that accounts for the diverse case population encountered in catheterization for congenital heart disease. CCC and our multivariable model could be used to understand financial characteristics of a population at a single point in time, longitudinally, and to compare populations. PMID:25113520

  12. Superciliary Keyhole Approach for Unruptured Anterior Circulation Aneurysms: Surgical Technique, Indications, and Contraindications

    PubMed Central

    2014-01-01

    Neurosurgeons have been trying to reduce surgical invasiveness by applying minimally invasive keyhole approaches. Therefore, this paper clarifies the detailed surgical technique, its limitations, proper indications, and contraindications for a superciliary keyhole approach as a minimally invasive modification of a pterional approach. Successful superciliary keyhole surgery for unruptured aneurysms requires an understanding of the limitations and the use of special surgical techniques. Essentially, this means the effective selection of surgical indications, usage of the appropriate surgical instruments with a tubular shaft, and refined surgical techniques, including straightforward access to the aneurysm, clean surgical dissection, and the application of clips with an appropriate configuration. A superciliary keyhole approach allows unruptured anterior circulation aneurysms to be clipped safely, rapidly, and less invasively on the basis of appropriate surgical indications. PMID:25535512

  13. Removal of gallstone from mesorectum after laparoscopic cholecystectomy - new indication for transanal endoscopic microsurgery technique.

    PubMed

    Szczepkowski, Marek; Przywózka, Alicja; Zieliński, Tomasz

    2016-01-01

    Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for local excision of benign and malignant neoplasms in the rectum. Indications for this technique are constantly changing and extending. The aim of this study is to describe a case of a unique and innovative application of this surgical technique. A 72-year-old patient was admitted to the Clinical Department of General and Colorectal Surgery for elective resection of a tumor located in the perianal area using the TEM surgical technique. In August 2005 the patient underwent laparoscopic cholecystectomy due to symptomatic cholecystitis. From March 2011 the patient complained about ongoing sharp pain in the perianal and presacral area. Computed tomography revealed two oval areas approximately 30 mm in size to the right of the sigmoido-rectal region communicating with the colon lumen. Subsequently diverticulitis was diagnosed. The TEM technique was uniquely used to successfully remove the gallstone from the 72-year-old patient's presacral area. PMID:26865896

  14. Removal of gallstone from mesorectum after laparoscopic cholecystectomy – new indication for transanal endoscopic microsurgery technique

    PubMed Central

    Przywózka, Alicja; Zieliński, Tomasz

    2015-01-01

    Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for local excision of benign and malignant neoplasms in the rectum. Indications for this technique are constantly changing and extending. The aim of this study is to describe a case of a unique and innovative application of this surgical technique. A 72-year-old patient was admitted to the Clinical Department of General and Colorectal Surgery for elective resection of a tumor located in the perianal area using the TEM surgical technique. In August 2005 the patient underwent laparoscopic cholecystectomy due to symptomatic cholecystitis. From March 2011 the patient complained about ongoing sharp pain in the perianal and presacral area. Computed tomography revealed two oval areas approximately 30 mm in size to the right of the sigmoido-rectal region communicating with the colon lumen. Subsequently diverticulitis was diagnosed. The TEM technique was uniquely used to successfully remove the gallstone from the 72-year-old patient's presacral area. PMID:26865896

  15. Catheterization: A Review of Various Methods for Catheterization of Handicapped Students in the School System. A Technical Assistance Publication.

    ERIC Educational Resources Information Center

    Martin, Marilyn

    The manual is intended to provide technical assistance to South Carolina local education agencies (LEAs)in regard to provision of catheterization services to students with disabilities in the school system. The first section defines catheterization and briefly discusses the basic need for this specialized health care service. Recent relevant…

  16. Developing Tools to Measure Quality in Congenital Catheterization and Interventions: The Congenital Cardiac Catheterization Project on Outcomes (C3PO)

    PubMed Central

    2014-01-01

    The broad range of relatively rare procedures performed in pediatric cardiac catheterization laboratories has made the standardization of care and risk assessment in the field statistically quite problematic. However, with the growing number of patients who undergo cardiac catheterization, it has become imperative that the cardiology community overcomes these challenges to study patient outcomes. The Congenital Cardiac Catheterization Project on Outcomes was able to develop benchmarks, tools for measurement, and risk adjustment methods while exploring procedural efficacy. Based on the success of these efforts, the collaborative is pursuing a follow-up project, the Congenital Cardiac Catheterization Project on Outcomes—Quality Improvement, aimed at improving the outcomes for all patients undergoing catheterization for congenital heart disease by reducing radiation exposure. PMID:25114756

  17. Indications for and techniques of keratoplasty at Vietnam National Institute of Ophthalmology

    PubMed Central

    Dong, Pham Ngoc; Han, Truong Nhu; Aldave, Anthony J.; Chau, Hoang Thi Minh

    2016-01-01

    AIM To report the indications for and techniques of corneal transplantation at Vietnam National Institute of Ophthalmology (VNIO) over a period of 12y (2002-2013). METHODS Records of patients who had undergone corneal transplantation at VNIO from January 1, 2002 to January 1, 2014 were reviewed to determine the indication for and type of corneal transplant performed. Patient age, gender, indication for corneal transplantation and surgical technique were recorded and analyzed. RESULTS Corneal transplantation were underwent in 1390 eyes of 1278 patients with a mean age of 44.9±18.1y during the period under review. The most common indication was infectious corneal ulcer (n=670; 48.2%), followed by corneal scar (n=333, 24.0%), corneal dystrophy (n=138, 9.9%) and failed graft (n=112, 8.1%). Nearly all procedures performed were penetrating keratoplasty (n=1300, 93.5%), with a few lamellar keratoplasty procedures performed: lamellar keratoplasty (n=52, 3.7%), Descemet's stripping automated endothelial keratoplasty (n=27, 1.9%) and deep anterior lamellar keratoplasty (n=11, 0.8%). CONCLUSION While the most common indication for keratoplasty was infectious keratitis, nearly all indications for corneal transplantation were managed with penetrating keratoplasty. However, lamellar keratoplasty techniques, including deep anterior lamellar keratoplasty and Descemet's stripping automated endothelial keratoplasty, are being performed with increasing frequency for isolated stromal and endothelial disorders, respectively. PMID:27158606

  18. Lung radiofrequency and microwave ablation: a review of indications, techniques and post-procedural imaging appearances

    PubMed Central

    Jennings, P E

    2015-01-01

    Lung ablation can be used to treat both primary and secondary thoracic malignancies. Evidence to support its use, particularly for metastases from colonic primary tumours, is now strong, with survival data in selected cases approaching that seen after surgery. Because of this, the use of ablative techniques (particularly thermal ablation) is growing and the Royal College of Radiologists predict that the number of patients who could benefit from such treatment may reach in excess of 5000 per year in the UK. Treatment is often limited to larger regional centres, and general radiologists often have limited awareness of the current indications and the techniques involved. Furthermore, radiologists without any prior experience are frequently expected to interpret post-treatment imaging, often performed in the context of acute complications, which have occurred after discharge. This review aims to provide an overview of the current indications for pulmonary ablation, together with the techniques involved and the range of post-procedural appearances. PMID:25465192

  19. Physiological assessment of coronary artery disease in the cardiac catheterization laboratory: a scientific statement from the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology.

    PubMed

    Kern, Morton J; Lerman, Amir; Bech, Jan-Willen; De Bruyne, Bernard; Eeckhout, Eric; Fearon, William F; Higano, Stuart T; Lim, Michael J; Meuwissen, Martijn; Piek, Jan J; Pijls, Nico H J; Siebes, Maria; Spaan, Jos A E

    2006-09-19

    With advances in technology, the physiological assessment of coronary artery disease in patients in the catheterization laboratory has become increasingly important in both clinical and research applications, but this assessment has evolved without standard nomenclature or techniques of data acquisition and measurement. Some questions regarding the interpretation, application, and outcome related to the results also remain unanswered. Accordingly, this consensus statement was designed to provide the background and evidence about physiological measurements and to describe standard methods for data acquisition and interpretation. The most common uses and support data from numerous clinical studies for the physiological assessment of coronary artery disease in the cardiac catheterization laboratory are reviewed. The goal of this statement is to provide a logical approach to the use of coronary physiological measurements in the catheterization lab to assist both clinicians and investigators in improving patient care. PMID:16940193

  20. Assessment of a Novel Hybrid Delphi and Nominal Groups Technique to Evaluate Quality Indicators

    PubMed Central

    Davies, Sheryl; Romano, Patrick S; Schmidt, Eric M; Schultz, Ellen; Geppert, Jeffrey J; McDonald, Kathryn M

    2011-01-01

    Objective To test the implementation of a novel structured panel process in the evaluation of quality indicators. Data Source National panel of 64 clinicians rating usefulness of indicator applications in 2008–2009. Study Design Hybrid panel combined Delphi Group and Nominal Group (NG) techniques to evaluate 81 indicator applications. Principal Findings The Delphi Group and NG rated 56 percent of indicator applications similarly. Group assignment (Delphi versus Nominal) was not significantly associated with mean ratings, but specialty and research interests of panelists, and indicator factors such as denominator level and proposed use were. Rating distributions narrowed significantly in 20.8 percent of applications between review rounds. Conclusions The hybrid panel process facilitated information exchange and tightened rating distributions. Future assessments of this method might include a control panel. PMID:21790589

  1. Endovascular aortic aneurysm repair with chimney and snorkel grafts: indications, techniques and results.

    PubMed

    Patel, Rakesh P; Katsargyris, Athanasios; Verhoeven, Eric L G; Adam, Donald J; Hardman, John A

    2013-12-01

    The chimney technique in endovascular aortic aneurysm repair (Ch-EVAR) involves placement of a stent or stent-graft parallel to the main aortic stent-graft to extend the proximal or distal sealing zone while maintaining side branch patency. Ch-EVAR can facilitate endovascular repair of juxtarenal and aortic arch pathology using available standard aortic stent-grafts, therefore, eliminating the manufacturing delays required for customised fenestrated and branched stent-grafts. Several case series have demonstrated the feasibility of Ch-EVAR both in acute and elective cases with good early results. This review discusses indications, technique, and the current available clinical data on Ch-EVAR. PMID:23674274

  2. Endovascular Aortic Aneurysm Repair with Chimney and Snorkel Grafts: Indications, Techniques and Results

    SciTech Connect

    Patel, Rakesh P.; Katsargyris, Athanasios Verhoeven, Eric L. G.; Adam, Donald J.; Hardman, John A.

    2013-12-15

    The chimney technique in endovascular aortic aneurysm repair (Ch-EVAR) involves placement of a stent or stent-graft parallel to the main aortic stent-graft to extend the proximal or distal sealing zone while maintaining side branch patency. Ch-EVAR can facilitate endovascular repair of juxtarenal and aortic arch pathology using available standard aortic stent-grafts, therefore, eliminating the manufacturing delays required for customised fenestrated and branched stent-grafts. Several case series have demonstrated the feasibility of Ch-EVAR both in acute and elective cases with good early results. This review discusses indications, technique, and the current available clinical data on Ch-EVAR.

  3. Comparison of an ultrasound-guided technique versus a landmark-guided technique for internal jugular vein cannulation.

    PubMed

    Dolu, Hasan; Goksu, Sıtkı; Sahin, Levent; Ozen, Onder; Eken, Levent

    2015-02-01

    Central venous cannulation is a commonly preformed procedure in many branches of medicine, particularly in anaesthesia and intensive care medicine. The purpose of this study was to compare the landmark-guided technique to the ultrasound-guided technique for internal jugular vein cannulation in cardiovascular surgery patients. One hundred cardiovascular surgery patients, of whom 65 were male and 35 were female with ages ranging from 22 to 65, who had internal jugular cannulation between December 2010-March 2011 in our clinic were investigated prospectively. Patients were randomized into two groups; ultrasound guided internal jugular cannulation cases in group U (n=50), and anatomic landmark guided cases in group A (n=50). The number of attempts until successful catheterization, the time required for successful catheterization, arising complications, the demographics and the duration of catheterization were recorded for each patient. There were no significant differences found in the demographic features between the two groups. The number of attempts for successful catheterization was statistically lower in group U (1.1±0.5) than in group A (2.2±1.6). The time required for successful catheterization was statistically lower in group U (109.4±30.4) than in group A (165.9±91.5). There were no significant differences found in the total complications of the two groups (p=0.092). Four patients had an arterial punction [group U (n=0) and group A (n=4)] and two patients had a hematoma [group U (n=1) and group A (n=1)]. Arterial punction complication was increased significantly in landmark group (p=0.041). The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of attempts. PMID:24838550

  4. Rigid Intramedullary Nailing of Femoral Shaft Fractures for Patients Age 12 and Younger: Indications and Technique.

    PubMed

    Martus, Jeffrey E

    2016-06-01

    Femoral shaft fractures are common injuries in the pediatric and adolescent age groups. Rigid intramedullary nailing is an excellent treatment option for older children and adolescents, particularly for length-unstable fractures and larger patients (>49 kg). Appropriate indications, contraindications, and preoperative assessment are described. The rigid nailing surgical technique is detailed including positioning, operative steps, pearls, and pitfalls. Complications and the reported outcomes of lateral trochanteric entry nailing are reviewed from the published series. PMID:27100036

  5. Racial Differences in Cardiac Catheterization as a Function of Patients’ Beliefs

    PubMed Central

    Kressin, Nancy R.; Chang, Bei-Hung; Whittle, Jeff; Peterson, Eric D.; Clark, Jack A.; Rosen, Amy K.; Orner, Michelle; Collins, Tracie C.; Alley, Linda G.; Petersen, Laura A.

    2004-01-01

    Objectives. We examined racial differences in cardiac catheterization rates and reviewed whether patients’ beliefs or other variables were associated with observed disparities. Methods. We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible cardiac ischemia. Results. There were few demographic differences between White and African American patients in our sample. African Americans were less likely than Whites to undergo cardiac catheterization. African Americans were more likely than Whites to indicate a strong reliance on religion and to report racial and social class discrimination and were less likely to indicate a generalized trust in people but did not differ from White patients on numerous other attitudes about health and health care. Neither sociodemographic or clinical characteristics nor patients’ beliefs explained the observed disparities, but physicians’ assessments of the procedure’s importance and patients’ likelihood of coronary disease seemed to account for differences not otherwise explained. Conclusions. Patients’ preferences are not the likely source of racial disparities in the use of cardiac catheterization among veterans using VA care, but physicians’ assessments warrant further attention. PMID:15569959

  6. Therapeutic Cardiac Catheterizations for Children with Congenital Heart Disease

    MedlinePlus

    ... Cardiac Catheterization In the last two decades, tremendous medical advances have been made. These allow congenital heart defects to be treated in the cath lab without surgery. Valvuloplasty or Balloon Valvotomy This procedure is done to open a ...

  7. Multimodality 3-Dimensional Image Integration for Congenital Cardiac Catheterization

    PubMed Central

    2014-01-01

    Cardiac catheterization procedures for patients with congenital and structural heart disease are becoming more complex. New imaging strategies involving integration of 3-dimensional images from rotational angiography, magnetic resonance imaging (MRI), computerized tomography (CT), and transesophageal echocardiography (TEE) are employed to facilitate these procedures. We discuss the current use of these new 3D imaging technologies and their advantages and challenges when used to guide complex diagnostic and interventional catheterization procedures in patients with congenital heart disease. PMID:25114757

  8. Cardiac catheterization in children with pulmonary hypertensive vascular disease: consensus statement from the Pulmonary Vascular Research Institute, Pediatric and Congenital Heart Disease Task Forces.

    PubMed

    Del Cerro, Maria Jesus; Moledina, Shahin; Haworth, Sheila G; Ivy, Dunbar; Al Dabbagh, Maha; Banjar, Hanaa; Diaz, Gabriel; Heath-Freudenthal, Alexandria; Galal, Ahmed Nasser; Humpl, Tilman; Kulkarni, Snehal; Lopes, Antonio; Mocumbi, Ana Olga; Puri, G D; Rossouw, Beyra; Harikrishnan, S; Saxena, Anita; Udo, Patience; Caicedo, Lina; Tamimi, Omar; Adatia, Ian

    2016-03-01

    Cardiac catheterization is important in the diagnosis and risk stratification of pulmonary hypertensive vascular disease (PHVD) in children. Acute vasoreactivity testing provides key information about management, prognosis, therapeutic strategies, and efficacy. Data obtained at cardiac catheterization continue to play an important role in determining the surgical options for children with congenital heart disease and clinical evidence of increased pulmonary vascular resistance. The Pediatric and Congenital Heart Disease Task Forces of the Pulmonary Vascular Research Institute met to develop a consensus statement regarding indications for, conduct of, acute vasoreactivity testing with, and pitfalls and risks of cardiac catheterization in children with PHVD. This document contains the essentials of those discussions to provide a rationale for the hemodynamic assessment by cardiac catheterization of children with PHVD. PMID:27076908

  9. Cardiac catheterization in children with pulmonary hypertensive vascular disease: consensus statement from the Pulmonary Vascular Research Institute, Pediatric and Congenital Heart Disease Task Forces

    PubMed Central

    del Cerro, Maria Jesus; Moledina, Shahin; Haworth, Sheila G.; Ivy, Dunbar; Al Dabbagh, Maha; Banjar, Hanaa; Diaz, Gabriel; Heath-Freudenthal, Alexandria; Galal, Ahmed Nasser; Humpl, Tilman; Kulkarni, Snehal; Lopes, Antonio; Mocumbi, Ana Olga; Puri, G. D.; Rossouw, Beyra; Harikrishnan, S.; Saxena, Anita; Udo, Patience; Caicedo, Lina; Tamimi, Omar

    2016-01-01

    Abstract Cardiac catheterization is important in the diagnosis and risk stratification of pulmonary hypertensive vascular disease (PHVD) in children. Acute vasoreactivity testing provides key information about management, prognosis, therapeutic strategies, and efficacy. Data obtained at cardiac catheterization continue to play an important role in determining the surgical options for children with congenital heart disease and clinical evidence of increased pulmonary vascular resistance. The Pediatric and Congenital Heart Disease Task Forces of the Pulmonary Vascular Research Institute met to develop a consensus statement regarding indications for, conduct of, acute vasoreactivity testing with, and pitfalls and risks of cardiac catheterization in children with PHVD. This document contains the essentials of those discussions to provide a rationale for the hemodynamic assessment by cardiac catheterization of children with PHVD. PMID:27076908

  10. A Review of Voltage Stability Assessment Techniques with an Improved Voltage Stability Indicator

    NASA Astrophysics Data System (ADS)

    Danish, Mir Sayed Shah; Yona, Atsushi; Senjyu, Tomonobu

    2015-04-01

    A blackout can take place in entire power system or a part of the system due to extreme voltage instability (voltage collapse) that can appear abruptly. Instability prediction and continuous monitoring of the power system performance is, therefore, known exigent. This paper is conducted with a broad overview of the voltage stability indices, which are previously studied in the literature, and have the same foundation during their formulation. Afterward, an improved voltage stability indicator is introduced as a result of the multi-criteria integration and enhancement of the original indices by employing linear algebra methods. It is found that the proposed algorithm can overcome on the probable limitations from calculating point view. Then comparative analysis of the indices is presented in order to reach a unique consensus about the typical techniques of modal analysis (sensitivity, eigenvalue, right eigenvectors, and bus participation factor) as a precise algorithm. Finally, the IEEE 14-bus, and 30-bus test systems are selected to verify the algorithm, and compare the performance of the improved indicator approach with the existing indices.

  11. Patient radiation exposure during pediatric cardiac catheterization

    SciTech Connect

    Fellows, K.E.; Leibovic, S.J.

    1983-08-01

    Exposure air product (EAP) and center field entrance exposure (free-in-air) were measured in seventeen pediatric patients undergoing cardiac catheterization. Exposures were recorded separately for biplane fluoroscopy and cine angiocardiography using flat-plate ionization chambers. In the posterior-anterior (PA) projections, median EAP was 425 Roentgen-square centimeter (R-cm/sup 2/), with a range of 90.5-3,882 R-cm/sup 2/; 29-35% of this exposure occurred during cine filming. In the lateral projection, median EAP was 276 R-cm/sup 2/ (range 117-1,173); 52-59% of this exposure was due to cine filming. Median center field entrance exposure in the PA view was 7.86 Roentgens (R) with a range 2.16-73.9 of and in the lateral projection 7.39 R (range 2.64-24.6). As much as 25% of the exposure from the entire examination was contributed by manual ''test'' exposures to set cine radiographic kVp. We recommend use of testing circuits, which determine cine radiographic factors automatically and thus should lower levels of exposure.

  12. The modified trephine/osteotome sinus augmentation technique: technical considerations and discussion of indications.

    PubMed

    Fugazzotto, P A

    2001-01-01

    A technique is presented, which uses trephines of various external diameters followed by an osteotome to implode a core of maxillary posterior alveolar bone before placement of regenerative materials, in anticipation of subsequent implant placement. A mathematical formula is presented, which relates the depth of core displacement to the apico-occlusal dimension of alveolar bone coronal to the floor of the sinus presurgically. Seventy-one sites have been treated. All sites exhibited sufficient regeneration for implant placement. Two of the sites required additional augmentation at the time of implant placement. Fifty-one of the implants have been restored and are in function for up to 3 years. All are functioning successfully, as defined by the Albrektsson criteria. The technique and its indications and contraindications are described in detail. PMID:11813667

  13. Modified multipurpose catheter enhances clinical utility for cardiac catheterizations.

    PubMed

    Mannino, S C; Scavina, M; Palmer, S

    1994-10-01

    The Multipurpose technique for coronary arteriography employs a single catheter. The benefits are a reduction in the cost of the procedure and a shorter procedural time by experienced operators. To enhance the performance of these catheters, a modification was made in the materials and tip design, and these modifications were clinically evaluated in a small study. Compared to the control group of patients (n = 41), patients catheterized with the Multipurpose-SM (n = 43) were shown to have a shorter procedural time as measured by a reduced fluoroscopy time (7.08 min vs. 9.52 min, P = .007). This difference is statistically significant at a 95% confidence level and resulted in less radiation exposure to the operator and cath lab staff. The procedural time was significantly reduced by fewer catheter exchanges (19% study vs. 46% control; P = .006), which were needed to successfully complete the procedure. The new Multipurpose-SM catheter also demonstrated enhanced flexibility for cannulating coronary arteries with superior or anterior takeoffs. This study concludes that the utilization of a modified Multipurpose-SM catheter is safe and effective in cannulating both the left and right coronary arteries, bypass grafts, and performing left ventriculography. The primary benefits of using this modified catheter are reduced fluoroscopy time and the need for fewer catheter exchanges. PMID:7834732

  14. Interventional catheterization in surgically treated patients with congenital heart disease.

    PubMed

    Friedli, B; Oberhänsli, I; Faidutti, B

    2000-12-01

    Interventional catheterization is an alternative to surgery for some congenital heart defects. For other malformations, the surgeon and the interventionist will join in an effort to obtain an optimal result: the typical example is pulmonary atresia with VSD and aortopulmonary collaterals. In other cases, the cardiologist may be called upon to intervene with catheter techniques to correct sequelae or residual lesions after surgical correction, avoiding redo surgery. Most often, the task consists of opening stenoses by balloon dilatation and/or stenting the main targets being pulmonary artery branch stenoses, venous obstructions after Mustard procedure, and recoarctations. Whereas simple balloon dilatation of recoarctation often brings good results, stents are often needed to obtain optimal results in pulmonary branch stenoses. Stenting of pulmonary veins has been disappointing. Closing unwanted vessels and defects is another task for the interventional cardiologist after cardiac surgery. Here, the most frequent procedure is closing aortopulmonary collaterals in pulmonary atresia and VSD after corrective surgery. Advantages and limitations of these procedures are discussed. PMID:11145397

  15. Elbow hemiarthroplasty for the management of distal humeral fractures: current technique, indications and results.

    PubMed

    Phadnis, Joideep; Watts, Adam C; Bain, Gregory I

    2016-07-01

    There has been a growing recent interest in the use of elbow hemiarthroplasty for the treatment of distal humeral trauma in select patients. However, the current available evidence regarding outcome after elbow hemiarthroplasty is limited to case series and biomechanical data. Consequently, the procedure remains unfamiliar to many surgeons. The aim of the present review is to outline the evidence regarding elbow hemiarthroplasty and to use this, along with the author's experience, to better describe the indications, surgical technique and outcomes after this procedure. PMID:27583016

  16. Pediatric Emergency Magnetic Resonance Imaging: Current Indications, Techniques, and Clinical Applications.

    PubMed

    Chang, Patricia T; Yang, Edward; Swenson, David W; Lee, Edward Y

    2016-05-01

    MR imaging plays an important role in the detection and characterization of several pediatric disease entities that can occur in the emergent setting because of its cross-sectional imaging capability, lack of ionizing radiation exposure, and superior soft tissue contrast. In the age of as low as reasonably achievable, these advantages have made MR imaging an increasingly preferred modality for diagnostic evaluations even in time-sensitive settings. In this article, the authors discuss the current indications, techniques, and clinical applications of MR imaging in the evaluation of pediatric emergencies. PMID:27150329

  17. Ultrasound-Guided Interventional Procedures of the Wrist and Hand: Anatomy, Indications, and Techniques.

    PubMed

    Colio, Sean W; Smith, Jay; Pourcho, Adam M

    2016-08-01

    Acute and chronic wrist and hand conditions are commonly seen by neuromuscular and musculoskeletal specialists. High-frequency diagnostic ultrasonography (US) has facilitated advances in the diagnosis and interventional management of wrist and hand disorders. US provides excellent soft tissue resolution, accessibility, portability, lack of ionizing radiation, and the ability to dynamically assess disorders and precisely guide interventional procedures. This article review the relevant anatomy, indications, and interventional techniques for common disorders of the wrist and hand, including radiocarpal joint arthritis, scaphotrapeziotrapezoidal joint arthritis, trapeziometacarpal joint arthritis, phalangeal joint arthritis, first dorsal compartment tenosynovitis, ganglion cysts, and stenosing tenosynovitis. PMID:27468668

  18. Elbow hemiarthroplasty for the management of distal humeral fractures: current technique, indications and results

    PubMed Central

    Watts, Adam C; Bain, Gregory I

    2016-01-01

    There has been a growing recent interest in the use of elbow hemiarthroplasty for the treatment of distal humeral trauma in select patients. However, the current available evidence regarding outcome after elbow hemiarthroplasty is limited to case series and biomechanical data. Consequently, the procedure remains unfamiliar to many surgeons. The aim of the present review is to outline the evidence regarding elbow hemiarthroplasty and to use this, along with the author’s experience, to better describe the indications, surgical technique and outcomes after this procedure.

  19. Ultrasound-Guided Interventional Procedures About the Shoulder: Anatomy, Indications, and Techniques.

    PubMed

    Pourcho, Adam M; Colio, Sean W; Hall, Mederic M

    2016-08-01

    Chronic and acute shoulder pain and dysfunction are common complaints among patients. Shoulder pain may be the result of abnormality involving the rotator cuff, subacromial-subdeltoid bursa, biceps tendon, glenoid labrum, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, or glenohumeral joint capsule. Ultrasound-guided (USG) procedures of the shoulder are well established for interventional management. Ultrasound provides the advantages of excellent soft tissue resolution, injection accuracy, low cost, accessibility, portability, lack of ionizing radiation, and the ability to perform real-time image-guided procedures. The purpose of this article is to review common indications and effective techniques for USG injections about the shoulder. PMID:27468666

  20. Optical fibre techniques for use within tamper indicating enclosures designed for arms control verification purposes

    NASA Astrophysics Data System (ADS)

    Dyer, Thomas C.; Thompson, Alexander W. J.; Wynn, Paul; White, Helen

    2014-10-01

    Ensuring that a future nuclear arms control agreement can be verified is a complex technical challenge. Tamper Indicating Enclosures (TIEs) are likely to be deployed as part of a chain of custody regime, providing an indication of an unauthorised attempt to access an item within the agreement. This paper focuses on the assessment of optical fibre techniques for ensuring boundary control as part of a TIE design. The results of optical fibre damage, subsequent repair attempts, enclosure construction considerations and unique identification features have been evaluated for a selection of fused-silica optical fibres. This paper focuses on detecting a fibre repair attempt, presents a method for increasing repair resistance and a method for uniquely identifying an enclosure using the optical signature from the embedded optical fibre.

  1. Compliance With Guideline Statements for Urethral Catheterization in an Iranian Teaching Hospital

    PubMed Central

    Taleschian-Tabrizi, Negar; Farhadi, Fereshteh; Madani, Neda; Mokhtarkhani, Mohaddeseh; Kolahdouzan, Kasra; Hajebrahimi, Sakineh

    2015-01-01

    Background: It is believed that healthcare staff play an important role in minimizing complications related to urethral catheterization. The purpose of this study was to determine whether or not healthcare staff complied with the standards for urethral catheterization. Methods: This study was conducted in Imam Reza teaching hospital, Tabriz, Iran, from July to September 2013. A total of 109 catheterized patients were selected randomly from surgical and medical wards and intensive care units (ICUs). A questionnaire was completed by healthcare staff for each patient to assess quality of care provided for catheter insertion, while catheter in situ, draining and changing catheter bags. Items of the questionnaire were obtained from guidelines for the prevention of infection. Data analysis was performed with SPSS 16. Results: The mean age of the patients was 50.54 ± 22.13. Of the 109 patients, 56.88% were admitted to ICUs. The mean duration of catheter use was 15.86 days. Among the 25 patients who had a urinalysis test documented in their hospital records, 11 were positive for urinary tract infection (UTI). The lowest rate of hand-washing was reported before bag drainage (49.52%). The closed drainage catheter system was not available at all. Among the cases who had a daily genital area cleansing, in 27.63% cases, the patients or their family members performed the washing. In 66.35% of cases, multiple-use lubricant gel was applied; single-use gel was not available. The rate of documentation for bag change was 79%. Conclusion: The majority of the guideline statements was adhered to; however, some essential issues, such as hand hygiene were neglected. And some patients were catheterized routinely without proper indication. Limiting catheter use to mandatory situations and encouraging compliance with guidelines are recommended. PMID:26673464

  2. The many faces of ALPPS: surgical indications and techniques among surgeons collaborating in the international registry

    PubMed Central

    Buac, Suzana; Schadde, Erik; Schnitzbauer, Andreas A.; Vogt, Kelly; Hernandez-Alejandro, Roberto

    2016-01-01

    Background ALPPS was developed to induce accelerated future liver remnant (FLR) hypertrophy in order to increase hepatic tumour resectability and reduce the risk of post-operative liver failure. While early studies demonstrated concerning complication rates, others reported favourable results. This inconsistency may be due to variability in surgical indications and technique. Methods A web-based survey was sent to surgeons participating in the International ALPPS Registry in September of 2014. Questions addressed surgeon demographics and training, surgical indications and technique, and clinical management approaches. Results Fifty six out of 85 surgeons from 78 centers responded (66%) and half (n = 30) had training in liver transplantation. Forty seven (84%) did not reserve ALPPS solely for colorectal liver metastases (CRLM) and 30 (54%) would perform ALPPS for an FLR over 30%. Neoadjuvant chemotherapy for CRLM was recommended by 37 (66%) respondents. Surgical approaches varied considerably, with 30% not preserving outflow to the middle hepatic vein and 39% believing it necessary to skeletonize the hepatoduodenal ligament. Twenty five (45%) surgeons have observed segment 4 necrosis. Conclusion There is considerable variability in how ALPPS is performed internationally. This heterogeneity in practice patterns may explain the current incongruity in published outcomes, and highlights the need for standardization. PMID:27154808

  3. Measurement of phloem transport rates by an indicator-dilution technique. [Triticum aestivum L

    SciTech Connect

    Fisher, D.B. )

    1990-10-01

    An indicator-dilution technique for the measurement of flow rates, commonly used by animal physiologists for circulation measurements, was adapted to the measurement of phloem translocation rates in the wheat (Triticum aestivum L.) peduncle. The approach is based on the observation that, during the transport of a given amount of solute, its mean concentration will be inversely proportional to flow rate. For phloem transport in the wheat peduncle, the necessary measurements are (a) the time course of tracer kinetics in the peduncle phloem, (b)the volume of sieve tubes and companion cells in the monitored segment of the peduncle, and (c) the amount of tracer transported past that point. The method was evaluated by in situ monitoring of {sup 32}PO{sub 4} transport in pulse-labeling experiments. Specific activities (i.e. {sup 32}P concentrations) of phloem exudate were in good agreement with those calculated from in situ count rates and measured phloem areas. Mass transport rates, calculated from volume flow rates and phloem exudate dry matter content, also agreed well with expected mass transport rates based on measurements of grain growth rate and net CO{sub 2} exchange by the ear. The indicator-dilution technique appears to offer good precision and accuracy for short-term measurements of phloem transport rates in the wheat peduncle and should be useful for other systems as well.

  4. Development of Needle Insertion Manipulator for Central Venous Catheterization

    NASA Astrophysics Data System (ADS)

    Kobayashi, Yo; Hong, Jaesung; Hamano, Ryutaro; Hashizume, Makoto; Okada, Kaoru; Fujie, Masakatsu G.

    Central venous catheterization is a procedure, which a doctor insert a catheter into the patient’s vein for transfusion. Since there are risks of bleeding from arterial puncture or pneumothorax from pleural puncture. Physicians are strictly required to make needle reach up into the vein and to stop the needle in the middle of vein. We proposed a robot system for assisting the venous puncture, which can relieve the difficulties in conventional procedure, and the risks of complication. This paper reports the design structuring and experimental results of needle insertion manipulator. First, we investigated the relationship between insertion force and angle into the vein. The results indicated that the judgment of perforation using the reaction force is possible in case where the needling angle is from 10 to 20 degree. The experiment to evaluate accuracy of the robot also revealed that it has beyond 0.5 mm accuracy. We also evaluated the positioning accuracy in the ultrasound images. The results displays that the accuracy is beyond 1.0 mm and it has enough for venous puncture. We also carried out the venous puncture experiment to the phantom and confirm our manipulator realized to make needle reach up into the vein.

  5. Preoperative portal vein embolization in liver cancer: indications, techniques and outcomes

    PubMed Central

    Favelier, Sylvain; Chevallier, Olivier; Estivalet, Louis; Genson, Pierre-Yves; Pottecher, Pierre; Gehin, Sophie; Krausé, Denis; Cercueil, Jean-Pierre

    2015-01-01

    Postoperative liver failure is a severe complication of major hepatectomies, in particular in patients with a chronic underlying liver disease. Portal vein embolization (PVE) is an approach that is gaining increasing acceptance in the preoperative treatment of selected patients prior to major hepatic resection. Induction of selective hypertrophy of the non-diseased portion of the liver with PVE in patients with either primary or secondary hepatobiliary, malignancy with small estimated future liver remnants (FLR) may result in fewer complications and shorter hospital stays following resection. Additionally, PVE performed in patients initially considered unsuitable for resection due to lack of sufficient remaining normal parenchyma may add to the pool of candidates for surgical treatment. A thorough knowledge of hepatic segmentation and portal venous anatomy is essential before performing PVE. In addition, the indications and contraindications for PVE, the methods for assessing hepatic lobar hypertrophy, the means of determining optimal timing of resection, and the possible complications of PVE need to be fully understood before undertaking the procedure. Technique may vary among operators, but cyanoacrylate glue seems to be the best embolic agent with the highest expected rate of liver regeneration for PVE. The procedure is usually indicated when the remnant liver accounts for less than 25-40% of the total liver volume. Compensatory hypertrophy of the non-embolized segments is maximal during the first 2 weeks and persists, although to a lesser extent during approximately 6 weeks. Liver resection is performed 2 to 6 weeks after embolization. The goal of this article is to discuss the rationale, indications, techniques and outcomes of PVE before major hepatectomy. PMID:26682142

  6. Radiation exposure to the child during cardiac catheterization

    SciTech Connect

    Waldman, J.D.; Rummerfield, P.S.; Gilpin, E.A.; Kirkpatrick, S.E.

    1981-07-01

    Few data are available regarding radiation exposure to children during cardiac catheterization. Using lithium fluoride thermoluminescent dosimeters, radiation exposure was measured during precatheterization chest roentgenography, fluoroscopy (hemodynamic assessment phase of catheterization and cineangiography in 30 infants and children, ages 3 days to 21 years. Dosimeters were placed over the eyes, thyroid, anterior chest, posterior chest, anterior abdomen, posterior abdomen and gonads. Average absorbed chest doses were 24.5 mR during chest roentgenography, 5810 mR during catheterization fluoroscopy and 1592 mR during cineangiography. During the complete catheterization, average doses were 26 mR to the eyes, 431 mR to the thyroid area, 150 mR to the abdomen and 11 mR to the gonads. Radiation exposure during pediatric cardiac catheterization is low to the eyes and gonads but high to the chest and thyroid area. To decrease radiation dosage we suggest: (1) low pulse-rate fluoroscopy; (2) substitution of contrast echocardiography for cineangiography; (3) large-plate abdominal/gonadal shielding; (4) a selective shield for thyroid area; (5) a very small field during catheter manipulation. Minimum radiation consistent with accurate diagnosis is optimal; however, erroneous or incomplete diagnosis is more dangerous than radiation-related hazards.

  7. Radiation exposure to the child during cardiac catheterization

    SciTech Connect

    Waldman, J.D.; Rummerfield, P.S.; Gilpin, E.A.; Kirkpatrick, S.E.

    1981-07-01

    Few data are available regarding radiation exposure to children during cardiac catheterization. Using lithium fluoride thermoluminescent dosimeters, radiation exposure was measured during precatheterization chest roentgenography, fluoroscopy (hemodynamic assessment phase of catheterization) and cineangiography in 30 infants and children, ages 3 days to 21 years. Dosimeters were placed over the eyes, thyroid, anterior chest, posterior chest, anterior abdomen, posterior abdomen and gonads. Average absorbed chest doses were 24.5 mR during chest roentgenography, 5810 mR during catheterization fluoroscopy and 1592 mR during cineangiography. During the complete catheterization, average doses were 26 mR to the eyes, 431 mR to the thyroid area, 150 mR to the abdomen and 11 mR to the gonads. Radiation exposure during pediatric cardiac catheterization is low to the eyes and gonads but high to the chest and thyroid area. To decrease radiation dosage we suggest (1) low pulse-rate fluoroscopy; (2) substitution of contrast echocardiography for cineangiography; (3) large-plate abdominal/gonadal shielding; (4) a selective shield for thyroid area; (5) a very small field during catheter manipulation. Minimum radiation consistent with accurate diagnosis is optimal; however, erroneous or incomplete diagnosis is more dangerous than radiation-related hazards.

  8. Indication and technique of transnasal microscopic orbital decompression for endocrine ophthalmopathy.

    PubMed

    May, A; Fries, U; von Ilberg, C; Weber, A

    2000-01-01

    If endocrine ophthalmopathy progresses despite conservative treatment then indications for surgical decompression are: loss of visual acuity, increasing strabism, and severe keratopathy. Endonasal microsurgery ensures a binocular view onto the intranasal landmarks of the orbital walls and allows simultaneous decompression of the medial and inferior wall as well as a good relief of pressure at the orbital apex. Surgical decompressions were performed on 29 orbits in 19 patients, 16 by using the endonasal microsurgical, 3 via external approach. The microscopic approach was entirely comparable with regard to the reduction of proptosis with a mean improvement of 4.2 mm against a mean of 4.7 mm by external approach and a mean 0.2 of better visual acuity in both procedures. The microsurgical technique is considered superior to an external approach avoiding external scars, neural pain, and reportedly less diplopia. The healing phase and the hospitalization time are shorter. PMID:10810256

  9. Computed tomography colonography in 2014: an update on technique and indications.

    PubMed

    Laghi, Andrea

    2014-12-01

    Twenty years after its introduction, computed tomographic colonography (CTC) has reached its maturity, and it can reasonably be considered the best radiological diagnostic test for imaging colorectal cancer (CRC) and polyps. This examination technique is less invasive than colonoscopy (CS), easy to perform, and standardized. Reduced bowel preparation and colonic distention using carbon dioxide favor patient compliance. Widespread implementation of a new image reconstruction algorithm has minimized radiation exposure, and the use of dedicated software with enhanced views has enabled easier image interpretation. Integration in the routine workflow of a computer-aided detection algorithm reduces perceptual errors, particularly for small polyps. Consolidated evidence from the literature shows that the diagnostic performances for the detection of CRC and large polyps in symptomatic and asymptomatic individuals are similar to CS and are largely superior to barium enema, the latter of which should be strongly discouraged. Favorable data regarding CTC performance open the possibility for many different indications, some of which are already supported by evidence-based data: incomplete, failed, or unfeasible CS; symptomatic, elderly, and frail patients; and investigation of diverticular disease. Other indications are still being debated and, thus, are recommended only if CS is unfeasible: the use of CTC in CRC screening and in surveillance after surgery for CRC or polypectomy. In order for CTC to be used appropriately, contraindications such as acute abdominal conditions (diverticulitis or the acute phase of inflammatory bowel diseases) and surveillance in patients with a long-standing history of ulcerative colitis or Crohn's disease and in those with hereditary colonic syndromes should not be overlooked. This will maximize the benefits of the technique and minimize potential sources of frustration or disappointment for both referring clinicians and patients. PMID:25492999

  10. Computed tomography colonography in 2014: An update on technique and indications

    PubMed Central

    Laghi, Andrea

    2014-01-01

    Twenty years after its introduction, computed tomographic colonography (CTC) has reached its maturity, and it can reasonably be considered the best radiological diagnostic test for imaging colorectal cancer (CRC) and polyps. This examination technique is less invasive than colonoscopy (CS), easy to perform, and standardized. Reduced bowel preparation and colonic distention using carbon dioxide favor patient compliance. Widespread implementation of a new image reconstruction algorithm has minimized radiation exposure, and the use of dedicated software with enhanced views has enabled easier image interpretation. Integration in the routine workflow of a computer-aided detection algorithm reduces perceptual errors, particularly for small polyps. Consolidated evidence from the literature shows that the diagnostic performances for the detection of CRC and large polyps in symptomatic and asymptomatic individuals are similar to CS and are largely superior to barium enema, the latter of which should be strongly discouraged. Favorable data regarding CTC performance open the possibility for many different indications, some of which are already supported by evidence-based data: incomplete, failed, or unfeasible CS; symptomatic, elderly, and frail patients; and investigation of diverticular disease. Other indications are still being debated and, thus, are recommended only if CS is unfeasible: the use of CTC in CRC screening and in surveillance after surgery for CRC or polypectomy. In order for CTC to be used appropriately, contraindications such as acute abdominal conditions (diverticulitis or the acute phase of inflammatory bowel diseases) and surveillance in patients with a long-standing history of ulcerative colitis or Crohn’s disease and in those with hereditary colonic syndromes should not be overlooked. This will maximize the benefits of the technique and minimize potential sources of frustration or disappointment for both referring clinicians and patients. PMID

  11. Vertical expandable prosthetic titanium rib (VEPTR): indications, technique, and management review.

    PubMed

    Shah, Shailja C; Birknes, John K; Sagoo, Sukh; Thome, Shelby; Samdani, Amer F

    2009-04-01

    Surgical correction is generally indicated as the primary form of management in children with severe early onset scoliosis. Even so, conservative, nonsurgical treatment is always considered first, as surgical correction carries significant concomitant consequences, including but not limited to crankshaft phenomenon and, more importantly, inhibition of further spine, lung, and chest growth in skeletally immature patients. Fusionless surgical procedures assuage some of these risks, as they are characteristically associated with techniques necessitating spinal fusion. One device looks particularly promising in treating and managing severe early onset scoliosis, the vertical expandable prosthetic titanium rib (VEPTR)-a device that was initially targeted toward children with thoracic insufficiency syndrome (TIS). Despite its promising results in correction of severe early onset scoliosis, as well as associated rib and chest wall deformities, the VEPTR nevertheless has a complication rate comparable to other fusionless techniques. Continued modifications and research will hopefully beget a device that permits thoracic and spinal growth in skeletally immature patients yet with fewer postoperative complications. In this chapter, the authors review the clinical experience with VEPTR to date and present their results in 16 children with congenital scoliosis cared for at Shriners Hospital of Philadelphia. PMID:19585438

  12. [Total elbow arthroplasty. Indications, operative technique and results after implantation of an Acclaim elbow prosthesis].

    PubMed

    Lerch, K; Tingart, M; Trail, I; Grifka, J

    2003-08-01

    Total elbow arthroplasty has become a reliable treatment option for patients with rheumatoid arthritis as well as primary or posttraumatic arthrosis. The aim of this study is to present the indications, operative technique and results for the implantation of an Acclaim elbow prosthesis. Case reports are given to demonstrate the indications for prosthesis implantation. Furthermore, the follow-up results are reported for 65 patients after implantation of an Acclaim prosthesis. Pre- and postoperative pain were evaluated using the visual analogue scale. The pain level decreased from 8.0 to 2.3 postoperatively. After implantation of an elbow prosthesis, there was a significant improvement in the range of motion. The mean flexion increased from 103 degrees preoperatively to 140 degrees postoperatively. An increase of 10 degrees was found for both supination and pronation. Complications included temporary ulnary nerve irritation in seven patients, intraoperative fractures in four cases and postoperative elbow dislocation in one case. In conclusion, total elbow arthroplasty results in a reduction of pain and an improvement in elbow movement. However, selection of the right patient is important. Patients are advised not to lift heavy objects or to perform hard physical work. If patients' compliance can not be ensured preoperatively, no total elbow arthroplasty should be performed. PMID:12955197

  13. [Cervical laminoplasty--review of surgical techniques, indications, methods of efficacy evaluation, and complications].

    PubMed

    Derenda, Marek; Kowalina, Ireneusz

    2006-01-01

    Techniques of expansive cervical laminoplasty evolved in the 1970s in Japan as an alternative to laminectomy connected with many complications. They were developed and modified in the following years. Nowadays cervical laminoplasty is the standard method of posterior decompression of the cervical spine which reflects the aspiration to preserve the spine stabilising structures. Indications for laminoplasty are multilevel cervical pathological changes leading to spinal canal stenosis and myelopathy as a consequence. Historical background is discussed. Technical details of Z-type laminoplasty (Oyama), open-door laminoplasty (Hirabayashi), spinous process-splitting laminoplasty (Kurokawa), hardware-augmented laminoplasty (O'Brien with Shaffrey's modification) and dorso-lateral decompression (Ohtsuka) are described. The Japanese Orthopaedic Association scale is widely accepted for the clinical evaluation of cervical myelopathy. Effectiveness of surgical treatment is evaluated using the Hirabayashi recovery rate. Postoperative complications are: diminution of neck motion range, kyphotic deformity, axial neck pain, C5 nerve root palsy, restenosis and late deterioration of neurological postoperative outcome. Contemporary theories explaining problems connected with the complications are described. The subject is discussed based on a review of literature and own practice. PMID:17103356

  14. Transjugular intrahepatic portosystemic shunt for acute variceal gastrointestinal bleeding: Indications, techniques and outcomes.

    PubMed

    Loffroy, R; Favelier, S; Pottecher, P; Estivalet, L; Genson, P Y; Gehin, S; Krausé, D; Cercueil, J-P

    2015-01-01

    Acute variceal bleeding is a life-threatening condition that requires a multidisciplinary approach for effective therapy. The transjugular intrahepatic portosystemic shunt (TIPS) procedure is a minimally invasive image-guided intervention used for secondary prevention of bleeding and as salvage therapy in acute bleeding. Emergency TIPS should be considered early in patients with refractory variceal bleeding once medical treatment and endoscopic sclerotherapy fail, before the clinical condition worsens. Furthermore, admission to specialized centers is mandatory in such a setting and regional protocols are essential to be organized effectively. This procedure involves establishment of a direct pathway between the hepatic veins and the portal veins to decompress the portal venous hypertension that is the source of the patient's bleeding. The procedure is technically challenging, especially in critically ill patients, and has a mortality of 30%-50% in the emergency setting, but has an effectiveness greater than 90% in controlling bleeding from gastro-esophageal varices. This review focuses on the role of TIPS in the setting of variceal bleeding, with emphasis on current indications and techniques for TIPS creation, TIPS clinical outcomes, and the role of adjuvant embolization of varices. PMID:26094039

  15. Teaching Self-Catheterization Skills to a Child with Myelomeningocele in a Preschool Setting.

    ERIC Educational Resources Information Center

    Robertson, Jo; And Others

    1992-01-01

    Simulation training and a prompt hierarchy were found to facilitate acquisition of clean intermittent self-catheterization skills by a four-year-old male with myelomeningocele. The child was first taught to perform catheterization on a doll, then on himself. Skills were clustered into three tasks of diapering, cleansing, and catheterization.…

  16. Patient Decision Control and the Use of Cardiac Catheterization

    PubMed Central

    Paasche-Orlow, Michael K.; Orner, Michelle B.; Stewart, Sabrina K.; Kressin, Nancy R.

    2015-01-01

    Background: Shared decision-making is a key determinant of patient-centered care. A lack of patient involvement in treatment decisions may explain persistent racial disparities in rates of cardiac catheterization (CCATH). To date, limited evidence exists to demonstrate whether patients who engage in shared decision-makingare more or less likely to undergo non-emergency CCATH. Objective: To assess the relationship between participation in the decision to undergo a CCATH and the use of CCATH. We also examined whether preference for or actual engagement in decision-making varied by patient race. Methods: We analyzed data from 826 male Veterans Administration patients for whom CCATH was indicated and who participated in the Cardiac Decision Making Study. Results: After controlling for confounders, patients reporting any degree of decision control were more likely to receive CCATH compared with those reporting no control (doctor made decision without patient input) (54% vs 39%, P<.0001). Across racial groups, patients were equally likely to report a preference for control over decision-making (P=.53) as well as to experience discordance between their preference for control and their perception of the actual decision-making process (P=.59). Therefore, these factors did not mediate racial disparities in rates of CCATH use. Conclusion: Shared decision-making is an essential feature of whole-person care. While participation in decision-making may not explain disparities in CCATH rates, further work is required to identify strategies to improve congruence between patients' desire for and actual control over decision-making to actualize patient-centered care. PMID:26331101

  17. Vasoreactivity of the radial artery after transradial catheterization.

    PubMed

    Sanmartin, Marcelo; Goicolea, Javier; Ocaranza, Raymundo; Cuevas, Diogenes; Calvo, Francisco

    2004-11-01

    The vasomotor response was used to assess the degree of radial artery injury after transradial catheterization. Vasoreactivity was studied by ultrasound before catheterization, 24 hours after, at 1 week and at 1 month in 18 patients. Mean radial artery diameter increased from 2.56+/-0.45 mm before catheterization to 2.86+/-0.48 mm at 24 hours (p=0.001) and returned to baseline values at 1-month (2.60+/-0.27 mm; p=0.95). Hyperemia-induced vasodilation did not change significantly (2.7+/-4.7% at baseline; 3.4+/-3.7% at 24 hours, 3.5+/-3.9% at 1 week and 4.8+/-4.7% at 1 month; p=0.59). Nitroglycerin-induced vasodilation was significantly attenuated at 24 hours (from 14.1+/-7.9% at baseline to 6.5+/-8.4% at 24 hours; p=0.01), but improved after 1 week (9.8+/-8.5%; p=0.1, compared to baseline) and after 1 month (13.0+/-8.9%; p=0.51, compared to baseline). Thus, soon after transradial catheterization vasoreactivity is impaired, but generally recovers as early as 1 month after the procedure. PMID:15550733

  18. Cerebral contrast retention after difficult cardiac catheterization: Case report

    PubMed Central

    Ho, David W; Lazar, Jason M; Marmur, JD

    2014-01-01

    Background: We report a diagnostic dilemma in a rare case of cerebral contrast retention after difficult cardiac catheterization in an elderly patient loaded with prasugrel. Summary: Our case report describes a 77-year-old female with history of hypertension, diabetes, and dyslipidemia who presented to emergency department complaining of chest pain. Patient was found to have an inferior wall ST elevation myocardial infarction. The patient was loaded with aspirin and prasugrel and taken for emergent cardiac catheterization. Cardiac catheterization revealed two-vessel coronary artery disease with unsuccessful attempt of percutaneous intervention. Immediately after procedure, patient developed an episode of seizure. Emergent computed tomography scan of the brain revealed hyperdensity in the right frontoparietal region consistent with intracerebral bleed. Repeat computed tomography (24 h later) revealed substantial interval improvement of hyperdensity. Follow-up magnetic resonance imaging of the head was normal. Given the lack of magnetic resonance imaging changes, the rate of resolution on computed tomography without expected subacute changes, and the lack of neurologic findings, the initial hyperdensity seen on computed tomography of the brain was believed to be secondary to contrast leakage during cardiac catheterization as opposed to intracranial hemorrhage. PMID:27489644

  19. Teaching Intermittent Self-Catheterization Skills to Mentally Retarded Children.

    ERIC Educational Resources Information Center

    Tarnowski, Kenneth J.; Drabman, Ronald S.

    1987-01-01

    In an A-B design with replication, the efficacy of a behavioral training program for teaching two mildly retarded six-year-old children intermittent self-catheterization skills was demonstrated. Component skills were task-analyzed and trained via a graduated prompting procedure. (Author/DB)

  20. In situ cephalic vein bypasses from axillary to the brachial artery after catheterization injuries.

    PubMed

    Hudorovic, Narcis; Lovricevic, Ivo; Ahel, Zaky

    2010-07-01

    The need to bypass to the brachial artery is rare. Over a five-year period, 16 patients had suffered iatrogenic post-catheterization injuries of the upper extremity. We have performed 16 bypasses, in 16 patients, mean age was 65 years (range 47-75), to the brachial artery originating from an artery proximal to the shoulder joint. In all cases, the axillary artery was the donor artery. All bypasses were created by using the cephalic vein with the in situ technique and distal anastomoses were made to a distance-free section of brachial artery. No operative mortality, neurological complications or major upper-extremity amputation was associated with the procedure. Life-long-conduit analysis showed 75% patency in the five-year period. After iatrogenic post-catheterization trauma of arterial system of upper extremity, bypasses from axillary to brachial artery with the cephalic vein with the in situ technique is a safe operation with satisfactory long-term patency. PMID:20395248

  1. Fine needle biopsy of abdominal organs in dogs -- indications, contraindications and performance technique.

    PubMed

    Glińska-Suchocka, K; Jankowski, M; Kubiak, K; Spuzak, J; Dzimira, S; Nicpoń, J

    2013-01-01

    Recent years have seen in both human and veterinary medicine the development of numerous techniques allowing for evaluation and classification of changes in individual organs and tissues. Despite introduction of such techniques into diagnostics as among others, CT, MRI, CEUS or elastography, biopsy is still considered a "golden standard" and it is a procedure performed in order to obtain a final diagnosis. There are many biopsy techniques, such as fine needle aspiration biopsy, core biopsy as well as methods of performing a procedure, e.g. blind biopsy, biopsy under USG control and biopsy during laparotomy. In the article usefulness of biopsy techniques in relation to diagnostics of individual abdominal organ, as well as the procedure technique, contraindication and complications are discussed. PMID:24597324

  2. Coronary thrombus detected by cardiac CT angiography before cardiac catheterization.

    PubMed

    Slim, Ahmad M; Slim, Jennifer N; Haney, Brian R; Shry, Eric A

    2010-11-01

    A patient presented with a complaint of pleuritic chest discomfort with elevated cardiac biomarkers. After a cardiac magnetic resonance imaging scan for the suspicion of myopericarditis showed a potential myocardial infarct, a coronary CT scan was performed. This revealed a thrombus of the left anterior descending artery. Cardiac catheterization confirmed the findings, and a small clot was removed. To our knowledge, this is the first reported case of coronary thrombus being detected by CT angiography with cardiac catheterization correlation. Coronary CT angiography has been increasingly used to evaluate acute chest pain with a negative predictive value close to 100%. In a young patient with suspicion of myopericarditis, CT angiography proved to be useful in diagnosing thrombus in the coronary tree. PMID:20463613

  3. Ensuring patient adherence to clean intermittent self-catheterization

    PubMed Central

    Seth, Jai H; Haslam, Collette; Panicker, Jalesh N

    2014-01-01

    Patient performance of clean intermittent self-catheterization is a crucial component of the management of incomplete bladder emptying, which can arise from a variety of conditions. This allows patients to have more control over their bladder emptying, and avoids the inconveniences that come with an indwelling urethral catheter. There are, however, barriers that patients face when performing this task which may ultimately limit adherence. In this article, these barriers are discussed in more detail with potential solutions to counter them. PMID:24611001

  4. Dissection of the posterior wall by guide-wire during internal jugular vein catheterization.

    PubMed

    Morimoto, Yasuhiro; Tanaka, Eriko; Shimamoto, Yoko; Tokumine, Joho

    2015-04-01

    We report a case of posterior wall hematoma formation in the internal jugular vein after the puncture of central vein. An 82-year-old woman was scheduled for laparotomy for an abdominal incisional hernia. After induction of general anesthesia, we performed central venous catheterization via the right internal jugular vein under ultrasound guidance in the short-axis view and out-of plane technique. The ultrasound view after insertion of a guide-wire revealed a hematoma-like space on the posterior wall of the vein. We removed and reinserted the guide-wire. This time, insertion of the wire and catheter was uneventful. Seven days after the surgery, no hematoma-like space was found in the vein. The malposition of the guide-wire was detected before dilation, which enabled us to avoid complications in this case. We should note that the confirmation of guide-wire placement in the vein is important during ultrasound-guided central venous catheterization. PMID:25138819

  5. HYPERSPECTRAL TECHNIQUE AS AN INDICATOR OF EUTROPHICATION AND SEDIMENT LOAD FOR DEEP RIVERS

    EPA Science Inventory

    Remote sensing techniques were used to characterize and quantify spatial and temporal variation in water quality of the Great Miami River in Ohio. An initial feasibility study was conducted in the summer of 1999 using a non-imaging hand-held spectroradiometer to ascertain the pre...

  6. INDICATOR OF EUTROPHICATION AND SEDIMENT LOAD: HYPERSPECTRAL TECHNIQUE FOR CONTINUOUS COVERAGE OF DEEP RIVERS

    EPA Science Inventory

    Remote sensing techniques were used to characterize and quantify spatial and temporal variation in water quality of the Great Miami River in Ohio. An initial feasibility study was conducted in the summer of 1999 using a non-imaging hand-held spectroradiometer to ascertain the pr...

  7. Accurate measurement of oxygen consumption in children undergoing cardiac catheterization.

    PubMed

    Li, Jia

    2013-01-01

    Oxygen consumption (VO(2) ) is an important part of hemodynamics using the direct Fick principle in children undergoing cardiac catheterization. Accurate measurement of VO(2) is vital. Obviously, any error in the measurement of VO(2) will translate directly into an equivalent percentage under- or overestimation of blood flows and vascular resistances. It remains common practice to estimate VO(2) values from published predictive equations. Among these, the LaFarge equation is the most commonly used equation and gives the closest estimation with the least bias and limits of agreement. However, considerable errors are introduced by the LaFarge equation, particularly in children younger than 3 years of age. Respiratory mass spectrometry remains the "state-of-the-art" method, allowing highly sensitive, rapid and simultaneous measurement of multiple gas fractions. The AMIS 2000 quadrupole respiratory mass spectrometer system has been adapted to measure VO(2) in children under mechanical ventilation with pediatric ventilators during cardiac catheterization. The small sampling rate, fast response time and long tubes make the equipment a unique and powerful tool for bedside continuous measurement of VO(2) in cardiac catheterization for both clinical and research purposes. PMID:22488802

  8. Assessing soil quality indicator under different land use and soil erosion using multivariate statistical techniques.

    PubMed

    Nosrati, Kazem

    2013-04-01

    Soil degradation associated with soil erosion and land use is a critical problem in Iran and there is little or insufficient scientific information in assessing soil quality indicator. In this study, factor analysis (FA) and discriminant analysis (DA) were used to identify the most sensitive indicators of soil quality for evaluating land use and soil erosion within the Hiv catchment in Iran and subsequently compare soil quality assessment using expert opinion based on soil surface factors (SSF) form of Bureau of Land Management (BLM) method. Therefore, 19 soil physical, chemical, and biochemical properties were measured from 56 different sampling sites covering three land use/soil erosion categories (rangeland/surface erosion, orchard/surface erosion, and rangeland/stream bank erosion). FA identified four factors that explained for 82 % of the variation in soil properties. Three factors showed significant differences among the three land use/soil erosion categories. The results indicated that based upon backward-mode DA, dehydrogenase, silt, and manganese allowed more than 80 % of the samples to be correctly assigned to their land use and erosional status. Canonical scores of discriminant functions were significantly correlated to the six soil surface indices derived of BLM method. Stepwise linear regression revealed that soil surface indices: soil movement, surface litter, pedestalling, and sum of SSF were also positively related to the dehydrogenase and silt. This suggests that dehydrogenase and silt are most sensitive to land use and soil erosion. PMID:22791019

  9. A Modified Catheterization Procedure to Reduce Bladder Damage when Collecting Urine Samples from Holstein Cows

    PubMed Central

    TAMURA, Tetsuo; NAKAMURA, Hiroshi; SATO, Say; SEKI, Makoto; NISHIKI, Hideto

    2014-01-01

    ABSTRACT This study proposed a modified procedure, using a small balloon catheter (SB catheter, 45 ml), for reducing bladder damage in cows. Holstein cows and the following catheters were prepared: smaller balloon catheter (XSB catheter; 30 ml), SB catheter and standard balloon catheter (NB catheter; 70 ml, as the commonly used, standard size). In experiment 1, each cow was catheterized. The occurrence of catheter-associated hematuria (greater than 50 RBC/HPF) was lower in the SB catheter group (0.0%, n=7) than in the NB catheter group (71.4%, n=7; P<0.05). In experiment 2, general veterinary parameters, urine pH, body temperature and blood values in cows were not affected before or after insertion of SB catheters (n=6). The incidence of urinary tract infection (UTI) was 3.0% per catheterized day (n=22). In experiment 3, feeding profiles, daily excretion of urinary nitrogen (P<0.05) and rate from nitrogen intake in urine (P<0.01), were higher with use of the SB catheter (n=13) than with the use of the vulva urine cup (n=18), indicating that using the SB catheter can provide accurate nutritional data. From this study, we concluded that when using an SB catheter, the following results occur; reduction in bladder damage without any veterinary risks and accuracy in regard to feeding parameters, suggesting this modified procedure using an SB catheter is a useful means of daily urine collection. PMID:24561376

  10. IMMUNOLOGICAL AND BIOSENSOR TECHNIQUES FOR DETECTING NON-MICROBIAL INDICATORS OF HUMAN FECAL POLLUTION

    EPA Science Inventory

    Limitations exist in applying the conventional microbial methods to the detection of human fecal contamination in water. Recently, there has been an increased interest in developing supplemental and/or alternate indicators of human contamination to better define water quality an...

  11. How To Better Track Effective School Indicators: The Control Chart Techniques.

    ERIC Educational Resources Information Center

    Coutts, Douglas

    1998-01-01

    Control charts are practical tools to monitor various school indicators (attendance rates, standardized test scores, grades, and graduation rates) by displaying data on the same scale over time. This article shows how principals can calculate the upper natural-process limit, lower natural-process limit, and upper control limit for attendance. (15…

  12. Laser and high-frequency cauthery gingivectomy in nonperiodontal indications: assessment and comparison of techniques

    NASA Astrophysics Data System (ADS)

    Bartak, Petr; Smucler, Roman

    2003-06-01

    The authors have verified the efficiency and safety of laser and high-frequency gingivectomy in non-periodontal indications. Within a prospective, non-selective study, they treated and monitored 357 dental areas in 139 teeth.Out of the total number, 248 areas were treated wtih a diode laser, 980nm; 109 areas with high-frequency electrocautery. The following parameters were monitored: a) regeneration of the marginal gingiva; b) generation of iatrogenic recessions or periodontal pockets; c) bleeding from gingival sulcus during probing; d) changes in tooth vitality; e) patient's subjective evaluation. The authors identified a high degree of safety in both laser and high-frequency gingivectomy, with no significant difference between these two methods. Laser gingivectomy appears to have a wider indication range, while high-frequency gingivectomy requires lower financial expenses.

  13. Survival analysis for the missing censoring indicator model using kernel density estimation techniques.

    PubMed

    Subramanian, Sundarraman

    2006-01-01

    This article concerns asymptotic theory for a new estimator of a survival function in the missing censoring indicator model of random censorship. Specifically, the large sample results for an inverse probability-of-non-missingness weighted estimator of the cumulative hazard function, so far not available, are derived, including an almost sure representation with rate for a remainder term, and uniform strong consistency with rate of convergence. The estimator is based on a kernel estimate for the conditional probability of non-missingness of the censoring indicator. Expressions for its bias and variance, in turn leading to an expression for the mean squared error as a function of the bandwidth, are also obtained. The corresponding estimator of the survival function, whose weak convergence is derived, is asymptotically efficient. A numerical study, comparing the performances of the proposed and two other currently existing efficient estimators, is presented. PMID:18953423

  14. Supporting 64-bit global indices in Epetra and other Trilinos packages : techniques used and lessons learned.

    SciTech Connect

    Jhurani, Chetan; Austin, Travis M.; Heroux, Michael Allen; Willenbring, James Michael

    2013-06-01

    The Trilinos Project is an effort to facilitate the design, development, integration and ongoing support of mathematical software libraries within an object-oriented framework. It is intended for large-scale, complex multiphysics engineering and scientific applications [2, 4, 3]. Epetra is one of its basic packages. It provides serial and parallel linear algebra capabilities. Before Trilinos version 11.0, released in 2012, Epetra used the C++ int data-type for storing global and local indices for degrees of freedom (DOFs). Since int is typically 32-bit, this limited the largest problem size to be smaller than approximately two billion DOFs. This was true even if a distributed memory machine could handle larger problems. We have added optional support for C++ long long data-type, which is at least 64-bit wide, for global indices. To save memory, maintain the speed of memory-bound operations, and reduce further changes to the code, the local indices are still 32-bit. We document the changes required to achieve this feature and how the new functionality can be used. We also report on the lessons learned in modifying a mature and popular package from various perspectives - design goals, backward compatibility, engineering decisions, C++ language features, effects on existing users and other packages, and build integration.

  15. A comparison of lactate indices during ramp exercise using modelling techniques and conventional methods.

    PubMed

    Thomas, Vincent; Costes, Frédéric; Chatagnon, Michel; Pouilly, Jean-Pierre; Busso, Thierry

    2008-11-01

    The aim of this study was to compare the lactate indices provided by single- and double-breakpoint models with lactate thresholds obtained with conventional methods. Arterial samples for the determination of lactate concentrations were drawn from eight participants at rest and every minute during a ramp test (15 W x min(-1)) on a cycle ergometer. Lactate thresholds were determined from a blood lactate concentration equal to 4 mM (LT(4)), from an increase of 1 mM above the resting level (Delta1 mM), and from indirect methods using ventilatory parameters. Other indices were computed from the modelling of the lactate curve using an exponential function (LSI), a polynomial function (Dmax), a semi-log model (SLog), a parabola plus delay model (Mod P), and a two-breakpoint model (Mod M). Mod P and Mod M showed poor agreement with the other methods. LT(4), Dmax, LSI, and respiratory exchange ratio equal to 1 were correlated with each other (0.81 indices that occur at similar power outputs. PMID:18923955

  16. Minimally invasive techniques for head and neck malignancies: current indications, outcomes and future directions.

    PubMed

    Hartl, Dana M; Ferlito, Alfio; Silver, Carl E; Takes, Robert P; Stoeckli, Sandro J; Suárez, Carlos; Rodrigo, Juan P; Sesterhenn, Andreas M; Snyderman, Carl H; Terris, David J; Genden, Eric M; Rinaldo, Alessandra

    2011-09-01

    The trend toward minimally invasive surgery, appropriately applied, has evolved over the past three decades to encompass all fields of surgery, including curative intent cancer surgery of the head and neck. Proper patient and tumor selection are fundamental to optimizing oncological and functional outcomes in such a personalized approach to cancer treatment. Training, experience, and appropriate technological equipment are prerequisites for any type of minimally invasive surgery. The aim of this review was to provide an overview of currently available techniques and the evidence justifying their use. Much evidence is in favor of routine use of transoral laser resection, transoral robot-assisted surgery, transnasal endoscopic resection, sentinel node biopsy, and endoscopic neck surgery for selected malignant tumors, by experienced surgical teams. Technological advances will enhance the scope of this type of surgery in the future and physicians need to be aware of the current applications and trends. PMID:21562814

  17. Percutaneous laser disk decompression under CT and fluoroscopic guidance: indications, technique, and clinical experience.

    PubMed

    Gangi, A; Dietemann, J L; Ide, C; Brunner, P; Klinkert, A; Warter, J M

    1996-01-01

    The aim of percutaneous laser disk decompression (PLDD) is to vaporize a small portion of the nucleus pulposus of an intervertebral disk, thereby reducing the volume and pressure of a diseased disk. This minimally invasive technique can be performed in patients who need surgical intervention for disk herniation with leg pain. PLDD is usually performed under fluoroscopic guidance with or without diskoscopy. However, it can also be performed under dual computed tomographic (CT) and fluoroscopic guidance as an outpatient procedure. CT and fluoroscopic guidance increases the safety and accuracy of PLDD, with high precision of instrument guidance, direct visualization of nucleus pulposus vaporization, and reduced risk of complications. Of 119 patients with lumbar disk herniation treated with PLDD under CT and fluoroscopic guidance, 91 (76.5%) had a good or fair response. PLDD performed with CT and fluoroscopic guidance appears to be a safe and effective treatment for herniated intervertebral disks. PMID:10946692

  18. [Corrective osteotomies of the head of the tibia (indications, technique and results) (author's transl)].

    PubMed

    Zilch, H; Adlkofer, M; Groher, W; Friedebold, G

    1978-11-01

    The best indication for corrective osteotomy of the head of the tibia is unilateral osteoarthrosis of the knee joint in which the apical angle of the deformity lies in the head of the tibia or in the joint. Full-length radiographs of the leg are indispensable to determine the level of the osteotomy and the angle of correction required. The indications for high openwedge osteotomy of the tibial condyles and high osteotomy of the head of the tibia are discussed, and some of the technical details of the osteotomy and its fixation are described. Between 1970 and 1977, 139 corrective osteotomies of the head of the tibia were carried out in our clinic. Seventy nine adult patients with 100 operated knees were followed up approximately 3.5 years after operation. In 80% there was an improvement with regard to pain and walking distance when compared with the praeoperative state. The results depend on the kind of deformity (varus deformities generally show a better result) and the seriousness and duration of pre-existing osteoarthrosis and laxity of the ligaments. PMID:726145

  19. Flexible Intramedullary Nailing of Pediatric Humeral Fractures: Indications, Techniques, and Tips.

    PubMed

    Kelly, Derek M

    2016-06-01

    Most proximal and diaphyseal pediatric humeral fractures can be treated successfully by closed means; however, certain patient factors or fracture characteristics may make surgical stabilization with flexible intramedullary nails (FIN) a better choice. Common indications for FIN of pediatric humeral fractures include unstable proximal-third fractures in children nearing skeletal maturity, unstable distal metaphyseal-diaphyseal junction fractures, shaft fractures in polytraumatized patients or patients with ipsilateral both-bone forearm fractures (floating elbow), and prophylactic stabilization of benign diaphyseal bone cysts or surgical stabilization of pathologic fractures. FIN can be safely inserted in an antegrade or retrograde manner depending on the fracture location and configuration. Careful dissection at the location of rod insertion can prevent iatrogenic nerve injuries. Rapid fracture union and return to full function can be expected in most cases. Implant prominence is the most common complication. PMID:27152902

  20. Irrigation Management with Remote Sensing Techniques. Crop Water Requirements and Biophysical Indicators

    NASA Astrophysics Data System (ADS)

    Toureiro, Célia; Serralheiro, Ricardo

    2013-04-01

    Saving water in irrigated agriculture is increasingly relevant, as the irrigation sector is in many regions the biggest water consumer, but must be a sustainable activity. Therefore, the need urges for water use control methods and water resources planning. In irrigated agriculture, the right way for saving water is constituted by the increase of efficiency in water management. This work validates procedures and methodologies with remote sensing to determine the water availability in the soil at each moment and therefore the opportunity for the application of the water volume strictly necessary to optimize crop growth (irrigation opportunity and irrigation amount). The analysis applied to the Irrigation District of Divor, Évora, having used 7 experiment plots, which are areas watered by center-pivot systems, cultivated to corn. Data were determined from multispectral and infrared images of the cultivated surface obtained by satellite or by flying unmanned platform and integrated with parameters of the atmosphere and of the crops for calculating biophysical indicators and indices of water stress in the vegetation (NDVI, Kc, Kcb, CWSI). Therefore, evapotranspiration (ETc) was estimated, with which crop water requirement was calculated, with the opportunity and the amount of irrigation water to allocate. As this information is geographic referenced, maps can be prepared with GIS technology, describing water situation and the opportunity for watering crops. If the remote images are available with enough high spatial and temporal resolution, the frequent availability of maps can serve as a basis for a farmers irrigation advice system and for the regional irrigation authority to make decisions on the irrigation management at the regional scale. This can be a significant contribute to an efficient water management technology and a sustainable irrigated agriculture. Key-Words: Remote Sensing, Vegetation Index, Crop Coefficients, Water Balance

  1. [To FIV or not to FIV: Will gestational surrogacy be an indication for assisted reproductive techniques?].

    PubMed

    Delaisi de Parseval, G

    2006-09-01

    Gestational surrogacy covers three different and often mixed up situations. In the first case (that of full surrogacy), the surrogate mother carries and has the baby anonymously. The child has been conceived by artificial insemination with her own oocyte and the help of the financing father, who has legally recognised the child before birth. This constitutes surrogacy motherhood practice, which was condemned by a judgment of the French Court of Cassation, in 1991. In the second case (gestational surrogacy), the mother only carries an embryo conceived in vitro by the biological parents to whom she will give back the baby when he is born. The filiation tie between the child and his parents is thereby maintained, the surrogate mother's role being limited to that of gestation. In the third case, the surrogate mother carries an embryo, the result of in vitro fertilization of the oocytes of a donor and the father's sperm. From the moment that surrogacy is not at variance with any of our fundamental rights, we cannot but wish that, with the guarantee of a rigorous frame, it might become a medical indication for IVF, in precise circumstances of female infertility. PMID:16959522

  2. Deep brain stimulation and ablation for obsessive compulsive disorder: evolution of contemporary indications, targets and techniques.

    PubMed

    Tierney, Travis S; Abd-El-Barr, Muhammad M; Stanford, Arielle D; Foote, Kelly D; Okun, Michael S

    2014-06-01

    Surgical therapy for treatment-resistant obsessive compulsive disorder (OCD) remains an effective option for well-selected patients managed within a multidisciplinary setting. Historically, lesions within the limbic system have been used to control both obsessive thoughts and repetitive compulsions associated with this disease. We discuss classical targets as well as contemporary neuromodulatory approaches that have been shown to provide symptomatic relief. Recently, deep brain stimulation (DBS) of the anterior limb of the internal capsule/ventral striatum received Conformité Européene (CE) mark and Food and Drug Administration (FDA) approvals for treatment of intractable OCD. Remarkably, this is the first such approval for neurosurgical intervention in a strictly psychiatric indication in modern times. This target is discussed in detail along with alternative targets currently being proposed. We close with a discussion of gamma knife capsulotomy, a modality with deep historical roots. Further directions in the surgical treatment of OCD will require better preoperative predictors of postoperative responses, optimal selection of individualized targets, and rigorous reporting of adverse events and standardized outcomes. To meet these challenges, centers must be equipped with a multidisciplinary team and patient-centered approach to ensure adequate screening and follow up of patients with this difficult-to-treat condition. PMID:24099662

  3. Comparison of remote sensing techniques for measurements of aircraft emissions indices at airports

    NASA Astrophysics Data System (ADS)

    Schaefer, Klaus P.; Jahn, Carsten; Sturm, Peter J.; Lechner, Bernhard; Bacher, Michael; Gostomczyk, Adam; Kabarowska, Barbara; Zalewski, Leszec; Dahl, Guenter

    2004-02-01

    The emission indices of aircraft engine exhausts were measured at airports non-intrusively by FTIR emission spectrometry at the engine nozzle exit as well as by FTIR absorption spectrometry and DOAS (Differential Optical Absorption Spectrometry) behind the aircraft. Two measurement campaigns were performed to compare these different measurement methods. A kerosene powered burner was operated in that way that the different methods were applied for the exhaust gas investigations during the same time and at nearly the same exhaust gas volume. The burner was built with a nozzle exit diameter of 37 cm and a power of about 150 kW. Fresh air was pumped into the burner tube by a fan. Calibration gases as pure CO and NO were added in different amounts to vary the concentration of these gases in the exhaust. The sampling probe of an intrusive measurement system was installed in the centre of the exhaust stream near the exhaust exit for measurements of these gases and CO2 as well as NO2, UHC, SO2 and O2. An APU (GTCP36-300) in a test bed was used in the same way. CO was mixed into the exhausts near the nozzle exit. The passive FTIR instrument was operated in the test bed using special noise and vibration isolation. The open-path instruments were installed at the chimney exit on the roof of the test bed building. The deviations between the different measurement methods were in the order of +/-10 up to +/-20 %.

  4. Shaping physiological indices, swimming technique, and their influence on 200m breaststroke race in young swimmers.

    PubMed

    Strzala, Marek; Stanula, Arkadiusz; Głab, Grzegorz; Glodzik, Jacek; Ostrowski, Andrzej; Kaca, Marcin; Nosiadek, Leszek

    2015-03-01

    The aim of this study was to investigate somatic properties and physiological capacity, and analyze kinematic parameters in the 200 m breaststroke swimming race. Twenty-seven male swimmers participated in the study. They were 15.7±1.98 years old. Their average height was 1.80 ± 0.02 m and lean body mass (LBM) was 62.45 ± 8.29 kg. Physiological exercise capacity was measured in two separate 90 sec. all-out tests, one for the arms and second for legs. During the tests total work of arm cranking (TWAR) and cycling (TWLG) as well as peak of VO2 for arm (VO2peakAR) and leg (VO2peakLG) were measured. The underwater swimmers body movements were recorded during the all-out swimming 200m breaststroke speed test using an underwater camera installed on a portable trolley. The swimming kinematic parameters and propulsive or non-propulsive movement phases of the arms and legs as well as average speed (V200), surface speed (V200surface) and swimming speed in turn zones (V200turns) were extracted. V200surface was significantly related to the percentage of leg propulsion and was shown to have large effect on VO2peakLG in the Cohen analysis. V200turns depended significantly on the indicators of physiological performance and body structure: TWAR, VO2peak LG and LBM, LBM, which in turn strongly determined the measured results of TWAR, TWLG, VO2peakAR and VO2peakLG. The V200turns and V200surface were strongly associated with V200, 0.92, p < 0.001 and 0.91, p < 0.001 respectively. In each lap of the 200m swimming there was an increased percentage of propulsion of limb movement observed simultaneously with a reduction in the gliding phase in the breaststroke cycles. Key pointsThis study investigated the influence of the selected indicators of somatic properties and physiological capacity as well kinematic and coordination parameters on breaststroke swimming.In this observations the body's functional capacity have an important impact on achieving good breaststroke swimming results

  5. Shaping Physiological Indices, Swimming Technique, and Their Influence on 200m Breaststroke Race in Young Swimmers

    PubMed Central

    Strzala, Marek; Stanula, Arkadiusz; Głab, Grzegorz; Glodzik, Jacek; Ostrowski, Andrzej; Kaca, Marcin; Nosiadek, Leszek

    2015-01-01

    The aim of this study was to investigate somatic properties and physiological capacity, and analyze kinematic parameters in the 200 m breaststroke swimming race. Twenty-seven male swimmers participated in the study. They were 15.7±1.98 years old. Their average height was 1.80 ± 0.02 m and lean body mass (LBM) was 62.45 ± 8.29 kg. Physiological exercise capacity was measured in two separate 90 sec. all-out tests, one for the arms and second for legs. During the tests total work of arm cranking (TWAR) and cycling (TWLG) as well as peak of VO2 for arm (VO2peakAR) and leg (VO2peakLG) were measured. The underwater swimmers body movements were recorded during the all-out swimming 200m breaststroke speed test using an underwater camera installed on a portable trolley. The swimming kinematic parameters and propulsive or non-propulsive movement phases of the arms and legs as well as average speed (V200), surface speed (V200surface) and swimming speed in turn zones (V200turns) were extracted. V200surface was significantly related to the percentage of leg propulsion and was shown to have large effect on VO2peakLG in the Cohen analysis. V200turns depended significantly on the indicators of physiological performance and body structure: TWAR, VO2peak LG and LBM, LBM, which in turn strongly determined the measured results of TWAR, TWLG, VO2peakAR and VO2peakLG. The V200turns and V200surface were strongly associated with V200, 0.92, p < 0.001 and 0.91, p < 0.001 respectively. In each lap of the 200m swimming there was an increased percentage of propulsion of limb movement observed simultaneously with a reduction in the gliding phase in the breaststroke cycles. Key points This study investigated the influence of the selected indicators of somatic properties and physiological capacity as well kinematic and coordination parameters on breaststroke swimming. In this observations the body’s functional capacity have an important impact on achieving good breaststroke swimming results

  6. USING THE DELPHI TECHNIQUE TO DEVELOP EFFECTIVENESS INDICATORS FOR SOCIAL MARKETING COMMUNICATION TO REDUCE HEALTH-RISK BEHAVIORS AMONG YOUTH.

    PubMed

    Vantamay, Nottakrit

    2015-09-01

    This study aimed to develop effectiveness indicators for social marketing communication to reduce health-risk behaviors among Thai youth by using the Delphi technique. The Delphi technique is a research approach used to gain consensus through a series of two or more rounds of questionnaire surveys where information and results are fed back to panel members between each round and it has been extensively used to generate many indicators relevant to health behaviors. The Delphi technique was conducted in 3 rounds by consulting a panel of 15 experts in the field of social marketing communication for public health campaigns in Thailand. We found forty-nine effectiveness indicators in eight core components reached consensus. These components were: 1) attitude about health-risk behavior reduction, 2) subjective norms, 3) perceived behavioral control, 4) intention to reduce health-risk behaviors, 5) practices for reducing health-risk behaviors, 6) knowledge about the dangers and impact of health-risk behaviors, 7) campaign brand equity, and 8) communication networks. These effectiveness indicators could be applied by health promotion organizations for evaluating the effectiveness of social marketing communication to effectively reduce health-risk behaviors among youth. PMID:26863866

  7. Indications, surgical technique, and long-term functional results of colon interposition or bypass.

    PubMed Central

    DeMeester, T R; Johansson, K E; Franze, I; Eypasch, E; Lu, C T; McGill, J E; Zaninotto, G

    1988-01-01

    Over a 17-year period, 92 patients with esophageal disease underwent colon interposition or bypass, with each operation performed by the same surgeon. The indication was cure of cancer in 20 patients, relief of dysphagia in 55 (cancer in 17 patients and benign in 38), loss of gastrointestinal (G.I.) continuity in ten, and tracheoesophageal fistula in seven patients (malignant in five, benign in 2). The thirty-day operative mortality rate was 5%, and the hospital mortality rate was 9%. Graft necrosis occurred in seven of 92 patients, four of whom later underwent a successful second reconstruction. Thirteen patients required subsequent revisional surgery. In 85 patients, the left colon based on the inferior mesenteric artery was used, and in seven, the right colon was used. Technical insights were gained to help preserve the blood supply to the graft and improve its function in transporting food. Thirty-four patients were available for interview 2-17 years after operation (median of 5 years) 28 of whom had benign disease, and six of whom had malignant disease); 82% of the patients felt they were cured of their preoperative symptoms, 18% improved, and none worsened. Eighty-eight per cent of the patients were able to receive an unrestricted diet. All patients except one were satisfied with the results of surgery, and, asked what they would do if they had to make the choice again, all responded that they would have the operation. Twenty-six of the interviewed patients had their eating ability evaluated with a test meal and the transit time of a liquid and solid barium bolus measured. Compared to controls, patients with colon interpositions consumed a smaller capacity meal over a longer period of time and were not dependent on liquids to flush the food through the colon graft. A colon interposition provides good quality of deglutition, is very durable, and is the organ of choice for patients who require an esophageal substitute and are potential candidates for long

  8. An audit of indications and techniques for supraclavicular fossa irradiation in early breast cancer in the United Kingdom.

    PubMed

    Landau, D B; Laing, R W

    2000-01-01

    This article describes an audit of the indications and techniques used by clinical oncologists in the United Kingdom (UK) in the delivery of adjuvant radiotherapy to the supraclavicular fossa (SCF) in patients with early breast cancer. A postal questionnaire was sent to one consultant clinical oncologist in each UK radiotherapy centre in November 1999. These were the same individuals listed in the Maher Committee Report as providing breast cancer services. Forty-one out of 51 completed forms were returned. The results show significant variation in the indications for SCF irradiation and for the definition of the radiotherapy target volume. We discuss the possible basis for the variations found in the audit. There was broad agreement on technique, in particular on the need for matching the tangential and SCF fields and maintaining patient position between fields, factors that are likely to minimize serious morbidity, including brachial plexus injury. PMID:10942334

  9. Determination of the mean cross-sectional area of the thoracic aorta using a double indicator dilution technique.

    PubMed

    Kornet, L; Jansen, J R; Gussenhoven, E J; Versprille, A

    1996-10-01

    A double indicator dilution technique for determining the mean cross-sectional area (CSA) of a blood vessel in vivo is presented. Analogous to the thermodilution method, dilution of hypertonic saline was measured by an electrical conductance technique. Because the change in conductance rather than absolute conductance was used to calculate CSA, pulsatile changes in shear rate of blood and conductance of surrounding tissues had no effect on the data. To calculate CSA from an ion mass balance, cardiac output was needed and estimated from the thermodilution curve using the same "cold" (hypertonic) saline injection. The mean CSA, obtained from this double indicator dilution method (CSAGD), was compared with the CSA obtained from the intravascular ultrasound method (IVUS) in 44 paired observations in six piglets. The regression line is close to the line of identity (CSAGD = -1.83 + 1.06 . CSAIVUS, r = 0.96). The difference between both CSAs was independent of the diameter of the vessel, on average -0.99 mm2 +/- 2.64 mm2 (mean CSAGD = 46.84 +/- 8.21 mm2, mean CSAIVUS = 47.82 +/- 9.08 mm2) and not significant. The results show that the double indicator dilution method is a reliable technique for estimating the CSA of blood vessels in vivo. PMID:8781202

  10. Urinary catheterization may not adversely impact quality of life in multiple sclerosis patients.

    PubMed

    James, Rebecca; Frasure, Heidi E; Mahajan, Sangeeta T

    2014-01-01

    Background. Multiple sclerosis (MS) healthcare providers (HCP) have undergone considerable educational efforts regarding the importance of evaluating and treating pelvic floor disorders, specifically, urinary dysfunction. However, limited data are available to determine the impact of catheterization on patient quality of life (QoL). Objectives. To describe the use of urinary catheterization among MS patients and determine the differences between those who report positive versus negative impact of this treatment on QoL. Methods. Patients were queried as part of the 2010 North American Research Committee On Multiple Sclerosis survey; topics included 1) urinary/bladder, bowel, or sexual problems; 2) current urine leakage; 3) current catheter use; 4) catheterizing and QoL. Results. Respondents with current urine leakage were 5143 (54.7%), of which 1201 reported current catheter use (12.8%). The types of catheters (intermittent self-catheterization and Foley catheter (indwelling and suprapubic)) did not differ significantly. Of the current catheter users, 304 (25.35%) respondents reported catheterization negatively impacting QoL, 629 (52.4%) reported a positive impact on QoL, and 223 (18.6%) reported neutral QoL. Conclusions. A large proportion of catheterized MS patients report negative or positive changes in QoL associated with urinary catheterization. Urinary catheterization does not appear to have a universally negative impact on patient QoL. PMID:25006498

  11. Optimizing Radiation Safety in the Cardiac Catheterization Laboratory: A Practical Approach.

    PubMed

    Christopoulos, Georgios; Makke, Lorenza; Christakopoulos, Georgios; Kotsia, Anna; Rangan, Bavana V; Roesle, Michele; Haagen, Donald; Kumbhani, Dharam J; Chambers, Charles E; Kapadia, Samir; Mahmud, Ehtisham; Banerjee, Subhash; Brilakis, Emmanouil S

    2016-02-01

    Reducing radiation exposure during cardiovascular catheterization is of paramount importance for both patient and staff safety. Over the years, advances in equipment and application of radiation safety protocols have significantly reduced patient dose and operator exposure. This review examines the current status of radiation protection in the cardiac and vascular catheterization laboratory and summarizes best practices for minimizing radiation exposure. PMID:26526181

  12. Left atrial appendage closure-indications, techniques, and outcomes: results of the European Heart Rhythm Association Survey.

    PubMed

    Pison, Laurent; Potpara, Tatjana S; Chen, Jian; Larsen, Torben B; Bongiorni, Maria Grazia; Blomström-Lundqvist, Carina

    2015-04-01

    The purpose of this EP Wire was to assess the indications, techniques, and outcomes of left atrial appendage occlusion (LAAO) in Europe. Thirty-three European centres, all members of the European Heart Rhythm Association electrophysiology (EP) research network, responded to this survey by completing the questionnaire. The major indication for LAAO (94%) was the prevention of stroke in patients at high thrombo-embolic risk (CHA2DS2-VASc ≥ 2) and contraindications to oral anticoagulants (OACs). Twenty-one (64%) of the responding centres perform LAAO in their own institution and 80% implanted 30 or less LAAO devices in 2014. Two-dimensional transoesophageal echocardiography was the preferred imaging technique to visualize LAA before, during, and after LAAO in 79, 58, and 62% of the participating centres, respectively. Following LAAO, 49% of the centres prescribe vitamin K antagonists or novel OACs. Twenty-five per cent of the centres combine LAAO with pulmonary vein isolation. The periprocedural complications included death (range, 0-3%), ischaemic or haemorrhagic stroke (0-25%), tamponade (0-25%), and device embolization (0-20%). In conclusion, this EP Wire has demonstrated that LAAO is most commonly employed in patients at high thrombo-embolic risk in whom OAC is contraindicated. The technique is not yet very widespread and the complication rates remain significant. PMID:25833883

  13. Changing indications and techniques for corneal transplantations at a tertiary referral center in Turkey, from 1995 to 2014

    PubMed Central

    Altay, Yesim; Burcu, Ayse; Aksoy, Gozde; Ozdemir, Evin Singar; Ornek, Firdevs

    2016-01-01

    Background Indications for corneal transplantation in developed and developing nations differ according to the different spectrum of corneal disease in each country. Objective The purpose of this study is to analyze the changing indications and surgical techniques for corneal transplantation over the past 20 years at a tertiary referral center in Turkey. Methods We retrospectively reviewed the records of patients who underwent keratoplasty from January 1995 to December 2014 (between 1995 and 2004, period 1, and between 2005 and 2014, period 2). Patients’ demographic data, indications for corneal transplantation, and the type of surgery were recorded. Results The number of keratoplasties performed ranged from 548 in period 1 to 782 in period 2. Between 1995 and 2004, the leading indications were keratoconus (34.1%), bullous keratopathy (17%), and non-herpetic corneal scar (13.3%), and between 2005 and 2014, they were keratoconus (33.8%), corneal stromal dystrophy (14.2%), and bullous keratopathy (12.7%). All the keratoplasties performed in the 1995–2004 period were penetrating keratoplasty (PKP). During the period 2005–2014, PKP accounted for 93%, automated lamellar keratoplasty 5.8%, and deep anterior lamellar keratoplasty 1.2% of all corneal transplantations. Conclusion Keratoconus was the leading indication for keratoplasty in both periods. In the 2005–2014 period, corneal stromal dystrophy increased significantly. All the keratoplasties performed in period 1 and 93% of all keratoplasties performed in period 2 were PKP. PMID:27330270

  14. Trends in Indications and Techniques of Corneal Transplantation in Iran from 2006 to 2013; an 8-year Review

    PubMed Central

    Rezaei Kanavi, Mozhgan; Javadi, Mohammad Ali; Motevasseli, Tahmineh; Chamani, Tahereh; Rezaei Kanavi, Mahnoush; Kheiri, Bahareh; Safi, Sare

    2016-01-01

    Purpose: To report changing trends in indications and techniques of corneal transplantation in Iran. Methods: We reviewed eye bank records of 47,129 patients who had undergone corneal transplantation between 2006 and 2013 at different eye centers throughout Iran. Results: The most common indication for corneal transplantation was keratoconus (KCN, n = 21,350 eyes, 45.3%), followed by bullous keratopathy (BK, n = 8,566 eyes, 18.2%), corneal opacity and scar (COS, n = 7,158 eyes, 15.2%), graft failure (n = 3,252 eyes, 6.9%), corneal dystrophies (n = 2,553 eyes, 5.4%), and infectious keratitis (n = 2,238 eyes, 4.7%). Over the study period, there was a significant increase in the frequency of BK (P = 0.001) and graft failure (P = 0.025), and a significant decrease in the relative frequency of COS (P = 0.012). The prevalence of KCN (P = 0.172), infectious keratitis (P = 0.107), and corneal dystrophies (P = 0.836) remained unchanged. The most common technique of corneal transplantation was penetrating keratoplasty (PKP, n = 33,476 eyes, 71.0%), followed by deep anterior lamellar keratoplasty (DALK, n = 8,363 eyes, 17.7%), Descemet's stripping automated endothelial keratoplasty (DSAEK, n = 3,516 eyes, 7.5%), tectonic (n = 1752, 3.7%), and keratolimbal allograft (KLAL, n = 19 eyes, 0.1%). Regarding the shift in surgical techniques, a significant increase was observed in DSAEK (P < 0.001), whereas PKP was significantly decreased (P = 0.005) over the 8-year period. No significant change was seen in the rates of DALK (P = 0.354), tectonic graft (P > 0.999) and KLAL (P = 0.151). Conclusion: KCN was the most common indication and PKP was the most prevalent technique used for corneal transplantation. Significant changes in surgical techniques were observed over the past 8 years; DSAEK demonstrated an increasing trend while PKP showed a decrease.

  15. Long-Term Catheterization of the Intestinal Lymph Trunk and Collection of Lymph in Neonatal Pigs.

    PubMed

    Uwiera, Richard R; Mangat, Rabban; Kelly, Sandra; Uwiera, Trina C; Proctor, Spencer D

    2016-01-01

    Catheterization of the intestinal lymph trunk in neonatal pigs is a technique allowing for the long-term collection of large quantities of intestinal (central) efferent lymph. Importantly, the collection of central lymph from the intestine enables researchers to study both the mechanisms and lipid constitutes associated with lipid metabolism, intestinal inflammation and cancer metastasis, as well as cells involved in immune function and immunosurveillance. A ventral mid-line surgical approach permits excellent surgical exposure to the cranial abdomen and relatively easy access to the intestinal lymph trunk vessel that lies near the pancreas and the right ventral segment of the portal vein underneath the visceral aspect of the right liver lobe. The vessel is meticulously dissected and released from the surrounding fascia and then dilated with sutures allowing for insertion and subsequent securing of the catheter into the vessel. The catheter is exteriorized and approximately 1 L/24 hr of lymph is collected over a 7 day period. While this technique enables the collection of large quantities of central lymph over an extended period of time, the success depends on careful surgical dissection, tissue handling and close attention to proper surgical technique. This is particularly important with surgeries in young animals as the lymph vessels can easily tear, potentially leading to surgical and experimental failure. The video demonstrates an excellent surgical technique for the collection of intestinal lymph. PMID:27023826

  16. Image-guided high-dose-rate brachytherapy of malignancies in various inner organs - technique, indications, and perspectives.

    PubMed

    Bretschneider, Tina; Ricke, Jens; Gebauer, Bernhard; Streitparth, Florian

    2016-06-01

    In the last few years, minimally invasive tumor ablation performed by interventional radiologists has gained increasing relevance in oncologic patient care. Limitations of thermal ablation techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), and laser-induced thermotherapy (LITT), including large tumor size, cooling effects of adjacent vessels, and tumor location near thermosensitive structures, have led to the development of image-guided high-dose-rate (HDR) brachytherapy, especially for the treatment of liver malignancies. This article reviews technical properties of image-guided brachytherapy, indications and its current clinical role in multimodal cancer treatment. Furthermore, perspectives of this novel therapy option will be discussed. PMID:27504135

  17. Image-guided high-dose-rate brachytherapy of malignancies in various inner organs – technique, indications, and perspectives

    PubMed Central

    Bretschneider, Tina; Ricke, Jens; Gebauer, Bernhard

    2016-01-01

    In the last few years, minimally invasive tumor ablation performed by interventional radiologists has gained increasing relevance in oncologic patient care. Limitations of thermal ablation techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), and laser-induced thermotherapy (LITT), including large tumor size, cooling effects of adjacent vessels, and tumor location near thermosensitive structures, have led to the development of image-guided high-dose-rate (HDR) brachytherapy, especially for the treatment of liver malignancies. This article reviews technical properties of image-guided brachytherapy, indications and its current clinical role in multimodal cancer treatment. Furthermore, perspectives of this novel therapy option will be discussed. PMID:27504135

  18. Neonatal Cardio-pulmonary Arrest: Emergency Catheterization of Umbilical Vein

    PubMed Central

    Paes, Bosco A.; Blatz, Susan; Kraftcheck, D.J.

    1990-01-01

    In an emergency, the physician responsible for neonatal care must be skilled in umbilical catheterization. Several drugs can be given through an endotracheal tube, but some require intravenous administration. The umbilical vein is a better route of administration than peripheral veins because it is easily located and can be entered readily. It allows immediate access to the central circulation, enhancing drug distribution. The authors outline the procedure in a step-by-step description. This pictorial article can be used as a handy reference by physicians needing to administer fluids and drugs during cardio-pulmonary arrest in neonates. Imagesp1136-ap1136-bp1136-cp1136-dp1137-ap1137-bp1137-cp1137-dp1137-ep1138-ap1138-bp1138-cp1138-dp1139-ap1139-bp1139-cp1139-dp1140-ap1140-bp1140-cp1140-d PMID:21233982

  19. Vestibular system paresis due to emergency endovascular catheterization

    PubMed Central

    Simoceli, Lucinda; Sguillar, Danilo Anunciatto; Santos, Henrique Mendes Paiva; Caputti, Camilla

    2012-01-01

    Summary Objective: The objective of this story of case is to describe an uncommon cause of associated peripheral Vestibulopathy to the unilateral auditory loss in aged patient after catheterization of urgency. Story of case: Patient of the masculine sort, 82 years, submitted to the correction of abdominal ragged aneurism of aorta, in the intra-operative suffered heart attack acute from the myocardium needing primary angioplasty. High after hospital it relates to complaint of accented hearing loss to the right and crippling vertigo, without focal neurological signals. To the otorhinolaryngological clinical examination it presented: Test of Weber lateralized for the left, spontaneous nystagmus for the left, marches rocking, has taken normal disbasia and ataxia, index-nose and diadochokinesia, Test of Romberg with oscillation without fall and Fukuda with lateral shunting line for the right. The audiometric examination evidenced deafness to the right and sensorineural loss to the left in sharps, areflexia initial to the right in caloric test e, the computerized tomography of the secular bones and brainstem, presence of metallic connecting rod crossing the right secular bone, from the vein internal jugular vein and bulb jugular vein, crossing the posterior, superior and vestibule semicircular canals, projecting itself in temporal lobe. The radiological diagnoses was traumatic injury for guide to endovascular metallic during catheterization of urgency and the behavior, considering that the patient had not compensated the balance, it was vestibular rehabilitation. Conclusion: Complaints of giddiness in the aged patient must be closely evaluated of its pathological clinical description because the antecedents of illnesses and previous treatments, in general, direct the diagnostic hypotheses however they can bring unexpected alterations. PMID:25991947

  20. Near infrared spectroscopy monitoring in the pediatric cardiac catheterization laboratory.

    PubMed

    Tanidir, Ibrahim Cansaran; Ozturk, Erkut; Ozyilmaz, Isa; Saygi, Murat; Kiplapinar, Neslihan; Haydin, Sertac; Guzeltas, Alper; Odemis, Ender

    2014-10-01

    Near-infrared spectroscopy (NIRS) is a noninvasive method used to evaluate tissue oxygenation. We evaluated the relationship between cerebral and renal NIRS parameters during transcatheter intervention and adverse events in the catheterization room. Between January 1 and May 31, 2012, 123 of 163 pediatric patients undergoing cardiac catheterization were followed by NIRS. All were monitored by electrocardiography, noninvasive blood pressure measurement, pulse oxymetry, initial and final blood lactate level measurement. The number of interventional procedures was 73 (59%). During the procedures, 39 patients experienced a total of 41 adverse events: 18 (19.5%) had desaturation, 10 (8.1%) arrhythmia, three (2.4%) had respiratory difficulty, six (4.8%) had a situation calling for cardiopulmonary resuscitation, three (2.4%) had anemia necessitating transfusion, and one (0.8%) had a cyanotic spell. Cranial NIRS values worsened in 12 (9.8%) and renal measurements worsened in 13 (12.5%) patients. The sensitivity and specificity of a 9% impairment of cranial values were 90 and 61%, respectively, while the corresponding calculations for a 21% fall in renal measurements were 54% sensitivity and 90% specificity. When arrhythmia developed, NIRS values fell simultaneously, while the development of a desaturation problem was heralded by NIRS falling 10-15 s earlier than changes in pulse oxymetry; on improving saturation, NIRS returned to earlier values 10-15 s before pulse oxymetry readings. NIRS monitoring may provide an early warning with regard to complications likely to develop during a procedure. A fall of 9% in cranial NIRS values, or of 21% in renal measurements, should raise clinician awareness. PMID:24404951

  1. Obtaining oblique technique source-to-skin distances for irregular field (Clarkson) calculations: The Mayo Off-axis Distance Indicator

    SciTech Connect

    Lajoie, W.N. )

    1988-09-01

    Significant dose inhomogeneities may exist between the supraclavicular fossa (SCF) and the internal mammary chain (IMC) regions in the irregular L-shaped (hockey stick) field associated with breast cancer treatments. This dose inhomogeneity exists, in part, because of a positive air gap in the SCF and a negative air gap in the IMC locations. Independent of treatment technique, (i.e., whether anterior-posterior (AP) or oblique fields are used), accurate source-to-skin distance (SSD) values for the SCF, IMC, and axilla are necessary when doing an irregular field (Clarkson) dose calculation. However, when an oblique technique is used to treat the hockey stick field, obtaining non-central-axis SSDs is not as straightforward as when an AP technique is employed. The Mayo Off-axis Distance Indicator was constructed to slide into the blocking tray slot of the simulator or treatment machine. This mechanical measuring device provides quick and accurate SSD measurements for non-central-axis points under either AP or, more importantly, oblique treatment conditions.

  2. Techniques for Estimating Emissions Factors from Forest Burning: ARCTAS and SEAC4RS Airborne Measurements Indicate Which Fires Produce Ozone

    NASA Technical Reports Server (NTRS)

    Chatfield, Robert B.; Andreae, Meinrat O.

    2015-01-01

    Previous studies of emission factors from biomass burning are prone to large errors since they ignore the interplay of mixing and varying pre-fire background CO2 levels. Such complications severely affected our studies of 446 forest fire plume samples measured in the Western US by the science teams of NASA's SEAC4RS and ARCTAS airborne missions. Consequently we propose a Mixed Effects Regression Emission Technique (MERET) to check techniques like the Normalized Emission Ratio Method (NERM), where use of sequential observations cannot disentangle emissions and mixing. We also evaluate a simpler "consensus" technique. All techniques relate emissions to fuel burned using C(sub burn) = delta C(sub tot) added to the fire plume, where C(sub tot) approximately equals (CO2 + CO). Mixed-effects regression can estimate pre-fire background values of Ctot (indexed by observation j) simultaneously with emissions factors indexed by individual species i, delta epsilon lambda tau alpha-x(sub i)/(C(sub burn))i,j., MERET and "consensus" require more than two emissions indicators. Our studies excluded samples where exogenous CO or CH4 might have been fed into a fire plume, mimicking emission. We sought to let the data on 13 gases and particulate properties suggest clusters of variables and plume types, using non-negative matrix factorization (NMF). While samples were mixtures, the NMF unmixing suggested purer burn types. Particulate properties (bscat, babs, SSA, AAE) and gas-phase emissions were interrelated. Finally, we sought a simple categorization useful for modeling ozone production in plumes. Two kinds of fires produced high ozone: those with large fuel nitrogen as evidenced by remnant CH3CN in the plumes, and also those from very intense large burns. Fire types with optimal ratios of delta-NOy/delta- HCHO associate with the highest additional ozone per unit Cburn, Perhaps these plumes exhibit limited NOx binding to reactive organics. Perhaps these plumes exhibit limited NOx

  3. Techniques for Estimating Emissions Factors from Forest Burning: ARCTAS and SEAC4RS Airborne Measurements Indicate which Fires Produce Ozone

    NASA Technical Reports Server (NTRS)

    Chatfield, Robert B.; Andreae, Meinrat O.

    2016-01-01

    Previous studies of emission factors from biomass burning are prone to large errors since they ignore the interplay of mixing and varying pre-fire background CO2 levels. Such complications severely affected our studies of 446 forest fire plume samples measured in the Western US by the science teams of NASA's SEAC4RS and ARCTAS airborne missions. Consequently we propose a Mixed Effects Regression Emission Technique (MERET) to check techniques like the Normalized Emission Ratio Method (NERM), where use of sequential observations cannot disentangle emissions and mixing. We also evaluate a simpler "consensus" technique. All techniques relate emissions to fuel burned using C(burn) = delta C(tot) added to the fire plume, where C(tot) approximately equals (CO2 = CO). Mixed-effects regression can estimate pre-fire background values of C(tot) (indexed by observation j) simultaneously with emissions factors indexed by individual species i, delta, epsilon lambda tau alpha-x(sub I)/C(sub burn))I,j. MERET and "consensus" require more than emissions indicators. Our studies excluded samples where exogenous CO or CH4 might have been fed into a fire plume, mimicking emission. We sought to let the data on 13 gases and particulate properties suggest clusters of variables and plume types, using non-negative matrix factorization (NMF). While samples were mixtures, the NMF unmixing suggested purer burn types. Particulate properties (b scant, b abs, SSA, AAE) and gas-phase emissions were interrelated. Finally, we sought a simple categorization useful for modeling ozone production in plumes. Two kinds of fires produced high ozone: those with large fuel nitrogen as evidenced by remnant CH3CN in the plumes, and also those from very intense large burns. Fire types with optimal ratios of delta-NOy/delta- HCHO associate with the highest additional ozone per unit Cburn, Perhaps these plumes exhibit limited NOx binding to reactive organics. Perhaps these plumes exhibit limited NOx binding to

  4. LipStaT: The Lip Stabilization Technique- Indications and Guidelines for Case Selection and Classification of Excessive Gingival Display.

    PubMed

    Bhola, Monish; Fairbairn, Peter Jm; Kolhatkar, Shilpa; Chu, Stephen J; Morris, Tamaara; de Campos, Marinele

    2015-01-01

    Excessive gingival display (EGD) is an esthetic concern affecting a substantial portion of the population. Identification, diagnosis, and classification of all factors resulting in EGD are imperative for its appropriate management. While many authors have described these factors individually, the authors of the current study propose a simple classification, which includes major etiologies of EGD. Where EGD is associated with maxillary lip hypermobility, a proposal of a subclass 1-3 is offered. A "decision-making tree" to help guide clinicians in managing EGD is included. A detailed description of the lip stabilization technique (LipStaT), including indications, surgical guidelines, postsurgical management, and clinical cases with long-term follow-up, is presented. PMID:26133145

  5. Technique to select the optimum modulation indices for suppression of undesired signals for simultaneous range and data operations

    NASA Astrophysics Data System (ADS)

    Nguyen, Tien Manh

    An algorithm to search for the optimum set of modulation indices that will optimize a given simultaneous range/command/telemetry communications link is presented. This technique provides a way to suppress the ranging signal in order to limit performance degradation in the data channel due to interference from the ranging channel to a desired level, given a specified ranging accuracy. The link (when optimized) will (1) provide maximum available power to both the data and ranging channels for a specified degradation in the data channel so that it will transmit at the required data rate, (2) achieve a specified ranging accuracy over a maximum distance, under a certain set of conditions, and (3) provide adequate power for carrier tracking without degrading the data-channel thresholds. In addition, both data and ranging channels will fall below the threshold at the same point.

  6. Surgical approaches for the management of idiopathic thoracic scoliosis and the indications for combined anterior-posterior technique.

    PubMed

    Rauzzino, M J; Shaffrey, C I; Wagner, J; Nockels, R; Abel, M

    1999-05-15

    The indications for surgical intervention in patients with idiopathic scoliosis have been well defined. The goals of surgery are to achieve fusion and arrest progressive curvature while restoring normal coronal and sagittal balance. As first introduced by Harrington, posterior fusion, the gold standard of treatment, has a proven record of success. More recently, anterior techniques for performing fusion procedures via either a thoracotomy or a retroperitoneal approach have been popularized in attempts to achieve better correction of curvature, preserve motion segments, and avoid some of the complications of posterior fusion such as the development of the flat-back syndrome. Anterior instrumentation alone, although effective, can be kyphogenic and has been shown to be associated with complications such as pseudarthrosis and instrumentation failure. Performing a combined approach in patients with scoliosis and other deformities has become an increasingly popular procedure to achieve superior correction of deformity and to minimize later complications. Indications for a combined approach (usually consisting of anterior release, arthrodesis with or without use of instrumentation, and posterior segmental fusion) include: prevention of crankshaft phenomenon in juvenile or skeletally immature adolescents; correction of large curves (75 degrees ) or excessively rigid curves in skeletally mature or immature patients; correction of curves with large sagittal-plane deformities such as thoracic kyphosis (> 90 degrees ) or thoracic lordosis (> 20 degrees ); and correction of thoracolumbar curves that need to be fused to the sacrum. Surgery may be performed either in a staged proceedure or, more commonly, in a single sitting. The authors discuss techniques for combined surgery and complication avoidance. PMID:17031912

  7. Application of image restoration and three-dimensional visualization techniques to frog microvessels in-situ loaded with fluorescent indicators

    NASA Astrophysics Data System (ADS)

    Pagakis, Stamatis N.; Curry, Fitz-Roy E.; Lenz, Joyce F.

    1993-07-01

    In situ experiments on microvessels require image sensors of wide dynamic range due to large variations of the intensity in the scene, and 3D visualization due to the thickness of the preparation. The images require restoration because of the inherent tissue movement, out-of- focus-light contamination, and blur. To resolve the above problems, we developed an imaging system for quantitative imaging based on a 12 bits/pixel cooled CCD camera and a PC based digital imaging system. We applied the optical sectioning technique with image restoration using a modified nearest neighbor algorithm and iterative constrained deconvolution on each of the 2D optical sections. For the 3D visualization of the data, a volume rendering software was used. The data provided 3D images of the distribution of fluorescent indicators in intact microvessels. Optical cross sections were also compared with cross sections of the same microvessels examined in the electron microscope after their luminal surfaces were labeled with a tracer which was both electron dense and fluorescent. This procedure enabled precise identification of the endothelial cells in the microvessel wall as the principal site of accumulation of the fluorescent calcium indicator, fura-2, during microperfusion experiments.

  8. Occupational radiation doses to operators performing cardiac catheterization procedures.

    PubMed

    Kim, Kwang Pyo; Miller, Donald L; Balter, Stephen; Kleinerman, Ruth A; Linet, Martha S; Kwon, Deukwoo; Simon, Steven L

    2008-03-01

    Cardiac catheterization procedures using fluoroscopy reduce patient morbidity and mortality compared to operative procedures. These diagnostic and therapeutic procedures require radiation exposure to patients and physicians. The objectives of the present investigation were to provide a systematic comprehensive summary of the reported radiation doses received by operators due to diagnostic or interventional fluoroscopically-guided procedures, to identify the primary factors influencing operator radiation dose, and to evaluate whether there have been temporal changes in the radiation doses received by operators performing these procedures. Using PubMed, we identified all English-language journal articles and other published data reporting radiation exposures to operators from diagnostic or interventional fluoroscopically-guided cardiovascular procedures from the early 1970's through the present. We abstracted the reported radiation doses, dose measurement methods, fluoroscopy system used, operational features, radiation protection features, and other relevant data. We calculated effective doses to operators in each study to facilitate comparisons. The effective doses ranged from 0.02-38.0 microSv for DC (diagnostic catheterizations), 0.17-31.2 microSv for PCI (percutaneous coronary interventions), 0.24-9.6 microSv for ablations, and 0.29-17.4 microSv for pacemaker or intracardiac defibrillator implantations. The ratios of doses between various anatomic sites and the thyroid, measured over protective shields, were 0.9 +/- 1.0 for the eye, 1.0 +/- 1.5 for the trunk, and 1.3 +/- 2.0 for the hand. Generally, radiation dose is higher on the left side of an operator's body, because the operator's left side is closer to the primary beam when standing at the patient's right side. Modest operator dose reductions over time were observed for DC and ablation, primarily due to reduction in patient doses due to decreased fluoroscopy/cineradiography time and dose rate by technology

  9. A New Measurement Equivalence Technique Based on Latent Class Regression as Compared with Multiple Indicators Multiple Causes

    PubMed Central

    Jamali, Jamshid; Ayatollahi, Seyyed Mohammad Taghi; Jafari, Peyman

    2016-01-01

    Background: Measurement equivalence is an essential prerequisite for making valid comparisons in mental health questionnaires across groups. In most methods used for assessing measurement equivalence, which is known as Differential Item Functioning (DIF), latent variables are assumed to be continuous. Objective: To compare a new method called Latent Class Regression (LCR) designed for discrete latent variable with the multiple indicators multiple cause (MIMIC) as a continuous latent variable technique to assess the measurement equivalence of the 12-item General Health Questionnaire (GHQ-12), which is a cross deferent subgroup of Iranian nurses. Methods: A cross-sectional survey was conducted in 2014 among 771 nurses working in the hospitals of Fars and Bushehr provinces of southern Iran. To identify the Minor Psychiatric Disorders (MPD), the nurses completed self-report GHQ-12 questionnaires and sociodemographic questions. Two uniform-DIF detection methods, LCR and MIMIC, were applied for comparability when the GHQ-12 score was assumed to be discrete and continuous, respectively. Results: The result of fitting LCR with 2 classes indicated that 27.4% of the nurses had MPD. Gender was identified as an influential factor of the level of MPD.LCR and MIMIC agree with detection of DIF and DIF-free items by gender, age, education and marital status in 83.3, 100.0, 91.7 and 83.3% cases, respectively. Conclusions: The results indicated that the GHQ-12 is to a great degree, an invariant measure for the assessment of MPD among nurses. High convergence between the two methods suggests using the LCR approach in cases of discrete latent variable, e.g. GHQ-12 and adequate sample size. PMID:27482129

  10. Transradial Approach for Cardiac Catheterization: The New Frontier of Coronary Intervention

    MedlinePlus Videos and Cool Tools

    Transradial approach for cardiac catheterization: The new frontier of coronary intervention Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2016 BroadcastMed, Inc. All rights reserved.

  11. Predicting patient volume in cardiac catheterization laboratory to improve resource management.

    PubMed

    Liu, Jianhua; Santangelo, Jennifer; James, Randy; Watters, Coyt D; Orsini, Anthony; Mekhjian, Hagop; Kamal, Jyoti

    2008-01-01

    Using historical data within the Information Warehouse of the Ohio State University Medical Center, prediction on daily patient volume to catheterization laboratory was attempted to facilitate resource management and planning. PMID:18998829

  12. High Court Requires Schools to Provide Catheterization Services under 94-142.

    ERIC Educational Resources Information Center

    Flygare, Thomas J.

    1984-01-01

    The United States Supreme Court requires school districts to provide catheterization services for handicapped students, in accordance with Public Law 94-142, the Education for All Handicapped Children Act. (DCS)

  13. Real-time MRI-guided right heart catheterization in adults using passive catheters

    PubMed Central

    Ratnayaka, Kanishka; Faranesh, Anthony Z.; Hansen, Michael S.; Stine, Annette M.; Halabi, Majdi; Barbash, Israel M.; Schenke, William H.; Wright, Victor J.; Grant, Laurie P.; Kellman, Peter; Kocaturk, Ozgur; Lederman, Robert J.

    2013-01-01

    Aims Real-time MRI creates images with superb tissue contrast that may enable radiation-free catheterization. Simple procedures are the first step towards novel interventional procedures. We aim to perform comprehensive transfemoral diagnostic right heart catheterization in an unselected cohort of patients entirely using MRI guidance. Methods and results We performed X-ray and MRI-guided transfemoral right heart catheterization in consecutive patients undergoing clinical cardiac catheterization. We sampled both cavae and both pulmonary arteries. We compared success rate, time to perform key steps, and catheter visibility among X-ray and MRI procedures using air-filled or gadolinium-filled balloon-tipped catheters. Sixteen subjects (four with shunt, nine with coronary artery disease, three with other) underwent paired X-ray and MRI catheterization. Complete guidewire-free catheterization was possible in 15 of 16 under both. MRI using gadolinium-filled balloons was at least as successful as X-ray in all procedure steps, more successful than MRI using air-filled balloons, and better than both in entering the left pulmonary artery. Total catheterization time and individual procedure steps required approximately the same amount of time irrespective of image guidance modality. Catheter conspicuity was best under X-ray and next-best using gadolinium-filled MRI balloons. Conclusion In this early experience, comprehensive transfemoral right heart catheterization appears feasible using only MRI for imaging guidance. Gadolinium-filled balloon catheters were more conspicuous than air-filled ones. Further workflow and device enhancement are necessary for clinical adoption. PMID:22855740

  14. Puncture point-traction method: A novel method applied for right internal jugular vein catheterization

    PubMed Central

    WU, TIANLIANG; ZANG, HONGCHENG

    2016-01-01

    The ultrasound probe and advancement of the needle during real-time ultrasound-assisted guidance of catheterization of the right internal jugular vein (RIJV) tend to collapse the vein, which reduces the success rate of the procedure. We have developed a novel puncture point-traction method (PPTM) to facilitate RIJV cannulation. The present study examined whether this method facilitated the performance of RIJV catheterization in anesthetized patients. In this study, 120 patients were randomly assigned to a group in which PPTM was performed (PPTM group, n=60) or a group in which it was not performed (non-PPTM group, n=60). One patient was excluded because of internal carotid artery puncture and 119 patients remained for analysis. The cross-sectional area (CSA), anteroposterior diameter (AD) and transverse diameter (TD) of the RIJV at the cricoid cartilage level following the induction of anesthesia and during catheterization were measured, and the number with obvious loss of resistance (NOLR), the number with easy aspiration of blood into syringe (NEABS) during advancement of the needle, and the number of first-pass punctures (NFPP) during catheterization were determined. In the non-PPTM group, the CSA was smaller during catheterization compared with that following the induction of anesthesia (P<0.01). In the PPTM group compared with the non-PPTM group during catheterization, the CSA was larger (P<0.01) and the AD (P<0.01) and TD (P<0.05) were wider; NOLR (P<0.01), NEABS (P<0.01) and NFPP (P<0.01) increased significantly. The findings from this study confirmed that the PPTM facilitated catheterization of the RIJV and improved the success rate of RIJV catheterization in anesthetized patients in the supine position. PMID:27347054

  15. Cystostomie percutanée à la pince de Kelly: indications, technique et résultats

    PubMed Central

    Diabaté, Ibrahima; Ouédraogo, Bouréima; Sow, Ibrahima; Bâ, Aliou

    2015-01-01

    Introduction La dérivation urinaire sus-pubienne est pratiquée dans différentes circonstances. Cette étude vise à décrire la technique de cystostomie percutanée (CPC) pratiquée à l'aide d'une pince de Kelly pour la pose d'une sonde de Foley, à définir les indications de cette technique et à rapporter les résultats. Méthodes Du 1er janvier 2005 au 31 décembre 2014, il a été réalisé 194 CPC à la pince de Kelly dans notre service, en urgence, sous anesthésie locale, chez des patients en rétention vésicale. Cette technique, dérivée de la cystostomie par ponction au trocart vise à placer dans la vessie une sonde de Foley après incision cutanée et aponévrotique (de 1 cm sur la ligne médiane, à 1,5 - 2 cm au-dessus de la symphyse pubienne) et la ponction vésicale à la pince de Kelly à travers cette incision. Résultats Les 194 patients étaient tous de sexe masculin, âgés en moyenne de 50 ans ± 21 (extrêmes de 17 ans et 86 ans). Les pathologies à l'origine des rétentions vésicales étaient: les rétrécissements urétraux (n=119), les hypertrophies bénignes de la prostate (n=47), les cancers de prostate (n=21), les traumatismes de l'urètre (n=7). Tous les patients ont été opérés avec succès par cette méthode et les suites ont été simples. Le temps de réalisation était de 6 minutes ± 1. Les sondes de Foley mises en place étaient de charrière 16 (n=59), charrière 18 (n=116) et charrière 20 (n=19). La cicatrisation du trajet de la CPC après l'ablation de la sonde de Foley n'a posée aucun problème chez 146 patients suivis, les 48 autres ayant été perdus de vue. Conclusion La CPC à la pince de Kelly est une technique simple, rapide et pas onéreuse. Ses indications sont les mêmes que pour toute CPC et elle représente une alternative à la cystostomie par chirurgie ouverte. PMID:26893798

  16. Estimation of the rate of Ca/sup 2 +/ influx in perfused rat liver using the multiple indicator dilution technique

    SciTech Connect

    Lapointe, D.S.; Olson, M.S.

    1987-05-01

    The multiple indicator dilution technique provides a useful mechanism for the determination of the rates of processes involved in the uptake and subsequent release of substances between an organ, such as the liver, and the vasculature. They have used this technique to investigate the uptake of /sup 45/Ca/sup 2 +/ into the perfused rat liver at a number of different perfusate Ca/sup 2 +/ concentrations. Each perfused liver is calibrated using reference injections of a mixture of /sup 3/H-sucrose and /sup 14/C-urea to determine parameters of a microcirculatory model of the liver, such as the characteristic transit times through vascular spaces and the ratio of tissue volume to extracellular volume. Using a single injection of a mixture of /sup 3/H-sucrose and /sup 45/Ca/sup 2 +/, the profiles of the efflux of the injected tracers are analyzed to estimate the rate constant for uptake of /sup 45/Ca/sup 2 +/. The estimated rate constant for uptake decreases with increasing perfusate Ca/sup 2 +/ concentration (kin = 0.155 +/- 0.036, 0.0896 +/- 0.024, 0.0713 +/- 0.009 for (Ca/sup 2 +/) = 0.05, 0.5, 1.25 mM; n=5). From these data, estimates for the maximum velocity of uptake of Ca/sup 2 +/ and the Ca/sup 2 +/ concentration for half maximal uptake are calculated to be 0.1208 mM/sec and 0.7278 mM respectively.

  17. Cardiac surgery and catheterization in patients with haemophilia.

    PubMed

    MacKinlay, N; Taper, J; Renisson, F; Rickard, K

    2000-03-01

    The present study summarizes the results of 12 cardiac surgical procedures performed in a carrier of Haemophilia B and in six patients with Haemophilia A at a single centre from 1979 to 1998. The median age of the patients at the time of intervention was 56 years ranging from 18 years to 73 years. The six patients with Haemophilia A ranged in severity from moderately to mildly affected. Three patients were hepatitis C antibody positive. No patients were HIV antibody or hepatitis B surface antigen positive. The cardiac procedures included cardiac catheterization (n=4), coronary artery bypass surgery (n=2), percutaneous transluminal coronary angioplasty (n=1), cardiac valve replacement (AVR n=1 and AVR/MVR n=2), and closure of an atrial septal defect and subsequent drainage of a pericardial effusion (n=1). No patients had demonstrable inhibitors at the time of surgery. Haemostasis was achieved with AHF in 10/11 procedures and high purity factor IX (Immunine) in one procedure. The initial procedures involved intermittent bolus factor therapy while more recently, AHF was administered by continuous intravenous infusion. All patients demonstrated excellent intra- and post-operative haemostasis. These results, although from a small and varied group of patients, demonstrate that cardiac surgical procedures can be performed safely in patients with Haemophilia. PMID:10781193

  18. Delayed Sudden Radial Artery Rupture After Left Transradial Coronary Catheterization

    PubMed Central

    Indolfi, Ciro; Passafaro, Francesco; Mongiardo, Annalisa; Spaccarotella, Carmen; Torella, Daniele; Sorrentino, Sabato; Polimeni, Alberto; Emanuele, Vittorio; Curcio, Antonio; De Rosa, Salvatore

    2015-01-01

    Abstract Local complications at the radial access site are not frequent, hence its large diffusion as the preferred access route for endovascular procedures. However, in a time of fast widespreading, better comprehension of all potential complications becomes critical to facilitate their early recognition and the most appropriate treatment. In this case report, we present for the first time a case of sudden massive bleeding at the left wrist, due to spontaneous gross rupture of the left radial artery bleeding 15 days after an endovascular procedure through a left radial arterial access. The patient had been readmitted to the hospital after evidence of local infection at the left wrist with loss of substance. The radial artery was patent with no evidence of pseudoaneurysm. After sudden radial artery rupture, with massive bleeding and suspicion that the local infection could have reached the arterial wall, surgical hemostasis with artery ligation was obtained. Healing of the large wound was then efficiently speeded up using a negative pressure wound therapy. This is the first case of macroscopic radial artery rupture associated with local wrist infection after arterial catheterization. After prompt surgical hemostasis, negative pressure wound therapy was very helpful in favoring healing of the large and deep wound. PMID:25761194

  19. Pharmacotherapy in the cardiac catheterization laboratory: evolution and recent developments.

    PubMed

    Thind, Guramrinder S; Parida, Raunak; Gupta, Nishant

    2014-01-01

    Many recent innovations have been made in developing new antiplatelet and anticoagulant drugs in the last few years, with a total of nine new antithrombotic drugs approved by the Food and Drug Administration after the year 2000. This has revolutionized the medical therapy given to manage acute coronary syndrome and support cardiac catheterization. The concept of dual antiplatelet therapy has been emphasized, and clopidogrel has emerged as the most-popular second antiplatelet drug after aspirin. Newer P2Y12 inhibitors like prasugrel and ticagrelor have been extensively studied and compared to clopidogrel. The role of glycoprotein (Gp) IIb/IIIa inhibitors is being redefined. Other alternatives to unfractionated heparin have become available, of which enoxaparin and bivalirudin have been studied the most. Apart from these, many more drugs with novel therapeutic targets are being studied and are currently under development. In this review, current evidence on these drugs is presented and analyzed in a way that would facilitate decision making for the clinician. For this analysis, various high-impact clinical trials, pharmacological studies, meta-analyses, and reviews were accessed through the MEDLINE database. Adopting a unique interdisciplinary approach, an attempt has been made to integrate pharmacological and clinical evidence to better understand and appreciate the pros and cons of each of these classes of drugs. PMID:25364258

  20. Incidence and Predictors of Radial Artery Occlusion Associated Transradial Catheterization

    PubMed Central

    Tuncez, Abdullah; Kaya, Zeynettin; Aras, Dursun; Yıldız, Abdulkadir; Gül, Enes Elvin; Tekinalp, Mehmet; Karakaş, Mehmet Fatih; Kısacık, Halil Lütfü

    2013-01-01

    In this study, we sought to assess the incidence and predictors of radial artery occlusion (RAO), which is a significant complication of transradial cardiac catheterization. We prospectively evaluated the results of 106 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) via the transradial approach (TRA). At the 3rd h of intervention, the radial artery was checked by palpation; color doppler ultrasonography was performed at the 24th h. Fluoroscopy duration, procedure success, and complications of the radial artery were recorded. The procedure was successfully completed in all patients. RAO was detected in eight female and two male patients. In terms of RAO, there was a statistically significant difference between males and females (p=0.019). Other parameters did not show a significant correlation with RAO. Altough did not have any effect on procedural success, eight patients developed transient radial artery spasm. Gender was not associated with radial arterial spasms (p=0.19). TRA in the diagnosis and treatment of coronary artery disease has shown high procedural success and low complication rates; it addition, it presents a low economic burden. It should be used widely and be involved in the routine cardiology residency program. PMID:24151442

  1. Assessment of protein requirement in octogenarian women with use of the indicator amino acid oxidation technique123

    PubMed Central

    Tang, Minghua; McCabe, George P; Elango, Rajavel; Pencharz, Paul B; Ball, Ronald O; Campbell, Wayne W

    2014-01-01

    Background: Data on the protein requirements of elderly adults are limited, because it is impractical to conduct repeated nitrogen balance protocols in these vulnerable humans. Objective: This study was designed to determine the dietary protein requirement of elderly women by using the recently developed minimally invasive indicator amino acid oxidation (IAAO) technique. Design: Six white women aged 80–87 y [mean ± SEM: 82 ± 1 y and body mass index (in kg/m2) 26 ± 2] completed a 3-d protocol 7 times. Each woman consumed an adaptation diet for 2 d and on day 3 consumed a complete test diet with a crystalline amino acid mixture containing 1 of 7 protein intakes (0.1, 0.3, 0.6, 0.9, 1.2, 1.5, or 1.8 g · kg−1 · d−1) tested randomly. A group-based protein requirement was assessed by using a nonlinear mixed model of protein intake and l-[1-13C]phenylalanine oxidation. The breakpoint, at which there was no further decline in the rate of appearance of 13C in the breath, was used as an index of the mean protein requirement. Results: The mean protein requirement (95% CI) was 0.85 (0.60, 1.09) g · kg−1 · d−1. This requirement is 29% higher than the current Estimated Average Requirement (EAR) for adults of 0.66 g · kg−1 · d−1 based on the nitrogen balance technique, although the 95% CI includes the current EAR. The corresponding adequate protein allowance of 1.15 (0.77, 1.54) g · kg−1 · d−1 is 44% higher, although the 95% CI includes the Recommended Dietary Allowance (RDA) of 0.80 g · kg−1 · d−1. Conclusions: Notwithstanding uncertainty about the validity of the use of the IAAO technique to assess protein requirements, the results of this study with octogenarian women suggest that the current EAR and RDA for elderly women may be underestimated. The limitations of this short-term, noninvasive method underscore the need for new research that uses alternative experimental designs and measuring physiologic, morphologic, and health

  2. Increased chromosome damage in pediatric heart catheterization patients after diagnostic fluoroscopy and cineangiography

    SciTech Connect

    Shafer, D.A.; Raviele, A.A.; Dunbar, V.G.; Click, L.A.

    1987-01-01

    Chromosome damage (CD) and sister chromatid exchange (SCE) levels were studied in lymphocytes from 30 pediatric heart catheterization patients receiving radiation during diagnostic fluoroscopy and cineangiography procedures. Forty-eight-hour CD and 72-hr SCE cultures were prepared from sequential samples taken from each patient: samples 1-3 via the catheter the same day (1) before exposure, (2) after fluoroscopy, and (3) after cineangiography; and sample 4 by venipuncture the next morning. Significant increases in CD (dicentrics, rings, and fragments), but not SCE, were observed. From a mean base level of 0.4% cells with CD, the CD levels increased 2-3-fold in samples 3 and 4 (p = .001). Rings only occurred in samples 3 and 4. While increased CD levels also correlated with increasing age, body surface area, and weight, partial correlations controlling for these factors clearly indicate that the CD effects are principally attributable to the radiological procedures (p = .001). Increased CD levels correlated with both the roentgen dose of cineangiography exposure (p = .002) and the volume of contrast medium (p = .000); however, partial correlations, controlling for either factor, indicate that the contrast medium was the principal factor (p = .006).

  3. On monitoring anthropogenic airborne uranium concentrations and (235)U/(238)U isotopic ratio by Lichen - bio-indicator technique.

    PubMed

    Golubev, A V; Golubeva, V N; Krylov, N G; Kuznetsova, V F; Mavrin, S V; Aleinikov, A Yu; Hoppes, W G; Surano, K A

    2005-01-01

    Lichens are widely used to assess the atmospheric pollution by heavy metals and radionuclides. However, few studies are available in publications on using lichens to qualitatively assess the atmospheric pollution levels. The paper presents research results applying epiphytic lichens as bio-monitors of quantitative atmospheric contamination with uranium. The observations were conducted during 2.5 years in the natural environment. Two experimental sites were used: one in the vicinity of a uranium contamination source, the other one - at a sufficient distance away to represent the background conditions. Air and lichens were sampled at both sites monthly. Epiphytic lichens Hypogimnia physodes were used as bio-indicators. Lichen samples were taken from various trees at about 1.5m from the ground. Air was sampled with filters at sampling stations. The uranium content in lichen and air samples as well as isotopic mass ratios (235)U/(238)U were measured by mass-spectrometer technique after uranium pre-extraction. Measured content of uranium were 1.45 mgkg(-1) in lichen at 2.09 E-04 microgm(-3) in air and 0.106 mgkg(-1) in lichen at 1.13 E-05 microgm(-3) in air. The relationship of the uranium content in atmosphere and that in lichens was determined, C(AIR)=exp(1.1 x C(LICHEN)-12). The possibility of separate identification of natural and man-made uranium in lichens was demonstrated in principle. PMID:16083999

  4. Design and characteristics evaluation of a novel teleoperated robotic catheterization system with force feedback for vascular interventional surgery.

    PubMed

    Guo, Jian; Guo, Shuxiang; Yu, Yang

    2016-10-01

    In this paper, we proposed a novel master-slave robotic catheterization system with force feedback for VIS (Vascular Interventional Surgery). The force feedback to the operator on the master side is the key factor to improve the safety during VIS. The developed system used the MR (magneto rheological) fluid to realize force feedback, and it used the developed multidimensional monitoring interface to realize the visualization of force feedback, the developed multidimensional monitoring interface can monitor the motion information of the catheter and contact force between catheter tip or side wall and blood vessel wall, and the motion data of the catheter was collected and generated diagram for reference to surgeon. We have developed a force sensor array to detect the contact force between catheter tip or side wall and blood vessel wall. The force information was detected by the developed contact force sensor array when the catheter contacted with the blood vessel. The force feedback and multidimensional information monitoring interface evaluation experiments were done, the tracking characteristic evaluation experiments were also carried out, the experimental results indicated that the developed novel robotic catheterization system with force feedback and visualization of force feedback is effective for VIS, it can improve the safety during VIS. PMID:27499092

  5. A peculiar complication of suprapubic catheterization: Recurrent ureteral obstruction and hydronephrosis

    PubMed Central

    Adeyemo, Bamidele; Makovitch, Steven; Foo, Dominic

    2013-01-01

    Context Suprapubic cystostomy (SPC) catheterization is a common and important technique for the management of vesicular drainage, especially in patients with neurogenic bladder. Some serious complications include bowel perforation and obstruction. Findings A 55-year-old man with C6 American Spinal Injury Association B tetraplegia and a urethral stricture requiring a chronic SPC was admitted for recurrent urosepsis. Computed tomography (CT) of the abdomen revealed severe right hydronephrosis and hydroureter due to obstruction of the right distal ureter by the SPC tip. The SPC (30 French/10-mm silicone catheter with a 10-ml balloon) was removed and replaced with a similar suprapubic catheter (30 French/10-mm silicone catheter with an 8-ml balloon). Symptoms recurred 2 months later and he was readmitted for urosepsis. CT of the abdomen again revealed severe right hydronephrosis and hydroureter due to obstruction of the right distal ureter by the SPC tip. The SPC was removed, and the patient was given a 14 French/4.67-mm urethral silicone catheter with a 5-ml balloon. Follow-up CT of the abdomen 2 months later showed complete resolution of the hydronephrosis and hydroureter. Of note, urodynamic studies 2 years earlier revealed an extremely small bladder with a capacity less than 20 ml. Conclusion This case illustrates that obstruction of the ureter by the tip of an SPC can be a cause of recurrent hydronephrosis and urosepsis. PMID:23809534

  6. Ultrasound stylet for non-image-guided ventricular catheterization.

    PubMed

    Coulson, Nathaniel K; Chiarelli, Peter A; Su, David K; Chang, Jason J; MacConaghy, Brian; Murthy, Revathi; Toms, Peter; Robb, Terrence L; Ellenbogen, Richard G; Browd, Samuel R; Mourad, Pierre D

    2015-10-01

    OBJECT Urgent ventriculostomy placement can be a lifesaving procedure in the setting of hydrocephalus or elevated intracranial pressure. While external ventricular drain (EVD) insertion is common, there remains a high rate of suboptimal drain placement. Here, the authors seek to demonstrate the feasibility of an ultrasound-based guidance system that can be inserted into an existing EVD catheter to provide a linear ultrasound trace that guides the user toward the ventricle. METHODS The ultrasound stylet was constructed as a thin metal tube, with dimensions equivalent to standard catheter stylets, bearing a single-element, ceramic ultrasound transducer at the tip. Ultrasound backscatter signals from the porcine ventricle were processed by custom electronics to offer real-time information about ventricular location relative to the catheter. Data collected from the prototype device were compared with reference measurements obtained using standard clinical ultrasound imaging. RESULTS A study of porcine ventricular catheterization using the experimental device yielded a high rate of successful catheter placement after a single pass (10 of 12 trials), despite the small size of pig ventricles and the lack of prior instruction on porcine ventricular architecture. A characteristic double-peak signal was identified, which originated from ultrasound reflections off of the near and far ventricular walls. Ventricular dimensions, as obtained from the width between peaks, were in agreement with standard ultrasound reference measurements (p < 0.05). Furthermore, linear ultrasound backscatter data permitted in situ measurement of the stylet distance to the ventricular wall (p < 0.05), which assisted in catheter guidance. CONCLUSIONS The authors have demonstrated the ability of the prototype ultrasound stylet to guide ventricular access in the porcine brain. The alternative design of the device makes it potentially easy to integrate into the standard workflow for bedside EVD

  7. Developing a visualized patient-centered, flow-based and objective-oriented care path of cardiac catheterization examination.

    PubMed

    Kuo, Ming Chuan; Chang, Polun

    2009-01-01

    It has been known that visualization is a user-preferred and more meaningful interface of information systems. To reduce the anxiety and uncertainty of patients, we transformed the sophisticated process of cardiac catheterization into visualized information. The Microsoft Visio 2003 and Excel 2003 with the VBA automation tool were used to design a process flow of Cardiac Catheterization. The results show the technical feasibility and potentials helpful for patient to realize the nursing process of cardiac catheterization. PMID:19593031

  8. Burnei’s “double X" internal fixation technique for supracondylar humerus fractures in children: indications, technique, advantages and alternative interventions

    PubMed Central

    Georgescu, I; Gavriliu, S; Pârvan, A; Martiniuc, A; Japie, E; Ghiță, R; Drăghici, I; Hamei, S; Ţiripa, I; El Nayef, T; Dan, D

    2013-01-01

    Background. The Study and Research Group in Pediatric Orthopedics-2012 initated this retrospective study due to the fact that in Romania and in other countries, the numerous procedures do not ensure the physicians a definite point of view related to the therapeutic criteria in the treatment of supracondylar fractures. That is why the number of complications and their severity brought into notice these existent deficiencies. In order to correct some of these complications, cubitus varus or valgus, Prof. Al. Pesamosca communicated a paper called "Personal procedure in the treatment of posttraumatic cubitus varus" at the County Conference from Bacău, in June 24, 1978. This procedure has next been made popular by Prof. Gh. Burnei and his coworkers by operating patients with cubitus varus or valgus due to supracondylar humeral fractures and by presenting papers related to the subject at the national and international congresses. The latest paper regarding this problem has been presented at the 29th Annual Meeting of the European Pediatric Orthopedic Society in Zagreb, Croatia, April 7-10, 2010, being titled “Distal humeral Z-osteotomy for posttraumatic cubitus varus or valgus", having as authors Gh. Burnei, Ileana Georgescu, Ştefan Gavriliu, Costel Vlad and Daniela Dan. As members of this group, based on the performed studies, we wish to make popular this type of osteosynthesis, which ensures a tight fixation, avoids complications and allows a rapid postoperative activity. Introduction. The acknowledged treatment for these types of fractures is the orthopedic one and it must be accomplished as soon as possible, in the first 6 hours, by reduction and cast immobilization or by closed or open reduction and fixation, using one of the several methods (Judet, Boehler, Kapandji, San Antonio, San Diego, Burnei’s double X technique). The exposed treatment is indicated in irreducible supracondylar humeral fractures, in reducible, but unstable type, in polytraumatized

  9. Phenolic acids from wheat show different absorption profiles in plasma: a model experiment with catheterized pigs.

    PubMed

    Nørskov, Natalja P; Hedemann, Mette S; Theil, Peter K; Fomsgaard, Inge S; Laursen, Bente B; Knudsen, Knud Erik Bach

    2013-09-18

    The concentration and absorption of the nine phenolic acids of wheat were measured in a model experiment with catheterized pigs fed whole grain wheat and wheat aleurone diets. Six pigs in a repeated crossover design were fitted with catheters in the portal vein and mesenteric artery to study the absorption of phenolic acids. The difference between the artery and the vein for all phenolic acids was small, indicating that the release of phenolic acids in the large intestine was not sufficient to create a porto-arterial concentration difference. Although, the porto-arterial difference was small, their concentrations in the plasma and the absorption profiles differed between cinnamic and benzoic acid derivatives. Cinnamic acids derivatives such as ferulic acid and caffeic acid had maximum plasma concentration of 82 ± 20 and 200 ± 7 nM, respectively, and their absorption profiles differed depending on the diet consumed. Benzoic acid derivatives showed low concentration in the plasma (<30 nM) and in the diets. The exception was p-hydroxybenzoic acid, with a plasma concentration (4 ± 0.4 μM), much higher than the other plant phenolic acids, likely because it is an intermediate in the phenolic acid metabolism. It was concluded that plant phenolic acids undergo extensive interconversion in the colon and that their absorption profiles reflected their low bioavailability in the plant matrix. PMID:23971623

  10. Application of spectrophotometric, densitometric, and HPLC techniques as stability indicating methods for determination of Zaleplon in pharmaceutical preparations

    NASA Astrophysics Data System (ADS)

    Metwally, Fadia H.; Abdelkawy, M.; Abdelwahab, Nada S.

    2007-12-01

    Spectrophotometric, spectrodensitometric and HPLC are stability indicating methods described for determination of Zaleplon in pure and dosage forms. As Zaleplon is easily degradable, the proposed techniques in this manuscript are adopted for its determination in presence of its alkaline degradation product, namely N-[4-(3-cyano-pyrazolo[1,5a]pyridin-7-yl)-phenyl]- N-ethyl-acetamide. These approaches are successfully applied to quantify Zaleplon using the information included in the absorption spectra of appropriate solutions. The second derivative (D 2) spectrophotometric method, allows determination of Zaleplon without interference of its degradate at 235.2 nm using 0.01N HCl as a solvent with obedience to Beer's law over a concentration range of 1-10 μg ml -1 with mean percentage recovery 100.24 ± 0.86%. The first derivative of the ratio spectra ( 1DD) based on the simultaneous use of ( 1DD) and measurement at 241.8 nm using the same solvent and over the same concentration range as (D 2) spectrophotometric method, with mean percentage recovery 99.9 ± 1.07%. The spectrodensitometric analysis allows the separation and quantitation of Zaleplon from its degradate on silica gel plates using chloroform:acetone:ammonia solution (9:1:0.2 by volume) as a mobile phase. This method depends on quantitave densitometric evaluation of thin layer chromatogram of Zaleplon at 338 nm over a concentration range of 0.2-1 μg band -1, with mean percentage recovery 99.73 ± 1.35. Also a reversed-phase liquid chromatographic method using 5-C8 (22 cm × 4.6 mm i.d. 5 μm particle size) column was described and validated for quantitation of Zaleplon using acetonitrile:deionised water (35:65, v/v) as a mobile phase using Paracetamol as internal standard and a flow rate of 1.5 ml min -1 with UV detection of the effluent at 232 nm at ambient temperature over a concentration range of 2-20 μg ml -1 with mean percentage recovery 100.19 ± 1.15%. The insignificance difference of the proposed

  11. Incidence and Predictors of Catheterization-Related Cerebral Infarction on Diffusion-Weighted Magnetic Resonance Imaging

    PubMed Central

    Okano, Mitsumasa; Suu, Kanae; Kimura, Masahiro; Minamino-Muta, Eri; Nakane, Eisaku; Izumi, Toshiaki; Miyamoto, Shoichi; Haruna, Tetsuya; Ueyama, Koji

    2016-01-01

    Introduction. The aim of this study was to examine the incidence and risk factors of catheterization-related CI in the contemporary era, using diffusion-weighted magnetic resonance imaging. Methods. We retrospectively analyzed consecutive 84 patients who underwent MRI (magnetic resonance imaging) after 2.81 ± 2.4 days (mean ± SD) of catheterization via aortic arch. We categorized the patients by the presence or absence of acute CI determined by diffusion-weighted MRI and analyzed the incidence and predictors. Results. Of 84 patients that underwent MRI after catheterization, acute CI was determined in 27 (32.1%) patients. In univariate analysis, dyslipidemia, age, coronary artery disease, antiplatelet agents, number of catheters used, urgent settings, and interventional procedures were significantly different. Multivariate analysis revealed dyslipidemia (odds ratio [OR], 4.46; 95% confidence interval [CI], 1.41–16.03; p = 0.01), higher age (OR, 1.09; 95% CI, 1.007–1.19; p = 0.03), and the number of catheters used (OR, 2.21; 95% CI, 1.21–4.36; p = 0.01) as independent predictors of the incidence of catheterization-related acute CI. Conclusions. Dyslipidemia, higher age, and number of catheters used were independent predictors for acute CI after catheterization. These findings imply that managing dyslipidemia and comprehensive planning to minimize the numbers of catheters are important. PMID:27127790

  12. Comparison of Ultrasonography-Guided Central Venous Catheterization Between Adult and Pediatric Populations

    SciTech Connect

    Tercan, Fahri Oguzkurt, Levent; Ozkan, Ugur; Eker, Hatice Evren

    2008-05-15

    The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. The preferred catheterization site was internal jugular vein in 97% of adults and 85% of children. The technical success rate, mean number of punctures, and rate of single wall puncture were 99.4%, 1.04 (range, 1-3), and 83% for adults and 90.3%, 1.25 (range, 1-5), and 49% for children, respectively. All the differences were statistically significant (p < 0.05). Complication rates were 2.3% and 2.4% for adults and children, respectively (p > 0.05). Major complications such as pneumothorax and hemothorax were not seen in any group. In conclusion, ultrasonography-guided central venous catheterization has a high technical success rate, lower puncture attempt rate, and higher single wall puncture rate in adults compared to children. Complication rates are comparable in the two groups.

  13. Comparison of ultrasonography-guided central venous catheterization between adult and pediatric populations.

    PubMed

    Tercan, Fahri; Oguzkurt, Levent; Ozkan, Ugur; Eker, Hatice Evren

    2008-01-01

    The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. The preferred catheterization site was internal jugular vein in 97% of adults and 85% of children. The technical success rate, mean number of punctures, and rate of single wall puncture were 99.4%, 1.04 (range, 1-3), and 83% for adults and 90.3%, 1.25 (range, 1-5), and 49% for children, respectively. All the differences were statistically significant (p < 0.05). Complication rates were 2.3% and 2.4% for adults and children, respectively (p > 0.05). Major complications such as pneumothorax and hemothorax were not seen in any group. In conclusion, ultrasonography-guided central venous catheterization has a high technical success rate, lower puncture attempt rate, and higher single wall puncture rate in adults compared to children. Complication rates are comparable in the two groups. PMID:18330631

  14. Urinary catheterization as a successful treatment option for post-cesarean section vesicouterine fistula.

    PubMed

    Rouzi, A A; Sahly, N; Mansouri, N; Khashoggi, K; Ashkar, L

    2016-01-01

    Surgery, the usual treatment option for vesicouterine fistula (VUF), is often delayed to allow involution of the uterus. The authors report a case of successful treatment with urinary catheterization. A 39-year-old, gravida 7, para 6, woman presented at term with obstructed labor. She had one previous cesarean section followed by a vaginal birth before. She underwent emergency cesarean section. She was readmitted after one week because of pelvic collection. Aspiration revealed pus and urine. Retrograde cystogram and pelvic MRI confirmed the presence of VHF. Urinary bladder catheterization for six weeks resulted in the successful treatment of the fistula. Urinary catheterization in the early postpartum period can result in resolution of post-cesarean section VUF, without delaying surgical intervention if it becomes necessary. PMID:27048039

  15. Can the Anesthesiologist Use the Radial Artery for Monitoring After Transradial Artery Catheterization?

    PubMed

    Awad, Hamdy; Quevedo, Eduardo; Abas, Motaz; Brown, Michelle; Satiani, Bhagwan; Capers, Quinn; Starr, Jean E

    2015-06-15

    The use of transradial coronary angiography and intervention is growing because of its advantages over the femoral approach. However, the small size of the radial artery can contribute to complications. We present a case of an in situ access complication of transradial coronary artery catheterization. It is important for the anesthesiologist to know about the short-term and long-term consequences of this intervention, which could lead to narrowing of the artery even beyond the site of puncture. Understanding these changes could help anesthesiologists make better decisions about using the radial artery for monitoring after transradial coronary artery catheterization procedures. PMID:26050247

  16. Spectrophotometric Determination of the Dissociation Constant of an Acid-Base Indicator Using a Mathematical Deconvolution Technique

    ERIC Educational Resources Information Center

    Alter, Krystyn P.; Molloy, John L.; Niemeyer, Emily D.

    2005-01-01

    A laboratory experiment reinforces the concept of acid-base equilibria while introducing a common application of spectrophotometry and can easily be completed within a standard four-hour laboratory period. It provides students with an opportunity to use advanced data analysis techniques like data smoothing and spectral deconvolution to…

  17. La réparation sphinctérienne directe: points techniques, indications et résultats

    PubMed Central

    Laalim, Said Ait; Hrora, Abdelmalek; Raiss, Mohammed; Ibnmejdoub, Karim; Toughai, Imane; Ahallat, Mohammed; Mazaz, Khalid

    2013-01-01

    L'incontinence anale est un handicap physique, psychique et social majeur qui a de nombreuses causes différentes. Les méthodes actuellement disponibles pour améliorer les symptômes de cette incontinence sont les méthodes médicales et de rééducation d'une part et les méthodes chirurgicales d'autre part. Quatre techniques chirurgicales répondent à ces objectifs pour la plupart des malades: la sphinctérorraphie, la neuromodulation des racines sacrées, et les deux techniques de substitution que sont le sphincter artificiel et la graciloplastie dynamisée. La réparation sphinctérienne directe est la technique la plus utilisée dans le traitement chirurgical de l'incontinence anale (IA) par lésion sphinctérienne. Cette technique est envisageable chez les malades ayant une incontinence fécale en rapport avec des lésions limitées du sphincter anal externe. La technique chirurgicale est simple (myorraphie par suture directe ou en paletot) et bien codifiée. Les résultats fonctionnels sont imparfaits et se dégradent avec la durée du suivi. Une continence parfaite après réparation sphinctérienne est rarement acquise de façon durable: le malade candidat à cette approche thérapeutique doit en être averti. PMID:23504542

  18. Safety of cardiac catheterization at a center specializing in the care of patients with pulmonary arterial hypertension

    PubMed Central

    2013-01-01

    Abstract Cardiac catheterization is important for the management of patients with pulmonary arterial hypertension (PAH). It is used for diagnosis, assessment, and monitoring of PAH patients, as well as to perform interventions such as balloon atrial septostomy and coil embolization of collateral vessels. Although reports on the risks of catheterization in PAH patients are scarce, many centers hesitate to perform these procedures in such fragile patients. We performed a retrospective chart review of all cardiac catheterizations performed in PAH patients over 10 years at our pulmonary hypertension center. Demographic, hemodynamic, and outcome data were collected. Complication rates were determined, and multivariate proportional hazards modeling was performed to identify predictors of catheterization-related complications. There were 1,637 catheterizations performed in 607 patients over 10 years. Pediatric patients accounted for 50% of these cases, 48% were performed in patients with idiopathic PAH, and 49% were performed under general anesthesia. While the overall complication rate was 5.7%, the rate of major complications was only 1.2% (). Although there were 8 deaths during the admission following catheterization, only 4 of these were related to the procedure, yielding a catheterization-related mortality of 0.2%. In conclusion, when performed at a pulmonary hypertension center with expertise in the care of PAH patients, cardiac catheterization is associated with low complication rates and mortality, and it should remain an important tool in the management of these patients. PMID:25006398

  19. Decomposing the trade-environment nexus for Malaysia: what do the technique, scale, composition, and comparative advantage effect indicate?

    PubMed

    Ling, Chong Hui; Ahmed, Khalid; Binti Muhamad, Rusnah; Shahbaz, Muhammad

    2015-12-01

    This paper investigates the impact of trade openness on CO2 emissions using time series data over the period of 1970QI-2011QIV for Malaysia. We disintegrate the trade effect into scale, technique, composition, and comparative advantage effects to check the environmental consequence of trade at four different transition points. To achieve the purpose, we have employed augmented Dickey-Fuller (ADF) and Phillips-Perron (PP) unit root tests in order to examine the stationary properties of the variables. Later, the long-run association among the variables is examined by applying autoregressive distributed lag (ARDL) bounds testing approach to cointegration. Our results confirm the presence of cointegration. Further, we find that scale effect has positive and technique effect has negative impact on CO2 emissions after threshold income level and form inverted U-shaped relationship-hence validates the environmental Kuznets curve hypothesis. Energy consumption adds in CO2 emissions. Trade openness and composite effect improve environmental quality by lowering CO2 emissions. The comparative advantage effect increases CO2 emissions and impairs environmental quality. The results provide the innovative approach to see the impact of trade openness in four sub-dimensions of trade liberalization. Hence, this study attributes more comprehensive policy tool for trade economists to better design environmentally sustainable trade rules and agreements. PMID:26300360

  20. The Use of MMF Screws: Surgical Technique, Indications, Contraindications, and Common Problems in Review of the Literature

    PubMed Central

    Cornelius, Carl-Peter; Ehrenfeld, Michael

    2010-01-01

    Mandibulo-maxillary fixation (MMF) screws are inserted into the bony base of both jaws in the process of fracture realignment and immobilisation. The screw heads act as anchor points to fasten wire loops or rubber bands connecting the mandible to the maxilla. Traditional interdental chain-linked wiring or arch bar techniques provide the anchorage by attached cleats, hooks, or eyelets. In comparison to these tooth-borne appliances MMF screws facilitate and shorten the way to achieve intermaxillary fixation considerably. In addition, MMF screws help to reduce the hazards of glove perforation and wire stick injuries. On the downside, MMF screws are attributed with the risk of tooth root damage and a lack of versatility beyond the pure maintenance of occlusion such as stabilizing loose teeth or splinting fragments of the alveolar process. The surgical technique of MMF screws as well as the pros and cons of the clinical application are reviewed. The adequate screw placement to prevent serious tooth root injuries is still an issue to rethink and modify conceptual guidelines. PMID:22110819

  1. Complications of Umbilical Artery Catheterization in a Model of Extreme Prematurity

    PubMed Central

    McAdams, Ryan M.; Winter, Vicki T.; McCurnin, Don C.; Coalson, Jacqueline J.

    2009-01-01

    Background Umbilical artery catheter (UAC) use is common in the management of critically ill neonates; however, little information exists regarding the anatomic and vascular effects of UAC placement in premature newborns. Methods and Results Baboons were delivered at 125 d of gestation (term = 185 d), treated with surfactant, had UACs placed, and were ventilated for either 6 d or 14 d. Animals were assigned to short-term (6 d, n = 6) and long-term (14 d, n = 30) UAC placement. At necropsy, aortas were removed with UACs still in place. Histological examination of upper, middle, and lower aorta specimens stained with hematoxylin and eosin and immunolabelled to detect smooth muscle (α-actin) was done in a blinded manner. Controls were delivered at 125d, 140d, and 185d and the aortas acquired immediately after birth. None of the non-catheterized control animals (125 d, n = 4; 140 d, n = 5; 185 d, n = 5) had aortic vessel thrombi or vascular wall abnormalities. All 6 animals with short-term (6/6, 100%) and 18 animals with long-term (18/30, 60%) UAC placement displayed aortic thrombi and neointimal proliferation of the vascular wall. The majority (60%) of analyzed animals with UAC placement displaying neointimal hyperplasia were immunopositive for α-actin, indicating the presence of smooth muscle in these lesions. Conclusion Our findings suggest that both short- and long-term UAC use is associated with aortic wall pathological abnormalities compared to control animals. This study emphasizes the judicious use and early removal of UACs if possible in order to potentially prevent significant hemostatic and aortic wall vascular complications. PMID:19554012

  2. Evaluation of educational content of YouTube videos relating to neurogenic bladder and intermittent catheterization

    PubMed Central

    Ho, Matthew; Stothers, Lynn; Lazare, Darren; Tsang, Brian; Macnab, Andrew

    2015-01-01

    Introduction: Many patients conduct internet searches to manage their own health problems, to decide if they need professional help, and to corroborate information given in a clinical encounter. Good information can improve patients’ understanding of their condition and their self-efficacy. Patients with spinal cord injury (SCI) featuring neurogenic bladder (NB) require knowledge and skills related to their condition and need for intermittent catheterization (IC). Methods: Information quality was evaluated in videos accessed via YouTube relating to NB and IC using search terms “neurogenic bladder intermittent catheter” and “spinal cord injury intermittent catheter.” Video content was independently rated by 3 investigators using criteria based on European Urological Association (EAU) guidelines and established clinical practice. Results: In total, 71 videos met the inclusion criteria. Of these, 12 (17%) addressed IC and 50 (70%) contained information on NB. The remaining videos met inclusion criteria, but did not contain information relevant to either IC or NB. Analysis indicated poor overall quality of information, with some videos with information contradictory to EAU guidelines for IC. High-quality videos were randomly distributed by YouTube. IC videos featuring a healthcare narrator scored significantly higher than patient-narrated videos, but not higher than videos with a merchant narrator. About half of the videos contained commercial content. Conclusions: Some good-quality educational videos about NB and IC are available on YouTube, but most are poor. The videos deemed good quality were not prominently ranked by the YouTube search algorithm, consequently user access is less likely. Study limitations include the limit of 50 videos per category and the use of a de novo rating tool. Information quality in videos with healthcare narrators was not higher than in those featuring merchant narrators. Better material is required to improve patients

  3. Acute respiratory distress associated with external jugular vein catheterization in the newborn.

    PubMed

    Bitar, Fadi F; Obeid, Mounir; Dabbous, Ibrahim; Hayek, Paula; Akel, Samir; Mroueh, Salman

    2003-12-01

    We report on the acute onset of respiratory distress secondary to fluid accumulation in the chest within hours of placement of an external jugular venous line in a newborn. External jugular venous catheterization in the newborn is a procedure with potentially serious complications, and should be avoided unless the patient is monitored closely. PMID:14618649

  4. Acute kidney injury after using contrast during cardiac catheterization in children with heart disease.

    PubMed

    Hwang, Young Ju; Hyun, Myung Chul; Choi, Bong Seok; Chun, So Young; Cho, Min Hyun

    2014-08-01

    Acute kidney injury (AKI) is closely associated with the mortality of hospitalized patients and long-term development of chronic kidney disease, especially in children. The purpose of our study was to assess the evidence of contrast-induced AKI after cardiac catheterization in children with heart disease and evaluate the clinical usefulness of candidate biomarkers in AKI. A total of 26 children undergoing cardiac catheterization due to various heart diseases were selected and urine and blood samples were taken at 0 hr, 6 hr, 24 hr, and 48 hr after cardiac catheterization. Until 48 hr after cardiac catheterization, there was no significant increase in serum creatinine level in all patients. Unlike urine kidney injury molecule-1, IL-18 and neutrophil gelatinase-associated lipocalin, urine liver-type fatty acid-binding protein (L-FABP) level showed biphasic pattern and the significant difference in the levels of urine L-FABP between 24 and 48 hr. We suggest that urine L-FABP can be one of the useful biomarkers to detect subclinical AKI developed by the contrast before cardiac surgery. PMID:25120320

  5. History of Right Heart Catheterization: 100 Years of Experimentation and Methodology Development

    PubMed Central

    Nossaman, Bobby D.; Scruggs, Brittni A.; Nossaman, Vaughn E.; Murthy, Subramanyam N.; Kadowitz, Philip J.

    2010-01-01

    The development of right heart catheterization has provided the clinician the ability to diagnose patients with congenital and acquired right heart disease, and to monitor patients in the ICU with significant cardiovascular illnesses. The development of bedside pulmonary artery catheterization has become a standard of care for the critically ill patient since its introduction into the ICU almost 40 years ago. However, adoption of this procedure into the mainstream of clinical practice occurred without prior evaluation or demonstration of its clinical or cost-effectiveness. Moreover, current randomized, controlled trials provide little evidence in support of the clinical utility of pulmonary artery catheterization in the management of critically ill patients. Nevertheless, the right heart catheter is an important diagnostic tool to assist the clinician in the diagnosis of congenital heart disease and acquired right heart disease, and moreover, when catheter placement is proximal to the right auricle (atria), this catheter provides an important and safe route for administration of fluids, medications, and parenteral nutrition. The purpose of this manuscript is to review the development of right heart catheterization that led to the ability to conduct physiologic studies in cardiovascular dynamics in normal individuals and in patients with cardiovascular diseases, and to review current controversies of the extension of the right heart catheter, the pulmonary artery catheter. PMID:20160536

  6. Part versus Whole: A Randomized Trial of Central Venous Catheterization Education

    ERIC Educational Resources Information Center

    Chan, Angela; Singh, Sunita; Dubrowski, Adam; Pratt, Daniel D.; Zalunardo, Nadia; Nair, Parvarthy; McLaughlin, Kevin; Ma, Irene W. Y.

    2015-01-01

    Central venous catheterization (CVC) is a complex but commonly performed procedure. How best to teach this complex skill has not been clearly delineated. We conducted a randomized trial of the effects of two types of teaching of CVC on skill acquisition and retention. We randomly assigned novice internal medicine residents to learning CVC in-part…

  7. Radiation exposure of pediatric patients and physicians during cardiac catheterization and balloon pulmonary valvuloplasty

    SciTech Connect

    Wu, J.R.; Huang, T.Y.; Wu, D.K.; Hsu, P.C.; Weng, P.S. )

    1991-07-15

    Thermoluminescent dosimeters were applied to various areas of 61 pediatric patients and physicians to measure radiation doses during routine cardiac catheterization and during 4 cases of balloon pulmonary valvuloplasty. Radiation doses were measured during chest roentgenography, fluoroscopy and cineangiography. Average skin dose to the chest was 121 microGy during chest x-ray, 5,182 microGy during catheterization and 641 mGy during valvuloplasty. For the eyes, thyroid and gonads of the patients, the exposure during routine catheterization was equal to 0.4, 6 and 0.2 chest x-rays, respectively. Radiation dose of the operator was 3 microGy for the eyes and 6 miCroGy in the thyroid. About 56% of the operator's dose could be reduced by thyroid shields, and 80% by lead aprons. The assistant received only 1 microGy outside the thyroid shield. Therefore, the authors have concluded that the patients dose during routine catheterization is largely based on our experimental results, but the dose is acceptable based on the risk factor analysis. The skin dose to the right lateral chest of the patient during valvuloplasty is extremely high, perhaps as high as the equivalent of 1,000 chest x-rays. Besides the clinical benefits of valvuloplasty, the long-term radiation-related hazards to the patient should be carefully monitored.

  8. Contrast-enhanced ultrasound for imaging blunt abdominal trauma - indications, description of the technique and imaging review.

    PubMed

    Cokkinos, D; Antypa, E; Stefanidis, K; Tserotas, P; Kostaras, V; Parlamenti, A; Tavernaraki, K; Piperopoulos, P N

    2012-02-01

    Patients with blunt abdominal trauma are initially imaged with ultrasound (US) for the evaluation of free abdominal fluid. However, lacerations of solid organs can be overlooked. Although computed tomography (CT) is the gold standard technique for abdominal trauma imaging, overutilization, ionizing radiation, need to transport the patient and potential artifacts are well known disadvantages. Contrast-enhanced US (CEUS) can be used as an imaging tool between the two methods. It can easily and reliably reveal solid abdominal organ injuries in patients with low-energy localized trauma and decrease the number of CT scans performed. It can be rapidly performed at the patient's bedside with no need for transportation. There are only very few contraindications and anaphylactoid reactions are extremely rare. Altogether, CEUS has proved to be very helpful for the initial imaging of traumatic lesions of the liver, kidney and spleen, as well as for patient follow-up. PMID:22274907

  9. Investigation of grapevine photosynthesis using hyperspectral techniques and development of hyperspectral band ratio indices sensitive to photosynthesis.

    PubMed

    Ozelkan, Emre; Karaman, Muhittin; Candar, Serkan; Coskun, Zafer; Ormeci, Cankut

    2015-01-01

    The photosynthetic rate of 9 different grapevines were analyzed with simultaneous photosynthesis and spectroradiometric measurements on 08.08.2012 (veraison) and 06.09.2012 (harvest). The wavelengths and spectral regions, which most properly express photosynthetic rate, were determined using correlation and regression analysis. In addition, hyperspectral band ratio (BR) indices sensitive to photosynthesis were developed using optimum band ratio (OBRA) method. The relation of BR results with photosynthesis values are presented with the correlation matrix maps created in this study. The examinations were performed for both specific dates (i.e., veraison and harvest) and also in aggregate (i.e., correlation between total spectra and photosynthesis data). For specific dates wavelength based analysis, the photosynthesis were best determined with -0.929 correlation coefficient (r) 609 nm of yellow region at veraison stage, and -0.870 at 641 nm of red region at harvest stage. For wavelength based aggregate analysis, 640 nm of red region was found to be correlated with 0.921 and -0.867 r values respectively and red edge (RE) (695 nm) was found to be correlated with -0.922 and -0.860 r values, respectively. When BR indices results were analyzed with photosynthetic values for specific dates, -0.987 r with R8../R, at veraison stage and -0.911 r with R696/R944 at harvest stage were found most correlated. For aggregate analysis of BR, common BR presenting great correlation with photosynthesis for both measurements was found to be R632/R971 with -0.974, -0.881 r values, respectively and other R610/R760 with -0.976, -0.879 r values. The final results of this study indicate that the proportion of RE region to a region with direct or indirect correlation with photosynthetic provides information about rate of photosynthesis. With the indices created in this study, the photosynthesis rate of vineyards can be determined using in-situ hyperspectral remote sensing. The findings of this

  10. Endoscopically Assisted Water Perfusion Esophageal Manometry with Minimal Sedation: Technique, Indications and Implication on the Clinical Management

    PubMed Central

    Brun, Rita; Staller, Kyle; Viner, Sofia; Kuo, Braden

    2015-01-01

    Goals To demonstrate feasibility and clinical utility of endoscopically-assisted manometry (EAM). Background Esophageal manometry performed without sedation is the standard for assessment of esophageal motility. However, some patients can not tolerate the procedure with intranasal intubation. We have accumulated experience performing EAM with minimal sedation on patients that can not tolerate standard esophageal manometry. Study We report our single center experience of EAM in adult patients. Patient records were analyzed retrospectively. Procedure protocol: Upper endoscopy is performed with minimal sedation to place a guide wire, over which a water perfusion manometry catheter is introduced and standard manometry protocol performed. Results From 2007-2009, 51 patients underwent EAM, 41 (80.4%) for failed transnasal esophageal manometry and 10 (19.6%) for Zencker diverticulum, achalasia, or neurologic disease. Five patients could not tolerate the procedure despite sedation. No early or late complications were recorded and 100% of the completed procedures were diagnostic: 15 (32.6%) patients had a normal study, 13 (28.3%) were diagnosed with achalasia, 12 (26.1%) patients had low LES pressure, 10 (21.7%) patients demonstrated Ineffective Esophageal Motility, 3 (6.5%) patients had hypertensive LES, and one (2.2%) patient had Nutcracker esophagus. Completed procedures resulted in treatment for achalasia (33.3%), medication changes (33.3%), completion of pre-operative assessment for antireflux surgery (27.7%), or no impact clinical management (11.1%). EAM had a direct clinical impact on 89% of patients. Conclusions EAM is a safe, reliable, and feasible technique providing objective diagnostic information that directly impacted clinical management in many problematic patients where the standard procedure failed. PMID:21602703

  11. Measuring urban sprawl on geospatial indices characterized by leap frog development using remote sensing and GIS techniques

    NASA Astrophysics Data System (ADS)

    Noor, N. M.; Asmawi, M. Z.; Rusni, N. A.

    2014-02-01

    Characterizing urban sprawl using spatial measures requires a concise definition of what constitutes sprawling urban spatial patterns. This research attempts to study a measurement of defining sprawl by using leapfrog development index through remote sensing and GIS approach. The IKONOS pan-sharpened and SPOT-5 with 1 and 2.5 meter resolution were used and combined with Geographical information system (GIS) database to analyze the geospatial indicators using the leapfrog development index. Kuantan city has been selected as a study area to examine the leapfrog development based on land use pattern for year 2012. The findings show Kuantan has identified as non-sprawling cities with result from characterization in leapfrog development that has been tested. However, the gap between sprawl and non-sprawling was very low. It is anticipated this research will provide a new direction in sprawl nationally that address finding of sprawl at the atomic level and present a robust analytical approach for characterizing urban development in city scale at once promoting a city via GIS & Remote Sensing technology respectively towards Digital and Green cities.

  12. Transcervical artificial insemination in dogs and cats: review of the technique and practical aspects.

    PubMed

    Romagnoli, S; Lopate, C

    2014-10-01

    The technique of transcervical catheterization for artificial insemination has gained practical importance over the last 3 and 1 decades in bitches and queens, respectively. The vagina of both species has a thickening of the dorsal aspect called dorsal medial fold, which restricts the lumen of the paracervix, making catheterization of the cervix difficult both with manual and endoscopic techniques. Manual catheters have been used initially in the bitch and are now gradually being replaced by rigid endoscopy through the adaptation of human cystoscopes and ureteroscopes. Cystoscopes provide excellent imaging of the vagina, but cervical catheterization is more difficult due to the oblique 30° viewing angle of its telescope and may not be long enough to catheterize large size bitches. Ureteroscopes allow an acceptable view of the vaginal mucosa and offer advantages such as the possibility to catheterize the cervix of bitches of all body sizes, manipulate the cervical tubercle when the external cervical os is not visible, offer a better visualization of the cervix using the shunt (a large Foley catheter which allows insufflation and distention of the vagina). Feline cervical catheterization has been achieved with three different types of catheters; the last one, developed following careful anatomical studies of how the feline vaginal lumen changes during estrus, allows cervical catheterization thanks to digital manipulation of the cervix through the rectum. PMID:25277433

  13. Umbilical vein catheterization in the critical newborn: a review of anatomy and technique.

    PubMed

    Tomek, Scott; Asch, Susan

    2013-02-01

    Why attempt a UVC line when intraosseous access is often available and the literature has demonstrated its ease of placement and effectiveness even in neonates? This article is not intended to suggest giving up IO vascular access if you currently have it in your toolbox. The intent was to discuss an alternative to IO vascular access when it fails--for example, when a tibia is fractured during an IO attempt or is not an option for other reasons. The Fast-Cath UVC is another tool in the advance EMS clinician's arsenal that can be easily learned and utilized. It is an effective option for vascular access in the distressed newborn when other options have failed or are not available. PMID:23469464

  14. Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation, Cooling, and Catheterization Registry (ROSCCC Registry)

    PubMed Central

    Chelvanathan, Anjala; Allen, David; Bews, Hilary; Ducas, John; Minhas, Kunal; Ravandi, Amir; Jassal, Davinder S.; Hussain, Farrukh

    2016-01-01

    Objective. Out of hospital cardiac arrest (OHCA) patients are a critically ill patient population with high mortality. Combining mild therapeutic hypothermia (MTH) with early coronary intervention may improve outcomes in this population. The aim of this study was to evaluate predictors of mortality in OHCA patients undergoing MTH with and without cardiac catheterization. Design. A retrospective cohort of OHCA patients who underwent MTH with catheterization (MTH + C) and without catheterization (MTH + NC) between 2006 and 2011 was analyzed at a single tertiary care centre. Predictors of in-hospital mortality and neurologic outcome were determined. Results. The study population included 176 patients who underwent MTH for OHCA. A total of 66 patients underwent cardiac catheterization (MTH + C) and 110 patients did not undergo cardiac catheterization (MTH + NC). Immediate bystander CPR occurred in approximately half of the total population. In the MTH + C and MTH + NC groups, the in-hospital mortality was 48% and 78%, respectively. The only independent predictor of in-hospital mortality for patients with MTH + C, after multivariate analysis, was baseline renal insufficiency (OR = 8.2, 95% CI 1.8–47.1, and p = 0.009). Conclusion. Despite early cardiac catheterization, renal insufficiency and the absence of immediate CPR are potent predictors of death and poor neurologic outcome in patients with OHCA. PMID:26885436

  15. Cardiac catheterization--before and after. What the patient should understand! What the nurse needs to know!

    PubMed

    Perdue, B

    1990-01-01

    This article provides helpful cardiac catheterization information for nurses preparing patients for this procedure and administering follow-up care. Pre-cath and post-cath teaching information and discharge instructions are included. PMID:2310468

  16. Successful intermittent self-catheterization teaching: one nurse's strategy of how and what to teach.

    PubMed

    Sheldon, Phyllis

    2013-01-01

    Learning how to perform intermittent self-catheterization (ISC) can be a daunting task for the patient with a newly diagnosed voiding dysfunction. The nurse can facilitate this learning process by working with the patient until knowledge and confidence is gained to successfully perform self-catheterization. Teaching ISC requires a knowledgeable and skilled nurse who can recognize the patient's physical and psychological readiness; instruct the patient in anatomy, physiology, and the disease process, as well as guide the patient through the procedure. With a comprehensive teaching program, the patient is empowered to care for his or her own urologic health and accomplish an important step in regaining independence. This article describes one nurse's strategy for teaching patients to become confident and competent in performing ISC. PMID:23930442

  17. A catheterization-training simulator based on a fast multigrid solver.

    PubMed

    Li, Shun; Guo, Jixiang; Wang, Qiong; Meng, Qiang; Chui, Yim-Pan; Qin, Jing; Heng, Pheng-Ann

    2012-01-01

    A VR-based simulator helps trainees develop skills for catheterization, a fundamental but difficult procedure in vascular interventional radiology. A deformable model simulates the complicated behavior of guide wires and catheters, using the principle of minimum total potential energy. A fast, stable multigrid solver ensures realistic simulation and real-time interaction. In addition, the system employs geometrically and topologically accurate vascular models based on improved parallel-transport frames, and it implements efficient collision detection. Experiments evaluated the method's stability, the solver's execution time, how well the simulation preserved the catheter's curved tip, and the catheter deformation's realism. An empirical study based on a typical selective-catheterization procedure assessed the system's feasibility and effectiveness. PMID:24807310

  18. Cutaneous antimicrobial preparation prior to intravenous catheterization in healthy dogs: clinical, microbiological, and histopathological evaluation.

    PubMed Central

    Coolman, B R; Marretta, S M; Kakoma, I; Wallig, M A; Coolman, S L; Paul, A J

    1998-01-01

    The purpose of this study was to determine the effects of a one-minute chlorhexidine gluconate skin preparation protocol prior to cephalic vein catheterization. Twenty-three healthy beagle dogs had one leg aseptically prepared and the opposite leg served as a control. Twenty-six- and 77-hour time groups were studied. Chlorhexidine-treated legs had significantly lower cutaneous bacterial counts than the control legs prior to catheter insertion and prior to catheter withdrawal for both time groups. Control legs developed significantly more dermatitis than the treated legs after 77 h. A one-minute preparation with 4% chlorhexidine gluconate was an effective method for sustained reduction of cutaneous bacterial counts at peripheral intravenous catheter insertion points in dogs. Increased cutaneous bacterial counts were associated with significantly more microscopic dermatitis in untreated legs after 77 h of catheterization. Images Figure 1. PMID:9861500

  19. Robot-assisted needle insertion for venous catheterization

    PubMed Central

    Pasternak, Jacyr

    2015-01-01

    Vein access can be challenging for a variety of patients. The development of robots-assisted central or peripheral veins puncture would facilitate life of health professionals and patients. New robots are under development for this purpose and probably they will become available for practical use in the near future. These techniques may decrease significantly the cost of medicine, which currently uses less informatics resources than other industries. PMID:26313434

  20. Severe papillary muscle dysfunction substantiated by atrial pacing during cardiac catheterization.

    PubMed

    Finn, M C; Bower, P J

    1977-05-01

    A patient experienced episodic pulmonary edema accompanying nocturnal angina pectoris. The symptoms were provoked at cardiac catheterization by atrial pacing. Simultaneous onset of chest pain, shortness of breath, and sudden appearance of a large V wave in the pulmonary artery wedge pressure contour confirmed acute mitral valve regurgitation. Rapid reversal of these changes after nitroglycerin administration supported "papillary muscle dysfunction" as the explanation for these hemodynamic changes. PMID:403754

  1. SU-E-P-10: Imaging in the Cardiac Catheterization Lab - Technologies and Clinical Applications

    SciTech Connect

    Fetterly, K

    2014-06-01

    Purpose: Diagnosis and treatment of cardiovascular disease in the cardiac catheterization laboratory is often aided by a multitude of imaging technologies. The purpose of this work is to highlight the contributions to patient care offered by the various imaging systems used during cardiovascular interventional procedures. Methods: Imaging technologies used in the cardiac catheterization lab were characterized by their fundamental technology and by the clinical applications for which they are used. Whether the modality is external to the patient, intravascular, or intracavity was specified. Specific clinical procedures for which multiple modalities are routinely used will be highlighted. Results: X-ray imaging modalities include fluoroscopy/angiography and angiography CT. Ultrasound imaging is performed with external, trans-esophageal echocardiography (TEE), and intravascular (IVUS) transducers. Intravascular infrared optical coherence tomography (IVOCT) is used to assess vessel endothelium. Relatively large (>0.5 mm) anatomical structures are imaged with x-ray and ultrasound. IVUS and IVOCT provide high resolution images of vessel walls. Cardiac CT and MRI images are used to plan complex cardiovascular interventions. Advanced applications are used to spatially and temporally merge images from different technologies. Diagnosis and treatment of coronary artery disease frequently utilizes angiography and intra-vascular imaging, and treatment of complex structural heart conditions routinely includes use of multiple imaging modalities. Conclusion: There are several imaging modalities which are routinely used in the cardiac catheterization laboratory to diagnose and treat both coronary artery and structural heart disease. Multiple modalities are frequently used to enhance the quality and safety of procedures. The cardiac catheterization laboratory includes many opportunities for medical physicists to contribute substantially toward advancing patient care.

  2. Thrombus Formation After Percutaneous Catheterization and Manual Compression of the Femoral Artery in Heparinized Sheep

    SciTech Connect

    Kim, Young Hwan; Pavcnik, Dusan Kakizawa, Hideyaki; Uchida, Barry T.; Burke, Allen; Loriaux, Marc; Keller, Frederick S.; Rosch, Josef

    2010-04-15

    The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The evaluation was done in 38 SFAs of 19 heparinized (100 mg/kg) sheep. After a 5-min catheterization with an 8-Fr sheath, a 5-min compression was applied. Follow-up angiograms to evaluate hemostasis were done immediately after release of compression and then at 2.5-min intervals until no extravasation was present. Compression was reapplied between angiograms. Final angiograms were performed approximately 30 min after hemostasis and after 3 min of passive flexion and extension of sheep hind limbs. Sheep were then euthanized and SFA specimens with surrounding tissues excised for histopathologic evaluation. Both types of compression caused similar changes in the catheterized SFAs. Follow-up angiograms showed mild arterial narrowing in 14 SFAs and intraluminal clots in 9 SFAs. Histology revealed periarterial hematoma in all 38 specimens. Intraluminal thrombi consisting predominantly of platelets and fibrin were present in 32 SFAs. Their size varied from superficial elevations (8 arteries) to medium-sized, 1- to 2-mm, polypoid protrusions (15 arteries) to large polypoid clots, 3-4 mm long (9 arteries). In six SFAs, the arterial access sites were not included in the obtained specimens. In conclusion, hemostasis with manual compression is achieved in the acute phase by formation of a predominantly platelet-fibrin thrombus occluding the arterial wall access site and often extending significantly into the arterial lumen. The healing process of arterial access sites should be explored several days after catheterization.

  3. X-Ray Magnetic Resonance Fusion to Internal Markers and Utility in Congenital Heart Disease Catheterization

    PubMed Central

    Dori, Yoav; Sarmiento, Marily; Glatz, Andrew C.; Gillespie, Matthew J.; Jones, Virginia M.; Harris, Matthew A.; Whitehead, Kevin K.; Fogel, Mark A.; Rome, Jonathan J.

    2012-01-01

    Background X-ray magnetic resonance fusion (XMRF) allows for use of 3D data during cardiac catheterization. However, to date, technical requirements have limited the use of this modality in clinical practice. We report on a new internal-marker XMRF method that we have developed and describe how we used XMRF during cardiac catheterization in congenital heart disease. Methods and Results XMRF was performed in a phantom and in 23 patients presenting for cardiac catheterization who also needed cardiac MRI for clinical reasons. The registration process was performed in <5 minutes per patient, with minimal radiation (0.004 to 0.024 mSv) and without contrast. Registration error was calculated in a phantom and in 8 patients using the maximum distance between angiographic and 3D model boundaries. In the phantom, the measured error in the anteroposterior projection had a mean of 1.15 mm (standard deviation, 0.73). The measured error in patients had a median of 2.15 mm (interquartile range, 1.65 to 2.56 mm). Internal markers included bones, airway, image artifact, calcifications, and the heart and vessel borders. The MRI data were used for road mapping in 17 of 23 (74%) cases and camera angle selection in 11 of 23 (48%) cases. Conclusions Internal marker–based registration can be performed quickly, with minimal radiation, without the need for contrast, and with clinically acceptable accuracy using commercially available software. We have also demonstrated several potential uses for XMRF in routine clinical practice. This modality has the potential to reduce radiation exposure and improve catheterization outcomes. PMID:21536785

  4. Mechanical chest compressions in the coronary catheterization laboratory - do not hesitate to go step further!

    PubMed

    Bělohlávek, Jan; Kovárník, Tomáš

    2016-01-01

    Authors Wagner et al. in your journal demonstrated effectiveness of mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts. We dare to comment on this article and advocate to use mechanical chest compressions only as a bridge to extracorporeal membrane oxygenation to completely substitute failed circulation and enable percutaneous coronary intervention or other procedures to treat the cause of cardiac arrest. PMID:27530540

  5. [Acute urinary retention: a few simple rules for a successful catheterization].

    PubMed

    Birkhäuser, Frédéric D; Studer, Urs E

    2015-01-01

    Acute urinary retention is a common emergency condition in elderly men. Transurethral and suprapubic catheterization are easy and safe procedures provided that a few simple rules are followed. Primarily, a transurethral catheter is placed if there is no urethral injury or stricture. Local anaesthesia of the urethra up to the sphincter region and a well-stretched penis warrant an atraumatic insertion of the catheter into the bladder. The use of a thick catheter with a round tip or of a catheter with a bended tip under rectal guidance facilitate the insertion of the catheter in difficult conditions. Alternatively, a suprapubic catheterization can be performed provided that no contraindication such as history or suspicion of transitional cell carcinoma is present. Optimal interventional conditions using ultrasound-guidance are mandatory in patients after abdominal surgery and with hemorrhagic diathesis in view of a safe and straight-forward placement of the suprapubic catheterization. In case of persistent bleeding after insertion of a suprapubic catheter, the suprapubic catheter should be replaced by one with a balloon blocked and kept under tension for several minutes. PMID:25533254

  6. Risk of Bleeding in End-Stage Liver Disease Patients Undergoing Cardiac Catheterization

    PubMed Central

    Mahmoud, Ahmed M.; Elgendy, Islam Y.; Choi, Calvin Y.

    2015-01-01

    Patients with end-stage liver disease frequently have baseline coagulopathies. The international normalized ratio is in common use for the estimation of bleeding tendency in such patients, especially those undergoing an invasive procedure like cardiac catheterization. The practice of international normalized ratio measurement—followed by pharmacologic (for example, vitamin K or fresh frozen plasma) or nonpharmacologic intervention—is still debatable. The results of multiple randomized trials have shown the superiority of the radial approach over femoral access in reducing catheterization bleeding. This reduction in bleeding in turn decreases the risk and cost of blood-product transfusion. However, there is little evidence regarding the use of the radial approach in the end-stage liver disease patient population specifically. In this review, we summarize the studies that have dealt with cardiac catheterization in patients who have end-stage liver disease. We also discuss the role of the current measurements that are used to reduce the risk of bleeding in these same patients. PMID:26504433

  7. Intermittent catheterization failure and an approach to bladder rehabilitation in spinal cord injury patients.

    PubMed

    Perkash, I

    1978-01-01

    Forty-six patients with spinal injury with dysfunctional neurogenic bladder were analyzed. Fourteen patients on prolonged intermittent catheterization from 12 weeks to more than 1 year did not develop a balanced bladder, 14 patients had indwelling catheters after intermittent catheterization failed elsewhere and 18 patients on external condom drainage presented with difficult voiding and repeated infections. There were 16 quadriplegics (1 incomplete), 21 paraplegics, and 9 incomplete cauda equina lesions. Urologic and urodynamic evaluation revealed detrusor-sphincter dyssynergia in 15 patients, vesicoureteral reflux in 10, and areflexic bladders in 11. Five patients over the age of 55 years showed slight enlargement of the prostrate. Some degree of bladder neck fibrosis was suspected in 26. More than one urologic pathology was encountered in the same patient. Transurethral sphincterotomy was carried out in 38 patients and only one transurethral resection of the prostrate (TURP) in an incomplete quadriplegic patient. In seven patients with no obvious urodynamic abnormality, a balanced bladder was achieved with intermittent catheterization; however, one of these patients needed a transurethral sphincterotomy on subsequent admission. A balanced bladder was achieved in all patients except the one with incomplete quadriplegia. Significant improvement in vesicoureteral reflux and relief from autonomic dysreflexic symptoms were recorded in all patients. PMID:619856

  8. Intermittent catheterization in neurologic patients: Update on genitourinary tract infection and urethral trauma.

    PubMed

    Biardeau, X; Corcos, J

    2016-04-01

    Intermittent catheterization is considered the standard of care in most neurologic patients with lower urinary tract disorders. However, in this context, genitourinary tract infection and urethral trauma represent specific challenges. Such conditions have been found to significantly deteriorate quality of life and complicate subsequent treatments. Only optimal prevention associated with appropriate treatment allows for the long-term continuation of such bladder management. Here, we discuss the diagnosis and therapeutic and preventive approaches associated with genitourinary tract infection and urethral trauma in this specific population. This "state-of-the-art" article results from a literature review (MEDLINE articles and scientific society guidelines) and the authors' experience. It was structured in a didactic way to facilitate comprehension and promote the implementation of advice and recommendations in daily practice. Genitourinary tract infection and urethral trauma associated with intermittent catheterization in neurologic patients should be managed with a global approach, including patient and caregiver education, optimal catheterization with hydrophilic-coated or pre-lubricated catheters and adequate use of antibiotic therapy. PMID:27053002

  9. Catheterization-Doppler discrepancies in nonsimultaneous evaluations of aortic stenosis.

    PubMed

    Aghassi, Payam; Aurigemma, Gerard P; Folland, Edward D; Tighe, Dennis A

    2005-05-01

    Prior validation studies have established that simultaneously measured catheter (cath) and Doppler mean pressure gradients (MPG) correlate closely in evaluation of aortic stenosis (AS). In clinical practice, however, cath and Doppler are rarely performed simultaneously; which may lead to discrepant results. Accordingly, our aim was to ascertain agreement between these methods and investigate factors associated with discrepant results. We reviewed findings in 100 consecutive evaluations for AS performed in 97 patients (mean age 72 +/- 10 yr) in which cath and Doppler were performed within 6 weeks. We recorded MPG, aortic valve area (AVA), cardiac output, and ejection fraction (EF) by both methods. Aortic root diameter, left ventricular end-diastolic dimension (LVIDd) and posterior wall thickness (PWT) were measured by echocardiography and gender, heart rate, and heart rhythm were also recorded. An MPG discrepancy was defined as an intrapatient difference > 10 mmHg. Mean pressure gradients by cath and Doppler were 36 +/- 22 mmHg and 37 +/- 20 mmHg, respectively (P = 0.73). Linear regression showed good correlation (r = 0.82) between the techniques. An MPG discrepancy was found in 36 (36%) of 100 evaluations; in 19 (53%) of 36 evaluations MPG by Doppler was higher than cath, and in 17 (47%) of 36, it was lower. In 33 evaluations, EF differed by >10% between techniques. Linear regression analyses revealed that EF difference between studies was a significant predictor of MPG discrepancy (P = 0.004). Women had significantly higher MPG than men by both cath and Doppler (43 +/- 25 mmHg versus 29 +/- 15 mmHg [P = 0.001]; 42 +/- 23 mmHg versus 32 +/- 15 mmHg [P = 0.014], respectively). Women exhibited discrepant results in 23 (47%) of 49 evaluations versus 13 (25%) of 51 evaluations in men (P = 0.037). After adjustment for women's higher MPG, there was no statistically significant difference in MPG discrepancy between genders (P = 0.22). No significant interactions between

  10. Sex, Socioeconomic Status, Access to Cardiac Catheterization and Outcomes for Acute Coronary Syndromes in the Context of Universal Healthcare Coverage

    PubMed Central

    Fabreau, Gabriel E.; Leung, Alexander A.; Southern, Danielle A.; Knudtson, Merrill L.; McWilliams, J. Michael; Ayanian, John Z.; Ghali, William A.

    2015-01-01

    Background Sex and neighborhood socioeconomic status (nSES) may independently affect the care and outcomes of acute coronary syndromes (ACS), partly through barriers in timely access to cardiac catheterization. We sought to determine whether sex modifies the association between nSES, and the receipt of cardiac catheterization and mortality following an ACS in a universal healthcare system. Methods and Results We studied 14,012 ACS patients admitted to cardiology services between April 18, 2004 and December 31, 2011 in Southern Alberta, Canada. We used multivariable logistic regression to compare the odds of cardiac catheterization within 2 and 30 days of admission and the odds of 30-day and 1-year mortality for men and women by quintile of neighborhood median household income. Significant relationships between nSES and the receipt of cardiac catheterization and mortality after ACS were detected for women but not men. When examined by nSES, each incremental decrease in neighborhood income quintile for women was associated with a 6% lower odds of receiving cardiac catheterization within 30 days (p=0.01) and a 14% higher odds of 30-day mortality (p=0.03). For men, each decrease in neighborhood income quintile was associated with a 2% lower odds of receiving catheterization within 30 days (p=0.10), and a 5% higher odds of 30-day mortality (p=0.36). Conclusions Associations between nSES and receipt of cardiac catheterization and 30-day mortality were noted for women but not men in a universal healthcare system. Care protocols designed to improve equity of access to care and outcomes are required, especially for low-income women. PMID:24895450