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Sample records for interventional radiology treatment

  1. Interventional Radiologic Treatment for Idiopathic Portal Hypertension

    SciTech Connect

    Hirota, Shozo; Ichikawa, Satoshi; Matsumoto, Shinichi; Motohara, Tomofumi; Fukuda, Tetsuya; Yoshikawa, Takeshi

    1999-07-15

    Purpose: To evaluate the usefulness of interventional radiological treatment for idiopathic portal hypertension. Methods: Between 1995 and 1998, we performed an interventional radiological treatment in five patients with idiopathic portal hypertension, four of whom had refused surgery and one of whom had undergone surgery. Three patients with gastroesophageal varices (GEV) were treated by partial splenic embolization (PSE), one patient with esophageal varices (EV) and massive ascites by transjugular intrahepatic portosytemic shunt (TIPS) and PSE, and one patient with GEV by percutaneous transhepatic obliteration (PTO). Midterm results were analyzed in terms of the effect on esophageal and/or gastric varices. Results: In one woman with severe GEV who underwent three sessions of PSE, there was endoscopic confirmation that the GEV had disappeared. In one man his EV shrunk markedly after two sessions of PSE. In two patients slight reduction of the EV was obtained with one application of PSE combined with endoscopic variceal ligation therapy. PTO for GV in one patient resulted in good control of the varices. All patients have survived for 16-42 months since the first interventional treatment, and varices are well controlled. Conclusion: Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone surgery.

  2. [Interventional radiology treatment of extensive pulmonary embolism and thromboembolic diseases].

    PubMed

    Battyáni, István; Dósa, Edit; Harmat, Zoltán

    2015-04-26

    The authors discuss interventional radiological methods in the field of vascular interventions applied in venous system diseases. Venous diseases can be life threatening without appropriate treatment and can lead to chronic venous diseases and venous insufficiency with long-term reduction in the quality of life. In addition, recurrent clinical symptoms require additional treatments. Interventional radiology has several methods that can provide fast and complete recovery if applied in time. The authors summarize these methods hoping that they will be available for a wide range of patients through the establishment of Interventional Radiological Centres and will be a part of the daily routine of patient care. Regarding the frequency of venous diseases and its influance on life quality the authors would like to draw attention to interventional radiological techniques and modern therapeutic possibilities. PMID:26047150

  3. Interventional Radiology Treatments for Liver Cancer

    MedlinePlus

    ... can be given without affecting the patient's overall health and most people can resume their usual activities in a few days. In this procedure, the interventional radiologist guides a small needle through the skin into ...

  4. Interventional radiology

    SciTech Connect

    Castaneda-Zuniga, W.R.

    1987-01-01

    This reference gives a step-by-step presentation of the elements of interventional radiology. CONTENTS: Introduction; Radiation protection; Embolotherapy; Interventional techniques in the management of gastrointestinal bleeding; Transluminal angioplasty; Thrombolytic therapy; Foreign body removal; Inferior vena cava filter placement; Percutaneous uroradiologic techniques; Interventional techniques in the biliary tract; Nonvascular gastrointestinal tract dilations; Percutaneous biopsy techniques; Drainage of abscess fluid collections in the abdomen.

  5. Radiological treatment of HCC: Interventional radiology at the heart of management.

    PubMed

    Aubé, C; Bouvier, A; Lebigot, J; Vervueren, L; Cartier, V; Oberti, F

    2015-06-01

    Interventional radiology is involved practically at each stage in the treatment of hepatocellular carcinoma, as recommended in the EASL-EORTC guidelines. It is even becoming more important as technological advances progress and as its long-term efficacy is assessed. Used curatively, thermoablation can obtain five-year survival rates of 40 to 70%, with a survival rate of 30% at 10years. As there are many tools available in order to be used, it requires a thorough pre-treatment assessment and discussion in a multidisciplinary team meeting. Regular patient reassessment is needed in order to be able to adjust treatment because of the complementarity of the treatments available and the course of the disease. PMID:25998997

  6. Interventional Radiology Strategies in the Treatment of Pseudomyxoma Peritonei

    SciTech Connect

    Sonnenberg, Eric van Goodacre, Brian W.; Wittich, Gerhard R.; Ali, Seham; Silverman, Stuart G.; Shankar, Sridhar; Tuncali, Kemal

    2005-05-15

    Purpose. To describe percutaneous maneuvers to treat the unusual entity symptomatic pseudomyxoma peritonei (PMP). Methods. Four patients with PMP were treated by interventional radiology techniques that included large catheters (20-30 Fr) alone (n = 3), multiple catheters (n = 4), and dextran sulfate as a catalytic agent through smaller catheters (n = 1). The causes of the PMP were tumors in the ovary (2 patients), appendix (1 patient), and colon (1 patient). Each patient previously had undergone at least two operations to remove the PMP, and all patients had symptomatic recurrence. An in vitro analysis of catalytic agents also was performed. Results. All four patients improved symptomatically. Follow-up CT scans demonstrated marked reduction of PMP material in all cases. One patient underwent another interventional radiology session 5 months after the first; the other three patients had no recurrence of symptoms. One patient had reversible hypotension 2 hr after the procedure. The amount of material removed varied from 3 to 6 L. Conclusion. These interventional radiology techniques were effective and safe for PMP and suggest options for this difficult medical and surgical problem.

  7. Common Interventional Radiology Procedures

    MedlinePlus

    ... of common interventional techniques is below. Common Interventional Radiology Procedures Angiography An X-ray exam of the ... into the vertebra. Copyright © 2016 Society of Interventional Radiology. All rights reserved. 3975 Fair Ridge Drive • Suite ...

  8. Pediatric Interventional Radiology: Vascular Interventions.

    PubMed

    Kandasamy, Devasenathipathy; Gamanagatti, Shivanand; Gupta, Arun Kumar

    2016-07-01

    Pediatric interventional radiology (PIR) comprises a range of minimally invasive diagnostic and therapeutic procedures that are performed using image guidance. PIR has emerged as an essential adjunct to various surgical and medical conditions. Over the years, technology has undergone dramatic and continuous evolution, making this speciality grow. In this review, the authors will discuss various vascular interventional procedures undertaken in pediatric patients. It is challenging for the interventional radiologist to accomplish a successful interventional procedure. There are many vascular interventional radiology procedures which are being performed and have changed the way the diseases are managed. Some of the procedures are life saving and have become the treatment of choice in those patients. The future is indeed bright for the practice and practitioners of pediatric vascular and non-vascular interventions. As more and more of the procedures that are currently being performed in adults get gradually adapted for use in the pediatric population, it may be possible to perform safe and successful interventions in many of the pediatric vascular lesions that are otherwise being referred for surgery. PMID:26964551

  9. Interventional radiology for the treatment of hepatic malignancy.

    PubMed

    Islam, M N; Azad, S A; Karim, E; Rahman, S M; Khan, N A

    2012-04-01

    Hepatic malignancies are commonly faced clinical problem. Non surgical minimally invasive therapies are current treatment goal. Interventional radiologists are going forwards with such minimally invasive but effective therapies by transarterial chemoembolization, radiofrequency ablation, percutaneous ethanol injection, cryoablation, laser ablation and upcoming promising procedures like focused ultrasound & gene therapy. Response rates of transarterial chemoembolization for primary and most metastatic tumors are 60-80% with survival rates of 70% at 1 year, 40% at 3 years, and 10% at 5 years. Percutaneous ethanol injection ablation is the most accepted minimally invasive method worldwide, for hepatocellular carcinomas less than 5 cm in diameter, the complete ablation rate is about 70-75%; in 5-8 cm diameter, encapsulated hepatocellular carcinomas, the rate is about 60%. RFA is becoming a widely used ablative technique for primary and secondary liver tumors, with a 52-67% complete ablation rate at 1 year and survival rates of 96%, 64%, and 40% at 1, 3 and 5 years, respectively. Meticulous patient selection, careful planning and execution are imperative and should be carried out with the participation of interventional and diagnostic radiologists, nuclear medicine specialists, and medical, surgical, and radiation oncologists. In terms of cost, equipment, technical efficiency, efficacy & repeated applicability percutaneous procedures particularly PEI & RFA can be carried out in Bangladesh. PMID:22561791

  10. Society of Interventional Radiology

    MedlinePlus

    ... how interventional radiology research improves patients’ lives at Society of Interventional Radiology’s 2017 Annual Scientific Meeting; read ... comments to CMS on two MACRA coding issues; society is engaged with CMS as they develop codes ...

  11. Interventional Radiology in China

    SciTech Connect

    Teng Gaojun Xu Ke; Ni Caifang; Li Linsun

    2008-03-15

    With more than 3000 members, the Chinese Society of Interventional Radiology (CSIR) is one of the world's largest societies for interventional radiology (IR). Nevertheless, compared to other societies such as CIRSE and SIR, the CSIR is a relatively young society. In this article, the status of IR in China is described, which includes IR history, structure and patient management, personnel, fellowship, training, modalities, procedures, research, turf battle, and insightful visions for IR from Chinese interventional radiologists.

  12. Current Status of Interventional Radiology Treatment of Infrapopliteal Arterial Disease

    SciTech Connect

    Rand, T.; Uberoi, R.

    2013-06-15

    Treatment of infrapopliteal arteries has developed to a standard technique during the past two decades. With the introduction of innovative devices, a variety of techniques has been created and is still under investigation. Treatment options range from plain balloon angioplasty (POBA), all sorts of stent applications, such as bare metal, balloon expanding, self-expanding, coated and drug-eluting stents, and bio-absorbable stents, to latest developments, such as drug-eluting balloons. Regarding the scientific background, several prospective, randomized studies with relevant numbers of patients have been (or will be) published that are Level I evidence. In contrast to older studies, which primarily were based mostly on numeric parameters, such as diameters or residual stenoses, more recent study concepts focus increasingly on clinical features, such as amputation rate improvement or changes of clinical stages and quality of life standards. Although it is still not decided, which of the individual techniques might be the best one, we can definitely conclude that whatever treatment of infrapopliteal arteries will be used it is of substantial benefit for the patient. Therefore, the goal of this review is to give an overview about the current developments and techniques for the treatment of infrapopliteal arteries, to present clinical and technical results, to weigh individual techniques, and to discuss the recent developments.

  13. How to Start Interventional Radiology

    PubMed Central

    Ghanaati, Hossein; Firouznia, Kavous; Jalali, Amir Hossein; Shakiba, Madjid

    2013-01-01

    Interventional techniques aim to find safer and better ways to treat vascular diseases even in many instances, the interventional radiology solutions has been considered the only treatment option for the patients. Interventional radiologists are specialists who perform minimally invasive procedures instead of surgery or other treatments. These procedures apply various imaging and catheterization procedures in order to diagnose and treat diseases. In each country, interventional radiology practice establishment of varies according to local factors, but following a standard strategy seems better to set up this facility. According to above mentioned points, we decided to establish this specialty in our hospital since 2001 as the pioneer center in Iran. In this presentation we will discuss about our experience for start interventional radiology. PMID:24693402

  14. Practical interventional radiology

    SciTech Connect

    Von Sonnenberg, E.; Mueller, P.R.

    1988-01-01

    This book describes techniques employed in interventional radiology with emphasis on imaging leading to intervention. Includes the entire array of procedures available to the radiologist, discussing the indications, materials, technique, results, and complications for each. Covers the chest, abdomen, bone, pediatric considerations, and nursing care.

  15. Interventional Radiological Treatment of Perihepatic Vascular Stenosis or Occlusion in Pediatric Patients After Liver Transplantation

    SciTech Connect

    Uller, Wibke; Knoppke, Birgit; Schreyer, Andreas G.; Heiss, Peter; Schlitt, Hans J.; Melter, Michael; Stroszczynski, Christian; Zorger, Niels; Wohlgemuth, Walter A.

    2013-12-15

    Purpose: Evaluation of the efficacy and safety of percutaneous treatment of vascular stenoses and occlusions in pediatric liver transplant recipients. Methods: Fifteen children (mean age 8.3 years) underwent interventional procedures for 18 vascular complications after liver transplantation. Patients had stenoses or occlusions of portal veins (n = 8), hepatic veins (n = 3), inferior vena cava (IVC; n = 2) or hepatic arteries (n = 5). Technical and clinical success rates were evaluated. Results: Stent angioplasty was performed in seven cases (portal vein, hepatic artery and IVC), and sole balloon angioplasty was performed in eight cases. One child underwent thrombolysis (hepatic artery). Clinical and technical success was achieved in 14 of 18 cases of vascular stenoses or occlusions (mean follow-up 710 days). Conclusion: Pediatric interventional radiology allows effective and safe treatment of vascular stenoses after pediatric liver transplantation (PLT). Individualized treatment with special concepts for each pediatric patient is necessary. The variety, the characteristics, and the individuality of interventional management of all kinds of possible vascular stenoses or occlusions after PLT are shown.

  16. Role of Interventional Radiology in the Treatment of Biliary Strictures Following Orthotopic Liver Transplantation

    SciTech Connect

    Righi, Dorico; Cesarani, Federico; Muraro, Emanuele; Gazzera, Carlo; Salizzoni, Mauro; Gandini, Giovanni

    2002-01-15

    Purpose: To evaluate the efficacy and safety of percutaneous treatment of biliary strictures complicating orthotopic liver transplantation (OLT). Methods: Between October 1990 and May 2000, 619 patients underwent 678 liver transplants. Seventy of the 619 (11%) patients were found to be affected by biliary strictures by July 2000. Bilioplasty was performed in 51 of these 70 (73%) patients. A cohort of 33 of 51 (65%) patients were clinically followed for more than 12 months after the last percutaneous treatment and included in the survey results. Results: After one to three treatments 24 of 33 (73%)patients were stricture-free on ultrasound and MR cholangiography follow-up. A delayed stricture recurrence required a fourth percutaneous bilioplasty in two of 33 (6%) patients. A surgical bilioenteric anastomosis was performed in six of 33 (18%) patients.Retransplantation was performed due to ischemic damage in one of 33(3%) patients. Conclusion: Interventional radiology is an effective therapeutic alternative for the treatment of most biliary strictures complicating OLT. It has a high success rate and should be considered before surgical interventions. Elective surgery may be necessary in a few failed cases or those with more severe and extensive biliary strictures.

  17. Interventional radiology in the elderly

    PubMed Central

    Katsanos, Konstantinos; Ahmad, Farhan; Dourado, Renato; Sabharwal, Tarun; Adam, Andreas

    2009-01-01

    Interventional radiological percutaneous procedures are becoming all the more important in the curative or palliative management of elderly frail patients with multiple underlying comorbidities. They may serve either as alternative primary minimally invasive therapies or adjuncts to traditional surgical treatments. The present report provides a concise review of the most important interventional radiological procedures with a special focus on the treatment of the primary debilitating pathologies of the elderly population. The authors elaborate on the scientific evidence and latest developments of thermoablation of solid organ malignancies, palliative stent placement for gastrointestinal tract cancer, airway stenting for tracheobronchial strictures, endovascular management of aortic and peripheral arterial vascular disease, and cement stabilization of osteoporotic vertebral fractures. The added benefits of high technical and clinical success coupled with lower procedural mortality and morbidity are highlighted. PMID:19503761

  18. Interventional Treatments for Liver Disease

    MedlinePlus

    ... Search Patient information Membership Directory (SIR login) Interventional Radiology Interventional Treatments for Liver Disease There are a ... liver that can be treated with nonsurgical, interventional radiology techniques. Portal Hypertension Seen most frequently in patients ...

  19. Cardiovascular and Interventional Radiological Society of Europe Commentary on the Treatment of Chronic Cerebrospinal Venous Insufficiency

    SciTech Connect

    Reekers, J. A.; Lee, M. J.; Belli, A. M.; Barkhof, F.

    2011-02-15

    directly approached by MS patients, contact the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) for advice. Worldwide, several centres are actively promoting and performing balloon dilatation, with or without stenting, for CCSVI. Thus far, no trial data are available, and there is currently no randomized controlled trial (RCT) in progress Therefore, the basis for this new treatment rests on anecdotal evidence and successful testimonies by patients on the Internet. CIRSE believes that this is not a sound basis on which to offer a new treatment, which could have possible procedure-related complications, to an often desperate patient population.

  20. Cardiovascular and Interventional Radiological Society of Europe commentary on the treatment of chronic cerebrospinal venous insufficiency.

    PubMed

    Reekers, J A; Lee, M J; Belli, A M; Barkhof, F

    2011-02-01

    , who are directly approached by MS patients, contact the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) for advice. Worldwide, several centres are actively promoting and performing balloon dilatation, with or without stenting, for CCSVI. Thus far, no trial data are available, and there is currently no randomized controlled trial (RCT) in progress Therefore, the basis for this new treatment rests on anecdotal evidence and successful testimonies by patients on the Internet. CIRSE believes that this is not a sound basis on which to offer a new treatment, which could have possible procedure-related complications, to an often desperate patient population. PMID:21136256

  1. Interventional radiology neck procedures.

    PubMed

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation. PMID:27138033

  2. Ruptured Internal Iliac Artery Aneurysm: Staged Emergency Endovascular Treatment in the Interventional Radiology Suite

    SciTech Connect

    Kelckhoven, Bas-Jeroen van Bruijninckx, Boy M. A.; Knippenberg, Bob; Overhagen, Hans van

    2007-07-15

    Ruptured aneurysms of the internal iliac artery (IIA) are rare and challenging to treat surgically. Due to their anatomic location they are difficult to operate on and perioperative morbidity is high. An endovascular approach can be helpful. We recently treated a patient with a ruptured IIA aneurysm in the interventional radiology suite with embolization of the side-branch of the IIA and placement of a covered stent in the ipsilateral common and external iliac arteries. A suitable stent-graft was not available initially and had to be brought in from elsewhere. An angioplasty balloon was temporarily placed across the ostium of the IIA to obtain hemostasis. Two hours later, the procedure was finished by placing the stent-graft.

  3. Poul Erik Andersen's radiological work on Osteochondrodysplasias and interventional radiology

    PubMed Central

    Andersen, Poul Erik

    2011-01-01

    Poul Erik Andersen is a Professor and Interventional Radiologist at the University of Southern Denmark, Odense and Odense University Hospital, Denmark. His innovative and expertise is primarily in vascular interventions where he has introduced and developed many procedures at Odense University Hospital. His significant experience and extensive scientific work has led to many posts in the Danish Society of Interventional Radiology, the European Society of Radiology and the Cardiovascular and Interventional Radiological Society of Europe, where he is a fellow and has passed the European Board of Interventional Radiology - The European qualification in Interventional Radiology. PMID:22022640

  4. Interventional Radiology in Liver Transplantation

    SciTech Connect

    Karani, John B. Yu, Dominic F.Q.C.; Kane, Pauline A.

    2005-04-15

    Radiology is a key specialty within a liver transplant program. Interventional techniques not only contribute to graft and recipient survival but also allow appropriate patient selection and ensure that recipients with severe liver decompensation, hepatocellular carcinoma or portal hypertension are transplanted with the best chance of prolonged survival. Equally inappropriate selection for these techniques may adversely affect survival. Liver transplantation is a dynamic field of innovative surgical techniques with a requirement for interventional radiology to parallel these developments. This paper reviews the current practice within a major European center for adult and pediatric transplantation.

  5. Minimally Invasive Radiologically Guided Intervention for the Treatment of Salivary Calculi

    SciTech Connect

    Brown, Jackie E.; Drage, Nicholas A.; Escudier, Michael P.; Wilson, Ron F.; McGurk, Mark

    2002-10-15

    Purpose: To describe the technique and examine the value of salivary stone extraction using a minimally invasive, radiologically guided approach as an alternative to salivary gland surgery for the treatment of benign salivary gland obstruction. Methods: Eighty-six cases of sialolithiasis (83 patients) were treated by stone removal using a Dormia basket under local anesthesia and fluoroscopic guidance. Postoperative assessment was made clinically at review, by sialogram and by questionnaire. Results: Of 86 cases of sialolithiasis treated, in 55 (64%)it was possible to remove all stones. In 12 cases (14%) part of a stone or some of a number of calculi were removed and in 19 cases (22%) the procedure failed. The commonest reason for failure was fixation of the stone within the duct. Symptoms at review (range 1-49 months, mean 17 months) were relieved in 55 of 67 (82%) of cases where a stone or portion of stone was removed. Conclusions:Stone removal from the salivary duct system by radiologically guided,minimally invasive approach is a simple procedure with low morbidity and high patient acceptance when appropriate selection criteria are applied. These criteria are considered and recommendations made.

  6. Interventional radiology. Application to family practice.

    PubMed Central

    Asch, M.; Law, P. K.; Jaffer, N.

    1996-01-01

    New minimally invasive interventional radiologic procedures are being developed and refined. These alternatives to standard surgical treatments have fewer complications, shorter hospital stays, and lower costs. A variety of procedures that assist in both benign and malignant diseases are particularly suited for palliative care in end-stage malignancy. Images Figure 1, Figure 2 Figure 3, Figure 4 Figure 5 PMID:8792020

  7. Pediatric urologic radiology. Intervention and endourology

    SciTech Connect

    Mandell, V.S.; Mandell, J.; Gaisie, G.

    1985-02-01

    Over the past 10 years new imaging and interventional techniques have drastically changed the ease and scope of urologic diagnosis and treatment. It is both rewarding and exciting to approach each clinical problem with a broad armamentarium of available studies, always seeking the most efficient and direct route to diagnosis. Similarly, radiologic interventional techniques are potentially applicable to a multitude of problems and should be innovatively considered in the urologic patient including patients in the pediatric age group.

  8. [Radiation protection in interventional radiology].

    PubMed

    Adamus, R; Loose, R; Wucherer, M; Uder, M; Galster, M

    2016-03-01

    The application of ionizing radiation in medicine seems to be a safe procedure for patients as well as for occupational exposition to personnel. The developments in interventional radiology with fluoroscopy and dose-intensive interventions require intensified radiation protection. It is recommended that all available tools should be used for this purpose. Besides the options for instruments, x‑ray protection at the intervention table must be intensively practiced with lead aprons and mounted lead glass. A special focus on eye protection to prevent cataracts is also recommended. The development of cataracts might no longer be deterministic, as confirmed by new data; therefore, the International Commission on Radiological Protection (ICRP) has lowered the threshold dose value for eyes from 150 mSv/year to 20 mSv/year. Measurements show that the new values can be achieved by applying all X‑ray protection measures plus lead-containing eyeglasses. PMID:26913507

  9. Interventional Radiology of the Urinary Tract.

    PubMed

    Berent, Allyson C

    2016-05-01

    Minimally invasive treatment options using interventional radiology and interventional endoscopy for urologic disease have become more common over the past decade in veterinary medicine. Urinary tract obstructions and urinary incontinence are the most common reasons for urinary interventions. Ureteral obstructions are underdiagnosed and a common clinical problem in veterinary medicine. Ureteral obstructions should be considered an emergency, and decompression should be performed as quickly as possible. Diagnostic imaging is the mainstay in diagnosing a ureteral obstruction and has changed in the last few years, with ultrasound and radiographs being the most sensitive tools in making this diagnosis preoperatively. PMID:26920646

  10. Successful treatment of complex cholangiolithiasis following orthotopic liver transplantation with interventional radiology

    PubMed Central

    Zhou, Chuan-Guo; Wei, Bao-Jie; Gao, Kun; Dai, Ding-Ke; Zhai, Ren-You

    2015-01-01

    Bile duct stones are a serious and the third most common complication of the biliary system that can occur following liver transplantation. The incidence rate of bile duct stones after liver transplantation is 1.8%-18%. The management of biliary stones is usually performed with endoscopic techniques; however, the technique may prove to be challenging in the treatment of the intrahepatic bile duct stones. We herein report a case of a 40-year-old man with rare, complex bile duct stones that were successfully eliminated with percutaneous interventional techniques. The complex bile duct stones were defined as a large number of bile stones filling the intra- and extrahepatic bile tracts, resulting in a cast formation within the biliary tree. Common complications such as hemobilia and acute pancreatitis were not present during the perioperative period. The follow-up period was 20 mo long. During the postoperative period, the patient maintained normal temperature, and normal total bilirubin and direct bilirubin levels. The patient is now living a high quality life. This case report highlights the safety and efficacy of the percutaneous interventional approach in the removal of complex bile duct stones following liver transplantation. PMID:25684970

  11. Successful treatment of complex cholangiolithiasis following orthotopic liver transplantation with interventional radiology.

    PubMed

    Zhou, Chuan-Guo; Wei, Bao-Jie; Gao, Kun; Dai, Ding-Ke; Zhai, Ren-You

    2015-02-14

    Bile duct stones are a serious and the third most common complication of the biliary system that can occur following liver transplantation. The incidence rate of bile duct stones after liver transplantation is 1.8%-18%. The management of biliary stones is usually performed with endoscopic techniques; however, the technique may prove to be challenging in the treatment of the intrahepatic bile duct stones. We herein report a case of a 40-year-old man with rare, complex bile duct stones that were successfully eliminated with percutaneous interventional techniques. The complex bile duct stones were defined as a large number of bile stones filling the intra- and extrahepatic bile tracts, resulting in a cast formation within the biliary tree. Common complications such as hemobilia and acute pancreatitis were not present during the perioperative period. The follow-up period was 20 mo long. During the postoperative period, the patient maintained normal temperature, and normal total bilirubin and direct bilirubin levels. The patient is now living a high quality life. This case report highlights the safety and efficacy of the percutaneous interventional approach in the removal of complex bile duct stones following liver transplantation. PMID:25684970

  12. Pediatric Interventional Radiology: Non-Vascular Interventions.

    PubMed

    Kandasamy, Devasenathipathy; Gamanagatti, Shivanand; Gupta, Arun Kumar

    2016-07-01

    Pediatric interventional radiology (PIR), which includes variety of procedures done under image guidance has emerged as an essential adjunct to various surgical and medical conditions, plays a significant role in the delivery of safe and effective care by reducing surgical risks, decreasing the length of hospital stay and reducing costs. The application of interventional techniques in children has been delayed over years as compared to adults due to lack of special hardwares/equipments, lack of adequately trained physicians and also the lack of awareness among the pediatric practitioners. This situation is gradually changing now owing to the advancements in technology. In this review, authors will discuss various non-vascular interventional procedures undertaken in pediatric patients. PMID:26762330

  13. Cardiovascular and Interventional Radiological Society of Europe Guidelines on Endovascular Treatment in Aortoiliac Arterial Disease

    SciTech Connect

    Rossi, Michele; Iezzi, Roberto

    2013-11-06

    PurposeThese guidelines are intended for use in assessing the standard for technical success and safety in aorto-iliac percutaneous endovascular interventions.MethodsAny recommendation contained in the text comes from the highest level and extension of literature review available to date.ResultsThe success of endovascular procedures is strictly related to an accurate planning based mainly on CT- or MR-angiography. TASC II A through C lesions have an endovascular-first option Pre-procedure ASA antiplatelet therapy is advisable in all cases. The application of stents improves the immediate hemodynamic and most likely long-term clinical results. Cumulative mean complication rate is 7.51 % according to the most relevant literature. Most of the complications can be managed by means of percutaneous techniques.ConclusionThe design and quality of devices, as well as the easy and accuracy of performing these procedures, have improved over the last decades, leading to the preferential treatment of aorto-iliac steno-obstructive disease via endovascular means, often as first-line therapy, with high technical success rate and low morbidity. This is mirrored by the decreasing number of patients undergoing surgical grafts over the last years with patency, limb salvage, and survival rates equivalent to open reconstruction.

  14. Radiation exposure in interventional radiology

    NASA Astrophysics Data System (ADS)

    Pinto, N. G. V.; Braz, D.; Vallim, M. A.; Filho, L. G. P.; Azevedo, F. S.; Barroso, R. C.; Lopes, R. T.

    2007-09-01

    The aim of this study is to evaluate dose values in patients and staff involved in some interventional radiology procedures. Doses have been measured using thermoluminescent dosemeters for single procedures (such as renal and cerebral arteriography, transjungular intrahepatic portasystemic shunt (TIPS) and chemoembolization). The magnitude of doses through the hands of interventional radiologists has been studied. Dose levels were evaluated in three points for patients (eye, thyroid and gonads). The dose-area product (DAP) was also investigated using a Diamentor (PTW-M2). The dose in extremities was estimated for a professional who generally performed one TIPS, two chemoembolizations, two cerebral arteriographies and two renal arteriographies in a week. The estimated annual radiation dose was converted to effective dose as suggested by the 453-MS/Brazil norm The annual dose values were 137.25 mSv for doctors, 40.27 mSv for nurses and 51.95 mSv for auxiliary doctors, and all these annual dose values are below the limit established. The maximum values of the dose obtained for patients were 6.91, 10.92 and 15.34 mGy close to eye, thyroid and gonads, respectively. The DAP values were evaluated for patients in the same interventional radiology procedures. The dose and DAP values obtained are in agreement with values encountered in the literature.

  15. Interventional Radiology of Male Varicocele: Current Status

    SciTech Connect

    Iaccarino, Vittorio Venetucci, Pietro

    2012-12-15

    Varicocele is a fairly common condition in male individuals. Although a minor disease, it may cause infertility and testicular pain. Consequently, it has high health and social impact. Here we review the current status of interventional radiology of male varicocele. We describe the radiological anatomy of gonadal veins and the clinical aspects of male varicocele, particularly the physical examination, which includes a new clinical and ultrasound Doppler maneuver. The surgical and radiological treatment options are also described with the focus on retrograde and antegrade sclerotherapy, together with our long experience with these procedures. Last, we compare the outcomes, recurrence and persistence rates, complications, procedure time and cost-effectiveness of each method. It clearly emerges from this analysis that there is a need for randomized multicentre trials designed to compare the various surgical and percutaneous techniques, all of which are aimed at occlusion of the anterior pampiniform plexus.

  16. Interventional radiology: a half century of innovation.

    PubMed

    Baum, Richard A; Baum, Stanley

    2014-11-01

    The evolution of modern interventional radiology began over half century ago with a simple question. Was it possible to use the same diagnostic imaging tools that had revolutionized the practice of medicine to guide the real-time treatment of disease? This disruptive concept led to rapid treatment advances in every organ system of the body. It became clear that by utilizing imaging some patients could undergo targeted procedures, eliminating the need for major surgery, while others could undergo procedures for previously unsolvable problems. The breadth of these changes now encompasses all of medicine and has forever changed the way we think about disease. In this brief review article, major advances in the field, as chronicled in the pages of Radiology, will be described. PMID:25340439

  17. Radiological interventions in malignant biliary obstruction

    PubMed Central

    Madhusudhan, Kumble Seetharama; Gamanagatti, Shivanand; Srivastava, Deep Narayan; Gupta, Arun Kumar

    2016-01-01

    Malignant biliary obstruction is commonly caused by gall bladder carcinoma, cholangiocarcinoma and metastatic nodes. Percutaneous interventions play an important role in managing these patients. Biliary drainage, which forms the major bulk of radiological interventions, can be palliative in inoperable patients or pre-operative to improve liver function prior to surgery. Other interventions include cholecystostomy and radiofrequency ablation. We present here the indications, contraindications, technique and complications of the radiological interventions performed in patients with malignant biliary obstruction. PMID:27247718

  18. Radiological interventions in malignant biliary obstruction.

    PubMed

    Madhusudhan, Kumble Seetharama; Gamanagatti, Shivanand; Srivastava, Deep Narayan; Gupta, Arun Kumar

    2016-05-28

    Malignant biliary obstruction is commonly caused by gall bladder carcinoma, cholangiocarcinoma and metastatic nodes. Percutaneous interventions play an important role in managing these patients. Biliary drainage, which forms the major bulk of radiological interventions, can be palliative in inoperable patients or pre-operative to improve liver function prior to surgery. Other interventions include cholecystostomy and radiofrequency ablation. We present here the indications, contraindications, technique and complications of the radiological interventions performed in patients with malignant biliary obstruction. PMID:27247718

  19. Contemporary Treatment for Critical Ischemia: The Evidence for Interventional Radiology or Surgery

    PubMed Central

    Hussey, Keith; Chandramohan, Sivanathan

    2014-01-01

    This article is a review of the evidence regarding the management of patients with critical limb ischemia. The aim of the study is to discuss the definition, incidence, and clinical importance of critical limb ischemia, as well as the aims of treatment in terms of quality of life and limb salvage. Endovascular and surgical treatments should not be viewed as competing therapies. In fact, these are complementary techniques each with strengths and weaknesses. The authors will propose a strategy based on the available evidence for deciding the optimal approach to management of patients with critical limb ischemia. PMID:25435654

  20. Interventional radiology of the abdomen. Second edition

    SciTech Connect

    Ferrucci, J.T.; Wittenberg, J.; Mueller, P.R.; Simeone, J.F.

    1985-01-01

    This book differs from several other presently available texts on interventional radiology in that it is explicitly not derived from the principles of catheter angiography. Abdominal interventional radiology depends as much, if not more, on ultrasonographic and computed tomographic guidance and, while perhaps less glamorous, also on conventional fluoroscopic guidance (for procedures such as urinary and biliary manipulations). Thus, while technical aspects of catheter design and manipulation can never be minimized, they are not the sole elements of successful interventional radiology in the abdomen. Relevant anatomy and pathophysiology, along with clinical aspects of medical and surgical care and thorough patient follow-up are of equal concern.

  1. Glove Perforations During Interventional Radiological Procedures

    SciTech Connect

    Leena, R. V. Shyamkumar, N. K.

    2010-04-15

    Intact surgical gloves are essential to avoid contact with blood and other body fluids. The objective of this study was to estimate the incidence of glove perforations during interventional radiological procedures. In this study, a total of 758 gloves used in 94 interventional radiological procedures were examined for perforations. Eleven perforations were encountered, only one of which was of occult type. No significant difference in the frequency of glove perforation was found between the categories with varying time duration.

  2. The interventionalism of medicine: interventional radiology, cardiology, and neuroradiology

    PubMed Central

    Lakhan, Shaheen E; Kaplan, Anna; Laird, Cyndi; Leiter, Yaacov

    2009-01-01

    Interventional medical practitioners are specialists who do minimally invasive procedures instead of surgery or other treatment. Most often, these procedures utilize various imaging and catheterization techniques in order to diagnose and treat vascular issues in the body. Interventionalist techniques, including injecting arteries with dye, visualizing these via x-ray, and opening up blockages, developed from early pioneers' bold and sometimes controversial experiments which aimed to find safer and better ways to treat coronary artery and other atherosclerotic vascular disease. Currently, the major interventional specialties are interventional (or vascular) radiology, interventional cardiology, and endovascular surgical (interventional) neuroradiology. All three are perfecting the use of stents and other procedures to keep diseased arteries open, while also evaluating the application these procedures. The rapid new development of imaging technologies, mechanical devices, and types of treatment, while certainly beneficial to the patient, can also lead to ambiguity regarding specific specialty claims on certain techniques and devices. While these practitioners can be in competition with each other, cooperation and communication are the most advantageous methods to deal with these "turf wars." All of the interventionalists are needed to deliver the best medical care to patients, now and in the future. PMID:19740425

  3. What does competence entail in interventional radiology?

    PubMed

    Ahmed, Kamran; Keeling, Aoife N; Khan, Reenam S; Ashrafian, Hutan; Arora, Sonal; Nagpal, Kamal; Burrill, Joshua; Darzi, Ara; Athanasiou, Thanos; Hamady, Mohamad

    2010-02-01

    Interventional radiology is a relatively new speciality and may be referred to as "image-guided surgery without a scalpel". Training and accreditation bodies regard interventional radiology training as being "different" from general radiology because of the additional need for dexterity and clinical acumen. Due to the multidimensional role of an interventional radiologist, a practitioner in this discipline must have a number of the competencies of anesthetists, surgeons, and radiologists. The attributes required of an interventional radiologist are akin to those required of a surgeon. This paper gives an overview of the skills required to be a competent interventional radiologist along with a succinct introduction to methods of assessment of technical and non-technical skills. PMID:19915902

  4. What Does Competence Entail in Interventional Radiology?

    SciTech Connect

    Ahmed, Kamran; Keeling, Aoife N.; Khan, Reenam S.; Ashrafian, Hutan; Arora, Sonal; Nagpal, Kamal; Burrill, Joshua; Darzi, Ara; Athanasiou, Thanos; Hamady, Mohamad

    2010-02-15

    Interventional radiology is a relatively new speciality and may be referred to as 'image-guided surgery without a scalpel.' Training and accreditation bodies regard interventional radiology training as being 'different' from general radiology because of the additional need for dexterity and clinical acumen. Due to the multidimensional role of an interventional radiologist, a practitioner in this discipline must have a number of the competencies of anesthetists, surgeons, and radiologists. The attributes required of an interventional radiologist are akin to those required of a surgeon. This paper gives an overview of the skills required to be a competent interventional radiologist along with a succinct introduction to methods of assessment of technical and non-technical skills.

  5. [Drug therapy in interventional radiology].

    PubMed

    Sumkauskaite, M; Bryant, M; Kortes, N; Stampfl, U; Radeleff, B

    2015-06-01

    In the context of pre-interventional drug therapy, a premedication is given to patients who are known to have an allergy to contrast media, have renal impairment or hyperthyroidism. An already existing anticoagulation therapy, in anticipation of the planned intervention, must be reviewed and changed or even suspended as required. For peri-interventional drug therapy it is important to consider how strenuous the procedure will be as well as the general condition of the patient. Further discussion with anesthetists may be required for the planning of pain therapy or sedation during the procedure. These factors help to ensure maximum patient comfort as well as the success of the intervention. Post-interventional anticoagulation therapy, usually started peri-interventionally, plays an important role in minimizing the risk of acute thrombosis as well as in maintaining long-term functioning of the implanted material. The form of the anticoagulation therapy is set according to the type of intervention. PMID:26063076

  6. Interventional radiology in living donor liver transplant

    PubMed Central

    Cheng, Yu-Fan; Ou, Hsin-You; Yu, Chun-Yen; Tsang, Leo Leung-Chit; Huang, Tung-Liang; Chen, Tai-Yi; Hsu, Hsien-Wen; Concerjero, Allan M; Wang, Chih-Chi; Wang, Shih-Ho; Lin, Tsan-Shiun; Liu, Yueh-Wei; Yong, Chee-Chien; Lin, Yu-Hung; Lin, Chih-Che; Chiu, King-Wah; Jawan, Bruno; Eng, Hock-Liew; Chen, Chao-Long

    2014-01-01

    The shortage of deceased donor liver grafts led to the use of living donor liver transplant (LDLT). Patients who undergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation (LT). Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplant. The aim of this paper is to review indications, diagnostic modalities, technical considerations, achievements and potential complications of interventional radiology procedures after LDLT. PMID:24876742

  7. Prophylactic Antibiotic Guidelines in Modern Interventional Radiology Practice

    PubMed Central

    Moon, Eunice; Tam, Matthew D.B.S.; Kikano, Raghid N.; Karuppasamy, Karunakaravel

    2010-01-01

    Modern interventional radiology practice is continuously evolving. Developments include increases in the number of central venous catheter placements and tumor treatments (uterine fibroid therapy, radio- and chemoembolization of liver tumor, percutaneous radiofrequency and cryoablation), and new procedures such as abdominal aortic aneurysm stent-graft repair, vertebroplasty, kyphoplasty, and varicose vein therapies. There have also been recent advancements in standard biliary and urinary drainage procedures, percutaneous gastrointestinal feeding tube placement, and transjugular intrahepatic portosystemic shunts. Prophylactic antibiotics have become the standard of care in many departments, with little clinical data to support its wide acceptance. The rise in antibiotic-resistant strains of organisms in all hospitals worldwide have forced every department to question the use of prophylactic antibiotics. The authors review the evidence behind use of prophylactic antibiotics in standard interventional radiology procedures, as well as in newer procedures that have only recently been incorporated into interventional radiology practice. PMID:22550374

  8. Antiplatelet and Anticoagulant Drugs in Interventional Radiology

    SciTech Connect

    Altenburg, Alexander; Haage, Patrick

    2012-02-15

    In treating peripheral arterial disease, a profound knowledge of antiplatelet and anticoagulative drug therapy is helpful to assure a positive clinical outcome and to anticipate and avoid complications. Side effects and drug interactions may have fatal consequences for the patient, so interventionalists should be aware of these risks and able to control them. Aspirin remains the first-line agent for antiplatelet monotherapy, with clopidogrel added where dual antiplatelet therapy is required. In case of suspected antiplatelet drug resistance, the dose of clopidogrel may be doubled; prasugrel or ticagrelor may be used alternatively. Glycoprotein IIb/IIIa inhibitors (abciximab or eptifibatide) may help in cases of hypercoagulability or acute embolic complications. Desmopressin, tranexamic acid, or platelet infusions may be used to decrease antiplatelet drug effects in case of bleeding. Intraprocedurally, anticoagulant therapy treatment with unfractionated heparin (UFH) still is the means of choice, although low molecular-weight heparins (LMWH) are suitable, particularly for postinterventional treatment. Adaption of LMWH dose is often required in renal insufficiency, which is frequently found in elderly patients. Protamine sulphate is an effective antagonist for UFH; however, this effect is less for LMWH. Newer antithrombotic drugs, such as direct thrombin inhibitors or factor X inhibitors, have limited importance in periprocedural treatment, with the exception of treating patients with heparin-induced thrombocytopenia (HIT). Nevertheless, knowing pharmacologic properties of the newer drugs facilitate correct bridging of patients treated with such drugs. This article provides a comprehensive overview of antiplatelet and anticoagulant drugs for use before, during, and after interventional radiological procedures.

  9. Safety of Conscious Sedation In Interventional Radiology

    SciTech Connect

    Arepally, Aravind; Oechsle, Denise; Kirkwood, Sharon; Savader, Scott J.

    2001-05-15

    Purpose: To identify rates of adverse events associated with the use of conscious sedation in interventional radiology.Methods: In a 5-month period, prospective data were collected on patients undergoing conscious sedation for interventional radiology procedures (n = 594). Adverse events were categorized as respiratory, sedative, or major adverse events. Respiratory adverse events were those that required oral airway placement, ambu bag, or jaw thrust. Sedation adverse events were unresponsiveness, oxygen saturation less than 90%, use of flumazenil/naloxone, or agitation. Major adverse events were hypotension, intubation, CPR, or cardiac arrest. The frequency of adverse events for the five most common radiology procedures were determined.Results: The five most common procedures (total n = 541) were biliary tube placement/exchange (n = 182), tunneled catheter placement (n 135), diagnostic arteriography (n = 125), vascular interventions (n = 52), and other catheter insertions (n = 46). Rates for respiratory, sedation, and major adverse events were 4.7%, 4.2%, and 2.0%, respectively. The most frequent major adverse event was hypotension (2.0%). Biliary procedures had the highest rate of total adverse events (p < .05) and respiratory adverse events (p < .05).Conclusion: The frequency of adverse events is low with the use of conscious sedation during interventional procedures. The highest rates occurred during biliary interventions.

  10. The Role of Interventional Radiology in Obstetric Hemorrhage

    SciTech Connect

    Gonsalves, M. Belli, A.

    2010-10-15

    Obstetric hemorrhage remains a major cause of maternal morbidity and mortality worldwide. Traditionally, in cases of obstetric hemorrhage refractory to conservative treatment, obstetricians have resorted to major surgery with the associated risks of general anesthesia, laparotomy, and, in the case of hysterectomy, loss of fertility. Over the past two decades, the role of pelvic arterial embolization has evolved from a novel treatment option to playing a key role in the management of obstetric hemorrhage. To date, interventional radiology offers a minimally invasive, fertility-preserving alternative to conventional surgical treatment. We review current literature regarding the role of interventional radiology in postpartum hemorrhage, abnormal placentation, abortion, and cervical ectopic pregnancy. We discuss techniques, success rates, and complications.

  11. [Non-vascular interventional radiology nonvascular interventional radiology of the urinary tract].

    PubMed

    Miki, M

    1989-08-01

    Several kinds of nonvascular interventional radiology of the urinary tract are reviewed. Transurethral balloon dilation of the prostate (TU-DP) is a newly developed nonsurgical treatment for benign prostate hyperplasia, which is performed under local anesthesia with minimal morbidity and requires no hospitalization. The TUDP technique involves dilating the prostatic urethra and bladder neck to 75 F for 10 minutes under fluoroscopic control using a high-pressure dilating balloon. Long-term follow-up studies are required. Percutaneous nephrolithotomy (PNL) and transurethral ureterolithotomy (TUL) have signified a revolution in stone surgery of upper urinary tract. Indications for these treatments, endoscopic manipulation, complications and their clinical features are presented. The procedure of PNL consists of 3 steps, puncture for nephrostomy tract, tract dilation and stone removal. Among these steps the most important is the puncture and it should be effected through the calyx. During the operation, if there is too much bleeding, it can be discontinued at any time while keeping the track open. It is no longer necessary for the kidney to be free of stones at the end of the operation. TUL is performed with a rigid or flexible ureterorenoscope. Dilation of the ureteral orifice and the intramural ureter is necessary for passing the scopes. When they have been sufficiently dilated, the ureterorenoscope can be passed to the level of the renal pelvis through the urethra. Calculi have been removed successfully at a higher rate in lower ureter. Endopyelotomy may be performed safely as an initial procedure to correct congenital obstruction of the ureteropelvic junction. Recent advancements have permitted an approach to percutaneous resection for renal pelvic tumor in a solitary kidney or bilateral synchronous disease. There are great expectations for continuing important innovations in the field of interventional radiology. PMID:2476077

  12. Hand dose measurements in interventional radiology

    SciTech Connect

    Felmlee, J.P.; McGough, P.F.; Morin, R.L.; Classic, K.L. )

    1991-02-01

    Measurements of radiation dose to the hand were conducted using TLD ring badges for individual interventional radiology cases. Results from over 30 examinations (including transhepatic cholangiograms and biliary and nephrostomy procedures) conducted by four radiologists using identical equipment show an average hand dose of 1.5 mGy (150 mrad) per procedure. Hand dose varied inversely with distance from the patient. Due to variable hand positions during clinical examinations, fluoroscopic time was not found to be a good indicator of hand dose.

  13. Hand dose measurements in interventional radiology.

    PubMed

    Felmlee, J P; McGough, P F; Morin, R L; Classic, K L

    1991-02-01

    Measurements of radiation dose to the hand were conducted using TLD ring badges for individual interventional radiology cases. Results from over 30 examinations (including transhepatic cholangiograms and biliary and nephrostomy procedures) conducted by four radiologists using identical equipment show an average hand dose of 1.5 mGy (150 mrad) per procedure. Hand dose varied inversely with distance from the patient. Due to variable hand positions during clinical examinations, fluoroscopic time was not found to be a good indicator of hand dose. PMID:1989948

  14. Sonography: the undiscovered jewel of interventional radiology.

    PubMed

    Dodd, G D; Esola, C C; Memel, D S; Ghiatas, A A; Chintapalli, K N; Paulson, E K; Nelson, R C; Ferris, J V; Baron, R L

    1996-11-01

    Because most radiologists in the United States have been taught that fluoroscopy and computed tomography (CT) are the best guidance techniques for nonvascular interventional procedures, sonography has been greatly underused in this regard. Recently, sonography has been gaining recognition as a highly useful and versatile guidance technique. It has many advantages over CT and fluoroscopic guidance, including real-time imaging with vessel visualization, decreased procedure time and cost, portability, and lack of ionizing radiation. Sonography should be the primary guidance technique for many nonvascular interventional procedures, and use of sonography as an adjunct guidance technique increases the ease and speed with which many other interventional procedures are performed. Sonography should generally be used instead of CT for guidance of abdominal and pelvic biopsy and drainage. Sonographic guidance should replace CT and fluoroscopic guidance for biopsy and drainage of accessible peripheral thoracic and mediastinal masses. Use of sonographic guidance should be integrated into all interventional radiology suites to reduce radiation exposure and facilitate the performance of many nonvascular and some vascular interventional procedures that have traditionally been performed under fluoroscopic guidance. PMID:8946535

  15. The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations.

    PubMed

    Tsetis, Dimitrios; Uberoi, Raman; Fanelli, Fabrizio; Roberston, Iain; Krokidis, Miltiadis; van Delden, Otto; Radeleff, Boris; Müller-Hülsbeck, Stefan; Szerbo-Trojanowska, Malgorzata; Lee, Michael; Morgan, Robert; Brountzos, Elias; Belli, Anna Maria

    2016-04-01

    Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond. PMID:26860717

  16. Vascular Closure Devices in Interventional Radiology Practice.

    PubMed

    Patel, Rafiuddin; Muller-Hulsbeck, Stefan; Morgan, Robert; Uberoi, Raman

    2015-08-01

    Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient. PMID:25944150

  17. Vascular Closure Devices in Interventional Radiology Practice

    SciTech Connect

    Patel, Rafiuddin; Muller-Hulsbeck, Stefan; Uberoi, Raman

    2015-08-15

    Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient.

  18. Interventional radiology in the diabetic lower extremity.

    PubMed

    Reekers, Jim A

    2013-09-01

    Most of what we know today for interventional techniques for revascularization in patients with DF disease is derived from our knowledge on CLI in patients with PAD. There are today no dedicated randomized controlled trials on interventional treatment of DF. It is, however, clear that huge progress in interventional techniques has been obtained during the past decade. In most institutions, the nonsurgical option is the current first choice. As the aim of treatment is ulcer healing through temporary increase in blood flow, it is still unclear what the contribution of new stent and drug-eluting technologies will have on the clinical outcome of DF treatment. Long-term follow-up studies, dedicated to patients with an arterial DF problem, have to be performed before we can evaluate all these new technologies. PMID:23992895

  19. Challenges in Interventional Radiology: The Pregnant Patient

    PubMed Central

    Moon, Eunice K.; Wang, Weiping; Newman, James S.; Bayona-Molano, Maria Del Pilar

    2013-01-01

    A pregnant patient presenting to interventional radiology (IR) has a different set of needs from any other patient requiring a procedure. Often, the patient's care can be in direct conflict with the growth and development of the fetus, whether it be optimal fluoroscopic imaging, adequate sedation of the mother, or the timing of the needed procedure. Despite the additional risks and complexities associated with pregnancy, IR procedures can be performed safely for the pregnant patient with knowledge of the special and general needs of the pregnant patient, use of acceptable medications and procedures likely to be encountered during pregnancy, in addition to strategies to protect the patient and her fetus from the hazards of radiation. PMID:24436567

  20. Slovenian experience from diagnostic angiography to interventional radiology

    PubMed Central

    Pavcnik, Dusan

    2014-01-01

    Background The purpose of writing this article is to document the important events and people in the first 50 years of diagnostic angiography and interventional radiology in Slovenia. During this period not only did the name of the institutions and departments change, but also its governance. Conclusions This depicted the important roles different people played at various times in the cardiovascular divisions inside and outside of the diagnostic and interventional radiology. Historical data show that Slovenian radiology has relatively immediately introduced the new methods of interventional radiology in clinical practice. PMID:25435857

  1. [Diagnostic reference levels in interventional radiology].

    PubMed

    Vañó Carruana, E; Fernández Soto, J M; Sánchez Casanueva, R M; Ten Morón, J I

    2013-12-01

    This article discusses the diagnostic reference levels for radiation exposure proposed by the International Commission on Radiological Protection (ICRP) to facilitate the application of the optimization criteria in diagnostic imaging and interventional procedures. These levels are normally established as the third quartile of the dose distributions to patients in an ample sample of centers and are supposed to be representative of good practice regarding patient exposure. In determining these levels, it is important to evaluate image quality as well to ensure that it is sufficient for diagnostic purposes. When the values for the dose received by patients are systematically higher or much lower than the reference levels, an investigation should determine whether corrective measures need to be applied. The European and Spanish regulations require the use of these reference values in quality assurance programs. For interventional procedures, the dose area product (or kerma area product) values are usually used as reference values together with the time under fluoroscopy and the total number of images acquired. The most modern imaging devices allow the value of the accumulated dose at the entrance to the patient to be calculated to optimize the distribution of the dose on the skin. The ICRP recommends that the complexity of interventional procedures be taken into account when establishing reference levels. In the future, diagnostic imaging departments will have automatic systems to manage patient dosimetric data; these systems will enable continuous dosage auditing and alerts about individual procedures that might involve doses several times above the reference values. This article also discusses aspects that need to be clarified to take better advantage of the reference levels in interventional procedures. PMID:24211195

  2. Informatics in Radiology: developing a touchless user interface for intraoperative image control during interventional radiology procedures.

    PubMed

    Tan, Justin H; Chao, Cherng; Zawaideh, Mazen; Roberts, Anne C; Kinney, Thomas B

    2013-01-01

    Review of prior and real-time patient images is critical during an interventional radiology procedure; however, it often poses the challenge of efficiently reviewing images while maintaining a sterile field. Although interventional radiologists can "scrub out" of the procedure, use sterile console covers, or verbally relay directions to an assistant, the ability of the interventionalist to directly control the images without having to touch the console could offer potential gains in terms of sterility, procedure efficiency, and radiation reduction. The authors investigated a potential solution with a low-cost, touch-free motion-tracking device that was originally designed as a video game controller. The device tracks a person's skeletal frame and its motions, a capacity that was adapted to allow manipulation of medical images by means of hand gestures. A custom software program called the Touchless Radiology Imaging Control System translates motion information obtained with the motion-tracking device into commands to review images on a workstation. To evaluate this system, 29 radiologists at the authors' institution were asked to perform a set of standardized tasks during a routine abdominal computed tomographic study. Participants evaluated the device for its efficacy as well as its possible advantages and disadvantages. The majority (69%) of those surveyed believed that the device could be useful in an interventional radiology practice and did not foresee problems with maintaining a sterile field. This proof-of-concept prototype and study demonstrate the potential utility of the motion-tracking device for enhancing imaging-guided treatment in the interventional radiology suite while maintaining a sterile field. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.332125101/-/DC1. PMID:23264282

  3. Interventional Radiology in the Management of Budd Chiari Syndrome

    SciTech Connect

    Beckett, David; Olliff, Simon

    2008-09-15

    Budd Chiari syndrome is an uncommon condition in the Western world but interventional radiology can contribute significantly to the management of the majority of patients. This review examines the role and technique of interventions including hepatic vein dilatation and stent insertion as well as thrombolysis and TIPS. Liver transplantation and surgical shunt surgery are discussed in relation to radiological interventions. With appropriate selection and technique, surgery is only required in a minority of patients.

  4. A Checklist to Improve Patient Safety in Interventional Radiology

    SciTech Connect

    Koetser, Inge C. J.; Vries, Eefje N. de; Delden, Otto M. van; Smorenburg, Susanne M.; Boermeester, Marja A.; Lienden, Krijn P. van

    2013-04-15

    To develop a specific RADiological Patient Safety System (RADPASS) checklist for interventional radiology and to assess the effect of this checklist on health care processes of radiological interventions. On the basis of available literature and expert opinion, a prototype checklist was developed. The checklist was adapted on the basis of observation of daily practice in a tertiary referral centre and evaluation by users. To assess the effect of RADPASS, in a series of radiological interventions, all deviations from optimal care were registered before and after implementation of the checklist. In addition, the checklist and its use were evaluated by interviewing all users. The RADPASS checklist has two parts: A (Planning and Preparation) and B (Procedure). The latter part comprises checks just before starting a procedure (B1) and checks concerning the postprocedural care immediately after completion of the procedure (B2). Two cohorts of, respectively, 94 and 101 radiological interventions were observed; the mean percentage of deviations of the optimal process per intervention decreased from 24 % before implementation to 5 % after implementation (p < 0.001). Postponements and cancellations of interventions decreased from 10 % before implementation to 0 % after implementation. Most users agreed that the checklist was user-friendly and increased patient safety awareness and efficiency. The first validated patient safety checklist for interventional radiology was developed. The use of the RADPASS checklist reduced deviations from the optimal process by three quarters and was associated with less procedure postponements.

  5. Musculoskeletal interventional radiology: ultrasound and CT.

    PubMed

    Martel Villagrán, J; Bueno Horcajadas, Á; Agrela Rojas, E

    2016-05-01

    We aim to describe imaging-guided (ultrasound and CT) interventional techniques in the musculoskeletal system that can be performed by general radiologists, whether in hospitals, primary care clinics, private offices, or other settings. The first requirement for doing these procedures is adequate knowledge of the anatomy of the musculoskeletal system. The second requirement is to inform the patient thoroughly about the technique, the risks involved, and the alternatives available in order to obtain written informed consent. The third requirement is to ensure that the procedure is performed in accordance with the principles of asepsis in relation to the puncture zone and to all the material employed throughout the procedure. The main procedures that can be done under ultrasound guidance are the following: fine needle aspiration cytology (FNAC), core needle biopsy (CNB), diagnostic and/or therapeutic arthrocentesis, drainage of juxta-articular fluid collections, drainage of abscesses, drainage of hematomas, treatment of Baker's cyst, treatment of ganglia, treatment of bursitis, infiltrations and treatment of plantar fasciitis, plantar fibrosis, epicondylitis, Achilles tendinopathy, and Morton's neuroma, puncture and lavage of calcifications in calcifying tendinopathy. We also review the following CT-guided procedures: diagnosis of spondylodiscitis, FNAC of metastases, arthrography, drainages. Finally, we also mention more complex procedures that can only be done in appropriate settings: bone biopsies, treatment of facet joint pain, radiofrequency treatment. PMID:27134018

  6. Interventional Radiological Management of Prehepatic Obstruction the Splanchnic Venous System

    SciTech Connect

    Semiz-Oysu, Aslihan Keussen, Inger; Cwikiel, Wojciech

    2007-07-15

    Purpose. The purpose of this study was to retrospectively evaluate interventional radiological management of patients with symptomatic portal hypertension secondary to obstruction of splanchnic veins. Material and Methods. Twenty-four patients, 15 males and 9 females, 0.75 to 79 years old (mean, 36.4 years), with symptomatic portal hypertension, secondary to splanchnic venous obstruction, were treated by percutaneous methods. Causes and extent of splanchnic venous obstruction and methods are summarized following a retrospective evaluation. Results. Obstructions were localized to the main portal vein (n = 22), intrahepatic portal veins (n = 8), splenic vein (n = 4), and/or mesenteric veins (n = 4). Interventional treatment of 22 (92%) patients included recanalization (n = 19), pharmacological thrombolysis (n = 1), and mechanical thrombectomy (n = 5). Partial embolization of the spleen was done in five patients, in two of them as the only possible treatment. TIPS placement was necessary in 10 patients, while an existing occluded TIPS was revised in two patients. Transhepatic embolization of varices was performed in one patient, and transfemoral embolization of splenorenal shunt was performed in another. Thirty-day mortality was 13.6% (n=3). During the follow-up, ranging between 2 days and 58 months, revision was necessary in five patients. An immediate improvement of presenting symptoms was achieved in 20 patients (83%). Conclusion. We conclude that interventional procedures can be successfully performed in the majority of patients with obstruction of splanchnic veins, with subsequent improvement of symptoms. Treatment should be customized according to the site and nature of obstruction.

  7. Role of interventional radiology in the management of acute gastrointestinal bleeding

    PubMed Central

    Ramaswamy, Raja S; Choi, Hyung Won; Mouser, Hans C; Narsinh, Kazim H; McCammack, Kevin C; Treesit, Tharintorn; Kinney, Thomas B

    2014-01-01

    Acute gastrointestinal bleeding (GIB) can lead to significant morbidity and mortality without appropriate treatment. There are numerous causes of acute GIB including but not limited to infection, vascular anomalies, inflammatory diseases, trauma, and malignancy. The diagnostic and therapeutic approach of GIB depends on its location, severity, and etiology. The role of interventional radiology becomes vital in patients whose GIB remains resistant to medical and endoscopic treatment. Radiology offers diagnostic imaging studies and endovascular therapeutic interventions that can be performed promptly and effectively with successful outcomes. Computed tomography angiography and nuclear scintigraphy can localize the source of bleeding and provide essential information for the interventional radiologist to guide therapeutic management with endovascular angiography and transcatheter embolization. This review article provides insight into the essential role of Interventional Radiology in the management of acute GIB. PMID:24778770

  8. Magnetic resonance--guided musculoskeletal interventional radiology.

    PubMed

    Carrino, John A; Blanco, Roberto

    2006-06-01

    As an imaging modality, magnetic resonance (MR) guidance has great potential to direct diagnostic and therapeutic procedures performed in the musculoskeletal region and influence patient management. MR-guided interventional procedures involving bone, soft tissue, intervertebral discs, and joints are safe and sufficiently effective for use in clinical practice. This article discusses and illustrates the procedural characteristics and techniques when performing MR-guided musculoskeletal interventions. Biopsy procedures are similar to other modalities for bone and soft tissue lesions. MR guidance is advantageous if the lesion is not visible by other modalities and for regions adjacent to hardware and implants, subselective targeting, intra-articular locations, and periarticular cyst aspiration. MR guidance has also been used for a host of spine injections and pain management procedures such as sacroiliac joint injections, discography, transforaminal epidural injection, selective nerve block, sympathetic block, celiac plexus block, and facet joint cryotherapy neurotomies. Future directions of clinical applications include tumor ablation and multimodality procedure suites. MR-guided musculoskeletal procedures will continue to be a growth area particularly for the diagnosis and treatment of bone and soft tissue neoplasia. PMID:16586322

  9. Malignant biliary obstruction: the current role of interventional radiology.

    PubMed

    Tsetis, Dimitrios; Krokidis, Μiltiadis; Negru, Dragos; Prassopoulos, Panagiotis

    2016-01-01

    Cholangiocarcinoma and pancreatic head cancer are still linked with extremely high 5-year mortality in the western world. The management of such patients is complex and typically requires a multidisciplinary approach in a tertiary care center. Interventional radiology offers minimally invasive, image-guided treatment for a variety of diseases and conditions. Regarding patients with malignant biliary obstruction, IR options are considered for more than two decades as a valid management tool for both operable and non-operable cases. The options include placement of percutaneous transhepatic biliary drains, preoperative embolization of the portal vein and deployment of covered and uncovered biliary stents. The purpose of this review is to describe the current evidence in this continuously evolving field. PMID:26752947

  10. Malignant biliary obstruction: the current role of interventional radiology

    PubMed Central

    Tsetis, Dimitrios; Krokidis, Μiltiadis; Negru, Dragos; Prassopoulos, Panagiotis

    2016-01-01

    Cholangiocarcinoma and pancreatic head cancer are still linked with extremely high 5-year mortality in the western world. The management of such patients is complex and typically requires a multidisciplinary approach in a tertiary care center. Interventional radiology offers minimally invasive, image-guided treatment for a variety of diseases and conditions. Regarding patients with malignant biliary obstruction, IR options are considered for more than two decades as a valid management tool for both operable and non-operable cases. The options include placement of percutaneous transhepatic biliary drains, preoperative embolization of the portal vein and deployment of covered and uncovered biliary stents. The purpose of this review is to describe the current evidence in this continuously evolving field. PMID:26752947

  11. Interventional radiology in bone and joint

    SciTech Connect

    Bard, M.; Laredo, J.D.

    1988-01-01

    Recent radiologic procedures in bone and joints, some of which eliminate the need for surgery are exposed, including: trephine biopsies of the thoracic and lumbar spine, sacro-iliac joints, peripheral bones synovial membrane and soft tissues, using either fluoroscopic echographic or CT guidance - chemonucleolysis - vascular embolization of skeletal tumors and management of vertebral hemangiomas - selective steroid injection in a broad spectrum of diseases including vertebral facet syndrome, cervicobrachial nerve root pain, rotator cuff calcium deposit, bone cysts.

  12. In vivo force during arterial interventional radiology needle puncture procedures.

    PubMed

    Healey, Andrew E; Evans, Jonathan C; Murphy, Micheal G; Powell, Steven; How, Thien V; Groves, David; Hatfield, Fraser; Diaz, Bernard M; Gould, Derek A

    2005-01-01

    To adequately simulate the forces generated during interventional radiological (IR) procedures, non intrusive in-vivo methods must be used. Using finger tip mounted, non intrusive capacitance force sensor pads (PPS, Los Angeles, California) we have been able to measure the forces involved in interventional radiology without a change in procedure technique. Data acquired during the process of calibration of the capacitance pads in conjunction with extensive in-vitro needle puncture force measurement using a commercially available tensile tester (Nene Industries, UK) are presented here. PMID:15718723

  13. Acute Pancreatitis: The Role of Imaging and Interventional Radiology

    SciTech Connect

    Maher, Michael M.; Lucey, Brian C.; Gervais, Debra A.; Mueller, Peter R.

    2004-09-15

    Acute pancreatitis can manifest as a benign condition with minimal abdominal pain and hyperamylasemia or can have a fulminant course, which can be life-threatening usually due to the development of infected pancreatic necrosis, and multisystem organ failure. Fortunately, 70-80% of patients with acute pancreatitis have a benign self-limiting course. The initial 24-48 hours after the initial diagnosis is usually the period that determines the subsequent course, and for many of the 20-30% of patients who subsequently have a fulminant course, this becomes apparent within this time frame. With reference to long-term outcome following acute pancreatitis, most cases recover without long-term sequelae with only a minority of cases progressing to chronic pancreatitis. In the initial management of acute pancreatitis, assessment of metabolic disturbances and systemic organ dysfunction is critical. However, the advent and continued refinement of cross-sectional imaging modalities over the past two decades has led to a prominent role for diagnostic imaging in assessing acute pancreatitis. Furthermore, these cross-sectional imaging modalities have enabled the development of diagnostic and therapeutic interventional techniques in the hands of radiologists. In this article we review the diagnostic features of acute pancreatitis, the clinical staging systems, complications and the role of imaging. The role of interventional radiology techniques in the management of acute pancreatitis will be discussed as well as potential complications associated with these treatments.

  14. A short review of basic head and neck interventional procedures in a general radiology department

    PubMed Central

    Yuen, H.Y.; Lee, Y.Y.P.; Bhatia, K.

    2013-01-01

    Abstract Image-guided interventional procedures provide a safe way to diagnose and treat a variety of head and neck abnormalities. The procedure time is usually short, and most procedures can be performed on an outpatient basis. Knowledge about strengths and weaknesses, efficacy, potential complications, and pitfalls of these procedures allows the best treatment to be chosen for a particular lesion type. This review discusses some of the commonly performed interventional radiology procedures in a general radiology department in the management of patients with neoplastic diseases in the head and neck region. PMID:24334514

  15. Limitations Influencing Interventional Radiology in Canada: Results of a National Survey by the Canadian Interventional Radiology Association (CIRA)

    SciTech Connect

    O'Brien, Jeremy; Baerlocher, Mark Otto Asch, Murray R.; Hayeems, Eran; Kachura, John R.; Collingwood, Peter

    2007-09-15

    Purpose. To describe the current state and limitations to interventional radiology (IR) in Canada through a large, national survey of Canadian interventional radiologists. Methods. An anonymous online survey was offered to members of the Canadian Interventional Radiology Association (CIRA). Only staff radiologists were invited to participate. Results. Seventy-five (75) responses were received from a total of 247, giving a response rate of 30%. Respondents were split approximately equally between academic centers (47%) and community practice (53%), and the majority of interventional radiologists worked in hospitals with either 200-500 (49%) or 500-1,000 (39%) beds. Procedures listed by respondents as most commonly performed in their practice included PICC line insertion (83%), angiography and stenting (65%), and percutaneous biopsy (37%). Procedures listed as not currently performed but which interventional radiologists believed would benefit their patient population included radiofrequency ablation (36%), carotid stenting (34%), and aortic stenting (21%); the majority of respondents noted that a lack of support from referring services was the main reason for not performing these procedures (56%). Impediments to increasing scope and volume of practice in Canadian IR were most commonly related to room or equipment shortage (35%), radiologist shortage (33%), and a lack of funding or administrative support (28%). Conclusion. Interventional radiology in Canada is limited by a number of factors including funding, manpower, and referral support. A concerted effort should be undertaken by individual interventional radiologists and IR organizations to increase training capacity, funding, remuneration, and public exposure to IR in order to help advance the subspecialty.

  16. Staff Radiation Doses to the Lower Extremities in Interventional Radiology

    SciTech Connect

    Shortt, C. P.; Al-Hashimi, H.; Malone, L.; Lee, M. J.

    2007-11-15

    The purpose of this study was to investigate the radiation doses to the lower extremities in interventional radiology suites and evaluate the benefit of installation of protective lead shielding. After an alarmingly increased dose to the lower extremity in a preliminary study, nine interventional radiologists wore thermoluminescent dosimeters (TLDs) just above the ankle, over a 4-week period. Two different interventional suites were used with Siemens undercouch fluoroscopy systems. A range of procedures was carried out including angiography, embolization, venous access, drainages, and biopsies. A second identical 4-week study was then performed after the installation of a 0.25-mm lead curtain on the working side of each interventional table. Equivalent doses for all nine radiologists were calculated. One radiologist exceeded the monthly dose limit for a Category B worker (12.5 mSv) for both lower extremities before lead shield placement but not afterward. The averages of both lower extremities showed a statistically significant dose reduction of 64% (p < 0.004) after shield placement. The left lower extremity received a higher dose than the right, 6.49 vs. 4.57 mSv, an increase by a factor of 1.42. Interventional radiology is here to stay but the benefits of interventional radiology should never distract us from the important issue of radiation protection. All possible measures should be taken to optimize working conditions for staff. This study showed a significant lower limb extremity dose reduction with the use of a protective lead curtain. This curtain should be used routinely on all C-arm interventional radiologic equipment.

  17. Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review.

    PubMed

    Mauri, Giovanni; Mattiuz, Chiara; Sconfienza, Luca Maria; Pedicini, Vittorio; Poretti, Dario; Melchiorre, Fabio; Rossi, Umberto; Lutman, Fabio Romano; Montorsi, Marco

    2015-04-01

    Pancreatic resections are surgical procedures associated with high incidence of complications, with relevant morbidity and mortality even at high volume centres. A multidisciplinary approach is essential in the management of these events and interventional radiology plays a crucial role in the treatment of patients developing post-surgical complications. This paper offers an overview on the interventional radiological procedures that can be performed to treat different type of complications after pancreatic resection. Procedures such as percutaneous drainage of fluid collections, percutaneous transhepatic biliary procedures, arterial embolisation, venous interventions and fistula embolisation are viable treatment options, with fewer complications compared with re-look surgery, shorter hospital stay and faster recovery. A selection of cases of complications following pancreatic surgery managed with interventional radiological procedure are presented and discussed. Teaching Points • Interventional radiology is crucial to treat complications after pancreatic surgery • Percutaneous drainage of collections can be performed under ultrasound or computed tomography guidance • Percutaneous biliary procedures can be used to treat biliary complications • Venous procedures can be performed effectively through transhepatic or transjugular access • Fistulas can be treated effectively by percutaneous embolisation. PMID:25516470

  18. 100 classic papers of interventional radiology: A citation analysis

    PubMed Central

    Crockett, Matthew T; Browne, Ronan FJ; MacMahon, Peter J; Lawler, Leo

    2015-01-01

    AIM: To define the 100 citation classic papers of interventional radiology. METHODS: Using the database of Journal Citation Reports the 40 highest impact factor radiology journals were chosen. From these journals the 100 most cited interventional radiology papers were chosen and analysed. RESULTS: The top paper received 2497 citations and the 100th paper 200 citations. The average number of citations was 320. Dates of publication ranged from 1953 - 2005. Most papers originated in the United States (n = 67) followed by Italy (n = 20) and France (n = 10). Harvard University (n = 18) and Osped Civile (n = 11) were the most prolific institutions. Ten journals produced all of the top 100 papers with “Radiology” and “AJR” making up the majority. SN Goldberg and T Livraghi were the most prolific authors. Nearly two thirds of the papers (n = 61) were published after 1990. CONCLUSION: This analysis identifies many of the landmark interventional radiology papers and provides a fascinating insight into the changing discourse within the field. It also identifies topics, authors and institutions which have impacted greatly on the specialty. PMID:25918585

  19. A guide to the Interventional Radiology residency program requirements.

    PubMed

    LaBerge, Jeanne M; Anderson, James C

    2015-08-01

    The program requirements for the new Interventional Radiology (IR) Residency were approved by the ACGME in September 2014. Soon, training institutions will be able to apply for accreditation and begin enrolling residents. The IR program requirements are long (44 pages) and a bit complex. In addition, some concepts in the program requirements, such as options for integrated or independent formats, may be unfamiliar to the radiology community. In this article, we summarize key concepts and explain important provisions in the IR program requirements. We hope to provide the reader with a firm foundation for understanding the full program requirement document and the application process. PMID:25979144

  20. Interventional radiology: the future of surgery in microgravity.

    PubMed

    Lerner, David J; Parmet, Allen J

    2013-12-01

    Explorer Class missions face situations requiring innovative answers, including medical/surgical dilemmas. Interventional radiology (IR) could play a very important role as sonographically guided procedures make possible many minimally invasive surgical solutions. A review of IR was performed, including performing many IR procedures. Surgical equipment is limited in microgravity. General anesthesia, surgical skill, large mass/volume equipment, and postsurgical/postanesthesia care are among the reasons that open compartment/laparoscopic procedures are undesirable. Sonographically guided percutaneous procedures treat these issues with minimal sedation. Catheters are interchangeable and extremely lightweight and placement could be performed with 0.5 lb (0.2268 kg) of material, nearly a 1000 fold decrease in mass from normal surgical devices. These carry a lower risk of complications comparable to surgery. These can further be researched using the KC-135 and remote "bases." Although further research is required, IR is ideally suited to handle many predicted medical problems that might arise during Explorer Class missions. The percutaneous treatment would allow symptoms to resolve during the mission, and be fully cured upon return to Earth. PMID:24459805

  1. Broken Esophageal Stent Successfully Treated by Interventional Radiology Technique

    SciTech Connect

    Zelenak, Kamil; Mistuna, Dusan; Lucan, Jaroslav; Polacek, Hubert

    2010-06-15

    Esophageal stent fractures occur quite rarely. A 61-year-old male patient was previously treated for rupture of benign stenosis, occurring after dilatation, by implanting an esophageal stent. However, a year after implantation, the patient suffered from dysphagia caused by the broken esophageal stent. He was treated with the interventional radiology technique, whereby a second implantation of the esophageal stent was carried out quite successfully.

  2. Patient Safety in Interventional Radiology: A CIRSE IR Checklist

    SciTech Connect

    Lee, M. J.; Fanelli, F.; Haage, P.; Hausegger, K.; Lienden, K. P. Van

    2012-04-15

    Interventional radiology (IR) is an invasive speciality with the potential for complications as with other invasive specialities. The World Health Organization (WHO) produced a surgical safety checklist to decrease the morbidity and mortality associated with surgery. The Cardiovascular and Interventional Society of Europe (CIRSE) set up a task force to produce a checklist for IR. Use of the checklist will, we hope, reduce the incidence of complications after IR procedures. It has been modified from the WHO surgical safety checklist and the RAD PASS from Holland.

  3. Radiological Interventions for Correction of Central Venous Port Catheter Migrations

    SciTech Connect

    Gebauer, Bernhard Teichgraeber, Ulf Karl; Podrabsky, Petr; Werk, Michael; Haenninen, Enrique Lopez; Felix, Roland

    2007-07-15

    Purpose. The purpose of this study was to evaluate radiological-interventional central venous port catheter corrections in migrated/malpositioned catheter tips. Materials and Methods. Thirty patients with migrated/malpositioned port catheter tips were included in this retrospective analysis. To visualize the catheter patency a contrast-enhanced port catheter series was performed, followed by transfemoral port catheter correction with various 5-F angiographic catheters (pigtail; Sos Omni), gooseneck snares, or combinations thereof. Results. One patient showed spontaneous reposition of the catheter tip. In 27 of 29 patients (93%), radiological-interventional port catheter correction was successful. In two patients port catheter malposition correction was not possible, because of the inability to catch either the catheter tip or the catheter in its course, possibly due to fibrin sheath formation with attachment of the catheter to the vessel wall. No disconnection or port catheter dysfunction was observed after correction. Conclusions. We conclude that in migrated catheter tips radiological-interventional port catheter correction is a minimally invasive alternative to port extraction and reimplantation. In patients with a fibrin sheath and/or thrombosis port catheter correction is often more challenging.

  4. Active pixel as dosimetric device for interventional radiology

    NASA Astrophysics Data System (ADS)

    Servoli, L.; Baldaccini, F.; Biasini, M.; Checcucci, B.; Chiocchini, S.; Cicioni, R.; Conti, E.; Di Lorenzo, R.; Dipilato, A. C.; Esposito, A.; Fanó, L.; Paolucci, M.; Passeri, D.; Pentiricci, A.; Placidi, P.

    2013-08-01

    Interventional Radiology (IR) is a subspecialty of radiology comprehensive of all minimally invasive diagnostic and therapeutic procedures performed using radiological devices to obtain image guidance. The interventional procedures are potentially harmful for interventional radiologists and medical staff due to the X-ray diffusion by the patient's body. The characteristic energy range of the diffused photons spans few tens of keV. In this work we will present a proposal for a new X-ray sensing element in the energy range of interest for IR procedures. The sensing element will then be assembled in a dosimeter prototype, capable of real-time measurement, packaged in a small form-factor, with wireless communication and no external power supply to be used for individual operators dosimetry for IR procedures. For the sensor, which is the heart of the system, we considered three different Active Pixel Sensors (APS). They have shown a good capability as single X-ray photon detectors, up to several tens keV photon energy. Two dosimetric quantities have been considered, the number of detected photons and the measured energy deposition. Both observables have a linear dependence with the dose, as measured by commercial dosimeters. The uncertainties in the measurement are dominated by statistic and can be pushed at ˜5% for all the sensors under test.

  5. Management of Dysfunctional Catheters and Tubes Inserted by Interventional Radiology

    PubMed Central

    Huang, Steven Y.; Engstrom, Bjorn I.; Lungren, Matthew P.; Kim, Charles Y.

    2015-01-01

    Minimally invasive percutaneous interventions are often used for enteral nutrition, biliary and urinary diversion, intra-abdominal fluid collection drainage, and central venous access. In most cases, radiologic and endoscopic placement of catheters and tubes has replaced the comparable surgical alternative. As experience with catheters and tubes grows, it becomes increasingly evident that the interventional radiologist needs to be an expert not only on device placement but also on device management. Tube dysfunction represents the most common complication requiring repeat intervention, which can be distressing for patients and other health care professionals. This manuscript addresses the etiologies and solutions to leaking and obstructed feeding tubes, percutaneous biliary drains, percutaneous catheter nephrostomies, and drainage catheters, including abscess drains. In addition, we will address the obstructed central venous catheter. PMID:26038615

  6. Interventional Radiological Procedures in Impaired Function of Surgically Implanted Catheter-Port Systems

    SciTech Connect

    Herrmann, Karin Anna; Waggershauser, Tobias; Heinemann, Volker; Reiser, Maximilian

    2001-01-15

    Purpose: System-related complications in surgically implanted catheter-port systems (CPS) for intraarterial (i.a.) chemotherapy are well known. In most cases of complications, the treatment must be interrupted and the catheter-port system must be repaired surgically. We describe microinvasive interventional radiological procedures to correct some dysfunctions of CPS.Methods: Five patients with repetitive dysfunction of CPS were treated with interventional techniques. Two patients presented with perfusion impairment, one patient had a pseudoaneurysm of the hepatic artery, and two patients presented with catheter displacement. Radiological interventions included mechanical recanalization with a guidewire, vascular stenting, and correction of catheter dislocation with a goose-neck snare.Results: In all cases, correct function of the CPS was restored. No intervention-related complications occurred and surgery was avoided. Chemotherapy could be continued for a period of 4-10 months.Conclusion: For some system-related complications, minimally invasive radiological interventions can be used to restore the function of CPS for i.a. chemotherapy.

  7. Current Trends in Heparin Use During Arterial Vascular Interventional Radiology

    SciTech Connect

    Durran, Alexandra C.; Watts, Christopher

    2012-12-15

    Purpose: This study was designed to assess the current use of heparinized saline and bolus doses of heparin in non-neurological interventional radiology and to determine whether consensus could be reached to produce guidance for heparin use during arterial vascular intervention. Methods: An interactive electronic questionnaire was distributed to members of the British Society of Interventional Radiology regarding their current practice in the use, dosage, and timing of heparin boluses and heparinized flushing solutions.ResultsA total of 108 completed questionnaires were received. More than 80% of respondents used heparinized saline with varying concentrations; the most prevalent was 1,000 IU/l (international units of heparin per liter) and 5,000 IU/l. Fifty-one percent of interventionalists use 3,000 IU as their standard bolus dose; however, the respondents were split regarding the timing of bolus dose with {approx}60% administering it after arterial access is obtained and 40% after crossing the lesion. There was no consensus on altering dose according to body weight, and only 4% monitored clotting parameters. Conclusions: There seems to be some coherence among practicing interventionalists regarding heparin administration. We hypothesize that heparinized saline should be used at a recognized standard concentration of 1,000 IU/l as a flushing concentration in all arterial vascular interventions and that 3,000 IU bolus is considered the standard dose for straightforward therapeutic procedures and 5000 IU for complex, crural, and endovascular aneurysm repair work. The bolus should be given after arterial access is obtained to allow time for optimal anticoagulation to be achieved by the time of active intervention and stenting. Further research into clotting abnormalities following such interventional procedures would be an interesting quantifiable follow-up to this initial survey of opinions and practice.

  8. Informed Consent for Interventional Radiology Procedures: A Survey Detailing Current European Practice

    SciTech Connect

    O'Dwyer, H.M.; Lyon, S.M.; Fotheringham, T.; Lee, M.J.

    2003-09-15

    Purpose: Official recommendations for obtaining informed consent for interventional radiology procedures are that the patient gives their consent to the operator more than 24 hr prior to the procedure. This has significant implications for interventional radiology practice. The purpose of this study was to identify the proportion of European interventional radiologists who conform to these guidelines. Methods: A questionnaire was designed consisting of 12 questions on current working practice and opinions regarding informed consent. These questions related to where, when and by whom consent was obtained from the patient. Questions also related to the use of formal consent forms and written patient information leaflets. Respondents were asked whether they felt patients received adequate explanation regarding indications for intervention,the procedure, alternative treatment options and complications. The questionnaire was distributed to 786 European interventional radiologists who were members of interventional societies. The anonymous replies were then entered into a database and analyzed. Results: Two hundred and fifty-four (32.3%) questionnaires were returned. Institutions were classified as academic (56.7%),non-academic (40.5%) or private (2.8%). Depending on the procedure,in a significant proportion of patients consent was obtained in the outpatient department (22%), on the ward (65%) and in the radiology day case ward (25%), but in over half (56%) of patients consent or re-consent was obtained in the interventional suite. Fifty percent of respondents indicated that they obtain consent more than 24 hr before some procedures, in 42.9% consent is obtained on the morning of the procedure and 48.8% indicated that in some patients consent is obtained immediately before the procedure. We found that junior medical staff obtained consent in 58% of cases. Eighty-two percent of respondents do not use specific consent forms and 61% have patient information leaflets. The

  9. Workflow in interventional radiology: uterine fibroid embolization (UFE)

    NASA Astrophysics Data System (ADS)

    Lindisch, David; Neumuth, Thomas; Burgert, Oliver; Spies, James; Cleary, Kevin

    2008-03-01

    Workflow analysis can be used to record the steps taken during clinical interventions with the goal of identifying bottlenecks and streamlining the procedure efficiency. In this study, we recorded the workflow for uterine fibroid embolization (UFE) procedures in the interventional radiology suite at Georgetown University Hospital in Washington, DC, USA. We employed a custom client/server software architecture developed by the Innovation Center for Computer Assisted Surgery (ICCAS) at the University of Leipzig, Germany. This software runs in a JAVA environment and enables an observer to record the actions taken by the physician and surgical team during these interventions. The data recorded is stored as an XML document, which can then be further processed. We recorded data from 30 patients and found a mean intervention time of 01:49:46 (+/- 16:04) minutes. The critical intervention step, the embolization, had a mean time of 00:15:42 (+/- 05:49) minutes, which was only 15% of the total intervention time.

  10. Radiation dose to physicians’ eye lens during interventional radiology

    NASA Astrophysics Data System (ADS)

    Bahruddin, N. A.; Hashim, S.; Karim, M. K. A.; Sabarudin, A.; Ang, W. C.; Salehhon, N.; Bakar, K. A.

    2016-03-01

    The demand of interventional radiology has increased, leading to significant risk of radiation where eye lens dose assessment becomes a major concern. In this study, we investigate physicians' eye lens doses during interventional procedures. Measurement were made using TLD-100 (LiF: Mg, Ti) dosimeters and was recorded in equivalent dose at a depth of 0.07 mm, Hp(0.07). Annual Hp(0.07) and annual effective dose were estimated using workload estimation for a year and Von Boetticher algorithm. Our results showed the mean Hp(0.07) dose of 0.33 mSv and 0.20 mSv for left and right eye lens respectively. The highest estimated annual eye lens dose was 29.33 mSv per year, recorded on left eye lens during fistulogram procedure. Five physicians had exceeded 20 mSv dose limit as recommended by international commission of radiological protection (ICRP). It is suggested that frequent training and education on occupational radiation exposure are necessary to increase knowledge and awareness of the physicians’ thus reducing dose during the interventional procedure.

  11. Action research regarding the optimisation of radiological protection for nurses during vascular interventional radiology.

    PubMed

    Mori, Hiroshige

    2015-06-01

    The optimisation and decision-making processes for radiological protection have been broadened by the introduction of re-examination or feedback after introducing protective measures. In this study, action research was used to reduce the occupational exposure of vascular interventional radiology (IR) nurses. Four radiological protection improvement measures were continuously performed in cooperation with the researchers, nurses and stakeholders, and the nurses' annual effective doses were compared before and after the improvements. First, the dosimetry equipment was changed from one electronic personal dosimeter (EPD) to two silver-activated phosphate glass dosimeters (PGDs). Second, the nurses were educated regarding maintaining a safe distance from the sources of scattered and leakage radiation. Third, portable radiation shielding screens were placed in the IR rooms. Fourth, the x-ray units' pulse rates were reduced by half. On changing the dosimetry method, the two PGDs recorded a 4.4 fold greater dose than the single EPD. Educating nurses regarding radiological protection and reducing the pulse rates by half decreased their effective doses to one-third and two-fifths of the baseline dose, respectively. No significant difference in their doses was detected after the placement of the shielding screens. Therefore, the action research effectively decreased the occupational doses of the vascular IR nurses. PMID:26052718

  12. The Basics of Interventional Radiology Management in a Large Radiology Group: A Bird's-Eye View.

    PubMed

    Hill, Gregory Q; Bob Smouse, H

    2006-12-01

    Through nearly 6 decades of growth we have enjoyed and suffered under many different types of management structures. From these experiences we have become believers in a central committee structure that advances our agenda with hospital administrators and third-party payers. The best way to illustrate what we think is a winning solution is by describing our present management system. Herein we describe what we do and what works for our large radiology group as well as our interventional practice. Although this structure works well for our large medical group, it will likely work equally well for a smaller medical group. PMID:21326780

  13. Workflow in interventional radiology: nerve blocks and facet blocks

    NASA Astrophysics Data System (ADS)

    Siddoway, Donald; Ingeholm, Mary Lou; Burgert, Oliver; Neumuth, Thomas; Watson, Vance; Cleary, Kevin

    2006-03-01

    Workflow analysis has the potential to dramatically improve the efficiency and clinical outcomes of medical procedures. In this study, we recorded the workflow for nerve block and facet block procedures in the interventional radiology suite at Georgetown University Hospital in Washington, DC, USA. We employed a custom client/server software architecture developed by the Innovation Center for Computer Assisted Surgery (ICCAS) at the University of Leipzig, Germany. This software runs in an internet browser, and allows the user to record the actions taken by the physician during a procedure. The data recorded during the procedure is stored as an XML document, which can then be further processed. We have successfully gathered data on a number if cases using a tablet PC, and these preliminary results show the feasibility of using this software in an interventional radiology setting. We are currently accruing additional cases and when more data has been collected we will analyze the workflow of these procedures to look for inefficiencies and potential improvements.

  14. Interventional Radiology in Hemodialysis Fistulae and Grafts: A Multidisciplinary Approach

    SciTech Connect

    Turmel-Rodrigues, Luc; Pengloan, Josette; Bourquelot, Pierre

    2002-01-15

    Purpose: To review the place of interventional radiology in arteriovenous access for hemodialysis. Methods: Prophylactic dilation of stenoses greater than 50% associated with clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. Stents are placed only in selected cases with clearly insufficient results of dilation but they must never overlap major side veins and obviate future access creation. Thrombosed fistulae and grafts can be declotted by purely mechanical methods or in combination with a lytic drug. Results: The success rates are over 90% for dilation, with frequent resort to stents in central veins. Long-term results in the largest series are better in forearm native fistulae compared with grafts (best 1-year primary patency: 51% versus 40%). The success rates for declotting are better in grafts compared with forearm fistulae but early rethrombosis is frequent in grafts so that primary patency rates can be better for native fistulae from the first month's follow-up (best 1-year primary patency: 49% versus 26%). Conclusion: Radiology achieves results comparable with surgery, with minimal invasiveness and better venous preservation. However, wide variations in the results suggest that the degree of commitment of physicians might be as important as the type of technique used.

  15. Current Status of Interventional Radiology in the Management of Gastro-Entero-Pancreatic Neuroendocrine Tumours (GEP-NETs)

    SciTech Connect

    Orgera, Gianluigi; Krokidis, Miltiadis; Cappucci, Matteo; Gourtsoyianni, Sofia; Tipaldi, Marcello Andrea; Hatzidakis, Adam; Rebonato, Alberto; Rossi, Michele

    2015-02-15

    Within the group of Gastro-Entero-Pancreatic Neuroendocrine tumours (GEP-NETs), several heterogeneous malignancies are included with a variety of clinical manifestations and imaging characteristics. Often these cases are inoperable and minimal invasive treatment offered by image-guided procedures appears to be the only option. Interventional radiology offers a valid solution in the management of primary and metastatic GEP-NETs. The purpose of this review article is to describe the current status of the role of Interventional Radiology in the management of GEP-NETs.

  16. Yttrium-90 hepatic radioembolization: clinical review and current techniques in interventional radiology and personalized dosimetry.

    PubMed

    Tong, Aaron K T; Kao, Yung Hsiang; Too, Chow Wei; Chin, Kenneth F W; Ng, David C E; Chow, Pierce K H

    2016-06-01

    In recent years, yttrium-90 ((90)Y) microsphere radioembolization has been establishing itself as a safe and efficacious treatment for both primary and metastatic liver cancers. This extends to both first-line therapies as well as in the salvage setting. In addition, radioembolization appears efficacious for patients with portal vein thrombosis, which is currently a contraindication for surgery, transplantation and transarterial chemoembolization. This article reviews the efficacy and expanding use of (90)Y microsphere radioembolization with an added emphasis on recent advances in personalized dosimetry and interventional radiology techniques. Directions for future research into combination therapies with radioembolization and expansion into sites other than the liver are also explored. PMID:26943239

  17. Radiological Evaluation and Endovascular Treatment of Hemoptysis.

    PubMed

    Ramírez Mejía, Alex Roberto; Méndez Montero, José Vicente; Vásquez-Caicedo, Marco Leyva; Bustos García de Castro, Ana; Cabeza Martínez, Beatriz; Ferreirós Domínguez, Joaquín

    2016-01-01

    Hemoptysis can be a life-threatening condition that warrants urgent investigation and intervention. Common causes include bronchiectasis, chronic obstructive pulmonary disease, tuberculosis, and malignancy. Computed tomography angiography is an accurate imaging modality for assessment of hemoptysis. The bronchial arteries are the source of bleeding in most cases of hemoptysis, and bronchial artery embolization is the treatment of choice. The aim of this article is to summarize the pathophysiology, causes, initial management, and diagnostic approach of hemoptysis. Endovascular treatment of hemoptysis, technique, embolic materials, outcomes, complications, and follow-up of patients are discussed. PMID:26293972

  18. Staff lens doses in interventional urology. A comparison with interventional radiology, cardiology and vascular surgery values.

    PubMed

    Vano, E; Fernandez, J M; Resel, L E; Moreno, J; Sanchez, R M

    2016-03-01

    The purpose of this work is to evaluate radiation doses to the lens of urologists during interventional procedures and to compare them with values measured during interventional radiology, cardiology and vascular surgery. The measurements were carried out in a surgical theatre using a mobile C-arm system and electronic occupational dosimeters (worn over the lead apron). Patient and staff dose measurements were collected in a sample of 34 urology interventions (nephrolithotomies). The same dosimetry system was used in other medical specialties for comparison purposes. Median and 3rd quartile values for urology procedures were: patient doses 30 and 40 Gy cm(2); personal dose equivalent Hp(10) over the apron (μSv/procedure): 393 and 848 (for urologists); 21 and 39 (for nurses). Median values of over apron dose per procedure for urologists resulted 18.7 times higher than those measured for radiologists and cardiologists working with proper protection (using ceiling suspended screens) in catheterisation laboratories, and 4.2 times higher than the values measured for vascular surgeons at the same hospital. Comparison with passive dosimeters worn near the eyes suggests that dosimeters worn over the apron could be a reasonable conservative estimate for ocular doses for interventional urology. Authors recommend that at least the main surgeon uses protective eyewear during interventional urology procedures. PMID:26583458

  19. Patient Dose Reference Levels for Interventional Radiology: A National Approach

    SciTech Connect

    Vano, Eliseo Sanchez, R.; Fernandez, J. M.; Gallego, J. J.; Verdu, J. F.; Garay, M. Gonzalez de; Azpiazu, A.; Segarra, A.; Hernandez, M. T.; Canis, M.; Diaz, F.; Moreno, F.; Palmero, J.

    2009-01-15

    A set of patient dose reference levels (RLs) for fluoroscopically guided interventional procedures was obtained in a survey launched by the National Society of Interventional Radiology (IR), involving 10 public hospitals, as recommended by the European Medical Exposures Directive. A sample of 1391 dose values (kerma area product [KAP]) was collected randomly during clinical procedures for seven of the most frequent procedures. Third quartiles of the KAP distributions were used to set the RLs. A regular quality control of the X-ray systems and a calibration of the dose meters were performed during the survey. The fluoroscopy time and total number of digital subtraction angiography images per procedure were also analyzed. The RL values proposed were 12 Gy cm{sup 2} for fistulography (hemodialysis access; sample of 180 cases), 73 Gy cm{sup 2} for lower limb arteriography (685 cases), 89 Gy cm{sup 2} for renal arteriography (55 cases), 80 Gy cm{sup 2} for biliary drainage (205 cases), 289 Gy cm{sup 2} for hepatic chemoembolization (151 cases), 94 Gy cm{sup 2} for iliac stent (70 cases), and 236 Gy cm{sup 2} for uterine embolization (45 cases). The provisional national RL values are lower than those obtained in a similar survey carried out in the United States from 2002 to 2004. These new values could be used to improve the practice of centers consistently working with doses higher than the RLs. This national survey also had a positive impact, as it helped increase the awareness of the members of the National Society of IR on a topic as crucial as patient dose values and programs on radiation protection.

  20. A real-time haptic interface for interventional radiology procedures.

    PubMed

    Moix, Thomas; Ilic, Dejan; Fracheboud, Blaise; Zoethout, Jurjen; Bleuler, Hannes

    2005-01-01

    Interventional Radiology (IR) is a minimally-invasive surgery technique (MIS) where guidewires and catheters are steered in the vascular system under X-ray imaging. In order to perform these procedures, a radiologist has to be correctly trained to master hand-eye coordination, instrument manipulation and procedure protocols. This paper proposes a computer-assisted training environment dedicated to IR. The system is composed of a virtual reality (VR) simulation of the anatomy of the patient linked to a robotic interface providing haptic force feedback.The paper focuses on the requirements, design and prototyping of a specific part of the haptic interface dedicated to catheters. Translational tracking and force feedback on the catheter is provided by two cylinders forming a friction drive arrangement. The whole friction can be set in rotation with an additional motor providing torque feedback. A force and a torque sensor are integrated in the cylinders for direct measurement on the catheter enabling disturbance cancellation with a close-loop force control strategy. PMID:15718754

  1. Entrance surface dose in cerebral interventional radiology procedures

    SciTech Connect

    Barrera-Rico, M.; Lopez-Rendon, X.; Rivera-Ordonez, C. E.; Gamboa-deBuen, I.

    2012-10-23

    At the Instituto Nacional de Neurologia y Neurocirugia (INNN) diagnostic as well as therapeutic procedures of interventional radiology are carried out. Since the procedures can last from some minutes to several hours, the absorbed dose for the patient could increase dangerously. An investigation had begun in order to determine the entrance surface dose (ESD) using 25 thermoluminiscent dosimeters TLD-100 and 8 strips of 15 Multiplication-Sign 1 cm{sup 2} of Gafchromic XR-QA2 film bound in a holder of 15 Multiplication-Sign 15 cm{sup 2} in the posteroanterior (PA) and lateral (LAT) positions during all the procedure. The results show that maximum ESD could be from 0.9 to 2.9 Gy for the PA position and between 1.6 and 2.5 Gy for the lateral position. The average ESD was between 0.7 and 1.3 Gy for the PA position, and from 0.44 to 1.1 Gy for the lateral position in a therapeutic procedure.

  2. Entrance surface dose in cerebral interventional radiology procedures

    NASA Astrophysics Data System (ADS)

    Barrera-Rico, M.; López-Rendón, X.; Rivera-Ordóñez, C. E.; Gamboa-deBuen, I.

    2012-10-01

    At the Instituto Nacional de Neurología y Neurocirugía (INNN) diagnostic as well as therapeutic procedures of interventional radiology are carried out. Since the procedures can last from some minutes to several hours, the absorbed dose for the patient could increase dangerously. An investigation had begun in order to determine the entrance surface dose (ESD) using 25 thermoluminiscent dosimeters TLD-100 and 8 strips of 15 ×1 cm2 of Gafchromic XR-QA2 film bound in a holder of 15×15 cm2 in the posteroanterior (PA) and lateral (LAT) positions during all the procedure. The results show that maximum ESD could be from 0.9 to 2.9 Gy for the PA position and between 1.6 and 2.5 Gy for the lateral position. The average ESD was between 0.7 and 1.3 Gy for the PA position, and from 0.44 to 1.1 Gy for the lateral position in a therapeutic procedure.

  3. Radium and Other Radiological Chemicals: Drinking Water Treatment Strategies

    EPA Science Inventory

    Radium and Other Radiological Chemicals: Drinking Water Treatment Technologies Topics include: Introduction to Rad Chemistry, Summary of the Rad, Regulations Treatment Technology, and Disposal. The introductions cover atoms, ions, radium and uranium and the removal of radioac...

  4. A review of the radiological treatment

    SciTech Connect

    Mueller, C.J.; Folga, S.; Nabelssi, B.; Kohout, E.

    1996-07-01

    The Draft Waste Management Programmatic Environmental Impact Statement (WM PEIS) was released by the U.S. Department of Energy (DOE) for public comment on September 22, 1995. Prepared in accordance with the National Environmental Policy Act (NEPA), the Final WM PEIS is currently scheduled for release in late summer 1996. The Draft WM PEIS was published after about 3 years of effort to select and evaluated the best alternatives for treating, storing, and disposing of the 50-year legacy of radioactive and chemically hazardous wastes existing within the DOE complex. The evaluation examined the potential health and environmental impacts of integrated waste management alternatives for five categories of waste types at 54 DOE sites. A primary consideration as a potential source of human health impacts at all sites is that of radiological releases resulting from postulated accidents involving facilities used to treat radioactive wastes. This paper first provides a brief, updated summary of the approach used to define and perform treatment facility accident analyses in the Draft WM PEIS. It reviews the selection of dominant sequences for the major sites most affected by the preferred waste management alternatives and highlights the salient accident analysis results. Finally, it summarizes and addresses key public and state and federal agency comments relating to accident analysis that were received in the public comment process.

  5. Is Your Interventional Radiology Service Ready for SARS?: The Singapore Experience

    SciTech Connect

    Lau, Te-Neng; Teo, Ngee; Tay, Kiang-Hiong; Chan, Ling-Ling; Wong, Daniel; Lim, Winston E.H.; Tan, Bien-Soo

    2003-09-15

    The recent epidemic of severe acute respiratory syndrome caught many by surprise. Hitherto, infection control has not been in the forefront of radiological practice. Many interventional radiology (IR) services are therefore not equipped to deal with such a disease. In this review, we share our experience from the interventional radiologist's perspective, report on the acute measures instituted within our departments and explore the long-term effects of such a disease on the practice of IR.

  6. The role of interventional radiology and imaging in pancreatic islet cell transplantation.

    PubMed

    Dixon, S; Tapping, C R; Walker, J N; Bratby, M; Anthony, S; Boardman, P; Phillips-Hughes, J; Uberoi, R

    2012-09-01

    Pancreatic islet cell transplantation (PICT) is a novel treatment for patients with insulin-dependent diabetes who have inadequate glycaemic control or hypoglycaemic unawareness, and who suffer from the microvascular/macrovascular complications of diabetes despite aggressive medical management. Islet transplantation primarily aims to improve the quality of life for type 1 diabetic patients by achieving insulin independence, preventing hypoglycaemic episodes, and reversing hypoglycaemic unawareness. The islet cells for transplantation are extracted and purified from the pancreas of brain-stem dead, heart-beating donors. They are infused into the recipient's portal vein, where they engraft into the liver to release insulin in order to restore euglycaemia. Initial strategies using surgical access to the portal vein have been superseded by percutaneous access using interventional radiology techniques, which are relatively straightforward to perform. It is important to be vigilant during the procedure in order to prevent major complications, such as haemorrhage, which can be potentially life-threatening. In this article we review the history of islet cell transplantation, present an illustrated review of our experience with islet cell transplantation by describing the role of imaging and interventional radiology, and discuss current research into imaging techniques for monitoring graft function. PMID:22554698

  7. Interventional Radiology in the Diagnosis, Management, and Follow-Up of Pseudoaneurysms

    SciTech Connect

    Keeling, A. N.; McGrath, F. P.; Lee, M. J.

    2009-01-15

    Arterial wall disruption, as a consequence of inflammation/infection, trauma (penetrating or blunt), or iatrogenic causes, may result in pseudoaneurysm formation. Currently, iatrogenic causes are increasing as a result of the growth of endovascular intervention. The frequency of other causes also seems to be increasing, but this may simply be the result of increased diagnosis by better imaging techniques, such as multidetector contrast-enhanced computed tomography. Clinically, pseudoaneurysms may be silent, may present with local or systemic signs, or can rupture with catastrophic consequences. Open surgical repair, previously the mainstay of treatment, has largely been replaced by image-guided occlusion methods. On the basis of an experience of over 100 pseudoaneurysms, treatments at various anatomical sites, imaging modalities used for accurate diagnosis, current changing therapeutic options for pseudoaneurysm management, approved embolization agents, and clinical follow-up requirements to ensure adequate treatment will be discussed. Image-guided direct percutaneous and endovascular embolization of pseudoaneurysms are established treatment options with favorable success rates and minimal morbidity. The pendulum has now swung from invasive surgical repair of pseudoaneurysms to that of image-guided interventional radiology.

  8. A brief history of interventional radiology in Singapore and its current status

    PubMed Central

    Teo, TKB; Tan, BS; Tay, KH

    2011-01-01

    X-ray services were first established in Singapore in 1898. With the opening of the General Hospital in 1926, there was subsequent increase in workload. However, a radiology department was not formed until the 1950s. Angiography was introduced in the same decade initially for diagnosis. By the 1960s and 1970s, both vascular and non-vascular interventions were performed. Subsequently, interventional radiology experienced exponential growth, with newer technology and better facilities established over the past 3 decades. With more trained interventional radiologists, the service is currently available in all public hospitals and in most private hospitals in Singapore today. It is envisaged that structured training and formal credentialing will be established, eventually leading to recognition of interventional radiology as a specialty in its own right. PMID:22291858

  9. Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology.

    PubMed

    Vano, E; Sanchez, R M; Fernandez, J M

    2015-07-01

    The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 µSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm(2), respectively. The median ratios for dosemeters worn over the apron by operators (protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 µSv Gy(-1) cm(-2), respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y(-1) and per operator were necessary to reach the new lens dose limit for the three interventional specialties. PMID:25848117

  10. A robust and fast approach to simulating the behavior of guidewire in vascular interventional radiology.

    PubMed

    Wang, Haoyu; Wu, Jianhuang; Wei, Mingqiang; Ma, Xin

    2015-03-01

    Interventional radiology (IR) is widely used in the treatment of cardiovascular disease. The manipulation of the guidewire and catheter is an essential skill in IR procedure. Computer-based training simulators can provide solutions to overcome many drawbacks of the traditional apprenticeship training during the procedure. In this paper, a physically-based approach to simulating the behavior of the guidewire is presented. Our approach models the guidewire as thin flexible elastic rods with different resolutions which are dynamically adaptive to the curvature of the vessel. More material characteristics of this deformable material are integrated into our discrete model to realistically simulate the behavior of the wire. A force correction strategy is proposed to adjust the elastic force to avoid endless collision detections. Several experimental tests on our simulator are given to demonstrate the effectiveness of our approach. PMID:25467803

  11. The Changing Face of Vascular Interventional Radiology: The Future Role of Pharmacotherapies and Molecular Imaging

    SciTech Connect

    Tapping, Charles R. Bratby, Mark J.

    2013-08-01

    Interventional radiology has had to evolve constantly because there is the ever-present competition and threat from other specialties within medicine, surgery, and research. The development of new technologies, techniques, and therapies is vital to broaden the horizon of interventional radiology and to ensure its continued success in the future. In part, this change will be due to improved chronic disease prevention altering what we treat and in whom. The most important of these strategies are the therapeutic use of statins, Beta-blockers, angiotensin-converting enzyme inhibitors, and substances that interfere with mast cell degeneration. Molecular imaging and therapeutic strategies will move away from conventional techniques and nano and microparticle molecular technology, tissue factor imaging, gene therapy, endothelial progenitor cells, and photodynamic therapy will become an important part of interventional radiology of the future. This review looks at these new and exciting technologies.

  12. The Importance of Curriculum-Based Training and Assessment in Interventional Radiology

    SciTech Connect

    Belli, Anna-Maria; Reekers, Jim A.; Lee, Michael

    2013-10-30

    Physician performance and outcomes are being scrutinised by health care providers to improve patient safety and cost efficiency. Patients are best served by physicians who have undergone appropriate specialist training and assessment and perform large numbers of cases to maintain their skills. The Cardiovascular and Interventional Radiological Society of Europe has put into place a curriculum for training in interventional radiology (IR) and a syllabus with an examination, the European Board of Interventional Radiology, providing evidence of attainment of an appropriate and satisfactory skill set for the safe practice of IR. This curriculum is appropriate for IR where there is a high volume of image-guided procedures in vascular and nonvascular organ systems with cross-use of minimally invasive techniques in patients with a variety of disease processes. Other specialties may require different, longer, and more focused training if their experience is “diluted” by the need to master a different skill set.

  13. The changing face of vascular interventional radiology: the future role of pharmacotherapies and molecular imaging.

    PubMed

    Tapping, Charles R; Bratby, Mark J

    2013-08-01

    Interventional radiology has had to evolve constantly because there is the ever-present competition and threat from other specialties within medicine, surgery, and research. The development of new technologies, techniques, and therapies is vital to broaden the horizon of interventional radiology and to ensure its continued success in the future. In part, this change will be due to improved chronic disease prevention altering what we treat and in whom. The most important of these strategies are the therapeutic use of statins, Beta-blockers, angiotensin-converting enzyme inhibitors, and substances that interfere with mast cell degeneration. Molecular imaging and therapeutic strategies will move away from conventional techniques and nano and microparticle molecular technology, tissue factor imaging, gene therapy, endothelial progenitor cells, and photodynamic therapy will become an important part of interventional radiology of the future. This review looks at these new and exciting technologies. PMID:23636247

  14. Imaging and radiology

    MedlinePlus

    Interventional radiology; Diagnostic radiology; X-ray imaging ... DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care professionals see structures inside your body. Doctors that specialize in the ...

  15. Imaging and radiology

    MedlinePlus

    Interventional radiology; Diagnostic radiology; X-ray imaging ... DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care professionals see structures inside your body. Doctors that specialize in the interpretation ...

  16. The Role of Interventional Radiology in the Diagnosis and Management of Male Impotence

    SciTech Connect

    Spiliopoulos, Stavros; Shaida, Nadeem; Katsanos, Konstantinos; Krokidis, Miltiadis

    2013-10-15

    Erectile dysfunction (ED) is defined as the persistent inability to reach or maintain penile rigidity enough for sexual satisfaction. Nearly 30% of the men between ages 40 and 70 years are affected by ED. A variety of pathologies, including neurological, psychological, or endocrine disorders and drug side effects, may incite ED. A commonly identified cause of ED is vascular disease. Initial diagnostic workup includes a detailed physical examination and laboratory tests. Whilst duplex ultrasound is considered the first-line diagnostic modality, intra-arterial digital subtraction angiography is still considered the 'gold standard' for the diagnosis of arteriogenic impotence. Percutaneous endovascular treatment may be offered in patients with vasculogenic ED that has failed to respond to oral medical therapy as an alternative to penile prosthesis or open surgical repair. In arteriogenic ED balloon angioplasty of the aorto-iliac axis, and in veno-occlusive ED, percutaneous venous ablation using various embolization materials has been reported to be safe and to improve sexual performance. Recently, the ZEN study investigated the safety and feasibility of drug-eluting stents for the treatment of arteriogenic ED attributed to internal pudendal artery stenosis with promising preliminary results. This manuscript highlights the role of interventional radiology in the diagnosis and minimally invasive treatment of male impotence.

  17. Changes in the American Interventional Radiology Literature: Comparison over a 10-Year Time Period

    SciTech Connect

    Ray, Charles E. Gupta, Rajan; Blackwell, John

    2006-08-15

    Purpose. To determine the changes that occurred regarding interventional radiologic research in the major American radiology journals between 1992-1993 and 2002-2003. Methods. Articles published in three major American radiology journals (Journal of Vascular and Interventional Radiology, American Journal of Roentgenology, and Radiology) during two distinct 24-month time periods (1992-1993 and 2002-2003) were evaluated. All articles judged to be pertinent to the interventional radiologic community were included. Investigations included in journal subheadings other than 'interventional' or 'vascular radiology' were included if the emphasis of the article was on a vascular imaging modality or peripheral intervention. Exclusions included: case reports, technical reports, letters to the editor, breast interventions, and primary neurointerventions. Data were collected regarding the affiliations of the primary author (nationality, hospital type, department); primary category of interest of the investigation; funding information; and study design variables. Two-by-two chi-squared statistical analyses were performed comparing the variables from the early and late data sets. Results. A total of 405 articles met the inclusion criteria for the early data set (1992-1993); 488 articles met the inclusion criteria for the late data set (2002-2003). Variables that demonstrated a statistically significant decrease from the early data set to the late data set included: articles in which the primary author was from a department of radiology (91.1% vs. 86.3%; p < 0.025); articles written by a primary author who was American (69.4% vs. 44.6%; p < 0.001); and articles with a primary category of investigation that had a nonvascular intervention focus (22.7% vs. 11.9%; p < 0.001). Variables that demonstrated a statistically significant increase from the early data set to the late data set included primary authors from Western Europe (18.0% vs. 30.1%; p < 0.001) and Asia (6.6% vs. 18.4%; p

  18. The impact of nonphysician providers on diagnostic and interventional radiology practices: regulatory, billing, and compliance perspectives.

    PubMed

    Hawkins, C Matthew; Bowen, Michael A; Gilliland, Charles A; Walls, D Gail; Duszak, Richard

    2015-08-01

    The numbers of nurse practitioners and physician assistants are increasing throughout the entire health care enterprise, and a similar expansion continues within radiology. Some practices have instead embraced radiologist assistants. The increased volume of services rendered by this growing nonphysician provider subset of the health care workforce within and outside of radiology departments warrants closer review. The authors evaluate the recent literature and offer recommendations to radiology practices regarding both regulatory and scope-of-practice issues related to these professionals. Additionally, billing and compliance issues for care provided by nurse practitioners, physician assistants, and radiologist assistants are detailed. An analysis of the integration of these professionals into interventional and diagnostic radiology practices, as well as potential implications for medical education, is provided in the second part of this series. PMID:26006744

  19. Interventional radiology in infants and children: clinical and technical aspects

    SciTech Connect

    Diament, M.J.; Boechat, M.I.; Kangarloo, H.

    1985-02-01

    The authors performed 53 extravascular interventional procedures in 47 pediatric patients between July 1981 and September 1983. Except for transhepatic cholangiography in patients without intrahepatic biliary dilatation, the success rate was high. There were few complications, and none that were life-threatening or required surgery. Factors essential to safe and successful intervention in infants, children, and adolescents, in the authors' opinion, include (a) active involvement by the radiologist, (b) guidance by real-time imaging, (c) careful matching of needles, catheters, and guidewires to patient size, and (d) adequate sedation and analgesia.

  20. In the Lead Again Horizontal-Ellipsis [Journal of Cardiovascular and Interventional Radiology

    SciTech Connect

    Vorwerk, Dierk

    2013-10-15

    The 2013 ISI journal rankings are out and it is my pleasure to inform our readership that CVIR ranks 43/120 (2012: 46/118) journals in the field of radiology. The 2013 impact factor further improved to 2.138 (2012: 2.093). This means that Cardiovascular and Interventional Radiology again continues to be the highest ranked journal dedicated to the field of interventional radiology in 2013.This is mainly due to the great support we achieve by you as authors and readers of CVIR, your dedication to the profession, and your loyalty both to the journal and to CIRSE. For all of this, we owe you our thanks and respect.

  1. Chronic Pelvic Pain due to Pelvic Congestion Syndrome: The Role of Diagnostic and Interventional Radiology

    SciTech Connect

    Ganeshan, Arul; Upponi, Sara; Hon, Lye-Quen; Uthappa, M. C.; Warakaulle, Dinuke R.; Uberoi, Raman

    2007-11-15

    Chronic pelvic pain (CPP) is a common cause of gynecologic referral. Pelvic congestion syndrome, which is said to occurs due to ovarian vein incompetence, is a recognized cause of CPP. The aim of this paper is to briefly describe the clinical manifestations, and to review the role of diagnostic and interventional radiology in the management of this probably under-diagnosed condition.

  2. Ultrasound-guided interventional radiology in critical care.

    PubMed

    Nicolaou, Savvas; Talsky, Aaron; Khashoggi, Khalid; Venu, Vicnays

    2007-05-01

    Ultrasound-guided intervention is becoming an increasingly popular and valuable tool in the critical care setting. In general, image-guided procedures can expedite wait times and increase the accuracy, safety, and efficacy of many procedures commonly performed within intensive care units. In the intensive care unit setting, ultrasound has particular advantages over other imaging modalities such as computed tomography and fluoroscopy, including real-time visualization, portability permitting bedside procedures, and reduced exposure to nephrotoxic contrast agents. We review the technical and procedural aspects of a number of ultrasound-guided interventions appropriate for critical care patients. These include central venous catheter deployment, thoracentesis, paracentesis, and drainage of a wide variety of abscesses, and percutaneous nephrostomy, percutaneous cholecystectomy, and inferior vena cava filter placement. Although we believe ultrasound is significantly underutilized in critical care today, we anticipate that with the improvement of ultrasound technology and the innovation of new ultrasound-guided procedures, the role of ultrasound in the intensive care unit will continue to expand, with bedside ultrasound-guided interventions increasingly becoming the norm. PMID:17446778

  3. Interventional Treatments of Cancer Pain.

    PubMed

    Sindt, Jill E; Brogan, Shane E

    2016-06-01

    Pain is a significant burden for patients with cancer and is particularly prevalent among those with advanced cancer. Appropriate interventional cancer pain therapies complement conventional pain management by reducing the need for systemic opioid therapy and its associated toxicity; however, these therapies are often underutilized. This article reviews techniques, indications, complications, and outcomes of the most common interventional approaches for the management of cancer-related pain. These approaches include intrathecal drug delivery, vertebral augmentation, neurolysis of the celiac, superior hypogastric and ganglion impar plexus', image-guided tumor ablation, and other less commonly performed but potentially beneficial interventions. PMID:27208713

  4. A survey of films for use as dosimeters in interventional radiology

    SciTech Connect

    Fajardo, L.C.; Geise, R.A.; Ritenour, E.R.

    1995-04-01

    Analysis of radiation doses in interventional radiological procedures that can lead to deterministic radiation effects such as erythema and epilation would assist physicians in planning patient care after exposure and in reducing doses. Photographic films used to measure skin exposure in the past are too sensitive for the high doses involved in interventional procedures. Seventeen different types of films, many of which are generally available in hospitals, were surveyed to see if any would meet the demands of interventional radiology. Sensitometric curves obtained demonstrate that most films are inappropriate for high dose procedures. Using Kodak Fine Grain Positive and Deupont duplicating films and automatic processing, doses as high as 2.8 Gy could be measured with reasonable accuracy. Similar results can be obtained by manually processing Kodak XV-2 verification film at room temperature.

  5. Radiology. Diagnosis/imaging/intervention. 5 volumes. Annual revision service

    SciTech Connect

    Taveras, J.M.; Ferrucci, J.T.

    1986-01-01

    This five-volume loose leaf work of approximately 4,500 pages is designed to be used as a clinical reference in modern radiologic practice. It covers all aspects of diagnostic imaging, starting with the physical foundation of each imaging modality. The material is organized according to organ systems and not along technical considerations. Thus, when discussing a disease process in any organ, all imaging modalities that can be brought to bear on the diagnosis of an entity are discussed. The volumes are lavishly illustrated, containing about 7,000 black-and-white illustrations and about 50 tables. The five volumes contain nine sections. The discussions of the organ systems are illustrated using examples from plain film, nuclear medicine, computerized tomography, magnetic resonance, position emission tomography and ultrasound. Wherever possible, each chapter begins with a discussion of anatomy, physiology, and general examination technique, and then proceeds to a discussion of disease categories. The loose leaf approach allows for updating of the contents each year through the annual revision service.

  6. Navigation with Electromagnetic Tracking for Interventional Radiology Procedures

    PubMed Central

    Wood, Bradford J.; Zhang, Hui; Durrani, Amir; Glossop, Neil; Ranjan, Sohan; Lindisch, David; Levy, Eliott; Banovac, Filip; Borgert, Joern; Krueger, Sascha; Kruecker, Jochen; Viswanathan, Anand; Cleary, Kevin

    2008-01-01

    PURPOSE To assess the feasibility of the use of preprocedural imaging for guide wire, catheter, and needle navigation with electromagnetic tracking in phantom and animal models. MATERIALS AND METHODS An image-guided intervention software system was developed based on open-source software components. Catheters, needles, and guide wires were constructed with small position and orientation sensors in the tips. A tetrahedral-shaped weak electromagnetic field generator was placed in proximity to an abdominal vascular phantom or three pigs on the angiography table. Preprocedural computed tomographic (CT) images of the phantom or pig were loaded into custom-developed tracking, registration, navigation, and rendering software. Devices were manipulated within the phantom or pig with guidance from the previously acquired CT scan and simultaneous real-time angiography. Navigation within positron emission tomography (PET) and magnetic resonance (MR) volumetric datasets was also performed. External and endovascular fiducials were used for registration in the phantom, and registration error and tracking error were estimated. RESULTS The CT scan position of the devices within phantoms and pigs was accurately determined during angiography and biopsy procedures, with manageable error for some applications. Preprocedural CT depicted the anatomy in the region of the devices with real-time position updating and minimal registration error and tracking error (<5 mm). PET can also be used with this system to guide percutaneous biopsies to the most metabolically active region of a tumor. CONCLUSIONS Previously acquired CT, MR, or PET data can be accurately codisplayed during procedures with reconstructed imaging based on the position and orientation of catheters, guide wires, or needles. Multimodality interventions are feasible by allowing the real-time updated display of previously acquired functional or morphologic imaging during angiography, biopsy, and ablation. PMID:15802449

  7. A survey of interventional radiology awareness among final-year medical students in a European country.

    PubMed

    Leong, Sum; Keeling, Aoife N; Lee, Michael J

    2009-07-01

    Interventional radiology (IR) is a rapidly expanding specialty that is facing the challenges of turf wars and personnel shortages. Appropriate exposure of medical students to this field can be vital to recruitment of potential future trainees or referring physicians. The aim of this study was to determine the knowledge and views of final-year medical students in a single EU country regarding various aspects of IR. An electronic survey was sent via e-mail to all final-year medical students in a European country. The students were given a month to respond to the questionnaire. A total of 234 students of 675 (34.5%) replied to the survey. Of the respondents, 35% had previously completed an attachment to the radiology department. The majority of students (63%) thought their knowledge in radiology in general was poor. The percentage of students who correctly identified procedures performed by interventional radiologists was 69% for Hickman line insertion, 79% for fibroid embolization, and 67.5% for lower limb angioplasty. Sixty percent, 30%, and 47% thought that interventional radiologists perform cardiac angioplasties, perform arterial bypasses, and create AV fistulas, respectively. Forty-nine percent felt that interventional radiologists are surgically trained. Eighty-three percent of students were first made aware of angioplasty by a cardiologist. Thirty-one percent thought that interventional radiologists do ward rounds, 24% thought that interventional radiologists have admitting rights, and 26% felt that interventional radiologists run an outpatient practice. A significant number of students (76%) thought that the job prospects in IR are good or excellent but only 40.5% were willing to consider a career in IR. In conclusion, this study indicates that IR remains a nascent but attractive specialty to the majority of medical students. Further development of the existing informal undergraduate curriculum to address shortcomings will ensure that IR continues to attract

  8. [Peri-interventional management of acute endovascular stroke treatment].

    PubMed

    Schönenberger, S; Bösel, J

    2015-10-01

    Due to the ground breaking consistent evidence that supports the effect of endovascular stroke treatment (EST), many acute care hospitals and stroke centers will have to be prepared to provide this treatment in an optimal way within the coming years. In addition to the intervention itself, patient preparation, stabilization and monitoring during the treatment as well as the aftercare represent significant challenges and have mostly not yet been sufficiently investigated. Under these aspects, the questions of optimal sedation and airway management have received the highest attention. Based on retrospective study results it already seems to be justified, respecting certain criteria, to prefer EST with the patient under conscious sedation (CS) in comparison to general anesthesia (GA) and to only switch to GA in cases of emergency until this question has been clarified by prospective studies. This and other aspects of peri-interventional management, such as logistics, monitoring, blood pressure, ventilation settings, postprocedural steps of intensive or stroke unit care and imaging follow-up are summarized in this overview. The clinical and radiological selection of patients and thus the decision for intervention or technical aspects of the intervention itself will not be part of this article. PMID:26311331

  9. Predictors of arteriovenous graft patency after radiologic intervention in hemodialysis patients.

    PubMed

    Lilly, R Z; Carlton, D; Barker, J; Saddekni, S; Hamrick, K; Oser, R; Westfall, A O; Allon, M

    2001-05-01

    Arteriovenous grafts in hemodialysis patients are prone to recurrent stenosis and thrombosis, requiring frequent radiologic and surgical interventions to optimize their long-term patency. Little is known about the factors that determine graft outcome after a radiologic intervention. The present study examined the clinical and radiologic predictors of intervention-free graft survival after elective angioplasty or thrombectomy. A prospective computerized database was used to determine the outcomes subsequent to all graft angioplasties (n = 330) and thrombectomies (n = 326) performed at the University of Alabama at Birmingham between April 1, 1996, and June 30, 1999. Primary graft survival rates after angioplasty and thrombectomy were 86% versus 43% at 1 month, 71% versus 30% at 3 months, 51% versus 19% at 6 months, and 28% versus 8% at 12 months, respectively. The median intervention-free graft survival time was substantially longer after angioplasty than thrombectomy (6.7 versus 0.6 months; P < 0.001). The superior outcome of angioplasty over thrombectomy was observed even for the subset of procedures with no residual stenosis (median survival, 6.9 versus 2.5 months; P < 0.001). The median graft survival was inversely related to the magnitude of residual stenosis for both elective angioplasty and thrombectomy. Median intervention-free graft survival after angioplasty was inversely related to the postangioplasty intragraft to systemic systolic pressure ratio (7.6, 6.9, and 5.6 months for ratios <0.4, 0.4 to 0.6, and >0.6, respectively; P < 0.001). Intervention-free graft survival after angioplasty or thrombectomy was not affected by graft location (forearm versus upper arm), number of stenotic sites, or presence of diabetes. In conclusion, graft survival is substantially longer after elective angioplasty than thrombectomy, even when the radiologic appearance after the procedure suggests complete resolution of the stenotic lesion. Moreover, the risk for requiring a

  10. Modern diagnostic and therapeutic interventional radiology in lung cancer

    PubMed Central

    Lau, Eddie W. F.; Chin, Kwang; Sedlaczek, Oliver; Steinke, Karin

    2013-01-01

    Imaging has an important role in the multidisciplinary management of primary lung cancer. This article reviews the current state-of-the-art imaging modalities used for the evaluation, staging and post-treatment follow-up and surveillance of lung cancers, and image-guided percutaneous techniques for biopsy to confirm the diagnosis and for local therapy in non-surgical candidates. PMID:24163744

  11. Evaluation of the calibration procedure of active personal dosemeters for interventional radiology.

    PubMed

    Bordy, J-M; Daures, J; Clairand, I; Denozière, M; Donadille, L; d'Errico, F; Gouriou, J; Itié, C; Struelens, L

    2008-01-01

    An overview of the use of active personal dosemeters (APD) in interventional radiology is presented. It is based on the work done by the working package 7 of the CONRAD coordinated action supported by the EC within the frame of the 6th FP. This study was done in collaboration with the working package 4 of CONRAD to deal with the calculations required for studying the new calibration facility. The main requirements of the standard for the APD and the difficulties caused by the use of pulsed radiations are presented through the results of an intercomparison organised in a realistic calibration facility similar to the workplace situation in interventional radiology. The main characteristics of this facility are presented. PMID:18757898

  12. Lessons from surgery and anaesthesia: evaluation of non-technical skills in interventional radiology

    PubMed Central

    Patel, Salil B; Pilkington, Nicola

    2015-01-01

    In the medical profession, surgery and anaesthesia are leading the way in identifying human errors that negatively affect patient safety. Evidence suggests that the implementation of non-technical skills assessments reduces such errors. Interventional Radiology is a procedural based speciality and therefore may also benefit from formal assessment of non-technical skills. This literature review supports the use of standardised assessment tools used in surgery and anaesthesia. Using the Downing framework of internal validity, the tools demonstrated good internal consistency but a spectrum of inter-rater variability, which can be partially improved with training. At present, a formal Interventional Radiology non-technical skills assessment tool is probably not suitable to be a stand-alone ‘high stakes’ assessment, but may be a useful adjunct to the existing array of workplace-based assessments. PMID:26664733

  13. Biological Treatment of Petroleum in Radiologically Contaminated Soil

    SciTech Connect

    BERRY, CHRISTOPHER

    2005-11-14

    This chapter describes ex situ bioremediation of the petroleum portion of radiologically co-contaminated soils using microorganisms isolated from a waste site and innovative bioreactor technology. Microorganisms first isolated and screened in the laboratory for bioremediation of petroleum were eventually used to treat soils in a bioreactor. The bioreactor treated soils contaminated with over 20,000 mg/kg total petroleum hydrocarbon and reduced the levels to less than 100 mg/kg in 22 months. After treatment, the soils were permanently disposed as low-level radiological waste. The petroleum and radiologically contaminated soil (PRCS) bioreactor operated using bioventing to control the supply of oxygen (air) to the soil being treated. The system treated 3.67 tons of PCRS amended with weathered compost, ammonium nitrate, fertilizer, and water. In addition, a consortium of microbes (patent pending) isolated at the Savannah River National Laboratory from a petroleum-contaminated site was added to the PRCS system. During operation, degradation of petroleum waste was accounted for through monitoring of carbon dioxide levels in the system effluent. The project demonstrated that co-contaminated soils could be successfully treated through bioventing and bioaugmentation to remove petroleum contamination to levels below 100 mg/kg while protecting workers and the environment from radiological contamination.

  14. Organ motion due to respiration: the state of the art and applications in interventional radiology and radiation oncology

    NASA Astrophysics Data System (ADS)

    Cleary, Kevin R.; Mulcahy, Maureen; Piyasena, Rohan; Zhou, Tong; Dieterich, Sonja; Xu, Sheng; Banovac, Filip; Wong, Kenneth H.

    2005-04-01

    Tracking organ motion due to respiration is important for precision treatments in interventional radiology and radiation oncology, among other areas. In interventional radiology, the ability to track and compensate for organ motion could lead to more precise biopsies for applications such as lung cancer screening. In radiation oncology, image-guided treatment of tumors is becoming technically possible, and the management of organ motion then becomes a major issue. This paper will review the state-of-the-art in respiratory motion and present two related clinical applications. Respiratory motion is an important topic for future work in image-guided surgery and medical robotics. Issues include how organs move due to respiration, how much they move, how the motion can be compensated for, and what clinical applications can benefit from respiratory motion compensation. Technology that can be applied for this purpose is now becoming available, and as that technology evolves, the subject will become an increasingly interesting and clinically valuable topic of research.

  15. Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

    SciTech Connect

    Haslam, Philip J.; Yap, Bernard; Mueller, Peter R.; Lee, Michael J.

    2000-07-15

    Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived from a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are

  16. Damage control interventional radiology (DCIR) in prompt and rapid endovascular strategies in trauma occasions (PRESTO): A new paradigm.

    PubMed

    Matsumoto, J; Lohman, B D; Morimoto, K; Ichinose, Y; Hattori, T; Taira, Y

    2015-01-01

    This article proposes an innovative concept of interventional radiology for hemodynamically unstable trauma patients. Damage control interventional radiology (DCIR) is an aggressive and time-conscious algorithm that prioritizes saving life of the hemorrhaging patient in extremis which conventional emergency interventional radiology (CEIR) cannot efficiently do. Briefly, DCIR aims to save life while CEIR aims to control bleeding with a constant concern to time-awareness. This article also presents the concept of "Prompt and Rapid Endovascular Strategies in Traumatic Occasions" (PRESTO) that entirely oversees and manages trauma patients from arrival to the trauma bay until initial completion of hemostasis with endovascular techniques. PRESTO's "Start soon and finish sooner" relies on the earlier activation of interventional radiology team but also emphasizes on a rapid completion of hemostasis in which DCIR has been specifically tailored. Both DCIR and PRESTO expand the role of IR and represent a paradigm shift in the realm of trauma care. PMID:26119866

  17. Impact of Treatment Integrity on Intervention Effectiveness

    ERIC Educational Resources Information Center

    Fryling, Mitch J.; Wallace, Michele D.; Yassine, Jordan N.

    2012-01-01

    Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity…

  18. Trichotillomania: Behavioral Assessment and Treatment Interventions

    ERIC Educational Resources Information Center

    Kell, Brandy L.; Kress, Victoria E.

    2006-01-01

    This article examines the behavioral treatment of Trichotillomania. A brief overview of the diagnosis and assessment of Trichotillomania is provided. Guidelines for a structured clinical evaluation when working with people diagnosed with Trichotillomania are supplied. The most effective behavioral interventions and treatments for working with…

  19. Collaborative work during interventional radiological procedures based on a multicast satellite-terrestrial network.

    PubMed

    Gortzis, Lefteris G; Papadopoulos, Homer; Roelofs, Theo A; Rakowsky, Stefan; Karnabatidis, Dimitris; Siablis, Dimitris; Makropoulos, Constantinos; Nikiforidis, George; Graschew, Georgi

    2007-09-01

    Collaboration is a key requirement in several contemporary interventional radiology procedures (IRPs). This work proposes a multicast hybrid satellite system capable of supporting advanced IRP collaboration, and evaluates its feasibility and applicability. Following a detailed IRP requirements study, we have developed a system which supports IRP collaboration through the employment of a hybrid satellite-terrestrial network, a prototype multicast version of wavelet based interactive communication system (WinVicos) application, and a partition aggregation and conditional coding (PACC) wavelet codec. A semistructured questionnaire was also used to receive evaluative feedback from collaborating participants. The departments of interventional radiology of University Hospital of Patras, Greece and of Charite Hospital of Berlin, Germany have been connected on the system. Eight interventional radiologists and a vascular surgeon participated periodically in three satellite-terrestrial "fully collaborative" IRPs (average time 90 min) of high complexity and in four terrestrial educational sessions with great success, evidenced by considerable improving the IRP outcomes (clinical and educational). In case of high complexity, where the simultaneous presence of remote interventional expert and/or surgeon is required, advanced collaboration among staff of geographically dispersed international centers is feasible via integration of existing networking and other technologies. PMID:17912978

  20. Current challenges in interventional mitral valve treatment

    PubMed Central

    Candreva, Alessandro; Pozzoli, Alberto; Guidotti, Andrea; Gaemperli, Oliver; Nietlispach, Fabian; Barthelmes, Jens; Emmert, Maximilian Y.; Weber, Alberto; Benussi, Stefano; Alfieri, Ottavio; Maisano, Francesco

    2015-01-01

    Transcatheter mitral valve therapies have emerged as an alternative option in high surgical risk or inoperable patients with severe and symptomatic mitral regurgitation (MR). As multiple technologies and different approaches will become available in the field of mitral valve interventions, different challenges are emerging, both patient- (clinical challenges) and procedure-related (technical challenges). This review will briefly explore the current open challenges in the evolving fields of interventional mitral valve treatment. PMID:26543599

  1. Decreasing pediatric patient anxiety about radiology imaging tests: prospective evaluation of an educational intervention.

    PubMed

    Johnson, Annette J; Steele, Jennifer; Russell, Gregory B; Moran, Rhonda; Fredericks, Kirsten P; Jennings, S Gregory

    2009-12-01

    This trial investigated anxiety levels and effect of an educational coloring book (CB) among pediatric patients about to undergo radiology imaging tests. Control group (N = 101) and intervention group (N = 175) children ages 3-10 years and their parents were surveyed to determine anxiety levels before the imaging test, with the intervention group being surveyed after patient and parental review of the CB. Anxiety was low for all subjects overall compared with findings from previously published literature, perhaps related to systemic measures to make children's hospitals more child friendly in recent years. Review of the CB was not associated with decreased anxiety among patients or parents. However, among a subgroup with higher baseline parental anxiety, there was a trend toward lower patient anxiety in the intervention group. Most parents indicated that the CB was informative and helped them and their child be less worried, and that they were pleased to have received the CB. PMID:19833667

  2. Automatic management system for dose parameters in interventional radiology and cardiology.

    PubMed

    Ten, J I; Fernandez, J M; Vaño, E

    2011-09-01

    The purpose of this work was to develop an automatic management system to archive and analyse the major study parameters and patient doses for fluoroscopy guided procedures performed in cardiology and interventional radiology systems. The X-ray systems used for this trial have the capability to export at the end of the procedure and via e-mail the technical parameters of the study and the patient dose values. An application was developed to query and retrieve from a mail server, all study reports sent by the imaging modality and store them on a Microsoft SQL Server data base. The results from 3538 interventional study reports generated by 7 interventional systems were processed. In the case of some technical parameters and patient doses, alarms were added to receive malfunction alerts so as to immediately take appropriate corrective actions. PMID:21831869

  3. [Measurement of the Dose Rate Using Dosimeters in Interventional Radiology and Its Difficulty].

    PubMed

    Yoshida, Hidenori; Takahashi, Chiharu; Narita, Nobuhiro; Mizusawa, Yasuhiko; Sekiya, Masaru; Ohkubo, Masaki

    2016-01-01

    In equipment used for interventional radiology (IVR), automatic exposure control (AEC) is incorporated to obtain the X-ray output suitable for the treatment of targeted lesions. For the AEC, users select a region as the signal sensing region (measuring field, MF) in the flat panel detector; MFs with various sizes and shapes were pre-defined and prepared in the system. The aim of this study was to examine the change of measured dose rate with the selection of MFs, the type of dosimeters (the ionization chamber dosimeter and the semiconductor dosimeter), and the dosimeter placement relative to the direction of X-ray tube (from cathode to anode). The IVR equipment was Allura Xper FD20/10 (Philips Medical Systems), and six kinds of built-in MFs were used. It was found that dose rate measured by the ionization chamber dosimeter showed a variation of -2 mGy/min with the MFs and the ionization chamber dosimeter placement. The dose rate measured by the semiconductor dosimeter showed more variation than the ionization chamber dosimeter. The change of dose rate with the dosimeter placement would be caused by the MF overlapping the dosimeter which would affect the AEC (the X-ray output). Also, the change of dose rate with the dosimeter placement was considered to be related to the heel effect of the X-ray beam. When performing dose rate measurements, we should notice that the selection of MFs, the type of dosimeters, and the dosimeter placement would affect the measured values. PMID:26796935

  4. The role of interventional radiology in the management of hepatocellular carcinoma

    PubMed Central

    Molla, N.; AlMenieir, N.; Simoneau, E.; Aljiffry, M.; Valenti, D.; Metrakos, P.; Boucher, L.M.; Hassanain, M.

    2014-01-01

    Background Hepatocellular carcinoma (hcc) is one of the most common causes of cancer-related death worldwide. Overall, liver transplantation and resection are the only available treatments with potential for cure. Various locoregional therapies are widely used to manage patients with advanced hcc or as a bridging therapy for patients with early and intermediate disease. This article reviews and evaluates the role of interventional radiology in the management of such cases by assessing various aspects of each method, such as effect on rates of survival, recurrence, tumour response, and complications. Methods A systemic search of PubMed, medline, Ovid Medline In-Process, and the Cochrane Database of Systematic Reviews retrieved all related scientific papers for review. Results Needle core biopsy is a highly sensitive, specific, and accurate method for hcc grading. Portal-vein embolization provides adequate expansion of the future liver remnant, making more patients eligible for resection. In focal or multifocal unresectable early-stage disease, radiofrequency ablation tops all other thermoablative methods. However, microwave ablation is preferred in large tumours and in patients with Child–Pugh B disease. Cryoablation is preferred in recurrent disease and in patients who are poor candidates for anesthesia. Of the various transarterial modalities—transarterial chemoembolization (tace), drug-eluting beads, and transarterial radio-embolization (tare)—tace is the method of choice in Child–Pugh A disease, and tare is the method of choice in hcc cases with portal vein thrombosis. Conclusions The existing data support the importance of a multidisciplinary approach in hcc management. Large randomized controlled studies are needed to provide clear indication guidelines for each method. PMID:24940108

  5. Interventional Treatment for Post-traumatic Headache.

    PubMed

    Conidi, Francis X

    2016-06-01

    Post-traumatic headache (migraine) is the most common symptom of concussion and traumatic brain injury. An expert opinion-based review along with a literature review (PubMed) was conducted looking at known interventional procedures for post-traumatic headache using the keywords post-traumatic headache, post-traumatic migraine headache, concussion, mild traumatic brain injury, and traumatic brain injury and the following categories: mechanism, pathophysiology, treatment, physical therapy, neurostimulation, Botox@/Onabotulinum toxin, and surgical intervention. The results returned a total of 181 articles of which 52 were selected. None of the articles included randomized placebo-controlled studies, and most were either prospective or retrospective case analysis and/or review articles or consensus opinion papers, with most studies yielding positive results. Despite a lack of hard evidence, interventional procedures, alone or in combination, appear to be an effective treatment for post-traumatic headaches. PMID:27130542

  6. Medical Management of Tumor Lysis Syndrome, Postprocedural Pain, and Venous Thromboembolism Following Interventional Radiology Procedures

    PubMed Central

    Faramarzalian, Ali; Armitage, Keith B.; Kapoor, Baljendra; Kalva, Sanjeeva P.

    2015-01-01

    The rapid expansion of minimally invasive image-guided procedures has led to their extensive use in the interdisciplinary management of patients with vascular, hepatobiliary, genitourinary, and oncologic diseases. Given the increased availability and breadth of these procedures, it is important for physicians to be aware of common complications and their management. In this article, the authors describe management of select common complications from interventional radiology procedures including tumor lysis syndrome, acute on chronic postprocedural pain, and venous thromboembolism. These complications are discussed in detail and their medical management is outlined according to generally accepted practice and evidence from the literature. PMID:26038627

  7. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III.

    PubMed

    Uberoi, Raman; Milburn, Simon; Moss, Jon; Gaines, Peter

    2009-09-01

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online. PMID:19644643

  8. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III

    SciTech Connect

    Uberoi, Raman Milburn, Simon; Moss, Jon

    2009-09-15

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online.

  9. The Role of Interventional Radiology in Treating Complications following Liver Transplantation

    PubMed Central

    Mehrzad, Homoyoon; Mangat, Kamarjit

    2013-01-01

    Liver transplantation (LT) is used to treat both adult and pediatric patients with end-stage liver disease or acute liver failure. It has become more prevalent as both the surgical technique and postoperative care have improved resulting in a reduced morbidity and mortality. As a result, there are more patients surviving longer after liver transplantation. Despite this, there remain serious complications from the procedure that have a significant outcome on the patient and may result in retransplantation. At the same time, there have been significant advances in the field of interventional radiology both in terms of technology and how these apply to the patients. In this paper, we review the commonest complications, diagnostic tests, and interventional management options available. PMID:27335821

  10. Assessment of eye lens doses for workers during interventional radiology procedures.

    PubMed

    Urboniene, A; Sadzeviciene, E; Ziliukas, J

    2015-07-01

    The assessment of eye lens doses for workers during interventional radiology (IR) procedures was performed using a new eye lens dosemeter. In parallel, the results of routine individual monitoring were analysed and compared with the results obtained from measurements with a new eye lens dosemeter. The eye lens doses were assessed using Hp(3) measured at the level of the eyes and were compared with Hp(10) measured with the whole-body dosemeter above the lead collar. The information about use of protective measures, the number of performed interventional procedures per month and their fluoroscopy time was also collected. The assessment of doses to the lens of the eye was done for 50 IR workers at 9 Lithuanian hospitals for the period of 2012-2013. If the use of lead glasses is not taken into account, the estimated maximum annual dose equivalent to the lens of the eye was 82 mSv. PMID:25877533

  11. The novel application of Benford's second order analysis for monitoring radiation output in interventional radiology.

    PubMed

    Cournane, S; Sheehy, N; Cooke, J

    2014-06-01

    Benford's law is an empirical observation which predicts the expected frequency of digits in naturally occurring datasets spanning multiple orders of magnitude, with the law having been most successfully applied as an audit tool in accountancy. This study investigated the sensitivity of the technique in identifying system output changes using simulated changes in interventional radiology Dose-Area-Product (DAP) data, with any deviations from Benford's distribution identified using z-statistics. The radiation output for interventional radiology X-ray equipment is monitored annually during quality control testing; however, for a considerable portion of the year an increased output of the system, potentially caused by engineering adjustments or spontaneous system faults may go unnoticed, leading to a potential increase in the radiation dose to patients. In normal operation recorded examination radiation outputs vary over multiple orders of magnitude rendering the application of normal statistics ineffective for detecting systematic changes in the output. In this work, the annual DAP datasets complied with Benford's first order law for first, second and combinations of the first and second digits. Further, a continuous 'rolling' second order technique was devised for trending simulated changes over shorter timescales. This distribution analysis, the first employment of the method for radiation output trending, detected significant changes simulated on the original data, proving the technique useful in this case. The potential is demonstrated for implementation of this novel analysis for monitoring and identifying change in suitable datasets for the purpose of system process control. PMID:24321401

  12. Imaging and radiological interventions in extra-hepatic portal vein obstruction

    PubMed Central

    Pargewar, Sudheer S; Desai, Saloni N; Rajesh, S; Singh, Vaibhav P; Arora, Ankur; Mukund, Amar

    2016-01-01

    Extrahepatic portal vein obstruction (EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension (PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt (PSS) and revision of PSS. PMID:27358683

  13. Radiological Instrumentation Assessment for King County Wastewater Treatment Division

    SciTech Connect

    Strom, Daniel J.; McConn, Ronald J.; Brodzinski, Ronald L.

    2005-05-19

    The King County Wastewater Treatment Division (WTD) have concern about the aftermath of a radiological dispersion event (RDE) leading to the introduction of significant quantities of radioactive material into its combined sanitary and storm sewer system. Radioactive material could come from the use of a radiological dispersion device (RDD). RDDs include "dirty bombs" that are not nuclear detonations but are explosives designed to spread radioactive material. Radioactive material also could come from deliberate introduction or dispersion of radioactive material into the environment, including waterways and water supply systems. Volume 2 of PNNL-15163 assesses the radiological instrumentation needs for detection of radiological or nuclear terrorism, in support of decisions to treat contaminated wastewater or to bypass the West Point Treatment Plant (WPTP), and in support of radiation protection of the workforce, the public, and the infrastructure of the WPTP. Fixed radiation detection instrumentation should be deployed in a defense-in-depth system that provides 1) early warning of significant radioactive material on the way to the WPTP, including identification of the radionuclide(s) and estimates of the soluble concentrations, with a floating detector located in the wet well at the Interbay Pump Station and telemetered via the internet to all authorized locations; 2) monitoring at strategic locations within the plant, including 2a) the pipe beyond the hydraulic ram in the bar screen room; 2b) above the collection funnels in the fine grit facility; 2c) in the sampling tank in the raw sewage pump room; and 2d) downstream of the concentration facilities that produce 6% blended and concentrated biosolids. Engineering challenges exist for these applications. It is necessary to deploy both ultra-sensitive detectors to provide early warning and identification and detectors capable of functioning in high-dose rate environments that are likely under some scenarios, capable

  14. Interventional treatment for unresectable hepatocellular carcinoma.

    PubMed

    Murata, Satoru; Mine, Takahiko; Sugihara, Fumie; Yasui, Daisuke; Yamaguchi, Hidenori; Ueda, Tatsuo; Onozawa, Shiro; Kumita, Shin-ichiro

    2014-10-01

    Hepatocellular carcinoma (HCC) is the sixth most common cancer and third leading cause of cancer-related death in the world. The Barcelona clinic liver cancer classification is the current standard classification system for the clinical management of patients with HCC and suggests that patients with intermediate-stage HCC benefit from transcatheter arterial chemoembolization (TACE). Interventional treatments such as TACE, balloon-occluded TACE, drug-eluting bead embolization, radioembolization, and combined therapies including TACE and radiofrequency ablation, continue to evolve, resulting in improved patient prognosis. However, patients with advanced-stage HCC typically receive only chemotherapy with sorafenib, a multi-kinase inhibitor, or palliative and conservative therapy. Most patients receive palliative or conservative therapy only, and approximately 50% of patients with HCC are candidates for systemic therapy. However, these patients require therapy that is more effective than sorafenib or conservative treatment. Several researchers try to perform more effective therapies, such as combined therapies (TACE with radiotherapy and sorafenib with TACE), modified TACE for HCC with arterioportal or arteriohepatic vein shunts, TACE based on hepatic hemodynamics, and isolated hepatic perfusion. This review summarizes the published data and data on important ongoing studies concerning interventional treatments for unresectable HCC and discusses the technical improvements in these interventions, particularly for advanced-stage HCC. PMID:25309076

  15. Interventional treatment for unresectable hepatocellular carcinoma

    PubMed Central

    Murata, Satoru; Mine, Takahiko; Sugihara, Fumie; Yasui, Daisuke; Yamaguchi, Hidenori; Ueda, Tatsuo; Onozawa, Shiro; Kumita, Shin-ichiro

    2014-01-01

    Hepatocellular carcinoma (HCC) is the sixth most common cancer and third leading cause of cancer-related death in the world. The Barcelona clinic liver cancer classification is the current standard classification system for the clinical management of patients with HCC and suggests that patients with intermediate-stage HCC benefit from transcatheter arterial chemoembolization (TACE). Interventional treatments such as TACE, balloon-occluded TACE, drug-eluting bead embolization, radioembolization, and combined therapies including TACE and radiofrequency ablation, continue to evolve, resulting in improved patient prognosis. However, patients with advanced-stage HCC typically receive only chemotherapy with sorafenib, a multi-kinase inhibitor, or palliative and conservative therapy. Most patients receive palliative or conservative therapy only, and approximately 50% of patients with HCC are candidates for systemic therapy. However, these patients require therapy that is more effective than sorafenib or conservative treatment. Several researchers try to perform more effective therapies, such as combined therapies (TACE with radiotherapy and sorafenib with TACE), modified TACE for HCC with arterioportal or arteriohepatic vein shunts, TACE based on hepatic hemodynamics, and isolated hepatic perfusion. This review summarizes the published data and data on important ongoing studies concerning interventional treatments for unresectable HCC and discusses the technical improvements in these interventions, particularly for advanced-stage HCC. PMID:25309076

  16. MCNP simulation of radiation doses distributions in a water phantoms simulating interventional radiology patients

    NASA Astrophysics Data System (ADS)

    He, Wenjun; Mah, Eugene; Huda, Walter; Selby, Bayne; Yao, Hai

    2011-03-01

    Purpose: To investigate the dose distributions in water cylinders simulating patients undergoing Interventional Radiological examinations. Method: The irradiation geometry consisted of an x-ray source, dose-area-product chamber, and image intensifier as currently used in Interventional Radiology. Water cylinders of diameters ranging between 17 and 30 cm were used to simulate patients weighing between 20 and 90 kg. X-ray spectra data with peak x-ray tube voltages ranging from 60 to 120 kV were generated using XCOMP3R. Radiation dose distributions inside the water cylinder (Dw) were obtained using MCNP5. The depth dose distribution along the x-ray beam central axis was normalized to free-in-air air kerma (AK) that is incident on the phantom. Scattered radiation within the water cylinders but outside the directly irradiated region was normalized to the dose at the edge of the radiation field. The total absorbed energy to the directly irradiated volume (Ep) and indirectly irradiated volume (Es) were also determined and investigated as a function of x-ray tube voltage and phantom size. Results: At 80 kV, the average Dw/AK near the x-ray entrance point was 1.3. The ratio of Dw near the entrance point to Dw near the exit point increased from ~ 26 for the 17 cm water cylinder to ~ 290 for the 30 cm water cylinder. At 80 kV, the relative dose for a 17 cm water cylinder fell to 0.1% at 49 cm away from the central ray of the x-ray beam. For a 30 cm water cylinder, the relative dose fell to 0.1% at 53 cm away from the central ray of the x-ray beam. At a fixed x-ray tube voltage of 80 kV, increasing the water cylinder diameter from 17 to 30 cm increased the Es/(Ep+Es) ratio by about 50%. At a fixed water cylinder diameter of 24 cm, increasing the tube voltage from 60 kV to 120 kV increased the Es/(Ep+Es) ratio by about 12%. The absorbed energy from scattered radiation was between 20-30% of the total energy absorbed by the water cylinder, and was affected more by patient size

  17. Risk of bleeding associated with interventional musculoskeletal radiology procedures. A comprehensive review of the literature.

    PubMed

    Foremny, Gregory B; Pretell-Mazzini, Juan; Jose, Jean; Subhawong, Ty K

    2015-05-01

    This review compiles the current literature on the bleeding risks in common musculoskeletal interventional procedures and attempts to provide guidance for practicing radiologists in making decisions regarding the periprocedural management of patients on antithrombotic therapy. The practitioner must weigh the risk of bleeding if therapy is continued against the possibility a thromboembolic occurring if anticoagulation therapy is withheld or reversed. Unfortunately, there is little empirical data to guide evidence-based decisions for many musculoskeletal interventions. However, a review of the literature shows that for low-risk procedures, such as arthrograms/arthrocenteses or muscle/tendon sheath injections, bleeding risks are sufficiently small that anticoagulants and antiplatelet therapies need not be withheld. Additionally, relatively higher-risk procedures, such as needle biopsies of bone and soft tissue, may be safely performed without holding antithrombotic therapy, provided pre-procedural INR is within therapeutic range. Thus, while a patient's particular clinical circumstances should dictate optimal individualized management, anticoagulation alone is not a general contraindication to most interventional musculoskeletal radiology procedures. PMID:25433718

  18. Emerging technologies for image guidance and device navigation in interventional radiology.

    PubMed

    Kagadis, George C; Katsanos, Konstantinos; Karnabatidis, Dimitris; Loudos, George; Nikiforidis, George C; Hendee, William R

    2012-09-01

    Recent developments in image-guidance and device navigation, along with emerging robotic technologies, are rapidly transforming the landscape of interventional radiology (IR). Future state-of-the-art IR procedures may include real-time three-dimensional imaging that is capable of visualizing the target organ, interventional tools, and surrounding anatomy with high spatial and temporal resolution. Remote device actuation is becoming a reality with the introduction of novel magnetic-field enabled instruments and remote robotic steering systems. Robots offer several degrees of freedom and unprecedented accuracy, stability, and dexterity during device navigation, propulsion, and actuation. Optimization of tracking and navigation of interventional tools inside the human body will be critical in converting IR suites into the minimally invasive operating theaters of the future with increased safety and unsurpassed therapeutic efficacy. In the not too distant future, individual image guidance modalities and device tracking methods could merge into autonomous, multimodality, multiparametric platforms that offer real-time data of anatomy, morphology, function, and metabolism along with on-the-fly computational modeling and remote robotic actuation. The authors provide a concise overview of the latest developments in image guidance and device navigation, while critically envisioning what the future might hold for 2020 IR procedures. PMID:22957641

  19. Minimally Invasive Treatments for Breast Cancer

    MedlinePlus

    ... SIR login) Interventional Radiology Minimally Invasive Treatments for Breast Cancer Interventional Radiology Treatments Offer New Options and Hope ... have in the fight against breast cancer. About Breast Cancer When breast tissue divides and grows at an ...

  20. Role of Interventional Radiology in the Emergent Management of Acute Upper Gastrointestinal Bleeding

    PubMed Central

    Navuluri, Rakesh; Patel, Jay; Kang, Lisa

    2012-01-01

    Approximately 100,000 cases of upper gastrointestinal bleeding (UGIB) require inpatient admission annually in the United States. When medical management and endoscopic therapy are inadequate, endovascular intervention can be lifesaving. These emergent situations highlight the importance of immediate competence of the interventional radiologist in the preangiographic evaluation as well as the endovascular treatment of UGIB. We describe a case of UGIB managed with endovascular embolization and detail the angiographic techniques used. The case description is followed by a detailed discussion of the treatment approach to UGIB, with attention to both nonvariceal and variceal algorithms. PMID:23997408

  1. The Role of Interventional Radiology in the Management of Abdominal Visceral Artery Aneurysms

    SciTech Connect

    Belli, Anna-Maria Markose, George; Morgan, Robert

    2012-04-15

    Abdominal visceral artery aneurysms (VAA) include true and false aneurysms. The majority are asymptomatic and are discovered on cross-sectional imaging performed for unrelated clinical indications. With the maturation of techniques and devices used for embolization procedures and the treatment of aneurysms in other locations, most VAAs are now suitable for treatment by minimally invasive transcatheter techniques. The choice of technique used greatly depends on the local anatomy of the VAA and the experience of the interventional radiologist in complex vascular interventional techniques.

  2. StarClose Vascular Closure Device: Prospective Study on 222 Deployments in an Interventional Radiology Practice

    SciTech Connect

    Imam, Atique; Carter, Ranjana M. S. Phillips-Hughes, Jane; Boardman, Philip; Uberoi, Raman

    2007-07-15

    The StarClose device (Abbott Vascular Devices; Abbott Laboratories, Redwood City, CA) utilizes an externally placed Nitinol clip to achieve arterial closure following femoral artery puncture. The objectives of this study were to assess the efficacy and complications of the StarClose device in patients undergoing interventional radiological procedures. Preprocedural clotting status, pulse and blood pressure, severity of vessel calcification, sheath size, and time to deployment were recorded. Postdeployment complications immediately postprocedure, at 1 h, at 2 h, and at 1 week were recorded. A duplex scan was performed in the first 10 patients to assess any immediate vascular complications. Deployments were successful in 96% achieving immediate hemostasis. Mean deployment time was 48 s. There were no major complications. The StarClose device was found to have a high technical and clinical efficacy.

  3. Diagnostic radiology

    SciTech Connect

    Leeds, N.E.; Jacobson, H.G.

    1986-10-17

    Developments in the burgeoning field of diagnostic radiology have continued apace. Four areas that represent either subspecialities or technological advances in diagnostic radiology will be considered in this report: ultrasonography, interventional radiology, nuclear radiology, and magnetic resonance. In no sense is the exclusion of other subdisciplines and modalities (eg, pediatric radiology, computed tomography) and indication of their of importance or their failure to include innovative concepts.

  4. Radiological Risk Assessment for King County Wastewater Treatment Division

    SciTech Connect

    Strom, Daniel J.

    2005-08-05

    Staff of the King County Wastewater Treatment Division (WTD) have concern about the aftermath of a radiological dispersion event (RDE) leading to the introduction of significant quantities of radioactive material into the combined sanitary and storm sewer system in King County, Washington. Radioactive material could come from the use of a radiological dispersion device (RDD). RDDs include "dirty bombs" that are not nuclear detonations but are explosives designed to spread radioactive material (National Council on Radiation Protection and Measurements (NCRP) 2001). Radioactive material also could come from deliberate introduction or dispersion of radioactive material into the environment, including waterways and water supply systems. This document develops plausible and/or likely scenarios, including the identification of likely radioactive materials and quantities of those radioactive materials to be involved. These include 60Co, 90Sr, 137Cs, 192Ir, 226Ra, plutonium, and 241Am. Two broad categories of scenarios are considered. The first category includes events that may be suspected from the outset, such as an explosion of a "dirty bomb" in downtown Seattle. The explosion would most likely be heard, but the type of explosion (e.g., sewer methane gas or RDD) may not be immediately known. Emergency first responders must be able to quickly detect the radioisotopes previously listed, assess the situation, and deploy a response to contain and mitigate (if possible) detrimental effects resulting from the incident. In such scenarios, advance notice of about an hour or two might be available before any contaminated wastewater reaches a treatment plant. The second category includes events that could go initially undetected by emergency personnel. Examples of such a scenario would be the inadvertent or surreptitious introduction of radioactive material into the sewer system. Intact rogue radioactive sources from industrial radiography devices, well-logging apparatus, or

  5. Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

    SciTech Connect

    Safari, M. J.; Wong, J. H. D.; Ng, K. H.; Jong, W. L.; Cutajar, D. L.; Rosenfeld, A. B.

    2015-05-15

    Purpose: The MOSkin is a MOSFET detector designed especially for skin dose measurements. This detector has been characterized for various factors affecting its response for megavoltage photon beams and has been used for patient dose measurements during radiotherapy procedures. However, the characteristics of this detector in kilovoltage photon beams and low dose ranges have not been studied. The purpose of this study was to characterize the MOSkin detector to determine its suitability for in vivo entrance skin dose measurements during interventional radiology procedures. Methods: The calibration and reproducibility of the MOSkin detector and its dependency on different radiation beam qualities were carried out using RQR standard radiation qualities in free-in-air geometry. Studies of the other characterization parameters, such as the dose linearity and dependency on exposure angle, field size, frame rate, depth-dose, and source-to-surface distance (SSD), were carried out using a solid water phantom under a clinical x-ray unit. Results: The MOSkin detector showed good reproducibility (94%) and dose linearity (99%) for the dose range of 2 to 213 cGy. The sensitivity did not significantly change with the variation of SSD (±1%), field size (±1%), frame rate (±3%), or beam energy (±5%). The detector angular dependence was within ±5% over 360° and the dose recorded by the MOSkin detector in different depths of a solid water phantom was in good agreement with the Markus parallel plate ionization chamber to within ±3%. Conclusions: The MOSkin detector proved to be reliable when exposed to different field sizes, SSDs, depths in solid water, dose rates, frame rates, and radiation incident angles within a clinical x-ray beam. The MOSkin detector with water equivalent depth equal to 0.07 mm is a suitable detector for in vivo skin dosimetry during interventional radiology procedures.

  6. The Effect of Realtime Monitoring on Dose Exposure to Staff Within an Interventional Radiology Setting

    SciTech Connect

    Baumann, Frederic Katzen, Barry T.; Carelsen, Bart; Diehm, Nicolas; Benenati, James F.; Peña, Constantino S.

    2015-10-15

    PurposeThe purpose of this study is to evaluate a new device providing real-time monitoring on radiation exposure during fluoroscopy procedures intending to reduce radiation in an interventional radiology setting.Materials and MethodsIn one interventional suite, a new system providing a real-time radiation dose display and five individual wireless dosimeters were installed. The five dosimeters were worn by the attending, fellow, nurse, technician, and anesthesiologist for every procedure taking place in that suite. During the first 6-week interval the dose display was off (closed phase) and activated thereafter, for a 6-week learning phase (learning phase) and a 10-week open phase (open phase). During these phases, the staff dose and the individual dose for each procedure were recorded from the wireless dosimeter and correlated with the fluoroscopy time. Further subanalysis for dose exposure included diagnostic versus interventional as well as short (<10 min) versus long (>10 min) procedures.ResultsA total of 252 procedures were performed (n = 88 closed phase, n = 50 learning phase, n = 114 open phase). The overall mean staff dose per fluoroscopic minute was 42.79 versus 19.81 µSv/min (p < 0.05) comparing the closed and open phase. Thereby, anesthesiologists were the only individuals attaining a significant dose reduction during open phase 16.9 versus 8.86 µSv/min (p < 0.05). Furthermore, a significant reduction of total staff dose was observed for short 51 % and interventional procedures 45 % (p < 0.05, for both).ConclusionA real-time qualitative display of radiation exposure may reduce team radiation dose. The process may take a few weeks during the learning phase but appears sustained, thereafter.

  7. Lean manufacturing and Toyota Production System terminology applied to the procurement of vascular stents in interventional radiology.

    PubMed

    de Bucourt, Maximilian; Busse, Reinhard; Güttler, Felix; Wintzer, Christian; Collettini, Federico; Kloeters, Christian; Hamm, Bernd; Teichgräber, Ulf K

    2011-08-01

    OBJECTIVES: To apply the economic terminology of lean manufacturing and the Toyota Production System to the procurement of vascular stents in interventional radiology. METHODS: The economic- and process-driven terminology of lean manufacturing and the Toyota Production System is first presented, including information and product flow as well as value stream mapping (VSM), and then applied to an interdisciplinary setting of physicians, nurses and technicians from different medical departments to identify wastes in the process of endovascular stent procurement in interventional radiology. RESULTS: Using the so-called seven wastes approach of the Toyota Production System (waste of overproducing, waiting, transport, processing, inventory, motion and waste of defects and spoilage) as well as further waste characteristics (gross waste, process and method waste, and micro waste), wastes in the process of endovascular stent procurement in interventional radiology were identified and eliminated to create an overall smoother process from the procurement as well as from the medical perspective. CONCLUSION: Economic terminology of lean manufacturing and the Toyota Production System, especially VSM, can be used to visualise and better understand processes in the procurement of vascular stents in interventional radiology from an economic point of view. PMID:22347963

  8. Screening, Brief Intervention, and Referral to Treatment.

    PubMed

    Borus, Joshua; Parhami, Iman; Levy, Sharon

    2016-10-01

    Screening, Brief Intervention, and Referral to Treatment is a quick, effective technique with which to manage substance use in adolescents and young adults. Use of a validated measure for detecting substance use and abuse is significantly more effective than unvalidated tools or provider intuition. There are a variety of validated tools available to use in the adolescent/young adult population, and there are opportunities to increase the efficiency and scalability of screening by using computerized questionnaires. This area continues to evolve rapidly. PMID:27613340

  9. A method to reduce patient's eye lens dose in neuro-interventional radiology procedures

    NASA Astrophysics Data System (ADS)

    Safari, M. J.; Wong, J. H. D.; Kadir, K. A. A.; Sani, F. M.; Ng, K. H.

    2016-08-01

    Complex and prolonged neuro-interventional radiology procedures using the biplane angiography system increase the patient's risk of radiation-induced cataract. Physical collimation is the most effective way of reducing the radiation dose to the patient's eye lens, but in instances where collimation is not possible, an attenuator may be useful in protecting the eyes. In this study, an eye lens protector was designed and fabricated to reduce the radiation dose to the patients' eye lens during neuro-interventional procedures. The eye protector was characterised before being tested on its effectiveness in a simulated aneurysm procedure on an anthropomorphic phantom. Effects on the automatic dose rate control (ADRC) and image quality are also evaluated. The eye protector reduced the radiation dose by up to 62.1% at the eye lens. The eye protector is faintly visible in the fluoroscopy images and increased the tube current by a maximum of 3.7%. It is completely invisible in the acquisition mode and does not interfere with the clinical procedure. The eye protector placed within the radiation field of view was able to reduce the radiation dose to the eye lens by direct radiation beam of the lateral x-ray tube with minimal effect on the ADRC system.

  10. Interventional radiology in the multidisciplinary management of liver lesions: pre- and postoperative roles.

    PubMed

    Ward, Thomas J; Madoff, David C; Weintraub, Joshua L

    2013-08-01

    The management algorithm for patents with liver lesions, most often hepatocellular carcinoma (HCC) or colorectal cancer metastasis, are complex, ever-changing, and involve multiple treatment modalities including chemotherapy, external-beam radiation, surgery, and locoregional therapies (LRTs). This complexity necessitates a multidisciplinary approach including hepatologists, oncologists, hepatobiliary surgeons, radiation oncologists, and interventional radiologists to coordinate and deliver the complex care that these patients need in a timely manner. The interventional radiologist and hepatobiliary surgeon work closely together in both the pre- and postoperative setting. Preoperative roles include delivering LRTs to patients with HCC and interventions aimed at hepatic optimization prior to resection or transplantation. LRT in this setting is performed either to bridge the patient to transplant or to downstage the initially nontransplant candidate so appropriate transplant criteria are met. Postoperative roles include the management of biliary and vascular complications that may occur after resection or transplantation. PMID:23943102

  11. The Role of Interventional Radiology in the Management of Deep Venous Thrombosis: Advanced Therapy

    SciTech Connect

    O'Sullivan, Gerard J.

    2011-06-15

    Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This 'usual treatment' is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer 'single-session' techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

  12. Occupational radiation doses to the extremities and the eyes in interventional radiology and cardiology procedures

    PubMed Central

    Efstathopoulos, E P; Pantos, I; Andreou, M; Gkatzis, A; Carinou, E; Koukorava, C; Kelekis, N L; Brountzos, E

    2011-01-01

    Objectives The aim of this study was to determine occupational dose levels in interventional radiology and cardiology procedures. Methods The study covered a sample of 25 procedures and monitored occupational dose for all laboratory personnel. Each individual wore eight thermoluminescent dosemeters next to the eyes, wrists, fingers and legs during each procedure. Radiation protection shields used in each procedure were recorded. Results The highest doses per procedure were recorded for interventionists at the left wrist (average 485 μSv, maximum 5239 μSv) and left finger (average 324 μSv, maximum 2877 μSv), whereas lower doses were recorded for the legs (average 124 μSv, maximum 1959 μSv) and the eyes (average 64 μSv, maximum 1129 μSv). Doses to the assisting nurses during the intervention were considerably lower; the highest doses were recorded at the wrists (average 26 μSv, maximum 41 μSv) and legs (average 18 μSv, maximum 22 μSv), whereas doses to the eyes were minimal (average 4 μSv, maximum 16 μSv). Occupational doses normalised to kerma area product (KAP) ranged from 11.9 to 117.3 μSv/1000 cGy cm2 and KAP was poorly correlated to the interventionists' extremity doses. Conclusion Calculation of the dose burden for interventionists considering the actual number of procedures performed annually revealed that dose limits for the extremities and the lenses of the eyes were not exceeded. However, there are cases in which high doses have been recorded and this can lead to exceeding the dose limits when bad practices are followed and the radiation protection tools are not properly used. PMID:21172967

  13. Exposures in interventional radiology using Monte Carlo simulation coupled with virtual anthropomorphic phantoms.

    PubMed

    Santos, William S; Neves, Lucio P; Perini, Ana P; Belinato, Walmir; Caldas, Linda V E; Carvalho, Albérico B; Maia, Ana F

    2015-12-01

    In this work we investigated the way in which conversion coefficients from air kerma-area product for effective doses (CCE) and entrance skin doses (CCESD) in interventional radiology (IR) are affected by variations in the filtration, projection angle of the X-ray beam, lead curtain attached to the surgical table, and suspended shield lead glass in regular conditions of medical practice. Computer simulations were used to model an exposure scenario similar to a real IR room. The patient and the physician were represented by MASH virtual anthropomorphic phantoms, inserted in the MCNPX 2.7.0 radiation transport code. In all cases, the addition of copper filtration also increased the CCE and CCESD values. The highest CCE values were obtained for lateral, cranial and caudal projections. In these projections, the X-ray tube was located above the table, and more scattered radiation reached the middle and upper portions of the physician trunk, where most of the radiosensitive organs are located. Another important result of this study was to show that the physician's protection is 358% higher when the lead curtain and suspended shield lead glasses are used. The values of CCE and CCESD, presented in this study, are an important resource for calculation of effective doses and entrance skin doses in clinical practice. PMID:26160701

  14. Doses to operators during interventional radiology procedures: focus on eye lens and extremity dosimetry.

    PubMed

    Koukorava, C; Carinou, E; Simantirakis, G; Vrachliotis, T G; Archontakis, E; Tierris, C; Dimitriou, P

    2011-03-01

    The present study is focused on the personnel doses during several types of interventional radiology procedures. Apart from the use of the official whole body dosemeters (thermoluminescence dosemeter type), measurements were performed to the extremities and the eyes using thermoluminescent loose pellets. The mean doses per kerma area product were calculated for the monitored anatomic regions and for the most frequent types of procedures. Higher dose values were measured during therapeutic procedures, especially embolisations. The maximum recorded doses during a single procedure were 1.8 mSv to the finger (nephrostomy), 2.1 mSv to the wrist (liver chemoembolisation), 0.6 mSv to the leg (brain embolisation) and 2.4 mSv to the eye (brain embolisation). The annual doses estimated for the operator with the highest workload according to the measurements and the system's log book were 90.4 mSv to the finger, 107.9 mSv to the wrist, 21.6 mSv to the leg and 49.3 mSv to the eye. Finally, the effect of the beam angulation (i.e. projection) and shielding equipment on the personnel doses was evaluated. The measurements were performed within the framework of the ORAMED (Optimization of RAdiation Protection for MEDical staff) project. PMID:21044993

  15. Monte Carlo calculations on extremity and eye lens dosimetry for medical staff at interventional radiology procedures.

    PubMed

    Carinou, E; Ferrari, P; Koukorava, C; Krim, S; Struelens, L

    2011-03-01

    There are many factors that can influence the extremity and eye lens doses of the medical staff during interventional radiology and cardiology procedures. Numerical simulations can play an important role in evaluating extremity and eye lens doses in correlation with many different parameters. In the present study, the first results of the ORAMED (Optimisation of Radiation protection of MEDical staff) simulation campaign are presented. The parameters investigated for their influence on eye lens, hand, wrist and leg doses are: tube voltage, filtration, beam projection, field size and irradiated part of the patient's body. The tube voltage ranged from 60 to 110 kV(p), filtration from 3 to 6 mm Al and from 0 to 0.9 mm Cu. For all projections, the results showed that doses received by the operator decreased with increasing tube voltage and filtration. The magnitude of the influence of the tube voltage and the filtration on the doses depends on the beam projection and the irradiated part of the patient's body. Finally, the influence of the field size is significant in decreasing the doses. PMID:21212075

  16. British Society of Interventional Radiology: Biliary Drainage and Stenting Registry (BDSR)

    SciTech Connect

    Uberoi, R. Das, N.; Moss, J.; Robertson, I.

    2012-02-15

    Objectives: This study was designed to audit current practice in percutaneous biliary drainage and stenting in the United Kingdom. Methods: In 2006, the British Society of Interventional Radiology set up the first web-based Biliary Drainage and Stenting Registry (BDSR). This consisted of a series of tick sheets, which were completed online. Data collection included technical and clinical success of the procedures and outcomes at discharge with a separate form for any follow-up visits. Two months before data analysis, all contributors were asked via email to complete any outstanding data. This paper reports on data collected between November 1, 2006 and August 18, 2009. Results: A total of 833 procedures were recorded and were entered by 62 operators from 44 institutions within the United Kingdom. There were 455 men and 378 women with a median age of 69 (range 20-101) years.The majority of procedures were performed by a consultant. Successful drainage of the biliary tree was achieved in 98.7%. Partial or complete relief of symptoms was seen in 65% of patients. Minor complications, predominantly pain (14.3%), were seen in 26% and major complications, predominantly sepsis (3.5%), were seen in 7.9% of patients. Conclusions: These figures provide an essential benchmark for both audit and patient information. Identifying areas of good practice and those that require improvement will ultimately result in better patient care.

  17. Using the Monte Carlo technique to calculate dose conversion coefficients for medical professionals in interventional radiology

    NASA Astrophysics Data System (ADS)

    Santos, W. S.; Carvalho, A. B., Jr.; Hunt, J. G.; Maia, A. F.

    2014-02-01

    The objective of this study was to estimate doses in the physician and the nurse assistant at different positions during interventional radiology procedures. In this study, effective doses obtained for the physician and at points occupied by other workers were normalised by air kerma-area product (KAP). The simulations were performed for two X-ray spectra (70 kVp and 87 kVp) using the radiation transport code MCNPX (version 2.7.0), and a pair of anthropomorphic voxel phantoms (MASH/FASH) used to represent both the patient and the medical professional at positions from 7 cm to 47 cm from the patient. The X-ray tube was represented by a point source positioned in the anterior posterior (AP) and posterior anterior (PA) projections. The CC can be useful to calculate effective doses, which in turn are related to stochastic effects. With the knowledge of the values of CCs and KAP measured in an X-ray equipment, at a similar exposure, medical professionals will be able to know their own effective dose.

  18. Evaluating the performance of a MOSFET dosimeter at diagnostic X-ray energies for interventional radiology.

    PubMed

    Chida, Koichi; Inaba, Youhei; Masuyama, Hanako; Yanagawa, Isao; Mori, Issei; Saito, Haruo; Maruoka, Shin; Zuguchi, Masayuki

    2009-01-01

    For reducing the risk of skin injury during interventional radiology (IR) procedures, it has been suggested that physicians track patients' exposure doses. The metal-oxide semiconductor field effect transistor (MOSFET) dosimeter is designed to measure patient exposure dose during radiotherapy applications at megavoltage photon energies. Our purpose in this study was to evaluate the feasibility of using a MOSFET dosimeter (OneDose system) to measure patients' skin dose during exposure to diagnostic X-ray energies used in IR. The response of the OneDose system was almost constant at diagnostic X-ray energies, although the sensitivity was higher than that at megavoltage photon energies. We found that the angular dependence was minimal at diagnostic X-ray energies. The OneDose is almost invisible on X-ray images at diagnostic energies. Furthermore, the OneDose is easy to handle. The OneDose sensor performs well at diagnostic X-ray energies, although real-time measurements are not feasible. Thus, the OneDose system may prove useful in measuring patient exposure dose during IR. PMID:20821130

  19. Occupational radiation dose to eyes from interventional radiology procedures in light of the new eye lens dose limit from the International Commission on Radiological Protection

    PubMed Central

    Walsh, C; Gallagher, A; Dowling, A; Guiney, M; Ryan, J M; McEniff, N; O'Reilly, G

    2015-01-01

    Objective: In 2011, the International Commission on Radiological Protection (ICRP) recommended a substantial reduction in the equivalent dose limit for the lens of the eye, in line with a reduced threshold of absorbed dose for radiation-induced cataracts. This is of particular relevance in interventional radiology (IR) where it is well established that staff doses can be significant, however, there is a lack of data on IR eye doses in terms of Hp(3). Hp(3) is the personal dose equivalent at a depth of 3 mm in soft tissue and is used for measuring lens dose. We aimed to obtain a reliable estimate of eye dose to IR operators. Methods: Lens doses were measured for four interventional radiologists over a 3-month period using dosemeters specifically designed to measure Hp(3). Results: Based on their typical workloads, two of the four interventional radiologists would exceed the new ICRP dose limit with annual estimated doses of 31 and 45 mSv to their left eye. These results are for an “unprotected” eye, and for IR staff who routinely wear lead glasses, the dose beneath the glasses is likely to be significantly lower. Staff eye dose normalized to patient kerma–area product and eye dose per procedure have been included in the analysis. Conclusion: Eye doses to IR operators have been established using a dedicated Hp(3) dosemeter. Estimated annual doses have the potential to exceed the new ICRP limit. Advances in knowledge: We have estimated lens dose to interventional radiologists in terms of Hp(3) for the first time in an Irish hospital setting. PMID:25761211

  20. Performance of CMOS imager as sensing element for a Real-time Active Pixel Dosimeter for Interventional Radiology procedures

    NASA Astrophysics Data System (ADS)

    Magalotti, D.; Bissi, L.; Conti, E.; Paolucci, M.; Placidi, P.; Scorzoni, A.; Servoli, L.

    2014-01-01

    Staff members applying Interventional Radiology procedures are exposed to ionizing radiation, which can induce detrimental effects to the human body, and requires an improvement of radiation protection. This paper is focused on the study of the sensor element for a wireless real-time dosimeter to be worn by the medical staff during the interventional radiology procedures, in the framework of the Real-Time Active PIxel Dosimetry (RAPID) INFN project. We characterize a CMOS imager to be used as detection element for the photons scattered by the patient body. The CMOS imager has been first characterized in laboratory using fluorescence X-ray sources, then a PMMA phantom has been used to diffuse the X-ray photons from an angiography system. Different operating conditions have been used to test the detector response in realistic situations, by varying the X-ray tube parameters (continuous/pulsed mode, tube voltage and current, pulse parameters), the sensor parameters (gain, integration time) and the relative distance between sensor and phantom. The sensor response has been compared with measurements performed using passive dosimeters (TLD) and also with a certified beam, in an accredited calibration centre, in order to obtain an absolute calibration. The results are very encouraging, with dose and dose rate measurement uncertainties below the 10% level even for the most demanding Interventional Radiology protocols.

  1. An intervention to increase alcohol treatment engagement: a pilot trial

    PubMed Central

    Stecker, Tracy; McGovern, Mark P.; Herr, Beverly

    2011-01-01

    Objectives Previous research has documented the difficulty individuals with alcohol use disorders have initiating alcohol treatment. This study assessed the feasibility of a brief, cognitive behavioral intervention designed to increase treatment initiation among individuals with alcohol use disorders. Methods This randomized controlled trial included one hundred and ninety six participants who screened positive for a possible alcohol use disorder on the AUDIT. Randomly assigned intervention participants were administered a brief cognitive-behaviorally-based intervention by phone designed to modify beliefs that may interfere with treatment-seeking behavior. Beliefs about treatment and treatment-seeking behavior were assessed post-intervention. Results Participants receiving the intervention had significantly improved their attitudes toward addiction treatment (p < 0.002) and increased their reported intention to seek treatment (p < 0.000) post-intervention. Further, intervention participants were almost three times more likely to attend treatment within a three-month period (OR = 2.60, p < 0.025) than participants in the control group. Conclusions A brief, cognitive-behavioral intervention delivered by phone and focused on modifying treatment interfering beliefs holds promise for increasing alcohol treatment-seeking among individuals in need. PMID:22138200

  2. Does Smoking Intervention Influence Adolescent Substance Use Disorder Treatment Outcomes?

    PubMed Central

    Myers, Mark G.; Prochaska, Judith J.

    2009-01-01

    Although tobacco use is reported by the majority of substance use disordered (SUD) youth, little work has examined tobacco focused interventions with this population. The present study is an initial investigation of the effect of a tobacco use intervention on adolescent SUD treatment outcomes. Participants were adolescents in SUD treatment taking part in a cigarette smoking intervention efficacy study, assessed at baseline and followed up at 3- and 6-months post-intervention. Analyses compared treatment and control groups on days using alcohol and drugs and proportion abstinent from substance use at follow up assessments. Adolescents in the treatment condition reported significantly fewer days of substance use and were somewhat more likely to be abstinent at 3-month follow up. These findings suggest that tobacco focused intervention may enhance SUD treatment outcome. The present study provides further evidence for the value of addressing tobacco use in the context of treatment for adolescent SUD’s. PMID:19042327

  3. Identifying the Learning Curve for Uterine Artery Embolisation in an Interventional Radiological Training Unit

    SciTech Connect

    Das, Raj E-mail: raj.das@stgeorges.nhs.uk; Lucatelli, Pierleone Wang, Haofan Belli, Anna-Maria

    2015-08-15

    AimA clear understanding of operator experience is important in improving technical success whilst minimising patient risk undergoing endovascular procedures, and there is the need to ensure that trainees have the appropriate skills as primary operators. The aim of the study is to retrospectively analyse uterine artery embolisation (UAE) procedures performed by interventional radiology (IR) trainees at an IR training unit analysing fluoroscopy times and radiation dose as surrogate markers of technical skill.MethodsTen IR fellows were primary operator in 200 UAE procedures over a 5-year period. We compared fluoroscopy times, radiation dose and complications, after having them categorised according to three groups: Group 1, initial five, Group 2, >5 procedures and Group 3, penultimate five UAE procedures. We documented factors that may affect screening time (number of vials employed and use of microcatheters).ResultsMean fluoroscopy time was 18.4 (±8.1), 17.3 (±9.0), 16.3 (±8.4) min in Groups 1, 2 and 3, respectively. There was no statistically significant difference between these groups (p > 0.05) with respect to fluoroscopy time or radiation dose. Analysis after correction for confounding factors showed no statistical significance (p > 0.05). All procedures were technically successful, and total complication rate was 4 %.ConclusionUAE was chosen as a highly standardised procedure followed by IR practitioners. Although there is a non-significant trend for shorter screening times with experience, technical success and safety were not compromised with appropriate Consultant supervision, which illustrates a safe construct for IR training. This is important and reassuring information for patients undergoing a procedure in a training unit.

  4. Biological and physical methods for risk estimation in interventional radiology: a detrimental effect approach.

    PubMed

    Ramos, M; Montoro, A; Almonacid, M; Barquinero, S Ferrer J F; Tortosa, R; Miró, R; Verdú, G; Rodríguez, P; Barrios, L L; Villaescusa, J I

    2011-01-01

    Interventional radiologists and staff members are frequently exposed to the effects of direct and scattered radiation, which undergo in deterministic effects (radiodermitis, aged skin, cataracts, telangiectasia in nasal region, vasocellular epitelioms, hands depilation) and/or stochastic ones (cancer incidence). A methodology has been proposed for estimating the radiation risk or detriment from a group of six exposed interventional radiologists of the Hospital Universitario La Fe (Valencia, Spain), which had developed general exposition symptoms attributable to deterministic effects of ionizing radiation. Equivalent doses have been periodically registered using termoluminiscence dosimeters (TLD's) and wrist dosimeters, H(p)(10) and H(p)(0.07), respectively, and estimated through the observation of translocations in lymphocytes of peripheral blood (biological methods), by extrapolating the yield of translocations to their respective dose-effect curves. The software RADRISK has been applied for estimating radiation risks in these occupational radiation exposures. The minimum and maximum average excess ratio for skin cancer has been, using wrist physical doses, of [1.03 × 10(-3), 5.06 × 10(-2)], concluding that there is not an increased risk of skin cancer incidence. The minimum and maximum average excess ratio for leukemia has been, using TLD physical doses, of [7.84 × 10(-2), 3.36 × 10(-1)], and using biological doses, of [1.40 × 10(-1), 1.51], which is considerably higher than incidence rates, showing an excess radio-induced risk of leukemia in the group under study. Finally, the maximum radiological detriment in the group, evaluated as the total number of radio-induced cancers using physical dosimetry, has been of 2.18 per 1000 person-year (skin and leukemia), and using biological dosimetry of 9.20 per 1000 PY (leukemia). As a conclusion, this study has provided an assessment of the non-deterministic effects (rate of radio-induced cancer incidence

  5. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

    SciTech Connect

    Uberoi, Raman Tapping, Charles Ross; Chalmers, Nicholas; Allgar, Victoria

    2013-12-15

    Purpose: The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods: The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results: IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate (<0.5 %). Cook Gunther Tulip (560 filters: 39 %) and Celect (359 filters: 25 %) filters constituted the majority of IVC filters inserted, with Bard G2, Recovery filters, Cordis Trapease, and OptEase constituting most of the remainder (445 filters: 31 %). More than 96 % of IVC filters deployed as intended. Operator inexperience (<25 procedure) was significantly associated with complications (p < 0.001). Of the IVC filters initially intended for temporary placement, retrieval was attempted in 78 %. Of these retrieval was technically successful in 83 %. Successful retrieval was significantly reduced for implants left in situ for >9 weeks versus those with a shorter dwell time. New lower limb deep vein thrombosis (DVT) and/or IVC thrombosis was reported in 88 patients following filter placement, there was no significant difference of incidence between filter types. Conclusions: This registry report provides interventional radiologists and clinicians with an improved understanding of the technical aspects of IVC filter placement to help improve practice, and the potential consequences of IVC filter

  6. Extra vascular interventional treatment of liver cancer, present and future.

    PubMed

    Hou, Wenjing; Zhu, Xiaolin

    2015-10-01

    Interventional therapy for liver cancer is a new type of treatment, and its progress has been influenced by the development of the large scale imaging instrument and various therapeutic apparatus. This article, from these two aspects, discusses the status and progress of interventional treatment of liver cancer. PMID:26632542

  7. Does Smoking Intervention Influence Adolescent Substance Use Disorder Treatment Outcomes?

    ERIC Educational Resources Information Center

    Myers, Mark G.; Prochaska, Judith J.

    2008-01-01

    Although tobacco use is reported by the majority of substance use disordered (SUD) youth, little work has examined tobacco focused interventions with this population. The present study is an initial investigation of the effect of a tobacco use intervention on adolescent SUD treatment outcomes. Participants were adolescents in SUD treatment taking…

  8. Treatment Acceptability of Interventions Published in Six School Psychology Journals

    ERIC Educational Resources Information Center

    Villarreal, Victor; Ponce, Christopher; Gutierrez, Heveli

    2015-01-01

    Treatment acceptability (TA) is critical when selecting and implementing an intervention, as TA is associated with treatment outcomes. The significance of TA is reflected in school psychology models for services that state that school psychologists should address TA during development, implementation, and evaluation of interventions. However, the…

  9. Treatment Failure and Mortality amongst Children with Severe Acute Malnutrition Presenting with Cough or Respiratory Difficulty and Radiological Pneumonia

    PubMed Central

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Bardhan, Pradip Kumar; Faruque, Abu S. G.; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Hossain, Md Iqbal; Ahmed, Tahmeed

    2015-01-01

    Background Appropriate intervention is critical in reducing deaths among under-five, severe acutely malnourished (SAM) children with danger signs of severe pneumonia; however, there is paucity of data on outcome of World Health Organisation (WHO) recommended interventions of SAM children with severe pneumonia. We sought to evaluate outcome of the interventions in such children. Methods We prospectively enrolled SAM children aged 0–59 months, admitted to the Intensive Care Unit (ICU) or Acute Respiratory Infection (ARI) ward of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), between April 2011 and June 2012 with cough or respiratory difficulty and radiological pneumonia. All the enrolled children were treated with ampicillin and gentamicin, and micronutrients as recommended by the WHO. Comparison was made among pneumonic children with (n = 111) and without WHO defined danger signs of severe pneumonia (n = 296). The outcomes of interest were treatment failure (if a child required changing of antibiotics) and deaths during hospitalization. Further comparison was also made among those who developed treatment failure and who did not and among the survivors and deaths. Results SAM children with danger signs of severe pneumonia more often experienced treatment failure (58% vs. 20%; p<0.001) and fatal outcome (21% vs. 4%; p<0.001) compared to those without danger signs. Only 6/111 (5.4%) SAM children with danger signs of severe pneumonia and 12/296 (4.0%) without danger signs had bacterial isolates from blood. In log-linear binomial regression analysis, after adjusting for potential confounders, danger signs of severe pneumonia, dehydration, hypocalcaemia, and bacteraemia were independently associated both with treatment failure and deaths in SAM children presenting with cough or respiratory difficulty and radiological pneumonia (p<0.01). Conclusion and Significance The result suggests that SAM children with cough or

  10. Red emission phosphor for real-time skin dosimeter for fluoroscopy and interventional radiology

    SciTech Connect

    Nakamura, Masaaki Chida, Koichi; Zuguchi, Masayuki

    2014-10-15

    Purpose: There are no effective real-time direct skin dosimeters for interventional radiology. Such a scintillation dosimeter would be available if there was a suitable red emission phosphor in the medical x-ray range, since the silicon photodiode is a highly efficient device for red light. However, it is unknown whether there is a suitable red emission phosphor. The purpose of this study is to find a suitable red emission phosphor that can be used in x-ray dosimeters. Methods: Five kinds of phosphors which emit red light when irradiated with electron beams or ultraviolet rays in practical devices were chosen. For the brightness measurement, phosphor was put into transparent plastic cells or coated onto plastic sheets. The phosphors were irradiated with medical range x-rays [60–120 kV(peak), maximum dose rate of 160 mGy min{sup −1}], and the emission was measured by a luminance meter. Several characteristics, such as brightness, dose rate dependence, tube voltage dependence, and brightness stability, were investigated. Results: The luminescence of Y V O{sub 4}:Eu, (Y,Gd,Eu) BO{sub 3}, and Y{sub 2}O{sub 3}:Eu significantly deteriorated by 5%–10% when irradiated with continuous 2 Gy x-rays. The 0.5MgF{sub 2}⋅3.5MgO⋅GeO{sub 2}:Mn phosphor did not emit enough. Only the Y{sub 2}O{sub 2}S:Eu,Sm phosphor had hardly any brightness deterioration, and it had a linear relationship so that the x-ray dose rate could be determined from the brightness with sufficient accuracy. For the tube voltage dependence of the Y{sub 2}O{sub 2}S:Eu,Sm phosphor, the brightness per unit dose rate with 120 kV(peak) x-rays was 30% higher than that with 60 kV(peak) x-rays. Conclusions: Five kinds of phosphors were chosen as an x-ray scintillator for a real-time direct skin dosimeter. The Y V O{sub 4}:Eu, (Y,Gd,Eu)BO{sub 3}, and Y{sub 2}O{sub 3}:Eu phosphors had brightness deterioration caused by the x-rays. Only the Y{sub 2}O{sub 2}S:Eu,Sm phosphor had hardly any brightness deterioration

  11. Integral role of interventional radiology in the development of a pediatric liver transplantation program.

    PubMed

    Rose, S C; Andre, M P; Roberts, A C; Kinney, T B; Valji, K; Ronaghi, A H; Hassanein, T I; Lavine, J E; Hart, M E; Khanna, A

    2001-10-01

    The aim of this study was to examine the role of interventional radiology (IR) in the pretransplant evaluation of potential living-related liver transplantation (LRLT) donors and in the post-transplant management of pediatric liver transplant recipients. Medical records and procedural reports were reviewed of 12 potential donors and five recipients for left lateral segment liver transplants. Procedures performed by the IR Division, clinical indications, and complications were tabulated. Retrospective calculation of radiation exposure to the skin and gonads of the donors and recipients were made. Three-dimensional ultrasound (3D US) was used in all 12 potential donors to screen for the donor with the most appropriately sized left lateral segment. The four optimal donor candidates underwent contrast angiography in order to measure the diameter and screen for variant arterial supply to the left lateral segment. Pretransplantation, one recipient underwent mesenteric angiography with indirect portography to confirm thrombosis of the portal vein and to prove patency of the splenomesenteric venous confluence. Three children underwent LRLT and two children received split livers from cadaveric donors. Thirty-two IR procedures were performed after transplantation (Tx) in the four transplant survivors (one child died following Tx). These IR procedures included: ultrasound-guided percutaneous liver biopsy to evaluate the pathologic cause of liver dysfunction (seven); placement of nasal jejunal feeding tubes (three) or a peripherally inserted central catheter (four) for nutritional and pharmacologic support; large-volume diagnostic and therapeutic paracentesis (two) and thoracentesis (one); percutaneous catheter drainage of symptomatic large pleural effusions (two), large-volume chylous ascites (one) (with later drain removal [one]), and a large biloma (one); percutaneous biliary drain placement (three), biliary drain replacement (two), and balloon cholangioplasty (four) to

  12. [Application of traditional Chinese medicine in interventional treatment of carcinoma].

    PubMed

    Cao, Li-Ping; Deng, Gao-Pi; Zhang, Xu-Bin

    2003-09-01

    Interventional therapy is characterized by mini-invasion, accuracy, obvious curative effect and little side effect. In China, interventional therapy has been applied widely in the treatment of malignant carcinoma in recent 10 years. Traditional Chinese medicine (TCM) also has been adopted in the interventional therapy in recent years. This article reviews the history, status quo and prospect in interventional treatment of carcinoma with traditional Chinese medicine in experimental and clinical domains in recent years. Interventional therapy combined with TCM preparation directly or TCM therapy as a supplementary method of interventional therapy for carcinoma has played an active role in improving clinical curative effect, controlling and reducing toxic side effect and complications. PMID:15339571

  13. Characterization of MOSFET detectors for in vivo dosimetry in interventional radiology and for dose reconstruction in case of overexposure.

    PubMed

    Bassinet, Céline; Huet, Christelle; Baumann, Marion; Etard, Cécile; Réhel, Jean-Luc; Boisserie, Gilbert; Debroas, Jacques; Aubert, Bernard; Clairand, Isabelle

    2013-04-01

    As MOSFET (Metal Oxide Semiconductor Field Effect Transistor) detectors allow dose measurements in real time, the interest in these dosimeters is growing. The aim of this study was to investigate the dosimetric properties of commercially available TN-502RD-H MOSFET silicon detectors (Best Medical Canada, Ottawa, Canada) in order to use them for in vivo dosimetry in interventional radiology and for dose reconstruction in case of overexposure. Reproducibility of the measurements, dose rate dependence, and dose response of the MOSFET detectors have been studied with a Co source. Influence of the dose rate, frequency, and pulse duration on MOSFET responses has also been studied in pulsed x-ray fields. Finally, in order to validate the integrated dose given by MOSFET detectors, MOSFETs and TLDs (LiF:Mg,Cu,P) were fixed on an Alderson-Rando phantom in the conditions of an interventional neuroradiology procedure, and their responses have been compared. The results of this study show the suitability of MOSFET detectors for in vivo dosimetry in interventional radiology and for dose reconstruction in case of accident, provided a well-corrected energy dependence, a pulse duration equal to or higher than 10 ms, and an optimized contact between the detector and the skin of the patient are achieved. PMID:23439141

  14. Improving Treatment Integrity through a Functional Approach to Intervention Support

    ERIC Educational Resources Information Center

    Liaupsin, Carl J.

    2015-01-01

    A functional approach to intervention planning has been shown to be effective in reducing problem behaviors and promoting appropriate behaviors in children and youth with behavior disorders. When function-based intervention plans are not successful, it is often due to issues of treatment integrity in which teachers omit or do not sufficiently…

  15. School based interventions versus family based interventions in the treatment of childhood obesity- a systematic review

    PubMed Central

    2014-01-01

    Background The prevalence of childhood obesity, which has seen a rapid increase over the last decade, is now considered a major public health problem. Current treatment options are based on the two important frameworks of school- and family-based interventions; however, most research has yet to compare the two frameworks in the treatment of childhood obesity. The objective of this review is to compare the effectiveness of school-based intervention with family-based intervention in the treatment of childhood obesity. Methods Databases such as Medline, Pub med, CINAHL, and Science Direct were used to execute the search for primary research papers according to inclusion criteria. The review included a randomised controlled trial and quasi-randomised controlled trials based on family- and school-based intervention frameworks on the treatment of childhood obesity. Results The review identified 1231 articles of which 13 met the criteria. Out of the thirteen studies, eight were family-based interventions (n = 8) and five were school-based interventions (n = 5) with total participants (n = 2067). The participants were aged between 6 and 17 with the study duration ranging between one month and three years. Family-based interventions demonstrated effectiveness for children under the age of twelve and school-based intervention was most effective for those aged between 12 and 17 with differences for both long-term and short-term results. Conclusions The evidence shows that family- and school-based interventions have a considerable effect on treating childhood obesity. However, the effectiveness of the interventional frameworks depends on factors such as age, short- or long-term outcome, and methodological quality of the trials. Further research studies are required to determine the effectiveness of family- and school-based interventions using primary outcomes such as weight, BMI, percentage overweight and waist circumference in addition to the aforementioned

  16. Research-Based Family Interventions for the Treatment of Schizophrenia.

    ERIC Educational Resources Information Center

    Gingerich, Susan L.; Bellack, Alan S.

    1996-01-01

    Well-controlled clinical trials have established the efficacy of a number of family-based psychosocial interventions for the treatment of schizophrenia. Reviews seven studies with long term follow-up. (Author)

  17. Acute behavioral interventions and outpatient treatment strategies with suicidal adolescents

    PubMed Central

    O’Brien, Kimberly H. McManama; Singer, Jonathan B.; LeCloux, Mary; Duarté-Vélez, Yovanska; Spirito, Anthony

    2015-01-01

    Despite the prevalence of suicidal thoughts and behaviors among adolescents, there is limited knowledge of effective interventions to use with this population. This paper reviews the findings of studies on behavioral interventions for adolescents who are at acute suicide risk, as well as outpatient treatment and risk management strategies with suicidal adolescents. The importance of addressing comorbid behaviors and enhancing protective factors are discussed. Cultural considerations in working with suicidal adolescents and strategies for conducting culturally competent treatment are explored. PMID:26279646

  18. Mass violence and early mental health intervention: a proposed application of best practice guidelines to chemical, biological, and radiological attacks.

    PubMed

    Ritchie, Elspeth Cameron; Friedman, Matthew; Watson, Patricia; Ursano, Robert; Wessely, Simon; Flynn, Brian

    2004-08-01

    Based on past episodes, there will be psychological sequelae to chemical, biological, and radiological attacks. Some of the psychological morbidity should be able to be ameliorated through planning and appropriate early intervention. Key components of early intervention are illustrated following a hypothetical scenario of a bomb and anthrax threat near the Pentagon. Many of these components, such as monitoring clear, consistent messages about health risks, are provided by physicians or politicians, not mental health providers, but have a serious impact on the mental health of the population. We hope that this scenario and the principles of response will prove useful to planners of emergency preparedness and responders in the case of an actual attack. PMID:15379065

  19. Designing Personalized Treatment Engagement Interventions for Depressed Older Adults

    PubMed Central

    Raue, Patrick J.; Sirey, Jo Anne

    2011-01-01

    SYNOPSIS Despite the benefits of treatment for late-life depression, we are faced with the challenges of underutilization of mental health services by older adults and non-adherence to offered interventions. This paper describes psychosocial and interactional barriers and facilitators of treatment engagement among depressed older adults served by community health care settings. We describe the need to engage older adults in treatment using interventions that: 1. target psychological barriers such as stigma and other negative beliefs about depression and its treatment; and 2. increase individuals’ involvement in the treatment decision-making process. We then present personalized treatment engagement interventions that our group has designed for a variety of community settings. PMID:21536170

  20. Comparing a Supine Radiologic Versus Standing Clinical Measurement of Kyphosis in Older Women: The Fracture Intervention Trial

    PubMed Central

    Kado, Deborah M.; Christianson, Lisa; Palermo, Lisa; Smith-Bindman, Rebecca; Cummings, Steven R.; Greendale, Gail A.

    2013-01-01

    Study Design A study of agreement between different measures of kyphosis, a clinical standing measure (Debrunner kyphometer; Protek AG, Bern, Switzerland) versus a supine radiologic measure (Cobb angle). Objectives To determine whether a supine radiologic measure of kyphosis in older women is a reasonable estimate of clinical kyphosis determined in the standing position, and to investigate a computerized assessment of the Cobb angle. Summary of Background Data Few studies have investigated kyphosis measurement agreement involving older adults. Methods Using data from the Fracture Intervention Trial, we randomly selected 120 women, aged 55– 80 years, who had a Debrunner kyphometer measure of kyphosis and supine lateral spine radiographs from which we measured the Cobb angle (either manually or by digitization). We calculated the intraclass correlation coefficient (ICC) from repeated measures analysis of variance to assess the agreement among the: (1) manual Cobb angle and Debrunner kyphometer, (2) digitized Cobb angle and Debrunner kyphometer, and (3) manual and digitized Cobb angle. Results The mean of both the manual and digitized Cobb angle was 45° (range 18°– 83°), and the mean Debrunner kyphometer reading was 48° (range 17°– 83°). The ICC between either of the 2 measures of the Cobb angle and Debrunner measurement was 0.68, indicating reasonable agreement. The ICC between the manual and digitized Cobb angle was 0.99, indicating excellent agreement. Conclusions There is reasonable agreement between a supine radiologic and standing clinical measurement of kyphosis in older women. PMID:16481959

  1. Early experience using an online reporting system for interventional radiology procedure-related complications integrated with a digital dictation system.

    PubMed

    Gupta, Sanjay; Patel, Jay; McEnery, Kevin; Wallace, Michael J; Ahrar, Kamran; Suitor, Chuck; Hicks, Marshall E

    2011-08-01

    The absence of user-friendly systems for reporting complications is a major barrier to improving quality assurance (QA) programs in interventional radiology (IR) services. We describe the implementation of a QA application that is completely integrated with the radiology dictation system. We implemented an IR QA process as a module within the electronic medical record and radiologist dictation system applications used at our institution. After a radiologist completes a dictation, he or she must select from a drop-down list of complications before proceeding to the next case. Delayed QA events can be entered using the same applications. All complication entries are sent to a database, which is queried to run reports. During the study period, all the 20,034 interventional procedures were entered in the QA database, 1,144 complications were reported, 110 (9.6%) of which were classified as major. Although majority of the complications (996) were entered at the time of dictation, 148 complications (12.9%) were entered afterwards. All major complications were referred to the IR peer review committee, and 30 of these were discussed in the morbidity and mortality meetings. We studied post-lung-biopsy pneumothorax and chest tube rates and initiated a quality improvement process based on the results.The integration of the IR QA reporting system into the workflow process and the mandatory requirements for completion has the potential to minimize the work effort required to enter complication data, and improve participation in the QA process. PMID:20717701

  2. Diagnostic radiology 1987

    SciTech Connect

    Margulis, A.R.; Gooding, C.A.

    1987-01-01

    This is the latest version of the continuing education course on diagnostic radiology given yearly by the Department of Radiology at the University of California, San Francisco. The lectures are grouped into sections on gastrointestinal radiology, mammography, uroradiology, magnetic resonance, hepatobiliary radiology, pediatric radiology, ultrasound, interventional radiology, chest radiology, nuclear medicine, cardiovascular radiology, and skeletal radiology. Each section contains four to eight topics. Each of these consists of text that represents highlights in narrative form, selected illustrations, and a short bibliography. The presentation gives a general idea of what points were made in the lecture.

  3. Neurodevelopmental Treatment (NDT): Therapeutic Intervention and Its Efficacy.

    ERIC Educational Resources Information Center

    Stern, Francine Martin; Gorga, Delia

    1988-01-01

    Use of neurodevelopmental treatment, also known as the Bobath method, is discussed, including its history, philosophy, goals, and treatment emphasis with infants and children with movement disorders. Examples of children before and after therapeutic intervention illustrate use of the technique, and controversies in measuring therapy efficacy are…

  4. [Role of interventional radiology in diagnosis and management of the painful spine].

    PubMed

    Ruiz Santiago, Fernando; Castellano García, María Del Mar; Aparisi Rodríguez, Francisco

    2013-05-13

    The aim of this article is to perform a general review of the different radiological percutaneous procedures used to diagnose and treat the many causes of back pain. These procedures can be merely diagnostic, such as discography and biopsy, diagnostic and therapeutic, such as epidural and facets injections, or only therapeutic, such as vertebroplasty, decompressive techniques of the intervertebral disk and tumour ablation. We review the indications, advantages and complications of these techniques. PMID:23177315

  5. Clinical pharmacist interventions on an assertive community treatment team.

    PubMed

    Gable, Kelly N; Stunson, Mary Janet

    2010-08-01

    Assertive Community Treatment (ACT) is a community-based treatment approach intended to help in the recovery and rehabilitation of clients with severe and persistent mental illnesses. A clinical pharmacist is not routinely a member of an ACT team. The purpose of this study is to demonstrate the role of a pharmacist by reviewing recommendations and interventions made by a clinical pharmacist on an ACT team. Information was gathered through a chart review of clients at Community Alternatives in St. Louis, Missouri. All recommendations and interventions performed by the clinical pharmacist between February 1, 2008 and July 31, 2008 were recorded. A total of 341 interventions and recommendations for 29 clients were completed by the pharmacist. Medication management, medication adjustment recommendations, and mental health assessments were the most frequent interventions. This study suggests a clinical pharmacist can be beneficial to an ACT team and provide diverse services to both clients and other team members. PMID:19809876

  6. Substance Use Screening, Brief Intervention, and Referral to Treatment.

    PubMed

    2016-07-01

    The enormous public health impact of adolescent substance use and its preventable morbidity and mortality show the need for the health care sector, including pediatricians and the medical home, to increase its capacity related to substance use prevention, detection, assessment, and intervention. The American Academy of Pediatrics published its policy statement "Substance Use Screening, Brief Intervention, and Referral to Treatment for Pediatricians" in 2011 to introduce the concepts and terminology of screening, brief intervention, and referral to treatment (SBIRT) and to offer clinical guidance about available substance use screening tools and intervention procedures. This policy statement is a revision of the 2011 SBIRT statement. An accompanying clinical report updates clinical guidance for adolescent SBIRT. PMID:27325638

  7. Reducing Blood-borne Exposure in Interventional Radiology: What the IR Should Know

    SciTech Connect

    Tso, David K.; Athreya, Sriharsha

    2013-08-01

    Interventional radiologists are at risk of exposure to blood-borne pathogens in their day-to-day practice. Percutaneous exposure from unsafe sharps handling, mucocutaneous exposure from body fluid splashes, and glove perforation from excessive wear can expose the radiologist to potentially infectious material. The increasing prevalence of blood-borne pathogens, including hepatitis B and C, and human immunodeficiency virus, puts nurses, residents, fellows, and interventional radiologists at risk for occupational exposure. This review outlines suggestions to establish a culture of safety in the interventional suite.

  8. Young Children and Trauma: Intervention and Treatment

    ERIC Educational Resources Information Center

    Osofsky, Joy D., Ed.

    2004-01-01

    Recent years have seen significant advances in knowledge about the effects of exposure to psychological trauma on young children from birth to age 5. This volume brings together leading experts to address practical considerations in working with traumatized young children and their caregivers. State-of-the-art assessment and treatment approaches…

  9. Behavioral Lifestyle Intervention in the Treatment of Obesity

    PubMed Central

    Looney, Shannon M.; Raynor, Hollie A.

    2013-01-01

    This article provides an overview of research regarding adult behavioral lifestyle intervention for obesity treatment. We first describe two trials using a behavioral lifestyle intervention to induce weight loss in adults, the Diabetes Prevention Program (DPP) and the Look AHEAD (Action for Health in Diabetes) trial. We then review the three main components of a behavioral lifestyle intervention program: behavior therapy, an energy- and fat-restricted diet, and a moderate- to vigorous-intensity physical activity prescription. Research regarding the influence of dietary prescriptions focusing on macronutrient composition, meal replacements, and more novel dietary approaches (such as reducing dietary variety and energy density) on weight loss is examined. Methods to assist with meeting physical activity goals, such as shortening exercise bouts, using a pedometer, and having access to exercise equipment within the home, are reviewed. To assist with improving weight loss outcomes, broadening activity goals to include resistance training and a reduction in sedentary behavior are considered. To increase the accessibility of behavioral lifestyle interventions to treat obesity in the broader population, translation of efficacious interventions such as the DPP, must be undertaken. Translational studies have successfully altered the DPP to reduce treatment intensity and/or used alternative modalities to implement the DPP in primary care, worksite, and church settings; several examples are provided. The use of new methodologies or technologies that provide individualized treatment and real-time feedback, and which may further enhance weight loss in behavioral lifestyle interventions, is also discussed. PMID:25114557

  10. Behavioral lifestyle intervention in the treatment of obesity.

    PubMed

    Looney, Shannon M; Raynor, Hollie A

    2013-01-01

    This article provides an overview of research regarding adult behavioral lifestyle intervention for obesity treatment. We first describe two trials using a behavioral lifestyle intervention to induce weight loss in adults, the Diabetes Prevention Program (DPP) and the Look AHEAD (Action for Health in Diabetes) trial. We then review the three main components of a behavioral lifestyle intervention program: behavior therapy, an energy- and fat-restricted diet, and a moderate- to vigorous-intensity physical activity prescription. Research regarding the influence of dietary prescriptions focusing on macronutrient composition, meal replacements, and more novel dietary approaches (such as reducing dietary variety and energy density) on weight loss is examined. Methods to assist with meeting physical activity goals, such as shortening exercise bouts, using a pedometer, and having access to exercise equipment within the home, are reviewed. To assist with improving weight loss outcomes, broadening activity goals to include resistance training and a reduction in sedentary behavior are considered. To increase the accessibility of behavioral lifestyle interventions to treat obesity in the broader population, translation of efficacious interventions such as the DPP, must be undertaken. Translational studies have successfully altered the DPP to reduce treatment intensity and/or used alternative modalities to implement the DPP in primary care, worksite, and church settings; several examples are provided. The use of new methodologies or technologies that provide individualized treatment and real-time feedback, and which may further enhance weight loss in behavioral lifestyle interventions, is also discussed. PMID:25114557

  11. Technical Basis for Radiological Emergency Plan Annex for WTD Emergency Response Plan: West Point Treatment Plant

    SciTech Connect

    Hickey, Eva E.; Strom, Daniel J.

    2005-08-01

    Staff of the King County Wastewater Treatment Division (WTD) have concern about the aftermath of a radiological dispersion event (RDE) leading to the introduction of significant quantities of radioactive material into the combined sanitary and storm sewer system in King County, Washington. Radioactive material could come from the use of a radiological dispersion device (RDD). RDDs include "dirty bombs" that are not nuclear detonations but are explosives designed to spread radioactive material (National Council on Radiation Protection and Measurements (NCRP) 2001). Radioactive material also could come from deliberate introduction or dispersion of radioactive material into the environment, including waterways and water supply systems. This document, Volume 3 of PNNL-15163 is the technical basis for the Annex to the West Point Treatment Plant (WPTP) Emergency Response Plan related to responding to a radiological emergency at the WPTP. The plan primarily considers response to radioactive material that has been introduced in the other combined sanitary and storm sewer system from a radiological dispersion device, but is applicable to any accidental or deliberate introduction of materials into the system.

  12. Current radiology. Volume 5

    SciTech Connect

    Wilson, G.H.; Hanafee, W.N.

    1984-01-01

    This book contains 10 selections. They are: Nuclear Magnetic Resonance Imaging, Interventional Vascular Radiology, Genitourinary Radiology, Skeletal Radiology, Digital Subtraction Angiography, Neuroradiology, Computed Tomographic Evaluation of Degenerative Diseases of the Lumbar Spine, The Lung, Otolaringology and Opthalmology, and Pediatric Radiology: Cranial, Facial, Cervical, Vertebral, and Appendicular.

  13. Role of Interventional Radiology in the Management of Chylothorax: A Review of the Current Management of High Output Chylothorax

    SciTech Connect

    Lyon, Stuart Mott, Nigel Koukounaras, Jim; Shoobridge, Jen; Hudson, Patricio Vargas

    2013-06-15

    Chylothorax is an uncommon type of pleural effusion whose etiology may be classified as traumatic or nontraumatic. Low-output chylothoraces usually respond well to conservative management, whereas high-output chylothoraces are more likely to require surgical or interventional treatment. Conservative management focuses on alleviation of symptoms, replacement of fluid and nutrient losses, and reduction of chyle output to facilitate spontaneous healing. Surgical management can be technically difficult due to the high incidence of variant anatomy and the high-risk patient population. Percutaneous treatments have rapidly developed and evolved during the past 14 years to represent a minimally invasive treatment compared with the more invasive nature of surgery. Percutaneous therapies provide a range of treatment options despite difficult or variant anatomy, with a reported high success rate coupled with low morbidity and mortality. This article is a review of etiology, diagnosis, and treatment of chylothorax, with a focus on interventional management techniques.

  14. Interventional treatment for low back pain: general risks.

    PubMed

    Hartog, Arthur

    2010-11-01

    The commonly performed spinal procedures, such as epidural injections, spinal nerve blocks, zygapophysial joint (z-joint) interventions, and discography, are reported to be safe. However, diagnostic and therapeutic spinal interventions can lead to serious complications, although their incidence seems to be low. Knowledge of potential complications is still required to minimize risks. This article describes the risks associated with the most commonly performed procedures, precautions that can be taken to minimize these risks, and treatment options available once complications have occurred. This article describes the risks associated with the most commonly performed procedures, precautions that can be taken to minimize these risks, and treatment options available once complications have occurred. PMID:20977964

  15. Radiation Injury Treatment Network (RITN): Healthcare professionals preparing for a mass casualty radiological or nuclear incident

    PubMed Central

    ROSS, JOEL R.; CASE, CULLEN; CONFER, DENNIS; WEISDORF, DANIEL J.; WEINSTOCK, DAVID; KRAWISZ, ROBERT; CHUTE, JOHN; WILHAUK, JULIE; NAVARRO, WILLIS; HARTZMAN, ROBERT; COLEMAN, C. NORMAN; HATCHETT, RICHARD; CHAO, NELSON

    2011-01-01

    Purpose To describe the history, composition, and activities of the Radiation Injury Treatment Network (RITN). The Radiation Injury Treatment Network® is a cooperative effort of the National Marrow Donor Program and the American Society for Blood and Marrow Transplantation. The goals of RITN are to educate hematologists, oncologists, and stem cell transplant practitioners about their potential involvement in the response to a radiation incident and provide treatment expertise. Injuries to the marrow system readily occur when a victim is exposed to ionising radiation. This focus therefore leverages the expertise of these specialists who are accustomed to providing the intensive supportive care required by patients with a suppressed marrow function. Following a radiological incident, RITN centres may be asked to: Accept patient transfers to their institutions; provide treatment expertise to practitioners caring for victims at other centres; travel to other centres to provide medical expertise; or provide data on victims treated at their centres. Moving forward, it is crucial that we develop a coordinated interdisciplinary approach in planning for and responding to radiological and nuclear incidents. The ongoing efforts of radiation biologists, radiation oncologists, and health physicists can and should complement the efforts of RITN and government agencies. Conclusion RITN serves as a vital partner in preparedness and response efforts for potential radiological and nuclear incidents. PMID:21801106

  16. Treatment options for low-level radiologically contaminated ORNL filtercake

    SciTech Connect

    Lee, Hom-Ti; Bostick, W.D.

    1996-04-01

    Water softening sludge (>4000 stored low level contaminated drums; 600 drums per year) generated by the ORNL Process Waste Treatment Plant must be treated, stabilized, and placed in safe storage/disposal. The sludge is primarily CaCO{sub 3} and is contaminated by low levels of {sup 90}Sr and {sup 137}Cs. In this study, microwave sintering and calcination were evaluated for treating the sludge. The microwave melting experiments showed promise: volume reductions were significant (3-5X), and the waste form was durable with glass additives (LiOH, fly ash). A commercial vendor using surrogate has demonstrated a melt mineralization process that yields a dense monolithic waste form with a volume reduction factor (VR) of 7.7. Calcination of the sludge at 850-900 C yielded a VR of 2.5. Compaction at 4500 psi increased the VR to 4.2, but the compressed form is not dimensionally stable. Addition of paraffin helped consolidate fines and yielded a VR of 3.5. In conclusion, microwave melting or another form of vitrification is likely to be the best method; however for immediate implementation, the calculation/compaction/waxing process is viable.

  17. Periprocedural Prophylactic Antithrombotic Strategies in Interventional Radiology: Current Practice in the Netherlands and Comparison with the United Kingdom

    SciTech Connect

    Wiersema, Arno M.; Vos, Jan-Albert; Bruijninckx, Cornelis M. A.; Delden, Otto M. van; Reijnen, Michel M. P. J.; Vahl, Anco; Zeebregts, Clark J.; Moll, Frans L.

    2013-12-15

    Purpose: The use of prophylactic antithrombotic drugs to prevent arterial thrombosis during the periprocedural period during (percutaneous) peripheral arterial interventions (PAIs) is still a matter of dispute, and clear evidence-based guidelines are lacking. To create those guidelines, a study group was formed in the Netherlands in cooperation with the Dutch Society of Vascular Surgery and the Society of Interventional Radiology. The study group is called 'Consensus on Arterial PeriProcedural Anticoagulation (CAPPA).' Materials and Methods: The CAPPA study group devised and distributed a comprehensive questionnaire amongst Dutch interventional radiologists (IRs). Results: One hundred forty-two IRs responded (68 %) to the questionnaire. Almost no IR stopped acetyl salicylic acid before interventions, and 40 % stopped clopidogrel before PAI but not before carotid artery stenting (CAS). A flushing solution on the sideport of the sheath was used routinely by 30 % of IRs in PAI and by 50 % of IRs during CAS. A minority of IRs used a heparinised flushing solution (28 %). Unfractionated heparin was used by 95 % of IRs as bolus; 5000 IU was the most used dosage. Timing of administration varied widely. A majority of IRs (75 %) repeated heparin administration after 1 h. Conclusion: A substantial variety exists amongst IRs in the Netherlands regarding the use of prophylactic periprocedural antithrombotic drugs to prevent arterial thrombosis during PAI. When compared with varying results regarding the use of heparin in the United Kingdom, the variety in the Netherlands showed a different pattern. The proven variety in these countries, and also between these countries, emphasises the need for authoritative studies to develop evidence-based practical guidelines.

  18. Economically affordable anatomical kidney phantom with calyxes for puncture and drainage training in interventional urology and radiology

    PubMed Central

    Ross, Peeter; Gavšin, Juri; Semjonov, Eero; Kruusmaa, Maarja

    2014-01-01

    Background Trends in interventional radiology and urology training are orientated towards reducing costs and increasing efficiency. In order to comply with the trends, we propose training on inexpensive patient-specific kidney phantoms. Purpose To develop a new kidney phantom for puncture and drainage training in interventional urology and radiology, and to evaluate their anatomical correctness and suitability for training compared to the traditional way of training on home-made phantoms. Material and Methods A case study for validation of kidney phantoms was conducted with nine radiology students divided into two groups: one trained on standard home-made training phantom (n = 4) and the other on our kidney phantoms (n = 5). Another test phantom was used to evaluate the effectiveness of the training of the two groups. The tests were video recorded and analyzed. Duration of the procedure was used as the primary indicator of procedure’s quality. Comparison tests were also conducted with professional radiologists. Anatomical correctness of the kidney phantom was evaluated by comparing the post mortem kidney scans with reconstructed models from CT scans. Subjective feedback was also collected from the participants. Wider use of kidney phantoms was analyzed. Results The average volumetric difference between post mortem kidney scans and reconstructed CT kidney models was 4.70 ± 3.25%. All five students practicing on the kidney phantom improved their performance and the results were almost equal to the results of the professional radiologist while in the other group two students out of four trained on standard home-made training phantoms failed to improve their performance. However, the small number of test subjects prevents us from drawing general conclusions about the efficiency of the new practice. The kidney phantoms were found usable also for nephrostomy catheter placement training under fluoroscopy. Conclusion The feedback from radiologists showed

  19. Effects of exercise interventions during different treatments in breast cancer.

    PubMed

    Fairman, Ciaran M; Focht, Brian C; Lucas, Alexander R; Lustberg, Maryam B

    2016-05-01

    Previous findings suggest that exercise is a safe and efficacious means of improving physiological and psychosocial outcomes in female breast cancer survivors. To date, most research has focused on post-treatment interventions. However, given that the type and severity of treatment-related adverse effects may be dependent on the type of treatment, and that the effects are substantially more pronounced during treatment, an assessment of the safety and efficacy of exercise during treatment is warranted. In this review, we present and evaluate the results of randomized controlled trials (RCTs) conducted during breast cancer treatment. We conducted literature searches to identify studies examining exercise interventions in breast cancer patients who were undergoing chemotherapy or radiation. Data were extracted on physiological and psychosocial outcomes. Cohen's d effect sizes were calculated for each outcome. A total of 17 studies involving 1,175 participants undergoing active cancer therapy met the inclusion criteria. Findings revealed that, on average, exercise interventions resulted in moderate to large improvements in muscular strength: resistance exercise (RE, = 0.86), aerobic exercise (AE, = 0.55), small to moderate improvements in cardiovascular functioning (RE, = 0.45; AE, = 0.17, combination exercise (COMB, = 0.31) and quality of life (QoL; RE, = 0.30; AE, = 0.50; COMB, = 0.63). The results of this review suggest that exercise is a safe, feasible, and efficacious intervention in breast cancer patients who are undergoing different types of treatment. Additional research addressing the different modes of exercise during each type of treatment is warranted to assess the comparable efficacy of the various exercise modes during established breast cancer treatments. PMID:27258052

  20. Non radiological issues in the treatment of low-level liquid wastes

    SciTech Connect

    Welbergen, Jeroen; Verhoef, Ewoud; Eijke, Anton; Best, Alex de; Hengst, Jan; Codee, Hans

    2007-07-01

    Available in abstract form only. Full text of publication follows: In the Netherlands there are some 200 producers of radioactive waste. Most of them generate only small volumes of low and medium level waste. These small volumes however cover a wide range of waste forms: solids, liquids of all nature, slurries, etc. Because of the resulting wide spectrum of radiological and chemical contaminations, a certain amount of flexibility is required in both solid and liquid waste treatment. In addition, the Nuclear Energy Act license requires a five yearly evaluation of the waste processing installation with respect to the Best Practicable Technologies. The bulk of the solid waste are compacted, conditioned as cemented packages and stored for at least hundred years. The low-level liquid waste is treated batch-wise as the volumes of liquid waste are too small to operate a continuous system. Moreover, batch-wise processing enables more flexibility. Discharge of treated water is bounded by concentration limits of chemicals and total activity per nuclide. Evaluation of the installation showed that the radiological constraints provide a larger degree of freedom to discharge, and the waste water treatment can effectively meet the required limits. The limits of concentration of chemicals are more restrictive. The liquid waste often has more chemical contamination than radiological. This paper describes the evaluation of the waste water treatment. (authors)

  1. Fetal Alcohol Spectrum Disorders: Experimental Treatments and Strategies for Intervention

    PubMed Central

    Idrus, Nirelia M.; Thomas, Jennifer D.

    2011-01-01

    Despite the known damaging effects of prenatal alcohol exposure, women continue to drink during pregnancy, creating a need for effective interventions and treatments for fetal alcohol spectrum disorders (FASD). Experimental models can be useful in identifying potential treatments, and this article describes the spectrum of experimental therapeutics that currently are being investigated, including pharmacological, nutritional, and environmental/behavioral interventions. Some treatments target the underlying mechanisms that contribute to alcohol-induced damage, protecting against alcohol’s teratogenic effects, whereas other treatments may enhance central nervous system plasticity either during alcohol exposure or long after alcohol exposure has ceased. The insights gained to date from experimental models offer several candidates for attenuating the deficits associated with FASD. PMID:23580044

  2. Effects of Video Modeling on Treatment Integrity of Behavioral Interventions

    ERIC Educational Resources Information Center

    DiGennaro-Reed, Florence D.; Codding, Robin; Catania, Cynthia N.; Maguire, Helena

    2010-01-01

    We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased…

  3. A Comparison of Treatment Integrity Assessment Methods for Behavioral Intervention

    ERIC Educational Resources Information Center

    Koh, Seong A.

    2010-01-01

    The purpose of this study was to examine the similarity of outcomes from three different treatment integrity (TI) methods, and to identify the method which best corresponded to the assessment of a child's behavior. Six raters were recruited through individual contact via snowball sampling. A modified intervention component list and 19 video clips…

  4. Novel Interventional Strategies for the Treatment of Atrial Fibrillation

    PubMed Central

    Siontis, Konstantinos C; Oral, Hakan

    2016-01-01

    The landscape of the invasive management of atrial fibrillation, the most common sustained arrhythmia in humans, has changed dramatically in the last decade owing to numerous advances in arrhythmia mapping and ablation technologies. The current review critically appraises novel interventional strategies for the treatment of atrial fibrillation with a focus on clinical effectiveness and safety. PMID:27403294

  5. Student Depression: General Treatment Dynamics and Symptom Specific Interventions.

    ERIC Educational Resources Information Center

    Ramsey, MaryLou

    1994-01-01

    Defines student depression, describes four different types of depression, and details etiology of depression. Reviews three evaluation instruments to assess student depression and suicidal potential. Discusses general treatment dynamics and symptom-specific interventions as basis for counseling depressed children and adolescents. (NB)

  6. Fast and Efficient Radiological Interventions via a Graphical User Interface Commanded Magnetic Resonance Compatible Robotic Device

    PubMed Central

    Özcan, Alpay; Christoforou, Eftychios; Brown, Daniel; Tsekos, Nikolaos

    2011-01-01

    The graphical user interface for an MR compatible robotic device has the capability of displaying oblique MR slices in 2D and a 3D virtual environment along with the representation of the robotic arm in order to swiftly complete the intervention. Using the advantages of the MR modality the device saves time and effort, is safer for the medical staff and is more comfortable for the patient. PMID:17946067

  7. Transcatheter intervention for the treatment of congenital cardiac defects.

    PubMed Central

    Grifka, R G

    1997-01-01

    Cardiac catheterization has an illustrious history, originating in 1929 when Werner Forsmann, a surgical resident, performed a heart catheterization on himself. Transcatheter interventional procedures have been performed since the 1960s. The 1st intracardiac procedure to become standard therapy was a balloon atrial septostomy. Skeptics attacked this innovative procedure. However, the balloon septostomy procedure soon became the standard emergency procedure for certain congenital heart defects, and was the impetus for other investigators in the field of transcatheter intervention. We will discuss transcatheter treatment for congenital vascular stenoses and vascular occlusion. Images PMID:9456482

  8. Intervention in the context of development: pathways toward new treatments.

    PubMed

    Veenstra-VanderWeele, Jeremy; Warren, Zachary

    2015-01-01

    Neuropsychiatric disorders vary substantially in age of onset but are best understood within the context of neurodevelopment. Here, we review opportunities for intervention at critical points in developmental trajectories. We begin by discussing potential opportunities to prevent neuropsychiatric disorders. Once symptoms begin to emerge, a number of interventions have been studied either before a diagnosis can be made or shortly after diagnosis. Although some of these interventions are helpful, few are based upon an understanding of pathophysiology, and most ameliorate rather than resolve symptoms. As such, in the next portion of the review, we turn our discussion to genetic syndromes that are rare phenocopies of common diagnoses such as autism spectrum disorder or schizophrenia. Cellular or animal models of these syndromes point to specific regulatory or signaling pathways. As examples, findings from the mouse models of Fragile X and Rett syndromes point to potential treatments now being tested in randomized clinical trials. Paralleling oncology, we can hope that our treatments will move from nonspecific, like chemotherapies thrown at a wide range of tumor types, to specific, like the protein kinase inhibitors that target molecularly defined tumors. Some of these targeted treatments later show benefit for a broader, yet specific, array of cancers. We can hope that medications developed within rare neurodevelopmental syndromes will similarly help subgroups of patients with disruptions in overlapping signaling pathways. The insights gleaned from treatment development in rare phenocopy syndromes may also teach us how to test treatments based upon emerging common genetic or environmental risk factors. PMID:25182180

  9. Intervention in the Context of Development: Pathways Toward New Treatments

    PubMed Central

    Veenstra-VanderWeele, Jeremy; Warren, Zachary

    2015-01-01

    Neuropsychiatric disorders vary substantially in age of onset but are best understood within the context of neurodevelopment. Here, we review opportunities for intervention at critical points in developmental trajectories. We begin by discussing potential opportunities to prevent neuropsychiatric disorders. Once symptoms begin to emerge, a number of interventions have been studied either before a diagnosis can be made or shortly after diagnosis. Although some of these interventions are helpful, few are based upon an understanding of pathophysiology, and most ameliorate rather than resolve symptoms. As such, in the next portion of the review, we turn our discussion to genetic syndromes that are rare phenocopies of common diagnoses such as autism spectrum disorder or schizophrenia. Cellular or animal models of these syndromes point to specific regulatory or signaling pathways. As examples, findings from the mouse models of Fragile X and Rett syndromes point to potential treatments now being tested in randomized clinical trials. Paralleling oncology, we can hope that our treatments will move from nonspecific, like chemotherapies thrown at a wide range of tumor types, to specific, like the protein kinase inhibitors that target molecularly defined tumors. Some of these targeted treatments later show benefit for a broader, yet specific, array of cancers. We can hope that medications developed within rare neurodevelopmental syndromes will similarly help subgroups of patients with disruptions in overlapping signaling pathways. The insights gleaned from treatment development in rare phenocopy syndromes may also teach us how to test treatments based upon emerging common genetic or environmental risk factors. PMID:25182180

  10. Multiparametric and Multimodality Functional Radiological Imaging for Breast Cancer Diagnosis and Early Treatment Response Assessment

    PubMed Central

    Wolff, Antonio C.; Macura, Katarzyna J.; Stearns, Vered; Ouwerkerk, Ronald; El Khouli, Riham; Bluemke, David A.; Wahl, Richard

    2015-01-01

    Breast cancer is the second leading cause of cancer death among US women, and the chance of a woman developing breast cancer sometime during her lifetime is one in eight. Early detection and diagnosis to allow appropriate locoregional and systemic treatment are key to improve the odds of surviving its diagnosis. Emerging data also suggest that different breast cancer subtypes (phenotypes) may respond differently to available adjuvant therapies. There is a growing understanding that not all patients benefit equally from systemic therapies, and therapeutic approaches are being increasingly personalized based on predictive biomarkers of clinical benefit. Optimal use of established and novel radiological imaging methods, such as magnetic resonance imaging and positron emission tomography, which have different biophysical mechanisms can simultaneously identify key functional parameters. These methods provide unique multiparametric radiological signatures of breast cancer, that will improve the accuracy of early diagnosis, help select appropriate therapies for early stage disease, and allow early assessment of therapeutic benefit. PMID:26063885

  11. [Medical and interventional treatment of right heart failure].

    PubMed

    Horn, Patrick; Westenfeld, Ralf; Figulla, Hans R

    2016-04-01

    New pharmacological approaches are introduced for the treatment of chronic right heart failure which aim at reduced mortality. Riociguat is a new drug for the treatment of chronic thrombembolic pulmonary hypertension. Transcatheter valve interventions are established for treatment of pulmonary valve diseases and introduced as promising upcoming therapeutic options for tricuspid regurgitation.The management of acute right heart failure is supported by the miniaturization of mechanical circulatory support systems with percutaneous cannulation applicable in terms of "Bridge to Recovery" and "Bridge to Decision" concepts and effective long-term support, respectively. PMID:27031201

  12. Calculation of conversion factors for effective dose for various interventional radiology procedures

    SciTech Connect

    Compagnone, Gaetano; Giampalma, Emanuela; Domenichelli, Sara; Renzulli, Matteo; Golfieri, Rita

    2012-05-15

    Purpose: To provide dose-area-product (DAP) to effective dose (E) conversion factors for complete interventional procedures, based on in-the-field clinical measurements of DAP values and using tabulated E/DAP conversion factors for single projections available from the literature. Methods: Nine types of interventional procedures were performed on 84 patients with two angiographic systems. Different calibration curves (with and without patient table attenuation) were calculated for each DAP meter. Clinical and dosimetric parameters were recorded in-the-field for each projection and for all patients, and a conversion factor linking DAP and effective doses was derived for each complete procedure making use of published, Monte Carlo calculated conversion factors for single static projections. Results: Fluoroscopy time and DAP values for the lowest-dose procedure (biliary drainage) were approximately 3-fold and 13-fold lower, respectively, than those for the highest-dose examination (transjugular intrahepatic portosystemic shunt, TIPS). Median E/DAP conversion factors from 0.12 (abdominal percutaneous transluminal angioplasty) to 0.25 (Nephrostomy) mSvGy{sup -1} cm{sup -2} were obtained and good correlations between E and DAP were found for all procedures, with R{sup 2} coefficients ranging from 0.80 (abdominal angiography) to 0.99 (biliary stent insertion, Nephrostomy and TIPS). The DAP values obtained in this study showed general consistency with the values provided in the literature and median E values ranged from 4.0 mSv (biliary drainage) to 49.6 mSv (TIPS). Conclusions: Values of E/DAP conversion factors were derived for each procedure from a comprehensive analysis of projection and dosimetric data: they could provide a good evaluation for the stochastic effects. These results can be obtained by means of a close cooperation between different interventional professionals involved in patient care and dose optimization.

  13. Psychological Interventions in the Treatment of Chronic Itch.

    PubMed

    Schut, Christina; Mollanazar, Nicholas K; Kupfer, Jörg; Gieler, Uwe; Yosipovitch, Gil

    2016-03-01

    Patients with chronic itch suffer from higher levels of depression and anxiety than their healthy counterparts. Furthermore, psychological factors, such as stress, are known to aggravate itch. The mere act of thinking about itching can induce the sensation. Interventions like habit reversal training and arousal reduction have been shown to have positive effects on itch relief. Yet, there is still limited data on the psychological management to control the itch scratch cycle and a description of methods suitable to address itch. In this review, we describe different psychological interventions shown to be effective in the treatment of chronic itch. We also provide suggestions based on our experience of suitable interventions for patients with different types of itch. PMID:26073701

  14. Substance Use Screening, Brief Intervention, and Referral to Treatment.

    PubMed

    Levy, Sharon J L; Williams, Janet F

    2016-07-01

    The enormous public health impact of adolescent substance use and its preventable morbidity and mortality highlight the need for the health care sector, including pediatricians and the medical home, to increase its capacity regarding adolescent substance use screening, brief intervention, and referral to treatment (SBIRT). The American Academy of Pediatrics first published a policy statement on SBIRT and adolescents in 2011 to introduce SBIRT concepts and terminology and to offer clinical guidance about available substance use screening tools and intervention procedures. This clinical report provides a simplified adolescent SBIRT clinical approach that, in combination with the accompanying updated policy statement, guides pediatricians in implementing substance use prevention, detection, assessment, and intervention practices across the varied clinical settings in which adolescents receive health care. PMID:27325634

  15. Evaluation of Core Vocabulary Intervention for Treatment of Inconsistent Phonological Disorder: Three Treatment Case Studies

    ERIC Educational Resources Information Center

    McIntosh, Beth; Dodd, Barbara

    2009-01-01

    Children with unintelligible speech differ in severity, underlying deficit, type of surface error patterns and response to treatment. Detailed treatment case studies, evaluating specific intervention protocols for particular diagnostic groups, can identify best practice for children with speech disorder. Three treatment case studies evaluated the…

  16. Evaluation of Core Vocabulary Intervention for Treatment of Inconsistent Phonological Disorder: Three Treatment Case Studies

    ERIC Educational Resources Information Center

    McIntosh, Beth; Dodd, Barbara

    2008-01-01

    Children with unintelligible speech differ in severity, underlying deficit, type of surface error patterns and response to treatment. Detailed treatment case studies, evaluating specific intervention protocols for particular diagnostic groups, can identify best practice for children with speech disorder. Three treatment case studies evaluated the…

  17. Psychosocial interventions for pregnant women in outpatient illicit drug treatment programs compared to other interventions

    PubMed Central

    Terplan, Mishka; Ramanadhan, Shaalini; Locke, Abigail; Longinaker, Nyaradzo; Lui, Steve

    2016-01-01

    Background Illicit drug use in pregnancy is a complex social and public health problem. The consequences of drug use in pregnancy are high for both the woman and her child. Therefore, it is important to develop and evaluate effective treatments. There is evidence for the effectiveness of psychosocial interventions in drug treatment but it is unclear whether they are effective in pregnant women. This is an update of a Cochrane review originally published in 2007. Objectives To evaluate the effectiveness of psychosocial interventions in pregnant women enrolled in illicit drug treatment programmes on birth and neonatal outcomes, on attendance and retention in treatment, as well as on maternal and neonatal drug abstinence. In short, do psychosocial interventions translate into less illicit drug use, greater abstinence, better birth outcomes, or greater clinic attendance? Search methods We conducted the original literature search in May 2006 and performed the search update up to January 2015. For both review stages (original and update), we searched the Cochrane Drugs and Alcohol Group Trial's register (May 2006 and January 2015); the Cochrane Central Register of Trials (CENTRAL; the Cochrane Library 2015, Issue 1); PubMed (1996 to January 2015); EMBASE (1996 to January 2015); and CINAHL (1982 to January 2015). Selection criteria We included randomized controlled trials comparing any psychosocial intervention vs. a control intervention that could include pharmacological treatment, such as methadone maintenance, a different psychosocial intervention, counselling, prenatal care, STD counselling and testing, transportation, or childcare. Data collection and analysis We used standard methodological procedures expected by the Cochrane Collaboration. We performed analyses based on three comparisons: any psychosocial intervention vs. control, contingency management (CM) interventions vs. control, and motivational interviewing based (MIB) interventions vs. control. Main results

  18. Alternative to surgery in early stage NSCLC—interventional radiologic approaches

    PubMed Central

    Lee, Kyungmouk Steve

    2013-01-01

    Interventional radiologists have a variety of techniques in their armamentarium to treat pulmonary tumors. While most therapies are targeted to metastasis or palliation, percutaneous thermal ablation represents a potential therapy for not only palliation, but to treat inoperable early stage disease. Although radiofrequency ablation (RFA) is the most studied of these ablative techniques, newer technologies of thermal ablation, such as microwave and cryoablation have emerged as additional options. In this article, we will review the three different thermal ablative modalities, including patient selection, technique, outcomes, complications, and imaging follow-up. A brief discussion of state of the art techniques such as irreversible electroporation (IRE) and catheter directed therapies will also be included. PMID:25806253

  19. Endovascular Intervention in the Treatment of Peripheral Artery Disease.

    PubMed

    Couto, Marian; Figueróa, Alejandro; Sotolongo, Antonio; Pérez, Reynerio; Ojeda, José Martinez

    2015-01-01

    Endovascular therapy has emerged as an essential part of the management we can offer patients suffering from peripheral arterial disease. The AHA/ACCF guidelines deemed ballon angioplasty as a reasonable alternative for patients with limb threatening lower extremity ischemia who are not candidates for an autologus venous graft. Endovascular treatment is most useful for the treatment of critical limb ischemia and should ensure adequate proximal flow before engaging in interventions of distal disease.To increase procedure success rate, a thorough diagnostic evaluation is fundamental. This evaluation must take into account amount of calcium, no flow occlusion, length of occlusion, and presence of collaterals. There are different tools and procedure techniques available. Among these are the medicated ballon angioplasty and atherectomy by laser or high-speed drill, among others. Further studies may consolidate endovascular intervention as a safe and effective management for patients with lower extremity arterial disease and possibly cause a change in the actual practice guidelines. PMID:26742196

  20. Evidence-based medical oncology and interventional radiology paradigms for liver-dominant colorectal cancer metastases.

    PubMed

    Sag, Alan Alper; Selcukbiricik, Fatih; Mandel, Nil Molinas

    2016-03-21

    Colorectal cancer metastasizes predictably, with liver predominance in most cases. Because liver involvement has been shown to be a major determinant of survival in this population, liver-directed therapies are increasingly considered even in cases where there is (limited) extrahepatic disease. Unfortunately, these patients carry a known risk of recurrence in the liver regardless of initial therapy choice. Therefore, there is a demand for minimally invasive, non-surgical, personalized cancer treatments to preserve quality of life in the induction, consolidation, and maintenance phases of cancer therapy. This report aims to review evidence-based conceptual, pharmacological, and technological paradigm shifts in parenteral and percutaneous treatment strategies as well as forthcoming evidence regarding next-generation systemic, locoregional, and local treatment approaches for this patient population. PMID:27003990

  1. Evidence-based medical oncology and interventional radiology paradigms for liver-dominant colorectal cancer metastases

    PubMed Central

    Sag, Alan Alper; Selcukbiricik, Fatih; Mandel, Nil Molinas

    2016-01-01

    Colorectal cancer metastasizes predictably, with liver predominance in most cases. Because liver involvement has been shown to be a major determinant of survival in this population, liver-directed therapies are increasingly considered even in cases where there is (limited) extrahepatic disease. Unfortunately, these patients carry a known risk of recurrence in the liver regardless of initial therapy choice. Therefore, there is a demand for minimally invasive, non-surgical, personalized cancer treatments to preserve quality of life in the induction, consolidation, and maintenance phases of cancer therapy. This report aims to review evidence-based conceptual, pharmacological, and technological paradigm shifts in parenteral and percutaneous treatment strategies as well as forthcoming evidence regarding next-generation systemic, locoregional, and local treatment approaches for this patient population. PMID:27003990

  2. Interventional Radiology in the Management of Visceral Artery Pseudoaneurysms: A Review of Techniques and Embolic Materials

    PubMed Central

    Venkatesh, Hosur Ananthashayana; Gamanagatti, Shivanand; Garg, Pramod; Srivastava, Deep Narayan

    2016-01-01

    Visceral artery pseudoaneurysms occur mostly as a result of inflammation and trauma. Owing to high risk of rupture, they require early treatment to prevent lethal complications. Knowledge of the various approaches of embolization of pseudoaneurysms and different embolic materials used in the management of visceral artery pseudoaneurysms is essential for successful and safe embolization. We review and illustrate the endovascular, percutaneous and endoscopic ultrasound techniques used in the treatment of visceral artery pseudoaneurysm and briefly discuss the embolic materials and their benefits and risks. PMID:27134524

  3. Changes in Occupational Radiation Exposures after Incorporation of a Real-time Dosimetry System in the Interventional Radiology Suite.

    PubMed

    Poudel, Sashi; Weir, Lori; Dowling, Dawn; Medich, David C

    2016-08-01

    A statistical pilot study was retrospectively performed to analyze potential changes in occupational radiation exposures to Interventional Radiology (IR) staff at Lawrence General Hospital after implementation of the i2 Active Radiation Dosimetry System (Unfors RaySafe Inc, 6045 Cochran Road Cleveland, OH 44139-3302). In this study, the monthly OSL dosimetry records obtained during the eight-month period prior to i2 implementation were normalized to the number of procedures performed during each month and statistically compared to the normalized dosimetry records obtained for the 8-mo period after i2 implementation. The resulting statistics included calculation of the mean and standard deviation of the dose equivalences per procedure and included appropriate hypothesis tests to assess for statistically valid differences between the pre and post i2 study periods. Hypothesis testing was performed on three groups of staff present during an IR procedure: The first group included all members of the IR staff, the second group consisted of the IR radiologists, and the third group consisted of the IR technician staff. After implementing the i2 active dosimetry system, participating members of the Lawrence General IR staff had a reduction in the average dose equivalence per procedure of 43.1% ± 16.7% (p = 0.04). Similarly, Lawrence General IR radiologists had a 65.8% ± 33.6% (p=0.01) reduction while the technologists had a 45.0% ± 14.4% (p=0.03) reduction. PMID:27356166

  4. Hospital Organization and Importance of an Interventional Radiology Inpatient Admitting Service: Italian Single-Center 3-Year Experience

    SciTech Connect

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

    2009-03-15

    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p < 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of Euro 1,009,095.35. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

  5. Clinical and Radiological Classification of the Jawbone Anatomy in Endosseous Dental Implant Treatment

    PubMed Central

    Kubilius, Marius

    2013-01-01

    ABSTRACT Objectives The purpose of present article was to review the classifications suggested for assessment of the jawbone anatomy, to evaluate the diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone, as well as to suggest new classification system of the jawbone anatomy in endosseous dental implant treatment. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandible; mandibular canal; alveolar nerve, inferior; anatomy, cross-sectional; dental implants; classification. The search was restricted to English language articles, published from 1972 to March 2013. Additionally, a manual search in the major anatomy and oral surgery books were performed. The publications there selected by including clinical and human anatomy studies. Results In total 109 literature sources were obtained and reviewed. The classifications suggested for assessment of the jawbone anatomy, diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone were discussed. New classification system of the jawbone anatomy in endosseous dental implant treatment based on anatomical and radiologic findings and literature review results was suggested. Conclusions The classification system proposed here based on anatomical and radiological jawbone quantity and quality evaluation is a helpful tool for planning of treatment strategy and collaboration among specialists. Further clinical studies should be conducted for new classification validation and reliability evaluation. PMID:24422030

  6. Prevention of Contrast-Induced Nephropathy (CIN) in Interventional Radiology Practice

    PubMed Central

    Gupta, Rajan K.; Bang, Tami J.

    2010-01-01

    Contrast-induced nephropathy (CIN) is a widely recognized and clinically significant problem in patients undergoing an increasing number of minimally invasive procedures that require contrast administration. Contrast-induced nephropathy is the third most common cause of hospital-acquired renal failure and has significant prognostic implications on patient outcomes. Interventional practitioners are faced with challenging decisions regarding prophylaxis and patient management. The major risk factor for developing CIN is preexisting renal dysfunction, particularly in association with diabetes. Patients are considered to be at risk when estimated glomerular filtration rate (eGFR) or estimated creatinine clearance (eCCr) is less than 60. The cornerstone of prevention of CIN is appropriate risk stratification, intravenous hydration with normal saline or sodium bicarbonate, appropriate withholding of nephrotoxic medications, use of low or iso-osmolar contrast media, and various intraprocedural methods for iodinated contrast dose reduction. Although N-acetylcysteine administration is popular, it remains unproven. Practitioners must be familiar with prevention strategies and diagnosis of CIN to minimize its clinical impact. PMID:22550376

  7. Increased Breastfeeding Rates in Black Women After a Treatment Intervention

    PubMed Central

    Endicott, Jean; Goetz, Raymond R.

    2013-01-01

    Abstract There has been a considerable increase in rates of breastfeeding in the United States. Despite these trends, black women continue to fall below medical recommendations. Impoverished and poorly educated women also have a comparatively lower rate of breastfeeding. Provider encouragement and supportive interventions increase breastfeeding initiation among women of all backgrounds. The data presented come from a three-site randomized controlled bilingual depression treatment trial from 2005 to 2011 that examined the comparative effectiveness of interpersonal psychotherapy and a parenting education program. Breastfeeding education and support were provided for the majority of participants in each intervention. Breastfeeding status was queried at postpartum week 4. We found higher rates of breastfeeding in black women compared with those reported in national surveys. The black breastfeeding rate did not significantly differ from that of white or Hispanic women. American-born black women were just as likely to breastfeed as American-born white women, both at significantly greater rates than American-born Hispanic women. We also found no differences in breastfeeding rate in poorly educated and impoverished women. These data must be seen against the backdrop of a significant intervention to treat depression. Because breastfeeding interventions have been shown to increase breastfeeding rates, the support provided in our study likely increased rates in groups that lag behind. PMID:23971683

  8. Increased breastfeeding rates in black women after a treatment intervention.

    PubMed

    Spinelli, Margaret G; Endicott, Jean; Goetz, Raymond R

    2013-12-01

    There has been a considerable increase in rates of breastfeeding in the United States. Despite these trends, black women continue to fall below medical recommendations. Impoverished and poorly educated women also have a comparatively lower rate of breastfeeding. Provider encouragement and supportive interventions increase breastfeeding initiation among women of all backgrounds. The data presented come from a three-site randomized controlled bilingual depression treatment trial from 2005 to 2011 that examined the comparative effectiveness of interpersonal psychotherapy and a parenting education program. Breastfeeding education and support were provided for the majority of participants in each intervention. Breastfeeding status was queried at postpartum week 4. We found higher rates of breastfeeding in black women compared with those reported in national surveys. The black breastfeeding rate did not significantly differ from that of white or Hispanic women. American-born black women were just as likely to breastfeed as American-born white women, both at significantly greater rates than American-born Hispanic women. We also found no differences in breastfeeding rate in poorly educated and impoverished women. These data must be seen against the backdrop of a significant intervention to treat depression. Because breastfeeding interventions have been shown to increase breastfeeding rates, the support provided in our study likely increased rates in groups that lag behind. PMID:23971683

  9. How to Interpret Thyroid Biopsy Results: A Three-Year Retrospective Interventional Radiology Experience

    SciTech Connect

    Oppenheimer, Jason D. Kasuganti, Deepa; Nayar, Ritu; Chrisman, Howard B.; Lewandowski, Robert J.; Nemcek, Albert A.; Ryu, Robert K.

    2010-08-15

    Results of thyroid biopsy determine whether thyroid nodule resection is appropriate and the extent of thyroid surgery. At our institution we use 20/22-gauge core biopsy (CBx) in conjunction with fine-needle aspiration (FNA) to decrease the number of passes and improve adequacy. Occasionally, both ultrasound (US)-guided FNA and CBx yield unsatisfactory specimens. To justify clinical recommendations for these unsatisfactory thyroid biopsies, we compare rates of malignancy at surgical resection for unsatisfactory biopsy results against definitive biopsy results. We retrospectively reviewed a database of 1979 patients who had a total of 2677 FNA and 663 CBx performed by experienced interventional radiologists under US guidance from 2003 to 2006 at a tertiary-care academic center. In 451 patients who had surgery following biopsy, Fisher's exact test was used to compare surgical malignancy rates between unsatisfactory and malignant biopsy cohorts as well as between unsatisfactory and benign biopsy cohorts. We defined statistical significance at P = 0.05. We reported an overall unsatisfactory thyroid biopsy rate of 3.7% (100/2677). A statistically significant higher rate of surgically proven malignancies was found in malignant biopsy patients compared to unsatisfactory biopsy patients (P = 0.0001). The incidence of surgically proven malignancy in unsatisfactory biopsy patients was not significantly different from that in benign biopsy patients (P = 0.8625). In conclusion, an extremely low incidence of malignancy was associated with both benign and unsatisfactory thyroid biopsy results. The difference in incidence between these two groups was not statistically significant. Therefore, patients with unsatisfactory biopsy specimens can be reassured and counseled accordingly.

  10. Percutaneous BioOrganic Sealing of Duodenal Fistulas: Case Report and Review of Biological Sealants with Potential Use in Interventional Radiology

    SciTech Connect

    Wadhwa, Vibhor; Leeper, William R.; Tamrazi, Anobel

    2015-08-15

    Biological sealants are being increasingly used in a variety of surgical specialties for their hemostatic and sealing capabilities. However, their use in interventional radiology has not been widely reported. The authors describe a case of duodenal perforation occurring after 15 years of gastric bypass surgery, in whom surgical diversion was unsuccessfully attempted and the leakage was successfully controlled using percutaneous administration of a combination of biological and organic sealants.

  11. [Drug treatment and interventional pain therapy in back pain patients].

    PubMed

    Sprott, Haiko; Klauke, Wolfgang

    2013-09-01

    The treatment of chronic, non-malignant low-back pain is based on the patients' history and the clinical examination. It can be assumed that half of the cases present with a neuropathic pain component which needs to be treated with antidepressive and antiepileptic drugs instead of "pure" analgesics. Opioids should be considered with extreme caution because of their toxicity. Chronic non-malignant back pain is the prototype for interdisciplinary treatment approaches and multi-modal interdisciplinary settings, including pain programmes. However, a personalised strategy has to be preferred in most cases. A quick relief of pain is important in order to improve function as well as to re-integrate the patient into professional life. Spinal infiltrations can be of both diagnostic as well as therapeutic benefits. Their indication must be considered carefully, especially if the invasive diagnostic intervention has no therapeutic consequences. The interventional procedures should only be used as part of a multimodal approach in patients without any psychological problem. The sole use of interventions supports the purely somatic orientation of many patients and thus leads us in the wrong direction. PMID:23985154

  12. Radiological evolution and delayed resolution of an optic nerve tuberculoma: Challenges in diagnosis and treatment.

    PubMed

    Sivadasan, Ajith; Alexander, Mathew; Mathew, Vivek; Mani, Sunithi; Patil, Anil Kumar B

    2013-01-01

    Optic nerve tuberculomas are rarely reported and their natural history, prognosis, and duration of required treatment remain unclear. A 40-year-old immunocompetent male presented with complete loss of vision in his right eye, which had evolved over 6 weeks. He had optic atrophy on examination. Initial imaging showed right optic nerve swelling and thickening suggesting an infiltrative inflammatory optic neuropathy (infectious or noninfectious). Serial imaging revealed appearance of ring enhancement with a necrotic centre. Biopsy and culture of the coexistent parietal lobe lesion revealed Mycobacterium tuberculosis. Persistent optic nerve granuloma with evidence of radiological improvement was noted at 18 months follow-up with antituberculous therapy (ATT). Visual recovery could not be achieved. The salient features in this case include the clinical presentation initially mimicking an infiltrative or compressive optic neuropathy, rapidradiological evolution into a tuberculoma, subtle paradoxical radiological worsening after initiation of ATT and persistence of granuloma on follow up scan. The challenges involved in early diagnosis and during the treatment course will be discussed. PMID:23661979

  13. Comparison of Explicit Forgiveness Interventions with an Alternative Treatment: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Wade, Nathaniel G.; Worthington, Everett L.; Haake, Shawn

    2009-01-01

    Forgiveness interventions can help people forgive past offenses. However, few studies have compared forgiveness interventions with genuine alternative treatments. The authors compared forgiveness interventions with a therapeutic alternative treatment. Participants reduced unforgiveness and increased forgiveness regardless of treatment condition.…

  14. The yearbook of diagnostic radiology. 1987

    SciTech Connect

    Bragg, D.G.

    1987-01-01

    This book contains seven selections. They are: Neuroradiology; Cardiovascular and Interventional Radiology; The Thorax; The Abdomen; The Musculoskeletal System; Pediatric Radiology; and Radiation Physics.

  15. Pseudomyxoma Peritonei: Symptom Control and Objective Radiological Response after Treatment with Lanreotide Autogel

    PubMed Central

    Zafra, Gema Marín; Luque, Pedro Segura

    2016-01-01

    Peritoneal mucinous carcinomatosis is an aggressive subtype of pseudomyxoma peritonei, which often leads to inoperable bowel obstruction and, ultimately, death. Due to the poor prognosis, treatment is often symptomatic and aimed at alleviating the symptoms – pain, nausea, and vomiting – associated with gastrointestinal obstruction. Due to their antisecretory activity, somatostatin analogues are commonly prescribed in such cases. In the case presented here, a patient diagnosed with disseminated peritoneal mucinous carcinomatosis of appendiceal origin responded well to symptomatic treatment with lanreotide Autogel® at a dose of 120 mg/28 days. More importantly, radiological evidence of a reduction in peritoneal ascites, indicative of antiproliferative activity, was observed. These findings are important, particularly given the negative impact of this disease on both quality of life and survival. This case adds to the growing body of evidence supporting the antiproliferative and antisecretory activity of lanreotide Autogel. PMID:26933420

  16. Importance of Dose Settings in the X-Ray Systems Used for Interventional Radiology: A National Survey

    SciTech Connect

    Vano, E. Sanchez, R.; Fernandez, J. M.; Rosales, F.; Garcia, M. A.; Sotil, J.; Hernandez, J.; Carrera, F.; Ciudad, J.; Soler, M. M.; Ballester, T.

    2009-01-15

    The purpose of this work was to investigate the differences in dose settings among the X-ray units involved in a national survey of patient doses in interventional radiology (IR). The survey was promoted by the National Society of IR and involved 10 centers. As part of the agreed quality control for the survey, entrance doses were measured in a 20-cm-thick acrylic phantom simulating a medium-sized patient. A standard digital subtraction angiography (DSA) imaging protocol for the abdomen was used at the different centers. The center of the phantom was placed at the isocenter of the C-arm system during the measurements to simulate clinical conditions. Units with image intensifiers and flat detectors were involved in the survey. Entrance doses for low, medium, and high fluoroscopy modes and DSA acquisitions were measured for a field of view of 20 cm (or closest). A widespread range of entrance dose values was obtained: 4.5-18.6, 9.2-28.4, and 15.4-51.5 mGy/min in low, medium, and high fluoroscopy mode, respectively, and 0.7-5.0 mGy/DSA image. The ratios between the maximum and the minimum values measured (3-4 for fluoroscopy and 7 for DSA) suggest an important margin for optimization. The calibration factor for the dose-area product meter was also included in the survey and resulted in a mean value of 0.73, with a standard deviation of 0.07. It seems clear that the dose setting for the X-ray systems used in IR requires better criteria and approaches.

  17. Eye lens monitoring for interventional radiology personnel: dosemeters, calibration and practical aspects of H p (3) monitoring. A 2015 review.

    PubMed

    Carinou, Eleftheria; Ferrari, Paolo; Bjelac, Olivera Ciraj; Gingaume, Merce; Merce, Marta Sans; O'Connor, Una

    2015-09-01

    A thorough literature review about the current situation on the implementation of eye lens monitoring has been performed in order to provide recommendations regarding dosemeter types, calibration procedures and practical aspects of eye lens monitoring for interventional radiology personnel. Most relevant data and recommendations from about 100 papers have been analysed and classified in the following topics: challenges of today in eye lens monitoring; conversion coefficients, phantoms and calibration procedures for eye lens dose evaluation; correction factors and dosemeters for eye lens dose measurements; dosemeter position and influence of protective devices. The major findings of the review can be summarised as follows: the recommended operational quantity for the eye lens monitoring is H p (3). At present, several dosemeters are available for eye lens monitoring and calibration procedures are being developed. However, in practice, very often, alternative methods are used to assess the dose to the eye lens. A summary of correction factors found in the literature for the assessment of the eye lens dose is provided. These factors can give an estimation of the eye lens dose when alternative methods, such as the use of a whole body dosemeter, are used. A wide range of values is found, thus indicating the large uncertainty associated with these simplified methods. Reduction factors from most common protective devices obtained experimentally and using Monte Carlo calculations are presented. The paper concludes that the use of a dosemeter placed at collar level outside the lead apron can provide a useful first estimate of the eye lens exposure. However, for workplaces with estimated annual equivalent dose to the eye lens close to the dose limit, specific eye lens monitoring should be performed. Finally, training of the involved medical staff on the risks of ionising radiation for the eye lens and on the correct use of protective systems is strongly recommended. PMID

  18. Psychosocial intervention following suicide attempt: a systematic review of treatment interventions.

    PubMed

    van der Sande, R; Buskens, E; Allart, E; van der Graaf, Y; van Engeland, H

    1997-07-01

    Repeated suicide attempts are a common problem. However, few randomized controlled studies on the treatment of suicide attempters have been described. Although some of these studies showed beneficial effects on measures of well-being, none of them demonstrated lasting positive effects on repeated suicidal behaviour. In an attempt to analyse the results obtained, a systematic review of randomized controlled trials of interventions for suicide attempters is presented. The literature was gathered by means of a CD-ROM literature reference search (MEDLINE/PSYCLIT). Subsequently, information on study design and treatment efficacy was abstracted. Studies that were homogeneous with regard to therapeutic principles were reviewed accordingly, and pooled analyses were performed. Meta-analyses accounted for inter-study variance (random-effects model) to estimate a common-effect measure (relative risk). Systematic review of the data showed considerable differences in both study design and therapeutic protocols. In view of these differences, a single pooled analysis of all studies appeared to be unfeasible. A pooled analysis of studies that focus on psychiatric management of poor compliance showed no significant effect on the repetition of suicide attempts. Similarly, studies of psychosocial crisis intervention, as well as studies of guaranteed in-patient shelter in cases of emergency, did not show a significant reduction in repeated suicide attempts. However, the pooled results of four studies on cognitive-behavioural therapies showed a significant preventive effect on repeated suicide attempts. At present, only the cognitive-behavioural approach appears to have a beneficial effect on repeated suicide attempts. However, because of methodological variability, the results obtained may be too optimistic. Additional research is required to establish the merits of this type of intervention. PMID:9259223

  19. RESULTS FROM CLINICAL AND RADIOLOGICAL FOLLOW-UP, AFTER SURGICAL TREATMENT OF CHONDROBLASTOMA

    PubMed Central

    Penna, Valter; Toller, Eduardo Areas; Ferreira, Adriano Jander; Dias, Dante Palloni Costa

    2015-01-01

    Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. Results: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%), followed by the proximal tibial epiphysis (16.6%) and the calcaneus (8.4%). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. Conclusion: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results. PMID:27027054

  20. Implementation Planning to Promote Parents' Treatment Integrity of Behavioral Interventions for Children with Autism

    ERIC Educational Resources Information Center

    Fallon, Lindsay M.; Collier-Meek, Melissa A.; Sanetti, Lisa M. H.; Feinberg, Adam B.; Kratochwill, Thomas R.

    2016-01-01

    Behavioral interventions delivered across home and school settings can promote positive outcomes for youth with autism spectrum disorders (ASD). Yet, stakeholders who deliver these interventions may struggle to implement interventions as intended. Low levels of treatment integrity can undermine potentially positive intervention outcomes. One way…

  1. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

    PubMed Central

    Idrizi, Shpend; Milev, Ivan; Zafirovska, Planinka; Tosheski, Goce; Zimbakov, Zan; Ampova-Sokolov, Vilma; Angjuseva, Tanja; Mitrev, Zan

    2015-01-01

    BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis. AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate. MATERIAL AND METHODS: The study included 43 patients, where 33 (74%) of them were children between the age of 1 month and 15 years. RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg) to 39.1 mmHg (20-80 mmHg). Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9%) required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55%) patients, and four (9%) patients developed moderate regurgitation, without affecting the function of the right ventricle. CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results. PMID:27275259

  2. Triage, monitoring, and treatment of mass casualty events involving chemical, biological, radiological, or nuclear agents

    PubMed Central

    Ramesh, Aruna C.; Kumar, S.

    2010-01-01

    In a mass casualty situation due to chemical, biological, radiological, or nuclear (CBRN) event, triage is absolutely required for categorizing the casualties in accordance with medical care priorities. Dealing with a CBRN event always starts at the local level. Even before the detection and analysis of agents can be undertaken, zoning, triage, decontamination, and treatment should be initiated promptly. While applying the triage system, the available medical resources and maximal utilization of medical assets should be taken into consideration by experienced triage officers who are most familiar with the natural course of the injury presented and have detailed information on medical assets. There are several triage systems that can be applied to CBRN casualties. With no one standardized system globally or nationally available, it is important for deploying a triage and decontamination system which is easy to follow and flexible to the available medical resources, casualty number, and severity of injury. PMID:21829319

  3. Genitourinary radiology

    SciTech Connect

    McClennan, B.L.

    1982-01-01

    A literature review of genitourinary radiology highlights new findings in the field that have occurred in the past year. The physiology of contrast media, and the occasional life-threatening contrast medial reaction are discussed. Common urologic problems such as stones, infection, and obstruction are examined in order to interpret static radiographs in a more meaningful way. The field of interventional uroradiology continues to expand, with new procedures being tried and new indications for old procedures being developed. (KRM)

  4. Long-term outcome of ischemic type biliary stricture after interventional treatment in liver living donors: a report of two cases.

    PubMed

    Jung, Dong-Hwan; Hwang, Shin; Ha, Tae-Yong; Song, Gi-Won; Kim, Ki-Hun; Ahn, Chul-Soo; Moon, Deok-Bog; Park, Gil-Chun; Jung, Bo-Hyun; Kwang, Sung-Hwa; Lee, Sung-Gyu

    2015-05-01

    The wall of normal proximal bile duct is occasionally thin with close approximation to the right hepatic artery. Thus, isolation of this hepatic artery can result in excessive weakening of the remnant proximal bile duct wall during hemiliver graft harvest. This type of injury can induce ischemic stricture of the donor common bile duct. This study aimed to review the clinical sequences of such ischemic type donor bile duct injuries primarily managed with endoscopic and radiological interventional treatments. A retrospective review of medical records was performed for two living donors who suffered from ischemic type donor bile duct injury. They were followed up for more than 10 years. The right and left liver grafts were harvested from these two donors. Bile duct anatomy was normal bifurcation in one and anomalous branching in the other. Bile duct stenosis was detected in them at 2 weeks and 1 week after liver donation. They underwent endoscopic balloon dilatation and temporary stent (endoscopic retrograde biliary drainage tube) insertion. After keeping the tube for 2 months, the tube was successfully removed in one donor. However, endoscopic treatment was not successful, thus additional radiological intervention was necessary in the other donor. On follow-up over 10 years, they are doing well so far with no recurrence of biliary stricture. Based on our limited experience, interventional treatment with subsequent long-term follow-up appears to be an essential and choice treatment for ischemic type biliary stricture occurring in liver living donors. PMID:26155280

  5. The Efficacy of Continued Sorafenib Treatment after Radiologic Confirmation of Progressive Disease in Patients with Advanced Hepatocellular Carcinoma

    PubMed Central

    2016-01-01

    Background Whether radiologically detected progressive disease (PD) is an accurate metric for discontinuing sorafenib treatment in patients with hepatocellular carcinoma (HCC) is unclear. We investigated the efficacy of sorafenib treatment after radiologic confirmation of PD in patients with advanced HCC. Methods We retrospectively analyzed HCC patients treated with sorafenib at Kyushu Medical Center. Six of the 92 patients with radiologically confirmed PD were excluded because they were classified as Child-Pugh C or had an Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥3; 86 patients were ultimately enrolled. Results Among the 86 patients, 47 continued sorafenib treatment after radiologic confirmation of PD (the continuous group), whereas 39 did not (the discontinuous group). The median survival time (MST) in the continuous group after confirmation was 12.9 months compared with 4.5 months in the discontinuous group (p <0.01). The time to progression in the continuous group after confirmation was 2.6 months compared with 1.4 months in the discontinuous group (p <0.01); it was 4.2 months and 2.1 months in patients who had received sorafenib ≥4 months and <4 months, respectively, before confirmation (p = 0.03). In these subgroups, the post-PD MST was 16.7 months and 9.6 months, respectively (p < 0.01). Independent predictors of overall survival after radiologic detection of PD were (hazard ratio, confidence interval): ECOG PS <2 (0.290, 0.107–0.880), Barcelona Clinical Liver Cancer stage B (0.146, 0.047–0.457), serum α-fetoprotein level ≥400 ng/mL (2.801, 1.355–5.691), and post-PD sorafenib administration (0.279, 0.150–0.510). Conclusion Continuing sorafenib treatment after radiologic confirmation of PD increased survival in patients with advanced HCC. Therefore, radiologically detected PD is not a metric for discontinuation of sorafenib treatment in such patients. PMID:26745625

  6. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  7. Constructing a Theory- and Evidence-Based Treatment Rationale for Complex eHealth Interventions: Development of an Online Alcohol Intervention Using an Intervention Mapping Approach

    PubMed Central

    Johansen, Ayna; Nesvåg, Sverre; Kok, Gerjo; Duckert, Fanny

    2013-01-01

    Background Due to limited reporting of intervention rationale, little is known about what distinguishes a good intervention from a poor one. To support improved design, there is a need for comprehensive reports on novel and complex theory-based interventions. Specifically, the emerging trend of just-in-time tailoring of content in response to change in target behavior or emotional state is promising. Objective The objective of this study was to give a systematic and comprehensive description of the treatment rationale of an online alcohol intervention called Balance. Methods We used the intervention mapping protocol to describe the treatment rationale of Balance. The intervention targets at-risk drinking, and it is delivered by email, mobile phone text messaging, and tailored interactive webpages combining text, pictures, and prerecorded audio. Results The rationale of the current treatment was derived from a self-regulation perspective, and the overarching idea was to support continued self-regulation throughout the behavior change process. Maintaining the change efforts over time and coping adaptively during critical moments (eg, immediately before and after a lapse) are key factors to successful behavior change. Important elements of the treatment rationale to achieving these elements were: (1) emotion regulation as an inoculation strategy against self-regulation failure, (2) avoiding lapses by adaptive coping, and (3) avoiding relapse by resuming the change efforts after a lapse. Two distinct and complementary delivery strategies were used, including a day-to-day tunnel approach in combination with just-in-time therapy. The tunnel strategy was in accordance with the need for continuous self-regulation and it functions as a platform from which just-in-time therapy was launched. Just-in-time therapy was used to support coping during critical moments, and started when the client reports either low self-efficacy or that they were drinking above target levels

  8. Biomimetic hydroxyapatite used in the treatment of periodontal intrabony pockets: clinical and radiological analysis

    PubMed Central

    Figliuzzi, Michele Mario; Giudice, Amerigo; Pileggi, Settimia; Scordamaglia, Francesco; Marrelli, Massimo; Tatullo, Marco; Fortunato, Leonzio

    2016-01-01

    Summary Aim Hydroxyapatite (PA) has a chemical composition and physical structure very similar to natural bone and therefore it has been considered to be the ideal biomaterial able to ensure a biomimetic scaffold to use in bone tissue engineering. The aim of this study is to clinically test hydroxyapatite used as osteoconductive biomaterial in the treatment of periodontal bone defects. Clinical and radiological evaluations were conducted at 6, 12 and 18 months after the surgery. Materials and methods Forty patients with 2- and 3-wall intrabony pockets were enrolled in this study. PPD, CAL, radiographic depth (RD) and angular defects were preoperatively measured. After surgery, patients were re-evaluated every 6 months for 18 months. Statistical analyses were also performed to investigate any differences between preoperative and postoperative measurements. Results Paired t-test samples conducted on the data obtained at baseline and 18 months after, showed significant (p<0.01) differences in each measurement performed. The role of preoperative RD was demonstrated to be a significant key factor (p<0.01). A relevant correlation between preoperative PPD and CAL gain was also found. Conclusions Within the limitations of this study, the absence of anatomical variables, except the morphology of the bone defect, emphasizes the importance of the proper surgical approach and the graft material used. PMID:27486507

  9. Effect of Preoperative Radiological Treatment of Hepatocellular Carcinoma Before Liver Transplantation: A Retrospective Study

    SciTech Connect

    Veltri, Andrea; Grosso, Maurizio; Martina, Maria C.; Ciancio, Alessia; David, Ezio; Salizzoni, Mauro; Soldano, Umberto; Galli, Joseph; Fava, Cesare

    1998-09-15

    Purpose: To assess the results of radiological treatment of patients with hepatocellular carcinoma (HCC) performed before orthotopic liver transplantation (OLT). Methods: Sixty-two transplanted patients with a total of 89 HCC nodules were studied; 50 lesions in 38 patients had been treated prior to OLT with transcatheter arterial chemoembolization (TACE; n= 29), percutaneous ethanol injection (PEI; n= 10), or combined therapy (TACE + PEI; n= 11). The induced necrosis was pathologically evaluated. The recurrence rate after OLT in the treated group of patients (n= 38) was compared with that in the non-treated group (n= 24). Results: After TACE, necrosis was complete in 7 of 29 lesions (24.1%), partial in 11 of 29 (37.9%), and absent in 11 of 29 (37.9%). After PEI, necrosis was complete in 8 of 10 lesions (80%), and partial in 2 of 10 (20%). Using combined therapy, necrosis was complete in 11 of 11 lesions (100%). Four of 24 untreated and 4 of 38 treated patients did not survive OLT from causes not related to the HCC; 3 of 20 non-treated patients (15%) and 4 of 34 treated patients (11.8%) had post-OLT recurrence (these last four patients had undergone only TACE and did not have tumor necrosis at pathological examination). Conclusion: TACE of HCC prior to OLT had no influence on the recurrence rate. PEI and combined therapy (TACE + PEI) may be recommended in patients awaiting OLT.

  10. Alzheimer's disease and language impairments: social intervention and medical treatment.

    PubMed

    Klimova, Blanka; Maresova, Petra; Valis, Martin; Hort, Jakub; Kuca, Kamil

    2015-01-01

    Communication is very important for people to be successfully integrated into social environment and make and maintain relationship. Particularly, language difficulties lead to social exclusion of the people affected with Alzheimer's disease (AD) and contribute to a significant decrease in the quality of their life and also have a big impact on their family members who in most cases become their caregivers who need to communicate with their loved ones in order to meet their needs. Therefore, the goal of this study is to describe language impairments in the individual phases of AD and discuss their improvement with respect to AD on the basis of literature review. The authors of this article use traditional research methods in order to achieve the goal set mentioned earlier. First, a method of literature review of available sources describing language impairments in the individual phases of AD is exploited. Second, to show how informal caregivers and relevant drugs can successfully intervene in the improvement of these language impairments, a method of comparison of different research studies exploring such social intervention and medical treatment is used. PMID:26346123

  11. Proposed method to calculate FRMAC intervention levels for the assessment of radiologically contaminated food and comparison of the proposed method to the U.S. FDA's method to calculate derived intervention levels

    SciTech Connect

    Kraus, Terrence D.; Hunt, Brian D.

    2014-02-01

    This report reviews the method recommended by the U.S. Food and Drug Administration for calculating Derived Intervention Levels (DILs) and identifies potential improvements to the DIL calculation method to support more accurate ingestion pathway analyses and protective action decisions. Further, this report proposes an alternate method for use by the Federal Emergency Radiological Assessment Center (FRMAC) to calculate FRMAC Intervention Levels (FILs). The default approach of the FRMAC during an emergency response is to use the FDA recommended methods. However, FRMAC recommends implementing the FIL method because we believe it to be more technically accurate. FRMAC will only implement the FIL method when approved by the FDA representative on the Federal Advisory Team for Environment, Food, and Health.

  12. Treatment Integrity: An Essential--But Often Forgotten--Component of School-Based Interventions

    ERIC Educational Resources Information Center

    Lane, Kathleen L.; Bocian, Kathleen M.; MacMillan, Donald L.; Gresham, Frank M.

    2004-01-01

    In this article, the authors introduce the construct of treatment integrity and illustrate the importance of treatment integrity as it relates to school-based intervention. Specifically, the authors address the following questions: What is treatment integrity? Why is it important to assess treatment integrity? How can treatment integrity be…

  13. Image-guided high-dose-rate brachytherapy: preliminary outcomes and toxicity of a joint interventional radiology and radiation oncology technique for achieving local control in challenging cases

    PubMed Central

    Kishan, Amar U.; Lee, Edward W.; McWilliams, Justin; Lu, David; Genshaft, Scott; Motamedi, Kambiz; Demanes, D. Jeffrey; Park, Sang June; Hagio, Mary Ann; Wang, Pin-Chieh

    2015-01-01

    Purpose To determine the ability of image-guided high-dose-rate brachytherapy (IG-HDR) to provide local control (LC) of lesions in non-traditional locations for patients with heavily pre-treated malignancies. Material and methods This retrospective series included 18 patients treated between 2012 and 2014 with IG-HDR, either in combination with external beam radiotherapy (EBRT; n = 9) or as monotherapy (n = 9). Lesions were located in the pelvis (n = 5), extremity (n = 2), abdomen/retroperitoneum (n = 9), and head/neck (n = 2). All cases were performed in conjunction between interventional radiology and radiation oncology. Toxicity was graded based on CTCAE v4.0 and local failure was determined by RECIST criteria. Kaplan-Meier analysis was performed for LC and overall survival. Results The median follow-up was 11.9 months. Two patients had localized disease at presentation; the remainder had recurrent and/or metastatic disease. Seven patients had prior EBRT, with a median equivalent dose in 2 Gy fractions (EQD2) of 47.0 Gy. The median total EQD2s were 34 Gy and 60.9 Gy for patients treated with monotherapy or combination therapy, respectively. Image-guided high-dose rate brachytherapy was delivered in one to six fractions. Six patients had local failures at a median interval of 5.27 months with a one-year LC rate of 59.3% and a one-year overall survival of 40.7%. Six patients died from their disease at a median interval of 6.85 months from the end of treatment. There were no grade ≥ 3 acute toxicities but two patients had serious long term toxicities. Conclusions We demonstrate a good one year LC rate of nearly 60%, and a favorable toxicity profile when utilizing IG-HDR to deliver high doses of radiation with high precision into targets not readily accessible by other forms of local therapy. These preliminary results suggest that further studies utilizing this approach may be considered for patients with difficult to access lesions that require LC. PMID:26622237

  14. Interventions for the treatment of borderline ovarian tumours

    PubMed Central

    Faluyi, Olusola; Mackean, Melanie; Gourley, Charlie; Bryant, Andrew; Dickinson, Heather O

    2014-01-01

    Background The safety of conservative surgery and the benefit of additional interventions after surgery for borderline ovarian tumours are unknown. Objectives To evaluate the benefits and harm of different treatment modalities offered for borderline ovarian tumours. Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register to 2009, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 4), MEDLINE and EMBASE to 2009. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies. Selection criteria Randomised controlled trials (RCTs) that compared different interventions in adult women diagnosed with borderline ovarian tumours of any histological variant. Data collection and analysis Two review authors independently abstracted data and assessed risk of bias. Main results We identified seven RCTs that enrolled 372 women. We could not pool results of trials as the treatment comparisons differed. Six RCTs (n = 340) conducted over 15 years ago, evaluated adjuvant therapy (chemotherapy, pelvic external irradiation or intraperitoneal radioactive isotope therapy) after radical surgery; over 87% of participants had Stage I tumours. Most participants were followed up for over 10 years. Overall and recurrence-free survival were similar between both arms of these trials, except that one trial (n = 66) showed a significantly lower survival (P = 0.03) in women who received chemotherapy (thio-TEPA). Adverse effects of treatment were incompletely reported and all six trials were at high risk of bias. One further trial (n = 32) that recruited participants with bilateral serous tumours who were wishing fertility preservation, revealed a significantly increased chance of pregnancy (hazard ratio (HR) = 3.3, 95% CI 1.4 to 8.0) but non-significantly earlier disease recurrence (HR = 1.5, 95% CI 0.6 to 3.8) in the women who had ultra-conservative surgery (bilateral

  15. Treatment Effects of a Relationship-Strengthening Intervention for Economically Disadvantaged New Parents

    ERIC Educational Resources Information Center

    Charles, Pajarita; Jones, Anne; Guo, Shenyang

    2014-01-01

    Objective: The purpose of the present study was to evaluate the treatment effects of a relationship skills and family strengthening intervention for n = 726 high-risk, disadvantaged new parents. Method: Hierarchical linear modeling and regression models were used to assess intervention treatment effects. These findings were subsequently verified…

  16. Treatment Integrity in a Home-Based Pre-Reading Intervention Programme

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan; Veldkamp, Esther

    2006-01-01

    Treatment integrity is an underexposed issue in the phonological awareness intervention research. The current study assessed the integrity of treatment of the families (N = 32) participating in the experimental condition of a home-based pre-reading intervention study. The participating kindergartners were all genetically at risk for developing…

  17. Behavioral Interventions in the Treatment of Pathological Gambling: A Review of Activity Scheduling and Desensitization

    ERIC Educational Resources Information Center

    Dowling, Nicki; Jackson, Alun C.; Thomas, Shane A.

    2008-01-01

    Cognitive and behavioral interventions have been cautiously recommended as "best practice" in the treatment of pathological gambling. Behavioral interventions, using a range of techniques, have been the most commonly evaluated approach to the psychological treatment of pathological gambling. The recent literature evaluating behavioral treatments…

  18. Treatment of child abuse: a review of the behavioral interventions.

    PubMed

    Isaacs, C D

    1982-01-01

    Child abuse has probably existed as a social problem as long as parents and children have lived under the same roof, and in recent years it has received tremendous attention. Most of the research has focused on etiology rather than treatment, leaving large gaps in our knowledge about remediating abuse. Behavioral scientists have only begun to formulate a conceptual framework from which to work. Many theoretical questions are yet unanswered, particularly the question of what constitutes abuse. Burgess (1978) believes that conceptual problems exist because abuse falls along a continuum of parent-child relationships--a continuum that at one end might include verbal punishment (e.g., threats, ridicule) or milder forms of physical punishment (e.g., slap on the hand, spanking), and at the other end include extreme forms of physical punishment that exceed community mores (for example, hitting a child with a closed fist, scalding a child in hot water, torturing or killing a child). Thus, the question-- where does discipline stop and abuse begin?-- faces every researcher who must operationally define abuse. Identifying the consequences of abuse in a child's development is another area of inquiry that remains untreated. Most of the literature is filled with the subjective impressions of professionals speculating that abused children become the juvenile delinquents and the child abusers of the future; however, as yet no longitudinal studies have been conducted that compare the developmental outcomes of abused and non-abused children from early childhood to later adulthood. What if there were no differences? How might this influence our approaches to the treatment of abuse? Answers to these and other questions will take years of study. Increased awareness of the problem of child abuse has led to greater efforts to remediate the problem. Treatment efforts with abusive families are still in the initial stages, but, undoubtedly, information from these early programs can be the

  19. Psychological Interventions with AIDS and HIV: Prevention and Treatment.

    ERIC Educational Resources Information Center

    Kelly, Jeffrey A.; Murphy, Debra A.

    1992-01-01

    Notes that research to date has yielded important findings for primary prevention efforts for Acquired Immune Deficiency Syndrome (AIDS) and has identified psychological dimensions relevant to mental health interventions for persons with human immunodeficiency virus (HIV). Sees pressing need for more systematic intervention outcome research in…

  20. Test Driving Interventions to Increase Treatment Integrity and Student Outcomes

    ERIC Educational Resources Information Center

    Dart, Evan H.; Cook, Clayton R.; Collins, Tai A.; Gresham, Frank M.; Chenier, Jeffrey S.

    2012-01-01

    Behavioral consultation has been shown to be an effective way for school psychologists to work with teachers in implementing interventions for student problem behavior. Some teachers are resistant to the behavioral consultation process and thereby fail to implement agreed upon interventions with integrity, which is problematic considering the…

  1. Treatment Approach, Autism Severity and Intervention Outcomes in Young Children

    ERIC Educational Resources Information Center

    Zachor, Ditza A.; Itzchak, Esther Ben

    2010-01-01

    The current study examined the relation between autism severity at baseline, type of intervention employed and outcomes in young children with autism spectrum disorder (ASD). Seventy-eight children with ASD, aged 15-35 months (M=25.4, SD=4.2), received either applied behavioral analysis (ABA) or integration of several intervention approaches…

  2. Gastric variceal bleeding precipitated by a mycotic splenic arteriovenous fistula in a cirrhotic patient: radiological diagnosis and endovascular treatment.

    PubMed

    Tun, Than Naing; Punamiya, Sundeep

    2014-11-01

    Splenic arteriovenous fistula (SAVF) is an unusual cause of portal hypertension, and is rarely associated with an infective aetiology. It is often difficult to identify SAVF clinically, and thus, radiological modalities are invariably required for diagnosis and treatment. We herein describe a case of SAVF occurring in a patient with compensated cirrhosis as a sequel to salmonella gastroenteritis, and presenting with acute gastric variceal bleeding. Selective transcatheter embolisation of the splenic artery was effective in controlling bleeding. PMID:25631980

  3. Facilitating outpatient treatment entry following detoxification for injection drug use: a multisite test of three interventions.

    PubMed

    Campbell, Barbara K; Fuller, Bret E; Lee, Eun Sul; Tillotson, Carrie; Woelfel, Tiffany; Jenkins, Lindsay; Robinson, James; Booth, Robert E; McCarty, Dennis

    2009-06-01

    A multisite, randomized trial within the National Drug Abuse Treatment Clinical Trials Network (CTN) was conducted to test 3 interventions to enhance treatment initiation following detoxification: (a) a single session, therapeutic alliance intervention (TA) added to usual treatment; (b) a 2-session, counseling and education, HIV/HCV risk reduction intervention (C&E), added to usual treatment; and (c) treatment as usual (TAU) only. Injection drug users (n=632) enrolled in residential detoxification at 8 community treatment programs were randomized to 1 of the 3 study conditions. TA participants reported entering outpatient treatment sooner and in greater numbers than TAU participants. Reported treatment entry for C&E fell between TA and TAU with no significant differences between C&E and the other conditions. There were no differences among the interventions in retention, as measured by weeks of outpatient treatment for all participants who reported treatment entry. Alliance building interventions appear to be effective in facilitating transfer from detoxification to outpatient treatment, but additional treatment engagement interventions may be necessary to improve retention. PMID:19586142

  4. Effectiveness of an HIV risk reduction counseling intervention for out-of-treatment drug users.

    PubMed

    Kotranski, L; Semaan, S; Collier, K; Lauby, J; Halbert, J; Feighan, K

    1998-02-01

    This study examined and compared the effectiveness of two counseling interventions designed to reduce the HIV drug and sexual risk behaviors of 684 out-of-treatment drug users recruited from South Philadelphia, PA. All study participants received a standard intervention and one half were randomly assigned to also receive the enhanced intervention. The standard intervention provided HIV risk reduction education, HIV testing with pretest and posttest counseling, and training in condom use and needle cleaning. The enhanced intervention provided additional information on STD risk reduction. Both interventions were effective in influencing behavior change between baseline and 6-month follow-up. A higher proportion of persons reduced their drug risk behaviors compared to their sexual risk behaviors. As sexual risk behaviors are more resistant to change, there is a need for tailored interventions that target out-of-treatment drug users. PMID:9505096

  5. Organizational-skills interventions in the treatment of ADHD.

    PubMed

    Langberg, Joshua M; Epstein, Jeffery N; Graham, Amanda J

    2008-10-01

    Children with attention-deficit/hyperactivity disorder (ADHD) often experience problems with temporal and materials organization. These difficulties remain prominent throughout development. For children, organizational problems are most apparent in the school setting and result in impairments such as lost and forgotten homework assignments and inadequate planning for tests. Temporal aspects of organization tend to be most salient for adults with ADHD and manifest as procrastination and missed appointments and deadlines. Skills and strategy training interventions have been developed to address the organizational problems of children and adults with ADHD. Patients are taught systems for managing their time and materials more effectively. Contingency management is often used in conjunction with organizational skills training to promote the use of organizational skills and their generalization. Organizational skills interventions have been evaluated as standalone interventions and part of multicomponent interventions for children, adolescents and adults with ADHD. These interventions are associated with significant improvements in the organization of materials, homework management, time management and planning. There is also some evidence to suggest that organizational improvements lead to reductions in ADHD symptoms and gains in academic functioning. Additional research using randomized controlled research designs and long-term follow-up evaluation is necessary before organizational interventions may be considered established evidence-based interventions for patients with ADHD. PMID:18928347

  6. SU-C-18C-06: Radiation Dose Reduction in Body Interventional Radiology: Clinical Results Utilizing a New Imaging Acquisition and Processing Platform

    SciTech Connect

    Kohlbrenner, R; Kolli, KP; Taylor, A; Kohi, M; Fidelman, N; LaBerge, J; Kerlan, R; Gould, R

    2014-06-01

    Purpose: To quantify the patient radiation dose reduction achieved during transarterial chemoembolization (TACE) procedures performed in a body interventional radiology suite equipped with the Philips Allura Clarity imaging acquisition and processing platform, compared to TACE procedures performed in the same suite equipped with the Philips Allura Xper platform. Methods: Total fluoroscopy time, cumulative dose area product, and cumulative air kerma were recorded for the first 25 TACE procedures performed to treat hepatocellular carcinoma (HCC) in a Philips body interventional radiology suite equipped with Philips Allura Clarity. The same data were collected for the prior 85 TACE procedures performed to treat HCC in the same suite equipped with Philips Allura Xper. Mean values from these cohorts were compared using two-tailed t tests. Results: Following installation of the Philips Allura Clarity platform, a 42.8% reduction in mean cumulative dose area product (3033.2 versus 1733.6 mGycm∧2, p < 0.0001) and a 31.2% reduction in mean cumulative air kerma (1445.4 versus 994.2 mGy, p < 0.001) was achieved compared to similar procedures performed in the same suite equipped with the Philips Allura Xper platform. Mean total fluoroscopy time was not significantly different between the two cohorts (1679.3 versus 1791.3 seconds, p = 0.41). Conclusion: This study demonstrates a significant patient radiation dose reduction during TACE procedures performed to treat HCC after a body interventional radiology suite was converted to the Philips Allura Clarity platform from the Philips Allura Xper platform. Future work will focus on evaluation of patient dose reduction in a larger cohort of patients across a broader range of procedures and in specific populations, including obese patients and pediatric patients, and comparison of image quality between the two platforms. Funding for this study was provided by Philips Healthcare, with 5% salary support provided to authors K. Pallav

  7. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Short Version).

    PubMed

    Dietrich, C F; Lorentzen, T; Appelbaum, L; Buscarini, E; Cantisani, V; Correas, J M; Cui, X W; D'Onofrio, M; Gilja, O H; Hocke, M; Ignee, A; Jenssen, C; Kabaalioğlu, A; Leen, E; Nicolau, C; Nolsøe, C P; Radzina, M; Serra, C; Sidhu, P S; Sparchez, Z; Piscaglia, F

    2016-02-01

    The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presented covering indications, contraindications, safety and efficacy of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (short version; a long version is published online). PMID:26871408

  8. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Long Version).

    PubMed

    Dietrich, C F; Lorentzen, T; Appelbaum, L; Buscarini, E; Cantisani, V; Correas, J M; Cui, X W; D'Onofrio, M; Gilja, O H; Hocke, M; Ignee, A; Jenssen, C; Kabaalioğlu, A; Leen, E; Nicolau, C; Nolsøe, C P; Radzina, M; Serra, C; Sidhu, P S; Sparchez, Z; Piscaglia, F

    2016-02-01

    The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound (INVUS) assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presented covering indications, contraindications, and safe and effective performance of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (long version). PMID:26670019

  9. Judging Outcomes in Psychosocial Interventions for Dementia Caregivers: The Problem of Treatment Implementation

    PubMed Central

    Burgio, Louis; Corcoran, Mary; Lichstein, Kenneth L.; Nichols, Linda; Czaja, Sara; Gallagher-Thompson, Dolores; Bourgeois, Michelle; Stevens, Alan; Ory, Marcia; Schulz, Richard

    2008-01-01

    Purpose In published dementia caregiver intervention research, there is widespread failure to measure the level at which treatment was implemented as intended, thereby introducing threats to internal and external validity. The purpose of this article is to discuss the importance of inducing and assessing treatment implementation (TI) strategies in caregiving trials and to propose Lichstein’s TI model as a potential guide. Design and Methods The efforts of a large cooperative research study of caregiving interventions, Resources for Enhancing Alzheimer’s Caregiver Health (REACH), illustrates induction and assessment of the three components of TI: delivery, receipt, and enactment. Results the approaches taken in REACH vary with the intervention protocols and include using treatment manuals, training and certification of interventionists, and continuous monitoring of actual implementation. Implications Investigation and description of treatment process variables allows researchers to understand which aspects of the intervention are responsible for therapeutic change, potentially resulting in development of more efficacious and efficient interventions. PMID:11490046

  10. Occupational exposure to the whole body, extremities and to the eye lens in interventional radiology in Poland, as based on personnel dosimetry records at IFJ PAN

    NASA Astrophysics Data System (ADS)

    Szumska, Agnieszka; Budzanowski, M.; Kopeć, R.

    2014-11-01

    We report results of measurements of Hp(10) from whole body dosimeters (about 53 thousand readouts), of Hp(0.07) from finger ring dosimeters (23 thousand readouts) and of Hp(3) from eye lens dosimeters (100 readouts), issued in the years 2010-12 to over 150 medical departments in Poland which apply X-rays in radiology, interventional radiology (haemodynamic, angiology, cardiac surgery), urology, orthopaedics, electrophysiology or electro-cardiology. In all measurements thermoluminescence detectors (TLD) were used: the well-known standard MTS-N (LiF:Mg, Ti) for whole body and extremity dosimetry, and the high-sensitivity MCP-N (LiF:Mg, Cu, P) for eye lens dosimetry and environmental monitoring. We analysed the data base of the accredited Laboratory of Individual and Environmental Dosimetry (LADIS) at the Institute of Nuclear Physics PAN which offers its dosimetry service to these departments on a regular basis. We found that in the population of radiation workers that studied over the years 2010-2012 in 84%, 87%, and 34% of Hp(10), Hp(0.07) and Hp(3) measurements, respectively, the level of 0.1 mSv/quarter did not exceed, indicating lack of their occupational exposure. In the remaining 16%, 13% and 66% of individual cases, the 0.1 mSv/quarter exceeded, occasionally reaching several hundreds of mSv/quarter.

  11. Effect of Depression on Risky Drinking and Response to a Screening, Brief Intervention, and Referral to Treatment Intervention

    PubMed Central

    Montag, Annika C.; Brodine, Stephanie K.; Alcaraz, John E.; Clapp, John D.; Allison, Matthew A.; Calac, Dan J.; Hull, Andrew D.; Gorman, Jessica R.; Jones, Kenneth Lyons

    2015-01-01

    We assessed alcohol consumption and depression in 234 American Indian/Alaska Native women (aged 18–45 years) in Southern California. Women were randomized to intervention or assessment alone and followed for 6 months (2011–2013). Depression was associated with risk factors for alcohol-exposed pregnancy (AEP). Both treatment groups reduced drinking (P < .001). Depressed, but not nondepressed, women reduced drinking in response to SBIRT above the reduction in response to assessment alone. Screening for depression may assist in allocating women to specific AEP prevention interventions. PMID:26066915

  12. Effect of Depression on Risky Drinking and Response to a Screening, Brief Intervention, and Referral to Treatment Intervention.

    PubMed

    Montag, Annika C; Brodine, Stephanie K; Alcaraz, John E; Clapp, John D; Allison, Matthew A; Calac, Dan J; Hull, Andrew D; Gorman, Jessica R; Jones, Kenneth Lyons; Chambers, Christina D

    2015-08-01

    We assessed alcohol consumption and depression in 234 American Indian/Alaska Native women (aged 18-45 years) in Southern California. Women were randomized to intervention or assessment alone and followed for 6 months (2011-2013). Depression was associated with risk factors for alcohol-exposed pregnancy (AEP). Both treatment groups reduced drinking (P < .001). Depressed, but not nondepressed, women reduced drinking in response to SBIRT above the reduction in response to assessment alone. Screening for depression may assist in allocating women to specific AEP prevention interventions. PMID:26066915

  13. Overcoming Barriers to HIV Treatment Adherence: A Brief Cognitive Behavioral Intervention for HIV-Positive Adults on Antiretroviral Treatment

    PubMed Central

    Olem, David; Sharp, Kelly M.; Taylor, Jonelle M.; Johnson, Mallory O.

    2014-01-01

    Maximizing HIV treatment adherence is critical in efforts to optimize health outcomes and to prevent further HIV transmission. The Balance Project intervention uses cognitive behavioral approaches to improve antiretroviral medication adherence through promoting adaptive coping with medication side effect and distress related to HIV. This 5-session intervention has been documented to prevent nonadherence among persons living with HIV who experience high levels of distress associated with their antiretroviral medication side effects. We describe the theoretical underpinnings of the intervention, provide details of the training and session protocols with a case example, and discuss implications for future applications of the intervention in both research and clinical settings. PMID:24855332

  14. Effects of embolic agents with different particle sizes on interventional treatment of uterine fibroids

    PubMed Central

    Wang, Xigong; Zhang, Zhengfu; Pan, Jirong; Zhang, Weizhong

    2015-01-01

    Objective: To compare the effects of embolic agents with different particle sizes on interventional treatment of uterine fibroids (UFs). Methods: One-hundred and thirty patients with UFs were divided into a treatment group and a control group (n=65) by random draw. All patients were treated by uterine artery embolization, with the treatment group using 200 μm polyvinyl alcohol (PVA) particles and the control group using 500 μm PVA particles. Results: The success rate of embolization was 100%. After intervention, the treatment group was significantly less prone to complications such as lower abdominal pain, fever, nausea, vomiting and bleeding than the control group (P<0.05). The follicle-stimulating hormone levels of both groups were similar before and after intervention, and there were also no significant inter-group differences. The uterine and UF volumes of both groups significantly decreased six months after intervention (P<0.05), and those of the treatment group were significantly lower (P<0.05). The two groups had similar physical function, role-physical, bodily pain and general health scores before intervention, but the treatment group scored significantly higher than the control group did six months after intervention (P<0.05). Conclusion: Interventional embolization can well treat UFs, without apparently affecting ovarian functions. Small-sized PVA particles can improve the quality of life by shrinking the uterus and UFs as well as by reducing the risks of complications. PMID:26870122

  15. Intervention Efficacy in Engaging Black and White Veterans with Post-traumatic Stress Disorder into Treatment.

    PubMed

    Stecker, Tracy; Adams, Leslie; Carpenter-Song, Elizabeth; Nicholson, Joanne; Streltzov, Nicholas; Xie, Haiyi

    2016-10-01

    This study examined racial differences among Black and White Veterans who screened positive for post-traumatic stress disorder (PTSD) but were not in PTSD treatment and were participating in an intervention trial. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans with PTSD but not yet engaged in treatment were recruited and randomly assigned to control or intervention conditions. Intervention participants received a cognitive-behavioral engagement intervention by phone. All participants received follow-up calls to assess symptoms and utilization of treatment. Black and White participants were compared to assess differences in treatment utilization. Intervention session notes were analyzed qualitatively for explanatory themes. Participants of both races who received the intervention had higher PTSD treatment initiation than their respective control groups (Blacks: 85% vs. 58% and Whites: 53% vs. 45%, respectively). However, Blacks completed fewer PTSD treatment sessions compared to Whites overall (M = 2.06 [SD = 2.3] vs. M = 3.77 [SD = 9.9]; p < .05). Within the intervention condition, Blacks were significantly more likely to initiate treatment (odds ratio = 2.3, p < .04), and had a greater reduction in PTSD symptom compared to Whites (PTSD Checklist - Military Version [PCL] scores: 12.75 vs. 9.68). Based on qualitative analysis of intervention session notes, themes emerged that may suggest cultural differences involving social connection, attitudes towards treatment, and the desire to appear "okay." Blacks had a higher initiation rate and greater reduction in PTSD severity but completed fewer treatment sessions than Whites. These are promising results with respect to other studies which demonstrate that Black Veterans are less likely to seek treatment for PTSD. PMID:27210830

  16. Treatment Integrity of Interventions with Children in the School Psychology Literature from 1995 to 2008

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Gritter, Katie L.; Dobey, Lisa M.

    2011-01-01

    Increased accountability in education has resulted in a focus on implementing interventions with strong empirical support. Both student outcome and treatment integrity data are needed to draw valid conclusions about intervention effectiveness. Reviews of the literature in other fields (e.g., applied behavior analysis, prevention science) suggest…

  17. A Meta-Analysis of Smoking Cessation Interventions With Individuals in Substance Abuse Treatment or Recovery

    ERIC Educational Resources Information Center

    Prochaska, Judith J.; Delucchi, Kevin; Hall, Sharon M.

    2004-01-01

    This meta-analysis examined outcomes of smoking cessation interventions evaluated in 19 randomized controlled trials with individuals in current addictions treatment or recovery. Smoking and substance use outcomes at posttreatment and long-term follow-up (? 6 months) were summarized with random effects models. Intervention effects for smoking…

  18. Calibration of an eye lens dosemeter in terms of Hp(3) to be used in interventional radiology

    NASA Astrophysics Data System (ADS)

    Borges, F. L. S.; Guimarães, M. C.; Da Silva, T. A.; Nogueira Tavares, M. S.

    2014-11-01

    Recently, the International Commission on Radiological Protection has reviewed epidemiological evidences suggesting that there were tissue reaction effects in the eye lens below the previously considered absorbed dose threshold. A new statement related to the eye lens was issued that changed the absorbed dose threshold and reduced the dose limits for occupationally exposed persons. As consequence, some planned exposures require eye lens dosimetry and a debate was raised on the adequacy of the dosimetric quantity and on its method of measurement. The aim of this work was to study the methodology for calibrating the EYE-DTM holder with a TLD-100H Harshaw chip detector and to determine its angular and energy dependences in terms of personal dose equivalent, Hp(3).

  19. Cognitive Counselling Intervention: Treatment Effectiveness in an Italian University Centre

    ERIC Educational Resources Information Center

    Strepparava, Maria Grazia; Bani, Marco; Zorzi, Federico; Corrias, Deborah; Dolce, Rossella; Rezzonico, Giorgio

    2016-01-01

    Offering counselling to students is increasingly considered as a key academic service. However, the reduction of resources allocated to Italian universities emphasises the need to assess the quality of interventions. This paper presents data reporting the effectiveness of a university counselling service. A sample of 45 undergraduate students…

  20. Musical "Tune-Ups" for Couples: Brief Treatment Interventions

    ERIC Educational Resources Information Center

    Duba, Jill D.; Roseman, Christopher

    2012-01-01

    Some couples seek counseling to address warning signs. They may not be facing a relationship crisis but may be more concerned about where they are headed. Hence, a marriage makeover may not necessarily be needed, but instead couples in counseling may benefit from something rejuvenating. In such cases, brief interventions or techniques may be…

  1. Functional and radiological results of open and closed treatment of intracapsular (diacapitular) condylar fractures of the mandible.

    PubMed

    Hlawitschka, M; Loukota, R; Eckelt, U

    2005-09-01

    The study was performed to evaluate and compare the results of open and closed treatments of diacapitular fractures of the mandible. Following open reduction and internal fixation (ORIF) 14 patients with 15 displaced condylar fractures, which had caused a shortening of the mandibular ramus, were examined clinically (Helkimo index), radiologically (Orthopantomogram, Clementschitsch [reversed Towne's] view, Submentovertex view) and axiographically (CARDIAX). These findings were compared to a group of 29 patients with 34 similar condylar fractures which had been treated using closed techniques. Following ORIF patients showed better radiological results with regard to the mandibular ramus height, resorption and pathological changes to the condyle, compared to the patient group after closed functional treatment. In both groups some signs of dysfunction persisted, although there were slightly better results in the ORIF group. In 30% of the closed treatment group, lateral deviation during mouth opening, crepitus and occlusal disturbances were noted. No cases of occlusal disturbance were observed in the ORIF group. The axiographic examinations revealed a significant limitation of movement of the fractured condyle in both groups. However, after open treatment, the temporomandibular joint displayed significantly less irregularities in the condylar paths. In cases of complex reconstruction of the mandibular condyle, ORIF appears to improve the function of fractured condyles, when combined with a postoperative therapeutic exercise regime. PMID:16053886

  2. Primary Chronic Osteomyelitis of the Jaws in Children: An Update on Pathophysiology, Radiological Findings, Treatment Strategies, and Prospective Analysis of Two Cases

    PubMed Central

    Berglund, Caroline; Ekströmer, Karin; Abtahi, Jahan

    2015-01-01

    Objective. Primary chronic osteomyelitis (PCO) of the jaws in children is associated with pain, trismus, and swelling. In children, temporomandibular joint involvement is rare and few studies have been published due to the relatively low incidence. This paper presents two cases of mandibular PCO in children with the involvement of the collum mandibulae. In addition, a review of the literature regarding demographic data, histological, radiological, and laboratory findings, and treatment strategies of PCO was also performed. Material and Methods. Prospective analyses of two PCO cases. A PubMed search was used and the articles were sorted according to their corresponding key area of focus. Results. Review of the literature revealed twenty-four cases of PCO with two cases of mandibular condyle involvement. The mean age was 18 years; the male to female ratio was 1 : 3. Most of the patients were treated with anti-inflammatory drugs in combination with decortication. Clinical recurrence was seen in 7 cases. Conclusion. A combination of anti-inflammatory drugs and surgical intervention appears to be the first choice of treatment. However, surgical removal of necrotic tissue adjacent to collum mandibulae has its limitations in children. Further investigations are of utmost importance in order to increase our knowledge and understanding of this disease. PMID:26435856

  3. Developing and implementing a positive behavioral reinforcement intervention in prison-based drug treatment: Project BRITE.

    PubMed

    Burdon, William M; St De Lore, Jef; Prendergast, Michael L

    2011-09-01

    Within prison settings, the reliance on punishment for controlling inappropriate or noncompliant behavior is self-evident. What is not so evident is the similarity between this reliance on punishment and the use of positive reinforcements to increase desired behaviors. However, seldom do inmates receive positive reinforcement for engaging in prosocial behaviors or, for inmates receiving drug treatment, behaviors that are consistent with or support their recovery. This study provides an overview of the development and implementation of a positive behavioral reinforcement intervention in male and female prison-based drug treatment programs. The active involvement of institutional staff, treatment staff, and inmates enrolled in the treatment programs in the development of the intervention along with the successful branding of the intervention were effective at promoting support and participation. However, these factors may also have ultimately impacted the ability of the randomized design to reliably demonstrate the effectiveness of the intervention. PMID:22185038

  4. Treatment of PTSD in older adults: Do cognitive-behavioral interventions remain viable?

    PubMed Central

    Clapp, Joshua D.; Beck, J. Gayle

    2011-01-01

    The literature examining trauma among older adults is growing, but little is known about the efficacy of empirically supported interventions for PTSD within this population. Clinical writing on this topic often implies that cognitive-behavioral treatments may be ineffective or inappropriate for older adults with PTSD given physical and/or cognitive vulnerabilities. Review of the limited research in this area, however, provides little support for the claim that cognitive-behavioral interventions are ineffective in treating PTSD among the elderly. In an effort to explicate specific issues related to treatment process and outcome among older survivors of trauma, a case series is presented outlining the treatment of three older adults within the context of a structured, cognitive-behavioral group intervention. Observations from this case series suggests that cognitive-behavioral interventions continue to be useful in treating PTSD with this population. Specific treatment issues unique to older adults are explored and recommendations for future research are discussed. PMID:22383863

  5. Angina Treatment -- Medical Versus Interventional Therapy (Beyond the Basics)

    MedlinePlus

    ... stop the progression of the disease and thereby prolong life. MEDICAL ANGINA TREATMENT — Medical treatment for coronary ... be recommended. Stenting has not been shown to prolong life compared with medical therapy. It is used ...

  6. Treatment Compliance in Group Therapy: Issues and Interventions

    ERIC Educational Resources Information Center

    Hunnicutt Hollenbaugh, Karen Michelle

    2011-01-01

    In this manuscript, research on treatment compliance and dropout in group therapy is reviewed. A number of variables found to be related to the compliance and dropout are identified including client characteristics, treatment characteristics, and therapist perceptions and behavior. Implications of these results for increasing treatment compliance…

  7. Increasing the treatment of hypertension through primary intervention

    SciTech Connect

    Fair, M.D.

    1994-12-31

    South Carolina is one of the leading states in stroke mortality. Hypertension is one of the major risk factors that lead to strokes. Unfortunately, many people who are hypertensive do not treat their disease properly due to lack of medical education. The specific objectives of this project are to access geographic areas to determine the level of medical representation available; to identify areas of medical needs based on race, income and health status; and, to structure an intervention plan to target areas that are in the highest hypertension at-risk category. The methods used are to identify medical coverage by geographic areas. Health in poor areas is identified and mapped. Implementation of intervention strategies is prioritized based on areas of need.

  8. Combined radiologic and endoscopic treatment (using the "rendezvous technique") of a biliary fistula following left hepatectomy.

    PubMed

    Gracient, Aurélien; Rebibo, Lionel; Delcenserie, Richard; Yzet, Thierry; Regimbeau, Jean-Marc

    2016-08-14

    Despite the ongoing decrease in the frequency of complications after hepatectomy, biliary fistulas still occur and are associated with high morbidity and mortality rates. Here, we report on an unusual technique for managing biliary fistula following left hepatectomy in a patient in whom the right posterior segmental duct joined the left hepatic duct. The biliary fistula was treated with a combined radiologic and endoscopic procedure based on the "rendezvous technique". The clinical outcome was good, and reoperation was not required. PMID:27570431

  9. Efficacy of Fifteen Emerging Interventions for the Treatment of Posttraumatic Stress Disorder: A Systematic Review.

    PubMed

    Metcalf, Olivia; Varker, Tracey; Forbes, David; Phelps, Andrea; Dell, Lisa; DiBattista, Ashley; Ralph, Naomi; O'Donnell, Meaghan

    2016-02-01

    Although there is an abundance of novel interventions for the treatment of posttraumatic stress disorder (PTSD), often their efficacy remains unknown. This systematic review assessed the evidence for 15 new or novel interventions for the treatment of PTSD. Studies that investigated changes to PTSD symptoms following the delivery of any 1 of the 15 interventions of interest were identified through systematic literature searches. There were 19 studies that met the inclusion criteria for this study. Eligible studies were assessed against methodological quality criteria and data were extracted. The majority of the 19 studies were of poor quality, hampered by methodological limitations, such as small sample sizes and lack of control group. There were 4 interventions, however, stemming from a mind-body philosophy (acupuncture, emotional freedom technique, mantra-based meditation, and yoga) that had moderate quality evidence from mostly small- to moderate-sized randomized controlled trials. The active components, however, of these promising emerging interventions and how they related to or were distinct from established treatments remain unclear. The majority of emerging interventions for the treatment of PTSD currently have an insufficient level of evidence supporting their efficacy, despite their increasing popularity. Further well-designed controlled trials of emerging interventions for PTSD are required. PMID:26749196

  10. Comparative study of clinico-bacterio-radiological profile and treatment outcome of smokers and nonsmokers suffering from pulmonary tuberculosis

    PubMed Central

    Rathee, Deepti; Arora, Piyush; Meena, Manoj; Sarin, Rohit; Chakraborty, Pitambar; Jaiswal, Anand; Goyal, Mukesh

    2016-01-01

    Introduction: Tuberculosis (TB) is one of the leading causes of death and disease worldwide. Tobacco smoking has been linked as a risk factor for TB. This study was aimed to affirm the strength of association between smoking and pulmonary TB. Materials and Methods: Pulmonary TB patients aged between 18 and 65 years were enrolled and followed-up until treatment completion. Two consecutive sputum smears were examined from each patient for the presence of acid-fast bacilli (AFB) using Ziehl–Neelsen technique. Radiological severity of disease was assessed using guidelines of National TB Association of USA. Sputum smears for AFB were graded for positivity as per WHO Revised National TB Control Programme criteria. Response was determined in terms of sputum conversion at the end of intensive phase and final treatment outcomes. Results: Sputum smear grading of 3+ increased from 12.5% to 68.18% and 66.66% as smoking index increased from <100 to 100–299 and >300 (P < 0.05). In nonsmokers, 79.2% patients had minimal disease while only 4.2% had advanced disease as compared to smokers where 52.4% had moderate disease, 26.2% advanced disease, and 21.4% minimal disease (P < 0.01). Smokers had significantly lower treatment success rate (69%) as against nonsmokers and former smokers (93.8% and 90.9%, respectively, P = 0.001) owing to a higher default rate among smokers (28.5%) than nonsmokers (6.3%) and former smokers (9.1%). Conclusion: Smokers during initial presentation, as well as at end of the treatment demonstrate more radiological findings, cavitary disease, and worse sputum AFB smear grading. Smokers also have a poorer treatment success rate largely due to high percentage of default rate thus suggesting noncompliance as a main confounder to treatment success. Focus needs to be made to reduce defaulters which are more common among smokers. PMID:27625444

  11. Tailored Treatment for HIV+ Persons with Mental Illness: The Intervention Cascade

    PubMed Central

    Blank, Michael; Eisenberg, Marlene

    2013-01-01

    The public health literature demonstrates disturbingly high HIV risk for persons with a serious mental illness (SMI), who are concurrently co-morbid for substance abuse (SA). Many HIV positives have not been tested, and therefore do not know their status, but for individuals who are triply diagnosed, adherence to HIV treatment results in meaningful reductions in viral loads and CD4 counts. Barriers to treatment compliance are reviewed, low threshold/low intensity community based interventions are discussed, and preliminary evidence is presented for the efficacy of the Intervention Cascade, defined as an integrated intervention delivered by specially trained nurses who individualize a treatment compliance intervention in real time as an adaptive response to demand characteristics of the individual. PMID:23673886

  12. Effectiveness of specific intervention on treatment adherence of persons with mental illness: A pilot study

    PubMed Central

    Ahmed, Nurnahar; Gandhi, Sailaxmi; Baruah, Arunjyoti

    2015-01-01

    Context: Treatment nonadherence is one of the major obstacles in recovery even with the availability of a broad range of pharmacological and psychosocial treatments for persons with mental illnesses. Aims: The aim was to evaluate the effectiveness of specific interventions in improvement of treatment adherence of persons with mental illnesses. Settings and Design: A quasi-experimental study was conducted at a tertiary mental health care setting in North-east India. Materials and Methods: Total 30 numbers of patients were selected randomly for the study. Treatment adherence was assessed using the Medication Adherence Rating Scale and a structured Treatment Adherence Checklist. Data were collected before and 1-month after the specific interventions to the patients and their family members. Results: Result showed a significant improvement in the treatment adherence as verbalized by the patient (paired t = 3.973, P = 0.00, df = 29) as well as reported by the family members (paired t = 2.94, P = 0.00, df = 29) following the specific intervention. Conclusion: The study result suggested that specific intervention may be used for a better outcome of treatment for mental illnesses. The findings might be generalized following implementation of the intervention to a larger sample. PMID:26816430

  13. Advances in Substance Abuse Prevention and Treatment Interventions Among Racial, Ethnic, and Sexual Minority Populations

    PubMed Central

    Blume, Arthur W.

    2016-01-01

    Substance abuse research among racial, ethnic, and sexual minority populations historically has lagged behind that conducted with majority samples. However, interesting and potentially important advances in prevention, brief interventions, and treatment have been made in the last few years, at least among some minority populations, such as American Indian youth. New prevention efforts have focused on point-of-sale interventions for alcohol, as well as on family-unit interventions designed with subpopulation cultural values in mind. In addition, previously established evidence-based and culturally relevant interventions are being combined with computer technology. Empirical data support using brief interventions with patients of color in medical settings, capitalizing on teachable and reachable moments during a physical trauma or other health crisis. Finally, use of empirically supported treatment may be helpful, with a caveat that these interventions must appropriately match cultural traditions and respect the values of the clients. More research clearly is needed, especially among certain minority populations in the United States. A greater emphasis should be placed on developing novel, culturally grounded interventions in partnership with communities, in addition to adapting existing mainstream interventions for use by other cultures. PMID:27159811

  14. Advances in Substance Abuse Prevention and Treatment Interventions Among Racial, Ethnic, and Sexual Minority Populations.

    PubMed

    Bloom, Arthur W

    2016-01-01

    Substance abuse research among racial, ethnic, and sexual minority populations historically has lagged behind that conducted with majority samples. However, interesting and potentially important advances in prevention, brief interventions, and treatment have been made in the last few years, at least among some minority populations, such as American Indian youth. New prevention efforts have focused on point-of-sale interventions for alcohol, as well as on family-unit interventions designed with subpopulation cultural values in mind. In addition, previously established evidence-based and culturally relevant interventions are being combined with computer technology. Empirical data support using brief interventions with patients of color in medical settings, capitalizing on teachable and reachable moments during a physical trauma or other health crisis. Finally, use of empirically supported treatment may be helpful, with a caveat that these interventions must appropriately match cultural traditions and respect the values of the clients. More research clearly is needed, especially among certain minority populations in the United States. A greater emphasis should be placed on developing novel, culturally grounded interventions in partnership with communities, in addition to adapting existing mainstream interventions for use by other cultures. PMID:27159811

  15. [Non pharmacological treatment for Alzheimer's disease: comparison between musical and non-musical interventions].

    PubMed

    Narme, Pauline; Tonini, Audrey; Khatir, Fatiha; Schiaratura, Loris; Clément, Sylvain; Samson, Séverine

    2012-06-01

    On account of the limited effectiveness of pharmacological treatments in Alzheimer's disease (AD), there is a growing interest on nonpharmacological treatments, including musical intervention. Despite the large number of studies showing the multiple benefits of music on behavioral, emotional and cognitive disorders of patients with AD, only a few of them used a rigorous method. Finally, the specificity of musical as compared to non-musical and pleasant interventions has rarely been addressed. To investigate this issue, two randomized controlled trials were conducted contrasting the effects of musical to painting (Study 1) or cooking (Study 2) interventions on emotional state of 33 patients with AD. The patients' emotional state was assessed by analyzing professional caregivers' judgments of the patient's mood, then facial expressions and valence of the discourse from short-filmed interviews. In the first study (n=22), each intervention lasted 3 weeks (two sessions per week) and the patients' emotional state was assessed before, during and after intervention periods. After the interventions, the results showed that facial expression, discourse content and mood assessment improved (more positive than negative expressions) as compared to pre-intervention assessment. However, musical intervention was more effective and had longer effects as compared with painting. In the second study (n=11), we further examined long lasting effects of music as compared to cooking by adding evaluation of the patients' emotional state 2 and 4 weeks after the last intervention. Again, music was more effective to improve the emotional state. Music had positive effects that remained significant up to 4 weeks after the intervention, while cooking only produced short-term effect on mood. In both studies, benefits were significant in more than 80% of patients. Taken together, these findings show that music intervention has specific effects on patients' emotional well being, offering promising

  16. A Review of Primary Care-Based Childhood Obesity Prevention and Treatment Interventions

    PubMed Central

    Olson-Bullis, Barbara A.; Bredeson, Dani M.; Hayes, Marcia G.; Sherwood, Nancy E.

    2015-01-01

    Effective obesity prevention and treatment interventions targeting children and their families are needed to help curb the obesity epidemic. Pediatric primary care is a promising setting for these interventions, and a growing number of studies are set in this context. This review aims to identify randomized controlled trials of pediatric primary care-based obesity interventions. A literature search of 3 databases retrieved 2947 publications, of which 2899 publications were excluded after abstract (n=2722) and full-text review (n=177). Forty-eight publications, representing 31 studies, were included in the review. Eight studies demonstrated a significant intervention effect on child weight outcomes (e.g., BMI z-score, weight-for-length percentile). Effective interventions were mainly treatment interventions, and tended to focus on multiple behaviors, contain weight management components, and include monitoring of weight-related behaviors (e.g., dietary intake, physical activity, or sedentary behaviors). Overall, results demonstrate modest support for the efficacy of obesity treatment interventions set in primary care. PMID:26213643

  17. Efficiency of radiation protection equipment in interventional radiology: a systematic Monte Carlo study of eye lens and whole body doses.

    PubMed

    Koukorava, C; Farah, J; Struelens, L; Clairand, I; Donadille, L; Vanhavere, F; Dimitriou, P

    2014-09-01

    Monte Carlo calculations were used to investigate the efficiency of radiation protection equipment in reducing eye and whole body doses during fluoroscopically guided interventional procedures. Eye lens doses were determined considering different models of eyewear with various shapes, sizes and lead thickness. The origin of scattered radiation reaching the eyes was also assessed to explain the variation in the protection efficiency of the different eyewear models with exposure conditions. The work also investigates the variation of eye and whole body doses with ceiling-suspended shields of various shapes and positioning. For all simulations, a broad spectrum of configurations typical for most interventional procedures was considered. Calculations showed that 'wrap around' glasses are the most efficient eyewear models reducing, on average, the dose by 74% and 21% for the left and right eyes respectively. The air gap between the glasses and the eyes was found to be the primary source of scattered radiation reaching the eyes. The ceiling-suspended screens were more efficient when positioned close to the patient's skin and to the x-ray field. With the use of such shields, the Hp(10) values recorded at the collar, chest and waist level and the Hp(3) values for both eyes were reduced on average by 47%, 37%, 20% and 56% respectively. Finally, simulations proved that beam quality and lead thickness have little influence on eye dose while beam projection, the position and head orientation of the operator as well as the distance between the image detector and the patient are key parameters affecting eye and whole body doses. PMID:24938591

  18. [Multifaceted Intervention to Explore the Appropriate Time of Anti-Cancer Treatment Cessation].

    PubMed

    Morita, Tatsuya; Okusaka, Takuji; Shimizu, Chikako

    2016-07-01

    When anti-cancer treatment should be ended is very controversial. This reviewprovides a narrative summary of recent empirical studies about the potential association between the timing of anti-cancer treatment cessation and patient quality of death and dying. Furthermore, we propose a multifaceted intervention model for Japanese oncology patients based on the evidence available. PMID:27431627

  19. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... participation under the Medicaid program that reasonably ensure that— (1) A resident will be transferred...

  20. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... participation under the Medicaid program that reasonably ensure that— (1) A resident will be transferred...

  1. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... participation under the Medicaid program that reasonably ensure that— (1) A resident will be transferred...

  2. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... participation under the Medicaid program that reasonably ensure that— (1) A resident will be transferred...

  3. Treatment Adherence in a Lay Health Adviser Intervention to Treat Tobacco Dependence

    ERIC Educational Resources Information Center

    Hood, N. E.; Ferketich, A. K.; Paskett, E. D.; Wewers, M. E.

    2013-01-01

    Lay health advisers (LHAs) are increasingly used to deliver tobacco dependence treatment, especially with low-socioeconomic status (SES) populations. More information is needed about treatment adherence to help interpret mixed evidence of LHA intervention effectiveness. This study examined adherence to behavioral counseling and nicotine patches in…

  4. Brief Interventions and Brief Therapies for Substance Abuse. Treatment Improvement Protocol (TIP) Series 34.

    ERIC Educational Resources Information Center

    CDM Group, Inc.

    This TIP, on the best practice guidelines for treatment of substance use disorders, was compiled from an increasing body of research literature that documents the effectiveness of brief interventions and therapies in both the mental health and substance abuse treatment fields. It links research to practice by providing counselors with up-to-date…

  5. Effectiveness of Community-Based Early Intervention Based on Pivotal Response Treatment

    ERIC Educational Resources Information Center

    Smith, Isabel M.; Flanagan, Helen E.; Garon, Nancy; Bryson, Susan E.

    2015-01-01

    Preschoolers (n = 118) with autism spectrum disorder (ASD) participated in this prospective effectiveness study of an early intervention program. Treatment entailed parent training and therapist-implemented components, incorporating Pivotal Response Treatment and Positive Behaviour Support. Standardized ability and behavioural measures were…

  6. Identifying Critical Elements of Treatment: Examining the Use of Turn Taking in Autism Intervention

    ERIC Educational Resources Information Center

    Reith, Sarah R.; Stahmer, Aubyn C.; Suhrheinrich, Jessica; Schreibman, Laura; Kennedy, Joanna; Ross, Benjamin

    2014-01-01

    Evidence-based treatments for autism spectrum disorders (ASD) are comprised of components that identify therapist behavior necessary to implement the treatment with integrity. Some components are shared across approaches from diverse theoretical backgrounds. One component included in several interventions that has not been researched in isolation…

  7. Battlefield radiology

    PubMed Central

    Graham, R N J

    2012-01-01

    With the increasing tempo of military conflicts in the last decade, much has been learnt about imaging battlefield casualties in the acute setting. Ultrasound in the form of focused abdominal sonography in trauma (FAST) has proven invaluable in emergency triage of patients for immediate surgery. Multidetector CT allows accurate determination of battlefield trauma injuries. It permits the surgeons and anaesthetists to plan their interventions more thoroughly and to be made aware of clinically occult injuries. There are common injury patterns associated with blast injury, gunshot wounds and blunt trauma. While this body of knowledge is most applicable to the battlefield, there are parallels with peacetime radiology, particularly in terrorist attacks and industrial accidents. This pictorial review is based on the experiences of a UK radiologist deployed in Afghanistan in 2010. PMID:22806621

  8. Impact on Patient Safety and Satisfaction of Implementation of an Outpatient Clinic in Interventional Radiology (IPSIPOLI-Study): A Quasi-Experimental Prospective Study

    SciTech Connect

    Lutjeboer, Jacob Burgmans, Mark Christiaan E-mail: mburgmans@hotmail.com; Chung, Kaman Erkel, Arian Robert van

    2015-06-15

    PurposeInterventional radiology (IR) procedures are associated with high rates of preparation and planning errors. In many centers, pre-procedural consultation and screening of patients is performed by referring physicians. Interventional radiologists have better knowledge about procedure details and risks, but often only get acquainted with the patient in the procedure room. We hypothesized that patient safety (PS) and patient satisfaction (PSAT) in elective IR procedures would improve by implementation of a pre-procedural visit to an outpatient IR clinic.Material and MethodsIRB approval was obtained and informed consent was waived. PS and PSAT were measured in patients undergoing elective IR procedures before (control group; n = 110) and after (experimental group; n = 110) implementation of an outpatient IR clinic. PS was measured as the number of process deviations. PSAT was assessed using a questionnaire measuring Likert scores of three dimensions: interpersonal care aspects, information/communication, and patient participation. Differences in PS and PSAT between the two groups were compared using an independent t test.ResultsThe average number of process deviations per patient was 0.39 in the control group compared to 0.06 in the experimental group (p < 0.001). In 9.1 % patients in the control group, no legal informed consent was obtained compared to 0 % in the experimental group. The mean overall Likert score was significantly higher in the experimental group compared to the control group: 2.68 (SD 0.314) versus 2.48 (SD 0.381) (p < 0.001).ConclusionPS and PSAT improve significantly if patients receive consultation and screening in an IR outpatient clinic prior to elective IR procedures.

  9. Lifestyle interventions for the treatment of non-alcoholic fatty liver disease

    PubMed Central

    Bradford, V; Dillon, JF; Miller, MH

    2014-01-01

    The burden of non-alcoholic fatty liver disease (NAFLD) worldwide is a significant clinical and public health issue, affecting approximately one third of the Western population. This review assesses the effect and impact lifestyle interventions have on the treatment of this common condition. We review studies comparing the effect of calorie restriction and exercise programs, as well as comparison of lifestyle intervention with pharmaceutical intervention. Both calorie restriction and exercise programs are shown to be beneficial in improving features of metabolic syndrome and surrogate markers of NAFLD. The paucity of studies using histological improvement hinders the ability to conclude a benefit on improvement of histological NAFLD, although this is shown in a small number of studies. There is a need to extend the intervention period to show a sustained improvement with intervention as most studies have a follow up period of 12 months of less. PMID:24826079

  10. Alternative treatment of restless legs syndrome: an overview of the evidence for mind-body interventions, lifestyle interventions, and neutraceuticals.

    PubMed

    Bega, Danny; Malkani, Roneil

    2016-01-01

    Conventional pharmacologic treatment of restless legs syndrome (RLS) may be limited in some people. Up to 65% of patients with RLS regularly use alternative practices for symptom relief. We reviewed the current clinical evidence, and we proposed physiologic basis for various alternative practices for RLS including mind-body interventions (conventional exercise, yoga, and acupuncture), non-pharmacologic lifestyle interventions (pneumatic compression devices [PCDs], light therapy, and cognitive-behavioral therapy [CBT]), and neutraceuticals (vitamins, valerian, and Chinese herbs). Based on the available evidence, regular physical activity should be recommended for the treatment of RLS symptoms. Oral iron supplementation should be considered for people with RLS who have low ferritin levels, although criteria to identify probable responders, and optimal formulations and durations of treatment are needed. Supplementation for low levels of vitamins E, C, and D could be considered, although evidence specifically in RLS is limited, and it is unclear if levels should routinely be checked in patients with RLS. Insufficient evidence exists for yoga, acupuncture, PCDs, near-infrared light therapy, CBT, valerian, or Chinese herbs, but preliminary studies on each of these suggest that high-quality randomized controlled trials may be warranted to support and verify the data presented. PMID:26847981

  11. The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments.

    PubMed

    Glisson, Charles; Schoenwald, Sonja K

    2005-12-01

    This paper reviews the implications of organizational and community intervention research for the implementation of effective mental health treatments in usual community practice settings. The paper describes an organizational and community intervention model named ARC for Availability, Responsiveness and Continuity, that was designed to support the improvement of social and mental health services for children. The ARC model incorporates intervention components from organizational development, interorganizational domain development, the diffusion of innovation, and technology transfer that target social, strategic, and technological factors in effective children's services. This paper also describes a current NIMH-funded study that is using the ARC intervention model to support the implementation of an evidence-based treatment, Multisystemic Therapy (MST), for delinquent youth in extremely rural, impoverished communities in the Appalachian Mountains of East Tennessee. PMID:16320107

  12. Improving Adherence to Sertraline Treatment: The Effectiveness of a Patient Education Intervention

    PubMed Central

    Bron, Morgan S.; O'Neill, John; Fogel, Ilan

    2006-01-01

    Background: Previous attempts to improve anti-depressant adherence have achieved mixed results. The current study evaluated the effectiveness of a patient education intervention designed to increase adherence to sertraline treatment. Method: Data from a national pharmacy claims database were used to retrospectively match (along key demographic and clinical variables) consecutive patients prescribed sertraline (N = 1462) who received an educational intervention (Knowing More) between May 1, 2003, and April 30, 2004, with a control group of concurrent sertraline-treated patients who did not receive the intervention (N = 1462). The intervention consisted of 10 newsletters distributed over a 9-month period by mail and e-mail. The intervention and control groups were compared over a 7-month follow-up period on 3 adherence measures: time to discontinuation, days on therapy, and percentage of days on therapy. Results: Cox regression analysis revealed that the time to discontinuation of sertraline (median = 100 days) was significantly greater (p < .0001) for the intervention group compared with the control group (median = 60 days). By the end of the follow-up period, 27% of patients remained on therapy with Knowing More versus 15% of those not enrolled in the compliance program. The mean number of days on therapy was 24.8 days (25.5%) longer for the intervention group compared with the control group (122.5 days for the intervention group versus 97.7 days for the control group). The percentage of days on therapy was 88.2% for the intervention group versus 77.7% for the control group among patients with at least 1 refill prescription (p < .001). Conclusion: The educational compliance intervention, Knowing More, was associated with a significant increase in adherence to antidepressant treatment. PMID:17235385

  13. Interventions for the treatment of stretch marks: a systematic review.

    PubMed

    Liu, Liping; Ma, Hong; Li, Yumei

    2014-08-01

    Stretch marks are a common disfiguring skin condition that can have a deep psychological impact on affected patients. Although there are a variety of treatments available, no consistently effective therapies have been established. In this systematic review, we evaluate 8 randomized controlled trials (RCTs) to assess the efficacy and safety of currently available therapies for the treatment of stretch marks. Due to the limited number of patients and high or unclear risk of bias in the studies included in this assessment, the evidence from this review is insufficient to provide clear guidelines for practice. Therefore, more high-quality RCTs are needed. PMID:25184641

  14. Towards the estimation of the scattered energy spectra reaching the head of the medical staff during interventional radiology: A Monte Carlo simulation study

    NASA Astrophysics Data System (ADS)

    Zagorska, A.; Bliznakova, K.; Buchakliev, Z.

    2015-09-01

    In 2012, the International Commission on Radiological Protection has recommended a reduction of the dose limits to the eye lens for occupational exposure. Recent studies showed that in interventional rooms is possible to reach these limits especially without using protective equipment. The aim of this study was to calculate the scattered energy spectra distribution at the level of the operator's head. For this purpose, an in-house developed Monte Carlo-based computer application was used to design computational phantoms (patient and operator), the acquisition geometry as well as to simulate the photon transport through the designed system. The initial spectra from 70 kV tube voltage and 8 different filtrations were calculated according to the IPEM Report 78. An experimental study was carried out to verify the results from the simulations. The calculated scattered radiation distributions were compared to the initial incident on the patient spectra. Results showed that there is no large difference between the effective energies of the scattered spectra registered in front of the operator's head obtained from simulations of all 8 incident spectra. The results from the experimental study agreed well to simulations as well.

  15. Factors Affecting Treatment Acceptability for Psychostimulant Medication versus Psychoeducational Intervention.

    ERIC Educational Resources Information Center

    Stinnett, Terry A.; Crawford, Stephanie A.; Gillespie, Marci D.; Cruce, Michael K.; Langford, Courtney A.

    2001-01-01

    Examines future teachers' judgments of acceptability for two common treatments for children with the Attention Deficit Hyperactivity Disorder (ADHD) label. In this study, the ADHD label evoked greater expectations of attentional difficulties even when the pattern of functioning was similar to nonlabeled children. On the other hand, children with…

  16. Radiological, physical, and chemical characterization of additional alpha contaminated and mixed low-level waste for treatment at the advanced mixed waste treatment project

    SciTech Connect

    Hutchinson, D.P.

    1995-07-01

    This document provides physical, chemical, and radiological descriptive information for a portion of mixed waste that is potentially available for private sector treatment. The format and contents are designed to provide treatment vendors with preliminary information on the characteristics and properties for additional candidate portions of the Idaho National Engineering Laboratory (INEL) and offsite mixed wastes not covered in the two previous characterization reports for the INEL-stored low-level alpha-contaminated and transuranic wastes. This report defines the waste, provides background information, briefly reviews the requirements of the Federal Facility Compliance Act (P.L. 102-386), and relates the Site Treatment Plans developed under the Federal Facility Compliance Act to the waste streams described herein. Each waste is summarized in a Waste Profile Sheet with text, charts, and tables of waste descriptive information for a particular waste stream. A discussion of the availability and uncertainty of data for these waste streams precedes the characterization descriptions.

  17. Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

    PubMed Central

    Karim, Rushmia; Sykakis, Evripidis; Lightman, Susan; Fraser-Bell, Samantha

    2013-01-01

    Background Uveitic macular edema is the major cause of reduced vision in eyes with uveitis. Objectives To assess the effectiveness of interventions in the treatment of uveitic macular edema. Search strategy Cochrane Central Register of Controlled Trials, Medline, and Embase. There were no language or data restrictions in the search for trials. The databases were last searched on December 1, 2011. Reference lists of included trials were searched. Archives of Ophthalmology, Ophthalmology, Retina, the British Journal of Ophthalmology, and the New England Journal of Medicine were searched for clinical trials and reviews. Selection criteria Participants of any age and sex with any type of uveitic macular edema were included. Early, chronic, refractory, or secondary uveitic macular edema were included. We included trials that compared any interventions of any dose and duration, including comparison with another treatment, sham treatment, or no treatment. Data collection and analysis Best-corrected visual acuity and central macular thickness were the primary outcome measures. Secondary outcome data including adverse effects were collected. Conclusion More results from randomized controlled trials with long follow-up periods are needed for interventions for uveitic macular edema to assist in determining the overall long-term benefit of different treatments. The only intervention with sufficiently robust randomized controlled trials for a meta-analysis was acetazolamide, which was shown to be ineffective in improving vision in eyes with uveitic macular edema, and is clinically now rarely used. Interventions showing promise in this disease include dexamethasone implants, immunomodulatory drugs and anti-vascular endothelial growth-factor agents. When macular edema has become refractory after multiple interventions, pars plana vitrectomy could be considered. The disease pathophysiology is uncertain and the course of disease unpredictable. As there are no clear guidelines from

  18. [Treatment of pulmonary fibrosis. New substances and new interventions].

    PubMed

    Costabel, U; Bonella, F

    2011-12-01

    Idiopathic pulmonary fibrosis is a chronic progressive lung disease with poor prognosis. The IFIGENIA trial showed that antioxidative therapy with N-acetylcysteine versus placebo for patients under treatment with prednisone plus azathioprine significantly slowed the deterioration of pulmonary function after 12 months. A number of other drugs have recently been evaluated in large multicenter placebo-controlled trials. Etanercept, interferon-γ, bosentan, ambrisentan, imatinib, and sildenafil did not show efficacy. The antifibrotic active ingredient pirfenidone is the first drug approved for the treatment of adult patients with mild to moderate idiopathic pulmonary fibrosis in the European Union. Approval was based on the results of 4 randomized, placebo-controlled clinical trials including more than 1,100 patients. Pirfenidone slowed the decline in lung function and reduced the risk of disease progression. Side effects include gastrointestinal discomfort, skin reactions, including photosensitivity, and rarely increased liver enzymes. PMID:22095049

  19. Clinical, radiologic and arthroscopic assessment and treatment of bilateral discoid lateral meniscus.

    PubMed

    Rao, Sharath K; Sripathi Rao, P

    2007-05-01

    The purpose of the study is to evaluate clinical, radiologic and arthroscopic features of bilateral discoid lateral meniscus and to assess the outcome of arthroscopic meniscectomy. Among the 177 arthroscopies performed for discoid lateral meniscus between January 1993 and January 2004, 12 were bilateral. The clinical and radiologic evaluation was done from the records. The type of discoid meniscus, the type of tear was assessed arthroscopically. All patients underwent arthroscopic meniscectomy. Patients were followed up for a minimum period of 2 years. All patients had pain as presenting symptom. Eight patients presented with bilateral knee pain and four patients developed pain in the opposite knee after the affected knee was treated. The classically described thud was present in 11 knees. The widening of the joint space was found in 13 knee radiographs; 14 knees had complete type, nine had incomplete type and one had ring type of discoid lateral meniscus on arthroscopic evaluation; 20 knees involving 10 complete types, all incomplete types and ring type of discoid lateral meniscus showed obvious meniscal tears. The remaining four meniscus showed softening of a portion of the meniscus. Underlying intra-substance tear was visualized arthroscopically in the softened areas on saucerisation. All but one discoid menisci underwent arthroscopic partial central meniscectomy. When followed up for an average period of 32.6 months 19 knees showed excellent results and 5 knees good results. Possibility of bilaterality should be suspected in discoid lateral meniscus. Softening of meniscus denotes underlying intra-substance tear. This finding has not been described in the literature so far. Arthroscopic partial meniscectomy gives good results in symptomatic bilateral discoid meniscus. This to our knowledge is the largest series of bilateral discoid lateral menisci. PMID:17225177

  20. Treatment matching for obesity: identifying mediators of psychosocial and behavioral intervention components

    PubMed Central

    Kiernan, M

    2012-01-01

    In light of the limited long-term success of obesity treatments, it is tempting to consider the elusive goal of ‘treatment matching', in which characteristics of individuals are optimally matched to targeted treatments to improve success. Previous frameworks for treatment matching in obesity have primarily focused on basic physiological characteristics, such as initial degree of overweight, and on treatment intensity, such as stepped-care alternatives (self-help manuals, group support, medication and surgery). Few studies have empirically evaluated the success of these frameworks. Given recent advances in genomics, neuroscience and other fields, both the breadth of domains and combinations of individuals' characteristics that could be used for treatment matching have increased markedly. Although the obesity field seems poised to build on these advances, a crucial challenge remains regarding the treatments themselves. Ultimately, the success of treatment matching will rely on identifying treatment intervention components with well-differentiated and empirically supported mediators, that is, clear insights into how intervention components work. Here we examine the scope of this challenge specifically for the design of efficacious psychosocial and behavioral intervention components, and identify areas for future research. PMID:25089190

  1. Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention.

    PubMed

    Hanefeld, Johanna; Bond, Virginia; Seeley, Janet; Lees, Shelley; Desmond, Nicola

    2015-12-01

    Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population. PMID:26524615

  2. Internet-based adherence interventions for treatment of chronic disorders in adolescents

    PubMed Central

    Bass, Alexandria M; Farhangian, Michael E; Feldman, Steven R

    2015-01-01

    Background Treatment adherence is a ubiquitous challenge in medicine, particularly in the adolescent population with chronic disorders. Web-based adherence interventions may be particularly useful in adolescents, due to their familiarity with and frequent use of the Internet. Objective To review web-based interventions used to improve adherence to medication in adolescent patients with chronic disorders. Methods A PubMed search was performed for full-text, English, clinical trials in adolescents using keywords “adherence” or “compliance”, “Internet” or “web”, and “treatment” from inception until November 2014. Articles were selected if they involved using the Internet to provide support to adolescents to help improve their adherence to treatment, excluding those focused on solely providing medical services through the Internet and articles focusing on preventative care, rather than treatment of an illness. Results Fourteen studies were found concentrating on chronic adolescent disorders. Interventions included online surveys, physician chat lines, monitoring programs, and interactive programs. All interventions experienced either greater improvement in adherence or another disease control measure or no statistically significant difference compared with the control group (in-clinic visits). Limitations Few clinical trials studying web-based interventions to improve adherence in adolescents were found. Due to not having one standard outcome measured in all of the studies, it was also difficult comparing the effectiveness of the interventions. Conclusion Web-based interventions play a role in improving adherence in adolescents with chronic disorders by being more time saving and cost effective compared with in-clinic visits. Further research focusing on adherence interventions using the Internet is necessary to determine the ideal ways of utilizing the Internet to improve adherence in adolescents with chronic disorders. PMID:26113787

  3. Early intervention for preventing posttraumatic stress disorder: an Internet-based virtual reality treatment

    PubMed Central

    Freedman, Sara A.; Dayan, Ehud; Kimelman, Yael Bleich; Weissman, Heidi; Eitan, Renana

    2015-01-01

    Background Posttraumatic stress disorder (PTSD) develops in approximately 20% of people exposed to a traumatic event, and studies have shown that cognitive-behavioral therapy (CBT) is effective as a treatment for chronic PTSD. It has also been shown to prevent PTSD when delivered early after a traumatic event. However, studies have shown that uptake of early treatment is generally low, and therefore, the need to provide interventions through other mediums has been identified. The use of technology may overcome barriers to treatment. Objective This paper describes a randomized controlled trial that will examine an early CBT intervention for PTSD. The treatment incorporates virtual reality (VR) as a method for delivering exposure-based elements of the treatment. The intervention is Internet based, such that the therapist and patient will “meet” in a secure online site. This site will also include multi-media components of the treatment (such as videos, audios, VR) that can be accessed by the patient between sessions. Method Two hundred patients arriving to a Level 1 emergency department following a motor vehicle accident will be randomly assigned to either treatment or control groups. Inclusion criteria are age 18–65, PTSD symptoms 2 weeks posttrauma related to current trauma, no suicidality, no psychosis. Patients will be assessed by telephone by a team blind to the study group, on four occasions: before and after treatment, and 6 and 12 months posttreatment. The primary outcome is PTSD symptoms at follow up. Secondary outcomes include depression and cost effectiveness. Analyses will be on an intention-to-treat basis. Discussion The results will provide more insight into the effects of preventive interventions, in general, and Internet-based early interventions, in particular, on PTSD, in an injured population, during the acute phase after trauma. We will discuss possible strengths and limitations. PMID:25843345

  4. Substance Use Disorders and HIV/AIDS Prevention and Treatment Intervention: Research and Practice Considerations

    PubMed Central

    CAMPBELL, AIMEE N. C.; TROSS, SUSAN; CALSYN, DONALD A.

    2013-01-01

    Social workers are often on the front lines of the HIV/AIDS epidemic – delivering prevention education and interventions, offering or linking individuals to HIV testing, and working to improve treatment access, retention, and adherence, especially among vulnerable populations. Individuals with substance use disorders face additional challenges to reducing sexual and drug risk behaviors, as well as barriers to testing, treatment, and antiretroviral therapy adherence. This paper presents current data on HIV transmission and research evidence on prevention and intervention with substance abusers and highlights how individual social workers can take advantage of this knowledge in practice and through adoption and implementation within organizations. PMID:23731423

  5. [Psychotherapeutic interventions in bipolar disorders--treatment programmes, their contents and effectiveness].

    PubMed

    Schaub, A; Neubauer, N

    2013-05-01

    Cognitive-behavioural interventions combined with pharmacotherapy have gained importance in the treatment of bipolar disorders. Based on the vulnerability-stress instability model psychoeducational, cognitive-behavioural, interpersonal and family interventions are provided. This paper gives an overview of treatment programmes and their foci. They include providing knowledge about the illness and its treatment, modifying dysfunctional cognitions and symptom management as well as relapse prevention by promoting a stable life style. There are several English- and German-based randomised controlled follow-up studies in English-speaking countries which provide support for the efficacy of combined treatment. Since 2004 German-based manualised treatment programmes have become available and have been shown to be clinically feasible and promising. PMID:23681713

  6. Importance of immediate surgical intervention and antifungal treatment for rhinocerebral mucormycosis: a case report

    PubMed Central

    Kim, Jin-Geun; Park, Hye Jeong; Park, Jung Hyun; Baek, Jiwoong; Kim, Hyung Jun; Cha, In-Ho

    2013-01-01

    Rhinocerebral mucormycosis (RCM) is an opportunistic, potentially life-threatening fungal disease. This infective disease invades not only the facial sinuses, but also the maxilla, zygoma, and rhino-cerebral structures with a massive destruction of the facial skeletons and soft tissue. This disease progresses within various underlying diseases, such as diabetes mellitus, hematologic malignancy, renal failure, and systemic immunodepression. The relationship between mucormycosis and these underlying conditions have been discussed extensively in the literature. The authors studied 6 cases of RCM diagnosed by a tissue biopsy and treated at the department of oral and maxillofacial surgery, from 1997 to 2012. Patients were treated with several kinds of surgical interventions and antifungal agents, and their clinical & radiological signs, underlying conditions, surgical methods, and outcomes were analyzed. PMID:24471053

  7. Dental radiology.

    PubMed

    Woodward, Tony M

    2009-02-01

    Dental radiology is the core diagnostic modality of veterinary dentistry. Dental radiographs assist in detecting hidden painful pathology, estimating the severity of dental conditions, assessing treatment options, providing intraoperative guidance, and also serve to monitor success of prior treatments. Unfortunately, most professional veterinary training programs provide little or no training in veterinary dentistry in general or dental radiology in particular. Although a technical learning curve does exist, the techniques required for producing diagnostic films are not difficult to master. Regular use of dental x-rays will increase the amount of pathology detected, leading to healthier patients and happier clients who notice a difference in how their pet feels. This article covers equipment and materials needed to produce diagnostic intraoral dental films. A simplified guide for positioning will be presented, including a positioning "cheat sheet" to be placed next to the dental x-ray machine in the operatory. Additionally, digital dental radiograph systems will be described and trends for their future discussed. PMID:19410234

  8. History of music therapy treatment interventions for children with autism.

    PubMed

    Reschke-Hernández, Alaine E

    2011-01-01

    The purpose of this paper is to provide a systematic review of the history of music therapy research and treatment of children with autism. Understanding such history is important in order to improve clinical efficacy and inform future research. This paper includes a history of autism diagnosis, reviews strengths and limitations of music therapy practice with children with autism from 1940-2009, and suggests direction for future music therapy research and clinical practice with this population. Literature was limited to the English language and obtained with the following search terms: autism, autistic, (early) infantile autism, child, therapeutic music, musical therapy, and music therapy. Table of contents from music therapy journals were searched, and reference lists from obtained articles were perused for additional articles. This historical review focused primarily on journal articles, however, books and book chapters that appeared to hold particular historical significance were also included. PMID:21938891

  9. Late-onset ankylosing spondylitis and related spondylarthropathies: clinical and radiological characteristics and pharmacological treatment options.

    PubMed

    Toussirot, Eric; Wendling, Daniel

    2005-01-01

    Ankylosing spondylitis is the prototype of related diseases commonly called spondylarthropathies which include reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel diseases (enteropathic arthritis) and undifferentiated spondylarthropathies. Ankylosing spondylitis and spondylarthropathies are generally observed in young patients but can be observed later in life or in persons >50 years of age. All the spondylarthropathy subgroups are represented in the elderly with some features particular to this age group. Indeed, radiological aspects of ankylosing spondylitis may be difficult to interpret because of the radiological changes induced by aging. Late-onset peripheral spondylarthropathies are characterised by severe disease, marked elevation of laboratory parameters of inflammation, oligoarthritis involving the lower limbs and oedema of the extremities. Psoriatic arthritis is more severe in the elderly and is associated with worse outcomes than in young patients. The clinical presentation of undifferentiated spondylarthropathy is as varied in the elderly as in young and middle-aged adults. Reactive arthritis and enteropathic arthritis are observed in the elderly more rarely. The effects of aging on drug metabolism and pharmacokinetics, together with the existence of co-morbidities and polypharmacy, are responsible for difficulties in the therapeutic management of late-onset ankylosing spondylitis or spondylarthropathies. Indeed, NSAIDs should be used with caution in older patients because of the high risk of serious gastrointestinal complications. Sulfasalazine and methotrexate have been used as disease-controlling drugs but did not prove very effective. Pamidronate and tumour necrosis factor (TNF)-alpha antagonists offer a therapeutic alternative but have not been specifically tested in the elderly. Pamidronate has been tested in young-onset ankylosing spondylitis and spondylarthropathies with conflicting results but can be used in

  10. Prevention, early intervention, harm reduction, and treatment of substance use in young people.

    PubMed

    Stockings, Emily; Hall, Wayne D; Lynskey, Michael; Morley, Katherine I; Reavley, Nicola; Strang, John; Patton, George; Degenhardt, Louisa

    2016-03-01

    We did a systematic review of reviews with evidence on the effectiveness of prevention, early intervention, harm reduction, and treatment of problem use in young people for tobacco, alcohol, and illicit drugs (eg, cannabis, opioids, amphetamines, or cocaine). Taxation, public consumption bans, advertising restrictions, and minimum legal age are effective measures to reduce alcohol and tobacco use, but are not available to target illicit drugs. Interpretation of the available evidence for school-based prevention is affected by methodological issues; interventions that incorporate skills training are more likely to be effective than information provision-which is ineffective. Social norms and brief interventions to reduce substance use in young people do not have strong evidence of effectiveness. Roadside drug testing and interventions to reduce injection-related harms have a moderate-to-large effect, but additional research with young people is needed. Scarce availability of research on interventions for problematic substance use in young people indicates the need to test interventions that are effective with adults in young people. Existing evidence is from high-income countries, with uncertain applicability in other countries and cultures and in subpopulations differing in sex, age, and risk status. Concerted efforts are needed to increase the evidence base on interventions that aim to reduce the high burden of substance use in young people. PMID:26905481

  11. Outside-of-school time obesity prevention and treatment interventions in African American youth.

    PubMed

    Barr-Anderson, D J; Singleton, C; Cotwright, C J; Floyd, M F; Affuso, O

    2014-10-01

    Outside-of-school time (OST; i.e. before/after-school hours, summer time), theory-based interventions are potential strategies for addressing increased obesity among African American youth. This review assessed interventions across multiple settings that took place during OST among African American youth aged 5-18 years old. Seven databases were searched for studies published prior to October 2013; 28 prevention and treatment interventions that assessed weight or related behaviours as a primary or secondary outcome were identified. Overall, these studies reported heterogeneous intervention length, theoretical frameworks, methodological quality, outcomes, cultural adaption and community engagement; the latter two attributes have been identified as potentially important intervention strategies when working with African Americans. Although not always significant, generally, outcomes were in the desired direction. When examining programmes by time of intervention (i.e. after-school, summer time, time not specified or multiple time periods), much of the variability remained, but some similarities emerged. After-school studies generally had a positive impact on physical activity, fruit/vegetable consumption and caloric intake, or body composition. The single summer time intervention showed a trend towards reduced body mass index. Overall findings suggest that after-school and summer programmes, alone or perhaps in combination, offer potential benefits for African American youth and could favourably influence diet and physical activity behaviour. PMID:25196405

  12. Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS.

    PubMed

    Collins, Linda M; Kugler, Kari C; Gwadz, Marya Viorst

    2016-01-01

    To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally. PMID:26238037

  13. Increasing Antiretroviral Adherence for HIV-Positive African Americans (Project Rise): A Treatment Education Intervention Protocol

    PubMed Central

    Bogart, Laura M; Mutchler, Matt G; McDavitt, Bryce; Mutepfa, Kieta D; Risley, Brian

    2016-01-01

    Background HIV-positive African Americans have been shown to have lower adherence to antiretroviral therapy (ART) than those of other races/ethnicities, yet adherence interventions have rarely been tailored to the needs of this population. Objective We developed and will evaluate a treatment education adherence intervention (called Rise) that was culturally adapted to address the needs of African Americans living with HIV. Methods This randomized controlled trial will examine the effects of the Rise intervention on ART adherence and HIV viral load. African Americans on ART who report adherence problems will be recruited from the community and randomly assigned to receive the intervention or usual care for 6 months. The intervention consists of 6-10 individual counseling sessions, with more sessions provided to those who demonstrate lower adherence. Primary outcomes include adherence as monitored continuously with Medication Event Monitoring Systems (MEMS) caps, and viral load data received from the participant’s medical provider. Survey assessments will be administered at baseline and month 6. Results The trial is ongoing. Conclusions If effective, the Rise intervention will provide community-based organizations with an intervention tailored to address the needs of African Americans for promoting optimal ART adherence and HIV clinical outcomes. Trial Registration Clinicaltrials.gov NCT01350544; https://clinicaltrials.gov/ct2/show/NCT01350544 (Archived by WebCite at http://www.webcitation.org/6fjqqnmn0). PMID:27025399

  14. A Preliminary Evaluation of Fast ForWord-Language as an Adjuvant Treatment in Language Intervention

    PubMed Central

    Fey, Marc E.; Finestack, Lizbeth H.; Gajewski, Byron J.; Popescu, Mihai; Lewine, Jeffrey D.

    2010-01-01

    Purpose Fast ForWord-Language (FFW-L) is designed to enhance children's processing of auditory–verbal signals and, thus, their ability to learn language. As a preliminary evaluation of this claim, we examined the effects of a 5-week course of FFW-L as an adjuvant treatment with a subsequent 5-week conventional narrative-based language intervention (NBLI) that targeted narrative comprehension and production and grammatical output. Method Twenty-three children 6–8 years of age with language impairments were assigned randomly to 1 of 3 intervention sequences: (a) FFW-L/NBLI, (b) NBLI/FFW-L, or (c) wait/NBLI. We predicted that after both treatment periods, the FFW-L/NBLI group would show greater gains on measures of narrative ability, conversational grammar, and nonword repetition than the other groups. Results After the first 5-week study period, the intervention groups, taken together (i.e., FFW-L/NBLI and NBLI/FFW-L), significantly outperformed the no-treatment wait/NBLI group on 2 narrative measures. At the final test period, all 3 groups displayed significant time-related effects on measures of narrative ability, but there were no statistically significant between-groups effects of intervention sequence. Conclusions This preliminary study provides no evidence to support the claim that FFW-L enhances children's response to a conventional language intervention. PMID:19696435

  15. Treatment Integrity of Interventions with Children in the "Journal of Positive Behavior Interventions" from 1999 to 2009

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Dobey, Lisa M.; Gritter, Katie L.

    2012-01-01

    For more than 10 years, the "Journal of Positive Behavior Interventions" has published, among other types of articles, behavioral intervention outcome studies related to positive behavior support. Operationally defining interventions is important to facilitating replication studies and adoption of intervention in applied settings. Furthermore,…

  16. Measuring safety treatment effects using full Bayes non-linear safety performance intervention functions.

    PubMed

    El-Basyouny, Karim; Sayed, Tarek

    2012-03-01

    Full Bayes linear intervention models have been recently proposed to conduct before-after safety studies. These models assume linear slopes to represent the time and treatment effects across the treated and comparison sites. However, the linear slope assumption can only furnish some restricted treatment profiles. To overcome this problem, a first-order autoregressive (AR1) safety performance function (SPF) that has a dynamic regression equation (known as the Koyck model) is proposed. The non-linear 'Koyck' model is compared to the linear intervention model in terms of inference, goodness-of-fit, and application. Both models were used in association with the Poisson-lognormal (PLN) hierarchy to evaluate the safety performance of a sample of intersections that have been improved in the Greater Vancouver area. The two models were extended by incorporating random parameters to account for the correlation between sites within comparison-treatment pairs. Another objective of the paper is to compute basic components related to the novelty effects, direct treatment effects, and indirect treatment effects and to provide simple expressions for the computation of these components in terms of the model parameters. The Koyck model is shown to furnish a wider variety of treatment profiles than those of the linear intervention model. The analysis revealed that incorporating random parameters among matched comparison-treatment pairs in the specification of SPFs can significantly improve the fit, while reducing the estimates of the extra-Poisson variation. Also, the proposed PLN Koyck model fitted the data much better than the Poisson-lognormal linear intervention (PLNI) model. The novelty effects were short lived, the indirect (through traffic volumes) treatment effects were approximately within ±10%, whereas the direct treatment effects indicated a non-significant 6.5% reduction during the after period under PLNI compared to a significant 12.3% reduction in predicted collision

  17. Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys.

    PubMed

    Burke, Jeffrey D; Loeber, Rolf

    2016-01-01

    Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress partially mediated improvements in child aggression. Improved emotion regulation skills partially mediated treatment-related child anxious-depressed outcomes. Improvements in parenting behaviors did not differ between treatment conditions. The results suggest that independent processes may drive affective and behavioral outcomes, with some specificity regarding the mechanisms related to differing treatment outcomes. PMID:25619927

  18. Effect of Interventions for Premature Ejaculation in the Treatment of Chronic Prostatitis with Secondary Premature Ejaculation.

    PubMed

    Chen, Chang-Qing; Yi, Qing-Tong; Chen, Chu-Hong; Gong, Min

    2016-08-01

    Objective To evaluate the effect of interventions for premature ejaculation (PE) in the management of patients with chronic prostatitis and secondary premature ejaculation. Methods Totally 90 patients diagnosed as chronic prostatitis with PE were randomly divided into control group (n=45) and interventional group (n=45). Control group received a conventional therapy consisted of oral administration of antibiotics,α-receptor blocker,and proprietary Chinese medicine for clearing away heat and promoting diuresis. Interventional group received a conventional therapy combined with treatment for ameliorating the PE symptom (oral dapoxetine on-demand and ejaculation control exercise).National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI),Chinese Index of Sexual Function for Premature Ejaculation (CIPE)-5 questionnaires,intravaginal ejaculatory latency time,and the number of coituses per week were applied for evaluating the treatment outcomes. Results Follow-up was accomplished in 35 and 38 patients in the control and interventional group.The CIPE-5 score,intravaginal ejaculatory latency time,and the number of coituses per week were significantly improved in both two groups but more significantly in interventional group (all P<0.05). The NIH-CPSI pain,urination,and quality of life subscores and total score were improved significantly in both two groups after treatment,but the NIH-CPSI pain and quality of life subscores had been improved more significantly in the interventional group (all P<0.05). The variation of NIH-CPSI was negatively correlated with that of CIPE-5 in both two groups (r=-0.362,P=0.016;r=-0.330,P=0.021). Conclusions For CP with secondary PE patients,the interventions for PE can not only improve the quality of sexual life but also help improve the NIH-CPSI pain and quality of life subscores. PE should be routinely screened and treated during the management of CP.p. PMID:27594150

  19. Effectiveness of community-based early intervention based on pivotal response treatment.

    PubMed

    Smith, Isabel M; Flanagan, Helen E; Garon, Nancy; Bryson, Susan E

    2015-06-01

    Preschoolers (n = 118) with autism spectrum disorder (ASD) participated in this prospective effectiveness study of an early intervention program. Treatment entailed parent training and therapist-implemented components, incorporating Pivotal Response Treatment and Positive Behaviour Support. Standardized ability and behavioural measures were gathered prior to and following the 1-year intervention. Analyses were conducted for three groups based on baseline IQ: Higher IQ (≥ 70; n = 36), Moderately Low IQ (40-69; n = 40), and Very Low IQ (<40, n = 42). Observed gains in key language and cognitive outcomes were significant for all groups. Baseline cognitive scores significantly predicted 1-year outcomes. Results are encouraging for this relatively low-intensity community-based intervention program. PMID:25563454

  20. Interventions to Alleviate Symptoms Related to Breast Cancer Treatments and Areas of Needed Research

    PubMed Central

    Janelsins, Michelle C; Mustian, Karen M; Peppone, Luke J; Sprod, Lisa K; Shayne, Michelle; Mohile, Supriya; Chandwani, Kavita; Gewandter, Jennifer S; Morrow, Gary R

    2012-01-01

    Treatments for breast cancer produce a host of side effects, which can become debilitating. Some cancer treatment-related side effects occur in up to 90% of patients during treatment and can persist for months or years after treatment has ended. As the number of breast cancer survivors steadily increases, the need for cancer control intervention research to alleviate side effects also grows. This review provides a general overview of recent clinical research studies of selected topics in the areas of symptom management for breast cancer with a focus on cognitive difficulties, fatigue, cardiotoxicity, bone loss, insomnia, and cancer pain. We review both pharmacological and behavioral intervention clinical research studies, conducted with breast cancer patients and survivors. Additionally, clinical perspectives on symptom management and recommendations for areas of needed research are provided. PMID:22855701

  1. Use of the Alternating Treatment Design to Evaluate Intervention in Low Vision Rehabilitation.

    ERIC Educational Resources Information Center

    LaGrow, S. J.; Murray, S.

    1992-01-01

    This article illustrates use of the alternating treatment design to assess effectiveness of individualized interventions in low vision rehabilitation. The design was used to determine whether enlarging copy (to one of two magnification levels) and adding contrast would be effective in reducing the time a visually impaired student required to read…

  2. Does goal setting in activity-focused interventions for children with cerebral palsy influence treatment outcome?

    PubMed

    Brogren Carlberg, Eva; Löwing, Kristina

    2013-11-01

    Today, treatment for children with cerebral palsy predominantly aims at improving the children's possibilities to perform everyday activities in their natural environment. The activities in focus for intervention are often expressed as specific goals, frequently defined in a collaborative goal-setting process between professionals and parents. The role of goal setting to improve the outcome of the intervention has not been shown in the literature so far. Thus, the aim of this systematic review was to explore if goal setting has an impact on treatment outcome assessed by standardized measures. CINAHL and MEDLINE were searched from January 2000 to October 2012, resulting in a final selection of 13 articles, six of which were randomized controlled trials. Methodological quality was assessed and study characteristics were analysed descriptively. Subject characteristics, type of intervention/s, frequency, and intensity of therapy varied largely. Outcome was assessed by standardized outcome measures as well as evaluated through aspects of goal attainment. Most studies showed robust within-group changes according to study-appropriate standardized measures, whereas the between-group comparisons exhibited less consistent differences in outcome. The review does not provide support for a positive effect of goal setting per se on treatment outcome. Studies that specifically measure the effect of goal setting on treatment outcome are needed. PMID:24237280

  3. Evaluating Predictors of Program Attrition among Women Mandated into Batterer Intervention Treatment

    ERIC Educational Resources Information Center

    Buttell, Frederick P.; Powers, Dolores; Wong, Asia

    2012-01-01

    Objective: The purpose of the present study was to evaluate pretreatment differences between treatment completers and dropouts among a large sample of women ordered into a 26-week batterer intervention program (BIP). Method: The study employed a nonequivalent, control-group design (comparing program completers to dropouts) in a secondary analysis…

  4. Exploring the Relevance of Interpersonal Dependency as a Treatment Issue in Batterer Intervention

    ERIC Educational Resources Information Center

    Carney, Michelle Mohr; Buttell, Fred

    2006-01-01

    Objective: The purpose of the study was to (a) investigate the pretreatment levels of interpersonal dependency and violence among men entering a 16-week, court-mandated, batterer intervention program (BIP) and determine if there were any associations between interpersonal dependency and violence and (b) evaluate the treatment effect of a standard…

  5. Examining the Influence of Treatment Integrity: Accuracy of Daily Report Card Intervention Implementation and Student Outcome

    ERIC Educational Resources Information Center

    Vujnovic, Rebecca Kate

    2010-01-01

    Given the deficits associated with ADHD and the significant prevalence, it is important to explore evidence based treatments for ADHD in the classroom and the efficacy with which the classroom teachers implement such interventions. The current investigation is a secondary analysis to investigate the integrity of a Daily Report Card (DRC)…

  6. Policy Issues for Integrating Parenting Interventions and Addiction Treatment for Women.

    ERIC Educational Resources Information Center

    VanBremen, Jane R.; Chasnoff, Ira J.

    1994-01-01

    This article addresses the rationale for linking addiction treatment programs and parenting education interventions in substance-abusing families. Specific components of a parenting program for women in recovery are detailed, including parenting classes and support groups, mother-child play groups, and family literacy activities. Program…

  7. A new standard of care for forensic mental health treatment: prioritizing forensic intervention.

    PubMed

    Warburton, Katherine D

    2015-06-01

    Many forensic psychiatric settings serve unique populations who have, in addition to traditional psychiatric symptoms, diverse legal and criminogenic needs. A lack of clear treatment standards that address all aspects of forensic care can lead to inefficient or inappropriate interventions and contribute to institutional violence. PMID:25882228

  8. Treatment Integrity: A Review of Intervention Studies Conducted with Children with Autism

    ERIC Educational Resources Information Center

    Wheeler, John J.; Baggett, Bob A.; Fox, James; Blevins, Leia

    2006-01-01

    The purpose of this study was to assess the degree to which behavioral intervention studies conducted with children diagnosed with autism operationally defined the independent variables (IVs) and evaluated treatment integrity (TI). The study replicated the criteria from Gresham, Gansle, and Noell (1993) and focused exclusively on research studies…

  9. An Assessment of Treatment Integrity in Behavioral Intervention Studies Conducted with Persons with Mental Retardation

    ERIC Educational Resources Information Center

    Wheeler, John J.; Mayton, Michael R.; Carter, Stacy L.; Chitiyo, Morgan; Menendez, Anthony L.; Huang, Ann

    2009-01-01

    The purpose of this study was to assess the degree to which behavioral intervention studies conducted with persons with mental retardation operationally defined the independent variables and evaluated and reported measures of treatment integrity. The study expands the previous work in this area reported by Gresham, Gansle, and Noell (1993) and…

  10. On-treatment platelet reactivity in patients with chronic obstructive pulmonary disease undergoing percutaneous coronary intervention.

    PubMed

    Campo, Gianluca; Pavasini, Rita; Pollina, Alberto; Tebaldi, Matteo; Ferrari, Roberto

    2014-01-01

    Patients with chronic obstructive pulmonary disease (COPD) show a poor prognosis after myocardial infarction (MI) and percutaneous coronary intervention (PCI). We evaluated on-treatment platelet reactivity (PR) and several gene polymorphisms related to PR in 130 patients undergoing PCI with and without COPD. Those with concomitant COPD showed higher on-treatment PR values both at the time of PCI and 1 month after. This finding may contribute to explain the poor prognosis of COPD patients after MI and PCI. PMID:23878160

  11. Percutaneous Stabilization System Osseofix® for Treatment of Osteoporotic Vertebral Compression Fractures - Clinical and Radiological Results after 12 Months

    PubMed Central

    Ender, Stephan Albrecht; Wetterau, Elmar; Ender, Michaela; Kühn, Jens-Peter; Merk, Harry Rudolf; Kayser, Ralph

    2013-01-01

    Study Design A prospective consecutive cohort study (follow-up study). Objective Our study investigated whether implantation of an expandable titanium mesh cage (Osseofix®) is a successful and safe minimally invasive therapy for osteoporotic vertebral compression fractures (VCF). Our experiences, clinical and radiological findings after 12 months follow-up are presented. Kypho- and vertebroplasty are well-established minimally invasive procedures for the treatment of osteoporotic VCF. The main complications associated with both procedures are uncontrolled bone cement leakage. Therefore a suitable alternative has been investigated. Methods During June 2010 to May 2011 24 patients were included with 32 osteoporotic VCF (T6 to L4). All of them were stabilized with the Osseofix® system. Preinterventionally we performed X-ray, MRI, and bone density measurements (DXA). Clinical and radiological results were evaluated preop., postop. and after 12 months postop. based on the Oswestry Disability Index (ODI) and the Visual Analogue Scale (VAS), X-ray (Beck Index, Cobb-angle) and CT. Results There was a significant improvement in the mean ODI (70,6% to 30,1%) as well as a significant reduction in pain intensity (VAS) (7,7 to 1,4) after 12 month. The mean kyphotic angle according to Cobb showed significant improvements (11,7° to 10,4°) after 12 months. Postinterventional imaging showed only one case of loss of height in a stabilized vertebral body (3.1%). We saw no changes in posterior vertebral wall or adjacent fractures. Except for one pronounced postoperative hematoma we saw no surgical complications including no cement leakage. Conclusions Stabilization of symptomatic osteoporotic VCF with Osseofix® system is a safe and effective procedure, even in fractures with posterior wall involvement. The clinical mid-term results are good at a very low complication rate. The Osseofix® system is an interesting alternative to the established procedures of cement augmentation

  12. The 1985 year book of diagnostic radiology

    SciTech Connect

    Bragg, D.G.

    1984-01-01

    This book provides reviews of 343 significant articles from 79 journals. Topics include the following: expanding use of nuclear magnetic resonance imaging; sonography and pediatric radiology; radiographic evaluation of skeletal stress injuries; cost effectiveness of radiographic procedures; radiologic manifestations of iatrogenic complications; breast cancer diagnosis; interventional radiology and underutilization; and computed tomography in diagnosis and staging of neoplasms.

  13. Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

    PubMed Central

    Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

    2014-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

  14. Age differences in treatment response to a collaborative care intervention for anxiety disorders*†

    PubMed Central

    Wetherell, Julie Loebach; Petkus, Andrew J.; Thorp, Steven R.; Stein, Murray B.; Chavira, Denise A.; Campbell-Sills, Laura; Craske, Michelle G.; Sherbourne, Cathy; Bystritsky, Alexander; Sullivan, Greer; Roy-Byrne, Peter

    2013-01-01

    Background Some data suggest that older adults with anxiety disorders do not respond as well to treatment as do younger adults. Aims We examined age differences in outcomes from the Coordinated Anxiety Learning and Management (CALM) study, an effectiveness trial comparing usual care to a computer-assisted collaborative care intervention for primary care patients with panic disorder, generalised anxiety disorder, post-traumatic stress disorder (PTSD), and/or social anxiety disorder. This is the first study to examine the efficacy of a collaborative care intervention in a sample that included both younger and older adults with anxiety disorders. We hypothesised that older adults would show a poorer response to the intervention than younger adults. Method We examined findings for the overall sample, as well as within each diagnostic category (clinicaltrials.gov identifier: NCT00347269). Results The CALM intervention was more effective than usual care among younger adults overall and for those with generalised anxiety disorder, panic disorder and social anxiety disorder. Among older adults, the intervention was effective overall and for those with social anxiety disorder and PTSD but not for those with panic disorder or generalised anxiety disorder. The effects of the intervention also appeared to erode by the 18-month follow-up, and there were no significant effects on remission among the older adults. Conclusions These results are consistent with the findings of other investigators suggesting that medications and psychotherapy for anxiety disorders may not be as effective for older individuals as they are for younger people. PMID:23580378

  15. Non-completion of personality disorder treatments: a systematic review of correlates, consequences, and interventions.

    PubMed

    McMurran, Mary; Huband, Nick; Overton, Eleanor

    2010-04-01

    Non-completion of treatment is a major concern in the provision of therapies for people diagnosed with personality disorder, with adverse consequences for services, therapists, and other patients. Of even greater concern is that non-completion of treatment may limit the effectiveness of therapy for individuals. Our main aim in this study was to conduct a systematic review of the literature on psychosocial treatments for personality disorder to identify factors associated with treatment non-completion. Two subsidiary aims were to identify studies that reported the relative outcomes of treatment completion and non-completion, and to identify studies that evaluated psychosocial interventions specifically aimed at improving retention in treatment. This information is potentially useful in informing selection criteria and directing efforts towards improving treatment engagement. Twenty-five empirical studies of factors predicting treatment non-completion were identified. The median non-completion rate was 37%. A range of patient characteristics, need factors, and environment factors were identified as associated with non-completion. However, the studies could not be considered homogeneous group for meta-analysis. Four studies investigated the effects of treatment non-completion, showing an association with adverse outcomes. Only two studies of interventions specifically aimed at reducing non-completion were identified. Implications for clinical practice and research are discussed. PMID:20047783

  16. Cost-effectiveness analysis of humanitarian relief interventions: visceral leishmaniasis treatment in the Sudan.

    PubMed

    Griekspoor, A; Sondorp, E; Vos, T

    1999-03-01

    Spending by aid agencies on emergencies has quadrupled over the last decade, to over US$6 billion. To date, cost-effectiveness has seldom been considered in the prioritization and evaluation of emergency interventions. The sheer volume of resources spent on humanitarian aid and the chronicity of many humanitarian interventions call for more attention to be paid to the issue of 'value for money'. In this paper we present data from a major humanitarian crisis, an epidemic of visceral leishmaniasis (VL) in war-torn Sudan. The special circumstances provided us, in retrospect, with unusually accurate data on excess mortality, costs of the intervention and its effects, thus allowing us to express cost-effectiveness as the cost per Disability Adjusted Life Year (DALY) averted. The cost-effectiveness ratio, of US$18.40 per DALY (uncertainty range between US$13.53 and US$27.63), places the treatment of VL in Sudan among health interventions considered 'very good value for money' (interventions of less than US$25 per DALY). We discuss the usefulness of this analysis to the internal management of the VL programme, the procurement of funds for the programme, and more generally, to priority setting in humanitarian relief interventions. We feel that in evaluations of emergency interventions attempts could be made more often to perform cost-effectiveness analyses, including the use of DALYs, provided that the outcomes of these analyses are seen in the broad context of the emergency situation and its consequences on the affected population. This paper provides a first contribution to what is hoped to become an international database of cost-effectiveness studies of health interventions during relief operations, which use a comparable measure of health outcome such as the DALY. PMID:10351471

  17. Comparison of Functional and Radiological Outcomes Between Two Posterior Approaches in the Treatment of Multilevel Cervical Spondylotic Myelopathy

    PubMed Central

    Ren, Da-Jiang; Li, Fang; Zhang, Zhi-Cheng; Kai, Guan; Shan, Jian-Lin; Zhao, Guang-Min; Sun, Tian-Sheng

    2015-01-01

    Background: Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy (CSM). Each posterior technique has its own advantages and disadvantages. In the present study, we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM. Methods: Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery, Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study. Patients were divided into two groups by surgical procedure: Laminoplasty (Group L) and hemilaminectomy (Group H). Perioperative parameters including age, sex, duration of symptoms, operative duration, and intraoperative blood loss were recorded and compared. Spinal canal area, calculated using AutoCAD® software (Autodesk Inc., San Rafael, CA, USA), and neurological improvement, evaluated with Japanese Orthopedic Association score, were also compared. Results: Neurological improvement did not differ significantly between groups. Group H had a significantly shorter operative duration and significantly less blood loss. Mean expansion ratio was significantly greater in Group L (77.83 ± 6.41%) than in Group H (62.72 ± 3.86%) (P < 0.01). Conclusions: Both surgical approaches are safe and effective in treating multilevel CSM. Laminoplasty provides a greater degree of enlargement of the spinal canal, whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss. PMID:26228218

  18. Successful treatment with hyperbaric oxygen therapy for severe brain edema characterized by radiological appearance of pseudosubarachnoid hemorrhage in a child

    PubMed Central

    Xin, Yi; Gao, Xingjuan; Ju, Xiuli; Li, Aimin

    2016-01-01

    Pseudosubarachnoid hemorrhage (PSAH) is a rare neuroradiological finding, particularly in pediatric patients. The appearance of PSAH is commonly associated with poor clinical outcome due to refractory cerebral edema. Recent clinical trials have favored hyperbaric oxygen therapy (HBOT) as a promising therapeutic strategy for adult patients with severe head injuries. The present report describes a pediatric case of diffuse brain edema characterized by the radiological appearance of PSAH successfully treated with HBOT. An adolescent boy collapsed unconscious following convulsion for 3–5 min with fever and headache for 2 days. A brain computed tomography (CT) scan provided an image compatible with subarachnoid hemorrhage (SAH). Lumbar puncture was conducted on admission to hospital and showed no evidence of SAH. The CT scan was again considered and eventually interpreted as PSAH. The patient received drug treatment including acyclovir and mannitol, but the condition deteriorated rapidly. HBOT was administered at 72 h post admission and the condition was clearly improved following the initial therapy. The patient was discharged with 20 sessions of HBOT and recovered completely after 1 year. The appearance of PSAH indicates severe cerebral edema refractory to treatment with conventional internal medicine. HBOT maybe an effective therapeutic strategy for this condition. PMID:27588084

  19. Clinical and radiological outcomes of transoral endoscope-assisted treatment of mandibular condylar fractures.

    PubMed

    You, H-J; Moon, K-C; Yoon, E-S; Lee, B-I; Park, S-H

    2016-03-01

    Fractures of the mandibular condyle are one of the most common craniofacial fractures. However, the diagnosis and treatment of these fractures is controversial because of the multiple surgical approaches available. The purposes of this study were to identify surgery-related technical tips for better outcomes and to evaluate the results as well as complications encountered during 7 years of endoscope use to supplement the limited intraoral approach in the treatment of mandibular condylar fractures. Between 2005 and 2012, 50 patients with condylar fractures underwent endoscope-assisted reduction surgery. Postoperative facial bone computed tomography and panoramic radiography demonstrated adequate reduction of the condylar fractures in all patients. No condylar resorption was detected, and most patients displayed a satisfactory functional and structural recovery. There was no facial nerve damage or transitory hypoesthesia, and there were no visible scars after the surgery. Transoral endoscope-assisted treatment is a challenging but reliable method with lower morbidity and a rapid recovery. PMID:26644218

  20. Correlation between Hemodynamics and Treatment Outcome of Intracranial Aneurysms after Intervention with Flow Diverters

    NASA Astrophysics Data System (ADS)

    Paliwal, Nikhil; Damiano, Robert; Davies, Jason; Siddiqui, Adnan; Meng, Hui

    2015-11-01

    Endovascular intervention by Flow Diverter (FD) - a densely woven stent - occludes an aneurysm by inducing thrombosis in the aneurysm sac and reconstructing the vessel. Hemodynamics plays a vital role in the thrombotic occlusion of aneurysms and eventual treatment outcome. CFD analysis of pre- and post-treatment aneurysms not only provides insight of flow modifications by FD, but also allows investigation of interventional strategies and prediction of their outcome. In this study 80 patient-specific aneurysms treated with FDs were retrospectively studied to evaluate the effect of intervention. Out of these cases, 16 required retreatment and thus are considered as having unfavorable outcome. Clinical FD deployment in these cases was simulated using an efficient virtual stenting workflow. CFD analysis was carried out on both pre- and post-treatment cases, and changes in hemodynamic parameters were calculated. Support vector machine algorithm was used to correlate the hemodynamic changes with outcome. Results show that cases having higher flow reduction into the aneurysmal sac have a better likelihood of occlusion. This suggests that changes in hemodynamics can be potentially used to predict the outcome of different clinical intervention strategies in aneurysms. This work was supported by the National Institutes of Health (R01 NS091075).

  1. Ovarian failure and cancer treatment: Incidence and interventions for premenopausal women

    SciTech Connect

    Feldman, J.E.

    1989-09-01

    Ovarian failure may be a long-term consequence of cancer treatment for premenopausal women. Caused by several treatments, including radiation therapy and the alkylating agents, it produces signs and symptoms associated with menopause: hot flashes, amenorrhea, dyspareunia, loss of libido, and irritability. Critical factors that determine ovarian functioning after treatment for cancer are the patient's age at the time of therapy, the amount of radiation that the ovaries received, and the dose of the antineoplastic agent(s). Medical interventions, such as hormonal therapy and surgical repositioning of the ovaries, may maintain ovarian function for some women. Nursing intervention includes assessment, education, and counseling. Counseling focuses on how the prematurely menopausal patient feels about herself as indicated by self-esteem, body image, and sexuality.

  2. Functional hypothalamic amenorrhoea: leptin treatment, dietary intervention and counselling as alternatives to traditional practice - systematic review.

    PubMed

    Kyriakidis, M; Caetano, L; Anastasiadou, N; Karasu, T; Lashen, H

    2016-03-01

    Functional hypothalamic amenorrhoea (FHA) is a neuroendocrine disorder caused by an energy deficit and characterized by low leptin levels. Based on this, previous studies have suggested that leptin administration may play a crucial role in FHA treatment. However, FHA is also associated with abnormal psychosocial and dietary behaviour that needs to be addressed. In this context, this systematic review examined the efficacy of leptin treatment, non-pharmacological therapy and nutritional interventions in FHA. PubMed, Medline and Cochrane Library databases were searched in order to find relevant papers, including randomized controlled trials, clinical trials, prospective studies and case reports. The effects of different treatments on reproductive function, hormonal status and bone markers were recorded. Studies regarding other forms of treatment were excluded. In total, 111 papers were retrieved. After the removal of 29 duplicate papers, the abstracts and titles of 82 papers were examined. Subsequently, 53 papers were excluded based on title, and seven papers were omitted based on abstract. The remaining 11 papers were used: three based on leptin treatment, three regarding non-pharmacological treatment and five regarding dietary intervention. This literature review indicates that all of these treatment strategies improved reproductive function and hormonal status significantly, although conclusive results could not be drawn on bone markers. While leptin may be a promising new treatment, social aspects of FHA should also be addressed. As a result, a multifaceted therapeutic approach should be applied to treat affected women. PMID:26849039

  3. Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions.

    PubMed

    Pelham, William E; Fabiano, Gregory A; Waxmonsky, James G; Greiner, Andrew R; Gnagy, Elizabeth M; Pelham, William E; Coxe, Stefany; Verley, Jessica; Bhatia, Ira; Hart, Katie; Karch, Kathryn; Konijnendijk, Evelien; Tresco, Katy; Nahum-Shani, Inbal; Murphy, Susan A

    2016-01-01

    Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder (ADHD) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and, in case of insufficient response to initial treatment, whether increasing dose of initial treatment or adding the other treatment modality is superior. Children with ADHD (ages 5-12, N = 146, 76% male) were treated for 1 school year. Children were randomized to initiate treatment with low doses of either (a) behavioral parent training (8 group sessions) and brief teacher consultation to establish a Daily Report Card or (b) extended-release methylphenidate (equivalent to .15 mg/kg/dose bid). After 8 weeks or at later monthly intervals as necessary, insufficient responders were rerandomized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality, with adaptive adjustments monthly as needed to these secondary treatments. The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations (the primary outcome) at study endpoint and tended to have fewer out-of-class disciplinary events. Further, adding medication secondary to initial behavior modification resulted in better outcomes on the primary outcomes and parent/teacher ratings of oppositional behavior than adding behavior modification to initial medication. Normalization rates on teacher and parent ratings were generally high. Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication. Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication. PMID:26882332

  4. Screening, Brief Intervention, and Referral to Treatment (SBIRT): Toward a Public Health Approach to the Management of Substance Abuse

    ERIC Educational Resources Information Center

    Babor, Thomas F.; McRee, Bonnie G.; Kassebaum, Patricia A.; Grimaldi, Paul L.; Ahmed, Kazi; Bray, Jeremy

    2007-01-01

    Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive and integrated approach to the delivery of early intervention and treatment services through universal screening for persons with substance use disorders and those at risk. This paper describes research on the components of SBIRT conducted during the past 25 years,…

  5. Combined interventional and surgical treatment for a rare case of double patent ductus arteriosus

    PubMed Central

    SHANG, XIAO-KE; ZHANG, GANG-CHENG; ZHONG, LIANG; ZHOU, XIN; LIU, MEI; LU, RONG

    2016-01-01

    The present study describes the case of a 2.5-year-old girl with double patent ductus arteriosus (PDA) that was successfully treated following interventional and surgical treatment. Bilateral ductus arteriosus is a very rare condition, which is assumed to occur when the branchial-type arterial system transforms into the mammalian-type arterial system during the development of the aorta and its branches. This case was misdiagnosed as ordinary PDA by echocardiography prior to the first surgery and the surgery was not successful because of poor accessibility. Enhanced computed tomography subsequently showed situs solitus, atrial situs, levocardia, right-sided aortic arch with right-sided descending aorta, an isolated left subclavian artery and double PDA. Interventional treatment was performed and intraoperative aortic arch angiography showed that the descending aorta was the origin of the first funnel-type PDA (PDA-1). The left subclavian artery was not connected to the aorta but was connected to the pulmonary artery with a very narrow winding duct, which was PDA-2. Interventional treatment via PDA-2 also failed because passing a guidewire through the twisted PDA-2 was difficult. The child was immediately transferred to the surgical operation room for double PDA ligation and left subclavian artery reconstruction under median thoracotomy. The surgical procedure succeeded and the patient recovered quickly. The failure of the interventional treatment may be attributed to the difficulty in establishing a path. The soft tip of the hardened guidewire was relatively long. If the hardened part of the wire was sent to the appropriate place to support the pathway, the soft tip would be forced to enter the vertebrobasilar artery system. A similar problem was encountered when the left subclavian artery was selected for intervention. Shortening the length of the soft tip of the hardened guidewire may have enabled smooth completion of the establishment of the pathway. However

  6. Surrogate formulations for thermal treatment of low-level mixed waste. Part 1: Radiological surrogates

    SciTech Connect

    Stockdale, J.A.D.; Bostick, W.D.; Hoffmann, D.P.; Lee, H.T.

    1994-01-01

    The evaluation and comparison of proposed thermal treatment systems for mixed wastes can be expedited by tests in which the radioactive components of the wastes are replaced by surrogate materials chosen to mimic, as far as is possible, the chemical and physical properties of the radioactive materials of concern. In this work, sponsored by the Mixed Waste Integrated Project of the US Department of Energy, the authors have examined reported experience with such surrogates and suggest a simplified standard list of materials for use in tests of thermal treatment systems. The chief radioactive nuclides of concern in the treatment of mixed wastes are {sup 239}Pu, {sup 238}U, {sup 235}U, {sup 137}Cs, {sup 103}Ru, {sup 99}Tc, and {sup 90}Sr. These nuclides are largely by-products of uranium enrichment, reactor fuel reprocessing, and weapons program activities. Cs, Ru, and Sr all have stable isotopes that can be used as perfect surrogates for the radioactive forms. Technetium exists only in radioactive form, as do plutonium and uranium. If one wishes to preclude radioactive contamination of the thermal treatment system under trial burn, surrogate elements must be chosen for these three. For technetium, the authors suggest the use of natural ruthenium, and for both plutonium and uranium, they recommend cerium. The seven radionuclides listed can therefore be simulated by a surrogate package containing stable isotopes of ruthenium, strontium, cesium, and cerium.

  7. Motor-based intervention protocols in treatment of childhood apraxia of speech (CAS)

    PubMed Central

    Maas, Edwin; Gildersleeve-Neumann, Christina; Jakielski, Kathy J.; Stoeckel, Ruth

    2014-01-01

    This paper reviews current trends in treatment for childhood apraxia of speech (CAS), with a particular emphasis on motor-based intervention protocols. The paper first briefly discusses how CAS fits into the typology of speech sound disorders, followed by a discussion of the potential relevance of principles derived from the motor learning literature for CAS treatment. Next, different motor-based treatment protocols are reviewed, along with their evidence base. The paper concludes with a summary and discussion of future research needs. PMID:25313348

  8. Treatment and technical intervention time analysis of a robotic stereotactic radiotherapy system.

    PubMed

    Crop, F; Lacornerie, T; Szymczak, H; Felin, A; Bailleux, C; Mirabel, X; Lartigau, E

    2014-02-01

    The purpose of this study is to obtain a better operational knowledge of Stereotactic Body Radiotherapy (SBRT) treatments with CyberKnife(r). An analysis of both In-room Times (IRT) and technical interventions of 5 years of treatments was performed, during which more than 1600 patients were treated for various indications, including liver (21%), lung (29%), intracranial (13%), head and neck (11%) and prostate (7%). Technical interventions were recorded along with the time of the failure, time to the intervention, and the complexity and duration of the repair. Analyses of Time Between Failures (TBF) and Service Disrupting TBF(disr) were performed. Treatment time data and variability per indication and following different system upgrades were evaluated. Large variations of IRTs were found between indications, but also large variations for each indication. The combination of the time reduction Tool (using Iris(r)) and Improved Stop Handling was of major impact to shortening of treatment times. The first implementation of the Iris collimator alone did not lead to significantly shorter IRTs for us except during prostate treatments. This was mostly due to the addition at the same time of larger rotational compensation for prostate treatments (58 instead of 1.58). Significant differences of duration between the first fraction and following fractions of a treatment, representing the necessity of defining imaging parameters and explanation to patients, were found for liver (12 min) and lung treatments using Xsight(r) Spine (5 min). Liver and lung treatments represent the longest IRT's and involve the largest variability's in IRT. The malfunction rate of the system followed a Weibull distribution with the shape and scale parameters of 0.8 and 39.7. Mean TBF(disr) was 68 work hours. 60 to 80% of the service disrupting interventions were resolved within 30-60 min, 5% required external intervention and 30% occurred in the morning. The presented results can be applied in the

  9. Radiological assessment of water treatment processes in a water treatment plant in Saudi Arabia: Water and sludge radium content, radon air concentrations and dose rates.

    PubMed

    Al-Jaseem, Q Kh; Almasoud, Fahad I; Ababneh, Anas M; Al-Hobaib, A S

    2016-09-01

    There is an increase demand for clean water sources in Saudi Arabia and, yet, renewable water resources are very limited. This has forced the authorities to explore deep groundwater which is known to contain large concentrations of radionuclides, mainly radium isotopes. Lately, there has been an increase in the number of water treatment plants (WTPs) around the country. In this study, a radiological assessment of a WTP in Saudi Arabia was performed. Raw water was found to have total radium activity of 0.23Bq/L, which exceeds the international limit of 0.185Bq/L (5pCi/L). The WTP investigated uses three stages of treatment: flocculation/sedimentation, sand filtration and reverse osmosis. The radium removal efficiency was evaluated for each stage and the respective values were 33%, 22% and 98%. Moreover, the activity of radium in the solid waste generated from the WTP in the sedimentation and sand filtrations stages were measured and found to be 4490 and 6750Bq/kg, respectively, which exceed the national limit of 1000Bq/kg for radioactive waste. A radiological assessment of the air inside the WTP was also performed by measuring the radon concentrations and dose rates and were found in the ranges of 2-18Bq/m(3) and 70-1000nSv/h, respectively. The annual effective dose was calculated and the average values was found to be 0.3mSv which is below the 1mSv limit. PMID:27169731

  10. Identifying the common elements of treatment engagement interventions in children's mental health services.

    PubMed

    Lindsey, Michael A; Brandt, Nicole E; Becker, Kimberly D; Lee, Bethany R; Barth, Richard P; Daleiden, Eric L; Chorpita, Bruce F

    2014-09-01

    Difficulty engaging families in mental health treatment is seen as an underlying reason for the disparity between child mental health need and service use. Interpretation of the literature on how best to engage families is complicated by a diversity of operational definitions of engagement outcomes and related interventions. Thus, we sought to review studies of engagement interventions using a structured methodology allowing for an aggregate summary of the most common practices associated with effective engagement interventions. We identified 344 articles through a combination of database search methods and recommendations from engagement research experts; 38 articles describing 40 studies met our inclusion criteria. Following coding methods described by Chorpita and Daleiden (J Consul Clin Psychol 77(3):566-579, 2009, doi: 10.1037/a0014565 ), we identified 22 engagement practice elements from 89 study groups that examined or implemented family engagement strategies. Most frequently identified engagement practice elements included assessment, accessibility promotion, psychoeducation about services, homework assignment, and appointment reminders. Assessment and accessibility promotion were two practice elements present in at least 50 % of treatment groups that outperformed a control group in a randomized controlled trial. With the exception of appointment reminders, these frequently identified engagement practice elements had a high likelihood of being associated with winning treatments when they were used. This approach offers a novel way of summarizing the engagement literature and provides the foundation for enhancing clinical decision-making around treatment engagement. PMID:24379129

  11. Differential responsiveness to a parenting intervention for mothers in substance abuse treatment.

    PubMed

    Paris, Ruth; Herriott, Anna; Holt, Melissa; Gould, Karen

    2015-12-01

    This study examines the relationship between levels of psychological distress in substance-dependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent-child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social-emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substance-dependent mothers need to account for the individual differences in levels of psychological distress. PMID:26455262

  12. Imaging and interventions in hilar cholangiocarcinoma: A review.

    PubMed

    Madhusudhan, Kumble Seetharama; Gamanagatti, Shivanand; Gupta, Arun Kumar

    2015-02-28

    Hilar cholangiocarcinoma is a common malignant tumor of the biliary tree. It has poor prognosis with very low 5-year survival rates. Various imaging modalities are available for detection and staging of the hilar cholangiocarcinoma. Although ultrasonography is the initial investigation of choice, imaging with contrast enhanced computed tomography scan or magnetic resonance imaging is needed prior to management. Surgery is curative wherever possible. Radiological interventions play a role in operable patients in the form of biliary drainage and/or portal vein embolization. In inoperable cases, palliative interventions include biliary drainage, biliary stenting and intra-biliary palliative treatment techniques. Complete knowledge of application of various imaging modalities available and about the possible radiological interventions is important for a radiologist to play a critical role in appropriate management of such patients.We review the various imaging techniques and appearances of hilar cholangiocarcinoma and the possible radiological interventions. PMID:25729485

  13. Therapeutic interventions in the treatment of eating disorders: A naturalistic study.

    PubMed

    Colli, Antonello; Gentile, Daniela; Tanzilli, Annalisa; Speranza, Anna Maria; Lingiardi, Vittorio

    2016-06-01

    This study used naturalistic data from psychodynamic (PD) and cognitive-behavioral (CB) clinicians in the community to offer a portrait of treatments for eating disorder (ED) patients as provided in everyday clinical practice. The research aims were (1) to examine the therapeutic interventions reported by PD and CB clinicians working with ED patients; and (2) to assess the impact of different variables (such as patient personality styles, ED symptomatology, and therapists' theoretical orientation and experience) on the technique use reported by clinicians. A national sample of PD and CB clinicians (N = 105) completed the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b) to assess personality disorders of a female patient with EDs in their care, as well as the Comparative Psychotherapy Process Scale-Bulimia Nervosa (CPPS-BN; Thompson-Brenner & Westen, 2005) to describe the characteristic interventions used in their treatments. Results showed that PD clinicians tended to use primarily PD interventions, while CB clinicians employed CB techniques supplementing them with a wider range of PD strategies. However, clinicians from both theoretical orientations used adjunctive treatment techniques for EDs at a similar level. In addition, use of PD interventions was strongly associated with the personality styles of ED patients regardless of therapists' orientation, primarily being used more often when patients exhibited dysregulated and impulsive styles. Conversely, use of CB interventions was primarily related to a clinicians' CB orientation, patients with more explicit symptoms of anorexia nervosa, and negatively related to clinicians' years of experience. The clinical implications of these findings were discussed. (PsycINFO Database Record PMID:27267501

  14. Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

    PubMed Central

    2012-01-01

    Background Cannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition. Objective To review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis. Methods A search was performed on the Pubmed, Lilacs, and Scielo online databases by combining the terms cannabis, intoxication, psychosis, anxiety, and treatment. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review. Results The reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol. Conclusion Although scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil. PMID:22273390

  15. Hepatobiliary Intervention in Children

    SciTech Connect

    Franchi-Abella, Stéphanie; Cahill, Anne Marie; Barnacle, Alex M.; Pariente, Danièle; Roebuck, Derek J.

    2013-08-02

    Various vascular and nonvascular hepatobiliary interventional radiology techniques are now commonly performed in children’s hospitals. Although the procedures are broadly similar to interventional practice in adults, there are important differences in indications and technical aspects. This review describes the indications, techniques, and results of liver biopsy, hepatic and portal venous interventions and biliary interventions in children.

  16. Clinical and radiological features of brain neurotoxicity caused by antitumor and immunosuppressant treatments.

    PubMed

    Erbetta, Alessandra; Salmaggi, Andrea; Sghirlanzoni, Angelo; Silvani, Antonio; Potepan, Paolo; Botturi, Andrea; Ciceri, Elisa; Bruzzone, Maria Grazia

    2008-06-01

    Antitumor and immunosuppressant treatment-related neurotoxicity can determine nonspecific clinical syndromes. Exclusion of other possible causes, among which tumor progression, appearance of paraneoplastic disease, renal or hepatic failure, diabetes or hypertension, is relevant. We report clinical and neuroradiological features in five patients with neurotoxic syndromes due to chemotherapy/radiotherapy or immunosuppression in the context of neoplastic disease/organ transplantation. Acute neurological syndrome developed in three patients after methotrexate (MTX), cyclosporine A, and L-asparaginase therapy, respectively. MRI showed posterior reversible encephalopathy in two cases and venous thrombosis with intraparenchymal hematoma in the third patient. Late onset clinical syndrome occurred in the last two patients, treated with MTX or radiation therapy for breast cancer metastasis and pituitary adenoma. Neuroimaging showed brain diffuse abnormalities. Patients affected by tumors suffer from increased risk for treatment-related toxicities. Appearance or worsening of neurological signs and symptoms challenge the clinician to discriminate between CNS involvement by the tumor, toxicity of drugs, parane-oplastic disease and infections. MRI has a key role in differential diagnosis. Close interaction between the neurologist, the oncologist and the neuroradiologist leads to the optimal management of patients. PMID:18612759

  17. European Psychiatric Association (EPA) guidance on the quality of eMental health interventions in the treatment of psychotic disorders.

    PubMed

    Gaebel, Wolfgang; Großimlinghaus, Isabell; Kerst, Ariane; Cohen, Yoram; Hinsche-Böckenholt, Andrea; Johnson, Bert; Mucic, Davor; Petrea, Ionela; Rössler, Wulf; Thornicroft, Graham; Zielasek, Jürgen

    2016-03-01

    The main aim was to develop recommendations on eMental health interventions for the treatment of psychotic disorders. A systematic literature search on eMental health interventions was performed, and 24 articles about interventions in psychotic disorders were retrieved and systematically assessed for their quality. Studies were characterized by a large heterogeneity with regard to study type, sample sizes, interventions and outcome measures. Five graded recommendations were developed dealing with the feasibility of eMental health interventions, beneficial effects of psychoeducation, preliminary results of clinical efficacy, the need of moderation in peer support eMental health groups and the need to develop quality standards. PMID:26874958

  18. Network meta-analysis for comparing treatment effects of multiple interventions: an introduction.

    PubMed

    Catalá-López, Ferrán; Tobías, Aurelio; Cameron, Chris; Moher, David; Hutton, Brian

    2014-11-01

    Systematic reviews and meta-analyses of randomized trials have long been important synthesis tools for guiding evidence-based medicine. More recently, network meta-analyses, an extension of traditional meta-analyses enabling the comparison of multiple interventions, use new statistical methods to incorporate clinical evidence from both direct and indirect treatment comparisons in a network of treatments and associated trials. There is a need to provide education to ensure that core methodological considerations underlying network meta-analyses are well understood by readers and researchers to maximize their ability to appropriately interpret findings and appraise validity. Network meta-analyses are highly informative for assessing the comparative effects of multiple competing interventions in clinical practice and are a valuable tool for health technology assessment and comparative effectiveness research. PMID:24691560

  19. Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective

    PubMed Central

    Radenkovic, Dejan V.; Johnson, Colin D.; Milic, Natasa; Gregoric, Pavle; Ivancevic, Nenad; Bezmarevic, Mihailo; Bilanovic, Dragoljub; Cijan, Vladimir; Antic, Andrija; Bajec, Djordje

    2016-01-01

    Abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment. PMID:26839539

  20. Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective.

    PubMed

    Radenkovic, Dejan V; Johnson, Colin D; Milic, Natasa; Gregoric, Pavle; Ivancevic, Nenad; Bezmarevic, Mihailo; Bilanovic, Dragoljub; Cijan, Vladimir; Antic, Andrija; Bajec, Djordje

    2016-01-01

    Abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment. PMID:26839539

  1. A Review of Supportive Interventions Targeting Individuals or Couples Undergoing Infertility Treatment: Directions for the Development of Interventions.

    PubMed

    Luk, Bronya Hi-Kwan; Loke, Alice Yuen

    2016-08-17

    The purpose of this systematic review is to explore the types, content, and outcomes of different psychosocial approaches used in existing interventions for infertile individuals or couples. Relevant intervention studies published in English between 2000 and 2014 were searched using the electronic databases MEDLINE, PsycINFO, and CINHAL Plus. A total of 23 articles were identified and included in this review. Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and counseling were the most commonly adopted psychosocial interventions for infertile individuals or couples. After reviewing the various approaches, directions are given on the development of interventions for couples suffering from infertility. PMID:26259844

  2. Combined Interventional and Surgical Treatment for Acute Aortic Type A Dissection

    SciTech Connect

    Liu Jincheng; Zhang Jinzhou Yang Jian; Zuo Jian; Zhang Jinbao; Yu Shiqiang; Chen Tao; Xu Xuezeng; Wei Xufeng; Yi Dinghua

    2008-07-15

    Surgical repair and endovascular stent-graft placement are both therapies for thoracic aortic dissection. A combination of these two approaches may be effective in patients with type A dissection. In this study, we evaluated the prognosis of this combined technique. From December 2003 to December 2006, 15 patients with type A dissection were admitted to our institute; clinical data were retrospectively reviewed. Follow-up was performed at discharge and approximately 12 months after operation. Endovascular stent-graft placement by interventional radiology and surgical repair for reconstruction of aortic arch was performed in all patients. Total arch replacement for distal arch aneurysm was carried out under deep hypothermia with circulatory arrest; antegrade-selected cerebral perfusion was used for brain protection. Four patients concomitantly received a coronary artery bypass graft. Hospital mortality rate was 6.7%; the patient died of cerebral infarction. Neurological complications developed in two patients. Multi-detector-row computed tomography scans performed before discharge revealed complete thrombosis of the false lumen in six patients and partial thrombosis in eight patients. At the follow-up examination, complete thrombosis was found in another three patients, aortic rupture, endoleaks, or migration of the stent-graft was not observed and injuries of peripheral organs or anastomotic endoleaks did not occur. For patients with aortic type A dissection, combining intervention and surgical procedures is feasible, and complete or at least partial thrombosis of the false lumen in the descending aorta can be achieved. This combined approach simplified the surgical procedures and shortened the circulatory arrest time, minimizing the necessity for further aortic operation.

  3. Effect of a perspective-taking intervention on the consideration of pain assessment and treatment decisions

    PubMed Central

    Wandner, Laura D; Torres, Calia A; Bartley, Emily J; George, Steven Z; Robinson, Michael E

    2015-01-01

    Objectives Pain is often poorly managed, highlighting the need to better understand and treat patients’ pain. Research suggests that pain is assessed and treated differently depending on patient sex, race, and/or age. Perspective-taking, whereby one envisions the perspective of another, has been found to reduce racial disparities in pain management. This study used virtual human (VH) technology to examine whether a perspective-taking intervention impacts pain management decisions. Methods Ninety-six participants were randomized to an online treatment or control group and viewed 16 video clips of VHs with standardized levels of pain. Participants provided ratings on the VHs’ pain intensity and their willingness to administer opioids to them. The intervention group received a brief perspective-taking intervention that consisted of having participants imagine how the patient’s suffering could affect his/her life, whereas the control group was asked to wait for the next VH videos to load. A LENS model analysis was used to investigate both group level (nomothetic) and individual level (idiographic) decision policies. A LENS model of analysis is typically used as an analog method for capturing how groups of people and individuals use information in their environment to form judgments. Results Nomothetic results found that participants rated pain higher and were more likely to prescribe opioids to VHs postintervention, irrespective of group. Idiographic results, however, found that the use of cues to make pain management decisions was mitigated by the perspective-taking group. The participants in the perspective-taking group were more likely to think about pain and the patients’ perspective during the intervention, while control participants were more likely to reflect on the VHs’ sex, race, or age. Conclusion A brief intervention may alter participants’ pain management decisions. These results indicate that a brief intervention might be an initial step toward

  4. Combination ibandronate and radiotherapy for the treatment of bone metastases: Clinical evaluation and radiologic assessment

    SciTech Connect

    Vassiliou, Vassilios; Kalogeropoulou, Christine; Christopoulos, Christos; Solomou, Ekaterini; Leotsinides, Michael; Kardamakis, Dimitrios . E-mail: kardim@med.upatras.gr

    2007-01-01

    Purpose: Ibandronate is a single-nitrogen, noncyclic bisphosphonate with proven efficacy for reducing metastatic bone pain. In this study, we assessed the palliative effects of combined ibandronate and radiotherapy. Methods and Materials: Forty-five patients with bone metastases from various solid tumors received external-beam radiotherapy, 30-40 Gy over 3-4.5, weeks combined with 10 cycles of monthly intravenous ibandronate, 6 mg. Results: After combined therapy, mean bone pain scores (graded from 0 to 10) were reduced from 6.3 at baseline to 0.8 after 3 months, with further reductions at later time points (all p < 0.001). Opioid use decreased from 84% of patients at baseline (38/45) to 24% (11/45) at 3 months, with further subsequent reductions (all p < 0.001). Mean performance status and functioning scores also significantly improved. Bone density (assessed by computed tomography scan) increased by 20% vs. baseline at 3 months, 46% at 6 months, and 73% at 10 months (all p < 0.001). Lesion improvement was also demonstrated by magnetic resonance imaging. Treatment was well tolerated with no renal toxicity. Conclusions: In this pilot study, combined radiotherapy and ibandronate provided substantial bone pain relief and increased bone density. Computed tomography-based or magnetic resonance imaging-based evaluations offer objective methods for assessing therapeutic outcomes.

  5. Prediction of treatment outcome in soft tissue sarcoma based on radiologically defined habitats

    NASA Astrophysics Data System (ADS)

    Farhidzadeh, Hamidreza; Chaudhury, Baishali; Zhou, Mu; Goldgof, Dmitry B.; Hall, Lawrence O.; Gatenby, Robert A.; Gillies, Robert J.; Raghavan, Meera

    2015-03-01

    Soft tissue sarcomas are malignant tumors which develop from tissues like fat, muscle, nerves, fibrous tissue or blood vessels. They are challenging to physicians because of their relative infrequency and diverse outcomes, which have hindered development of new therapeutic agents. Additionally, assessing imaging response of these tumors to therapy is also difficult because of their heterogeneous appearance on magnetic resonance imaging (MRI). In this paper, we assessed standard of care MRI sequences performed before and after treatment using 36 patients with soft tissue sarcoma. Tumor tissue was identified by manually drawing a mask on contrast enhanced images. The Otsu segmentation method was applied to segment tumor tissue into low and high signal intensity regions on both T1 post-contrast and T2 without contrast images. This resulted in four distinctive subregions or "habitats." The features used to predict metastatic tumors and necrosis included the ratio of habitat size to whole tumor size and components of 2D intensity histograms. Individual cases were correctly classified as metastatic or non-metastatic disease with 80.55% accuracy and for necrosis ≥ 90 or necrosis <90 with 75.75% accuracy by using meta-classifiers which contained feature selectors and classifiers.

  6. A Review of Computer-Based Interventions Used in the Assessment, Treatment, and Research of Drug Addiction

    PubMed Central

    Bickel, Warren K.; Christensen, Darren R.; Marsch, Lisa A.

    2011-01-01

    Computer-based interventions are cost-efficient methods that may result in greater access to drug addiction treatment. We review recent findings from our laboratory where computer-based interventions have produced outcomes that are comparable to therapist-delivered interventions. We also examine how computer-based interventions targeting substance abuse disorders relate to cognitive functioning. This review will suggest that not only are computer-based interventions cost-efficient and accessible but that they are also effective methods for the motivation, engagement, and treatment of drug-dependent individuals. Moreover, computer-based interventions are compatible with a recently proposed biological mechanism implicated as the basis for drug addiction. PMID:21190401

  7. Modern wound care - practical aspects of non-interventional topical treatment of patients with chronic wounds.

    PubMed

    Dissemond, Joachim; Augustin, Matthias; Eming, Sabine A; Goerge, Tobias; Horn, Thomas; Karrer, Sigrid; Schumann, Hauke; Stücker, Markus

    2014-07-01

    The treatment of patients with chronic wounds is becoming increasingly complex. It was therefore the aim of the members of the working group for wound healing (AGW) of the German Society of Dermatology (DDG) to report on the currently relevant aspects of non-interventional, topical wound treatment for daily practice. -Beside necessary procedures, such as wound cleansing and débridement, we describe commonly used wound dressings, their indications and practical use. Modern antiseptics, which are currently used in wound therapy, usually contain polyhexanide or octenidine. Physical methods, such as negative-pressure treatment, are also interesting options. It is always important to objectify and adequately treat pain symptoms which often affect these patients. Modern moist wound therapy may promote healing, reduce complications, and improve the quality of life in patients with chronic wounds. Together with the improvement of the underlying causes, modern wound therapy is an important aspect in the overall treatment regime for patients with chronic wounds. PMID:24813380

  8. Peer-delivered interventions reduce HIV risk behaviors among out-of-treatment drug abusers.

    PubMed Central

    Cottler, L B; Compton, W M; Ben Abdallah, A; Cunningham-Williams, R; Abram, F; Fichtenbaum, C; Dotson, W

    1998-01-01

    OBJECTIVE: The purpose of this chapter is to describe the results of a randomized study (funded by the National Institute on Drug Abuse [NIDA]) comparing a peer-delivered enhanced intervention to the NIDA standard intervention for reducing human immunodeficiency virus (HIV) risk behaviors. METHODS: Data come from the ongoing St. Louis Each One Teach One (EOTO) study on HIV risk behaviors among out-of-treatment crack cocaine users and injecting drug users (IDUs). The study has a randomized prospective design, and for this chapter, three risk behaviors were analyzed--the frequency of crack cocaine use and the number of sex partners and condom use over the past 30-day period. We report the level of risk at baseline and at the three-month follow-up period to determine the proportion of individuals improving or worsening based on a dichotomous outcome in which remaining at low risk or decreasing moderate or high risk behaviors is considered "improving" and increasing risk behavior or remaining at moderate or high risk is considered "worsening". RESULTS: Overall, 80% of the sample "improved" their crack cocaine use, meaning they maintained at low level or reduced their use. Although both the standard and enhanced intervention groups made substantial improvement in their crack cocaine use, individuals in the enhanced intervention group were statistically more likely to reduce their risk than those assigned to the standard intervention (83% vs. 75%, P < 0.05). As for the number of sex partners, 75% of the overall sample improved; that is, they reduced the number of sex partners or remained abstinent or in a one-partner relationship at baseline and follow-up. There was no statistically significant difference between the enhanced and standard groups (76% vs 73%). Stratified by gender, the results showed a trend toward improvement among women assigned to the enhanced intervention compared with those assigned to the standard. In terms of condom use, the overall sample worsened

  9. Online and Social Networking Interventions for the Treatment of Depression in Young People: A Systematic Review

    PubMed Central

    Goodall, Joanne; Hetrick, Sarah E; Parker, Alexandra G; Gilbertson, Tamsyn; Amminger, G. Paul; Davey, Christopher G; McGorry, Patrick D; Gleeson, John; Alvarez-Jimenez, Mario

    2014-01-01

    Background Major depression accounts for the greatest burden of all diseases globally. The peak onset of depression occurs between adolescence and young adulthood, and for many individuals, depression displays a relapse-remitting and increasingly severe course. Given this, the development of cost-effective, acceptable, and population-focused interventions for depression is critical. A number of online interventions (both prevention and acute phase) have been tested in young people with promising results. As these interventions differ in content, clinician input, and modality, it is important to identify key features (or unhelpful functions) associated with treatment outcomes. Objective A systematic review of the research literature was undertaken. The review was designed to focus on two aspects of online intervention: (1) standard approaches evaluating online intervention content in randomized controlled designs (Section 1), and (2) second-generation online interventions and services using social networking (eg, social networking sites and online support groups) in any type of research design (Section 2). Methods Two specific literature searches were undertaken. There was no date range specified. The Section 1 search, which focused on randomized controlled trials, included only young people (12-25 years) and yielded 101 study abstracts, of which 15 met the review inclusion criteria. The Section 2 search, which included all study design types and was not restricted in terms of age, yielded 358 abstracts, of which 22 studies met the inclusion criteria. Information about the studies and their findings were extracted and tabulated for review. Results The 15 studies identified in Section 1 described 10 trials testing eight different online interventions, all of which were based on a cognitive behavioral framework. All but one of the eight identified studies reported positive results; however, only five of the 15 studies used blinded interviewer administered outcomes

  10. Orthopaedic radiology

    SciTech Connect

    Park, W.M.; Hughes, S.P.F.

    1987-01-01

    This book is an account of the principles of modern diagnostic imaging techniques and their applications in orthopedics. The aim is to show radiology as a dynamic subject. Orthopaedic Radiology is divided into two sections with the first part focusing on the principles of diagnostic imaging and interpretation and the second applying this information to practical clinical problems.

  11. Skeletal radiology

    SciTech Connect

    Bowerman, J.W.

    1982-01-01

    The main emphasis of the chapter on skeletal radiology is CAT scanning and its use in the diagnosis of neoplasms. Other topics that are discussed include infections, arthritis, trauma, and metabolic and endocrine diseases as they relate to skeletal radiology. (KRM)

  12. Adherence to Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea: Implications for Future Interventions

    PubMed Central

    Weaver, Terri E.; Sawyer, Amy M.

    2010-01-01

    Adherence to continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) is a critical problem with adherence rates ranging from 30–60%. Poor adherence to CPAP is widely recognized as a significant limiting factor in treating OSA, reducing the overall effectiveness of the treatment and leaving many OSA patients at heightened risk for comorbid conditions, impaired function and quality of life. The extant literature examining adherence to CPAP provides critical insight to measuring adherence outcomes, defining optimal adherence levels, and predicting CPAP adherence. This research has revealed salient factors that are associated with or predict CPAP adherence and may guide the development of interventions to promote CPAP adherence. Over the past 10 years, intervention studies to promote CPAP adherence have incorporated a multitude of strategies including education, support, cognitive behavioral approaches, and mixed strategies. This review of the current state of science of CPAP adherence will (1) synthesize the extant literature with regard to measuring, defining, and predicting CPAP adherence, (2) review published intervention studies aimed at promoting CPAP adherence, and (3) suggest directions for future empiric study of adherence to CPAP that will have implications for translational science. Our current understanding of CPAP adherence suggests that adherence is a multi-factorial, complex clinical problem that requires similarly designed approaches to effectively address poor CPAP adherence in the OSA population. PMID:20308750

  13. Development of the triage, monitoring and treatment Handbook for Members of the Public Affected by Radiological Terrorism - A European Response

    SciTech Connect

    Kruse, P.; Rojas-Palma, C.

    2007-07-01

    European national emergency response plans have long been focused on accidents at nuclear power plants. Recently, the possible threats by disaffected groups have shifted the focus to being prepared also for malevolent use of radiation that are aimed at creating disruption and panic in the society. The casualties will most likely be members of the public. According to the scenario, the number of affected people can vary from a few to mass casualties. The radiation exposure can range from very low to substantial, possibly combined with conventional injuries. There is a need to develop practicable tools for the adequate response to such acts and more specifically to address European guidelines for triage, monitoring and treatment of exposed people. Although European countries have developed emergency response plans for nuclear accidents they have not all made plans for handling malevolent use of radioactive material. Indeed, there is a need to develop practical guidance on emergency response and medical treatment of the public affected by malevolent acts. Generic guidance on this topic has been published by international organisations. They are, however, not operational documents to be used in emergency situations. The Triage, Monitoring and Treatment (TMT) Handbook aims to strengthen the European ability to efficiently respond to malevolent acts in terms of protecting and treating exposed people. Part of the Handbook is also devoted to public information and communication issues which would contribute to public reassurance in emergency situations. The Handbook will be drafted by European and international experts before it is circulated to all emergency response institutions in Europe that would be a part of the handling of malevolent acts using radioactive material. The institutions would be given a 6 months consultation time with encouragement to test the draft Handbook in national exercises. A workshop will allow feedback from these end users on the content

  14. Characterization of a cable-free system based on p-type MOSFET detectors for 'in vivo' entrance skin dose measurements in interventional radiology

    SciTech Connect

    Falco, Maria Daniela; D'Andrea, Marco; Strigari, Lidia; D'Alessio, Daniela; Quagliani, Francesco; Santoni, Riccardo; Bosco, Alessia Lo

    2012-08-15

    Purpose: During radiological interventional procedures (RIP) the skin of a patient under examination may undergo a prolonged x-ray exposure, receiving a dose as high as 5 Gy in a single session. This paper describes the use of the OneDose{sup TM} cable-free system based on p-type MOSFET detectors to determine the entrance skin dose (ESD) at selected points during RIP. Methods: At first, some dosimetric characteristics of the detector, such as reproducibility, linearity, and fading, have been investigated using a C-arc as a source of radiation. The reference setting (RS) was: 80 kV energy, 40 cm Multiplication-Sign 40 cm field of view (FOV), current-time product of 50 mAs and source to skin distance (SSD) of 50 cm. A calibrated PMX III solid state detector was used as the reference detector and Gafchromic{sup Registered-Sign} films have been used as an independent dosimetric system to test the entire procedure. A calibration factor for the RS and correction factors as functions of tube voltage and FOV size have been determined. Results: Reproducibility ranged from 4% at low doses (around 10 cGy as measured by the reference detector) to about 1% for high doses (around 2 Gy). The system response was found to be linear with respect to both dose measured with the PMX III and tube voltage. The fading test has shown that the maximum deviation from the optimal reading conditions (3 min after a single irradiation) was 9.1% corresponding to four irradiations in one hour read 3 min after the last exposure. The calibration factor in the RS has shown that the system response at the kV energy range is about four times larger than in the MV energy range. A fifth order and fourth order polynomial functions were found to provide correction factors for tube voltage and FOV size, respectively, in measurement settings different than the RS. ESDs measured with the system after applying the proper correction factors agreed within one standard deviation (SD) with the corresponding ESDs

  15. Technology-Enhanced Maintenance of Treatment Gains in Eating Disorders: Efficacy of an Intervention Delivered via Text Messaging

    ERIC Educational Resources Information Center

    Bauer, Stephanie; Okon, Eberhard; Meermann, Rolf; Kordy, Hans

    2012-01-01

    Objective: Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment. Method: The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on…

  16. Treatment Integrity of Literacy Interventions for Students with Emotional and/or Behavioral Disorders: A Review of Literature

    ERIC Educational Resources Information Center

    Griffith, Annette K.; Hurley, Kristin Duppong; Hagaman, Jessica L.

    2009-01-01

    This review examines the treatment integrity data of literacy interventions for students with emotional and/or behavioral disorders (EBD). Forty-four studies published between 1977 and 2005 were examined. Findings indicate that studies focusing on literacy interventions for students with EBD included clear operational definitions and data on…

  17. Psychology in School-based Prevention, Early Intervention, Treatment and Abstinence Maintenance: Some Reponses to Marijuana Use in the Schools.

    ERIC Educational Resources Information Center

    Sharp, Robbie N.; McLaughlin, Robert J.; McClanahan, Kimberly K.

    1999-01-01

    Outlines factors to consider when planning prevention, treatment, or abstinence maintenance intervention for drug abuse, particularly marijuana abuse in schools. Discusses literature on effectiveness of anti-drug campaigns on drug use; reviews spectrum of mental health interventions; and provides examples of programming. Examines role that…

  18. Therapist Competence and Treatment Adherence for a Brief Intervention addressing Alcohol and Violence among Adolescents

    PubMed Central

    Resko, Stella M.; Walton, Maureen A.; Chermack, Stephen T.; Blow, Frederic C.; Cunningham, Rebecca M.

    2011-01-01

    This study examines therapist competency and treatment adherence for a brief intervention addressing alcohol misuse and violent behaviors among adolescents aged 14–18. Three observational measures of fidelity were used by independent raters to evaluate 60 therapist-delivered sessions (m=32.5 minutes). Individual items from the Content Adherence scale, the Global Rating of Competence (GROMIT) and Self Exploration and Change Talk (SECT) demonstrated fair to excellent inter-rater reliability (intraclass correlations ranged from .40 to 1.0). Principal components analysis (PCA) was utilized to identify the underlying factor structure of the Content Adherence and GROMIT. Parallel analysis suggested the extraction of three components for the Content Adherence reflecting the three distinct goals for each segment of the intervention. Two components were identified for the GROMIT representing the general spirit of motivational interviewing and empowerment. Findings provide support for the fidelity instruments adapted for this study and offer direction for future training and clinical supervision. PMID:22119182

  19. Interventional Treatment of a Symptomatic Neonatal Hepatic Cavernous Hemangioma Using the Amplatzer Vascular Plug

    SciTech Connect

    Kretschmar, Oliver Knirsch, Walter; Bernet, Vera

    2008-03-15

    Percutaneous intervention is one treatment option for symptomatic hepatic hemangioma in infants. We report the case of a newborn (birth weight 4060 g) with a large hepatic cavernous hemangioma, which presented early with high cardiac output failure due to arteriovenous shunting and signs of incipient Kasabach-Merritt syndrome. We performed a successful superselective transcatheter coil embolization of three feeding arteries on the seventh day of life. Because of remaining diffuse very small arteries causing a relevant residual shunt, additional occlusion of the three main draining veins was necessary with three Amplatzer vascular plugs. Cardiac failure resolved immediately. Without any additional therapy the large venous cavities disappeared within the following months. The tumor continues to regress in size 8 months after the intervention.

  20. An Examination of Treatment Intensity with an Oral Reading Fluency Intervention: Do Intervention Duration and Student-Teacher Instructional Ratios Impact Intervention Effectiveness?

    ERIC Educational Resources Information Center

    Ross, Sarah G.; Begeny, John C.

    2014-01-01

    With an increasing percentage of schools moving toward approaches to data-based instructional problem-solving and early remediation of learning difficulties, the development and execution of intervention plans often warrants the pragmatic question: How intensive should an intervention be so that it is effective, while also feasible and time…

  1. Maternal Depression and Treatment Gains Following a Cognitive Behavioral Intervention for Posttraumatic Stress in Preschool Children

    PubMed Central

    Weems, Carl F.; Scheeringa, Michael

    2013-01-01

    The evidence base for cognitive behavioral therapy (CBT) to treat child emotional and behavioral symptoms following exposure to trauma in youth is compelling, but relatively few studies are available on preschool children and on moderators of treatment outcomes. This paper examines maternal and child characteristics as moderators of posttraumatic stress (PTS) treatment outcomes in preschool children. Outcome data from a previously published randomized trial in three to six year old preschool children with diagnostic interview data from participating mothers were used. Hypotheses were tested via hierarchical linear modeling. Maternal depression was associated with higher initial child posttraumatic stress disorder (PTSD) symptoms, and was associated with increasing PTSD symptom trends at follow up suggesting potential child PTSD symptom relapse. Maternal PTSD symptoms similarly predicted differential child separation anxiety symptom change but not child PTSD symptom change. Targeting dyads with child PTSD symptoms and maternal depression or PTSD symptoms with enhanced interventions may be a useful strategy to improve treatment maintenance. PMID:23376601

  2. Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition.

    PubMed

    Takeuchi, Yoshito; Morishita, Hiroyuki; Sato, Yozo; Hamaguchi, Shingo; Sakamoto, Noriaki; Tokue, Hiroyuki; Yonemitsu, Takafumi; Murakami, Kenji; Fujiwara, Hiroyasu; Sofue, Keitaro; Abe, Toshi; Higashihara, Hideyuki; Nakajima, Yasuo; Sato, Morio

    2014-08-01

    Cyanoacrylates are a group of fast-acting adhesives. They form low viscosity liquids in the monomer state and instantly polymerize to become adhesive upon contact with ionic substances. Since the 1950s, they have been used around the world for industrial and household purposes. N-butyl cyanoacrylate (NBCA) is a cyanoacrylate that is commonly used for medical care, and the closure of skin wounds with NBCA has been found to promote hemostasis. However, in Japan, the intravascular injection of NBCA is considered to be off-label use, except during the treatment of gastric varices under endoscopy. The use of NBCA in embolotherapy is considered when the target vessels cannot be cannulated superselectively, for vascular diseases that require long segments of the target vessel to be embolized, or for patients in a hypocoagulable state. NBCA-based embolotherapy can be used to treat vascular malformations, acute hemorrhaging, tumors, and venous disease. The complications associated with NBCA-based embolotherapy include tissue ischemia, hemorrhaging, systemic or local reactions, and catheter adhesion to blood vessels. NBCA is mixed with Lipiodol to make it radiopaque and to adjust its polymerization time. Since there are various technical aspects to performing NBCA-based embolotherapy safely, it should be carried out by, or with the assistance of, proficient interventional radiologists. PMID:24889662

  3. [A case of bile peritonitis caused by jejunal perforation after radiofrequency ablation for the multiple liver metastases from cholangiocarcinoma successfully treated with various interventional radiological procedures after pancreatoduodenectomy].

    PubMed

    Yasumoto, Taku; Shimizu, Junzo; Watanabe, Noriyuki; Inada, Masami; Nakata, Saki; Sato, Masayuki; Hayashi, Shoho; Dono, Keizo; Kitada, Masashi; Shimano, Takashi

    2009-11-01

    The case is a man in his 50s who had a curative surgical resection for cholangiocarcinoma in August 2006. The lesion was judged to be T3, N1, H0, P0, M0 and Stage III, and then he received various treatments including thermotherapy, CD3-activated T lymphocyte therapy. Then from June 2007, he was treated for multiple liver metastases by GEM, radiofrequency ablation (RFA), stereotactic radiotherapy, S-1, dendritic cell therapy. But there were multiple liver metastases whose maximum size was 17 mm in diameter and he was introduced to our hospital. In September 2008, ultrasonography and CT fluoroscopy guided RFA was operated on him for the liver tumors with a safety margin. But 2 hours after the ablation, he complained of epigastralgia. CT examination revealed a bile peritonitis caused by perforation of the jejunum which has been anastomosed to the pancreas, and was adjacent to the avascular area caused by RFA in segment 4 of the liver. We treated him by various interventional procedures including percutaneous drainage for bile leakage, pancreatic fistula, abscess in peritoneal cavity, and biloma in segment 3. Fifty days after the ablation, T-tube, with which pancreatic fluid and bile was induced from the cecal portion of the anastomosed jejunum to the anal side slipping through the perforated point, was successfully inserted through right flank, and resulted in complete recovery from a major technical complication of the bile peritonitis. PMID:20037334

  4. Advanced medical countermeasures for radiological accidents and nuclear disasters: prevention, prophylaxis, treatment and pre- and post-exposure management.

    NASA Astrophysics Data System (ADS)

    Popov, Dmitri; Maliev, Slava; Jones, Jeffrey

    Countermeasures against nuclear terrorism to prevent or limit the number of irradiated human population or radiation intoxications include early identification of the nuclear terrorism event and all persons which exposed by radiation, decontamination program and procedures, radiation control, and medical countermeasures which include medical diagnosis,differential diagnosis of Acute Radiation Syndromes by Immune Enzyme Assay , pre-exposure vaccination with Human Antiradiation Vaccine, post-exposure specific treatment - de-intoxication with Radiation Antidote IgG (blocking Antiradiation Antibodies). Our Advanced Medical Technology elaborated as a part of effective countermeasure include Plan of Action.Countermeasures against nuclear terrorism to prevent or limit the number of high level of lethality and severe forms of radiation illness or intoxications include A.early identification of the nuclear terrorism event and persons exposed,b. appropriate decontamination, c. radiation control, and d.medical countermeasures and medical management of ARS. Medical countermeasures, which include medical interventions such as active immuneprophylaxis with Human Antiradiation Vaccine , passive immune-prophylaxis with Antiradiation Antitoxins immune-globulins IgG , and chemoprophylaxis - post-exposure antioxidants prophylaxis and antibioticprophylaxis. Medical countermeasures with Antiradiation Vaccine should be initiated before an exposure (if individuals are identified as being at high risk for exposure)but after a confirmed exposure event Antiradiation Vaccine not effective and Antiradiation Antidot IgG must be applyed for treatment of Acute Radiation Syndromes.

  5. Handbook of radiologic procedures

    SciTech Connect

    Hedgcock, M.

    1986-01-01

    This book is organized around radiologic procedures with each discussed from the points of view of: indications, contraindications, materials, method of procedures and complications. Covered in this book are: emergency radiology chest radiology, bone radiology, gastrointestinal radiology, GU radiology, pediatric radiology, computerized tomography, neuroradiology, visceral and peripheral angiography, cardiovascular radiology, nuclear medicine, lymphangiography, and mammography.

  6. Treatment of complex dissociative disorders: a comparison of interventions reported by community therapists versus those recommended by experts.

    PubMed

    Myrick, Amie C; Chasson, Gregory S; Lanius, Ruth A; Leventhal, Barry; Brand, Bethany L

    2015-01-01

    There is a paucity of empirical data to assist clinicians in choosing interventions to use with patients with complex dissociative disorder (DD; i.e., dissociative identity disorder and dissociative disorder not otherwise specified) at different stages in treatment. This study compared interventions used by a sample of international outpatient therapists treating DD clients in the 1st 2 stages of treatment with those recommended by expert DD therapists. There were many similarities between therapists' and experts' interventions, including the use of several emotion regulation and dissociation-focused interventions. However, community therapists reported significantly less focus on relationally oriented interventions, teaching and using grounding and containment skills, and stabilizing patients after revictimization by alleged perpetrators. This study has important implications for the development and implementation of training opportunities for DD therapists. PMID:25365637

  7. [Liver intervention].

    PubMed

    Oi, H

    2000-12-01

    Interventional radiology is now widely performed for the treatment of liver tumors, because surgery is sometimes limited by poor liver function. Transcatheter arterial chemoembolization(TACE) is an effective therapy for hepatocellular carcinoma. Lipiodol TACE shows a strong antitumor effect because of the overflow of excess iodized oil into the portal veins, and segmental TACE is recommended to avoid deteriorating liver function. Selective CT arteriography is performed in order to decide on the treatment area, and TACE under CT guidance leads to effective results in terms of dense accumulation of the chemotherapeutic drug in the individual tumors that are affected by the ischemic state and anticancer drugs. Percutaneous microwave or radiofrequency coagulation therapy is adequate for a few of the hypovascular tumors. Excessive coagulation through the needle tract is indispensable in these therapies, and precisely designed puncture is necessary to minimize damage to the liver parenchyma. Selective chemotherapy to the tumor-bearing organ is the first step in a number of liver tumors. Continuous intra-arterial infusion chemotherapy is performed for multiple liver metastases. The reservoir implantation technique is percutaneously achieved via the left subclavian artery under ultrasound guidance, without the exposure of an artery in the incision method, which can induce thrombus formation. PMID:11197832

  8. Retroflex Versus Bunched in Treatment for Rhotic Misarticulation: Evidence From Ultrasound Biofeedback Intervention

    PubMed Central

    Byun, Tara McAllister; Hitchcock, Elaine R.; Swartz, Michelle T.

    2014-01-01

    Purpose To document the efficacy of ultrasound biofeedback treatment for misarticulation of the North American English rhotic in children. Because of limited progress in the first cohort, a series of two closely related studies was conducted in place of a single study. The studies differed primarily in the nature of tongue-shape targets (e.g., retroflex, bunched) cued during treatment. Method Eight participants received 8 weeks of individual ultrasound biofeedback treatment targeting rhotics. In Study 1, all 4 participants were cued to match a bunched tongue-shape target. In Study 2, participants received individualized cues aimed at eliciting the tongue shape most facilitative of perceptually correct rhotics. Results Participants in Study 1 showed only minimal treatment effects. In Study 2, all participants demonstrated improved production of rhotics in untreated words produced without biofeedback, with large to very large effect sizes. Conclusions The results of Study 2 indicate that with proper parameters of treatment, ultrasound biofeedback can be a highly effective intervention for children with persistent rhotic errors. In addition, qualitative comparison of Studies 1 and 2 suggests that treatment for the North American English rhotic should include opportunities to explore different tongue shapes, to find the most facilitative variant for each individual speaker. PMID:25088034

  9. Interventions for the treatment, management and rehabilitation of patients with chronic fatigue syndrome/myalgic encephalomyelitis: an updated systematic review

    PubMed Central

    Chambers, Duncan; Bagnall, Anne-Marie; Hempel, Susanne; Forbes, Carol

    2006-01-01

    Objectives To determine whether any particular intervention or combination of interventions is effective in the treatment, management and rehabilitation of adults and children with a diagnosis of chronic fatigue syndrome / myalgic encephalomyelitis (CFS/ME). Design Substantive update of a systematic review published in 2002. Randomized (RCTs) and non-randomized controlled trials of any intervention or combination of interventions were eligible for inclusion. Study participants could be adults or children with a diagnosis of CFS/ME based on any criteria. We searched eleven electronic databases, reference lists of articles and reviews, and textbooks on CFS/ME. Additional references were sought by contact with experts. Results Seventy studies met the inclusion criteria. Studies on behavioural, immunological, pharmacological and complementary therapies, nutritional supplements and miscellaneous other interventions were identified. Graded exercise therapy and cognitive behaviour therapy appeared to reduce symptoms and improve function based on evidence from RCTs. For most other interventions, evidence of effectiveness was inconclusive and some interventions were associated with significant adverse effects. Conclusions Over the last five years, there has been a marked increase in the size and quality of the evidence base on interventions for CFS/ME. Some behavioural interventions have shown promising results in reducing the symptoms of CFS/ME and improving physical functioning. There is a need for research to define the characteristics of patients who would benefit from specific interventions and to develop clinically relevant objective outcome measures. PMID:17021301

  10. Depressive Symptoms Moderate Treatment Response to Brief Intervention for Prevention of Alcohol Exposed Pregnancy

    PubMed Central

    Penberthy, J. Kim; Hook, Joshua; Hettema, Jennifer; Farrell-Carnahan, Leah; Ingersoll, Karen

    2013-01-01

    The previously published randomized controlled trial, EARLY, tested the efficacy of a Motivational Interviewing (MI) plus Feedback condition against a Video Information (VI) condition and an Informational Brochure (IB) condition in reducing drinking and/or increasing contraception effectiveness, and found that drinking and rates of effective contraception improved in all conditions. In this reanalysis of the data from EARLY, potential moderating effects of depressive, global distress, and anxiety symptoms in response to the 3 brief interventions to reduce alcohol exposed pregnancy risk were examined. Women with higher levels of depression at baseline reported greater improvements in the MI plus Feedback condition versus the VI and IB conditions with depression moderating both drinking and contraceptive effectiveness. Global distress moderated only drinking behavior in the MI plus Feedback but not other groups and anxiety was not a moderator of outcome in any of the intervention groups. Depressed or distressed women at risk for AEP may benefit from an AEP risk reduction intervention that incorporates interaction with a treatment provider versus educational information provided via video or written materials. PMID:23810264

  11. Common Elements Treatment Approach based on a Cognitive Behavioral Intervention: implementation in the Colombian Pacific.

    PubMed

    Pacichana-Quinayáz, Sara Gabriela; Osorio-Cuéllar, Gisel Viviana; Bonilla-Escobar, Francisco Javier; Fandiño-Losada, Andrés; Gutiérrez-Martínez, María Isabel

    2016-06-01

    Due to the limited supply of mental health services for Afro-Colombian victims of violence, a Common Elements Treatment Approach (CETA) intervention has been implemented in the Colombian Pacific. Given the importance of improvement in mental health interventions for this population, it is necessary to characterize this process. This article seeks to describe the implementation of CETA for Afro-Colombian victims of violence in Buenaventura and Quibdó, Colombia through case studieswith individual in-depth interviews with Lay Psychosocial Community Workers (LPCW), supervisors, and coordinators responsible for implementing CETA. From this six core categories were obtained: 1. Effect of armed conflict and poverty 2. Trauma severity 3. Perceived changes with CETA 4. Characteristics and LPCW's performance 5. Afro-Colombian culturalapproach and 6. Strategies to promote users' well-being.Colombian Pacific's scenario implies several factors, such as the active armed conflict, economic crisis, and lack of mental health care resources, affecting the implementation process and the intervention effects. This implies the need to establish and strengthen partnerships between institutions in order to administer necessary mental health care for victims of violence in the Colombian Pacific. PMID:27276543

  12. Paediatric Interventional Uroradiology

    SciTech Connect

    Barnacle, Alex M.; Wilkinson, A. Graham; Roebuck, Derek J.

    2011-04-15

    Paediatric interventional uroradiology lies at the intersection of the disciplines of paediatric interventional radiology and paediatric endourology. Interdisciplinary collaboration has led to the development of new techniques and refinement of procedures adopted from adult practice. This article reviews the major procedures used in paediatric interventional uroradiology, with emphasis on nephrostomy, percutaneous nephrolithotomy, balloon-burst pyeloplasty, and antegrade ureteric stenting.

  13. A medicoeconomic review of early intervention with biologic agents in the treatment of inflammatory bowel diseases.

    PubMed

    Odes, Shmuel; Greenberg, Dan

    2014-01-01

    The treatment of inflammatory bowel disease with standard therapy fails to control the disease in many patients. Biologic therapy has an increasing role in altering the natural history of Crohn's disease and ulcerative colitis, and is improving patient prognosis. However, indications for treatment and issues with drug costs and value for money remain unclear. Also, when to perform early intervention with biologic agents is at present unclear. We performed an extensive literature search and review to address these issues. The biologics provide better care for many patients. The choice of biologic agent, the indications for its use, the switch between agents, and the considerations of cost are outlined, with a view to guiding the treating physician in managing these cases. Outstanding issues and anticipated future developments are defined. PMID:25336980

  14. Endovascular Acute Stroke Treatment Performed by Vascular Interventional Radiologists: Is It Safe and Efficacious?

    SciTech Connect

    Fjetland, Lars Roy, Sumit; Kurz, Kathinka D.; Larsen, Jan Petter; Kurz, Martin W.

    2012-10-15

    Purpose: To evaluate the safety and efficacy of neurointerventional procedures in acute stroke patients performed by a team of vascular interventional radiologists in close cooperation with diagnostic neuroradiologists and stroke neurologists and to compare the results with those of previous reports from centres with specialised interventional neuroradiologists. Material and Methods: A total of 39 patients with acute ischemic stroke due to large-vessel occlusion not responding to or not eligible for intravenous thrombolysis were treated with either intra-arterial thrombolysis or mechanical thrombectomy (Penumbra System or solitaire FR thrombectomy system, respectively) and included in our prospective study. Outcomes were measured using the modified Rankin scale after 90 days, and recanalization was assessed by thrombolysis using the myocardial infarction score. Results: Mean patient age was 68.3 {+-} 14.2 years; the average National Institutes of Health Stroke Scale score at hospital admission was 17.2 (SD = 6.2 [n = 38]). Successful recanalization was achieved in 74.4 % of patients. Median time from clinical onset to recanalization was 5 h 11 min. Procedure-related complications occurred in 5 % of patients, and 7.5 % had a symptomatic intracerebral hemorrhage. Of the patients, 22.5 % died within the first 90 postprocedural days, 5 % of these from cerebral causes. Patients who were successfully recanalized had a clinical better outcome at follow-up than those in whom treatment failed. Of the patients, 35.9 % had an mRS score {<=}2 after 90 days. Conclusion: Our results are in line with those in the published literature and show that a treatment strategy with general interventional radiologists performing neurointerventional procedures in acute stroke patients with large vessel occlusions can be achieved to the benefit of patients.

  15. Rethinking psychopharmacotherapy: The role of treatment context and brain plasticity in antidepressant and antipsychotic interventions.

    PubMed

    Rief, W; Barsky, A J; Bingel, U; Doering, B K; Schwarting, R; Wöhr, M; Schweiger, U

    2016-01-01

    Emerging evidence indicates that treatment context profoundly affects psychopharmacological interventions. We review the evidence for the interaction between drug application and the context in which the drug is given both in human and animal research. We found evidence for this interaction in the placebo response in clinical trials, in our evolving knowledge of pharmacological and environmental effects on neural plasticity, and in animal studies analyzing environmental influences on psychotropic drug effects. Experimental placebo research has revealed neurobiological trajectories of mechanisms such as patients' treatment expectations and prior treatment experiences. Animal research confirmed that "enriched environments" support positive drug effects, while unfavorable environments (low sensory stimulation, low rates of social contacts) can even reverse the intended treatment outcome. Finally we provide recommendations for context conditions under which psychotropic drugs should be applied. Drug action should be steered by positive expectations, physical activity, and helpful social and physical environmental stimulation. Future drug trials should focus on fully controlling and optimizing such drug×environment interactions to improve trial sensitivity and treatment outcome. PMID:26616735

  16. Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs

    PubMed Central

    Bray, Jeremy W; Mallonee, Erin; Dowd, William; Aldridge, Arnie; Cowell, Alexander J; Vendetti, Janice

    2014-01-01

    This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT) services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist) and service delivery setting (emergency department, hospital inpatient, outpatient). Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service provision for some settings and implementation models. PMID:25114610

  17. Protocol for a pilot randomised controlled trial of an online intervention for post-treatment cancer survivors with persistent fatigue

    PubMed Central

    Corbett, Teresa; Walsh, Jane C; Groarke, AnnMarie; Moss-Morris, Rona; McGuire, Brian E

    2016-01-01

    Introduction Many post-treatment cancer survivors experience persistent fatigue that can disrupt attempts to resume normal everyday activities after treatment. Theoretical models that aim to explain contributory factors that initiate and sustain fatigue symptoms, or that influence the efficacy of interventions for cancer-related fatigue (CrF) require testing. Adjustment to fatigue is likely to be influenced by coping behaviours that are guided by the representations of the symptom. Objectives This paper describes the protocol for a pilot trial of a systematically and theoretically designed online intervention to enable self-management of CrF after cancer treatment. Methods and analysis This 2-armed randomised controlled pilot trial will study the feasibility and potential effectiveness of an online intervention. Participants will be allocated to either the online intervention (REFRESH (Recovery from Cancer-Related Fatigue)), or a leaflet comparator. Participants 80 post-treatment cancer survivors will be recruited for the study. Interventions An 8-week online intervention based on cognitive–behavioural therapy. Primary and secondary outcome measures The primary outcome is a change in fatigue as measured by the Piper Fatigue Scale (revised). Quality of life will be measured using the Quality of Life in Adult Survivors of Cancer Scale. Outcome measures will be collected at baseline, and at completion of intervention. Results The feasibility of trial procedures will be tested, as well as the effect of the intervention on the outcomes. Conclusions This study may lead to the development of a supportive resource to target representations and coping strategies of cancer survivors with CrF post-treatment. Setting Recruitment from general public in Ireland. Ethics and dissemination This trial was approved by the Research Ethics Committee at National University of Ireland Galway in January 2013. Trial results will be communicated in a peer-reviewed journal. Trial

  18. The Efficacy of a Condensed "Seeking Safety" Intervention for Women in Residential Chemical Dependence Treatment at 30 Days Posttreatment

    ERIC Educational Resources Information Center

    Cash Ghee, Anna; Bolling, Lanny C.; Johnson, Candace S.

    2009-01-01

    This study examined the efficacy of a condensed version of the "Seeking Safety" intervention in the reduction of trauma-related symptoms and improved drug abstinence rates among women in residential chemical dependence treatment. One hundred and four women were randomly assigned to treatment including a condensed (six session) "Seeking Safety"…

  19. Treatment Acceptability of Behavioral Interventions for Children: An Assessment by Mothers of Children with Disruptive Behavior Disorders.

    ERIC Educational Resources Information Center

    Jones, Melanie L.; Eyberg, Sheila M.; Adams, Christina D.; Boggs, Stephen R.

    1998-01-01

    Study assesses the acceptability of six child-management interventions as rated by mothers (N=20) of children referred for treatment for a disruptive-behavior disorder. Positive reinforcement was rated as a more acceptable treatment than response time, time-out, differential attention, overcorrection, and spanking. Results validate findings of…

  20. Diet and Body Composition Outcomes of an Environmental and Educational Intervention among Men in Treatment for Substance Addiction

    ERIC Educational Resources Information Center

    Cowan, Jennifer A.; Devine, Carol M.

    2013-01-01

    Objective: To determine the effect of an educational and environmental intervention on diet, body mass index, and waist circumference of men in substance addiction treatment. Methods: One hundred three racially/ethnically diverse men in 6 urban substance addiction residential treatment facilities in Upstate New York participated in weekly…

  1. Training and Implementation Support Opportunities for Screening, Brief Intervention, and Referral to Treatment (SBIRT) Models in Secondary Schools

    ERIC Educational Resources Information Center

    Smith, Douglas C.

    2016-01-01

    Some secondary students use alcohol and other drugs, and because so few receive specialized treatment, school social workers are in the optimal position for delivering brief interventions targeting substance use. Common misunderstandings about the nature of substance use problems and substance use disorder treatment will be discussed, and school…

  2. Resiniferatoxin for Pain Treatment: An Interventional Approach to Personalized Pain Medicine

    PubMed Central

    Iadarola, Michael J.; Gonnella, Gian Luigi

    2015-01-01

    This review examines existing preclinical and clinical studies related to resiniferatoxin (RTX) and its potential uses in pain treatment. Like capsaicin, RTX is a vanilloid receptor (TRPV1) agonist, only more potent. This increased potency confers both quantitative and qualitative advantages in terms of drug action on the TRPV1 containing nerve terminal, which result in an increased efficacy and a long duration of action. RTX can be delivered by a central route of administration through injection into the subarachnoid space around the lumbosacral spinal cord. It can also be administered peripherally into a region of skin or deep tissue where primary afferents nerves terminate, or directly into a nerve trunk or a dorsal root ganglion. The central route is currently being evaluated as a treatment for intractable pain in patients with advanced cancer. Peripheral administration offers the possibility to treat a wide diversity of pain problems because of the ability to bring the treatment to the site of the pain (the peripheral generator). While not all pain disorders are appropriate for RTX, tailoring treatment to an individual patient's needs via a selective and local intervention that chemically targets a specific population of nerve terminals provides a new capability for pain therapy and a simplified and effective approach to personalized pain medicine. PMID:26779292

  3. A wraparound treatment engagement intervention for homeless veterans with co-occurring disorders.

    PubMed

    Smelson, David A; Kline, Anna; Kuhn, John; Rodrigues, Stephanie; O'Connor, Kathryn; Fisher, William; Sawh, Leon; Kane, Vincent

    2013-05-01

    This article reports the results of a low-intensity wraparound intervention, Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking (MISSION), to augment Treatment as Usual (TAU) and engage and retain homeless veterans with a co-occurring disorder (COD) in care. Using a quasi-experimental design, 333 homeless veterans were enrolled, 218 who received MISSION along with TAU and 115 who received TAU alone. Group assignment was based on MISSION treatment slot availability at time of enrollment. Compared with TAU alone, individuals receiving MISSION demonstrated greater outpatient session attendance within the 30 days before the 12-month follow up assessment and a larger decline from baseline in the number of psychiatric hospitalization nights. Individuals in the MISSION and TAU-only groups both showed statistically significant improvements in substance use and related problems at 12 months, with those in MISSION less likely to drink to intoxication and experience serious tension or anxiety. Although this study confirmed that compared with TAU alone, MISSION along with TAU is effective in augmenting usual care and engaging and retaining homeless veterans in treatment, some caution is warranted as this study did not involve random assignment. These results, however, are similar to a recent study involving a briefer version of the intervention which included random assignment. Based on these findings, MISSION is being further studied in the joint Department of Housing and Urban Development (HUD) - Department of Veterans Affairs (VA) Supportive Housing (HUD-VASH) program, which offers rapid housing placement and case management to aid in housing maintenance. PMID:23244030

  4. TOPICAL REVIEW: Endovascular interventional magnetic resonance imaging

    NASA Astrophysics Data System (ADS)

    Bartels, L. W.; Bakker, C. J. G.

    2003-07-01

    Minimally invasive interventional radiological procedures, such as balloon angioplasty, stent placement or coiling of aneurysms, play an increasingly important role in the treatment of patients suffering from vascular disease. The non-destructive nature of magnetic resonance imaging (MRI), its ability to combine the acquisition of high quality anatomical images and functional information, such as blood flow velocities, perfusion and diffusion, together with its inherent three dimensionality and tomographic imaging capacities, have been advocated as advantages of using the MRI technique for guidance of endovascular radiological interventions. Within this light, endovascular interventional MRI has emerged as an interesting and promising new branch of interventional radiology. In this review article, the authors will give an overview of the most important issues related to this field. In this context, we will focus on the prerequisites for endovascular interventional MRI to come to maturity. In particular, the various approaches for device tracking that were proposed will be discussed and categorized. Furthermore, dedicated MRI systems, safety and compatibility issues and promising applications that could become clinical practice in the future will be discussed.

  5. Current approaches to treatments for schizophrenia spectrum disorders, part II: psychosocial interventions and patient-focused perspectives in psychiatric care

    PubMed Central

    Chien, Wai Tong; Leung, Sau Fong; Yeung, Frederick KK; Wong, Wai Kit

    2013-01-01

    Schizophrenia is a disabling psychiatric illness associated with disruptions in cognition, emotion, and psychosocial and occupational functioning. Increasing evidence shows that psychosocial interventions for people with schizophrenia, as an adjunct to medications or usual psychiatric care, can reduce psychotic symptoms and relapse and improve patients’ long-term outcomes such as recovery, remission, and illness progression. This critical review of the literature was conducted to identify the common approaches to psychosocial interventions for people with schizophrenia. Treatment planning and outcomes were also explored and discussed to better understand the effects of these interventions in terms of person-focused perspectives such as their perceived quality of life and satisfaction and their acceptability and adherence to treatments or services received. We searched major health care databases such as EMBASE, MEDLINE, and PsycLIT and identified relevant literature in English from these databases. Their reference lists were screened, and studies were selected if they met the criteria of using a randomized controlled trial or systematic review design, giving a clear description of the interventions used, and having a study sample of people primarily diagnosed with schizophrenia. Five main approaches to psychosocial intervention had been used for the treatment of schizophrenia: cognitive therapy (cognitive behavioral and cognitive remediation therapy), psychoeducation, family intervention, social skills training, and assertive community treatment. Most of these five approaches applied to people with schizophrenia have demonstrated satisfactory levels of short- to medium-term clinical efficacy in terms of symptom control or reduction, level of functioning, and/or relapse rate. However, the comparative effects between these five approaches have not been well studied; thus, we are not able to clearly understand the superiority of any of these interventions. With the

  6. Assuring the Form Has Substance: Treatment Plan Implementation as the Foundation of Assessing Response to Intervention

    ERIC Educational Resources Information Center

    Noell, George H.; Gansle, Kristin A.

    2006-01-01

    Assessing response to intervention (RTI) is a complex process that requires selecting interventions, identifying a reasonable strength of intervention, implementing the intervention, assessing progress, and applying decision rules to the resulting data. Appropriate standards and practices are critically important for all of these activities.…

  7. [Acamprosate and psychosocial intervention. An integrative treatment approach for prevention of alcohol dependent patients in Switzerland].

    PubMed

    Fuchs, W J; Riebenfeld, D

    2002-04-24

    105 patients with severe alcohol dependence, who were treated in 13 centers in Switzerland, took part in this open study. The abstinence rate achieved under treatment with Acamprosat, which was used within the framework of established psychotherapeutic intervention programmes in which the doctors could choose between five different procedures, was determined over a period of 24 weeks. In addition, a sociodemographic profile was drawn up, a physical examination was carried out and data were collected on the safety aspect of Acamprosat. It was also of interest to ascertain whether, and if so how, the patients' quality of life changed under the treatment, and in what form they received psychosocial support. As supportive therapy almost two-thirds of the patients (63%) received individual psychotherapy, in 28% the doctor decided on cognitive behavioural therapy, in 4% a short intervention was carried out, in 4% group therapy and in 2% family therapy. In 85.7% of the patients the doctor continued with the initial form of psychotherapy, while in the remaining patients it was changed once. Due to the very uneven distribution a comparison of the outcome in regard to the concomitant therapy was rather problematical. Psychiatric problems (21%), polyneuritis (12%) and liver damage (10.6%)--all known complications of chronic alcohol abuse--were the most frequent concomitant diagnoses. Of the 91 patients who had remained abstinent for the first two weeks after the start of the study, 12.9% had a recurrence at the end of the study, 56% did not have a recurrence (they were abstinent, but did have a binge or a lapse) and 31.8% did not return for the control visits. When a recurrence did occur, however, significantly less alcohol was consumed than before the treatment. As a result of the combined intervention all the parameters relating to the quality of life that were documented in connection with the SF 36 showed improvement. With this study carried out in Switzerland, which is

  8. Improving Depression Treatment for Women: Integrating a Collaborative Care Depression Intervention into OB-GYN Care

    PubMed Central

    LaRocco-Cockburn, Anna; Reed, Susan D.; Melville, Jennifer; Croicu, Carmen; Russo, Joan; Inspektor, Michal; Edmondson, Eddie; Katon, Wayne

    2013-01-01

    Background Women have higher rates of depression and often experience depression symptoms during critical reproductive periods, including adolescence, pregnancy, postpartum, and menopause. Collaborative care intervention models for mood disorders in patients receiving care in an OB-GYN clinic setting have not been evaluated. Study design and methodology for a randomized, controlled trial of collaborative care depression management versus usual care in OB-GYN clinics and the details of the adapted collaborative care intervention and model implementation are described in this paper. Methods Women over age 18 years with clinically significant symptoms of depression, as measured by a Patient Health Questionnaire-9 (PHQ-9) score ≥10 and a clinical diagnosis of major depression or dysthymia, were randomized to the study intervention or to usual care and were followed for 18 months. The primary outcome assessed was change over time in the SCL-20 depression scale between baseline and 12 months. Baseline Results 205 women were randomized: 57% white, 20% African American, 9% Asian or Pacific Islander, 7% Hispanic, and 6% Native American. Mean age was 39 years. 4.6% were pregnant and 7.5% were within 12 months postpartum. The majority were single, (52%), and 95% had at least the equivalent of a high school diploma. Almost all patients met DSM IV criteria for major depression (99%) and approximately 33% met criteria for dysthymia. Conclusions An OB-GYN collaborative care team including a social worker, psychiatrist and OB-GYN physician who met weekly and used an electronic tracking system for patients were essential elements of the proposed depression care treatment model described here. Further study of models that improve quality of depression care that are adapted to the unique OB-GYN setting are needed. PMID:23939510

  9. Balancing Fidelity and Adaptation in the Dissemination of Empirically-Supported Treatments: The Promise of Transdiagnostic Interventions

    PubMed Central

    McHugh, R. Kathryn; Murray, Heather W.; Barlow, David H.

    2009-01-01

    Assessing treatment fidelity is a core methodological consideration in the study of treatment outcome; it influences both the degree to which changes can be attributed to the intervention and the ability to replicate and disseminate the intervention. Efforts to increase access to evidence-based psychological treatments are receiving unprecedented support; but pressures exist to adapt treatments to service settings, running the risk of compromising fidelity. However, little evidence is available to inform the necessary conditions for the transportation of interventions to service provision settings, and the degree to which fidelity is even evaluated or emphasized in dissemination and implementation programs varies dramatically. Moreover, adaptation is associated with several benefits for dissemination efforts and may address relevant barriers to adoption. A particularly promising strategy for maximizing the benefits of both fidelity and adaptation is the use of transdiagnostic interventions. Such treatments allow for greater flexibility of the pacing and content of treatment, while still providing structure to facilitate testing and replication. Preliminary evidence supports the efficacy of this strategy, which may be particularly conducive to dissemination into service provision settings. At this time, further research is needed to evaluate the relationships among fidelity, adaptation, and outcome, and to determine the potential for transdiagnostic treatments to facilitate dissemination. PMID:19643395

  10. Physiotherapy intervention as a complementary treatment for people living with HIV/AIDS

    PubMed Central

    Pullen, Sara D; Chigbo, Nnenna Nina; Nwigwe, Emmanuel Chukwudi; Chukwuka, Chinwe J; Amah, Christopher Chim; Idu, Stanley C

    2014-01-01

    Background The advent of highly active antiretroviral therapy has dramatically extended the life expectancy of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Despite this increased longevity, HIV disease and its pharmacological treatment can cause long-term and acute health complications, many of which can be treated successfully by physiotherapy. The purpose of this paper is to report the effect of a 12-week rehabilitation program on several health-related markers in a 43-year-old woman living with HIV. Methods This case study examined the effect of a 12-week exercise and manual therapy intervention on morphology, pain, cardiopulmonary fitness, strength, neurological balance, immune markers (CD4 cell count), and quality of life in a 43-year-old woman living with HIV. Results The results showed complete elimination of pain and shortness of breath on exertion. There was also a reduction in resting heart rate, waist circumference, exercise duration, muscle strength, and endurance. The patient showed an increase in peak expiratory flow rate, maximal heart rate attained, upper arm, forearm, and thigh circumference, and CD4+ cell count. The patient also showed improvements in the quality of life domains of general health, pain, energy/fatigue, social and physical functioning, and emotional well-being. Conclusion Physiotherapy interventions consisting of exercise and manual therapy appear beneficial in several areas as an adjunct therapy in HIV management. PMID:24936132

  11. Prevention and Treatment of Type 2 Diabetes: Current Role of Lifestyle, Natural Product, and Pharmacological Interventions

    PubMed Central

    Hays, Nicholas P.; Galassetti, Pietro R.; Coker, Robert H.

    2008-01-01

    Common complications of Type 2 diabetes (T2D) are eye, kidney and nerve diseases, as well as an increased risk for the development of cardiovascular disease and cancer. The overwhelming influence of these conditions contributes to a decreased quality of life and life span, as well as significant economic consequences. Although obesity once served as a surrogate marker for the risk of T2D, we know now that excess adipose tissue secretes inflammatory cytokines that left unchecked, accelerate the progression to insulin resistance and T2D. In addition, excess alcohol consumption may also increase the risk of T2D. From a therapeutic standpoint, lifestyle interventions such as dietary modification and/or exercise training have been shown to improve glucose homeostasis but may not normalize the disease process unless weight loss is achieved and increased physical activity patterns are established. Furthermore, utilization of natural products may serve as a significant adjunct in the fight against insulin resistance but further research is needed to ascertain their validity. Since it is clear that pharmaceutical therapy plays a significant role in the treatment of insulin resistance, this review will also discuss some of the newly developed pharmaceutical therapies that may work in conjunction with lifestyle interventions, and lessen the burden of behavioral change as the only strategy against the development of T2D. PMID:18423879

  12. Concussion treatment after combat trauma: development of a telephone based, problem solving intervention for service members.

    PubMed

    Bell, Kathleen R; Brockway, Jo Ann; Fann, Jesse R; Cole, Wesley R; St De Lore, Jef; Bush, Nigel; Lang, Ariel J; Hart, Tessa; Warren, Michael; Dikmen, Sureyya; Temkin, Nancy; Jain, Sonia; Raman, Rema; Stein, Murray B

    2015-01-01

    Military service members (SMs) and veterans who sustain mild traumatic brain injuries (mTBI) during combat deployments often have co-morbid conditions but are reluctant to seek out therapy in medical or mental health settings. Efficacious methods of intervention that are patient-centered and adaptable to a mobile and often difficult-to-reach population would be useful in improving quality of life. This article describes a new protocol developed as part of a randomized clinical trial of a telephone-mediated program for SMs with mTBI. The 12-session program combines problem solving training (PST) with embedded modules targeting depression, anxiety, insomnia, and headache. The rationale and development of this behavioral intervention for implementation with persons with multiple co-morbidities is described along with the proposed analysis of results. In particular, we provide details regarding the creation of a treatment that is manualized yet flexible enough to address a wide variety of problems and symptoms within a standard framework. The methods involved in enrolling and retaining an often hard-to-study population are also highlighted. PMID:25460344

  13. An HIV Prevention Intervention for Ethnically Diverse Men in Substance Abuse Treatment: Pilot Study Findings

    PubMed Central

    Burlew, A. Kathleen; Hatch-Maillette, Mary A.; Beadnell, Blair; Wright, Lynette; Wilson, Jerika

    2013-01-01

    Objectives. We determined the acceptability, participants' receptivity, and effectiveness of a culturally adapted version of Real Men Are Safe (REMAS-CA), an HIV prevention intervention for men in substance abuse treatment. Methods. In 2010 and 2011, we compared participants who attended at least 1 (of 5) REMAS-CA session (n = 66) with participants in the original REMAS study (n = 136). Participants completed an assessment battery at baseline and at 3-month follow-up with measures of substance abuse, HIV risk behaviors, perceived condom barriers, and demographics. We conducted postintervention focus groups at each clinic. Results. Minority REMAS-CA participants were more likely to have attended 3 or more sessions (87.0%), meeting our definition of intervention completion, than were minority participants in the REMAS study (75.1%; odds ratio = 2.1). For REMAS-CA participants with casual partners (n = 25), the number of unprotected sexual occasions in the past 90 days declined (6.2 vs 1.6). Among minority men in the REMAS study (n = 36), the number of unprotected sexual occasions with casual partners changed little (9.4 vs 8.4; relative risk = 4.56). Conclusions. REMAS-CA was effective across ethnic groups, a benefit for HIV risk reduction programs that serve a diverse clientele. PMID:23488494

  14. Nutritional interventions for the adjunctive treatment of schizophrenia: a brief review.

    PubMed

    Arroll, Megan Anne; Wilder, Lorraine; Neil, James

    2014-01-01

    Schizophrenia is a chronic condition that impacts significantly not only on the individual and family, but the disorder also has wider consequences for society in terms of significant costs to the economy. This highly prevalent condition affects approximately 1% of the worldwide population, yet there are few therapeutic options. The predominant treatment strategy for schizophrenia is anti-psychotic medication (with or without additional talking therapy) even though this approach lacks efficacy in managing the negative symptoms of the condition, is not effective in one-third of the patient group and the side effects of the medication can be severe and debilitating. In recent years, a number of pathophysiological processes have been identified in groups of people with schizophrenia including oxidative stress, one-carbon metabolism and immune-mediated responses. A number of studies have shown that these altered physiological mechanisms can be ameliorated by nutritional interventions in some individuals with schizophrenia. This review briefly describes the aforementioned processes and outlines research that has investigated the utility of nutritional approaches as an adjunct to anti-psychotic medication including antioxidant and vitamin B supplementation, neuroprotective and anti-inflammatory nutrients and exclusion diets. Whilst none of these interventions provides a 'one-size-fits-all' therapeutic solution, we suggest that a personalised approach warrants research attention as there is growing agreement that schizophrenia is a spectrum disorder that develops from the interplay between environmental and genetic factors. PMID:25228271

  15. The SCIDOTS Project: Evidence of benefits of an integrated tobacco cessation intervention in tuberculosis care on treatment outcomes

    PubMed Central

    2011-01-01

    Background There is substantial evidence to support the association between tuberculosis (TB) and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. Methods An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS) providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group) or conventional TB DOTS alone (comparison or DOTS group). At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. Results A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when compared with those who

  16. Parenting Practices as Mediators of Treatment Effects in an Early-Intervention Trial of Multidimensional Family Therapy

    PubMed Central

    Henderson, Craig E.; Rowe, Cindy L.; Dakof, Gayle A.; Hawes, Sam W.; Liddle, Howard A.

    2009-01-01

    Background Contemporary intervention models use research about the determinants of adolescent problems and their course of symptom development to design targeted interventions. Because developmental detours begin frequently during early-mid adolescence, specialized interventions that target known risk and protective factors in this period are needed. Methods This study (n = 83) examined parenting practices as mediators of treatment effects in an early-intervention trial comparing Multidimensional Family Therapy (MDFT), and a peer group intervention. Participants were clinically referred, low-income, predominantly ethnic minority adolescents (average age 14). Assessments were conducted at intake, and six weeks after intake, discharge, and at 6 and 12 months following intake. Results Previous studies demonstrated that MDFT was more effective than active treatments as well as services as usual in decreasing substance use and improving abstinence rates. The current study demonstrated that MDFT improves parental monitoring—a fundamental treatment target—to a greater extent than group therapy, and these improvements occur during the period of active intervention, satisfying state-of-the-science criteria for assessing mediation in randomized clinical trials. Conclusions and Scientific Significance Findings indicate that change in MDFT occurs through improvements in parenting practices. These results set the foundation for examining family factors as mediators in other samples. PMID:20180674

  17. Early experience with X-ray magnetic resonance fusion for low-flow vascular malformations in the pediatric interventional radiology suite.

    PubMed

    Hwang, Tiffany J; Girard, Erin; Shellikeri, Sphoorti; Setser, Randolph; Vossough, Arastoo; Ho-Fung, Victor; Cahill, Anne Marie

    2016-03-01

    This technical innovation describes our experience using an X-ray magnetic resonance fusion (XMRF) software program to overlay 3-D MR images on real-time fluoroscopic images during sclerotherapy procedures for vascular malformations at a large pediatric institution. Five cases have been selected to illustrate the application and various clinical utilities of XMRF during sclerotherapy procedures as well as the technical limitations of this technique. The cases demonstrate how to use XMRF in the interventional suite to derive additional information to improve therapeutic confidence with regards to the extent of lesion filling and to guide clinical management in terms of intraprocedural interventional measures. PMID:26681438

  18. Interventional pulmonology approaches in the diagnosis and treatment of early stage non small cell lung cancer

    PubMed Central

    Tofts, Ryu Peter Hambrook; Lee, Peter MJ

    2013-01-01

    Lung cancer management is complex and requires a multi-disciplinary approach to provide comprehensive care. Interventional pulmonology (IP) is an evolving field that utilizes minimally invasive modalities for the initial diagnosis and staging of suspected lung cancers. Endobronchial ultrasound guided sampling of mediastinal lymph nodes for staging and detection of driver mutations is instrumental for prognosis and treatment of early and later stage lung cancers. Advances in navigational bronchoscopy allow for histological sampling of suspicious peripheral lesions with minimal complication rates, as well as assisting with fiducial marker placements for stereotactic radiation therapy. Furthermore, IP can also offer palliation for inoperable cancers and those with late stage diseases. As the trend towards early lung cancer detection with low dose computed tomography is developing, it is paramount for the pulmonary physician with expertise in lung nodule management, minimally invasive sampling and staging to integrate into the paradigm of multi-specialty care. PMID:25806251

  19. Non-interventional study evaluating efficacy and tolerability of rifaximin for treatment of uncomplicated diverticular disease.

    PubMed

    Stallinger, Sylvia; Eller, Norbert; Högenauer, Christoph

    2014-01-01

    Patients with symptomatic uncomplicated diverticular disease represent a spectrum of patients who report recurrent abdominal symptoms, however are lacking substantial colonic inflammation in contrast to patients with acute diverticulitis. This non-interventional study investigated the efficacy and tolerability of rifaximin, a broad-spectrum poorly absorbable antibiotic, in cyclic treatment of these patients. Adult patients with uncomplicated diverticular disease in care of physicians in private practice intended to be treated with rifaximin were included. Patients with acute diverticulitis and symptoms suggestive of more severe intestinal inflammation were excluded. Data of 1,003 patients treated in cycles of 7-10 days per month over a period of 3 months were evaluated. In total, 75 % of patients had more than three episodes of symptoms in the last year before inclusion in the study. However, two-third of patients did not receive any treatment before. Over the 3-month treatment period with rifaximin, all assessed symptoms of diverticular disease, such as abdominal pain, diarrhoea and flatulence, improved significantly. There was an overall good compliance to the scheme of cyclic drug administration of rifaximin. During the study, 24 adverse events in 20 patients were recorded, of which 6 adverse events showed a causal relationship to the use of rifaximin (0.6 %). We conclude that cyclic rifaximin shows good clinical efficacy and tolerability in patients with symptomatic uncomplicated diverticular disease treated in a routine private practice outpatient setting. PMID:24240607

  20. Respiratory and Cognitive Mediators of Treatment Change in Panic Disorder: Evidence for Intervention Specificity

    PubMed Central

    Meuret, Alicia E.; Rosenfield, David; Seidel, Anke; Bhaskara, Lavanya; Hofmann, Stefan G.

    2012-01-01

    Objective There are numerous theories of panic disorder, each proposing a unique pathway of change leading to treatment success. However, little is known about whether improvements in proposed mediators are indeed associated with treatment outcomes and whether these mediators are specific to particular treatment modalities. Our purpose in this study was to analyze pathways of change in theoretically distinct interventions using longitudinal, moderated mediation analyses. Method Forty-one patients with panic disorder and agoraphobia were randomly assigned to receive 4 weeks of training aimed at altering either respiration (capnometry-assisted respiratory training) or panic-related cognitions (cognitive training). Changes in respiration (PCO2, respiration rate), symptom appraisal, and a modality-nonspecific mediator (perceived control) were considered as possible mediators. Results The reductions in panic symptom severity and panic-related cognitions and the improvements in perceived control were significant and comparable in both treatment groups. Capnometry-assisted respiratory training, but not cognitive training, led to corrections from initially hypocapnic to normocapnic levels. Moderated mediation and temporal analyses suggested that in capnometry-assisted respiratory training, PCO2 unidirectionally mediated and preceded changes in symptom appraisal and perceived control and was unidirectionally associated with changes in panic symptom severity. In cognitive training, reductions in symptom appraisal were bidirectionally associated with perceived control and panic symptom severity. In addition, perceived control was bidirectionally related to panic symptom severity in both treatment conditions. Conclusion The findings suggest that reductions in panic symptom severity can be achieved through different pathways, consistent with the underlying models. PMID:20873904

  1. Risk management in radiology departments

    PubMed Central

    Craciun, Horea; Mankad, Kshitij; Lynch, Jeremy

    2015-01-01

    Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as a result of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients. PMID:26120383

  2. mHealth self-care interventions: managing symptoms following breast cancer treatment

    PubMed Central

    Fu, Mei R.; Axelrod, Deborah; Guth, Amber A.; Rampertaap, Kavita; El-Shammaa, Nardin; Hiotis, Karen; Scagliola, Joan; Yu, Gary; Wang, Yao

    2016-01-01

    Background Many women suffer from daily distressing symptoms related to lymphedema following breast cancer treatment. Lymphedema, an abnormal accumulation of lymph fluid in the ipsilateral body area or upper limb, remains an ongoing major health problem affecting more than 40% of 3.1 million breast cancer survivors in the United States. Patient-centered care related to lymphedema symptom management is often inadequately addressed in clinical research and practice. mHealth plays a significant role in improving self-care, patient-clinician communication, and access to health information. The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral mHealth interventions focusing on safe, innovative, and pragmatic electronic assessment and self-care strategies for lymphedema symptom management. The purpose of this paper is to describe the development and test of TOLF system. Methods The development of TOLF was guided by the Model of Self-Care for Lymphedema Symptom Management and designed based on principles fostering accessibility, convenience, and efficiency of mHealth system to enhance training and motivating assessment of and self-care for lymphedema symptoms. Test of TOLF was accomplished by conducting a psychometric study to evaluate reliability, validity, and efficiency of the electronic version of Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI), a usability testing and a pilot feasibility testing of mHealth self-care interventions. Results Findings from the psychometric study with 355 breast cancer survivors demonstrated high internal consistency of the electronic version of the instrument: a Cronbach’s alpha coefficient of 0.959 for the total scale, 0.919 for symptom occurrence, and 0.946 for symptom distress. Discriminant validity of the instrument was supported by a significant difference in symptom occurrence (z=−6.938, P<0.000), symptom distress (z=−5.894, P<0.000), and total

  3. Feasibility and Acceptance of a Telehealth Intervention to Promote Symptom Management during Treatment for Head and Neck Cancer.

    PubMed

    Head, Barbara A; Keeney, Cynthia; Studts, Jamie L; Khayat, Mamdouh; Bumpous, Jeffrey; Pfeifer, Mark

    2011-01-01

    Patients undergoing treatment for head and neck cancers have a myriad of distressing symptoms and treatment side effects which significantly alter communication and lower quality of life. Telehealth technology has demonstrated promise in improving patient-provider communication by delivering supportive educational content and guidance to patients in their homes. A telehealth intervention using a simple telemessaging device was developed to provide daily education, guidance, and encouragement for patients undergoing initial treatment of head and neck cancer. The goal of this article is to report the feasibility and acceptance of the intervention using both quantitative and qualitative measures. No eligible patients declined participation based on technology issues. Participants completed the intervention over 86% of the expected days of use. Direct nursing contact was seldom needed during the study period. Satisfaction with the technology and the intervention was very high. In this study a telehealth intervention was shown to be feasible, well accepted, and regularly used by patients experiencing extreme symptom burden and declining quality of life as a result of aggressive treatment for head and neck cancer. PMID:21499540

  4. Technology in radiology: advances in diagnostic imaging & therapeutics.

    PubMed

    Stern, S M

    1993-01-01

    Nearly 100 years from its birth, radiology continues to grow as though still in adolescence. Although some radiologic technologies have matured more than others, new applications and techniques appear regularly in the literature. Radiology has evolved from purely diagnostic devices to interventional technologies. New contrast agents in MRI, X ray and ultrasound enable physicians to make diagnoses and plan therapies with greater precision than ever before. Techniques are less and less invasive. Advances in computer technology have given supercomputer-like power to high-end nuclear medicine and MRI systems. Imaging systems in most modalities are now designed with upgrades in mind instead of "planned obsolescence." Companies routinely upgrade software and other facets of their products, sometimes at no additional charge to existing customers. Hospitals, radiology groups and imaging centers will face increasing demands to justify what they do according to patient outcomes and management criteria. Did images make the diagnosis or confirm it? Did the images determine optimal treatment strategies or confirm which strategies might be appropriate? Third-party payers, especially the government, will view radiology in those terms. The diagnostic imaging and therapy systems of today require increasingly sophisticated technical support for maintenance and repair. Hospitals, radiology groups and imaging centers will have to determine the most economic and effective ways to guarantee equipment up-time. Borrowing from the automotive industry, some radiology manufacturers have devised transtelephonic software systems to facilitate remote troubleshooting. To ensure their fiscal viability, hospitals continue to acquire new imaging and therapy technologies for competitive and access-to-services reasons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10129808

  5. Orthopaedic radiology

    SciTech Connect

    Park, W.M.; Hughes, S.P.F.

    1985-01-01

    This book provides an account of the principles of modern diagnostic imaging techniques and their applications in orthopedics. The aim of the book is to show radiology as a dynamic subject which can help clinicians, while at the same time assisting radiologists to understand the needs of the orthopedic surgeon.

  6. Fluid Retention Associated with Imatinib Treatment in Patients with Gastrointestinal Stromal Tumor: Quantitative Radiologic Assessment and Implications for Management

    PubMed Central

    Shinagare, Atul B.; Krajewski, Katherine M.; Pyo, Junhee; Tirumani, Sree Harsha; Jagannathan, Jyothi P.; Ramaiya, Nikhil H.

    2015-01-01

    Objective We aimed to describe radiologic signs and time-course of imatinib-associated fluid retention (FR) in patients with gastrointestinal stromal tumor (GIST), and its implications for management. Materials and Methods In this Institutional Review Board-approved, retrospective study of 403 patients with GIST treated with imatinib, 15 patients with imaging findings of FR were identified by screening radiology reports, followed by manual confirmation. Subcutaneous edema, ascites, pleural effusion, and pericardial effusion were graded on a four-point scale on CT scans; total score was the sum of these four scores. Results The most common radiologic sign of FR was subcutaneous edema (15/15, 100%), followed by ascites (12/15, 80%), pleural effusion (11/15, 73%), and pericardial effusion (6/15, 40%) at the time of maximum FR. Two distinct types of FR were observed: 1) acute/progressive FR, characterized by acute aggravation of FR and rapid improvement after management, 2) intermittent/steady FR, characterized by occasional or persistent mild FR. Acute/progressive FR always occurred early after drug initiation/dose escalation (median 1.9 month, range 0.3-4.0 months), while intermittent/steady FR occurred at any time. Compared to intermittent/steady FR, acute/progressive FR was severe (median score, 5 vs. 2.5, p = 0.002), and often required drug-cessation/dose-reduction. Conclusion Two distinct types (acute/progressive and intermittent/steady FR) of imatinib-associated FR are observed and each type requires different management. PMID:25741192

  7. Combined radiologic and endoscopic treatment (using the “rendezvous technique”) of a biliary fistula following left hepatectomy

    PubMed Central

    Gracient, Aurélien; Rebibo, Lionel; Delcenserie, Richard; Yzet, Thierry; Regimbeau, Jean-Marc

    2016-01-01

    Despite the ongoing decrease in the frequency of complications after hepatectomy, biliary fistulas still occur and are associated with high morbidity and mortality rates. Here, we report on an unusual technique for managing biliary fistula following left hepatectomy in a patient in whom the right posterior segmental duct joined the left hepatic duct. The biliary fistula was treated with a combined radiologic and endoscopic procedure based on the “rendezvous technique”. The clinical outcome was good, and reoperation was not required. PMID:27570431

  8. Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: a randomized controlled superiority trial.

    PubMed

    Rubio-Valera, Maria; March Pujol, Marian; Fernández, Ana; Peñarrubia-María, M Teresa; Travé, Pere; López Del Hoyo, Yolanda; Serrano-Blanco, Antoni

    2013-09-01

    Major depression is associated with high burden, disability and costs. Non-adherence limits the effectiveness of antidepressants. Community pharmacists (CP) are in a privileged position to help patients cope with antidepressant treatment. The aim of the study was to evaluate the impact of a CP intervention on primary care patients who had initiated antidepressant treatment. Newly diagnosed primary care patients were randomised to usual care (UC) (92) or pharmacist intervention (87). Patients were followed up at 6 months and evaluated three times (Baseline, and at 3 and 6 months). Outcome measurements included clinical severity of depression (PHQ-9), health-related quality of life (HRQOL) (Euroqol-5D) and satisfaction with pharmacy care. Adherence was continuously registered from the computerised pharmacy records. Non-adherence was defined as refilling less than 80% of doses or having a medication-free gap of more than 1 month. Patients in the intervention group were more likely to remain adherent at 3 and 6 months follow-up but the difference was not statistically significant. Patients in the intervention group showed greater statistically significant improvement in HRQOL compared with UC patients both in the main analysis and PP analyses. No statistically significant differences were observed in clinical symptoms or satisfaction with the pharmacy service. The results of our study indicate that a brief intervention in community pharmacies does not improve depressed patients' adherence or clinical symptoms. This intervention helped patients to improve their HRQOL, which is an overall measure of patient status. PMID:23219937

  9. Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Schreibman, Laura; Dawson, Geraldine; Stahmer, Aubyn C.; Landa, Rebecca; Rogers, Sally J.; McGee, Gail G.; Kasari, Connie; Ingersoll, Brooke; Kaiser, Ann P.; Bruinsma, Yvonne; McNerney, Erin; Wetherby, Amy; Halladay, Alycia

    2015-01-01

    Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. "Naturalistic Developmental Behavioral Interventions…

  10. Do pharmacological and behavioral interventions differentially affect treatment outcome for children with social phobia?

    PubMed

    Scharfstein, Lindsay A; Beidel, Deborah C; Finnell, Laura Rendon; Distler, Aaron; Carter, Nathan T

    2011-09-01

    In a randomized trial for children with social phobia (SP), Social Effectiveness Therapy for Children (SET-C; a treatment consisting of exposure and social skills training) and fluoxetine were more effective than pill placebo in reducing social distress and behavioral avoidance, but only SET-C demonstrated significantly improved overall social skill and social competence. In the current study, the authors examined the specific social skills enhanced by SET-C using a recently developed coding schema. At posttreatment, children treated with SET-C displayed a more effective ability to manage the conversational topic (pragmatic social behaviors) and more appropriate motor movement, facial orientation, and posture (paralinguistic social behaviors) than children treated with fluoxetine or placebo. In contrast, children treated with fluoxetine displayed no more pragmatic or paralinguistic skill than children given a pill placebo. There were no group differences on ratings of voice volume and vocal inflection (speech and prosodic social behaviors). Furthermore, only children treated with SET-C improved from pre- to posttreatment on all three skill variables. Findings suggest that pharmacological interventions that only target reduction in anxious arousal may not have an impact on social skill deficits and may not be adequate to optimally treat SP. The relationship of social skill to social avoidance and the importance of social skills training to enhance social competence in the treatment of childhood SP are discussed. PMID:21586501

  11. Hybrid Interventional Treatment of Iatrogenic Innominate Artery Aneurysm in a Child.

    PubMed

    Paczkowski, Konrad; Haponiuk, Ireneusz; Chojnicki, Maciej; Brzezińska-Rajszys, Grażyna

    2016-01-01

    An iatrogenic aneurysm of an innominate artery is an extremely rare complication, especially in children. Nevertheless, this pathology was diagnosed in a child given palliative care with chronic respiratory insufficiency and a history of encephalitis requiring permanent ventilation at home via a tracheal tube.A nine-year-old girl with colitis ulcerosa and a history of hemorrhagic encephalitis, with chronic home ventilation therapy, was admitted in an emergency setting because of massive bleeding from the upper respiratory tract and the area surrounding the tracheotomy. Repeated tamponade with topically applied thrombin, and administration of tranexamid acid and cyclonamine appeared ineffective Because of a life-threatening condition and unknown origin of massive bleeding, the child was referred for cardiac catheterization with aortography before qualifying for surgery, with the option of alternative interventional treatment. An alternative option with PTFE-coated stent direct implantation into the brachiocephalic trunk from a peripheral vascular approach was performed. The girl was discharged home after a short recovery. Her chronic home ventilation was continued without additional problems.Stenting of a brachiocephalic trunk aneurysm with a PTFE-coated stent appeared to be a safe and effective treatment of massive bleeding from the respiratory tract, with its main advantage of avoiding the risk of a classic surgical approach in a palliatively treated patient. PMID:27585203

  12. Suppression of Myocardial Injury Markers following Percutaneous Coronary Interventions by Pre-treatment with Carvedilol

    PubMed Central

    Moloudi, Abdolrasoul; Sabzi, Feridoun; Rashidi, Shirin

    2012-01-01

    Background Retrospective studies and clinical trials have indicated that β-receptor blockers have an influential role in improving survival and reducing risk of recurrent infarction in patients with myocardial infarction. However, there is still controversy regarding the effects of β-receptor blockers on the markers of myocardial infarction following percutaneous coronary interventions (PCI). Objective The aim of this study was to evaluate the pre-treatment effect of Carvedilol on markers of myocardial injury in patients undergoing elective PCI. Method and Materials In this clinical trial patients undergoing elective PCI were categorized randomly in the Carvedilol group including 100 patients who received two doses of 12.5 mg, 6 and 12 hours prior to PCI, and the control group (105 patients). Blood samples were obtained to analyse cardiac biomarker, 12 and 24 hours after PCI. Results The clinical features were not significantly different between the two groups. A increase in the level of Troponin I was observed in the control group 24 hours following PCI (P=0.042), whereas this rise in troponin I was slight and insignificant in the Carvedilol group (P>0.05). some difference was observed between the two groups in regard to the level of CPK-MB after PCI (P=0.041). Conclusion The findings of our study indicate that pre-treatment with Carvedilol confers cardio-protection by limiting the rise of markers of myocardial injury following PCI. PMID:24757599

  13. Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: a systematic review

    PubMed Central

    2014-01-01

    Background The purpose of this systematic review is to assess the effectiveness of brief interventions (BIs) as part of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances. Methods Bibliographic databases (including MEDLINE, Embase, The Cochrane Library, CINAHL, and PsycINFO to April 2012) and gray literature sources were searched. We included randomized controlled trials that opportunistically screened adolescents or adults and then provided a one-to-one, verbal BI to those at risk of substance-use harm. Of interest was the nonmedical use of psychoactive substances (for example, drugs prohibited by international law), excluding alcohol, nicotine, and caffeine. Interventions comprised four or fewer sessions and were compared with no/delayed intervention or provision of information only. Studies were assessed for bias using the Cochrane risk of bias tool. Results were synthesized narratively. Evidence was interpreted according to the GRADE framework. Results We identified 8,836 records. Of these, five studies met our inclusion criteria. Two studies compared BI with no BI, and three studies compared BI with information only. Studies varied in characteristics such as substances targeted, screening procedures, and BI administered. Outcomes were mostly reported by a single study, leading to limited or uncertain confidence in effect estimates. Conclusions Insufficient evidence exists as to whether BIs, as part of SBIRT, are effective or ineffective for reducing the use of, or harms associated with nonmedical use of, psychoactive substances when these interventions are administered to nontreatment-seeking, screen-detected populations. Updating this review with emerging evidence will be important. Trial registration CRD42012002414 PMID:24887418

  14. Treatment of Psychogenic Nonepileptic Seizures: Updated Review and Findings From a Mindfulness-Based Intervention Case Series

    PubMed Central

    Baslet, Gaston; Dworetzky, Barbara; Perez1, David L.; Oser, Megan

    2015-01-01

    Psychogenic non-epileptic seizures (PNES) were first described in the medical literature in the 19th century as seizure-like attacks not related to an identified central nervous system lesion and are currently classified as a conversion disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). While a universally accepted and unifying etiological model does not yet exist, several risk factors have been identified. Management of PNES should be based on interdisciplinary collaboration, targeting modifiable risk factors. The first treatment phase in PNES is patient engagement, which is challenging given the demonstrated low rates of treatment retention. Acute interventions constitute the next phase in treatment and most research studies focus on short-term evidence-based interventions. Randomized controlled pilot trials support cognitive-behavioral therapy. Other psychotherapeutic and psychopharmacological interventions have been less well-studied using controlled and uncontrolled trials. Within the discussion of acute interventions, we present a preliminary evaluation for feasibility of a mindfulness-based psychotherapy protocol in a very small sample of PNES patients. We demonstrated in 6 subjects that this intervention is feasible in real-life clinical scenarios and warrants further investigation in larger scale studies. The final treatment phase is long-term follow-up. Long-term outcome studies in PNES show that a significant proportion of patients remain symptomatic and experience continued impairments in quality of life and functionality. We believe that PNES should be understood as a disease that requires different types of intervention during the various phases of treatment. PMID:25465435

  15. Identification of Escherichia coli O157:H7 surrogate organisms to evaluate beef carcass intervention treatment efficacy.

    PubMed

    Ingham, Steven C; Algino, Ryan J; Ingham, Barbara H; Schell, Ronald F

    2010-10-01

    We compared the survival of potential pathogen surrogates-meat-hygiene indicators (non-Escherichia coli coliforms), biotype I E. coli, and lactic acid bacteria starter cultures-with survival of an E. coli O157:H7 (ECO157:H7) inoculum in beef carcass intervention trials. Survival of one lactic acid bacteria starter culture (Bactoferm LHP Dry [Pediococcus acidilactici and Pediococcus pentosaceus]), a five-isolate biotype I inoculum, and a five-isolate non-E. coli coliform inoculum, was compared with survival of a 12-isolate ECO157:H7 inoculum in interventions by using beef brisket (adipose and lean), cod fat membrane, or neck tissue. Treatments were grouped by abattoir size: small (6-day dry aging; 22°C acid treatment [2.5% acetic acid, 2% lactic acid, or Fresh Bloom], followed by 1-day dry aging; hot water) and large (warm acid treatment [5% acetic acid or 2% lactic acid] with or without a preceding hot water treatment). Reductions in pathogen and surrogate inocula were determined with excision sampling. A surrogate was considered a suitable replacement for ECO157:H7 if the intervention produced a reduction in surrogate levels that was not significantly greater (P≥0.05) than that observed for ECO157:H7. All three surrogate inocula were suitable as ECO157 surrogates for dry aging and acid spray plus dry-aging treatments used by small abattoirs. No one inoculum was suitable as an ECO157 surrogate across all intervention treatments used by large abattoirs. Effects seen on neck tissue were representative of other tissues, and the low value of the neck supports its use as the location for evaluating treatment efficacy in in-plant trials. Results support using nonpathogenic surrogate organisms to validate beef carcass intervention efficacy. PMID:21067675

  16. Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds.

    PubMed

    Farah, J; Trianni, A; Carinou, E; Ciraj-Bjelac, O; Clairand, I; Dabin, J; De Angelis, C; Domienik, J; Jarvinen, H; Kopec, R; Majer, M; Malchair, F; Negri, A; Novák, L; Siiskonen, T; Vanhavere, F; Knežević, Ž

    2015-04-01

    To help operators acknowledge patient dose during interventional procedures, EURADOS WG-12 focused on measuring patient skin dose using XR-RV3 gafchromic films, thermoluminescent detector (TLD) pellets or 2D TL foils and on investigating possible correlation to the on-line dose indicators such as fluoroscopy time, Kerma-area product (KAP) and cumulative air Kerma at reference point (CK). The study aims at defining non-centre-specific European alert thresholds for skin dose in three interventional procedures: chemoembolization of the liver (CE), neuroembolization (NE) and percutaneous coronary interventions (PCI). Skin dose values of >3 Gy (ICRP threshold for skin injuries) were indeed measured in these procedures confirming the need for dose indicators that correlate with maximum skin dose (MSD). However, although MSD showed fairly good correlation with KAP and CK, several limitations were identified challenging the set-up of non-centre-specific European alert thresholds. This paper presents preliminary results of this wide European measurement campaign and focuses on the main challenges in the definition of European alert thresholds. PMID:25316909

  17. Technology-based interventions for the treatment and recovery management of substance use disorders: a JSAT special issue.

    PubMed

    Marsch, Lisa A; Carroll, Kathleen M; Kiluk, Brian D

    2014-01-01

    A growing line of research has highlighted the promising role that interactive web and mobile technologies may play in improving the effectiveness, cost-effectiveness, and reach of efforts to assess, prevent, treat, and support the recovery management of substance use disorders and other risk behavior. Manuscripts in this special issue of the Journal of Substance Abuse Treatment focus on the application of technology to the delivery of interventions for the treatment and recovery management of substance use disorders. These manuscripts are intended to highlight the diversity and current state of the science of empirically-supported innovations in this area of intervention delivery. The included manuscripts range from experimental evaluations of a variety of types of technology-based interventions (brief interventions, behavior therapy, medication adherence tools, and HIV prevention interventions) and technology platforms (mobile, Web, videoconferencing, and telephone-based interactive voice response), for an array of populations (adults, adolescents, criminal justice populations, and post-partum women), in a number of different settings (addiction specialty treatment programs, schools, emergency rooms, and criminal justice settings). They additionally reflect a variety of experimental research designs, including those focused on the design, development, and clinical evaluation of these technology-based therapeutic tools, as well as research focused on models for their successful implementation and sustained use. PMID:24041749

  18. Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery)

    PubMed Central

    2014-01-01

    Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients

  19. Vascular Complications of Pancreatitis: Imaging and Intervention

    SciTech Connect

    Kirby, John M. Vora, Parag; Midia, Mehran; Rawlinson, John

    2008-09-15

    The objective of this study was to highlight technical challenges and potential pitfalls of diagnostic imaging, intervention, and postintervention follow-up of vascular complications of pancreatitis. Diagnostic and interventional radiology imaging from patients with pancreatitis from 2002 to 2006 was reviewed. We conclude that biphasic CT is the diagnostic modality of choice. Catheter angiography may (still) be required to diagnose small pseudoaneurysms. Endovascular coiling is the treatment of choice for pseudoaneurysms. Close clinical follow-up is required, as patients may rebleed/develop aneurysms elsewhere.

  20. Integrating Prevention Interventions for People Living With HIV Into Care and Treatment Programs: A Systematic Review of the Evidence

    PubMed Central

    Medley, Amy; Bachanas, Pamela; Grillo, Michael; Hasen, Nina; Amanyeiwe, Ugochukwu

    2015-01-01

    Introduction This review assesses the impact of prevention interventions for people living with HIV on HIV-related mortality, morbidity, retention in care, quality of life, and prevention of ongoing HIV transmission in resource-limited settings (RLSs). Methods We conducted a systematic review of studies reporting the results of prevention interventions for people living with HIV in RLS published between January 2000 and August 2014. Standardized methods of searching and data abstraction were used. Results Ninety-two studies met the eligibility criteria: 24 articles related to adherence counseling and support, 13 on risk reduction education and condom provision, 19 on partner HIV testing and counseling, 14 on provision of family planning services, and 22 on assessment and treatment of other sexually transmitted infections. Findings indicate good evidence that adherence counseling and sexually transmitted infection treatment can have a high impact on morbidity, whereas risk reduction education, partner HIV testing and counseling, and family planning counseling can prevent transmission of HIV. More limited evidence was found to support the impact of these interventions on retention in care and quality of life. Most studies did not report cost information, making it difficult to draw conclusions about the cost-effectiveness of these interventions. Conclusions This evidence suggests that these prevention interventions, if brought to sufficient scale and coverage, can help support and optimize the impact of core treatment and prevention interventions in RLS. Further operational research with more rigorous study designs, and ideally with biomarkers and costing information, is needed to determine the best model for providing these interventions in RLS. PMID:25768868

  1. Responding to Requests of Families for Unproven Interventions in Neurodevelopmental Disorders: Hyperbaric Oxygen "Treatment" and Stem Cell "Therapy" in Cerebral Palsy

    ERIC Educational Resources Information Center

    Bell, Emily; Wallace, Tessa; Chouinard, Isabelle; Shevell, Michael; Racine, Eric

    2011-01-01

    Faced with the limitations of currently available mainstream medical treatments and interventions, parents of children with neurodevelopmental disorders often seek information about unproven interventions. These interventions frequently have undetermined efficacy and uncertain safety profiles. In this article, we present a general background and…

  2. The Behavior Education Support and Treatment (BEST) School Intervention Program: Pilot Project Data Examining Schoolwide, Targeted-School, and Targeted-Home Approaches

    ERIC Educational Resources Information Center

    Waschbusch, Daniel A.; Pelham, William E., Jr.; Massetti, Greta

    2005-01-01

    As part of a pilot project, four elementary schools were randomly assigned to receive one of four interventions: (a) a schoolwide intervention that incorporated universal and targeted treatment, (b) a targeted-school intervention delivered to individual students in regular and special education classrooms, (c) a targeted-home intervention…

  3. Shared Decision-Making in the Primary Care Treatment of Late-Life Major Depression: A Needed New Intervention?

    PubMed Central

    Raue, Patrick J.; Schulberg, Herbert C.; Lewis-Fernandez, Roberto; Boutin-Foster, Carla; Hoffman, Amy S.; Bruce, Martha L.

    2010-01-01

    Objective We suggest that clinicians consider models of shared decision-making for their potential ability to improve the treatment of major depression in the primary care setting and overcome limitations of collaborative care and other interventions. Methods We explore the characteristics and techniques of patient-clinician shared decision-making, with particular emphasis on this model’s relevance to the unique treatment concerns of depressed older adults. Results We describe a shared decision-making intervention to engage older adults in depression treatment in the primary care sector. Conclusions It is timely to examine shared decision-making models for elderly depressed primary care patients given their potential ability to improve treatment adherence and clinical outcomes. PMID:19946872

  4. Chest radiology

    SciTech Connect

    Reed, J.C.

    1990-01-01

    This book is a reference in plain chest film diagnosis provides a thorough background in the differential diagnosis of 22 of the most common radiologic patterns of chest disease. Each chapter is introduced with problem cases and a set of questions, followed by a tabular listing of the appropriate differential considerations. The book emphasizes plain films, CT and some MR scans are integrated to demonstrate how these modalities enhance the work of a case.

  5. Evaluating the Expected Costs and Budget Impact of Interventional Therapies for the Treatment of Chronic Venous Disease

    PubMed Central

    Carlton, Rashad; Mallick, Rajiv; Campbell, Chelsey; Raju, Aditya; O'Donnell, Thomas; Eaddy, Michael

    2015-01-01

    Background Chronic venous disease is a common disorder in the United States. The manifestations of chronic venous disease include varicosities and related sequelae that are frequent contributors to the morbidity and high costs associated with the disease. The interventional treatment options for chronic venous disease have expanded greatly in recent years and include various surgical and vein ablation techniques. Polidocanol injectable foam (also known as polidocanol endovenous microfoam 1%), a chemical ablation agent, is the most recent entrant to the market. Objective To evaluate the expected patient-level total treatment costs and health plan–level budgetary impact of polidocanol injectable foam compared with the currently available interventional treatment options from a third-party US payer perspective. Methods A Microsoft Excel–based budget impact model was designed to compare the costs of polidocanol injectable foam with other interventional treatments (ie, laser ablation, radiofrequency ablation, surgery, and multimodality treatment). The model included drug acquisition, medical procedure, administration, additional treatment, and disease progression costs. The treatment patterns and rates of additional treatment were incorporated from a recent retrospective claims analysis for established treatment modalities and from the clinical trials for polidocanol injectable foam. The model estimates the 1-year total estimated costs and the health plan budget impact assuming an 8-week treatment time frame. Results The total expected 8-week treatment costs were $2165 for polidocanol injectable foam, $1827 for endovenous laser ablation, $2106 for radiofrequency ablation, $2374 for surgery, and $2844 for multimodality treatment. The initial treatment costs were higher for surgery and multimodality treatment compared with polidocanol injectable foam and were lower for endovenous laser ablation and radiofrequency ablation treatments. Polidocanol injectable foam is

  6. Predictive factors of radiological progression after 2 years of remission-steered treatment in early arthritis patients: a post hoc analysis of the IMPROVED study

    PubMed Central

    Akdemir, Gülşah; Verheul, Marije K; Heimans, Lotte; Wevers-de Boer, Kirsten V C; Goekoop-Ruiterman, Yvonne P M; van Oosterhout, Maikel; Harbers, Joop B; Bijkerk, Casper; Steup-Beekman, Gerda M; Lard, Leroy R; Huizinga, Tom W J; Trouw, Leendert A; Allaart, Cornelia F

    2016-01-01

    Objectives To identify predictive factors of radiological progression in early arthritis patients treated by remission-steered treatment. Methods In the IMPROVED study, 610 patients with early rheumatoid arthritis (RA) or undifferentiated arthritis (UA) were treated with methotrexate (MTX) and a tapered high dose of prednisone. Patients in early remission (disease activity score (DAS) <1.6 after 4 months) tapered prednisone to zero. Patients not in early remission were randomised to arm 1: MTX plus hydroxychloroquine, sulfasalazine and prednisone, or to arm 2: MTX plus adalimumab. Predictors of radiological progression (≥0.5 Sharp/van der Heijde score; SHS) after 2 years were assessed using logistic regression analysis. Results Median (IQR) SHS progression in 488 patients was 0 (0–0) point, without differences between RA or UA patients or between treatment arms. In only 50/488 patients, the SHS progression was ≥0.5: 33 (66%) were in the early DAS remission group, 9 (18%) in arm 1, 5 (10%) in arm 2, 3 (6%) in the outside of protocol group. Age (OR (95% CI): 1.03 (1.00 to 1.06)) and the combined presence of anticarbamylated protein antibodies (anti-CarP) and anticitrullinated protein antibodies (ACPA) (2.54 (1.16 to 5.58)) were independent predictors for SHS progression. Symptom duration <12 weeks showed a trend. Conclusions After 2 years of remission steered treatment in early arthritis patients, there was limited SHS progression in only a small group of patients. Numerically, patients who had achieved early DAS remission had more SHS progression than other patients. Positivity for both anti-CarP and ACPA and age were independently associated with SHS progression. Trial registration numbers ISRCTN Register number 11916566 and EudraCT number 2006 06186-16. PMID:26925251

  7. Implementing a Statewide Screening, Brief Intervention, and Referral to Treatment (SBIRT) Service in Rural Health Settings: New Mexico SBIRT

    ERIC Educational Resources Information Center

    Gonzales, Arturo; Westerberg, Verner S.; Peterson, Thomas R.; Moseley, Ana; Gryczynski, Jan; Mitchell, Shannon Gwin; Buff, Gary; Schwartz, Robert P.

    2012-01-01

    This is a report on the New Mexico Screening, Brief Intervention, and Referral to Treatment (SBIRT) project conducted over 5 years as part of a national initiative launched by the Substance Abuse and Mental Health Services Administration with the aim of increasing integration of substance use services and medical care. Throughout the state, 53,238…

  8. A Systematic Review on the Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction

    PubMed Central

    Dugosh, Karen; Abraham, Amanda; Seymour, Brittany; McLoyd, Keli; Chalk, Mady; Festinger, David

    2016-01-01

    Opioid use and overdose rates have risen to epidemic levels in the United States during the past decade. Fortunately, there are effective medications (ie, methadone, buprenorphine, and oral and injectable naltrexone) available for the treatment of opioid addiction. Each of these medications is approved for use in conjunction with psychosocial treatment; however, there is a dearth of empirical research on the optimal psychosocial interventions to use with these medications. In this systematic review, we outline and discuss the findings of 3 prominent prior reviews and 27 recent publications of empirical studies on this topic. The most widely studied psychosocial interventions examined in conjunction with medications for opioid addiction were contingency management and cognitive behavioral therapy, with the majority focusing on methadone treatment. The results generally support the efficacy of providing psychosocial interventions in combination with medications to treat opioid addictions, although the incremental utility varied across studies, outcomes, medications, and interventions. The review highlights significant gaps in the literature and provides areas for future research. Given the enormity of the current opioid problem in the United States, it is critical to gain a better understanding of the most effective ways to deliver psychosocial treatments in conjunction with these medications to improve the health and well-being of individuals suffering from opioid addiction. PMID:26808307

  9. Position of the Academy of Nutrition and Dietetics: Interventions for the Treatment of Overweight and Obesity in Adults.

    PubMed

    Raynor, Hollie A; Champagne, Catherine M

    2016-01-01

    It is the position of the Academy of Nutrition and Dietetics that successful treatment of overweight and obesity in adults requires adoption and maintenance of lifestyle behaviors contributing to both dietary intake and physical activity. These behaviors are influenced by many factors; therefore, interventions incorporating more than one level of the socioecological model and addressing several key factors in each level may be more successful than interventions targeting any one level and factor alone. Registered dietitian nutritionists, as part of a multidisciplinary team, need to be current and skilled in weight management to effectively assist and lead efforts that can reduce the obesity epidemic. Using the Academy of Nutrition and Dietetics' Evidence Analysis Process and Evidence Analysis Library, this position paper presents the current data and recommendations for the treatment of overweight and obesity in adults. Evidence on intrapersonal influences, such as dietary approaches, lifestyle intervention, pharmacotherapy, and surgery, is provided. Factors related to treatment, such as intensity of treatment and technology, are reviewed. Community-level interventions that strengthen existing community assets and capacity and public policy to create environments that support healthy energy balance behaviors are also discussed. PMID:26718656

  10. Implementation of a "Learner-Driven" Curriculum: An Screening, Brief Intervention, and Referral to Treatment (SBIRT) Interdisciplinary Primary Care Model

    ERIC Educational Resources Information Center

    Stanton, Marina R.; Atherton, W. Leigh; Toriello, Paul J.; Hodgson, Jennifer L.

    2012-01-01

    Although screening, brief intervention, and referral to treatment (SBIRT) has been a popular model to address potential substance abuse issues in primary care, there is a need for innovative approaches for training providers and staff on SBIRT protocols. An interdisciplinary approach to SBIRT training, named ICARE, was implemented at 3 different…

  11. Developing and Implementing a Multispecialty Graduate Medical Education Curriculum on Screening, Brief Intervention, and Referral to Treatment (SBIRT)

    ERIC Educational Resources Information Center

    Tetrault, Jeanette M.; Green, Michael L.; Martino, Steve; Thung, Stephen F.; Degutis, Linda C.; Ryan, Sheryl A.; Martel, Shara; Pantalon, Michael V.; Bernstein, Steven L.; O'Connor, Patrick G.; Fiellin, David A.; D'Onofrio, Gail

    2012-01-01

    The authors sought to evaluate the feasibility and acceptability of initiating a Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and other drug use curriculum across multiple residency programs. SBIRT project faculty in the internal medicine (traditional, primary care internal medicine, medicine/pediatrics),…

  12. Effect of an Organizational Linkage Intervention on Staff Perceptions of Medication-Assisted Treatment and Referral Intentions in Community Corrections

    PubMed Central

    Friedmann, Peter D.; Wilson, Donna; Knudsen, Hannah; Ducharme, Lori; Welsh, Wayne; Frisman, Linda; Knight, Kevin; Lin, Hsiu-Ju; James, Amy; Albizu-Garcia, Carmen; Pankow, Jennifer; Hall, Elizabeth; Urbine, Terry; Abdel-Salam, Sami; Duvall, Jamieson; Vocci, Frank

    2014-01-01

    Introduction Medication-assisted treatment (MAT) is effective for alcohol and opioid use disorders but it is stigmatized and underutilized in criminal justice settings. Methods This study cluster-randomized 20 community corrections sites to determine whether an experimental implementation strategy of training and an organizational linkage intervention improved staff perceptions of MAT and referral intentions more than training alone. The 3-hour training was designed to address deficits in knowledge, perceptions and referral information, and the organizational linkage intervention brought together community corrections and addiction treatment agencies in an interagency strategic planning and implementation process over 12 months. Results Although training alone was associated with increases in familiarity with pharmacotherapy and knowledge of where to refer clients, the experimental intervention produced significantly greater improvements in functional attitudes (e.g. that MAT is helpful to clients) and referral intentions. Corrections staff demonstrated greater improvements in functional perceptions and intent to refer opioid dependent clients for MAT than did treatment staff. Conclusion Knowledge, perceptions and information training plus interorganizational strategic planning intervention is an effective means to change attitudes and intent to refer clients for medication assisted treatment in community corrections settings, especially among corrections staff. PMID:25456091

  13. A Systematic Review on the Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction.

    PubMed

    Dugosh, Karen; Abraham, Amanda; Seymour, Brittany; McLoyd, Keli; Chalk, Mady; Festinger, David

    2016-01-01

    Opioid use and overdose rates have risen to epidemic levels in the United States during the past decade. Fortunately, there are effective medications (ie, methadone, buprenorphine, and oral and injectable naltrexone) available for the treatment of opioid addiction. Each of these medications is approved for use in conjunction with psychosocial treatment; however, there is a dearth of empirical research on the optimal psychosocial interventions to use with these medications. In this systematic review, we outline and discuss the findings of 3 prominent prior reviews and 27 recent publications of empirical studies on this topic. The most widely studied psychosocial interventions examined in conjunction with medications for opioid addiction were contingency management and cognitive behavioral therapy, with the majority focusing on methadone treatment. The results generally support the efficacy of providing psychosocial interventions in combination with medications to treat opioid addictions, although the incremental utility varied across studies, outcomes, medications, and interventions. The review highlights significant gaps in the literature and provides areas for future research. Given the enormity of the current opioid problem in the United States, it is critical to gain a better understanding of the most effective ways to deliver psychosocial treatments in conjunction with these medications to improve the health and well-being of individuals suffering from opioid addiction. PMID:26808307

  14. Examining the Effectiveness of a Multicomponent Reading Comprehension Intervention in Middle Schools: A Focus on Treatment Fidelity

    ERIC Educational Resources Information Center

    Fogarty, Melissa; Oslund, Eric; Simmons, Deborah; Davis, John; Simmons, Leslie; Anderson, Leah; Clemens, Nathan; Roberts, Greg

    2014-01-01

    In this experimental study, we examined the effects of a multicomponent reading comprehension intervention in sixth- to eighth-grade English language arts classes with a focus on factors to enhance treatment implementation. We tested the contribution of a theoretically derived fidelity framework that included adherence, quality, dosage, program…

  15. Treatment Effects of a Modular Intervention for Early-Onset Child Behavior Problems on Family Contextual Outcomes

    ERIC Educational Resources Information Center

    Shaffer, Anne; Lindhiem, Oliver; Kolko, David J.

    2013-01-01

    The overall aim of this multi-informant study was to examine pre-post treatment changes, and maintenance at 3-year follow-up, for multiple dimensions of the family context, for a modular intervention that has previously demonstrated significant clinical improvements in child behavior and maintenance of these effects. Family outcomes included…

  16. Developing Brain Injury Interventions on Both Ends of the Treatment Continuum Depends upon Early Research Partnerships and Feasibility Studies

    ERIC Educational Resources Information Center

    Sohlberg, McKay Moore; Kucheria, Priya; Fickas, Stephen; Wade, Shari L.

    2015-01-01

    Purpose: The purpose of this research article is to describe two very different lines of brain injury treatment research, both of which illuminate the benefits of implementation science. Method: The article first describes the development and pilot of a computerized cognitive intervention and highlights how adherence to implementation science…

  17. Teaching the Teachers: Faculty Preparedness and Evaluation of a Retreat in Screening, Brief Intervention, and Referral to Treatment

    ERIC Educational Resources Information Center

    Childers, Julie W.; Broyles, Lauren M.; Hanusa, Barbara H.; Kraemer, Kevin L.; Conigliaro, Joseph; Spagnoletti, Carla; McNeil, Melissa; Gordon, Adam J.

    2012-01-01

    Effective clinical faculty are essential for disseminating substance abuse screening, brief intervention, and referral to treatment (SBIRT). The authors developed an 8-hour SBIRT training for internal medicine faculty preceptors. Trainers conducted SBIRT lectures and small-group communication practice sessions. The authors assessed participants'…

  18. Non-pharmacological treatments in autism spectrum disorders: an overview on early interventions for pre-schoolers.

    PubMed

    Narzisi, Antonio; Costanza, Colombi; Umberto, Balottin; Filippo, Muratori

    2014-02-01

    This paper evaluates the current literature on non-pharmacological early interventions (behavior behavioral, developmental and educational approaches) for pre-schoolers (aged 24-71 months) with autism spectrum disorders. Although there lies a significant heterogeneity among the available studies, the present review emphasizes the importance of considering the wide range of interventions through behavioral (behavioral or developmental interventions) and educational continuum according to the suggestions of the recent literature in this field. Furthermore, the present review: 1) outlines the issues about the scientific validity of the treatment outcome studies; 2) describes the findings of different parent-mediated interventions; 3) highlights the importance to use the same outcome measures through the studies to compare findings of different literature contributions; and 4) focuses on the importance to consider pre-treatment variables to identify children who will have better outcomes. Furthermore, some evidence-based guidelines about clinical management and treatment have also been outlined and summarized in this review. Finally, the review concludes on providing a number of practical recommendations to clinicians working in the field suggesting both the presence of a specialized team and role of an active collaboration of the family to treatment as core milestones for the clinical management. PMID:24050743

  19. Institutional Incorporation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Residency Training: Achieving a Sustainable Curriculum

    ERIC Educational Resources Information Center

    Scott, Denise M.; McLaurin-Jones, TyWanda; Brown, Fannie D.; Newton, Robin; Marshall, Vanessa J.; Kalu, Nnenna; Cain, Gloria E.; Taylor, Robert E.

    2012-01-01

    The success of implementing a screening, brief intervention and referral to treatment (SBIRT) program within a medical residency program for sustainability is contingent upon a well-crafted training curriculum that incorporates substance abuse education and clinical practice skills. The goal of the Howard University (HU) SBIRT program is to train…

  20. Finite Element Modeling of Endovascular Intervention Enables Hemodynamic Prediction of Complex Treatment Strategies for Coiling and Flow Diversion

    PubMed Central

    Damiano, Robert J.; Ma, Ding; Xiang, Jianping; Siddiqui, Adnan H.; Snyder, Kenneth V.; Meng, Hui

    2016-01-01

    Endovascular interventions using coil embolization and flow diversion are becoming the mainstream treatment for intracranial aneurysms (IAs). To help assess the effect of intervention strategies on aneurysm hemodynamics and treatment outcome, we have developed a finite-element-method (FEM)-based technique for coil deployment along with our HiFiVS technique for flow diverter (FD) deployment in patient-specific IAs. We tested four clinical intervention strategies: coiling (1–8 coils), single FD, FD with adjunctive coils (1–8 coils), and overlapping FDs. By evaluating post-treatment hemodynamics using computational fluid dynamics (CFD), we compared the flow-modification performance of these strategies. Results show that a single FD provides more reduction in inflow rate than low PD coiling, but less reduction in average velocity inside the aneurysm. Adjunctive coils add no additional reduction of inflow rate beyond a single FD until coil PD exceeds 11%. This suggests that the main role of FDs is to divert inflow, while that of coils is to create stasis in the aneurysm. Overlapping FDs decreases inflow rate, average velocity, and average wall shear stress (WSS) in the aneurysm sac, but adding a third FD produces minimal additional reduction. In conclusion, our FEM-based techniques for virtual coiling and flow diversion enable recapitulation of complex endovascular intervention strategies and detailed hemodynamics to identify hemodynamic factors that affect treatment outcome. PMID:26169778