Glenohumeral abduction contracture in children with unresolved neonatal brachial plexus palsy.

Science.gov (United States)

Eismann, Emily A; Little, Kevin J; Laor, Tal; Cornwall, Roger

2015-01-21

Following neonatal brachial plexus palsy, the Putti sign-obligatory tilt of the scapula with brachiothoracic adduction-suggests the presence of glenohumeral abduction contracture. In the present study, we utilized magnetic resonance imaging (MRI) to quantify this glenohumeral abduction contracture and evaluate its relationship to shoulder joint deformity, muscle atrophy, and function. We retrospectively reviewed MRIs of the thorax and shoulders obtained before and after shoulder rebalancing surgery (internal rotation contracture release and external rotation tendon transfer) for twenty-eight children with unresolved neonatal brachial plexus palsy. Two raters measured the coronal positions of the scapula, thoracic spine, and humeral shaft bilaterally on coronal images, correcting trigonometrically for scapular protraction on axial images. Supraspinatus, deltoid, and latissimus dorsi muscle atrophy was assessed, blinded to other measures. Correlations between glenohumeral abduction contracture and glenoid version, humeral head subluxation, passive external rotation, and Mallet shoulder function before and after surgery were performed. MRI measurements were highly reliable between raters. Glenohumeral abduction contractures were present in twenty-five of twenty-eight patients, averaging 33° (range, 10° to 65°). Among those patients, abductor atrophy was present in twenty-three of twenty-five, with adductor atrophy in twelve of twenty-five. Preoperatively, greater abduction contracture severity correlated with greater Mallet global abduction and hand-to-neck function. Abduction contracture severity did not correlate preoperatively with axial measurements of glenohumeral dysplasia, but greater glenoid retroversion was associated with worse abduction contractures postoperatively. Surgery improved passive external rotation, active abduction, and hand-to-neck function, but did not change the abduction contracture. A majority of patients with persistent shoulder weakness

Probabilistic Abductive Logic Programming in Constraint Handling Rules

DEFF Research Database (Denmark)

Christiansen, Henning

A class of Probabilistic Abductive Logic Programs (PALPs) is introduced and an implementation is developed in CHR for solving abductive problems, providing minimal explanations with their probabilities. Both all-explanations and most-probable-explanations versions are given. % Compared with other...

Alien Abductions

Science.gov (United States)

Nickell, Joe

2000-03-01

Since the beginning of the modern UFO craze in 1947, an elaborate mythology has developed concerning alleged extraterrestrial visitations. ``Flying saucer" sightings (typically involving misperceptions of such mundane phenomena as meteors and research balloons) began to be accompanied in the 1950s by reports from ``contactees," persons who claimed to have had close encounters with, even to have been transported to distant planets by, UFO occupants. By the 1960s came reports of sporadic ``abductions" which have proliferated in correlation with media interest. (Indeed, by interaction between claimants and media the portrayal of aliens has evolved from a multiplicity of types into the rather standardized big-eyed humanoid model.) While evidence of alien contact has often been faked--as by spurious photos, ``crop circles," and the notorious ``Alien Autopsy" film--few alien abduction reports appear to be hoaxes. Most seem instead to come from sincere, sane individuals. Nevertheless, not one has been authenticated, and serious investigation shows that such claims can be explained as sleep-related phenomena (notably ``waking dreams"), hypnotic confabulation, and other psychological factors. As is typical of other mythologies, the alien myth involves supernormal beings that may interact with humans, and it purports to explain the workings of the universe and humanity's place within it.

Legg-Calvé-Perthes disease: Diagnostics and contemporary treatment

Directory of Open Access Journals (Sweden)

Vukašinović Zoran

2008-01-01

Full Text Available Legg-Calvé-Perthes disease represents avascular necrosis of the femoral head in a growing child. It commonly affects children aged 2-14 years, mostly boys, and has familiar pattern. The etiology of this disease is unknown. It is based on avascular necrosis due to variations of the femoral head vascular supply, trauma, coagulation of endocrine disturbances. The disease presents with limping and pain localized in the hip with projection to thigh and knee, frequently accompanied by the limitation of abduction and internal rotation, as well as slight limitation in flexion of about 20 degrees. Plain radiography is most informative additional diagnostic procedure, enabling assessment of the stage of disease, containment of the femoral head within the acetabulum, acetabular coverage and the extent of disease. Main treatment goal is obtaining the spherical congruity of the hip joint. This can be achieved by abduction bracing, varization femoral osteotomies and various innominate osteotomies (sometimes combined with femoral osteotomies. Children younger than four years of age, with minimal femoral head involvement, do not need any treatment. These children with a larger involvement, older than four years of age, with possible containment in hip abducion, should be treated by one of the following procedures: Salter innominate osteotomy, Salter innominate osteotomy with femoral shortening, or triple pelvic osteotomy. The patients with containment of the hip is not possible in abduction (related to subluxation and femoral head crush, should be treated by Chiari pelvic osteotomy.

Patients exposure assessment for radiographic procedures in diagnostic radiology

International Nuclear Information System (INIS)

Arandjic, D.; Ciraj-Bjelac, O.; Stankovic, K.; Lazarevic, Dj.; Ciraj-Bjelac, O.)

2007-01-01

In this work the results of dose assessment for the most frequent radiographic procedures in diagnostic radiology are shown. Entrance surface doses were assessed for 7 radiographic procedures. Three hospitals, six x-ray units in total, were enrolled in investigation. Patient doses were estimated based on results of x-ray tube output measurements. Finally, doses were compared with Diagnostic reference level. Higher dose values were observed for chest examinations. In comparison with results from other countries, doses from this procedure in Serbia are significantly higher. Estimated doses for other procedures were well below Diagnostic reference levels [sr

Implementing Probabilistic Abductive Logic Programming with Constraint Handling Rules

DEFF Research Database (Denmark)

Christiansen, Henning

2008-01-01

A class of Probabilistic Abductive Logic Programs (PALPs) is introduced and an implementation is developed in CHR for solving abductive problems, providing minimal explanations with their probabilities. Both all-explanations and most-probable-explanations versions are given. Compared with other...

Biphasic threat to femoral head perfusion in abduction: arterial hypoperfusion and venous congestion

Energy Technology Data Exchange (ETDEWEB)

Yousefzadeh, David K. [Comer Children' s Hospital, Department of Radiology, Chicago, IL (United States); University of Chicago, Department of Radiology, Chicago, IL (United States); Jaramillo, Diego [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Johnson, Neil [Cincinnati Children' s Hospital, Department of Radiology, Cincinnati, OH (United States); Doerger, Kirk [Radiology Associates of Northern Kentucky, Crestview Hills, KY (United States); Sullivan, Christopher [University of Chicago, Department of Surgery, Chicago, IL (United States)

2010-09-15

Hip abduction can cause avascular necrosis (AVN) of the femoral head in infants. To compare the US perfusion pattern of femoral head cartilage in neutral position with that in different degrees and duration of abduction, testing the venous congestion theory of post-abduction ischemia. In 20 neonates, the Doppler flow characteristics of the posterosuperior (PS) branch of the femoral head cartilage feeding vessels were evaluated in neutral and at 30 , 45 , and 60 abduction. In three neonates the leg was held in 45-degree abduction and flow was assessed at 5, 10, and 15 min. Male/female ratio was 11/9 with a mean age of 1.86 {+-} 0.7 weeks. The peak systolic velocities (PSV) declined in all three degrees of abduction. After 15 min of 45-degree abduction, the mean PSV declined and showed an absent or reversed diastolic component and undetectable venous return. No perfusion was detected at 60-degree abduction. Abduction-induced femoral head ischemia is biphasic and degree- and duration-dependent. In phase I there is arterial hypoperfusion and in phase II there is venous congestion. A new pathogeneses for femoral head ischemia is offered. (orig.)

Hip abduction strength training in the clinical setting: with or without external loading?

DEFF Research Database (Denmark)

Thorborg, Kristian; Bandholm, T; Petersen, Jesper

2010-01-01

only the weight of the leg as resistance, whereas training with external loading was performed with a relative load corresponding to 10 repetition maximum. Hip abduction strength was measured pre- and post-intervention. Isometric and eccentric hip abduction strength of the trained leg increased after......The side-lying hip abduction exercise is one of the most commonly used exercises in rehabilitation to increase hip abduction strength, and is often performed without external loading. The aim of this study was to compare the effect of 6 weeks of side-lying hip abduction training, with and without...... external loading, on hip abduction strength in healthy subjects. Thirty-one healthy, physically active men and women were included in a randomised controlled trial and allocated to side-lying hip abduction training, with or without external loading. Training without external loading was performed using...

Normative values of eccentric hip abduction strength in novice runners

DEFF Research Database (Denmark)

Jørgensen, Daniel Ramskov; Pedersen, Mette Broen; Kastrup, Kristrian

2014-01-01

.354) Nm/kg. CONCLUSION: Normative values for maximal eccentric hip abduction strength in novice runners can be calculated by taking into account the differences in strength across genders and the decline in strength that occurs with increasing age. Age and gender were associated with maximal eccentric hip...... associated with maximal eccentric hip abduction strength from a univariate analysis were included in a multivariate linear regression model. Based on the results from the regression model, a regression equation for normative hip abduction strength is presented. RESULTS: A SIGNIFICANT DIFFERENCE IN MAXIMAL...... was found, p gender. Based on this, the equation to calculate normative values for relative eccentric hip abduction strength became: (1.600 + (age * -0.005) + (gender (1 = male / 0 = female) * 0.215) ± 1 or 2 * 0...

ICD-11 Trauma Questionnaires for PTSD and Complex PTSD: Validation among Civilians and Former Abducted Children in Northern Uganda

DEFF Research Database (Denmark)

Dokkedahl, Sarah Bøgelund; Oboke, Henry; Elklit, Ask

2015-01-01

Objectives: ICD-11 is expected to introduce a new diagnosis of C-PTSD, along with a revision of the current PTSD diagnosis. Are the suggested diagnostic tools for PTSD and C-PTSD valid in a developing country? Method: The tools have been tested on former abducted and regular civilians in northern...

[Costing nuclear medicine diagnostic procedures].

Science.gov (United States)

Markou, Pavlos

2005-01-01

To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

Adversarial Geospatial Abduction Problems

Science.gov (United States)

2011-01-01

better). We assume the reasoning agent is using the Spatial Cultural Abductive Reasoning Engine (SCARE) to provide information on cache locations. OAS...Technology, Vol. , No. , 20. 38 · Paulo Shakarian et al. Rossmo, D. K. and Rombouts, S. 2008. Geographic Profiling. In Enviromental Criminology and Crime

Unproven diagnostic procedures in IgE-mediated allergic diseases.

Science.gov (United States)

Niggemann, B; Grüber, C

2004-08-01

A considerable body of literature on therapeutic aspects of complementary and alternative medicine has been published in recent years, but little is known on diagnostic procedures. This short review lists complementary and alternative diagnostic procedures for the diagnosis of allergic diseases and presents an assessment of their usefulness for the daily practice. The review of the literature revealed that neither the determination of specific immunoglobulin G-antibodies in serum, the hair-analysis, the cytotoxic test, kinesiology, iridology, or electrodermal testing represent useful tests for the daily practice. To date, no complementary or alternative diagnostic procedure can be recommended as a meaningful element in the diagnostic work-up of allergic diseases. This is especially true for food allergy: properly performed oral food challenges still represent the gold standard for implementing specific diets in food allergic individuals. Ineffective diagnostic approaches may be costly for the consumer and delay appropriate therapy.

Normative values of eccentric hip abduction strength in novice runners

DEFF Research Database (Denmark)

Ramskov, D; Pedersen, M B; Kastrup, K

2014-01-01

normative values of maximal eccentric hip abduction strength in novice runners. METHODS: Novice healthy runners (n = 831) were recruited through advertisements at a hospital and a university. Maximal eccentric hip abduction strength was measured with a hand-held dynamometer. The demographic variables...... was found, p values were identified using a regression equation adjusting for age and gender. Based on this, the equation to calculate normative values for relative eccentric hip abduction strength became: (1.600 + (age * -0.005) + (gender (1 = male / 0 = female) * 0.215) ± 1 or 2 * 0......PURPOSE: Low eccentric strength of the hip abductors, might increase the risk of patellofemoral pain syndrome and iliotibial band syndrome in runners. No normative values for maximal eccentric hip abduction strength have been established. Therefore the purpose of this study was to establish...

Assessment of Abductive Reasoning in Strategy

DEFF Research Database (Denmark)

Guenther, Agnes; Garbuio, Massimo; Eisenbart, Boris

Strategic tools and frameworks mostly analyse past developments to predict future potentials and rely primarily on deductive/inductive logics. While these logics help decision-makers, they limit the pool of strategic options; resulting strategies often lack novelty. Building on the idea that ‘good......’ and ‘bad’ strategies can be differentiated and that out-of-the-boxthinking creates novel strategies, we analyse differences in strategies’ underlying logics. We develop and test a coding scheme to assess reasoning, in particular abductive reasoning. Furthermore, we introduce the notion of observation set...... and show how analogies, anomalies and paradoxes prompt abductive reasoning and create strategic options....

Some Aspects of International Children Abduction - Theoretical and Practical Approach from the Perspective of the European Law and Judicial Practice

Directory of Open Access Journals (Sweden)

Gabriela Lupşan

2015-05-01

Full Text Available Everyday life revealed even in the media by presenting cases of international abduction of minors, on the one hand, and on the other hand, the existence of cases increasingly complex from the national/ EU practice, to which we should add the insufficient analysis in the doctrine of the topic in representing some evidence to support the elaboration of this paper. Through its international and / or European regulations (Hague Convention of 25 October 1980 on the Civil Aspects of International Child Abduction, which is supplemented by Regulation (EC no. 2201/2003 of 27 November 2003 concerning jurisdiction, the recognition and enforcement of judgments in matrimonial matters and in matters of parental responsibility, (prevailing the latter and national ones (Law no. 63/2014 amending and supplementing Law no. 369/2004 on the application of the Convention on the Civil Aspects of International Child Abduction which Romania adhered to by the Law no. 100/199, the legislator sought to ensure the prompt return of children abducted in the Member State of origin, the objective being the same: discouraging underage child abduction by a parent or by third parties, usually relatives and, in case of committing an act of international abduction of minors, ensuring the best interests of the child through the cooperation of the competent authorities in the field. The structure includes sections that address theoretical issues (e.g. the notion of international abduction of minors, regulations, procedure for solving the request, the competent authorities and practical aspects, without neglecting the interpretation given by the Court of Justice of the European Union of some texts from the Regulation.

Sidestep cutting technique and knee abduction loading: implications for ACL prevention exercises.

Science.gov (United States)

Kristianslund, Eirik; Faul, Oliver; Bahr, Roald; Myklebust, Grethe; Krosshaug, Tron

2014-05-01

Sidestep cutting technique is essential in programmes to prevent anterior cruciate ligament (ACL) injury. A better understanding of how technique affects potentially harmful joint loading may improve prevention programmes. The purpose of this study was to investigate the effect of sidestep cutting technique on maximum knee abduction moments. Cross-sectional study. Whole-body kinematics and knee joint kinetics were calculated in 123 female handball players (mean±SD, 22.5±7.0 years, 171±7 cm, 67±7 kg) performing sidestep cutting. Three cuts from each side were analysed. Linear regression was applied between selected technique factors and maximum knee abduction moment during the first 100 ms of the contact phase. Furthermore, we investigated to what degree the abduction moment originated from the magnitude of the ground reaction force (GRF) or the knee abduction moment arm of the GRF. Technique factors explained 62% of the variance in knee abduction moments. Cut width, knee valgus, toe landing, approach speed and cutting angle were the most significant predictors. An increase in one of these factors of 1 SD increased the knee abduction moment from 12% to 19%. The effect of the moment arm of the GRF was more important than the force magnitude for maximum knee abduction moments. Lower knee abduction loads during sidestep cutting may be achieved if cuts are performed as narrow cuts with low knee valgus and toe landings. These factors may be targeted in ACL injury prevention programmes.

Foreign Affairs: Specific Action Plan Needed to Improve Response to Parental Child Abductions

Science.gov (United States)

2000-03-01

the child or prejudice to interested parties; (3) secure the voluntary return of the child or to bring about an amicable resolution of the issues, and...FOREIGN AFFAIRS Specific Action Plan Needed to Improve Response to Parental Child Abductions DISTRIBUTION STATEMENT A Approved for Public Release...International Parental Child Abduction 17 Page 1 GAO/NSIAD-00-10 Parental Child Abduction Page 2 GAO/NSIAD-00-10 Parental Child Abduction GAP

ABox abduction in ALC using a DL tableau

CSIR Research Space (South Africa)

Halland, K

2012-10-01

Full Text Available a DL tableau Ken Halland School of Computing University of South Africa Pretoria, South Africa hallakj@unisa.ac.za Katarina Britz Centre for Artificial Intelligence Research UKZN and CSIR Meraka Institute South Africa arina... Intelligence]: Knowledge Representation Formalisms and Methods General Terms Algorithms, Theory Keywords Description logics, abduction, semantic tableaux 1. INTRODUCTION Abduction is a form of non-standard reasoning where expla- nations are sought...

Contribution of Lateral Column Lengthening to Correction of Forefoot Abduction in Stage IIb Adult Acquired Flatfoot Deformity Reconstruction.

Science.gov (United States)

Chan, Jeremy Y; Greenfield, Stephen T; Soukup, Dylan S; Do, Huong T; Deland, Jonathan T; Ellis, Scott J

2015-12-01

Correction of forefoot abduction in stage IIb adult acquired flatfoot likely depends on the amount of lateral column lengthening (LCL) performed, although this represents only one aspect of a successful reconstruction. The purpose of this study was to evaluate the correlation between common reconstructive variables and the observed change in forefoot abduction. Forty-one patients who underwent flatfoot reconstruction involving an Evans-type LCL were assessed retrospectively. Preoperative and postoperative anteroposterior (AP) radiographs of the foot at a minimum of 40 weeks (mean, 2 years) after surgery were reviewed to determine correction in forefoot abduction as measured by talonavicular coverage (TNC) angle, talonavicular uncoverage percent, talus-first metatarsal (T-1MT) angle, and lateral incongruency angle. Fourteen demographic and intraoperative variables were evaluated for association with change in forefoot abduction including age, gender, height, weight, body mass index, as well as the amount of LCL and medializing calcaneal osteotomy performed, LCL graft type, Cotton osteotomy, first tarsometatarsal fusion, flexor digitorum longus transfer, spring ligament repair, gastrocnemius recession and any one of the modified McBride/Akin/Silver procedures. Two variables significantly affected the change in lateral incongruency angle. These were weight (P = .04) and the amount of LCL performed (P < .001). No variables were associated with the change in TNC angle, talonavicular uncoverage percent, or T-1MT angle. Multivariate regression analysis revealed that LCL was the only significant predictor of the change in lateral incongruency angle. The final regression model for LCL showed a good fit (R2 = 0.70, P < .001). Each millimeter of LCL corresponded to a 6.8-degree change in lateral incongruency angle. Correction of forefoot abduction in flatfoot reconstruction was primarily determined by the LCL procedure and could be modeled linearly. We believe that the

Towards Verification of Operational Procedures Using Auto-Generated Diagnostic Trees

Science.gov (United States)

Kurtoglu, Tolga; Lutz, Robyn; Patterson-Hine, Ann

2009-01-01

The design, development, and operation of complex space, lunar and planetary exploration systems require the development of general procedures that describe a detailed set of instructions capturing how mission tasks are performed. For both crewed and uncrewed NASA systems, mission safety and the accomplishment of the scientific mission objectives are highly dependent on the correctness of procedures. In this paper, we describe how to use the auto-generated diagnostic trees from existing diagnostic models to improve the verification of standard operating procedures. Specifically, we introduce a systematic method, namely the Diagnostic Tree for Verification (DTV), developed with the goal of leveraging the information contained within auto-generated diagnostic trees in order to check the correctness of procedures, to streamline the procedures in terms of reducing the number of steps or use of resources in them, and to propose alternative procedural steps adaptive to changing operational conditions. The application of the DTV method to a spacecraft electrical power system shows the feasibility of the approach and its range of capabilities

Is There Abduction in Aristotle? Peirce, Eco, and Some Further Remarks

Directory of Open Access Journals (Sweden)

Giampaolo Proni

2016-12-01

Full Text Available In several places of the Collected Papers , Peirce states that Abduction, or adoption of a Hypothesis, the form of inference he has discovered and described, could be found in Aristotle, though not fully developed. Umberto Eco (1983, investigates, following Peirce, the presence of abductive elements in Aristotle, and extends Peirce's scope, finding more traces of hypothetical logic. The purpose of this article is to extend and refine the inquiry, trying to answer the question "Did Aristotle know Abductive reasoning?"

Comparative cost analysis -- computed tomography vs. alternative diagnostic procedures, 1977-1980

International Nuclear Information System (INIS)

Gempel, P.A.; Harris, G.H.; Evans, R.G.

1977-12-01

In comparing the total national cost of utilizing computed tomography (CT) for medically indicated diagnoses with that of conventional x-ray, ultrasonography, nuclear medicine, and exploratory surgery, this investigation concludes that there was little, if any, added net cost from CT use in 1977 or will there be in 1980. Computed tomography, generally recognized as a reliable and useful diagnostic modality, has the potential to reduce net costs provided that an optimal number of units can be made available to physicians and patients to achieve projected reductions in alternative procedures. This study examines the actual cost impact of CT on both cranial and body diagnostic procedures. For abdominal and mediastinal disorders, CT scanning is just beginning to emerge as a diagnostic modality. As such, clinical experience is somewhat limited and the authors assume that no significant reduction in conventional procedures took place in 1977. It is estimated that the approximately 375,000 CT body procedures performed in 1977 represent only a 5 percent cost increase over use of other diagnostic modalities. It is projected that 2,400,000 CT body procedures will be performed in 1980 and, depending on assumptions used, total body diagnostic costs will increase only slightly or be reduced. Thirty-one tables appear throughout the text presenting cost data broken down by types of diagnostic procedures used and projections by years. Appendixes present technical cost components for diagnostic procedures, the comparative efficacy of CT as revealed in abstracts of published literature, selected medical diagnoses, and references

Did He Jump or Was He Pushed? Abductive Practical Reasoning

NARCIS (Netherlands)

Bex, F.J.; Bench-Capon, T.J.M.; Atkinson, K.; Francesconi, E; Sartor, E; Tiscornia, D

2008-01-01

In this paper we present an approach to abductive reasoning in law by examining it in the context of an argumentation scheme for practical reasoning. We present a particular scheme, based on an established scheme for practical reasoning, that can be used to reason abductively about how an agent

MR diagnostics after Ross procedure

International Nuclear Information System (INIS)

Steffens, J.C.; Link, J.; Harringer, W.; Haverich, A.; Heller, M.

1996-01-01

Purpose: To determine the ability of MRI to diagnose morphological and functional changes in patients after Ross procedure. Material and methods: During one year, 5 patients after Ross procedure were studied by MRI. T 1 -weighted spin-echo sequences in different orientations as well as cine sequences and a VENC-sequence were used. Results: In all patients the morphology including the postoperative changes could be visualised by MRI. The cine sequences provided functional information on valvular and ventricular function. VENC-MR yielded an exact quantification of the regurgitant fraction. Conclusion: MRI is capable of providing all important diagnostic information in patients after Ross procedure such as valvular and ventricular function and valvular and outflow tract morphology in a single examination. (orig.) [de

Hip adduction and abduction strength profiles in elite soccer players

DEFF Research Database (Denmark)

Thorborg, Kristian; Serner, Andreas; Petersen, Jesper

2011-01-01

An ipsilateral hip adduction/abduction strength ratio of more than 90%, and hip adduction strength equal to that of the contralateral side have been suggested to clinically represent adequate strength recovery of hip adduction strength in athletes after groin injury. However, to what extent side-......-to-side symmetry in isometric hip adduction and abduction strength can be assumed in soccer players remains uncertain.......An ipsilateral hip adduction/abduction strength ratio of more than 90%, and hip adduction strength equal to that of the contralateral side have been suggested to clinically represent adequate strength recovery of hip adduction strength in athletes after groin injury. However, to what extent side...

Experiences and directions for Abduction and Induction using Constraint Handling Rules

DEFF Research Database (Denmark)

Christiansen, Henning

2005-01-01

Techniques for doing abduction in a combination of Prolog and Constraint Handling Rules (CHR) are reviewed, and the possible extension to combine with induction is considered. While the indicated implementation for abduction is very efficient, the ideas for induction are at a much more experimental...

Radiation risk of diagnostical procedures

International Nuclear Information System (INIS)

Pohlit, W.

1986-01-01

The environmental radiation burden of man in Germany is about 1 mGy (Milligray) per year. This is, of course, also valid for children. Due to diagnostical procedures this burden is increased to about 1.3 mGy. The question arises wether this can be neglected, or important consequences have to be drawn. To give a clear answer, the action of ionizing radiation in living cells and in organisms is explained in detail. Many of the radiation actions at the DNA can soon be repaired by the cell, if the radiation dose was small. Some damage, however will remain irreparable for the cell and consequently leads to cell death, to mutations or to cell transformation. The number of these lesion increases or decreases linearily with radiation dose. Therefore, it must be expected that the risk of tumour induction is increased to above the normal background even by the smallest doses. This small but not negligible risk has to be compared with other risks of civilization or with other medical risks. But also the benefit and the efficacy of diagnostic procedures have to be considered. (orig./HSCH) [de

Passive contribution of the rotator cuff to abduction and joint stability.

Science.gov (United States)

Tétreault, Patrice; Levasseur, Annie; Lin, Jenny C; de Guise, Jacques; Nuño, Natalia; Hagemeister, Nicola

2011-11-01

The purpose of this study is to compare shoulder joint biomechanics during abduction with and without intact non-functioning rotator cuff tissue. A cadaver model was devised to simulate the clinical findings seen in patients with a massive cuff tear. Eight full upper limb shoulder specimens were studied. Initially, the rotator cuff tendons were left intact, representing a non-functional rotator cuff, as seen in suprascapular nerve paralysis or in cuff repair with a patch. Subsequently, a massive rotator cuff tear was re-created. Three-dimensional kinematics and force requirements for shoulder abduction were analyzed for each condition using ten abduction cycles in the plane of the scapula. Mediolateral displacements of the glenohumeral rotation center (GHRC) during abduction with an intact non-functioning cuff were minimal, but massive cuff tear resulted in significant lateral displacement of the GHRC (p non-functional cuff (p requirements were significantly less with an intact non-functioning cuff than with massive cuff tear (p requirement for abduction from 5 to 30° as compared with the results following a massive rotator cuff tear. This provides insight into the potential biomechanical effect of repairing massive rotator cuff tears with a biological or synthetic "patch," which is a new treatment for massive cuff tear.

Hip adduction and abduction strength profiles in elite soccer players

DEFF Research Database (Denmark)

Thorborg, Kristian; Serner, Andreas; Petersen, Jesper

2011-01-01

An ipsilateral hip adduction/abduction strength ratio of more than 90%, and hip adduction strength equal to that of the contralateral side have been suggested to clinically represent adequate strength recovery of hip adduction strength in athletes after groin injury. However, to what extent side-......-to-side symmetry in isometric hip adduction and abduction strength can be assumed in soccer players remains uncertain....

HYPROLOG: A New Logic Programming Language with Assumptions and Abduction

DEFF Research Database (Denmark)

Christiansen, Henning; Dahl, Veronica

2005-01-01

We present HYPROLOG, a novel integration of Prolog with assumptions and abduction which is implemented in and partly borrows syntax from Constraint Handling Rules (CHR) for integrity constraints. Assumptions are a mechanism inspired by linear logic and taken over from Assumption Grammars. The lan......We present HYPROLOG, a novel integration of Prolog with assumptions and abduction which is implemented in and partly borrows syntax from Constraint Handling Rules (CHR) for integrity constraints. Assumptions are a mechanism inspired by linear logic and taken over from Assumption Grammars....... The language shows a novel flexibility in the interaction between the different paradigms, including all additional built-in predicates and constraints solvers that may be available. Assumptions and abduction are especially useful for language processing, and we can show how HYPROLOG works seamlessly together...

The relationship between abduction deficit and reoperation among patients with infantile esotropia.

Science.gov (United States)

Rajavi, Zhale; Sabbaghi, Hamideh; Torkian, Pooya; Behradfar, Narges; Yaseri, Mehdi; Feizi, Mohadeseh; Faghihi, Mohammad; Sheibani, Kourosh

2018-01-01

To determine the relationship between abduction deficit and reoperation among patients with infantile esotropia (IET). The records of 216 patients (432 eyes) with IET who underwent surgery, from 2010 to 2015 were studied. Patients with IET whose deviation appeared before 6mo of age and had stable preoperative deviation in two examinations with at least 2wk apart and a minimum 3mo postoperative follow up were included. Cases with early onset accommodative esotropia, congenital cataract, retinopathy of prematurity (ROP), manifest nystagmus, fundus lesions, neurologic and ophthalmic anomalies, 6 th nerve palsy and Duane's syndrome were excluded. Preoperative abduction deficit was considered from -1 to -3 grading scale. Three months after surgery, children were classified into no-need reoperation [deviation≤15 prism diopters (PD)], and need-reoperation groups (deviation>15 PD). In this retrospective study, 117 female and 99 male patients with the mean surgical age of 4.7±6.4y were included. Reoperation rate was 33.3% and 16.0% in IET patients with and without abduction deficit, respectively in patients who had a history of late surgery. Abduction deficit increased the odds of reoperation by 82% [OR=1.82, 95% confidence interval (CI) =1.05 to 3.19, P =0.003] in patients who had a history of late surgery (>2 years old, P =0.021). Abduction deficit was improved significantly after operation ( P <0.001). Based on our results, abduction deficit can be considered as a risk factor of reoperation in IET patients who are operated at the age of more than 2y.

Diagnostical Procedure for Logistical Management in Turistical Entities

Directory of Open Access Journals (Sweden)

Libia Arlen Fergusson-Álvarez

2016-06-01

Full Text Available This research aims to design a diagnostic procedure of the logistics management for turistical entities, they could be hotels or not. This procedure was validated in Commercial Branch Caracol Santiago de Cuba and finally, different actions for the detected problems were proposed with the objective of improving the logistics management of the organization. To develop this research various tools and techniques served as support, such as: surveys, SPSS software (Statistical Package for Social Sciences 15.0 version and Decision 1.0 version, exponential smoothing, Cronbach's Alpha, the coefficient of Kendall W, financial and logistical indicators, the ABC or Pareto Method, the matrices for the classification of stocks and suppliers, among others. This research made possible the design of a diagnostic procedure for logistical management for turistical entities. And it was validated in the Comercial Branch Caracol Santiago, which allowed the proposition of improvement actions for increasing customer satisfaction.

Investigation of radialization and rerouting of the extensor digiti minimi (EDM) in the abduction deformity of the little finger: a cadaver study.

Science.gov (United States)

van Aaken, Jan; Zhu, Jin; Fasel, Jean H D; Beaulieu, Jean-Yves

2011-06-01

One of several operations to correct abduction deformity of the little finger, (Wartenberg's sign) in ulnar nerve palsy, is a combined procedure that radializes the extensor digiti minimi (EDM) at the level of the fifth metacarpophalangeal (MCP) joint and reroutes it from the fifth to fourth extensor compartment. This cadaveric study was designed to investigate the impact of both elements on adduction. Anatomy of the little finger extensor apparatus was studied in 16 freshly frozen cadaver hands sectioned at mid forearm. We observed little finger motion after different modifications of the EDM. We tested the effect of a rerouting maneuver by pulling on the EDM, as well as radialization of the EDM alone and in combination with rerouting. The EDM was present in all cases. Little finger extensor digitorum communis (EDC(V)) was missing in two cadavers. In no case was adduction created by rerouting the EDM to the fourth compartment. Radialization of the EDM corrected the abduction deformity beyond the axis of abduction/adduction of the fifth MCP joint in 13 cases and only up to it in three cases. In one of the three with limited correction, a rerouting maneuver allowed for further adduction. The key to correct abduction deformity of the little finger is radialization of the EDM, which can be done through a solitary incision at the level of the MCP joint. Rerouting alone does not correct the abduction deformity, and in combination with radialization it does not predictably enhance the correction.

Fear of knowledge: Clinical hypotheses in diagnostic and prognostic reasoning.

Science.gov (United States)

Chiffi, Daniele; Zanotti, Renzo

2017-10-01

Patients are interested in receiving accurate diagnostic and prognostic information. Models and reasoning about diagnoses have been extensively investigated from a foundational perspective; however, for all its importance, prognosis has yet to receive a comparable degree of philosophical and methodological attention, and this may be due to the difficulties inherent in accurate prognostics. In the light of these considerations, we discuss a considerable body of critical thinking on the topic of prognostication and its strict relations with diagnostic reasoning, pointing out the distinction between nosographic and pathophysiological types of diagnosis and prognosis, underlying the importance of the explication and explanation processes. We then distinguish between various forms of hypothetical reasoning applied to reach diagnostic and prognostic judgments, comparing them with specific forms of abductive reasoning. The main thesis is that creative abduction regarding clinical hypotheses in diagnostic process is very unlikely to occur, whereas this seems to be often the case for prognostic judgments. The reasons behind this distinction are due to the different types of uncertainty involved in diagnostic and prognostic judgments. © 2016 John Wiley & Sons, Ltd.

9 CFR 147.8 - Procedures for preparing egg yolk samples for diagnostic tests.

Science.gov (United States)

2010-01-01

... samples for diagnostic tests. 147.8 Section 147.8 Animals and Animal Products ANIMAL AND PLANT HEALTH... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for diagnostic... for diagnostic testing. (b) The authorized laboratory must identify each egg as to the breeding flock...

The relationship between abduction deficit and reoperation among patients with infantile esotropia

Directory of Open Access Journals (Sweden)

Zhale Rajavi

2018-03-01

Full Text Available AIM: To determine the relationship between abduction deficit and reoperation among patients with infantile esotropia (IET. METHODS: The records of 216 patients (432 eyes with IET who underwent surgery, from 2010 to 2015 were studied. Patients with IET whose deviation appeared before 6mo of age and had stable preoperative deviation in two examinations with at least 2wk apart and a minimum 3mo postoperative follow up were included. Cases with early onset accommodative esotropia, congenital cataract, retinopathy of prematurity (ROP, manifest nystagmus, fundus lesions, neurologic and ophthalmic anomalies, 6th nerve palsy and Duane’s syndrome were excluded. Preoperative abduction deficit was considered from -1 to -3 grading scale. Three months after surgery, children were classified into no-need reoperation [deviation≤15 prism diopters (PD], and need-reoperation groups (deviation>15 PD. RESULTS: In this retrospective study, 117 female and 99 male patients with the mean surgical age of 4.7±6.4y were included. Reoperation rate was 33.3% and 16.0% in IET patients with and without abduction deficit, respectively in patients who had a history of late surgery. Abduction deficit increased the odds of reoperation by 82% [OR=1.82, 95% confidence interval (CI =1.05 to 3.19, P=0.003] in patients who had a history of late surgery (>2 years old, P=0.021. Abduction deficit was improved significantly after operation (P<0.001. CONCLUSION: Based on our results, abduction deficit can be considered as a risk factor of reoperation in IET patients who are operated at the age of more than 2y.

Cumulative ionizing radiation during coronary diagnostic and interventional procedures

International Nuclear Information System (INIS)

Oyarzun C, Carlos; Ramirez, Alfredo

2001-01-01

The diagnostic ability of ionizing radiation is well known and has led to the development of high speed, high resolution axial tomography, for which we must assume that the patient population is being exposed to ionizing radiation that could become great. In cardiology, especially, we attend patients that have to undergo two or three angio graph, diagnostic and other therapeutic procedures, accumulating radiation doses that are ignored and are not recorded. The skin doses are shown that were received by 18 patients in procedures that included coronary angiography and that were measured with cesium thermoluminescent detectors, varying from 54 to 877 mSv. per procedure. We propose that a personal register be set up in Chile to record the magnitude of the radiation received by a patient (CO)

Diagnostic x-ray procedures and risk of leukemia, lymphoma, and multiple myeloma

International Nuclear Information System (INIS)

Boice, J.D. Jr.; Morin, M.M.; Glass, A.G.; Friedman, G.D.; Stovall, M.; Hoover, R.N.; Fraumeni, J.F. Jr.

1991-01-01

Exposure to diagnostic x-rays and the risk of leukemia, non-Hodgkin's lymphoma (NHL), and multiple myeloma were studied within two prepaid health plans. Adult patients with leukemia (n = 565), NHL (n = 318), and multiple myeloma (n = 208) were matched to controls (n = 1390), and over 25,000 x-ray procedures were abstracted from medical records. Dose response was evaluated by assigning each x-ray procedure a score based on estimated bone marrow dose. X-ray exposure was not associated with chronic lymphocytic leukemia, one of the few malignant conditions never linked to radiation (relative risk [RR], 0.66). For all other forms of leukemia combined (n = 358), there was a slight elevation in risk (RR, 1.17) but no evidence of a dose-response relationship when x-ray procedures near the time of diagnosis were excluded. Similarly, patients with NHL were exposed to diagnostic x-ray procedures more often than controls (RR, 1.32), but the RR fell to 0.99 when the exposure to diagnostic x-ray procedures within 2 years of diagnosis was ignored. For multiple myeloma, overall risk was not significantly high (RR, 1.14), but there was consistent evidence of increasing risk with increasing numbers of diagnostic x-ray procedures. These data suggest that persons with leukemia and NHL undergo x-ray procedures frequently just prior to diagnosis for conditions related to the development or natural history of their disease. There was little evidence that diagnostic x-ray procedures were causally associated with leukemia or NHL. The risk for multiple myeloma, however, was increased among those patients who were frequently exposed to x-rays

Child abduction murder: the impact of forensic evidence on solvability.

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Brown, Katherine M; Keppel, Robert D

2012-03-01

This study examined 733 child abduction murders (CAMs) occurring from 1968 to 2002 to explore the influence of forensic evidence on case solvability in CAM investigations. It was hypothesized that the presence of forensic evidence connecting the offender to the crime would enhance case solvability in murder investigations of abducted children. This study examined the impact of CAM of different types of forensic evidence and the impact of the summed total of forensic evidence items on case solvability by controlling for victim age, victim race, victim gender, and victim-offender relationship. Time and distance theoretical predictors were also included. Binomial logistic regression models were used to determine whether forensic evidence was a critical solvability factor in murder investigations of abducted children. This research indicated that, while forensic evidence increased case solvability, the impact of forensic evidence on solvability was not as important as other solvability factors examined. © 2011 American Academy of Forensic Sciences.

Feasibility of vocal fold abduction and adduction assessment using cine-MRI.

Science.gov (United States)

Baki, Marina Mat; Menys, Alex; Atkinson, David; Bassett, Paul; Morley, Simon; Beale, Timothy; Sandhu, Guri; Naduvilethil, Georgekutty; Stevenson, Nicola; Birchall, Martin A; Punwani, Shonit

2017-02-01

Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) METHODS: Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC). VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44). Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability. • Cine-MRI is used to assess vocal folds (VFs) mobility: abduction and adduction. • New quantitative metrics are derived from VF position and abduction potential. • Cine-MRI able to depict the difference between normal and abnormal VF mobility. • Cine-MRI derived quantitative metrics have good repeatability.

Genetic risk from diagnostic X-ray procedures

International Nuclear Information System (INIS)

Stephan, G.

1980-01-01

This essay introduces epidemiologic studies concerned with the question whether diagnostic X-ray procedures might be the cause of an increased genetic risk. All studies have selected Down's syndrome (mongolism) as genetic indicator. They indiscriminately present the opinion of the respective author. Approximately one half of the studies conclude that radiation exposure will not influence the spontaneous incidence of Down's syndrome in diagnostics, the other half finds a positive relationship between frequent radiation exposure and the incidence of the syndrome. For various reasons, explained in detail, the results of the studies under discussion are suitable for forming hypotheses, but should not be viewed as providing evidence. (orig.) [de

Analysis of utilization patterns and associated costs of the breast imaging and diagnostic procedures after screening mammography

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Vlahiotis A

2018-03-01

Full Text Available Anna Vlahiotis,1 Brian Griffin,2 A Thomas Stavros,3 Jay Margolis1 1Value Based Care, Outcomes Research, Truven Health Analytics, an IBM Company, Bethesda, MD USA; 2Value Based Care, Outcomes Research, Truven Health Analytics, an IBM Company, Newark, NJ, USA; 3Seno Medical Instruments, Inc., San Antonio, TX, USA Background: Little data exist on real-world patterns and associated costs of downstream breast diagnostic procedures following an abnormal screening mammography or clinical exam.Objectives: To analyze the utilization patterns in real-world clinical settings for breast imaging and diagnostic procedures, including the frequency and volume of patients and procedures, procedure sequencing, and associated health care expenditures.Materials and methods: Using medical claims from 2011 to 2015 MarketScan Commercial and Medicare Databases, adult females with breast imaging/diagnostic procedures (diagnostic mammography, ultrasound, molecular breast imaging, tomosynthesis, magnetic resonance imaging, or biopsy other than screening mammography were selected. Continuous health plan coverage without breast diagnostic procedures was required for ≥13 months before the first found breast diagnostic procedure (index event, with a 13-month post-index follow-up period. Key outcomes included diagnostic procedure volumes, sequences, and payments. Results reported descriptively were projected to provide US national patient and procedure volumes.Results: The final sample of 875,526 patients was nationally projected to 12,394,432 patients annually receiving 8,732,909 diagnostic mammograms (53.3% of patients, 6,987,399 breast ultrasounds (42.4% of patients, and 1,585,856 biopsies (10.3% of patients. Following initial diagnostic procedures, 49.4% had second procedures, 20.1% followed with third procedures, and 10.0% had a fourth procedure. Mean (SD costs for diagnostic mammograms of US$349 ($493, ultrasounds US$132 ($134, and biopsies US$1,938 ($2,343 contributed

Anaesthesiological aspects of thorax-diagnostic procedures in intensive-care units

International Nuclear Information System (INIS)

Schulte am Esch, J.

1989-01-01

Diagnostic procedures of the thorax in intensive-care units are conventional X-ray chest images, chest images by digital luminescence radiography, sonography and transoesophageal Doppler echocardiography. In addition to these bedside methods the stationary usable techniques, such as computed tomography, digital subtraction angiography and the seldom in intensive care patients used computed nuclear spin resonance tomography (NMR) are applicable. The selection of the above mentioned techniques depends on the availability and the quality of the methods as well as the qualifications of the involved staff. The diagnostic procedures of the chest must be arranged depending on the decision if patients have to be transported or not. In conclusion it can be stated that in spite of growing technical preconditions the availability of the methods in immobile patients and the diagnostic potency of the techniques have to be examined. (orig.) [de

Past-life identities, UFO abductions, and satanic ritual abuse: the social construction of memories.

Science.gov (United States)

Spanos, N P; Burgess, C A; Burgess, M F

1994-10-01

People sometimes fantasize entire complex scenarios and later define these experiences as memories of actual events rather than as imaginings. This article examines research associated with three such phenomena: past-life experiences, UFO alien contact and abduction, and memory reports of childhood ritual satanic abuse. In each case, elicitation of the fantasy events is frequently associated with hypnotic procedures and structured interviews which provide strong and repeated demands for the requisite experiences, and which then legitimate the experiences as "real memories." Research associated with these phenomena supports the hypothesis that recall is reconstructive and organized in terms of current expectations and beliefs.

Higher-level fusion for military operations based on abductive inference: proof of principle

Science.gov (United States)

Pantaleev, Aleksandar V.; Josephson, John

2006-04-01

The ability of contemporary military commanders to estimate and understand complicated situations already suffers from information overload, and the situation can only grow worse. We describe a prototype application that uses abductive inferencing to fuse information from multiple sensors to evaluate the evidence for higher-level hypotheses that are close to the levels of abstraction needed for decision making (approximately JDL levels 2 and 3). Abductive inference (abduction, inference to the best explanation) is a pattern of reasoning that occurs naturally in diverse settings such as medical diagnosis, criminal investigations, scientific theory formation, and military intelligence analysis. Because abduction is part of common-sense reasoning, implementations of it can produce reasoning traces that are very human understandable. Automated abductive inferencing can be deployed to augment human reasoning, taking advantage of computation to process large amounts of information, and to bypass limits to human attention and short-term memory. We illustrate the workings of the prototype system by describing an example of its use for small-unit military operations in an urban setting. Knowledge was encoded as it might be captured prior to engagement from a standard military decision making process (MDMP) and analysis of commander's priority intelligence requirements (PIR). The system is able to reasonably estimate the evidence for higher-level hypotheses based on information from multiple sensors. Its inference processes can be examined closely to verify correctness. Decision makers can override conclusions at any level and changes will propagate appropriately.

Evaluation of radiation protection in nuclear medicine diagnostic procedures

International Nuclear Information System (INIS)

Mohammed, Ezzeldien Mohammed Nour

2013-05-01

This study conducted to evaluate the radiation protection in nuclear medicine diagnostic procedures in four nuclear medicine departments in Sudan. The evaluated procedures followed in these departments were in accordance with the standards, International Recommendations and code of practice for radiation protection in nuclear medicine. The evolution included the optimum design for diagnostic nuclear medicine departments, dealing with radioactive sources, quality assurance and quality control, training and responsibilities for radiation worker taking into account economic factors in Sudan. Evaluation of radiation protection procedures in diagnostic investigations was carried out by taken direct measurements of dose rate and the contamination level in some areas where radiation sources, radiation workers and public are involved. Designated questionnaires covered thirteen areas of radiation protection based on inspection check list for nuclear medicine prepared by the International Atomic Energy Agency (IAEA) and American Association of Physicist in Medicine (AAPM) were used in the evaluation. This questionnaire has been Filled by Radiation Protection Officer (RPO), nuclear medicine technologist, nuclear medicine specialist in the nuclear medicine departments. Four hospitals, two governmental hospital and two private hospitals, have been assisted, the assessment shows that although the diagnostic nuclear medicine department in Sudan are not applying a fully safety and radiation protection procedures, but the level of radiation dose and the contamination level were found within acceptable limits. The private hospital D scored the higher level of protection (85.25%) while the governmental hospital C scored the lower level of protection (59.02%). Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a proper radiation protection

Meaning and Abduction as Process-Structure: A Diagram of Reasoning

Directory of Open Access Journals (Sweden)

Inna Semetsky

2009-11-01

Full Text Available This paper is informed by Charles Sanders Peirce’s philosophy as semiotics or the doctrine of signs. The paper’s purpose is to explore Peirce’s category of abduction as not being limited to the inference to the best explanation. In the context of the logic of discovery, abduction is posited as a necessary although not sufficient condition for the production of meanings. The structure of a genuine sign is triadic and represents a synthesis between precognitive ideas and conceptual representations. The novel model of reasoning is offered, based on the mathematical formalism borrowed from Gauss’ interpretation of the complex number. It is suggested that this model in a form of a diagram not only represents a semiotic process-structure but also overcomes the long-standing paradox of new knowledge. For Peirce, it is a diagram as a visual representation that may yield solutions to the otherwise unsolvable logical problems. What appears to us as a paradox is the very presence of abductive, or hypothetical, inference, as Peircean generic category of Firstness within the Thirdness of the total thought-process. Firstness (feeling, Secondness (action, and Thirdness (reason together constitute a dynamic structure of experience.

21 CFR 890.3665 - Congenital hip dislocation abduction splint.

Science.gov (United States)

2010-04-01

... SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890... abduction splint is a device intended for medical purposes to stabilize the hips of a young child with...

Abduction, ASP and Open Logic Programs

OpenAIRE

Bonatti, Piero A.

2002-01-01

Open logic programs and open entailment have been recently proposed as an abstract framework for the verification of incomplete specifications based upon normal logic programs and the stable model semantics. There are obvious analogies between open predicates and abducible predicates. However, despite superficial similarities, there are features of open programs that have no immediate counterpart in the framework of abduction and viceversa. Similarly, open programs cannot be immediately simul...

The Influence of Surgical Stabilization on Glenohumeral Abduction Using 3-Dimensional Computed Tomography in Patients With Shoulder Instability.

Science.gov (United States)

Bakshi, Neil K; Jameel, Omar F; Merrill, Zachary F; Debski, Richard E; Sekiya, Jon K

2016-08-01

This study compared the amount of glenohumeral abduction during arm abduction in the affected and unaffected shoulders of 3 groups of patients with shoulder instability: failed surgical stabilization, successful surgical stabilization, and unstable shoulder with no prior surgical intervention. All patients underwent bilateral shoulder computed tomography scans in 3 positions: 0° of abduction and 0° of external rotation (0-0 position), 30° of abduction and 30° of external rotation (30-30 position), and arms maximally abducted (overhead position). Three-dimensional computed tomography reconstruction was performed for both shoulders in all 3 positions. A specialized coordinate system marked specific points and directions on the humerus and glenoid of each model. These coordinates were used to calculate the glenohumeral abduction for the normal and affected sides in the 0-0, 30-30, and overhead positions. Thirty-nine patients with shoulder instability were included, of whom 14 had failed surgical repairs, 10 had successful surgical repairs, and 15 had unstable shoulders with no prior surgical intervention. In the overhead position, patients with failed surgical intervention had significantly less glenohumeral abduction in the failed shoulder (95.6° ± 12.7°) compared with the normal shoulder (101.5° ± 12.4°, P = .02). Patients with successfully stabilized shoulders had significantly less glenohumeral abduction in the successfully stabilized shoulder (93.6° ± 10.8°) compared with the normal shoulder (102.1° ± 12.5°, P = .03). Unstable shoulders with no prior surgical intervention (102.1° ± 10.3°) did not differ when compared with the normal shoulders (101.9° ± 10.9°, P = .95). Surgical intervention, regardless of its success, limits the amount of abduction at the glenohumeral joint. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The active abduction view: A new maneuvre in the diagnosis of rotator cuff tears

International Nuclear Information System (INIS)

Bloom, R.A.

1991-01-01

A new projection is described, the active abduction view of the shoulder, where in many patients with a comlete rotator cuff tear the humeral head is closely apposed to the acromion, obliterating the subacromial space. In such a situation,the medial portion of the torn rotator cuff retracts during active abduction, allowing approximation of the two bones. (orig./GDG)

Activation of the gluteus maximus and hamstring muscles during prone hip extension with knee flexion in three hip abduction positions.

Science.gov (United States)

Kang, Sun-Young; Jeon, Hye-Seon; Kwon, Ohyun; Cynn, Heon-Seock; Choi, Boram

2013-08-01

The direction of fiber alignment within a muscle is known to influence the effectiveness of muscle contraction. However, most of the commonly used clinical gluteus maximus (GM) exercises do not consider the direction of fiber alignment within the muscle. Therefore, the purpose of this study was to investigate the influence of hip abduction position on the EMG (electromyography) amplitude and onset time of the GM and hamstrings (HAM) during prone hip extension with knee flexion (PHEKF) exercise. Surface EMG signals were recorded from the GM and HAM during PHEKF exercise in three hip abduction positions: 0°, 15°, and 30°. Thirty healthy subjects voluntarily participated in this study. The results show that GM EMG amplitude was greatest in the 30° hip abduction position, followed by 15° and then 0° hip abduction during PHEKF exercise. On the other hand, the HAM EMG amplitude at 0° hip abduction was significantly greater than at 15° and 30° hip abduction. Additionally, GM EMG onset firing was delayed relative to that of the HAM at 0° hip abduction. On the contrary, the GM EMG onset occurred earlier than the HAM in the 15° and 30° hip abduction positions. These findings indicate that performing PHEKF exercise in the 30° hip abduction position may be recommended as an effective way to facilitate the GM muscle activity and advance the firing time of the GM muscle in asymptomatic individuals. This finding provides preliminary evidence that GM EMG amplitude and onset time can be modified by the degree of hip abduction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Real-time feedback on knee abduction moment does not improve frontal-plane knee mechanics during jump landings.

Science.gov (United States)

Beaulieu, M L; Palmieri-Smith, R M

2014-08-01

Excessive knee abduction loading is a contributing factor to anterior cruciate ligament (ACL) injury risk. The purpose of this study was to determine whether a double-leg landing training program with real-time visual feedback improves frontal-plane mechanics during double- and single-leg landings. Knee abduction angles and moments and vertical ground reaction forces (GRF) of 21 recreationally active women were quantified for double- and single-leg landings before and after the training program. This program consisted of two sessions of double-leg jump landings with real-time visual feedback on knee abduction moments for the experimental group and without real-time feedback for the control group. No significant differences were found between training groups. In comparison with pre-training data, peak knee abduction moments decreased 12% post-training for both double- and single-leg landings; whereas peak vertical GRF decreased 8% post-training for double-leg landings only, irrespective of training group. Real-time feedback on knee abduction moments, therefore, did not significantly improve frontal-plane knee mechanics during landings. The effect of the training program on knee abduction moments, however, transferred from the double-leg landings (simple task) to single-leg landings (more complex task). Consequently, ACL injury prevention efforts may not need to focus on complex tasks during which injury occurs. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Analysis of risk in computerized tomography and other diagnostic radiology procedures

International Nuclear Information System (INIS)

Mossman, K.L.

1982-01-01

Medical practice entails continuous risks to the patient taken in good faith by the physician for the benefit of the patient. Risk of radiation induced cancer death approximates 10(-4) per cGy (rad). Assuming an average whole body dose of 0.1 cGy for many diagnostic X-ray procedures, the probability of radiation-induced cancer death is about 10(-5). The purpose of this paper is to compare the risks of common diagnostic X-ray procedures including computerized tomography (CT) with risks of smoking or automobile travel. Such comparisons should be constructive in putting radiation in perspective and facilitating explanation of risk/benefit to patients

Current diagnostic procedures for diagnosing vertigo and dizziness

Science.gov (United States)

Walther, Leif Erik

2017-01-01

Vertigo is a multisensory syndrome that otolaryngologists are confronted with every day. With regard to the complex functions of the sense of orientation, vertigo is considered today as a disorder of the sense of direction, a disturbed spatial perception of the body. Beside the frequent classical syndromes for which vertigo is the leading symptom (e.g. positional vertigo, vestibular neuritis, Menière’s disease), vertigo may occur as main or accompanying symptom of a multitude of ENT-related diseases involving the inner ear. It also concerns for example acute and chronic viral or bacterial infections of the ear with serous or bacterial labyrinthitis, disorders due to injury (e.g. barotrauma, fracture of the oto-base, contusion of the labyrinth), chronic-inflammatory bone processes as well as inner ear affections in the perioperative course. In the last years, diagnostics of vertigo have experienced a paradigm shift due to new diagnostic possibilities. In the diagnostics of emergency cases, peripheral and central disorders of vertigo (acute vestibular syndrome) may be differentiated with simple algorithms. The introduction of modern vestibular test procedures (video head impulse test, vestibular evoked myogenic potentials) in the clinical practice led to new diagnostic options that for the first time allow a complex objective assessment of all components of the vestibular organ with relatively low effort. Combined with established methods, a frequency-specific assessment of the function of vestibular reflexes is possible. New classifications allow a clinically better differentiation of vertigo syndromes. Modern radiological procedures such as for example intratympanic gadolinium application for Menière’s disease with visualization of an endolymphatic hydrops also influence current medical standards. Recent methodical developments significantly contributed to the possibilities that nowadays vertigo can be better and more quickly clarified in particular in

Effect of acetabular cup abduction angle on wear of ultrahigh-molecular-weight polyethylene in hip simulator testing.

Science.gov (United States)

Korduba, Laryssa A; Essner, Aaron; Pivec, Robert; Lancin, Perry; Mont, Michael A; Wang, Aiguo; Delanois, Ronald E

2014-10-01

The effect of acetabular component positioning on the wear rates of metal-on-polyethylene articulations has not been extensively studied. Placement of acetabular cups at abduction angles of more than 40° has been noted as a possible reason for early failure caused by increased wear. We conducted a study to evaluate the effects of different acetabular cup abduction angles on polyethylene wear rate, wear area, contact pressure, and contact area. Our in vitro study used a hip joint simulator and finite element analysis to assess the effects of cup orientation at 4 angles (0°, 40°, 50°, 70°) on wear and contact properties. Polyethylene bearings with 28-mm cobalt-chrome femoral heads were cycled in an environment mimicking in vivo joint fluid to determine the volumetric wear rate after 10 million cycles. Contact pressure and contact area for each cup abduction angle were assessed using finite element analysis. Results were correlated with cup abduction angles to determine if there were any differences among the 4 groups. The inverse relationship between volumetric wear rate and acetabular cup inclination angle demonstrated less wear with steeper cup angles. The largest abduction angle (70°) had the lowest contact area, largest contact pressure, and smallest head coverage. Conversely, the smallest abduction angle (0°) had the most wear and most head coverage. Polyethylene wear after total hip arthroplasty is a major cause of osteolysis and aseptic loosening, which may lead to premature implant failure. Several studies have found that high wear rates for cups oriented at steep angles contributed to their failure. Our data demonstrated that larger cup abduction angles were associated with lower, not higher, wear. However, this potentially "protective" effect is likely counteracted by other complications of steep cup angles, including impingement, instability, and edge loading. These factors may be more relevant in explaining why implants fail at a higher rate if

Comfort and acceptability of various immobilization positions using a shoulder external rotation and abduction brace.

Science.gov (United States)

Hatta, Taku; Yamamoto, Nobuyuki; Sano, Hirotaka; Itoi, Eiji

2017-03-01

Immobilization with shoulder braces is used for conservative treatment of an initial shoulder dislocation. Various arm positions have been investigated to determine optimal position in terms of the anatomical reduction of the Bankart lesion. Recently, the effect of immobilization in shoulder abduction as well as in external rotation has been reported. However, there are few studies assessing subjects' acceptability of the brace in various arm positions. We hypothesized that a certain arm position regarding abduction or external rotation for immobilization would induce significant discomfort during activities of daily living. A dominant arm of 20 healthy participants was immobilized with a shoulder brace in 4 different positions; adduction and internal rotation (Add-IR), adduction and external rotation (Add-ER), 30° of abduction and 30° of external rotation (Abd-30ER), and 30° of abduction and 60° of external rotation (Abd-60ER). After completing immobilization for 24 h, subjects were asked to assess the discomfort of bracing for overall and individual activities, using a visual analogue scale. Data were compared among the four positions. For overall activities and several activities (eating, reading books, and removing and putting on pants), Abd-60ER was significantly more uncomfortable than adducted arm positions. Abd-30ER did not show any differences compared to the other arm positions. Immobilization in abduction and external rotation seems to be acceptable although the arm position in 30° of abduction and 60° of external rotation is less comfortable than the others. Our results might be useful in determining and developing the ideal shoulder brace which could keep patients' compliance and improve their outcomes. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Abduction aiming at empirical progress or even at truth approximation, leading to challenge for computational modelling

NARCIS (Netherlands)

Kuipers, Theo A.F.

1999-01-01

This paper primarily deals with the conceptual prospects for generalizing the aim of abduction from the standard one of explaining surprising or anomalous observations to that of empirical progress or even truth approximation. It turns out that the main abduction task then becomes the

Pain related to cancer treatments and diagnostic procedures: a no man's land?

Science.gov (United States)

Ripamonti, C I; Bossi, P; Santini, D; Fallon, M

2014-06-01

While guidelines are available for the management of cancer-related pain, little attention is given to the assessment and treatment of pain caused by treatments and diagnostic procedures in cancer patients. We evaluated the literature on pain related to cancer treatment and diagnostic procedures within a critical analysis. The data available are sparse, suggesting that little attention has been directed at this important aspect of oncology. This points to potentially suboptimal patient management. Appropriate studies are necessary in order to understand the incidence and appropriate management of pain, both during and/or after oncological treatments and diagnostic procedures. At the same time, Health Care Professionals should have heightened awareness of the causes and treatment of pain with the aim of anticipating and managing pain most appropriately for each individual patient. This is clearly an important component of holistic patient care before, during, and after oncological treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

From war to classroom: PTSD and depression in formerly abducted youth in Uganda

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Nina eWinkler

2015-03-01

Full Text Available Background: Trained local screeners assessed the mental health status of male and female students in Northern Ugandan schools. The study aimed to disclose potential differences in mental health-related impairment in two groups, former child soldiers (n=354 and other war-affected youth (n=489, as well as to separate factors predicting mental suffering in learners. Methods: Participants were randomly selected. We used the Post-Traumatic Diagnostic Scale (PDS to assess symptoms of PTSD and for potential depression the respective section of the Hopkins Symptom Checklist (DHSCL with a locally validated cut-off. Results: Almost all respondents had been displaced at least once in their life. Thirty percent of girls and 50% of the boys in the study reported past abduction history. Trauma exposure was notably higher in the group of abductees. In former child soldiers a PTSD rate of 32% was remarkably higher than that for non-abductees (12%. Especially in girls rates of potential depression were double those in the group of former abductees (17% than in the group of non-abductees (8%. In all groups trauma exposure increased the risk of developing PTSD. A path-analytic model for developing PTSD and potential depression revealed both previous trauma exposure as well as duration of abduction to have significant influences on trauma-related mental suffering. Findings also suggest that in Northern Ugandan schools trauma spectrum disorders are common among war-affected learners. Conclusions: Therefore, it is suggested the school context should be used to provide mental health support structures within the education system for war-affected youth at likely risk of developing war-related mental distress.

The association between eccentric hip abduction strength and hip and knee angular movements in recreational male runners

DEFF Research Database (Denmark)

Brund, René B. Korsgaard; Rasmussen, Sten; Nielsen, Rasmus O.

2018-01-01

Weak hip abductors may be related with increased hip adduction and knee abduction angular movement, which may be risk factors of lower extremity injuries. As the role of eccentric hip abduction strength (EHAS) on hip adduction angular movement and knee abduction angular movement (KABD) remains...... and Codamotion active marker system. Using multiple linear regression models (n=186 legs), no relationships between EHAS and hip and knee kinematics were found. A possible reason for the lack of relationship between EHAS and hip and knee kinematics may be owing to differences in the running kinematics. Some...

Lasciar parlare il silenzio. La Partition del subcontinente indiano e le abducted women

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Piera Cavenaghi

2011-10-01

Full Text Available The acts of violence committed during the Partition of India in 1947 are known and proved. Less well known is violence that struck tens of thousands of abducted and raped women. Both India and Pakistan admitted these crimes and agreed to recover and restore the abducted women. The Indian Government especially committed to accomplish the recovery plan even at the cost of sending the women forcedly back. The recovery of abducted women became a issue of national honour that apparently contrasted with the family and community concept of honour. Many of the recovered women were indeed rejected by their families, regarding them as impure. On its part the Indian Government made a great deal of effort to restore them. After that, silence enshrouded them and the memory of their pain faded. By contrast memories of women who had committed suicide “to save their honour”, were emphatically handed on.

Mental Health among Former Child Soldiers and Never-Abducted Children in Northern Uganda

Directory of Open Access Journals (Sweden)

Ughetta Moscardino

2012-01-01

Full Text Available The present study aimed to evaluate posttraumatic stress symptoms, psychological distress, and emotional and behavioral problems in former Ugandan child soldiers in comparison with civilian children living in the same conflict setting. Participants included 133 former child soldiers and 101 never-abducted children in northern Uganda, who were interviewed about exposure to traumatic war-related experiences, posttraumatic stress symptoms, psychological distress, and emotional and behavioral problems. Results indicated that former child soldiers had experienced significantly more war-related traumatic events than nonabducted children, with 39.3% of girls having been forced to engage in sexual contact. Total scores on measures of PTSD symptoms, psychological distress, and emotional and behavioral problems were significantly higher among child soldiers compared to their never-abducted peers. Girls reported significantly more emotional and behavioral difficulties than boys. In never-abducted children, more mental health problems were associated with experiencing physical harm, witnessing the killings of other people, and being forced to engage in sexual contact.

Comparative analysis of diagnostic accuracy of different brain biopsy procedures.

Science.gov (United States)

Jain, Deepali; Sharma, Mehar Chand; Sarkar, Chitra; Gupta, Deepak; Singh, Manmohan; Mahapatra, A K

2006-12-01

Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different stereotactic and ultrasound-guided brain biopsy procedures. A retrospective analysis was conducted of all brain biopsies (frame-based and frameless stereotactic and ultrasound-guided) performed in a single tertiary care neurosciences center between 1995 and 2005. The overall diagnostic accuracy achieved on histopathology and correlation with type of biopsy technique was evaluated. A total of 130 cases were included, which consisted of 82 males and 48 females. Age ranged from 4 to 75 years (mean age 39.5 years). Twenty per cent (27 patients) were in the pediatric age group, while 12% (16 patients) were >or= 60-years of age. A definitive histological diagnosis was established in 109 cases (diagnostic yield 80.2%), which encompassed 101 neoplastic and eight nonneoplastic lesions. Frame-based, frameless stereotactic and ultrasound-guided biopsies were done in 95, 15 and 20 patients respectively. Although the numbers of cases were small there was trend for better yield with frameless image-guided stereotactic biopsy and maximum diagnostic yield was obtained i.e, 87% (13/15) in comparison to conventional frame-based CT-guided stereotactic biopsy and ultrasound-guided biopsy. Overall, a trend of higher diagnostic yield was seen in cases with frameless image-guided stereotactic biopsy. Thus, this small series confirms that frameless neuronavigator-guided stereotactic procedures represent the lesion sufficiently in order to make histopathologic diagnosis.

Treatment of the Developmental Dysplasia of the Hip with an Abduction Brace in Children up to 6 Months Old

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Raphaël Wahlen

2015-01-01

Full Text Available Introduction. Use of Pavlik harness for the treatment of DDH can be complicated for parents. Any misuse or failure in the adjustments may lead to significant complications. An abduction brace was introduced in our institution, as it was thought to be easier to use. Aim. We assess the results for the treatment of DDH using our abduction brace in children of 0–6 months old and compare these results with data on treatments using the Pavlik harness. Method. Retrospective analysis of patients with DDH from 0 to 6 months old at diagnosis, performed from 2004 to 2009. Outcomes were rates of reduction of the hip and avascular necrosis of the femoral head (AVN. Follow-up was at one year and up to 4 years old. Results. Hip reduction was successful in 28 of 33 patients (85%, with no AVN. Conclusion. Our results in terms of hip reduction rate and AVN rate are similar to those found in literature assessing Pavlik harness use, with a simpler and comfortable treatment procedure.

Quality control procedure for a general diagnostic x-ray machine

International Nuclear Information System (INIS)

Md Saion Salikin; Mazlyfarina Mohamad

2001-01-01

Performance tests of a particular medical diagnostic x-ray machine have to be carried out regularly in order to ensure that the machine always complies with the required standard. A performance report which is prepared based on the performance tests on the x-ray machine is used as one of the requirement by the authority for issuance and renewal licence to operate and use of the x-ray machine in a clinic or hospital. The Ministry of Health will only issue a licence to the clinic or hospital to use and operate x-ray machines, if the machines have complied with the standards. The clinic or hospital may get the service to carry out performance tests on a diagnostic x-ray machine from any licence H holder, issued by the authority under Atomic Energy Licensing Act 1984. A comparative study between the standard procedure and other procedures on performance test of a general diagnostic x-ray machine is carried out and presented in brief in this paper. The criteria for compliance or otherwise as required by the Ministry of Health Malaysia is discussed and explained in brief. (Author)

Updating Allergy and/or Hypersensitivity Diagnostic Procedures in the WHO ICD-11 Revision.

Science.gov (United States)

Tanno, Luciana Kase; Calderon, Moises A; Li, James; Casale, Thomas; Demoly, Pascal

2016-01-01

The classification of allergy and/or hypersensitivity conditions for the World Health Organization (WHO) International Classification of Diseases (ICD)-11 provides the appropriate corresponding codes for allergic diseases, assuming that the final diagnosis is correct. This classification should be linked to in vitro and in vivo diagnostic procedures. Considering the impact for our specialty, we decided to review the codification of these procedures into the ICD aiming to have a baseline and to suggest changes and/or submit new proposals. For that, we prepared a list of the relevant allergy and/or hypersensitivity diagnostic procedures that health care professionals are dealing with on a daily basis. This was based on the main current guidelines and selected all possible and relevant corresponding terms from the ICD-10 (2015 version) and the ICD-11 β phase foundation (June 2015 version). More than 90% of very specific and important diagnostic procedures currently used by the allergists' community on a daily basis are missing. We observed that some concepts usually used by the allergist community on a daily basis are not fully recognized by other specialties. The whole scheme and the correspondence in the ICD-10 (2015 version) and ICD-11 foundation (June 2015 version) provided us a big picture of the missing or imprecise terms and how they are scattered in the current ICD-11 framework, allowing us to submit new proposals to increase the visibility of the allergy and/or hypersensitivity conditions and diagnostic procedures. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. All rights reserved.

Naive ABox abduction in ALC using a DL tableau

CSIR Research Space (South Africa)

Halland, K

2012-06-01

Full Text Available The formal definition of abduction asks what needs to be added to a knowledge base to enable an observation to be entailed by the knowledge base. An observation which is not entailed by the knowledge base will result in open branches in a complete...

Diagnostic criteria and reporting procedures for pre-eclampsia

DEFF Research Database (Denmark)

Klemmensen, Ase K; Olsen, Sjurdur F.; Wengel, Christina M

2005-01-01

OBJECTIVE: A precondition for the rational use of obstetric databases in biomedical research is detailed knowledge on how data are being generated. We identified the diagnostic procedures and criteria for pre-eclampsia (PE) and assessed the level of obstetric training of the personnel responsible...... of pregnancy diagnoses to the National Patient Registry differed widely in training. For complicated pregnancies, departments ranged from having only specialists reporting all cases to secretaries reporting up to 50%. Cut off limits of blood pressure (BP) and protein loss used to diagnose pre-eclampsia showed...... large differences across departments. The diagnoses given to three case stories showed little correlation to the criteria the departments reported using. CONCLUSION: Even in a small country like Denmark with 34 obstetrical departments, there was little consensus on the diagnostic criteria for pre-eclampsia...

Radiation doses from medical diagnostic procedures in Canada

Energy Technology Data Exchange (ETDEWEB)

Aldrich, J E; Lentle, B C; Vo, C [British Columbia Univ., Vancouver, BC (Canada). Dept. of Radiology

1997-03-01

This document sets out to record and analyze the doses incurred in Canada from medical procedures involving the use of ionizing radiation in a typical year. Excluded are those doses incurred during therapeutic irradiation, since they differ in scale to such a large degree and because they are used almost exclusively in treating cancer. In this we are following a precedent set by the United Nations Scientific Committee on the Effects of Ionizing Radiation. Although the International Commission on Radiological Protection (ICRP) notes that dose limits should not be applied to medical exposures, it also observes that doses in different settings for the same procedure may vary by as much as two orders of magnitude, and that there are considerable opportunities for dose reductions in diagnostic radiology. Because these data do not stand in isolation the report also encompasses a review of the relevant literature and some background comment on the evolving technology of the radiological sciences. Because there is a somewhat incomplete perception of the changes taking place in diagnostic methods we have also provided some introductory explanations of the relevant technologies. In addition, there is an analysis of at least some of the limitations on the completeness of the data which are reported here. (author).

Radiation doses from medical diagnostic procedures in Canada

International Nuclear Information System (INIS)

Aldrich, J.E.; Lentle, B.C.; Vo, C.

1997-03-01

This document sets out to record and analyze the doses incurred in Canada from medical procedures involving the use of ionizing radiation in a typical year. Excluded are those doses incurred during therapeutic irradiation, since they differ in scale to such a large degree and because they are used almost exclusively in treating cancer. In this we are following a precedent set by the United Nations Scientific Committee on the Effects of Ionizing Radiation. Although the International Commission on Radiological Protection (ICRP) notes that dose limits should not be applied to medical exposures, it also observes that doses in different settings for the same procedure may vary by as much as two orders of magnitude, and that there are considerable opportunities for dose reductions in diagnostic radiology. Because these data do not stand in isolation the report also encompasses a review of the relevant literature and some background comment on the evolving technology of the radiological sciences. Because there is a somewhat incomplete perception of the changes taking place in diagnostic methods we have also provided some introductory explanations of the relevant technologies. In addition, there is an analysis of at least some of the limitations on the completeness of the data which are reported here. (author)

Effect of shoulder abduction angle on biomechanical properties of the repaired rotator cuff tendons with 3 types of double-row technique.

Science.gov (United States)

Mihata, Teruhisa; Fukuhara, Tetsutaro; Jun, Bong Jae; Watanabe, Chisato; Kinoshita, Mitsuo

2011-03-01

After rotator cuff repair, the shoulder is immobilized in various abduction positions. However, there is no consensus on the proper abduction angle. To assess the effect of shoulder abduction angle on the biomechanical properties of the repaired rotator cuff tendons among 3 types of double-row techniques. Controlled laboratory study. Thirty-two fresh-frozen porcine shoulders were used. A simulated rotator cuff tear was repaired by 1 of 3 double-row techniques: conventional double-row repair, transosseous-equivalent repair, and a combination of conventional double-row and bridging sutures (compression double-row repair). Each specimen underwent cyclic testing followed by tensile testing to failure at a simulated shoulder abduction angle of 0° or 40° on a material testing machine. Gap formation and failure loads were measured. Gap formation in conventional double-row repair at 0° (1.2 ± 0.5 mm) was significantly greater than that at 40° (0.5 ± 0.3mm, P = .01). The yield and ultimate failure loads for conventional double-row repair at 40° were significantly larger than those at 0° (P row repair (P row repair was the greatest among the 3 double-row techniques at both 0° and 40° of abduction. Bridging sutures have a greater effect on the biomechanical properties of the repaired rotator cuff tendon at a low abduction angle, and the conventional double-row technique has a greater effect at a high abduction angle. Proper abduction position after rotator cuff repair differs between conventional double-row repair and transosseous-equivalent repair. The authors recommend the use of the combined technique of conventional double-row and bridging sutures to obtain better biomechanical properties at both low and high abduction angles.

The effectiveness of drama therapy on preparation for diagnostic and therapeutic procedures in children suffering from cancer

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Ľubica Ilievová

2015-10-01

Full Text Available Introduction: The integral part of the treatment of pediatric oncological patients is a range of diagnostic and therapeutic procedures. These procedures are often associated with the fear and anxiety of the suffering child. We investigated whether a psychological preparation through drama therapy and the therapeutic puppet may reduce the anxiety related to diagnostic and therapeutic procedures in the preschool or early school children suffering from cancer.Methods: Twenty consecutive pediatric patients of preschool and early school age, with the diagnosis of lymphoblastic leukemia, were included in the study. The patients were alternatingly assigned to experimental or control group, and subjected or not subjected to drama therapy, respectively. We measured the changes in heart rate, blood pressure and respiratory rate as indicators of anxiety and fear, before and after the diagnostic or therapeutic procedures.Results: Heart rate, blood pressure, and respiratory rate in pediatric oncological patients before and after the diagnostic or therapeutic procedure were significantly lower in the experimental group of patients.Conclusion: Our results show that psychological preparation using drama therapy and therapeutic puppet reduced the fear and anxiety related to diagnostic or therapeutic procedures in pediatric oncological patients.Key words: drama therapy; therapeutic puppet; children; oncology; psychology 

Feasibility of vocal fold abduction and adduction assessment using cine-MRI

Energy Technology Data Exchange (ETDEWEB)

Baki, Marina Mat [National University of Malaysia, Faculty of Medicine, Kuala Lumpur (Malaysia); Menys, Alex; Morley, Simon; Beale, Timothy [University College London, Centre for Medical Imaging, London (United Kingdom); Atkinson, David; Punwani, Shonit [University College London, Centre for Medical Imaging, London (United Kingdom); Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); Bassett, Paul [University College London, London (United Kingdom); Sandhu, Guri [Charing Cross Hospital, Imperial College Healthcare NHS Trust, London (United Kingdom); Naduvilethil, Georgekutty; Stevenson, Nicola [Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); Birchall, Martin A. [Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); University of California, Davis, Department of Otolaryngology, Davis, CA (United States); University College London, Ear Institute, London (United Kingdom)

2017-02-15

Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC). VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44). Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability. (orig.)

Feasibility of vocal fold abduction and adduction assessment using cine-MRI

International Nuclear Information System (INIS)

Baki, Marina Mat; Menys, Alex; Morley, Simon; Beale, Timothy; Atkinson, David; Punwani, Shonit; Bassett, Paul; Sandhu, Guri; Naduvilethil, Georgekutty; Stevenson, Nicola; Birchall, Martin A.

2017-01-01

Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC). VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44). Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability. (orig.)

Wide step width reduces knee abduction moment of obese adults during stair negotiation.

Science.gov (United States)

Yocum, Derek; Weinhandl, Joshua T; Fairbrother, Jeffrey T; Zhang, Songning

2018-05-15

An increased likelihood of developing obesity-related knee osteoarthritis may be associated with increased peak internal knee abduction moments (KAbM). Increases in step width (SW) may act to reduce this moment. The purpose of this study was to determine the effects of increased SW on knee biomechanics during stair negotiation of healthy-weight and obese participants. Participants (24: 10 obese and 14 healthy-weight) used stairs and walked over level ground while walking at their preferred speed in two different SW conditions - preferred and wide (200% preferred). A 2 × 2 (group × condition) mixed model analysis of variance was performed to analyze differences between groups and conditions (p < 0.05). Increased SW increased the loading-response peak knee extension moment during descent and level gait, decreased loading-response KAbMs, knee extension and abduction range of motion (ROM) during ascent, and knee adduction ROM during descent. Increased SW increased loading-response peak mediolateral ground reaction force (GRF), increased peak knee abduction angle during ascent, and decreased peak knee adduction angle during descent and level gait. Obese participants experienced disproportionate changes in loading-response mediolateral GRF, KAbM and peak adduction angle during level walking, and peak knee abduction angle and ROM during ascent. Increased SW successfully decreased loading-response peak KAbM. Implications of this finding are that increased SW may decrease medial compartment knee joint loading, decreasing pain and reducing joint deterioration. Increased SW influenced obese and healthy-weight participants differently and should be investigated further. Copyright © 2018. Published by Elsevier Ltd.

Evaluation of movements of lower limbs in non-professional ballet dancers: hip abduction and flexion

Directory of Open Access Journals (Sweden)

Valenti Erica E

2011-08-01

Full Text Available Abstract Background The literature indicated that the majority of professional ballet dancers present static and active dynamic range of motion difference between left and right lower limbs, however, no previous study focused this difference in non-professional ballet dancers. In this study we aimed to evaluate active movements of the hip in non-professional classical dancers. Methods We evaluated 10 non professional ballet dancers (16-23 years old. We measured the active range of motion and flexibility through Well Banks. We compared active range of motion between left and right sides (hip flexion and abduction and performed correlation between active movements and flexibility. Results There was a small difference between the right and left sides of the hip in relation to the movements of flexion and abduction, which suggest the dominant side of the subjects, however, there was no statistical significance. Bank of Wells test revealed statistical difference only between the 1st and the 3rd measurement. There was no correlation between the movements of the hip (abduction and flexion, right and left sides with the three test measurements of the bank of Wells. Conclusion There is no imbalance between the sides of the hip with respect to active abduction and flexion movements in non-professional ballet dancers.

Evaluation of movements of lower limbs in non-professional ballet dancers: hip abduction and flexion

Science.gov (United States)

2011-01-01

Background The literature indicated that the majority of professional ballet dancers present static and active dynamic range of motion difference between left and right lower limbs, however, no previous study focused this difference in non-professional ballet dancers. In this study we aimed to evaluate active movements of the hip in non-professional classical dancers. Methods We evaluated 10 non professional ballet dancers (16-23 years old). We measured the active range of motion and flexibility through Well Banks. We compared active range of motion between left and right sides (hip flexion and abduction) and performed correlation between active movements and flexibility. Results There was a small difference between the right and left sides of the hip in relation to the movements of flexion and abduction, which suggest the dominant side of the subjects, however, there was no statistical significance. Bank of Wells test revealed statistical difference only between the 1st and the 3rd measurement. There was no correlation between the movements of the hip (abduction and flexion, right and left sides) with the three test measurements of the bank of Wells. Conclusion There is no imbalance between the sides of the hip with respect to active abduction and flexion movements in non-professional ballet dancers. PMID:21819566

Additional radiation dose to population due to X-ray diagnostic procedures

International Nuclear Information System (INIS)

Chougule, A.

2006-01-01

Full text of publication follows: Discovery of X rays has revolutionised the medical diagnosis but the fact that the diagnostic radiological procedures contribute about 80 to 90 % of the radiation dose to population as compared to other man made radiation sources cannot be ignored especially when X ray diagnostic facilities are being made available to larger section of the society. The estimated frequency of radiological procedures in India is 12,000 procedures/ year/100,000 population, though it is quite less as compared to developed countries, its increasing day by day. As part of the project, a radiation protection survey of X ray installations and patient radiation dose measurement during various radiological procedures was undertaken. 193 X ray installations were surveyed and the radiation doses received by the patient during various radiological procedure was measured. For measurement of radiation doses, CaSO 4 : Dy thermoluminescence (T.L.) discs of size 13.3 mm diameter and 0.8 mm thickness were used. Pre annealed T.L. discs were fixed by adhesive tape on the patient skin at the center of entrance beam before the exposure. After exposure the T.L. discs were estimated f or entrance skin dose during that particular projection/ examination. 10,000 measurements at different centers during various radiological procedures were done. It was found that chest radiography accounts for 37 % of all radiological procedures and further it was observed that 70 % of the chest X rays were normal with out any pathology indicating scope for curtailing the unwarranted radiological procedures. The special investigations like barium swallow, barium meal and fallow through accounts for about 1.5 % of the total radiological procedures. The entrance skin dose [E.S.D.] during chest radiography was 0.3 + 0.1 mGy where as during K.U.B. and cervical spine radiography it was 6.2 + 1.1 mGy and 5.1 + 0.9 mGy respectively. The details of frequency of various radiological procedures and the

Prenatal radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

International Nuclear Information System (INIS)

Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.

2002-01-01

Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has the right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data have shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% (ICRP84, 2000) up to 0.14% per 10 mSv (BEIR-V 1990). In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy (ICRP84, 2000), and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; 1. The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. 2. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period

Tool wear modeling using abductive networks

Science.gov (United States)

Masory, Oren

1992-09-01

A tool wear model based on Abductive Networks, which consists of a network of `polynomial' nodes, is described. The model relates the cutting parameters, components of the cutting force, and machining time to flank wear. Thus real time measurements of the cutting force can be used to monitor the machining process. The model is obtained by a training process in which the connectivity between the network's nodes and the polynomial coefficients of each node are determined by optimizing a performance criteria. Actual wear measurements of coated and uncoated carbide inserts were used for training and evaluating the established model.

Diagnostic reference activities for nuclear medicine procedures in Australia and New Zealand

International Nuclear Information System (INIS)

Smart, R.C.; Towson, J.E.

2000-01-01

In July 1998 a survey of diagnostic nuclear medicine procedures in Australia and New Zealand was undertaken on behalf of the Australian and New Zealand Society of Nuclear Medicine (ANZSNM) and the Australasian Radiation Protection Society (ARPS) in order to establish diagnostic reference activities. A total of 96 responses were received representing 154 practices, comprising 45 public hospital departments, 21 private hospital departments, 87 private practices and 1 unspecified practice. The survey requested the usual activities administered for a standard adult, the method used to determine the activity for children and the minimum activities used for paediatric patients. Data was obtained for 80 different imaging procedures and for 17 non-imaging tracer studies. For those procedures for which information was available from 10 or more practices, 68 in total, the reference activity was calculated as the 75th percentile of the distribution of activities. The Most Common Activity, the Reference Activity, together with the effective dose in both male and female patients, is tabulated for all these procedures. Copyright (2000) Australasian Radiation Protection Society Inc

Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty. Hierarchy of surgical and implant-design-related factors.

Science.gov (United States)

Gutiérrez, Sergio; Comiskey, Charles A; Luo, Zong-Ping; Pupello, Derek R; Frankle, Mark A

2008-12-01

Evaluations of functional outcomes of reverse shoulder arthroplasty have revealed variable improvements in the range of motion and high rates of scapular notching. The purpose of this study was to systematically examine the impact of surgical factors (location of the glenosphere on the glenoid and tilt angle of the glenosphere on the glenoid) and implant-related factors (implant size, center-of-rotation offset, and humeral neck-shaft angle) on impingement-free abduction motion. A computer model was developed to virtually simulate abduction/adduction motion and its dependence on five surgical and implant-related factors. Three conditions were tested for each factor, resulting in a total of 243 simulated combinations. The overall motion was determined from 0 degrees of abduction until maximum abduction, which would be limited by impingement of the humerosocket on the scapula. In those combinations in which 0 degrees of abduction could not be achieved, the adduction deficit was recorded. The largest average increase in the range of impingement-free abduction motion resulted from a more lateral center-of-rotation offset: the average increase was 31.9 degrees with a change in the center-of-rotation offset from 0 to 10 mm, and this change resulted in an increase in abduction motion in eighty of the eighty-one combinations. The position of the glenosphere on the glenoid was associated with the second largest average increase in abduction motion (28.1 degrees when the glenosphere position was changed from superior to inferior, with the change resulting in an increase in seventy-one of the eighty-one combinations). These factors were followed by glenosphere tilt, humeral neck-shaft angle, and prosthetic size in terms of their effects on abduction motion. The largest effect in terms of avoiding an adduction deficit was provided by a humeral neck-shaft angle of 130 degrees (the deficit was avoided in forty-nine of the eighty-one combinations in which this angle was used

The Relative Contribution to Small Finger Abduction of the Ulnar Versus Radial Slip of the EDM: Implications for Tendon Transfers.

Science.gov (United States)

Akinleye, Sheriff D; Culbertson, Maya Deza; Cappelleti, Giacomo; Garofolo, Garret; Choueka, Jack

2017-09-01

The extensor digiti minimi (EDM) tendon is commonly divided into a radial slip (EDM-R) and an ulnar slip (EDM-U). To our knowledge, the degree to which each EDM slip concomitantly abducts the small finger with active extension has not been formally tested. This study sought to characterize the comparative contributions of finger abduction inherent to each slip of the EDM to observe the sequelae of active small finger extension following transfer of the contralateral slip. Eighteen fresh-frozen cadaveric hands were used in this study. Starting with the hand in resting position, a controlled traction of 10 N was applied to each slip of the EDM tendon. The range of small finger abduction with respect to the fixed ring finger was recorded utilizing infrared reflective markers tracked through the range of motion using a digital video camera. The mean abduction of the small finger when the radial slip of the EDM tendon was tested was 13.33° (95% confidence interval [CI]: 10.10°-16.55°), which was significantly different ( P ≤ .001) than small finger abduction produced by the ulnar slip of the EDM, with a mean of 23.72° (95% CI: 19.40°-28.04°). Given the fact that the ulnar slip of the EDM tendon is shown to be the major contributor of aberrant abduction with active small finger extension, as traction on this slip produces almost twice as much abduction as the radial slip, the EDM-U is the ideal donor graft with respect to tendon transfers of the EDM.

Raciocínio abdutivo, criativídade e auto-organiszão [Abductive reasoning, creativity and self-organization

NARCIS (Netherlands)

Gonzalez, M.E.Q.; Haselager, W.F.G.

2002-01-01

We are going to investigate the nature of Creativity focusing on Peirce's notion of abductive reasoning and on the main premises of the Theory of Self-Organization. As an initial hypothesis we characterize Creativity as a self-organizing process in which abductive reasoning occurs allowing the

Kidnapping and abduction minimizing the threat and lessons in survival

CERN Document Server

Heard, Brian John

2014-01-01

Terrorist groups and organized crime cartels pose an increasing threat of kidnapping throughout many regions in the word. At the same time, international travel has become more commonplace for both business and leisure purposes. Kidnapping and Abduction: Minimizing the Threat and Lessons in Survival provides a practical guide on the precautions travelers can take to avoid being kidnapped or derail a kidnapping attempt in progress. In the event this cannot be avoided, the book supplies advice on how to ensure survival during captivity. Readers will learn: The basic elements of kidnapping and abduction The motivations and mechanisms of kidnappers The hotspots where kidnapping/hostage taking is prevalent Vehicles best suited for avoidance of kidnap threat and proposals for up-armoring an existing vehicle How to recognize immediate threats and precautions to be taken in assessing threat level The types of weapons most favored by kidnappers and their threat level Available bullet-resistant materials and their use ...

Kinematic design of a finger abduction mechanism for an anthropomorphic robotic hand

Directory of Open Access Journals (Sweden)

L.-A. A. Demers

2011-02-01

Full Text Available This paper presents the kinematic design of an abduction mechanism for the fingers of an underactuated anthropomorphic robotic hand. This mechanism will enhance the range of feasible grasps of the underactuated hand without significantly increasing its complexity. The analysis of the link between the index finger and the third finger is first assessed, where the parameters are studied in order to follow the amplitude constraint and to minimize the coordination error. Then, the study of the mechanism joining the third finger and the little finger is summarized. Finally, a prototype of the finger's abduction system is presented.

This paper was presented at the IFToMM/ASME International Workshop on Underactuated Grasping (UG2010, 19 August 2010, Montréal, Canada.

Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis

Directory of Open Access Journals (Sweden)

Abdullah Şimşek

Full Text Available ABSTRACT Objective: To determine the proportional distribution of endobronchial tuberculosis (EBTB subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. Methods: This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. Results: The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both. Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%. Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%. Smear microscopy of BAL fluid (BALF was performed in 16 patients and was positive for AFB in 10 (62.5%. Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%. Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%; bronchial brushing, in 7 (38.8%; fine-needle aspiration biopsy, in 2 (11.1%; and BAL, in 2 (11.1%. Bronchial anthracofibrosis was observed in 5 (27.7% of the 18 cases evaluated. Conclusions: In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB.

Renal diagnostic nuclear medicine procedures in progressive systemic scleroderma (PSS)

Energy Technology Data Exchange (ETDEWEB)

Ammari, B.; Hotze, A.; Gruenwald, F.; Biersack, H.J.; Blitz, H.; Kuester, W.; Kreysel, H.W.

1989-02-01

The involvement of kidneys in progressive systemic scleroderma (PSS) is one of the most frequent causes of death in this disease. Using clinical criteria and laboratory tests only the frequency of kidney involvement would be clearly underestimated. Invasive diagnostic procedures such as biopsy and angiography can not be applied in those patients. Nuclear medicine techniques (hippurate clearance, DMSA-scan), however, offer non invasive and sensitive methods in the diagnosis of renal involvement in PSS patients. In our study 46 of 76 patients (60%) revealed pathologic findings. The mentioned diagnostic techniques show a high sensitivity and are in agreement with pathological findings described in PSS.

Renal diagnostic nuclear medicine procedures in progressive systemic scleroderma (PSS)

International Nuclear Information System (INIS)

Ammari, B.; Hotze, A.; Gruenwald, F.; Biersack, H.J.; Blitz, H.; Kuester, W.; Kreysel, H.W.

1989-01-01

The involvement of kidneys in progressive systemic scleroderma (PSS) is one of the most frequent causes of death in this disease. Using clinical criteria and laboratory tests only the frequency of kidney involvement would be clearly underestimated. Invasive diagnostic procedures such as biopsy and angiography can not be applied in those patients. Nuclear medicine techniques (hippurate clearance, DMSA-scan), however, offer non invasive and sensitive methods in the diagnosis of renal involvement in PSS patients. In our study 46 of 76 patients (60%) revealed pathologic findings. The mentioned diagnostic techniques show a high sensitivity and are in agreement with pathological findings described in PSS. (orig.) [de

Procedure to describe clavicular motion.

Science.gov (United States)

Gutierrez Delgado, Guivey; De Beule, Matthieu; Ortega Cardentey, Dolgis R; Segers, Patrick; Iznaga Benítez, Arsenio M; Rodríguez Moliner, Tania; Verhegghe, Benedict; Palmans, Tanneke; Van Hoof, Tom; Van Tongel, Alexander

2017-03-01

For many years, researchers have attempted to describe shoulder motions by using different mathematical methods. The aim of this study was to describe a procedure to quantify clavicular motion. The procedure proposed for the kinematic analysis consists of 4 main processes: 3 transcortical pins in the clavicle, motion capture, obtaining 3-dimensional bone models, and data processing. Clavicular motion by abduction (30° to 150°) and flexion (55° to 165°) were characterized by an increment of retraction of 27° to 33°, elevation of 25° to 28°, and posterior rotation of 14° to 15°, respectively. In circumduction, clavicular movement described an ellipse, which was reflected by retraction and elevation. Kinematic analysis shows that the articular surfaces move by simultaneously rolling and sliding on the convex surface of the sternum for the 3 movements of abduction, flexion, and circumduction. The use of 3 body landmarks in the clavicle and the direct measurement of bone allowed description of the osteokinematic and arthrokinematic movement of the clavicle. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

The Influence of Task Constraints on the Glenohumeral Horizontal Abduction Angle of the Overarm Throw of Novice Throwers

Science.gov (United States)

Breslin, Casey M.; Garner, John C.; Rudisill, Mary E.; Parish, Loraine E.; St. Onge, Paul M.; Campbell, Brian J.; Weimar, Wendi H.

2009-01-01

This study determines the effects of three baseballs and softballs of different masses (0.113 kg, 0.198 kg, 0.340 kg) and regulation diameters (22.86 and 30.48 cm, respectively) on the glenohumeral horizontal abduction angle of an overarm throw performed by young children who were novice throwers. Glenohumeral horizontal abduction angle was…

Risk and safety requirements for diagnostic and therapeutic procedures in allergology

DEFF Research Database (Denmark)

Kowalski, Marek L; Ansotegui, Ignacio; Aberer, Werner

2016-01-01

One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment) of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin...... attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO), representing various continents and areas of allergy expertise, presents this report on risk...... associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access...

Reproducibility of a 3-dimensional gyroscope in measuring shoulder anteflexion and abduction

Directory of Open Access Journals (Sweden)

Penning Ludo I F

2012-07-01

Full Text Available Abstract Background Few studies have investigated the use of a 3-dimensional gyroscope for measuring the range of motion (ROM in the impaired shoulder. Reproducibility of digital inclinometer and visual estimation is poor. This study aims to investigate the reproducibility of a tri axial gyroscope in measurement of anteflexion, abduction and related rotations in the impaired shoulder. Methods Fifty-eight patients with either subacromial impingement (27 or osteoarthritis of the shoulder (31 participated. Active anteflexion, abduction and related rotations were measured with a tri axial gyroscope according to a test retest protocol. Severity of shoulder impairment and patient perceived pain were assessed by the Disability of Arm Shoulder and Hand score (DASH and the Visual Analogue Scale (VAS. VAS scores were recorded before and after testing. Results In two out of three hospitals patients with osteoarthritis (n = 31 were measured, in the third hospital patients with subacromial impingement (n = 27. There were significant differences among hospitals for the VAS and DASH scores measured before and after testing. The mean differences between the test and retest means for anteflexion were −6 degrees (affected side, 9 (contralateral side and for abduction 15 degrees (affected side and 10 degrees (contralateral side. Bland & Altman plots showed that the confidence intervals for the mean differences fall within −6 up to 15 degrees, individual test - retest differences could exceed these limits. A simulation according to ‘Generalizability Theory’ produces very good coefficients for anteflexion and related rotation as a comprehensive measure of reproducibility. Optimal reproducibility is achieved with 2 repetitions for anteflexion. Conclusions Measurements were influenced by patient perceived pain. Differences in VAS and DASH might be explained by different underlying pathology. These differences in shoulder pathology however did not alter

Combined Deep And Shallow Knowledge In A Unified Model For Diagnosis By Abduction

Directory of Open Access Journals (Sweden)

Viorel Ariton

2006-10-01

Full Text Available Abstract: Fault Diagnosis in real systems usually involves human expert’s shallow knowledge (as pattern causes-effects but also deep knowledge(as structural / functional modularization and models on behavior. The paper proposes a unified approach on diagnosis by abduction based onplausibility and relevance criteria multiple applied, in a connectionist implementation. Then, it focuses elicitation of deep knowledge on targetconductive flow systems – most encountered in industry and not only, in the aim of fault diagnosis. Finally, the paper gives hints on design andbuilding of diagnosis system by abduction, embedding deep and shallow knowledge (according to case and performing hierarchical fault isolation,along with a case study on a hydraulic installation in a rolling mill plant.

COMBINED DEEP AND SHALLOW KNOWLEDGE IN A UNIFIED MODEL FOR DIAGNOSIS BY ABDUCTION

Directory of Open Access Journals (Sweden)

Viorel Ariton

2007-05-01

Full Text Available Fault Diagnosis in real systems usually involves human expert’s shallow knowledge (as pattern causeseffectsbut also deep knowledge (as structural / functional modularization and models on behavior. The paperproposes a unified approach on diagnosis by abduction based on plausibility and relevance criteria multipleapplied, in a connectionist implementation. Then, it focuses elicitation of deep knowledge on target conductiveflow systems – most encountered in industry and not only, in the aim of fault diagnosis. Finally, the paper giveshints on design and building of diagnosis system by abduction, embedding deep and shallow knowledge(according to case and performing hierarchical fault isolation, along with a case study on a hydraulicinstallation in a rolling mill plant.

Searching for the Unknowable: A Process of Detection — Abductive Research Generated by Projective Techniques

Directory of Open Access Journals (Sweden)

Miri Levin-Rozalis

2004-06-01

Full Text Available This article looks at the process of doing research ‘from scratch.’ The author began a project investigating children of Ethiopian origin living in Israel to see how ones who attended a kindergartern program years earlier differed from those who had not attended. However, the problem from the outset was that there may not be a difference to find. In this article, the author compares inductive, deductive, and abductive reasoning, and argues that abductive reasoning is the proper technique when nothing is known about the research at the outset.

Diagnostic imaging of shoulder impingement

International Nuclear Information System (INIS)

Merl, T.; Weinhardt, H.; Oettl, G.; Lenz, M.; Riel, K.A.

1996-01-01

Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage [de

[Evaluation of quality of HIV diagnostic procedures in Poland].

Science.gov (United States)

Parczewski, Miłosz; Madaliński, Kazimierz; Leszczyszyn-Pynka, Magdalena; Boroń-Kaczmarska, Anna

2010-01-01

The aim of this work was quality assessment of HIV diagnostic procedures in Poland, including human and technical resources as well as laboratory practice. Sixty questionnaires were distributed among diagnostic centers to obtain qualitative data. Basing on the survey data serological control using coded panels of HIV-1/2 samples was performed. Thirty-one filled questionnaires were received (50.8%). Surveyed laboratories perform from 350 to 5500 serological screening tests per year. In most of laboratories fourth generation assays are available, while Blood Donation Centers screen the blood both with serological assays and by HIV-RNA detection. Sanitary and Epidemiological Stations and academic laboratories hold the ISO/IEC 17025 or IS0 9001:2001 accreditation, five of the surveyed centers participate in Labquality assurance and two in Quality Control in Molecular Diagnostics programs. Data of control serological testing were received from 21 centers. In the quality control assessment 194 analyses were performed with 91 true negative, 2 false negative, 96 true positive and 5 false positive results. False negative rate of % and false positive rate of 5.2% was noted for this study. Currently, virtually no guidelines related to the HIV-diagnostics quality assurance and control in Poland are in delineated. Development of the national unified quality control system, basing on the central institution is highly desirable. National certification within the frames of the quality control and assurance program should be mandatory for all the diagnostic labs, and aim at improvement of reliability of the result distributed among clinicians and patients.

Developing an automated database for monitoring ultrasound- and computed tomography-guided procedure complications and diagnostic yield.

Science.gov (United States)

Itri, Jason N; Jones, Lisa P; Kim, Woojin; Boonn, William W; Kolansky, Ana S; Hilton, Susan; Zafar, Hanna M

2014-04-01

Monitoring complications and diagnostic yield for image-guided procedures is an important component of maintaining high quality patient care promoted by professional societies in radiology and accreditation organizations such as the American College of Radiology (ACR) and Joint Commission. These outcome metrics can be used as part of a comprehensive quality assurance/quality improvement program to reduce variation in clinical practice, provide opportunities to engage in practice quality improvement, and contribute to developing national benchmarks and standards. The purpose of this article is to describe the development and successful implementation of an automated web-based software application to monitor procedural outcomes for US- and CT-guided procedures in an academic radiology department. The open source tools PHP: Hypertext Preprocessor (PHP) and MySQL were used to extract relevant procedural information from the Radiology Information System (RIS), auto-populate the procedure log database, and develop a user interface that generates real-time reports of complication rates and diagnostic yield by site and by operator. Utilizing structured radiology report templates resulted in significantly improved accuracy of information auto-populated from radiology reports, as well as greater compliance with manual data entry. An automated web-based procedure log database is an effective tool to reliably track complication rates and diagnostic yield for US- and CT-guided procedures performed in a radiology department.

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

International Nuclear Information System (INIS)

1994-01-01

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-12-31

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs.

The effect of hip abduction on the EMG activity of vastus medialis obliquus, vastus lateralis longus and vastus lateralis obliquus in healthy subjects

Directory of Open Access Journals (Sweden)

Arakaki Juliano

2006-07-01

Full Text Available Abstract Study design Controlled laboratory study. Objectives The purposes of this paper were to investigate (d whether vastus medialis obliquus (VMO, vastus lateralis longus (VLL and vastus lateralis obliquus (VLO EMG activity can be influenced by hip abduction performed by healthy subjects. Background Some clinicians contraindicate hip abduction for patellofemoral patients (with based on the premise that hip abduction could facilitate the VLL muscle activation leading to a VLL and VMO imbalance Methods and measures Twenty-one clinically healthy subjects were involved in the study, 10 women and 11 men (aged X = 23.3 ± 2.9. The EMG signals were collected using a computerized EMG VIKING II, with 8 channels and three pairs of surface electrodes. EMG activity was obtained from MVIC knee extension at 90° of flexion in a seated position and MVIC hip abduction at 0° and 30° with patients in side-lying position with the knee in full extension. The data were normalized in the MVIC knee extension at 50° of flexion in a seated position, and were submitted to ANOVA test with subsequent application of the Bonferroni multiple comparisons analysis test. The level of significance was defined as p ≤ 0.05. Results The VLO muscle demonstrated a similar pattern to the VMO muscle showing higher EMG activity in MVIC knee extension at 90° of flexion compared with MVIC hip abduction at 0° and 30° of abduction for male (p Conclusion The results showed that no selective EMG activation was observed when comparison was made between the VMO, VLL and VLO muscles while performing MVIC hip abduction at 0° and 30° of abduction and MVIC knee extension at 90° of flexion in both male and female subjects. Our findings demonstrate that hip abduction do not facilitated VLL and VLO activity in relation to the VMO, however, this study included only healthy subjects performing maximum voluntary isometric contraction contractions, therefore much remains to be discovered by

Quality control procedures of dental diagnostic radiology systems

International Nuclear Information System (INIS)

Andrade, Paula Serra Sasaki

2007-01-01

This work presents quality control reference procedures for dental diagnostic radiology systems, following the recommendations of the Publication 453 of the Brazilian Health Ministry (PF453), to be applied in dental clinics, in order to achieve an improvement in the radiological image qualities and the patient dose reduction. All tests were applied in an intraoral X rays system, following the methodology developed and the requirements of the PF 453. In order to verify the best quality of the image in relation to the smaller exposition time an object test was also developed in this work. The use of this object allowed the reduction of the exposition time of 0.5 seconds, the maximum value of the linear region of the characteristic curve, for 0.2 seconds. The tested X rays system showed a very good agreement with the applied procedures, detaching the reduction of the skin entrance dose using the film-holding devices. However, the size of the field increased and exceeded the maximum value of 6 cm recommended in the standard. The importance of the quality control in dental diagnostic radiology systems is essential due to the constant use of X radiation in dental clinics. The PF453 recommends the frequency of at least two years for the constancy tests. However, it is suggested that the professional, surgeon-dentist, should be responsible for the internal control of the image quality obtained from the X rays device. This can be done through monthly exposures of the object test developed in this work. (author)

Effect of combined actions of hip adduction/abduction on the force generation and maintenance of pelvic floor muscles in healthy women.

Directory of Open Access Journals (Sweden)

Amanda C Amorim

Full Text Available Pelvic floor muscle (PFM force and coordination are related to urinary incontinence severity and to sexual satisfaction. Health professionals frequently combine classic PFM exercises with hip adduction/abduction contraction to treat these disorders, but the real benefits of this practice are still unknown. Based on a theoretical anatomy approach whereby the levator ani muscle is inserted into the obturator internus myofascia and in which force generated by hip movements should increase the contraction quality of PFMs, our aim was to investigate the effects of isometric hip adduction and abduction on PFM force generation. Twenty healthy, nulliparous women were evaluated using two strain-gauge dynamometers (one cylinder-like inside the vaginal cavity, and the other measuring hip adduction/abduction forces around both thighs while performing three different tasks: (a isolated PFM contraction; (b PFM contraction combined with hip adduction (30% and 50% maximum hip force; and (c PFM contraction combined with hip abduction (30% and 50% maximum hip force. Data were sampled at 100Hz and subtracted from the offset if existent. We calculated a gradient between the isolated PFM contraction and each hip condition (Δ Adduction and Δ Abduction for all variables: Maximum force (N, instant of maximum-force occurrence (s, mean force in an 8-second window (N, and PFM force loss (N.s. We compared both conditions gradients in 30% and 50% by paired t-tests. All variables did not differ between hip conditions both in 30% and 50% of maximum hip force (p>.05. PFM contraction combined with isometric hip abduction did not increase vaginal force in healthy and nulliparous women compared to PFM contraction combined with isometric hip adduction. Therefore, so far, the use of hip adduction or abduction in PFM training and treatments are not justified for improving PFM strength and endurance.

MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

Science.gov (United States)

Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

2017-07-01

The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Unintentional exposure to radiation during pregnancy from nuclear medical diagnostic procedures

International Nuclear Information System (INIS)

Moka, D.

2005-01-01

The administration of radiopharmaceuticals during pregnancy is contraindicated due to a lack of vital indications. However, if prenatal exposure to radiation should occur in the framework of a nuclear medical diagnostic procedure then fortunately no longterm side-effects would normally be expected. Radiation damage in the preimplantation phase leads to early abortion. However, if the further course of pregnancy remains uncomplicated then no subsequent side-effects need be expected. On a conservative estimate, it would require doses exceeding 50 mGy to cause radiation damage within the uterus after the preimplantation phase. However, the standard radioactivities applied for diagnostic purposes in nuclear medicine, can be obtained with doses of less than 20 mGy. On the basis of current knowledge, therefore, there is no reason to terminate pregnancy on medical grounds after diagnostic exposure to radiopharmaceuticals. (orig.)

Prenatal Radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

International Nuclear Information System (INIS)

Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.; Hellman, S.; Helmrot, E.; Persliden, J.; Cederlund, T.

2003-01-01

Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has a right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data has shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% up to 0.14% per 10 mSv. In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy, and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period. The frequency of foetus exposure is not well documented. In Sweden, there are well-established routines to track down pregnant patients before examinations are being performed. However, there are no general obligations or routines to document the cases either (i) when

Characteristics of Abductive Inquiry in Earth Science: An Undergraduate Case Study

Science.gov (United States)

Oh, Phil Seok

2011-01-01

The goal of this case study was to describe characteristic features of abductive inquiry learning activities in the domain of earth science. Participants were undergraduate junior and senior students who were enrolled in an earth science education course offered for preservice secondary science teachers at a university in Korea. The undergraduate…

Radiation dose to the pediatric population of Slovak Republic from diagnostic nuclear medicine procedures

International Nuclear Information System (INIS)

Ftacnikova, S.; Fueriova, A.

1996-01-01

The increased number of in vitro diagnostic nuclear medicine examinations has created the need for more precise determination of radiation dose to the population, specially to the children. A questionnaire survey has been performed on all nuclear medicine facilities in Slovak Republic through 1982 to 1994 with a special attention to pediatric patients in 1994. The information obtained was about the age distribution, number of different types of examinations, radiopharmaceuticals used and the value of mean administered radioactivity per exam. These data were used to evaluate the mean effective dose per exam and per capita, the collective effective dose for special type of examinations, for different radiopharmaceuticals and for radionuclides used in diagnostic procedures. In calculations we used the best available biokinetic models of the distribution of radiopharmaceuticals in organs as a function of age. The results show that the Slovak Republic appeared favorable in comparison to other countries in the judicious use of diagnostic nuclear medicine procedures performed on pediatric population. (author)

Validity and reliability of smartphone magnetometer-based goniometer evaluation of shoulder abduction--A pilot study.

Science.gov (United States)

Johnson, Linda B; Sumner, Sean; Duong, Tina; Yan, Posu; Bajcsy, Ruzena; Abresch, R Ted; de Bie, Evan; Han, Jay J

2015-12-01

Goniometers are commonly used by physical therapists to measure range-of-motion (ROM) in the musculoskeletal system. These measurements are used to assist in diagnosis and to help monitor treatment efficacy. With newly emerging technologies, smartphone-based applications are being explored for measuring joint angles and movement. This pilot study investigates the intra- and inter-rater reliability as well as concurrent validity of a newly-developed smartphone magnetometer-based goniometer (MG) application for measuring passive shoulder abduction in both sitting and supine positions, and compare against the traditional universal goniometer (UG). This is a comparative study with repeated measurement design. Three physical therapists utilized both the smartphone MG and a traditional UG to measure various angles of passive shoulder abduction in a healthy subject, whose shoulder was positioned in eight different positions with pre-determined degree of abduction while seated or supine. Each therapist was blinded to the measured angles. Concordance correlation coefficients (CCCs), Bland-Altman plotting methods, and Analysis of Variance (ANOVA) were used for statistical analyses. Both traditional UG and smartphone MG were reliable in repeated measures of standardized joint angle positions (average CCC > 0.997) with similar variability in both measurement tools (standard deviation (SD) ± 4°). Agreement between the UG and MG measurements was greater than 0.99 in all positions. Our results show that the smartphone MG has equivalent reliability compared to the traditional UG when measuring passive shoulder abduction ROM. With concordant measures and comparable reliability to the UG, the newly developed MG application shows potential as a useful tool to assess joint angles. Published by Elsevier Ltd.

Patient radiation dose in diagnostic and interventional procedures for intracranial aneurysms: Experience at a single center

International Nuclear Information System (INIS)

Chun, Chang Woo; Kim, Bum Soo; Lee, Cheol Hyoun; Ihn, Yon Kwon; Shin, Yong Sam

2014-01-01

To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms in a large sample size from a single center. We studied a sample of 439 diagnostic and 149 therapeutic procedures for intracranial aneurysms in 480 patients (331 females, 149 males; median age, 57 years; range, 21-88 years), which were performed in 2012 with a biplane unit. Parameters including fluoroscopic time, dose-area product (DAP), and total angiographic image frames were obtained and analyzed. Mean fluoroscopic time, total mean DAP, and total image frames were 12.6 minutes, 136.6 +/- 44.8 Gy-cm 2 , and 251 +/- 49 frames for diagnostic procedures, 52.9 minutes, 226.0 +/- 129.2 Gy-cm 2 , and 241 frames for therapeutic procedures, and 52.2 minutes, 334.5 +/- 184.6 Gy-cm 2 , and 408 frames for when both procedures were performed during the same session. The third quartiles for diagnostic reference levels (DRLs) were 14.0, 61.1, and 66.1 minutes for fluoroscopy time, 154.2, 272.8, and 393.8 Gy-cm 2 for DAP, and 272, 276, and 535 for numbers of image frames in diagnostic, therapeutic, and both procedures in the same session, respectively. The proportions of fluoroscopy in DAP for the procedures were 11.4%, 50.5%, and 36.1%, respectively, for the three groups. The mean DAP for each 3-dimensional rotational angiographic acquisition was 19.2 +/- 3.2 Gy-cm 2 . On average, rotational angiography was used 1.4 +/- 0.6 times/session (range, 1-4; n = 580). Radiation dose in our study as measured by DAP, fluoroscopy time and image frames did not differ significantly from other reported DRL studies for cerebral angiography, and DAP was lower with fewer angiographic image frames for embolization. A national registry of radiation-dose data is a necessary next step to refine the dose reference level.

LA HIPÓTESIS ABDUCTIVA COMO ESTRATEGIA DIDÁCTICA DE INVESTIGACIÓN EN EL AULA THE ABDUCTIVE HYPOTHESIS AS A TEACHING STRATEGY FOR RESEARCH IN THE CLASSROOM

Directory of Open Access Journals (Sweden)

Mónica Moreno Torres

2012-08-01

Full Text Available Este texto aborda la pregunta acerca de cómo traducir la hipótesis abductiva en una estrategia didáctica para la investigación en el aula. Su comprensión e interpretación se apoyan en procedimientos metodológicos del discurso peirceano aplicados en la educación y en la literatura, y de la lógica del razonamiento científico basada en la abducción, la deducción y la inducción. Se expone un caso didáctico en el que se aplican los procedimientos de la hipótesis abductiva y que arroja como resultado las ventajas que representa para la educación el impulso de una libertad racional en el aula, respetando las diferencias individuales de los estudiantes, su bienestar físico y su gusto estético. Finalmente, se concluye que la aplicación de la hipótesis abductiva en educación exige de un uso creativo del conocimiento fundado en la lógica del razonamiento científico, que rompe con la visión racionalista de la inducción y la deducción, y en la concepción de los métodos de la ciencia como actos liberadores que estimulan la capacidad de investigar, juzgar y actuar en medio de lo diverso, en oposición a una visión homogénea de la sociedad.This text addresses the question of how to translate abductive hypothesis in a teaching strategy for classroom research. Its understanding and interpretation is based on methodological procedures of the Peircean speech applied in education and literature, and of the logic of scientific reasoning based on abduction, deduction and induction. A teaching case is presented in which procedures of the abductive hypothesis are applied, which indicates as a result, the advantages of education for the promotion of rational freedom in the classroom, respecting the individual differences of students, their physical welfare and aesthetic taste. Finally, it was concluded that the application of abductive hypothesis in education requires creative use of knowledge, founded on the logic of scientific reasoning

Novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics?

Science.gov (United States)

Soldati, Gino; Smargiassi, Andrea; Mariani, Alberto A; Inchingolo, Riccardo

2017-01-01

Medical approach to patients is a fundamental step to get the correct diagnosis. The aim of this paper is to analyze some aspects of the reasoning process inherent in medical diagnosis in our era. Pathologic signs (anamnestic data, symptoms, semiotics, laboratory and strumental findings) represent informative phenomena to be integrated for inferring a diagnosis. Thus, diagnosis begins with "signs" and finishes in a probability of disease. The abductive reasoning process is the generation of a hypothesis to explain one or more observations (signs) in order to decide between alternative explanations searching the best one. This process is iterative during the diagnostic activity while collecting further observations and it could be creative generating new knowledge about what has not been experienced before. In the clinical setting the abductive process is not only theoretical, conversely the physical exploitation of the patient (palpation, percussion, auscultation) is always crucial. Through this manipulative abduction, new and still unexpressed information is discovered and evaluated and physicians are able "to think through doing" to get the correct diagnosis. Abductive inferential path originates with an emotional reaction (discovery of the signs), step by step explanations are formed and it ends with another emotional reaction (diagnosis). Few bedside instruments are allowed to physicians to amplify their ability to search for signs. Stethoscope is an example. Similarities between ultrasound exploration and percussion can be found. Bedside ultrasonography can be considered an external amplifier of signs, a particular kind of percussion and represents a valid example of abductive manipulation. In this searching for signs doctors act like detectives and sometimes the discovering of a strategic, unsuspected sign during abductive manipulation could represent the key point for the correct diagnosis. This condition is called serendipity. Ultrasound is a powerful tool

Abduction in Proximal Hamstring Tendon Avulsion Injury Mechanism-A Report on 3 Athletes

NARCIS (Netherlands)

van der Made, Anne D.; Peters, Rolf W.; Verheul, Claire; Maas, Mario; Kerkhoffs, Gino M.

2017-01-01

Proximal hamstring tendon avulsions are typically sustained during forced hip hyperflexion combined with knee extension. We present 3 cases of athletes with a proximal hamstring tendon avulsion caused by an alternative injury mechanism that also involves a considerable hip abduction component

Activities of radiopharmaceuticals administered for diagnostic and therapeutic procedures in nuclear medicine in Argentina: results of a national survey

International Nuclear Information System (INIS)

Bomben, Ana M.; Chiliutti, Claudia A.

2004-01-01

Nuclear medicine in Argentine is carried out at 292 centres, distributed all over the country, mainly concentrated in the capital cities of the provinces. With the purpose of knowing the activity levels of radiopharmaceuticals that were administered to patients for diagnostic and therapeutic procedures in nuclear medicine, a national survey was conducted, during 2001 and 2002. This survey was answered voluntarily by 107 centres. Sixty-four percent of the participants centres are equipped with SPECT system while the other centres have a gamma camera or scintiscanner. There were 37 nuclear medicine procedures, chosen among those most frequently performed, were included in the survey. In those diagnostic procedures were included tests for: bone, brain, thyroid, kidney, liver, lung and cardiovascular system; and also activities administered for some therapeutic procedures. The nuclear medicine physicians reported the different radiopharmaceutical activities administered to typical adult patients. In this paper are presented the average radiopharmaceutical activity administered for each of the diagnostic and therapeutic procedures included in the survey and the range and distribution of values. In order to place these data in a frame of reference, these average values were compared to the guidance levels for diagnostic procedures in nuclear medicine mentioned at the Safety Series no. 115. From this comparison it was noticed that the activities administered in the 40% of the diagnostic procedures included in the survey were between ±30% of the reference values. For those nuclear medicine procedures that could not be compared with the above mentioned guidance levels, the comparison was made with values published by UNSCEAR or standards recommended by international bodies. As a result of this study, it is important to point out the need to continue the gathering of data in a wider scale survey to increase the knowledge about national trends. It is also essential to widely

Working Notes of the 1990 Spring Symposium on Automated Abduction

Science.gov (United States)

1990-09-27

arbitrating it, and updating the database can all be formidable. Conclusion Application of abduction to speech act recognition has used a methodology...inferences to correctly generalizes the plan to many other situations. Forex - compute the new situation B. For example suppose F is (alive ample, the...making assumptions that have nothing to do with unified with a fact in the database (a "zero cost proof"), the observaLion, the syntactic minimality

Value of noninvasive diagnostic procedures in cardiology: typical findings in hypertrophic obstructive cardiomyopathy

International Nuclear Information System (INIS)

Riebeling, V.; Bubenheimer, P.

1984-01-01

Routine chest X-ray often yields poor information for diagnosis of heart disease. The diagnostic value of invasive procedures in cardiology is generally accepted. The patient's as well as the physician's risk of the examination, however, has to be considered. A high number of heart diseases, e.g. hypertrophic obstructive cardiomyopathy (HOCM) is mainly detected by noninvasive procedures such as auscultation, electrocardiography, phonomechanocardiography, echocardiography, physical manoeuvres, and pharmacological provocation tests. Typical findings in hypertrophic obstructive cardiomyopathy are demonstrated. (orig.) [de

Preoperative Duplex Scanning is a Helpful Diagnostic Tool in Neurogenic Thoracic Outlet Syndrome.

Science.gov (United States)

Orlando, Megan S; Likes, Kendall C; Mirza, Serene; Cao, Yue; Cohen, Anne; Lum, Ying Wei; Freischlag, Julie A

2016-01-01

To evaluate the diagnostic role of venous and arterial duplex scanning in neurogenic thoracic outlet syndrome (NTOS). Retrospective review of patients who underwent duplex ultrasonography prior to first rib resection and scalenectomy (FRRS) for NTOS from 2005 to 2013. Abnormal scans included ipsilateral compression (IC) with abduction of the symptomatic extremity (>50% change in subclavian vessel flow), contralateral (asymptomatic side) compression (CC) or bilateral compression (BC). A total of 143 patients (76% female, average age 34, range 13-59) underwent bilateral preoperative duplex scanning. Ipsilateral compression was seen in 44 (31%), CC in 12 (8%), and BC in 14 (10%). Seventy-three (51%) patients demonstrated no compression. Patients with IC more often experienced intraoperative pneumothoraces (49% vs. 25%, P duplex ultrasonography can assist in NTOS diagnosis. Ipsilateral compression on abduction often correlates with Adson testing. © The Author(s) 2016.

Glenosphere size in reverse shoulder arthroplasty: is larger better for external rotation and abduction strength?

Science.gov (United States)

Müller, Andreas M; Born, Marian; Jung, Christian; Flury, Matthias; Kolling, Christoph; Schwyzer, Hans-Kaspar; Audigé, Laurent

2018-01-01

The role of glenosphere size in reverse shoulder arthroplasty (RSA) may be important in prosthetic stability, joint kinematics, rotator cuff tension and excursion, scapular impingement, humeral lateralization, deltoid wrap, and the occurrence of "notching." This study compared short- and midterm clinical and radiographic outcomes for 2 different glenosphere sizes of a single RSA type with respect to implant positioning, glenoid size, and morphology. This retrospective analysis included 68 RSA procedures that were prospectively documented in a local register during a 5-year postoperative period. Two glenosphere diameter sizes of 36 mm (n = 33) and 44 mm (n = 35) were used. Standard radiographs were made preoperatively (ie, baseline) and at 6, 12, 24, and 60 months after surgery. Range of motion, strength, the Constant-Murley score, and the Shoulder Pain and Disability Index were also assessed at all follow-up visits. The effect of glenosphere size on measured outcomes was adjusted for baseline values, patient gender, and humeral head diameter. No significant differences were found in the functional scores between treatment groups at all follow-up assessments. At the 12-month follow-up, patients with a 44-mm glenosphere had greater external rotation in adduction (mean difference, 12°; P = .001) and abduction strength (mean difference, 1.4 kg; P = .026) compared with those with the smaller implant. These differences remained at 60 months. Scapular notching was observed in 38% of all patients, without any relevant difference between the groups. An increase in glenosphere diameter leads to a clinically moderate but significant increase in external rotation in adduction and abduction strength at midterm follow-up. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

New perineal injection technique for pudendal nerve infiltration in diagnostic and therapeutic procedures

NARCIS (Netherlands)

Weinschenk, Stefan; Hollmann, Markus W.; Strowitzki, Thomas

2016-01-01

Pudendal nerve injection is used as a diagnostic procedure in the vulvar region and for therapeutic purposes, such as in vulvodynia. Here, we provide a new, easy-to-perform perineal injection technique. We analyzed 105 perineal injections into the pudendal nerve with a local anesthetic (LA),

Pneumatic Multi-Pocket Elastomer Actuators for Metacarpophalangeal Joint Flexion and Abduction-Adduction

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Tapio Veli Juhani Tarvainen

2017-09-01

Full Text Available During recent years, interest has been rising towards developing fluidic fiber-reinforced elastomer actuators for wearable soft robotics used in hand rehabilitation and power-assist. However, they do not enable finger abduction-adduction, which plays an important role in activities of daily living, when grasping larger objects. Furthermore, the developed gloves often do not have separate control of joints, which is important for doing various common rehabilitation motions. The main obstacle for the development of a fully-assisting glove is moving a joint with multiple degrees of freedom. If the functions are built into the same structure, they are naturally coupled and affect each other, which makes them more difficult to design and complex to control than a simple flexion-extension actuator. In this study, we explored the key design elements and fabrication of pneumatic multi-pocket elastomer actuators for a soft rehabilitation glove. The goal was to gain more control over the metacarpophalangeal joint’s response by increasing the degree of actuation. Three main functional designs were tested for achieving both flexion and abduction-adduction. Five prototypes, with four different actuator geometries and four different reinforcement types, were designed and fabricated. They were evaluated by recording their free motion with motion capture and measuring their torque output using a dummy finger. Results showed the strengths and weaknesses of each design in separating the control of the two functions. We discuss the different improvements that are needed in order to make each design plausible for developing an actuator that meets the requirements for full assist of the hand’s motions. In conclusion, we show that it is possible to produce multi-pocket actuators for assisting MCP joint motion in both flexion and abduction-adduction, although coupling between the separate functions is still problematic and should be considered further.

Validity and reliability of isometric muscle strength measurements of hip abduction and abduction with external hip rotation in a bent-hip position using a handheld dynamometer with a belt.

Science.gov (United States)

Aramaki, Hidefumi; Katoh, Munenori; Hiiragi, Yukinobu; Kawasaki, Tsubasa; Kurihara, Tomohisa; Ohmi, Yorikatsu

2016-07-01

[Purpose] This study aimed to investigate the relatedness, reliability, and validity of isometric muscle strength measurements of hip abduction and abduction with an external hip rotation in a bent-hip position using a handheld dynamometer with a belt. [Subjects and Methods] Twenty healthy young adults, with a mean age of 21.5 ± 0.6 years were included. Isometric hip muscle strength in the subjects' right legs was measured under two posture positions using two devices: a handheld dynamometer with a belt and an isokinetic dynamometer. Reliability was evaluated using an intra-class correlation coefficient (ICC); relatedness and validity were evaluated using Pearson's product moment correlation coefficient. Differences in measurements of devices were assessed by two-way ANOVA. [Results] ICC (1, 1) was ≥0.9; significant positive correlations in measurements were found between the two devices under both conditions. No main effect was found between the measurement values. [Conclusion] Our findings revealed that there was relatedness, reliability, and validity of this method for isometric muscle strength measurements using a handheld dynamometer with a belt.

Prenatal diagnostic procedures used in pregnancies with congenital malformations in 14 regions of Europe

NARCIS (Netherlands)

Garne, E; Loane, M; de Vigan, C; Scarano, G; de Walle, H; Gillerot, Y; Stoll, C; Addor, MC; Stone, D; Gener, B; Feijoo, M; Mosquera-Tenreiro, C; Gatt, M; Queisser-Luft, A; Baena, N; Dolk, H

2004-01-01

Objective To investigate outcomes of ultrasound investigations (US) and invasive diagnostic procedures in cases of congenital malformations (CM), and to compare the use of invasive prenatal test techniques (amniocentesis (AC) versus chorionic villus sampling (CVS)) among European populations. Design

Sonography as a new diagnostic procedure for investigating abnormalities of the shoulder

International Nuclear Information System (INIS)

Rapf, C.; Furtschegger, A.; Resch, H.; Innsbruck Univ.

1986-01-01

Eighty-one sonographic examinations of patients with complaints relating to the shoulder joint have shown that this is the method next in value to radiological examination. So far, lesions of the rotator cuff and of the long head of the biceps could only be demonstrated by invasive procedures such as arthrography or arthroscopy. In these situations, sonography attains a similar accuracy. Diffuse lesions can also be diagnosed correctly, making arthrography and arthroscopy unnecessary. In addition, sonography can demonstrate inflammatory and degenerative changes and incomplete sub-acromial and intermediary tears of the rotator cuff, unlike conventional diagnostic methods. In future, arthrography and arthroscopy will only be necessary as additional diagnostic methods if sonography remains inconclusive. (orig.) [de

Prenatal diagnosis--principles of diagnostic procedures and genetic counseling.

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Ryszard Slezak

2008-04-01

Full Text Available The frequency of inherited malformations as well as genetic disorders in newborns account for around 3-5%. These frequency is much higher in early stages of pregnancy, because serious malformations and genetic disorders usually lead to spontaneous abortion. Prenatal diagnosis allowed identification of malformations and/or some genetic syndromes in fetuses during the first trimester of pregnancy. Thereafter, taking into account the severity of the disorders the decision should be taken in regard of subsequent course of the pregnancy taking into account a possibilities of treatment, parent's acceptation of a handicapped child but also, in some cases the possibility of termination of the pregnancy. In prenatal testing, both screening and diagnostic procedures are included. Screening procedures such as first and second trimester biochemical and/or ultrasound screening, first trimester combined ultrasound/biochemical screening and integrated screening should be widely offered to pregnant women. However, interpretation of screening results requires awareness of both sensitivity and predictive value of these procedures. In prenatal diagnosis ultrasound/MRI searching as well as genetic procedures are offered to pregnant women. A variety of approaches for genetic prenatal analyses are now available, including preimplantation diagnosis, chorion villi sampling, amniocentesis, fetal blood sampling as well as promising experimental procedures (e.g. fetal cell and DNA isolation from maternal blood. An incredible progress in genetic methods opened new possibilities for valuable genetic diagnosis. Although karyotyping is widely accepted as golden standard, the discussion is ongoing throughout Europe concerning shifting to new genetic techniques which allow obtaining rapid results in prenatal diagnosis of aneuploidy (e.g. RAPID-FISH, MLPA, quantitative PCR.

Behavioural processes in social context: female abductions, male herding and female grooming in hamadryas baboons.

Science.gov (United States)

Polo, Pablo; Colmenares, Fernando

2012-06-01

The formation of bonds between strangers is an event that occurs routinely in many social animals, including humans, and, as social bonds in general, they affect the individuals' welfare and biological fitness. The present study was motivated by an interest in the behavioural processes that drive bond formation in a social context of hostility, in which the incumbent partners vary greatly in physical power and reproductive interests, a situation in which individuals of many group-living species find themselves often throughout their lives. We focused on the quantitative analysis of female abductions via male aggressive herding in a nonhuman primate, the hamadryas baboon, in which intersexual bonds are known to be strong. We tested three hypotheses informed by sexual conflict/sexual coercion theory (male herding-as-conditioning and female grooming-as-appeasement) and by socioecological theory (unit size and female competition). The results supported the predictions: males resorted to coercive tactics (aggressive herding) with abducted females, and abducted females elevated the amount of grooming directed at their new unit males; in fact, they escaped from the otherwise negative effect of unit size on female-to-male grooming. These findings reveal that conflicts of interest are natural ingredients underpinning social bonds and that resorting to coercive aggression may be an option especially when partners differ greatly in their physical power. Copyright © 2012 Elsevier B.V. All rights reserved.

Determining and managing fetal radiation dose from diagnostic radiology procedures in Turkey

International Nuclear Information System (INIS)

Ozbayrak, Mustafa; Cavdar, Iffet; Seven, Mehmet; Uslu, Lebriz; Yeyin, Nami; Tanyildizi, Handan; Abuqbeitah, Mohammad; Acikgoz, A. Serdar; Tuten, Abdullah; Demir, Mustafa

2015-01-01

We intended to calculate approximate fetal doses in pregnant women who underwent diagnostic radiology procedures and to evaluate the safety of their pregnancies. We contacted hospitals in different cities in Turkey where requests for fetal dose calculation are usually sent. Fetal radiation exposure was calculated for 304 cases in 218 pregnant women with gestational ages ranging from 5 days to 19 weeks, 2 days. FetDose software (ver. 4.0) was used in fetal dose calculations for radiographic and computed tomography (CT) procedures. The body was divided into three zones according to distance from the fetus. The first zone consisted of the head area, the lower extremities below the knee, and the upper extremities; the second consisted of the cervicothoracic region and upper thighs; and the third consisted of the abdominopelvic area. Fetal doses from radiologic procedures between zones were compared using the Kruskal-Wallis test and a Bonferroni-corrected Mann-Whitney U-test. The average fetal doses from radiography and CT in the first zone were 0.05 ± 0.01 mGy and 0.81 ± 0.04 mGy, respectively; 0.21 ± 0.05 mGy and 1.77 ± 0.22 mGy, respectively, in the second zone; and 6.42 ± 0.82 mGy and 22.94 ± 1.28 mGy, respectively, in the third zone (p < 0.001). Our results showed that fetal radiation exposures in our group of pregnant women did not reach the level (50 mGy) that is known to increase risk for congenital anomalies. Fetal radiation exposure in the diagnostic radiology procedures in our study did not reach risk levels that might have indicated abortion

Determining and managing fetal radiation dose from diagnostic radiology procedures in Turkey

Energy Technology Data Exchange (ETDEWEB)

Ozbayrak, Mustafa; Cavdar, Iffet; Seven, Mehmet; Uslu, Lebriz; Yeyin, Nami; Tanyildizi, Handan; Abuqbeitah, Mohammad; Acikgoz, A. Serdar; Tuten, Abdullah; Demir, Mustafa [Istanbul University, Istanbul (Turkmenistan)

2015-12-15

We intended to calculate approximate fetal doses in pregnant women who underwent diagnostic radiology procedures and to evaluate the safety of their pregnancies. We contacted hospitals in different cities in Turkey where requests for fetal dose calculation are usually sent. Fetal radiation exposure was calculated for 304 cases in 218 pregnant women with gestational ages ranging from 5 days to 19 weeks, 2 days. FetDose software (ver. 4.0) was used in fetal dose calculations for radiographic and computed tomography (CT) procedures. The body was divided into three zones according to distance from the fetus. The first zone consisted of the head area, the lower extremities below the knee, and the upper extremities; the second consisted of the cervicothoracic region and upper thighs; and the third consisted of the abdominopelvic area. Fetal doses from radiologic procedures between zones were compared using the Kruskal-Wallis test and a Bonferroni-corrected Mann-Whitney U-test. The average fetal doses from radiography and CT in the first zone were 0.05 ± 0.01 mGy and 0.81 ± 0.04 mGy, respectively; 0.21 ± 0.05 mGy and 1.77 ± 0.22 mGy, respectively, in the second zone; and 6.42 ± 0.82 mGy and 22.94 ± 1.28 mGy, respectively, in the third zone (p < 0.001). Our results showed that fetal radiation exposures in our group of pregnant women did not reach the level (50 mGy) that is known to increase risk for congenital anomalies. Fetal radiation exposure in the diagnostic radiology procedures in our study did not reach risk levels that might have indicated abortion.

Radiation injury of the skin following diagnostic and interventional fluoroscopic procedures

International Nuclear Information System (INIS)

Koenig, T.R.; Wagner, L.K.; Mettler, F.A.

2001-01-01

Many radiation injuries to the skin, resulting from diagnostic and interventional fluoroscopic procedures, have been reported in recent years. In some cases skin damage was severe and debilitating. We analyzed 72 reports of skin injuries for progression and location of injury, type and number of procedures, and contributing patient and operator factors. Most cases (46) were related to coronary angiography and percutaneous transluminal coronary angioplasty (PTCA). A smaller number was documented after cardiac radiofrequency catheter ablation (12), transjugular intrahepatic portosystemic shunt (TIPS) placement (7), neuroradiological interventions (3) and other procedures (4). Important factors leading to skin injuries were long exposure times over the same skin area, use of high dose rates, irradiation through thick tissue masses, hypersensitivity to radiation, and positioning of arms or breasts into the radiation entrance beam. Physicians were frequently unaware of the high radiation doses involved and did not recognize the injuries as radiation induced. Based on these findings, recommendations to reduce dose and improve patient care are provided. (author)

Overview of radiation protection programme in nuclear medicine facility for diagnostic procedures

International Nuclear Information System (INIS)

Ahmed, Ezzeldein Mohammed Nour Mohammed

2015-02-01

This project was conducted to review Radiation Protection Program in Nuclear Medicine facility for diagnostic procedures which will provide guide for meeting the standard and regulatory requirements in diagnostic nuclear medicine. The main objective of this project is to keep dose to staff, patient and public as low as reasonably achievable (ALARA). The specific objectives were to review the Radiation Protection Program (RPP) in diagnostic nuclear medicine and to make some recommendation for improving the level of radiation protection in diagnostic nuclear medicine that will help to control normal exposure and prevent or mitigate potential exposure. The methodology used is review of various documents. The review showed that if the Radiation Protection Program is inadequate it leads to unjustified exposure to radiation. Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a qualified Radiation Protection Officer (RPO) should be appointed to lay down and oversee a radiation protection in the nuclear medicine department. The RPO must be given the full authority and the adequate time to enable him to perform his duties effectively. (au)

Development of procedures to ensure quality and integrity in Tandem Mirror Experiment-Upgrade (TMX-U) diagnostics systems

International Nuclear Information System (INIS)

Coutts, G.W.; Coon, M.L.; Hinz, A.F.; Hornady, R.S.; Lang, D.D.; Lund, N.P.

1983-01-01

The diagnostic systems for Tandem Mirror Experiment-Upgrade (TMX-U) have grown from eleven initial systems to more than twenty systems. During operation, diagnostic system modifications are sometimes required to complete experimental objectives. Also, during operations new diagnostic systems are being developed and implemented. To ensure and maintain the quality and integrity of the data signals, a set of plans and systematic actions are being developed. This paper reviews the procedures set in place to maintain the integrity of existing data systems and ensure the performance objectives of new diagnostics being added

INTERACTION BETWEEN HAGUE CONVENTION ON THE CIVIL ASPECTS OF INTERNATIONAL CHILD ABDUCTION AND DOMESTIC LITIGATIONS CONCERNING DOMICILE OF THE CHILD AND PARENTAL AUTHORITY

Directory of Open Access Journals (Sweden)

Anca Magda VOICULESCU

2018-05-01

Full Text Available In the vast majority of cases, international abduction of a child determines almost per se litigations both at international and national level, namely an international litigation based on provisions of Hague Convention on the civil aspects of international child abduction and a domestic litigation aiming at establishing the domicile of the child in the state of destination and other different measures concerning the child which fall within the area of parental authority (joint or exclusive. The purpose of the article is to analyze the interaction between the international and the national case and how they influence each other from a double perspective (procedural and substantial, taking into account that the two litigations are generally pending at the same time. Even the mere coexistence of the two litigations gives rise to the question which one should have priority in solving. Therefore, the objectives of this study are, on the one hand, to examine the implications in the domestic litigation of the decision pronounced in the Hague litigation (international competence, suspension of the national case, elements which are covered by the res judicata principle, and on the other hand to identify how a national decision on domicile and parental authority may influence the solution in the Hague case.

Patient dose assessment in different diagnostic procedures in nuclear medicine

International Nuclear Information System (INIS)

Sena, E. de; Bejar, M.J.; Berenguer, R.; Ruano, R.; Tamayo, P.

2001-01-01

Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

Patient dose assessment in different diagnostic procedures in nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Sena, E de; Bejar, M J; Berenguer, R [Servicio de Radiofisica y Proteccion Radiologica, Salamanca (Spain); Ruano, R; Tamayo, P [Servicio de Medicina Nuclear, Hospital Universitario de Salamanca (Spain)

2001-03-01

Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

Longitudinal Increases in Knee Abduction Moments in Females during Adolescent Growth

Science.gov (United States)

HEWETT, TIMOTHY E.; MYER, GREGORY D.; KIEFER, ADAM W.; FORD, KEVIN R.

2015-01-01

ABSTRACT Purpose Knee abduction moment (KAM) is an injury risk factor for anterior cruciate ligament (ACL) injury that shows divergent incidence between males and females during adolescence. The objective of this study was to determine the relation between skeletal growth and increased KAM. The hypotheses tested were that females would demonstrate peak KAM during landing at peak height velocity (PHV) and that they would diverge from males at PHV. Methods The subject pool consisted of 674 females and 218 males (1387 female and 376 male assessments) who participated in a preseason testing session before their basketball or soccer seasons. They were tested longitudinally for multiple years (2 ± 1 yr) to capture maturation via estimates of percent (%) adult stature and biomechanical analysis during a drop vertical jump maneuver. Data were analyzed using three-dimensional motion analysis that used a 37 retroreflective marker body model and inverse dynamics to calculate segment joint centers and peak KAM. Results Mature females, as defined as 92% adult stature or greater, displayed increased peak KAM and knee abduction angles relative to growing (≤91% adult stature) adolescent females (P injury in females. KAM peaked in females at PHV. Tracking longitudinal increases in peak KAM may be useful for the identification of females at increased risk of ACL injury. PMID:25970663

Diagnosing alcoholism in high-risk drinking drivers: comparing different diagnostic procedures with estimated prevalence of hazardous alcohol use

NARCIS (Netherlands)

Korzec, A.; Bär, M.; Koeter, M. W.; de Kieviet, W.

2001-01-01

In several European countries, drivers under influence (DUI), suspected of an alcohol use disorder (AUD, 'alcoholism') are referred for diagnostic examination. The accuracy of diagnostic procedures used in diagnosing AUD in the DUI population is unknown. The aim of this study was to compare three

Hip abduction weakness in elite junior footballers is common but easy to correct quickly: a prospective sports team cohort based study

Directory of Open Access Journals (Sweden)

Osborne Hamish R

2012-10-01

Full Text Available Abstract Background Hip abduction weakness has never been documented on a population basis as a common finding in a healthy group of athletes and would not normally be found in an elite adolescent athlete. This study aimed to show that hip abduction weakness not only occurs in this group but also is common and easy to correct with an unsupervised home based program. Methods A prospective sports team cohort based study was performed with thirty elite adolescent under-17 Australian Rules Footballers in the Australian Institute of Sport/Australian Football League Under-17 training academy. The players had their hip abduction performance assessed and were then instructed in a hip abduction muscle training exercise. This was performed on a daily basis for two months and then they were reassessed. Results The results showed 14 of 28 athletes who completed the protocol had marked weakness or a side-to-side difference of more than 25% at baseline. Two months later ten players recorded an improvement of ≥ 80% in their recorded scores. The mean muscle performance on the right side improved from 151 Newton (N to 202 N (p Conclusions The baseline values show widespread profound deficiencies in hip abduction performance not previously reported. Very large performance increases can be achieved, unsupervised, in a short period of time to potentially allow large clinically significant gains. This assessment should be an integral part of preparticipation screening and assessed in those with lower limb injuries. This particular exercise should be used clinically and more research is needed to determine its injury prevention and performance enhancement implications.

Software for the estimation of organ equivalent and effective doses from diagnostic radiology procedures

International Nuclear Information System (INIS)

Osei, Ernest K; Barnett, Rob

2009-01-01

Diagnostic radiological imaging such as conventional radiography, fluoroscopy and computed tomography (CT) examinations will continue to provide tremendous benefits in modern healthcare. The benefit derived by the patient should far outweigh the risk associated with a properly conducted imaging examination. Nonetheless, it is very important to be able to quantify the risk associated with any radiological examination of patients, and effective dose has been considered a useful indicator of patient exposure. Quantification of the risks associated with radiological imaging is very important as such information will be helpful to physicians and their patients for comparing risks from various imaging examinations and for making informed decisions whenever there is a need for any radiological imaging. The determination of equivalent and effective doses in diagnostic radiology is of interest as a basis for estimates of risk from medical exposures. In this paper we describe a simple computer program OrgDose, which calculates the doses to 27 organs in the body and then calculates the organ equivalent and effective doses and the risk from various procedures in the radiology department including conventional radiography, fluoroscopy and computed tomography examinations. The program will be a useful tool for the medical and paramedical personnel who are involved with assessing organ and effective doses and risks from diagnostic radiology procedures.

42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for hospital outpatient radiology services... radiology services and other diagnostic procedures. (a) Basis and purpose. (1) This section implements section 1833(n) of the Act and establishes the method for determining Medicare payments for radiology...

Education and training in radiological protection for diagnostic and interventional procedures ICRP 113 in brief

International Nuclear Information System (INIS)

Salama, S.; Gomaa, M. A.; Alshoufi, J.H.

2013-01-01

The international commission on radiological protection (ICRP) is the primary body in protection against ionizing radiation. Among its latest publication is ICRP publication 113 e ducation and training in radiological protection for diagnostic and interventional procedures . This document introduces diagnostic and interventional medical procedures using ionizing radiations in deep details. The document is approved by the commission in October 2010 and translated into Arabic at December 2011. This work is a continuation of the efforts series to translate some of the most important of the radiological protection references into the Arabic; aiming to maximize the benefit. The previous translation include WHO handbook on indoor radon: a public health perspective, issued by world health organization 2009 and Radiation Protection in Medicine, ICRP Publication 105 2007 that translated into Arabic with support of Arab atomic energy authority at 2011.

Use of a shoulder abduction brace after arthroscopic rotator cuff repair: A study on gait performance and falls.

Science.gov (United States)

Sonoda, Yuma; Nishioka, Takashi; Nakajima, Ryo; Imai, Shinji; Vigers, Piers; Kawasaki, Taku

2018-04-01

Fall prevention is essential in patients after arthroscopic rotator cuff repair because of the high risk of re-rupture. However, there are no reports related to falls that occur during the early postoperative period, while the affected limb is immobilized. This study assessed gait performance and falls in patients using a shoulder abduction brace after arthroscopic rotator cuff repair. Prospective cohort and postoperative repeated measures. This study included 29 patients (mean age, 67.1 ± 7.4 years) who underwent arthroscopic rotator cuff repair followed by rehabilitation. The timed up and go test, Geriatric Depression Scale, and Falls Efficacy Scale were measured, and the numbers of falls were compared between those shoulder abduction brace users and patients who had undergone total hip or knee arthroplasty. In arthroscopic rotator cuff repair patients, there were significant improvements in timed up and go test and Geriatric Depression Scale, but no significant differences in Falls Efficacy Scale, between the second and fifth postoperative weeks ( p rotator cuff repair patients fell more often than patients with total hip arthroplasty or total knee arthroplasty during the same period. The findings suggest that rehabilitation in arthroscopic rotator cuff repair patients is beneficial, but decreased gait performance due to the immobilizing shoulder abduction brace can lead to falls. Clinical relevance Although rehabilitation helps motor function and mental health after arthroscopic rotator cuff repair, shoulder abduction brace use is associated with impaired gait performance, high Falls Efficacy Scale scores, and risk of falls, so awareness of risk factors including medications and lower limb dysfunctions is especially important after arthroscopic rotator cuff repair.

Perceptions of the risk of child abduction or loss and the utility of child electronic security devices.

Science.gov (United States)

Dixon, R M; Pasnak, R

1997-09-01

Perceptions of the susceptibility of young children to becoming lost or being abducted, and of the potential usefulness of child electronic security devices, were examined via a questionnaire. Data were provided by 41 volunteers, most of them from a local government office centre. The questionnaire asked for demographic data, and then for the risk of a child being abducted or lost when under the supervision of different caregivers and in different situations. The probable effectiveness of three common abductor ploys was also addressed. The questionnaire concluded with 10 questions about child electronic security devices. Respondents viewed mothers, fathers, and grandparents as equally responsible caregivers and young adults/babysitters as the least responsible. These effects diminished as the age of the children increased. The garden at home was judged to be the most secure environment for children of all ages, while an amusement park was judged the least secure environment. Children were perceived to be more at risk of an abduction when a stranger asked for physical assistance or to take them to the hospital because their parents were hurt, than when asked for directions. Furthermore, the respondents expressed a moderately strong need for child electronic security devices, and viewed parents who use them as more responsible than those who do not.

The all-too-flexible abductive method: ATOM's normative status.

Science.gov (United States)

Romeijn, Jan-Willem

2008-09-01

The author discusses the abductive theory of method (ATOM) by Brian Haig from a philosophical perspective, connecting his theory with a number of issues and trends in contemporary philosophy of science. It is argued that as it stands, the methodology presented by Haig is too permissive. Both the use of analogical reasoning and the application of exploratory factor analysis leave us with too many candidate theories to choose from, and explanatory coherence cannot be expected to save the day. The author ends with some suggestions to remedy the permissiveness and lack of normative force in ATOM, deriving from the experimental practice within which psychological data are produced.

Diagnostic procedures of the solitary pulmonary nodule

International Nuclear Information System (INIS)

Aoe, Keisuke; Hiraki, Akio; Kohara, Hiroyuki

2003-01-01

The spread of computed tomography (CT) brought the frequent further examinations of the solitary pulmonary nodules (SPN). To aim the evaluation of initial data on examinations of SPN for differential diagnosis, we studied retrospective cases. Thirty-one cases of SPN less than 20 mm in diameter were compared in clinical findings and CT image findings and were examined the diagnostic procedures in recent three years in National Sanyo Hospital. The 31 patients consisted of 14 males and 17 females ranging 44 to 79 years old, median 65 years old. The causes of SPN were lung cancer (11 patients), cryptococcosis (4 patients), tuberculoma (3 patients), non-tuberculous mycobacteria (2 patients), pneumoconiosis (2 patients), pneumonia scar (one patient), hamartoma (one patient), and unknown (7 patients). There were no significant differences in laboratory findings between lung cancer and the others. CT findings showed significant differences in four categories. All patients underwent fiberoptic bronchoscopy (FB) examinations and 12 patients were determined the diagnosis initial FB. Five patients were established their diagnosis using videoassociated thoracoscopic surgeries. (author)

Activities identification for activity-based cost/management applications of the diagnostics outpatient procedures.

Science.gov (United States)

Alrashdan, Abdalla; Momani, Amer; Ababneh, Tamador

2012-01-01

One of the most challenging problems facing healthcare providers is to determine the actual cost for their procedures, which is important for internal accounting and price justification to insurers. The objective of this paper is to find suitable categories to identify the diagnostic outpatient medical procedures and translate them from functional orientation to process orientation. A hierarchal task tree is developed based on a classification schema of procedural activities. Each procedure is seen as a process consisting of a number of activities. This makes a powerful foundation for activity-based cost/management implementation and provides enough information to discover the value-added and non-value-added activities that assist in process improvement and eventually may lead to cost reduction. Work measurement techniques are used to identify the standard time of each activity at the lowest level of the task tree. A real case study at a private hospital is presented to demonstrate the proposed methodology. © 2011 National Association for Healthcare Quality.

Diagnostic procedure on brake pad assembly based on Young's modulus estimation

International Nuclear Information System (INIS)

Chiariotti, P; Santolini, C; Tomasini, E P; Martarelli, M

2013-01-01

Quality control of brake pads is an important issue, since the pad is a key component of the braking system. Typical damage of a brake pad assembly is the pad–backing plate detachment that affects and modifies the mechanical properties of the whole system. The most sensitive parameter to the damage is the effective Young's modulus, since the damage induces a decrease of the pad assembly stiffness and therefore of its effective Young's modulus: indeed its variation could be used for diagnostic purposes. The effective Young's modulus can be estimated from the first bending resonance frequency identified from the frequency response function measured on the pad assembly. Two kinds of excitation methods, i.e. conventional impulse excitation and magnetic actuation, will be presented and two different measurement sensors, e.g. laser Doppler vibrometer and microphone, analyzed. The robustness of the effective Young's modulus as a diagnostic feature will be demonstrated in comparison to the first bending resonance frequency, which is more sensitive to geometrical dimensions. Variability in the sample dimension, in fact, will induce a variation of the resonance frequency which could be mistaken for damage. The diagnostic approach has been applied to a set of undamaged and damaged pad assemblies showing good performance in terms of damage identification. The environmental temperature can be an important interfering input for the diagnostic procedure, since it influences the effective Young's modulus of the assembly. For that reason, a test at different temperatures in the range between 15 °C and 30 °C has been performed, evidencing that damage identification technique is efficient at any temperature. The robustness of the Young's modulus as a diagnostic feature with respect to damping is also presented. (paper)

Hip abduction weakness in elite junior footballers is common but easy to correct quickly: a prospective sports team cohort based study

OpenAIRE

Osborne, Hamish R; Quinlan, John F; Allison, Garry T

2012-01-01

Abstract Background Hip abduction weakness has never been documented on a population basis as a common finding in a healthy group of athletes and would not normally be found in an elite adolescent athlete. This study aimed to show that hip abduction weakness not only occurs in this group but also is common and easy to correct with an unsupervised home based program. Methods A prospective sports team cohort based study was performed with thirty elite adolescent under-17 Australian Rules Footba...

Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement

Directory of Open Access Journals (Sweden)

Marek L. Kowalski

2016-10-01

Full Text Available Abstract One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin testing, deliberate induction in the office of allergic symptoms to offending compounds (provocation tests or intentional application of potentially dangerous substances (allergy vaccine to sensitized patients. These situations may be associated with a significant risk of unwanted, excessive or even dangerous reactions, which in many instances cannot be completely avoided. However, adverse reactions can be minimized or even avoided if a physician is fully aware of potential risk and is prepared to appropriately handle the situation. Information on the risk of diagnostic and therapeutic procedures in allergic diseases has been accumulated in the medical literature for decades; however, except for allergen specific immunotherapy, it has never been presented in a systematic fashion. Up to now no single document addressed the risk of the most commonly used medical procedures in the allergy office nor attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO, representing various continents and areas of allergy expertise, presents this report on risk associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access to specialized emergency services, etc. for various procedures have been recommended. This document should be useful for allergists with already established

Heartbeat Classification Using Abstract Features From the Abductive Interpretation of the ECG.

Science.gov (United States)

Teijeiro, Tomas; Felix, Paulo; Presedo, Jesus; Castro, Daniel

2018-03-01

This paper aims to prove that automatic beat classification on ECG signals can be effectively solved with a pure knowledge-based approach, using an appropriate set of abstract features obtained from the interpretation of the physiological processes underlying the signal. A set of qualitative morphological and rhythm features are obtained for each heartbeat as a result of the abductive interpretation of the ECG. Then, a QRS clustering algorithm is applied in order to reduce the effect of possible errors in the interpretation. Finally, a rule-based classifier assigns a tag to each cluster. The method has been tested with the MIT-BIH Arrhythmia Database records, showing a significantly better performance than any other automatic approach in the state-of-the-art, and even improving most of the assisted approaches that require the intervention of an expert in the process. The most relevant issues in ECG classification, related to a large extent to the variability of the signal patterns between different subjects and even in the same subject over time, will be overcome by changing the reasoning paradigm. This paper demonstrates the power of an abductive framework for time-series interpretation to make a qualitative leap in the significance of the information extracted from the ECG by automatic methods.

Horizontal gaze palsy and progressive scoliosis in a patient with congenital esotropia and inability to abduct. A case report.

Science.gov (United States)

Fernández-Vega Cueto, A; Rodríguez-Ezcurra, J J; Rodríguez-Maiztegui, I

2016-12-01

The case is presented on a 4- year-old child with congenital esotropia, limitation of abduction, cross-fixation, and thoracolumbar scoliosis. Genetic testing of ROBO3 gene confirmed the diagnosis of horizontal gaze palsy and scoliosis (HGPSS) DISCUSSION: HGPPS is a rare congenital disorder characterised by absence of conjugate horizontal eye movements and progressive scoliosis developed in childhood and adolescence. We highlight this motility disorder as a part of the differential diagnosis of early childhood esotropia with cross- fixation and limitation of abduction. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Lost in Translation? Ethical Challenges of Implementing a New Diagnostic Procedure.

Science.gov (United States)

Schmitz, Dagmar

2016-01-01

Since cell-free DNA (cfDNA) fragments of placental origin can be isolated and analyzed from the blood of pregnant women. Applications of this finding have been developed and implemented in clinical care pathways worldwide at an unprecedented pace and manner. Implementation patterns, however, exhibit considerable insufficiencies. Different "motors" of implementation processes, like the market or various regulatory institutions, can be identified at a national level. Each "motor" entails characteristic ethical challenges which are exemplified impressively by a rising number of case reports.Empirical data demonstrate that there are significant "losses" in the respective translational processes, especially when the results from clinical research are to be translated into the clinical reality of NIPT (the so called "second roadblock" (T2)). These "losses" are perceived in the fields of knowledge transfer, professional standardization and ethical debate. Recommendations of professional organizations often fail to reach general practitioners. Blindsided by the new diagnostic procedure in their clinical practice, professionals in prenatal care express their insecurities with regard to its handling. Ethical debate appears to adhere to pre-existing (and partly already proven to be insufficient) normative frameworks for prenatal testing. While all of these deficits are typical for the implementation processes of many new molecular diagnostic procedures, especially in NIPT, they show a high variability between different nations.A critical assessment of the preferred strategy of implementation against the background of already existing national ethical frameworks is indispensable, if potential adverse effects are to be diminished. The described translational losses seem to be significantly reducible by granting the translational process in roadblock T2 more time.

INTERACTION BETWEEN HAGUE CONVENTION ON THE CIVIL ASPECTS OF INTERNATIONAL CHILD ABDUCTION AND DOMESTIC LITIGATIONS CONCERNING DOMICILE OF THE CHILD AND PARENTAL AUTHORITY

OpenAIRE

Anca Magda VOICULESCU

2018-01-01

In the vast majority of cases, international abduction of a child determines almost per se litigations both at international and national level, namely an international litigation based on provisions of Hague Convention on the civil aspects of international child abduction and a domestic litigation aiming at establishing the domicile of the child in the state of destination and other different measures concerning the child which fall within the area of parental authority (joint or ...

Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital.

Science.gov (United States)

Hada, Mahesh Singh; Chakravarty, Abhijit; Mukherjee, Partha

2014-10-01

Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments.

Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital

International Nuclear Information System (INIS)

Hada, Mahesh Singh; Chakravarty, Abhijit; Mukherjee, Partha

2014-01-01

Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments

Wearable Inertial Sensors Allow for Quantitative Assessment of Shoulder and Elbow Kinematics in a Cadaveric Knee Arthroscopy Model.

Science.gov (United States)

Rose, Michael; Curtze, Carolin; O'Sullivan, Joseph; El-Gohary, Mahmoud; Crawford, Dennis; Friess, Darin; Brady, Jacqueline M

2017-12-01

To develop a model using wearable inertial sensors to assess the performance of orthopaedic residents while performing a diagnostic knee arthroscopy. Fourteen subjects performed a diagnostic arthroscopy on a cadaveric right knee. Participants were divided into novices (5 postgraduate year 3 residents), intermediates (5 postgraduate year 4 residents), and experts (4 faculty) based on experience. Arm movement data were collected by inertial measurement units (Opal sensors) by securing 2 sensors to each upper extremity (dorsal forearm and lateral arm) and 2 sensors to the trunk (sternum and lumbar spine). Kinematics of the elbow and shoulder joints were calculated from the inertial data by biomechanical modeling based on a sequence of links connected by joints. Range of motion required to complete the procedure was calculated for each group. Histograms were used to compare the distribution of joint positions for an expert, intermediate, and novice. For both the right and left upper extremities, skill level corresponded well with shoulder abduction-adduction and elbow prono-supination. Novices required on average 17.2° more motion in the right shoulder abduction-adduction plane than experts to complete the diagnostic arthroscopy (P = .03). For right elbow prono-supination (probe hand), novices required on average 23.7° more motion than experts to complete the procedure (P = .03). Histogram data showed novices had markedly more variability in shoulder abduction-adduction and elbow prono-supination compared with the other groups. Our data show wearable inertial sensors can measure joint kinematics during diagnostic knee arthroscopy. Range-of-motion data in the shoulder and elbow correlated inversely with arthroscopic experience. Motion pattern-based analysis shows promise as a metric of resident skill acquisition and development in arthroscopy. Wearable inertial sensors show promise as metrics of arthroscopic skill acquisition among residents. Copyright © 2017

Immobilization in external rotation combined with abduction reduces the risk of recurrence after primary anterior shoulder dislocation.

Science.gov (United States)

Heidari, Kamran; Asadollahi, Shadi; Vafaee, Reza; Barfehei, Abbas; Kamalifar, Hossein; Chaboksavar, Zein Alabedin; Sabbaghi, Mohammad

2014-06-01

We aimed to compare the effectiveness of immobilization in abduction and external rotation vs immobilization in adduction and internal rotation after primary anterior dislocation of the shoulder. The study randomized 102 patients (age range, 15-55 years) with the diagnosis of primary anterior dislocation of the shoulder to receive immobilization in adduction and internal rotation (AdIR, n = 51) using sling and swathe bandage or immobilization in abduction and external rotation (AbER, n = 51) with a stabilizer brace. Patients received a rehabilitation program 3 weeks after the intervention. After a 24-month follow-up, 33.3% in the AdIR group and 3.9% in the AbER group had recurrence (P patients in the AbER group (19.6%) and 3 in the AdIR group (5.8%) discontinued shoulder immobilization before 3 weeks (P = .03). In patients without recurrence, the anterior apprehension test was positive in 6 of 34 in the AdIR group (17.6%) and in 4 of 49 in the AbER group (8.1%, P = .19). Immobilization with the shoulder joint in abduction and external rotation is an effective method to reduce the risk of recurrence after primary anterior shoulder dislocations and should be preferred to the traditional method of immobilization in adduction and internal rotation in clinical practice. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Role of the trochlear nerve in eye abduction and frontal vision of the red-eared slider turtle (Trachemys scripta elegans).

Science.gov (United States)

Dearworth, J R; Ashworth, A L; Kaye, J M; Bednarz, D T; Blaum, J F; Vacca, J M; McNeish, J E; Higgins, K A; Michael, C L; Skrobola, M G; Jones, M S; Ariel, M

2013-10-15

Horizontal head rotation evokes significant responses from trochlear motoneurons of turtle that suggests they have a functional role in abduction of the eyes like that in frontal-eyed mammals. The finding is unexpected given that the turtle is generally considered lateral-eyed and assumed to have eye movements instead like that of lateral-eyed mammals, in which innervation of the superior oblique muscle by the trochlear nerve (nIV) produces intorsion, elevation, and adduction (not abduction). Using an isolated turtle head preparation with the brain removed, glass suction electrodes were used to stimulate nIV with trains of current pulses. Eyes were monitored via an infrared camera with the head placed in a gimble to quantify eye rotations and their directions. Stimulations of nIV evoked intorsion, elevation, and abduction. Dissection of the superior oblique muscle identified lines of action and a location of insertion on the eye, which supported kinematics evoked by nIV stimulation. Eye positions in alert behaving turtles with their head extended were compared with that when their heads were retracted in the carapace. When the head was retracted, there was a reduction in interpupillary distance and an increase in binocular overlap. Occlusion of peripheral fields by the carapace forces the turtle to a more frontal-eyed state, perhaps the reason for the action of abduction by the superior oblique muscle. These findings support why trochlear motoneurons in turtle respond in the same way as abducens motoneurons to horizontal rotations, an unusual characteristic of vestibulo-ocular physiology in comparison with other mammalian lateral-eyed species. Copyright © 2013 Wiley Periodicals, Inc.

NaI(Tl) scintillator detectors stripping procedure for air kerma measurements of diagnostic X-ray beams

Science.gov (United States)

Oliveira, L. S. R.; Conti, C. C.; Amorim, A. S.; Balthar, M. C. V.

2013-03-01

Air kerma is an essential quantity for the calibration of national standards used in diagnostic radiology and the measurement of operating parameters used in radiation protection. Its measurement within the appropriate limits of accuracy, uncertainty and reproducibility is important for the characterization and control of the radiation field for the dosimetry of the patients submitted to diagnostic radiology and, also, for the assessment of the system which produces radiological images. Only the incident beam must be considered for the calculation of the air kerma. Therefore, for energy spectrum, counts apart the total energy deposition in the detector must be subtracted. It is necessary to establish a procedure to sort out the different contributions to the original spectrum and remove the counts representing scattered photons in the detector's materials, partial energy deposition due to the interactions in the detector active volume and, also, the escape peaks contributions. The main goal of this work is to present spectrum stripping procedure, using the MCNP Monte Carlo computer code, for NaI(Tl) scintillation detectors to calculate the air kerma due to an X-ray beam usually used in medical radiology. The comparison between the spectrum before stripping procedure against the reference value showed a discrepancy of more than 63%, while the comparison with the same spectrum after the stripping procedure showed a discrepancy of less than 0.2%.

NaI(Tl) scintillator detectors stripping procedure for air kerma measurements of diagnostic X-ray beams

Energy Technology Data Exchange (ETDEWEB)

Oliveira, L.S.R. [Centro Tecnológico do Exército, CTEx (Brazilian Army Technological Center), Av. das Américas n° 28705, 23085-470 Rio de Janeiro (Brazil); Instituto de Radioprotecão e Dosimetria, CNEN/IRD (Institute for Radioprotection and Dosimetry, CNEN/IRD), Av. Salvador Allende s/no, P.O. Box 37750, 22783-127 Barra da Tijuca, Rio de Janeiro (Brazil); Conti, C.C., E-mail: ccconti@ird.gov.br [Instituto de Radioprotecão e Dosimetria, CNEN/IRD (Institute for Radioprotection and Dosimetry, CNEN/IRD), Av. Salvador Allende s/no, P.O. Box 37750, 22783-127 Barra da Tijuca, Rio de Janeiro (Brazil); Amorim, A.S.; Balthar, M.C.V. [Centro Tecnológico do Exército, CTEx (Brazilian Army Technological Center), Av. das Américas n° 28705, 23085-470 Rio de Janeiro (Brazil)

2013-03-21

Air kerma is an essential quantity for the calibration of national standards used in diagnostic radiology and the measurement of operating parameters used in radiation protection. Its measurement within the appropriate limits of accuracy, uncertainty and reproducibility is important for the characterization and control of the radiation field for the dosimetry of the patients submitted to diagnostic radiology and, also, for the assessment of the system which produces radiological images. Only the incident beam must be considered for the calculation of the air kerma. Therefore, for energy spectrum, counts apart the total energy deposition in the detector must be subtracted. It is necessary to establish a procedure to sort out the different contributions to the original spectrum and remove the counts representing scattered photons in the detector’s materials, partial energy deposition due to the interactions in the detector active volume and, also, the escape peaks contributions. The main goal of this work is to present spectrum stripping procedure, using the MCNP Monte Carlo computer code, for NaI(Tl) scintillation detectors to calculate the air kerma due to an X-ray beam usually used in medical radiology. The comparison between the spectrum before stripping procedure against the reference value showed a discrepancy of more than 63%, while the comparison with the same spectrum after the stripping procedure showed a discrepancy of less than 0.2%.

Effects of experimental muscle pain on shoulder-abduction force steadiness and muscle activity in healthy subjects

DEFF Research Database (Denmark)

Bandholm, Thomas Quaade; Rasmussen, Lars; Aagaard, Per

2007-01-01

We previously demonstrated that the steadiness of shoulder abduction is reduced in patients with subacromial impingement syndrome (SIS), which might be related to shoulder pain associated with the SIS. The aim of the present study was to examine the acute effects of experimental shoulder muscle p...

Radiation protection problems by diagnostic procedures of pediatric nuclear medicine

International Nuclear Information System (INIS)

Kletter, K.

1994-01-01

Special dosimetry considerations are necessary in the application of radiopharmaceuticals in pediatric nuclear medicine. The influence of differences in irradiation geometry and biokinetic parameters on the radiation dose in children and adults is discussed. Assuming an equal activity concentration, both factors lead rather to a reduced radiation dose than an increased radiation burden in children compared to adults. However, the same radiation dose in children and adults may lead to a different detriment. This is explained by differences in life expectancy and radiation sensitivity for both groups. From special formulas an age dependent reduction factor can be calculated for the application of radiopharmaceuticals in pediatric nuclear medicine. Radiation exposure to hospital staff and parents from children, undergoing nuclear medicine diagnostic or therapeutic procedures, is low. (author)

DIVA and DIAPO: two diagnostic knowledge based systems used for French nuclear power plants

International Nuclear Information System (INIS)

Porcheron, M.; Ricard, B.; Joussellin, A.

1997-01-01

In order to improve monitoring and diagnosis capabilities in nuclear power plants, Electricite de France (EDF) has designed an integrated monitoring and diagnosis assistance system: PSAD-Poste de Surveillance et d'Aide au Diagnostic. The development of such a sophisticated monitoring and data processing systems has emphasized the need for the addition of analysis and diagnosis assistance capabilities. Therefore, diagnostic knowledge based systems have been added to the functions monitored in PSAD: DIVA for turbine generators, and DIAPO for reactor coolant pumps. These systems were designed from a representation of the diagnostic reasoning process of experts and of the supporting knowledge. Diagnosis in both systems relies on an abduction reasoning process applied to component fault models and observations derived from their actual behavior, as provided by the monitoring functions. The basic theoretical elements of this diagnostic model are summarized in a first part. In a second part, DIVA and DIAPO specific elements are described

Evaluating the Performance Diagnostic Checklist-Human Services to Assess Incorrect Error-Correction Procedures by Preschool Paraprofessionals

Science.gov (United States)

Bowe, Melissa; Sellers, Tyra P.

2018-01-01

The Performance Diagnostic Checklist-Human Services (PDC-HS) has been used to assess variables contributing to undesirable staff performance. In this study, three preschool teachers completed the PDC-HS to identify the factors contributing to four paraprofessionals' inaccurate implementation of error-correction procedures during discrete trial…

Refining a complex diagnostic construct: subtyping Dysthymia with the Shedler-Westen Assessment Procedure-II.

Science.gov (United States)

Huprich, Steven K; Defife, Jared; Westen, Drew

2014-01-01

We sought to determine whether meaningful subtypes of Dysthymic patients could be identified when grouping them by similar personality profiles. A random, national sample of psychiatrists and clinical psychologists (n=1201) described a randomly selected current patient with personality pathology using the descriptors in the Shedler-Westen Assessment Procedure-II (SWAP-II), completed assessments of patients' adaptive functioning, and provided DSM-IV Axis I and II diagnoses. We applied Q-factor cluster analyses to those patients diagnosed with Dysthymic Disorder. Four clusters were identified-High Functioning, Anxious/Dysphoric, Emotionally Dysregulated, and Narcissistic. These factor scores corresponded with a priori hypotheses regarding diagnostic comorbidity and level of adaptive functioning. We compared these groups to diagnostic constructs described and empirically identified in the past literature. The results converge with past and current ideas about the ways in which chronic depression and personality are related and offer an enhanced means by which to understand a heterogeneous diagnostic category that is empirically grounded and clinically useful. © 2013 Published by Elsevier B.V.

Hague Convention on the Civil Aspects of International Child Abduction. Report from the Committee on Foreign Relations (To Accompany Treaty Doc. 99-11). 99th Congress, 2d Session.

Science.gov (United States)

Congress of the U.S., Washington, DC. Senate Committee on Foreign Relations.

The Hague Convention on the Civil Aspects of International Child Abduction, an international law whose purpose is to establish uniform rules to be applied in cases of international child abduction, is described. The Hague Convention requires that children wrongfully removed or retained abroad in connection with parental custody disputes be…

Heroines of gendercide: The religious sensemaking of rape and abduction in Aramean, Assyrian and Chaldean migrant communities

NARCIS (Netherlands)

Mutlu-Numansen, Sofia; Ossewaarde, Marinus R.R.

2015-01-01

This study seeks to understand a diaspora community narrative of rape and abduction suffered during the genocidal massacre of 1915 in the Ottoman Empire and its aftermath. Based on interviews with 50 Aramean, Assyrian and Chaldean migrants in Sweden, Germany and the Netherlands, whose families are

Using Abductive Research Logic: "The Logic of Discovery", to Construct a Rigorous Explanation of Amorphous Evaluation Findings

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Levin-Rozalis, Miri

2010-01-01

Background: Two kinds of research logic prevail in scientific research: deductive research logic and inductive research logic. However, both fail in the field of evaluation, especially evaluation conducted in unfamiliar environments. Purpose: In this article I wish to suggest the application of a research logic--"abduction"--"the logic of…

Abducted children and youth in Lord's Resistance Army in Northeastern Democratic Republic of the Congo (DRC): mechanisms of indoctrination and control.

Science.gov (United States)

Kelly, Jocelyn Td; Branham, Lindsay; Decker, Michele R

2016-01-01

Globally, an estimated 300,000 children under the age of 18 participate in combat situations; those in armed groups in particular suffer prolonged exposure to psychological and physical abuse. The Lord's Resistance Army (LRA) is a rebel movement known for its widespread conscription of children; yet little is known about this process once the group moved beyond northern Uganda. In this paper, we describe the processes related to abduction and indoctrination of youth by the LRA in northeastern Democratic Republic of the Congo ( DRC). In-depth interviews were conducted with formerly abducted children, their family members, community leaders, and service providers (total n = 34) in four communities in LRA-affected areas of northeastern DRC. Inductive coding of transcripts was undertaken to identify salient themes. Informants articulated a range of practices by the LRA to exert high levels of control over new recruits, including strict social isolation from recent abductees; control of communication; promoting new identity formation; and compelling children to act out strictly defined gendered roles. Witchcraft and secrecy are used to intimidate recruits and to magnify perception of the group's power. These methods promote de-identification with one's civilian and family life; and eventually the assimilation of a new language and identity. Indoctrination of newly abducted children into the LRA occurs via a complex system of control. This study provides one of the first detailed explorations of social and psychological mechanisms through which this is achieved, and focuses particularly on the gendered differences in the indoctrination process. Results support past findings that the LRA is a strategic and well-organized organization in its approach to enlisting child soldiers. Understanding some of the ways in which the LRA controls its recruits and the psychological impact of indoctrination enables reintegration programs to more effectively address these issues

The radiopharmaceuticals in nuclear medicine diagnostic procedures and the problem of radiation protection

Energy Technology Data Exchange (ETDEWEB)

Ftacnikova, S [Inst. of Preventive and Clinical Medicine, 83301 Bratislava (Slovakia)

1996-12-31

In this paper equivalent dose from Auger electron emitters was reevaluated. The presented approach represents a practical step toward the estimation of equivalent dose for incorporated Auger electron emitters, an aspects that has not been given adequate consideration so far. Given the widespread use of this class of radionuclides in nuclear medicine and in biomedical research, the formalism and practical calculation presented here may be of value to assessing the risk associated with this radionuclides (in diagnostic nuclear medicine procedures), as well as predicting their therapeutic efficiency. (J.K.) 2 tabs., 11 refs.

The impact of shoulder abduction loading on EMG-based intention detection of hand opening and closing after stroke.

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Lan, Yiyun; Yao, Jun; Dewald, Julius P A

2011-01-01

Many stroke patients are subject to limited hand functions in the paretic arm due to a significant loss of Corticospinal Tract (CST) fibers. A possible solution for this problem is to classify surface Electromyography (EMG) signals generated by hand movements and uses that to implement Functional Electrical Stimulation (FES). However, EMG usually presents an abnormal muscle coactivation pattern shown as increased coupling between muscles within and/or across joints after stroke. The resulting Abnormal Muscle Synergies (AMS) could make the classification more difficult in individuals with stroke, especially when attempting to use the hand together with other joints in the paretic arm. Therefore, this study is aimed at identifying the impact of AMS following stroke on EMG pattern recognition between two hand movements. In an effort to achieve this goal, 7 chronic hemiparetic chronic stroke subjects were recruited and asked to perform hand opening and closing movements at their paretic arm while being either fully supported by a virtual table or loaded with 25% of subject's maximum shoulder abduction force. During the execution of motor tasks EMG signals from the wrist flexors and extensors were simultaneously acquired. Our results showed that increased synergy-induced activity at elbow flexors, induced by increasing shoulder abduction loading, deteriorated the performance of EMG pattern recognition for hand opening for those with a weak grasp strength and EMG activity. However, no such impact on hand closing has yet been observed possibly because finger/wrist flexion is facilitated by the shoulder abduction-induced flexion synergy.

[Turning the head, an unusual mechanism to compensate for diplopia caused by abduction restriction of one eye

NARCIS (Netherlands)

Kappelle, A.C.; Schelhaas, H.J.; Pasman, J.W.; Bloem, B.R.

2004-01-01

A 59-year-old-man visited the neurological outpatient clinic because of a leftward rotation of his head for the last 8 months. This head deviation turned out to represent a compensatory mechanism to alleviate diplopia that resulted from an abduction restriction of his left eye. By turning his head

Transfracture abduction osteotomy: A solution for nonunion of femoral neck fractures

Directory of Open Access Journals (Sweden)

Jairamchander Pingle

2014-01-01

femur with or without bone graft, valgus osteotomy or hip arthroplasty. We conducted a retrospective analysis of cases of nonunion of femoral neck fracture treated by transfracture abduction osteotomy (TFAO. Materials and Methods: Over a period of 35 years (1974-2008, 30 patients with nonunion of femoral neck fractures were treated with TFAO over a period of 35 years (1974-2008, All patients were less than 50 years of age. Absence of clinical and radiological signs of union after four months was considered as nonunion. Patients more than 50 years of age were excluded from the study. Union was assessed at 6 months radiologically. Limb length was measured at six months. The mean duration of femoral neck fracture was 19 months (range 4 months 10 years. Results were analyzed in terms of radiological union at six months. Average followup was five years and six months. Results: Consistent union was noted at the followup after six months in 29 cases. One case was lost to followup after five and one-half months postoperatively. However, the fracture had united in this case at the last followup. Average shortening of the limb at six months was 1.9 cm. Average neck shaft angle was 127° (range 120-145°. Five cases went into AVN but were asymptomatic. Two cases required reoperation due to back out of Moore′s pins. These were reopened and cancellous screws were inserted in the same tracks. Conclusions: Consistent union of nonunion femoral neck fracture was noted at the followup after six months in 29 cases. The major drawback of the procedure is immobilization of the patient in the hip spica for eight weeks.

Student and intern awareness of ionising radiation exposure from common diagnostic imaging procedures

International Nuclear Information System (INIS)

Zhou, G. Z.; Wong, D. D.; Nguyen, L. K.; Mendelson, R. M.

2010-01-01

Full text: This study aims to evaluate medical student and intern awareness of ionising radiation exposure from common diagnostic imaging procedures and to suggest how education could be improved. Fourth to sixth year medical students enrolled at a Western Australian university and interns from three teaching hospitals in Perth were recruited. Participants were asked to complete a questionnaire consisting of 26 questions on their background, knowledge of ionising radiation doses and learning preferences for future teaching on this subject. A total of 331 completed questionnaires were received (95.9%). Of the 17 questions assessing knowledge of ionising radiation, a mean score of 6.0 was obtained by respondents (95% CI 5.8-6.2). Up to 54.8% of respondents underestimated the radiation dose from commonly requested radiological procedures. Respondents (11.3 and 25.5%) incorrectly believed that ultrasound and MRI emit ionising radiation, respectively. Of the four subgroups of respondents, the intern doctor subgroup performed significantly better (mean score 6.9, P< 0.0001, 95% CI 6.5-7.3) than each of the three medical student subgroups. When asked for the preferred method of teaching for future radiation awareness, a combination of lectures, tutorials and workshops was preferred. This study has clearly shown that awareness of ionising radiation from diagnostic imaging is lacking among senior medical students and interns. The results highlight the need for improved education to minimise unnecessary exposure of patients and the community to radiation. Further studies are required to determine the most effective form of education.

Pericardiectomy as a diagnostic and therapeutic procedure.

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Konik, Ewa; Geske, Jeffrey; Edwards, William; Gersh, Bernard

2016-11-14

A 70-year-old man presented with recent onset, predominantly right-sided heart failure. Echocardiogram demonstrated features of hypertensive heart disease and was suggestive of, but non-diagnostic for, constrictive pericarditis (CP). CT demonstrated mild pericardial thickening. Right heart catheterisation showed elevation and equalisation of diastolic pressures in all cardiac chambers with early rapid filling, minimal ventricular interdependence, and no dissociation of intrathoracic and intracardiac pressures. While several features pointed towards CP, the minimal ventricular interdependence and no dissociation of intrathoracic and intracardiac pressures suggested other pathology. Diagnostic pericardiectomy was performed, after which the central venous pressure decreased from 22 to 12 mm Hg. Pathology revealed pericardial fibrosis. The patient experienced sustained resolution of his heart failure. A potential explanation for lack of CP criteria was the presence of hypertensive heart disease. CP needs to be considered when approaching patients with heart failure as diagnostic evaluation can be multifaceted and treatment curative. 2016 BMJ Publishing Group Ltd.

Sexual violence and general functioning among formerly abducted girls in Northern Uganda: the mediating roles of stigma and community relations - the WAYS study

Directory of Open Access Journals (Sweden)

Kennedy Amone-P’Olak

2016-01-01

Full Text Available Abstract Background Although sexual violence in war is associated with long-term mental health problems, little is known about its association with general functioning and the factors that explain this association. This study aims to illuminate the path from sexual violence to poor functioning. The prevalence of sexual violence among formerly abducted girls in Northern Uganda was assessed as well as the extent to which stigma and community relations explain the association between sexual violence and general functioning. Method In a cross-sectional analysis using data from the WAYS study (N = 210, baseline age 22.06, SD = 2.06, minimum-maximum 18–25, the extent of mediation of the association between sexual violence and general functioning was assessed in multiple regression models. Results Sexual violence was found to be associated with increased stigma, poor community relations, and poor general functioning. The association between sexual violence and general functioning was mediated by stigma and community relations. The bootstrap results indicated significant mediation by stigma of 47 % (95 % confidence interval [CI] 35 to 78 % and by community relations of 67 % (95 % CI: 52 to 78 % in the association between sexual violence and general functioning. Conclusion Thus, poor functioning among formerly abducted girls is largely mediated by stigma and poor community relations. However, due to the relatively small effect sizes of the associations, targeted interventions to prevent impaired functioning may have only modest benefits to the formerly abducted girls. Interventions to alleviate the toxic effects of sexual violence in formerly abducted girls would benefit from a holistic approach that targets stigma and poor relationships within communities.

Muscular activation during plyometric exercises in 90° of glenohumeral joint abduction.

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Ellenbecker, Todd S; Sueyoshi, Tetsuro; Bailie, David S

2015-01-01

Plyometric exercises are frequently used to increase posterior rotator cuff and periscapular muscle strength and simulate demands and positional stresses in overhead athletes. The purpose of this study was to provide descriptive data on posterior rotator cuff and scapular muscle activation during upper extremity plyometric exercises in 90° of glenohumeral joint abduction. Levels of muscular activity in the posterior rotator cuff and scapular stabilizers will be high during plyometric shoulder exercises similar to previously reported electromyographic (EMG) levels of shoulder rehabilitation exercises. Descriptive laboratory study. Twenty healthy subjects were tested using surface EMG during the performance of 2 plyometric shoulder exercises: prone external rotation (PERP) and reverse catch external rotation (RCP) using a handheld medicine ball. Electrode application included the upper and lower trapezius (UT and LT, respectively), serratus anterior (SA), infraspinatus (IN), and the middle and posterior deltoid (MD and PD, respectively) muscles. A 10-second interval of repetitive plyometric exercise (PERP) and 3 repetitions of RCP were sampled. Peak and average normalized EMG data were generated. Normalized peak and average IN activity ranged between 73% and 102% and between 28% and 52% during the plyometric exercises, respectively, with peak and average LT activity measured between 79% and 131% and between 31% and 61%. SA activity ranged between 76% and 86% for peak and between 35% and 37% for average activity. Muscular activity levels in the MD and PD ranged between 49% and 72% and between 12% and 33% for peak and average, respectively. Moderate to high levels of muscular activity were measured in the rotator cuff and scapular stabilizers during these plyometric exercises with the glenohumeral joint abducted 90°.

[Causes, Diagnostic and Therapeutical Procedures of Malassimilation].

Science.gov (United States)

Schröder, Torsten; Kistenmacher, Alina; Smollich, Martin; Sina, Christian

2018-05-01

Patients with malassimilation suffer from disturbed exploitation of available nutrients, which can affect macro- and micronutrients. Malassimilation can be subdivided in maldigestion and malabsorption. Many different disorders, especially gastrointestinal diseases, can lead to malassimilation. The wide variety of differential diagnoses necessitates big diagnostic as well as financial efforts in order to assure good clinical care. This review provides an overview on diagnostic as well as therapeutic processes of patients with malassimilation and gives practical advice for their physicians and therapists. © Georg Thieme Verlag KG Stuttgart · New York.

Thyroid Radiation Dose to Patients from Diagnostic Radiology Procedures over Eight Decades: 1930-2010.

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Chang, Lienard A; Miller, Donald L; Lee, Choonsik; Melo, Dunstana R; Villoing, Daphnée; Drozdovitch, Vladimir; Thierry-Chef, Isabelle; Winters, Sarah J; Labrake, Michael; Myers, Charles F; Lim, Hyeyeun; Kitahara, Cari M; Linet, Martha S; Simon, Steven L

2017-12-01

This study summarizes and compares estimates of radiation absorbed dose to the thyroid gland for typical patients who underwent diagnostic radiology examinations in the years from 1930 to 2010. The authors estimated the thyroid dose for common examinations, including radiography, mammography, dental radiography, fluoroscopy, nuclear medicine, and computed tomography (CT). For the most part, a clear downward trend in thyroid dose over time for each procedure was observed. Historically, the highest thyroid doses came from the nuclear medicine thyroid scans in the 1960s (630 mGy), full-mouth series dental radiography (390 mGy) in the early years of the use of x rays in dentistry (1930s), and the barium swallow (esophagram) fluoroscopic exam also in the 1930s (140 mGy). Thyroid uptake nuclear medicine examinations and pancreatic scans also gave relatively high doses to the thyroid (64 mGy and 21 mGy, respectively, in the 1960s). In the 21st century, the highest thyroid doses still result from nuclear medicine thyroid scans (130 mGy), but high thyroid doses are also associated with chest/abdomen/pelvis CT scans (18 and 19 mGy for males and females, respectively). Thyroid doses from CT scans did not exhibit the same downward trend as observed for other examinations. The largest thyroid doses from conventional radiography came from cervical spine and skull examinations. Thyroid doses from mammography (which began in the 1960s) were generally a fraction of 1 mGy. The highest average doses to the thyroid from mammography were about 0.42 mGy, with modestly larger doses associated with imaging of breasts with large compressed thicknesses. Thyroid doses from dental radiographic procedures have decreased markedly throughout the decades, from an average of 390 mGy for a full-mouth series in the 1930s to an average of 0.31 mGy today. Upper GI series fluoroscopy examinations resulted in up to two orders of magnitude lower thyroid doses than the barium swallow. There are

Diagnostic imaging procedures during pregnancy: what are the fetal risks?

International Nuclear Information System (INIS)

Taylor, K.

2008-01-01

An important facet of health care is the counsel of patients seeking a better understanding of their medical treatment. One of the most challenging scenarios is the management of female patients exposed to ionizing radiation while pregnant. It requires careful consideration of both maternal benefit and fetal risk. Given the increased frequency of diagnostic examinations involving ionizing radiation, this situation has become commonplace. This paper reviews current literature discussing the risk associated with prenatal exposure to ionizing radiation. The fetal dose received during common radiological procedures is reported in order to emphasize that these doses do not exceed threshold levels for deterministic effects. The definitive cancer risk associated with radiation exposure in utero has yet to be established. This paper will also show that physicians who deal with pregnant women are generally uninformed or misinformed of the doses and risks associated with the exams that they prescribe. This lack of information could be leading to inappropriate advice and actions with respect to patient care. (author)

Diagnostic imaging procedures during pregnancy: what are the fetal risks?

Energy Technology Data Exchange (ETDEWEB)

Taylor, K. [McMaster Univ., Hamilton, Ontario (Canada)

2008-07-01

An important facet of health care is the counsel of patients seeking a better understanding of their medical treatment. One of the most challenging scenarios is the management of female patients exposed to ionizing radiation while pregnant. It requires careful consideration of both maternal benefit and fetal risk. Given the increased frequency of diagnostic examinations involving ionizing radiation, this situation has become commonplace. This paper reviews current literature discussing the risk associated with prenatal exposure to ionizing radiation. The fetal dose received during common radiological procedures is reported in order to emphasize that these doses do not exceed threshold levels for deterministic effects. The definitive cancer risk associated with radiation exposure in utero has yet to be established. This paper will also show that physicians who deal with pregnant women are generally uninformed or misinformed of the doses and risks associated with the exams that they prescribe. This lack of information could be leading to inappropriate advice and actions with respect to patient care. (author)

Hip abduction-adduction strength and one-leg hop tests: test-retest reliability and relationship to function in elite ice hockey players.

Science.gov (United States)

Kea, J; Kramer, J; Forwell, L; Birmingham, T

2001-08-01

Single group, test-retest. To determine: (1) hip abduction and adduction torques during concentric and eccentric muscle actions, (2) medial and lateral one-leg hop distances, (3) the test-retest reliability of these measurements, and (4) the relationship between isokinetic measures of hip muscle strength and hop distances in elite ice hockey players. The skating motion used in ice hockey requires strong contractions of the hip and knee musculature. However, baseline scores for hip strength and hop distances, their test-retest reliability, and measures of the extent to which these tests are related for this population are not available. The dominant leg of 27 men (mean age 20 +/- 3 yrs) was tested on 2 occasions. Hip abduction and adduction movements were completed at 60 degrees.s(-1) angular velocity, with the subject lying on the non-test side and the test leg moving vertically in the subject's coronal plane. One-leg hops requiring jumping from and landing on the same leg without losing balance were completed in the medial and lateral directions. Hip adduction torques were significantly greater than abduction torques during both concentric and eccentric muscle actions, while no significant difference was observed between medial and lateral hop distances. Although hop test scores produced excellent ICCs (> 0.75) when determined using scores on 1 occasion, torques needed to be averaged over 2 test occasions to reach this level. Correlations between the strength and hop tests ranged from slight to low (r = -0.26 to 0.27) and were characterized by wide 95% confidence intervals (-0.54 to 0.61). Isokinetic tests of hip abduction and adduction did not provide a strong indication of performance during sideways hop tests. Although isokinetic tests can provide a measure of muscular strength under specific test conditions, they should not be relied upon as a primary indicator of functional abilities or readiness to return to activity.

42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

Science.gov (United States)

2010-10-01

... Procedural Terminology published by the American Medical Association. (3) Levels of supervision. Except where... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

IMPAIRED MOBILITY OF VOCAL FOLDS – DIAGNOSTIC PROCEDURES AND TREATMENT, part 2

Directory of Open Access Journals (Sweden)

Karlo Pintarić

2015-09-01

Full Text Available Paresis or paralysis of one or both vocal cords affects phonation, swallowing and breathing. The major cause for reduced mobility or even immobility is innervation damage, less often mechanical disorder.The main procedures in the diagnostics of disordered vocal fold mobility are indirect laryngoscopy and videoendostroboscopy. Different imaging techniques (especially computerized tomography are of great value in searching for a cause of the impaired mobility.In unilateral vocal fold immobility, the treatment is focused on the improvement of voice quality and the prevention of aspiration during swallowing. In bilateral paralysis, it is crucial to find a balance between effective breathing and sufficient voice quality. The treatment of unilateral paralysis is started with voice therapy and swallowing rehabilitation. If these procedures are not enough surgical treatment for the medialization of the paralyzed vocal fold is applied. In the case of breathing difficulties in bilateral vocal fold immobility there is a possibility of surgical lateralization of one or both folds or a surgical excision of a part or the entire vocal fold. Surgical reinnervation, functional electrostimulation of certain laryngeal muscles and gene therapy are developing treatment modalities.

Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis.

Science.gov (United States)

Şimşek, Abdullah; Yapıcı, İlhami; Babalık, Mesiha; Şimşek, Zekiye; Kolsuz, Mustafa

2016-01-01

To determine the proportional distribution of endobronchial tuberculosis (EBTB) subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both). Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%). Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%). Smear microscopy of BAL fluid (BALF) was performed in 16 patients and was positive for AFB in 10 (62.5%). Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%). Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%); bronchial brushing, in 7 (38.8%); fine-needle aspiration biopsy, in 2 (11.1%); and BAL, in 2 (11.1%). Bronchial anthracofibrosis was observed in 5 (27.7%) of the 18 cases evaluated. In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB. Determinar a distribuição proporcional dos subtipos de tuberculose endobrônquica (TBEB) e avaliar os tipos de procedimentos diagnósticos broncoscópicos que podem revelar inflamação granulomatosa. Este foi um estudo retrospectivo com 18 pacientes HIV negativos com TBEB comprovada

Progressive Abduction Loading Therapy with Horizontal-Plane Viscous Resistance Targeting Weakness and Flexion Synergy to Treat Upper Limb Function in Chronic Hemiparetic Stroke: A Randomized Clinical Trial.

Science.gov (United States)

Ellis, Michael D; Carmona, Carolina; Drogos, Justin; Dewald, Julius P A

2018-01-01

Progressive abduction loading therapy has emerged as a promising exercise therapy in stroke rehabilitation to systematically target the loss of independent joint control (flexion synergy) in individuals with chronic moderate/severe upper-extremity impairment. Preclinical investigations have identified abduction loading during reaching exercise as a key therapeutic factor to improve reaching function. An augmentative approach may be to additionally target weakness by incorporating resistance training to increase constitutive joint torques of reaching with the goal of improving reaching function by "overpowering" flexion synergy. The objective was, therefore, to determine the therapeutic effects of horizontal-plane viscous resistance in combination with progressive abduction loading therapy. 32 individuals with chronic hemiparetic stroke were randomly allocated to two groups. The two groups had equivalent baseline characteristics on all demographic and outcome metrics including age (59 ± 11 years), time poststroke (10.1 ± 7.6 years), and motor impairment (Fugl-Meyer, 26.7 ± 6.5 out of 66). Both groups received therapy three times/week for 8 weeks while the experimental group included additional horizontal-plane viscous resistance. Quantitative standardized progression of the intervention was achieved using a robotic device. The primary outcomes of reaching distance and velocity under maximum abduction loading and secondary outcomes of isometric strength and a clinical battery were measured at pre-, post-, and 3 months following therapy. There was no difference between groups on any outcome measure. However, for combined groups, there was a significant increase in reaching distance (13.2%, effect size; d  = 0.56) and velocity (13.6%, effect size; d  = 0.27) at posttesting that persisted for 3 months and also a significant increase in abduction, elbow extension, and external rotation strength at posttesting that did not persist 3�

Exposure of the French paediatric population to ionising radiation from diagnostic medical procedures in 2010

International Nuclear Information System (INIS)

Etard, Cecile; Aubert, Bernard; Mezzarobba, Myriam; Bernier, Marie-Odile

2014-01-01

Medical examination is the main source of artificial radiation exposure. Because children present an increased sensitivity to ionising radiation, radiology practices at a national level in paediatrics should be monitored. This study describes the ionising radiation exposure from diagnostic medical examinations of the French paediatric population in 2010. Data on frequency of examinations were provided by the French National Health Insurance through a representative sample including 107,627 children ages 0-15 years. Effective doses for each type of procedure were obtained from the published French literature. Median and mean effective doses were calculated for the studied population. About a third of the children were exposed to at least one examination using ionising radiation in 2010. Conventional radiology, dental exams, CT scans and nuclear medicine and interventional radiology represent respectively 55.3%, 42.3%, 2.1% and 0.3% of the procedures. Children 10-15 years old and babies from birth to 1 year are the most exposed populations, with respectively 1,098 and 734 examinations per 1,000 children per year. Before 1 year of age, chest and pelvis radiographs are the most common imaging tests, 54% and 32%, respectively. Only 1% of the studied population is exposed to CT scan, with 62% of these children exposed to a head-and-neck procedure. The annual median and mean effective doses were respectively 0.03 mSv and 0.7 mSv for the exposed children. This study gives updated reference data on French paediatric exposure to medical ionising radiation that can be used for public health or epidemiological purposes. Paediatric diagnostic use appears much lower than that of the whole French population as estimated in a previous study. (orig.)

Exposure of the French paediatric population to ionising radiation from diagnostic medical procedures in 2010

Energy Technology Data Exchange (ETDEWEB)

Etard, Cecile; Aubert, Bernard [Institut de Radioprotection et de Surete Nucleaire, Medical Expertise Unit, Fontenay-aux-Roses (France); Mezzarobba, Myriam [Institut de Radioprotection et de Surete Nucleaire, Laboratory of Epidemiology, Fontenay-aux-Roses (France); Bernier, Marie-Odile [Institut de Radioprotection et de Surete Nucleaire, Laboratory of Epidemiology, Fontenay-aux-Roses (France); Institut de Radioprotection et de Surete Nucleaire, IRSN/PRP-HOM/SRBE/LEPID, Laboratoire d' Epidemiologie, Fontenay-aux-Roses (France)

2014-12-15

Medical examination is the main source of artificial radiation exposure. Because children present an increased sensitivity to ionising radiation, radiology practices at a national level in paediatrics should be monitored. This study describes the ionising radiation exposure from diagnostic medical examinations of the French paediatric population in 2010. Data on frequency of examinations were provided by the French National Health Insurance through a representative sample including 107,627 children ages 0-15 years. Effective doses for each type of procedure were obtained from the published French literature. Median and mean effective doses were calculated for the studied population. About a third of the children were exposed to at least one examination using ionising radiation in 2010. Conventional radiology, dental exams, CT scans and nuclear medicine and interventional radiology represent respectively 55.3%, 42.3%, 2.1% and 0.3% of the procedures. Children 10-15 years old and babies from birth to 1 year are the most exposed populations, with respectively 1,098 and 734 examinations per 1,000 children per year. Before 1 year of age, chest and pelvis radiographs are the most common imaging tests, 54% and 32%, respectively. Only 1% of the studied population is exposed to CT scan, with 62% of these children exposed to a head-and-neck procedure. The annual median and mean effective doses were respectively 0.03 mSv and 0.7 mSv for the exposed children. This study gives updated reference data on French paediatric exposure to medical ionising radiation that can be used for public health or epidemiological purposes. Paediatric diagnostic use appears much lower than that of the whole French population as estimated in a previous study. (orig.)

Towards the definition of Institutional diagnostic reference levels in paediatric interventional cardiology procedures in Greece.

Science.gov (United States)

Kottou, S; Kollaros, N; Plemmenos, C; Mastorakou, I; Apostolopoulou, S C; Tsapaki, V

2018-02-01

This study aimed to evaluate paediatric radiation doses in a dedicated cardiology hospital, with the objective of characterising patterns in dose variation. The ultimate purpose was to define Local (Institutional) Diagnostic Reference Levels (LDRLs) for different types of paediatric cardiac interventional procedures (IC), according to patient age. From a total of 710 cases performed during three consecutive years, by operators with more than 15 years of experience, the age was noted in only 477 IC procedures. The median values obtained for Fluoroscopy Time (FT), Number of Frames (N) and Kerma Area Product (P KA ) by age range were 5.8 min, 1322 and 2.0 Gy.cm 2 for definition of LDRLs presents challenges mainly due to the multiple clinical and technical factors affecting the outcome. On the other hand the lack of paediatric IC DRLs makes the identification of good practices more difficult. A consensus is needed on IC procedures nomenclature and grouping in order to allow a common assessment and comparison of doses. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Verification of examination procedures in clinical laboratory for imprecision, trueness and diagnostic accuracy according to ISO 15189:2012: a pragmatic approach.

Science.gov (United States)

Antonelli, Giorgia; Padoan, Andrea; Aita, Ada; Sciacovelli, Laura; Plebani, Mario

2017-08-28

Background The International Standard ISO 15189 is recognized as a valuable guide in ensuring high quality clinical laboratory services and promoting the harmonization of accreditation programmes in laboratory medicine. Examination procedures must be verified in order to guarantee that their performance characteristics are congruent with the intended scope of the test. The aim of the present study was to propose a practice model for implementing procedures employed for the verification of validated examination procedures already used for at least 2 years in our laboratory, in agreement with the ISO 15189 requirement at the Section 5.5.1.2. Methods In order to identify the operative procedure to be used, approved documents were identified, together with the definition of performance characteristics to be evaluated for the different methods; the examination procedures used in laboratory were analyzed and checked for performance specifications reported by manufacturers. Then, operative flow charts were identified to compare the laboratory performance characteristics with those declared by manufacturers. Results The choice of performance characteristics for verification was based on approved documents used as guidance, and the specific purpose tests undertaken, a consideration being made of: imprecision and trueness for quantitative methods; diagnostic accuracy for qualitative methods; imprecision together with diagnostic accuracy for semi-quantitative methods. Conclusions The described approach, balancing technological possibilities, risks and costs and assuring the compliance of the fundamental component of result accuracy, appears promising as an easily applicable and flexible procedure helping laboratories to comply with the ISO 15189 requirements.

High eccentric hip abduction strength reduces the risk of developing patellofemoral pain among novice runners initiating a self-structured running program

DEFF Research Database (Denmark)

Ramskov, Daniel; Barton, Christian; Nielsen, Rasmus O

2015-01-01

Study Design Observational prospective cohort study with 1-year follow-up. Objectives To investigate the relationship between eccentric hip abduction strength and the development of patellofemoral pain (PFP) in novice runners, during a self-structured running regime. Background Recent research...

New perspective for radiation protection in diagnostic procedure in Paraguay

International Nuclear Information System (INIS)

Sosky, R.A.; Gamarra, M.

2001-01-01

The Government in Paraguay approved by Decree Law 10754, dated October 6, 2000, its National Regulation on Basic Safety Standards for Radiation Protection and the Safety of Radiation Sources, based on the IAEA Safety Standards 115. The primary goal of Patient Protection is to ensure that both Regulatory Authorities and all Responsible parties in Medical Practices observe procedural process in conducting their responsibilities on regulatory and administrative affairs. On one side the Government, 'Department de Proteccion Radiologica', under the Health Ministry and Comision Nacional de Energia Atomica, and on the other side, the medical practitioner who prescribes or conducts diagnostic or therapeutic treatment, both ensure that the exposure of patients be the minimum. This document describes how the Regulatory Authorities intend to implement this recent act and on the other hand take the advantage of this Conference to understand better this subject, especially on the following subjects: essential requirement for licensing, inspection and enforcement programme in the country's capital and in the interior, where there are more difficulties; workers and medical training and lessons learned applying to developing countries. (author)

Degree of vertical integration between the undergraduate program and clinical internship with respect to cervical and cranial diagnostic and therapeutic procedures taught at the canadian memorial chiropractic college.

Science.gov (United States)

Leppington, Charmody; Gleberzon, Brian; Fortunato, Lisa; Doucet, Nicolea; Vandervalk, Kyle

2012-01-01

The purpose of this study was to determine if diagnostic and therapeutic procedures for the cervical and cranial spine taught to students during the undergraduate program at Canadian Memorial Chiropractic College are required to be used during their internship by their supervising clinicians and, if so, to what extent these procedures are used. Course manuals and course syllabi from the Applied Chiropractic and Clinical Diagnosis faculty of the undergraduate chiropractic program for the academic year 2009-2010 were consulted and a list of all diagnostic and therapeutic procedures for the cranial and cervical spine was compiled. This survey asked clinicians to indicate if they themselves used or if they required the students they were supervising to use each procedure listed and, if so, to what extent each procedure was used. Demographic information of each clinician was also obtained. In general, most diagnostic procedures of the head and neck were seldom used, with the exception of postural observation and palpation. By contrast, most cervical orthopaedic tests were often used, with the exception of tests for vertigo. Most therapeutic procedures were used frequently with the exception of prone cervical and "muscle" adjustments. There was a low degree of vertical integration for cranial procedures as compared to a much higher degree of vertical integration for cervical procedures between the undergraduate and clinical internship programs taught. Vertical integration is an important element of curricular planning and these results may be helpful to aid educators to more appropriately allocate classroom instruction.

Consensus guidelines for the use of bowel preparation prior to colonic diagnostic procedures: colonoscopy and small bowel video capsule endoscopy

NARCIS (Netherlands)

Mathus-Vliegen, Elisabeth; Pellisé, Maria; Heresbach, Denis; Fischbach, Wolfgang; Dixon, Tricia; Belsey, Jonathan; Parente, Fabrizio; Rio-Tinto, Ricardo; Brown, Alistair; Toth, Ervin; Crosta, Cristiano; Layer, Peter; Epstein, Owen; Boustiere, Christian

2013-01-01

Adequate bowel preparation prior to colonic diagnostic procedures is essential to ensure adequate visualisation. This consensus aims to provide guidance as to the appropriate use of bowel preparation for a range of defined clinical circumstances. A consensus group from across Europe was convened and

Detection of heat abduction on the walls by artificial neural network and selection of materials with decision support system

Directory of Open Access Journals (Sweden)

Egemen Tekkanat

2017-08-01

Full Text Available Today energy conservation is a very important issue in the world and Turkey. The aim of this study is to minimize the heat abduction, thus to save energy by utilizing the factors to prevent the heat abduction on the walls of buildings. First of all, a back-propagation network model with artificial neural network model was used for the factors that can cause heat loss on the walls. Whether the walls have insulation were considered. After that, Decision Support Systems were used for heat insulation to select the appropriate materials. A Decision Support Model with Analytic Hierarchy Process (AHP was recommended to meet the needs of a customer best and to make better decisions for the selection of the materials. The method was used by construction firms for their decision processes for the best materials and the results were evaluated. After the evaluations were done, the factors that cause heat loss were considered and it became clear which factors were more important for the prevention of heat loss.

Unintentional exposure to radiation during pregnancy from nuclear medical diagnostic procedures; Unabsichtliche Strahlenexposition in der Schwangerschaft durch nuklearmedizinische Diagnostik

Energy Technology Data Exchange (ETDEWEB)

Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin, Essen (Germany)

2005-12-01

The administration of radiopharmaceuticals during pregnancy is contraindicated due to a lack of vital indications. However, if prenatal exposure to radiation should occur in the framework of a nuclear medical diagnostic procedure then fortunately no longterm side-effects would normally be expected. Radiation damage in the preimplantation phase leads to early abortion. However, if the further course of pregnancy remains uncomplicated then no subsequent side-effects need be expected. On a conservative estimate, it would require doses exceeding 50 mGy to cause radiation damage within the uterus after the preimplantation phase. However, the standard radioactivities applied for diagnostic purposes in nuclear medicine, can be obtained with doses of less than 20 mGy. On the basis of current knowledge, therefore, there is no reason to terminate pregnancy on medical grounds after diagnostic exposure to radiopharmaceuticals. (orig.)

Kinematic magnetic resonance imaging (MRI) of the normal shoulder: assessment of the shapes and signals of the superior and inferior labra with abductive movement using an open-type imager.

OpenAIRE

Togami, Izumi; Sasai, Nobuya; Tsunoda, Masatoshi; Sei, Tetsuro; Yabuki, Takayuki; Kitagawa, Takahiro; Mitani, Masahiko; Akaki, Shiro; Kuroda, Masahiro; Hiraki, Yoshio

2001-01-01

A preliminary study was conducted to evaluate the superior and inferior glenoid labra with abductive movement using an open-type MR unit in asymptomatic healthy volunteers. Both fast low angle shot (FLASH) and turbo spin echo (TSE) images were obtained to evaluate the shapes of both the superior and inferior labra, as well as to assess changes in signal at these sites. As the abduction angle was increased, the shape of the superior labrum changed from round or triangular to crescentic and a h...

Abduction of Arm Facilitates Correction of Kinked Peel-Away Sheath During Subclavian Central Line Placement.

Science.gov (United States)

Kim, Sunghoon

2015-12-01

A tunneled central line catheter placement using a subclavian vein approach can be complicated by an occurrence of peel-away sheath kink which prevents the advancement of the catheter through the sheath. The kink is created due to the angular junction of subclavian and brachiocephalic veins which meet at 90 degree angle. A technique is described which corrects the peel-away sheath kink by extending the subclavian/brachiocephalic vein angle to greater than 90 degrees by abducting the patient's arm. Copyright © 2015 Elsevier Inc. All rights reserved.

The Medical Exposure to Ionizing Radiation and Protection of the Patient in Medical Imaging Procedures for Diagnostic and Therapeutic Purposes (Excluding Radiotherapy) using X-Rays in Israel - Risk - Cost and Benefit

International Nuclear Information System (INIS)

Ben-Shlomo, A.

1998-10-01

Diagnostic and therapeutic radiology is playing a major role in modern medicine. The utilization of devices emitting ionizing radiation for medical diagnostic and therapeutic purposes is classified into three categories: a. Radiotherapy procedures for the treatment of malignant and benign tumors. b. Nuclear medicine procedures using radiopharmaceuticals that are introduced into the patient's body for diagnostic and therapeutic purposes. c. Diagnostic and therapeutic x-ray imaging procedures. This group includes conventional radiography, conventional fluoroscopy, cardiac catheterization, angiography, CT, mammography, dental, and fluoroscopy operation procedures. A survey was carried out on a sample of three major Israeli hospitals in order to: 1. Determine the status of radiation protection of patients in Israel with regard to the use of x-rays in medical imaging and interventional radiology. 2. Assess the extent of exposure of the population to medical x-rays, and assess the collective risk in Israel in this relation (based on Icr-60). 3. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of Israeli patients under x-ray procedures. 4. Establish a of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. 5. Establish a number of basic rules to be utilized by health policy makers in Israel

The Medical Exposure to Ionizing Radiation and Protection of the Patient in Medical Imaging Procedures for Diagnostic and Therapeutic Purposes (Excluding Radiotherapy) using X-Rays in Israel - Risk - Cost and Benefit

Energy Technology Data Exchange (ETDEWEB)

Ben-Shlomo, A

1998-10-01

Diagnostic and therapeutic radiology is playing a major role in modern medicine. The utilization of devices emitting ionizing radiation for medical diagnostic and therapeutic purposes is classified into three categories: a. Radiotherapy procedures for the treatment of malignant and benign tumors. b. Nuclear medicine procedures using radiopharmaceuticals that are introduced into the patient's body for diagnostic and therapeutic purposes. c. Diagnostic and therapeutic x-ray imaging procedures. This group includes conventional radiography, conventional fluoroscopy, cardiac catheterization, angiography, CT, mammography, dental, and fluoroscopy operation procedures. A survey was carried out on a sample of three major Israeli hospitals in order to: 1. Determine the status of radiation protection of patients in Israel with regard to the use of x-rays in medical imaging and interventional radiology. 2. Assess the extent of exposure of the population to medical x-rays, and assess the collective risk in Israel in this relation (based on Icr-60). 3. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of Israeli patients under x-ray procedures. 4. Establish a of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. 5. Establish a number of basic rules to be utilized by health policy makers in Israel.

The nuclear medical diagnostic procedures at the hospitals in Sofia over a period of ten years - from 1990 to 2000 - structure, number and doses

International Nuclear Information System (INIS)

Adelina, P.; Ingilizova, K.; Paskalev, Z

2003-01-01

The aim of this study is to analyze the structure and the number of nuclear diagnostic procedures at hospitals in Sofia over a period of ten years (from 1990 to 2000); to calculate the effective doses received by patients; to compare the results from different hospitals. We have developed a form in order to collect the necessary information from hospitals (nuclear laboratories). The information has been collected according to examined organ, applied radioactive pharmaceutical and injected activity (MBq), patient's age and sex. The effective doses have been calculated using transition coefficients for each of the applied radioactive pharmaceuticals and for each of the diagnostic procedures. We have received the information and calculated the doses. We have compared the data from different hospitals (nuclear laboratories). The results show that the doctors in different hospitals have used different radioactive pharmaceuticals and applied different activities for one and the same procedure. (orig.)

Abdominal Hollowing Reduces Lateral Trunk Displacement During Single-Leg Squats in Healthy Females But Does Not Affect Peak Hip Abduction Angle or Knee Abductio Angle/Moment.

Science.gov (United States)

Linde, Lukas D; Archibald, Jessica; Lampert, Eve C; Srbely, John Z

2017-07-17

Females suffer 4-6 times more non-contact anterior cruciate ligament (ACL) injuries than males due to neuromuscular control deficits of the hip musculature leading to increases in hip adduction angle, knee abduction angle, and knee abduction moment during dynamic tasks such as single-leg squats. Lateral trunk displacement has been further related to ACL injury risk in females, leading to the incorporation of core strength/stability exercises in ACL preventative training programs. However, the direct mechanism relating lateral trunk displacement and lower limb ACL risk factors is not well established. To assess the relationship between lateral trunk displacement and lower limb measures of ACL injury risk by altering trunk control through abdominal activation techniques during single-leg squats in healthy females. Interventional Study Setting: Movement and Posture Laboratory Participants: 13 healthy females (21.3±0.88y, 1.68±0.07m, 58.27±5.46kg) Intervention: Trunk position and lower limb kinematics were recorded using an optoelectric motion capture system during single-leg squats under differing conditions of abdominal muscle activation (abdominal hollowing, abdominal bracing, control), confirmed via surface electromyography. Lateral trunk displacement, peak hip adduction angle, peak knee abduction angle/moment, and average muscle activity from bilateral internal oblique, external oblique, and erector spinae muscles. No differences were observed for peak lateral trunk displacement, peak hip adduction angle or peak knee abduction angle/moment. Abdominal hollowing and bracing elicited greater muscle activation than the control condition, and bracing was greater than hollowing in four of six muscles recorded. The lack of reduction in trunk, hip, and knee measures of ACL injury risk during abdominal hollowing and bracing suggests that these techniques alone may provide minimal benefit in ACL injury prevention training.

Sensitivity of the diagnostic radiological index of protection to procedural factors in fluoroscopy

Energy Technology Data Exchange (ETDEWEB)

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Pasciak, Alexander S. [Department of Radiology, The University of Tennessee Medical Center at Knoxville, Knoxville, Tennessee 37922 (United States); Wagner, Louis K. [Department of Diagnostic and Interventional Imaging, The John P. and Katharine G. McGovern Medical School, Houston, Texas 77030 (United States)

2016-07-15

Purpose: To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Methods: Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (E{sub avg}) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusions: The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.

Preliminary survey on the distribution of medical equipment and frequency of diagnostic and therapeutic procedures in Brazil: a contribution to the UNSCEAR report

International Nuclear Information System (INIS)

Biazotto, Bruna; Taboza de Oliveira, Alexandre; Baptista de Freitas, Marcelo

2008-01-01

Information about Brazil published in the UNSCEAR 2000 report are still scarce when compared to others countries. In this study, a survey on the distribution of medical equipment (X-ray generators, ultrasound, CT and MRI scanners, nuclear medicine equipment and teletherapy and brachytherapy units) and frequency of diagnostic and therapeutic procedures at the various Brazilian States was carried out. The overall information was obtained from a national database supported by the Brazilian Ministry of Health through the Computer Science Department of the National Health System (SUS - Sistema Unico de Saude). The distribution of equipment and the annual frequency of each type of procedure were analyzed considering the five geographical regions that form the country and their respective population. Temporal and regional trends in the annual frequency of procedures for 2000-2007 were also summarized in this study. National annual frequencies for the total of all medical X-ray examinations (259.0 examinations per 1000 population) were evaluated. Some examples can be given from chest, mammography and CT examinations: 67.4, 30.2 and 7.2 per 1000 population, respectively. In addition, annual frequencies for other modalities of diagnostic imaging have also been estimated: 61.5, 1.6 and 1.4 per 1000 population for ultrasound, nuclear medicine and MRI procedures, respectively. A total of 38.7 therapeutic procedures per 1000 population (teletherapy and brachytherapy) are annually performed in the country. The health services localized in Brazil comprised a total number of 253.1 diagnostic imaging equipment per million population, without considering dental X-ray. Amongst them, X-ray equipment used in common radiological examinations (chest, skull, spine, etc.) stands for 39% (97.7 per million). As expected, a significant decrease in the offer of equipment is observed when technologically more sophisticated equipment is concerned: magnetic resonance (3.5 per million), gamma

Examination of the torque required to passively palmar abduct the thumb CMC joint in a pediatric population with hemiplegia and stroke.

Science.gov (United States)

Stirling, Leia; Ahmad, Mona Qureshi; Kelty-Stephen, Damian; Correia, Annette

2015-12-16

Many activities of daily living involve precision grasping and bimanual manipulation, such as putting toothpaste on a toothbrush or feeding oneself. However, children afflicted by stroke, cerebral palsy, or traumatic brain injury may have lost or never had the ability to actively and accurately control the thumb. To translate insights from adult rehabilitation robotics to innovative therapies for hand rehabilitation in pediatric care, specifically for thumb deformities, an understanding of the torque needed to abduct the thumb to assist grasping tasks is required. Participants (n=16, 10 female, 13.2±3.1 years) had an upper extremity evaluation and measures were made of their passive range of motion, anthropometrics, and torques to abduct the thumb for both their affected and non-affected sides. Torque measures were made using a custom wrist orthosis that was adjusted for each participant. The torque to achieve maximum abduction was 1.47±0.61inlb for the non-affected side and 1.51±0.68inlb for the affected side, with a maximum recorded value of 4.87inlb. The overall maximum applied torque was observed during adduction and was 5.10inlb. We saw variation in the applied torque, which could have been due to the applied torques by the Occupational Therapist or the participant actively assisting or resisting the motion rather than remaining passive. We expect similar muscle and participant variation to exist with an assistive device. Thus, the data presented here can be used to inform the specifications for the development of an assistive thumb orthosis for children with "thumb-in-palm" deformity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of forearm axially rotated posture on shoulder load and shoulder abduction / flexion angles in one-armed arrest of forward falls.

Science.gov (United States)

Hsu, Hsiu-Hao; Chou, You-Li; Lou, Shu-Zon; Huang, Ming-Jer; Chou, Paul Pei-Hsi

2011-03-01

Falling onto the outstretched hand is the most common cause of upper extremity injury. This study develops an experimental model for evaluating the shoulder load during a simulated forward fall onto one hand with three different forearm axially rotated postures, and examines the shoulder abduction angle and shoulder flexion angle in each case. Fifteen healthy young male subjects with an average age of 23.7 years performed a series of one-armed arrests from a height of 5 cm onto a force plate. The kinematics and kinetics of the upper extremity were analyzed for three different forearm postures, namely 45° externally rotated, non-rotated, and 45° internally rotated. The shoulder joint load and shoulder abduction/flexion angles were significantly dependent on the rotational posture of the forearm. The shoulder medio-lateral shear forces in the externally rotated group were found to be 1.61 and 2.94 times higher than those in the non-rotated and internally rotated groups, respectively. The shoulder flexion angles in the externally rotated, non-rotated and internally rotated groups were 0.6°, 8.0° and 19.2°, respectively, while the corresponding shoulder abduction angles were 6.1°, 34.1° and 46.3°, respectively. In falls onto the outstretched hand, an externally rotated forearm posture should be avoided in order to reduce the medio-lateral shear force acting on the shoulder joint. In falls of this type, a 45° internally rotated forearm posture represents the most effective fall strategy in terms of minimizing the risk of upper extremity injuries. Copyright © 2010 Elsevier Ltd. All rights reserved.

Perceived risk of prenatal diagnostic procedure-related miscarriage and Down syndrome among pregnant women.

Science.gov (United States)

Caughey, Aaron B; Washington, A Eugene; Kuppermann, Miriam

2008-03-01

The objective of the study was to identify correlates of perceived risk of carrying a Down syndrome-affected fetus or experiencing a procedure-related miscarriage among a diverse group of pregnant women. We conducted a cross-sectional survey of 1081 English-, Spanish-, or Chinese-speaking women receiving prenatal care in the San Francisco Bay area. Perceived risk of procedure-related miscarriage or carrying a Down syndrome-affected fetus was assessed using a linear rating scale from 0 (no risk) to 1 (high risk). Bivariate and multivariable analyses were used to explore associations between maternal characteristics including age, race/ethnicity, and socioeconomic status and perceived risks of carrying a Down syndrome-affected fetus or experiencing a procedure-related miscarriage. Women aged 35 years old or older had a higher perceived risk of Down syndrome than younger women (0.28 vs 0.22 on a scale from 0 to 1, P self-perceived health status (+0.08, P = .045). Latinas (+0.11, P = .008), women with an annual income less than $35,000 (+0.09, P = .003), and those who had difficulty conceiving (+0.09, P = .026) had higher perceived procedure-related miscarriage risk. Among women aged 35 years or older, perceived risk of carrying a Down syndrome-affected fetus was associated with the inclination to undergo prenatal diagnosis. Women's perceived risks of carrying a Down syndrome-affected fetus or having a procedure-related miscarriage are associated with numerous characteristics that have not been shown to be associated with the actual risks of these events. These perceived risks are associated with prenatal diagnostic test inclination. Understanding patients' risk perceptions and effectively communicating risk is critical to helping patients make informed decisions regarding use of invasive prenatal testing.

CT fluoroscopy-guided renal tumour cutting needle biopsy. Retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

International Nuclear Information System (INIS)

Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu

2018-01-01

To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. (orig.)

CT fluoroscopy-guided renal tumour cutting needle biopsy. Retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

Energy Technology Data Exchange (ETDEWEB)

Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu [Okayama University Medical School, Department of Radiology, Okayama (Japan)

2018-01-15

To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. (orig.)

Pelvicalyceal system duplication with ectopic ureter – diagnostic difficulties associated with the imaging procedure. Two cases report

Directory of Open Access Journals (Sweden)

Agnieszka Pukajło-Marczyk

2014-09-01

Full Text Available Urinary tract abnormalities are the most frequently occurring developmental anomaly in children. Pelvicalyceal system duplication is one of them and signifies the existence of two urine diverting separate systems. This anomaly occurs in 10% of population, usually in girls, and is associated with complete or partial ureter duplication. The frequency of total ureter duplication, which in 20–40% of patients is found as bilateral, is 1:125 children (0.8% of the population. The most frequent malformation is asymptomatic, diagnosed coincidentally casually and does not require any treatment. In some patients with pelvicalyceal system duplication, vesicoureteral reflux (VUR and ectopic ureter may coexist. Malposition of ureter’s orifice into the bladder predispose to urinary retention, development of hydronephrosis and urinary tract infection (UTI. Ectopic ureterocele is recognized in 6–20% of children with recurrent UTI. The reason why children are referred to the hospital is UTI or hydronephrosis revealed by ultrasound imaging. When the ultrasound image of pelvicalyceal system duplication is ambiguous, micturating cystourethrography (MCU and scintigraphy become the primary diagnostic procedure, or urography – in more complicated cases. In the case of ectopic ureter, the danger of inappropriate catheterization, i.e. directly into its lumen, may occur. Though very rare, this may cause some diagnostic difficulties and lead to injury of the urinary tract. For this reason, we want to further discuss this complication following a diagnostic procedure on the example of two cases of pelvicalyceal system duplication with ectopic ureter.

MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder

Energy Technology Data Exchange (ETDEWEB)

Schaeffeler, Christoph [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kantonsspital Graubuenden, Musculoskeletal Imaging, Chur (Switzerland); Waldt, Simone; Bauer, Jan S.; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kirchhoff, Chlodwig [Technische Universitaet Muenchen, Department of Traumatology, Munich (Germany); Haller, Bernhard [Technische Universitaet Muenchen, Institute for Medical Statistics and Epidemiology, Munich (Germany); Schroeder, Michael [Center for Sports Orthopedics and Medicine, Orthosportiv, Munich (Germany); Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Orthopedic Sports Medicine, Munich (Germany)

2014-06-15

To evaluate diagnostic signs and measurements in the assessment of capsular redundancy in atraumatic multidirectional instability (MDI) of the shoulder on MR arthrography (MR-A) including abduction/external rotation (ABER) images. Twenty-one MR-A including ABER position of 20 patients with clinically diagnosed MDI and 17 patients without instability were assessed by three radiologists. On ABER images, presence of a layer of contrast between the humeral head (HH) and the anteroinferior glenohumeral ligament (AIGHL) (crescent sign) and a triangular-shaped space between the HH, AIGHL and glenoid (triangle sign) were evaluated; centring of the HH was measured. Anterosuperior herniation of the rotator interval (RI) capsule and glenoid version were determined on standard imaging planes. The crescent sign had a sensitivity of 57 %/62 %/48 % (observers 1/2/3) and specificity of 100 %/100 %/94 % in the diagnosis of MDI. The triangle sign had a sensitivity of 48 %/57 %/48 % and specificity of 94 %/94 %/100 %. The combination of both signs had a sensitivity of 86 %/90 %/81 % and specificity of 94 %/94 %/94 %. A positive triangle sign was significantly associated with decentring of the HH. Measurements of RI herniation, RI width and glenoid were not significantly different between both groups. Combined assessment of redundancy signs on ABER position MR-A allows for accurate differentiation between patients with atraumatic MDI and patients with clinically stable shoulders; measurements on standard imaging planes appear inappropriate. (orig.)

Value measurement of nuclear medicine procedures

International Nuclear Information System (INIS)

Potchen, E.J.; Harris, G.I.; Schonbein, W.R.; Rashford, N.J.

1977-01-01

The difficulty in measuring the benefit component for cost/benefit analysis of diagnostic procedures in medicine is portrayed as a complex issue relating the objective of intent to a classification of types of decisions a physician must make in evaluating a patient's problem. Ultimately, it seems desirable to develop measuring instruments such as attitude measurement tools by which the relative value of alternative diagnostic procedures could be measured in terms of what they contribute to diminishing the patient's personal perception of disease. Even without this idealized objective, it is reasonable to assume that diagnostic tests which do not contain information, defined as a change in the randomness of a state of knowledge, could not be expected to ultimately benefit the patient. Thus diagnostic information should provide a rational direction for the physician to modify the course of the patient's illness. Since information can be measured as a change in randomness of a knowledge state, we can determine the information content of a specific nuclear medicine procedure when faced with an array of diagnostic problems. These measurements remain to be made for clinical nuclear medicine procedures and are currently under study

Human rather than ape-like orbital morphology allows much greater lateral visual field expansion with eye abduction

Science.gov (United States)

Denion, Eric; Hitier, Martin; Levieil, Eric; Mouriaux, Frédéric

2015-01-01

While convergent, the human orbit differs from that of non-human apes in that its lateral orbital margin is significantly more rearward. This rearward position does not obstruct the additional visual field gained through eye motion. This additional visual field is therefore considered to be wider in humans than in non-human apes. A mathematical model was designed to quantify this difference. The mathematical model is based on published computed tomography data in the human neuro-ocular plane (NOP) and on additional anatomical data from 100 human skulls and 120 non-human ape skulls (30 gibbons; 30 chimpanzees / bonobos; 30 orangutans; 30 gorillas). It is used to calculate temporal visual field eccentricity values in the NOP first in the primary position of gaze then for any eyeball rotation value in abduction up to 45° and any lateral orbital margin position between 85° and 115° relative to the sagittal plane. By varying the lateral orbital margin position, the human orbit can be made “non-human ape-like”. In the Pan-like orbit, the orbital margin position (98.7°) was closest to the human orbit (107.1°). This modest 8.4° difference resulted in a large 21.1° difference in maximum lateral visual field eccentricity with eyeball abduction (Pan-like: 115°; human: 136.1°). PMID:26190625

Efficacy of clinical diagnostic procedures utilized in nuclear medicine. Nine month progress report

Energy Technology Data Exchange (ETDEWEB)

None

1978-01-01

This study is designed to determine the efficacy of nuclear medicine procedures in clinical practice. Several methods of determining efficacy will be evaluated to determine those most suitable. Nuclear medicine methods will be confined to the study of lung diseases by pulmonary perfusion and ventilation. In addition to evaluating the above methods data will be obtained to determine the sensitivity, specificity, predictive value and efficiency of the test under consideration. These values, corrected for prevalence of the disease processes under consideration will then be compared to the values obtained by the MACRO and MICRO methods and will help to bound the clinical reliability of the diagnostic method depending on the degree to which the several methods trend together. Depending on the practicality of these two methods, in addition to the determination of efficacy, cost effectiveness factors and benefit-risk estimates which are used to apply to radiation effects will be determined for nuclear medicine studies of the brain, bone, heart, liver and thyroid subsequently. The measurement techniques will then be utilized to establish guidelines for the most useful applications of the given procedure so that clinicians will be able to obtain a pretest estimate of the utility of the nuclear medicine test.

Effects of augmented trunk stabilization with external compression support on shoulder and scapular muscle activity and maximum strength during isometric shoulder abduction.

Science.gov (United States)

Jang, Hyun-jeong; Kim, Suhn-yeop; Oh, Duck-won

2015-04-01

The aim of the present study was to investigate the effects of augmented trunk stabilization with external compression support (ECS) on the electromyography (EMG) activity of shoulder and scapular muscles and shoulder abductor strength during isometric shoulder abduction. Twenty-six women volunteered for the study. Surface EMG was used to monitor the activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and middle deltoid (MD), and shoulder abductor strength was measured using a dynamometer during three experimental conditions: (1) no external support (condition-1), (2) pelvic support (condition-2), and (3) pelvic and thoracic supports (condition-3) in an active therapeutic movement device. EMG activities were significantly lower for UT and higher for MD during condition 3 than during condition 1 (p strength was significantly higher during condition 3 than during condition 1 (p isometric shoulder abduction and increasing shoulder abductor strength. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Framework to Debug Diagnostic Matrices

Science.gov (United States)

Kodal, Anuradha; Robinson, Peter; Patterson-Hine, Ann

2013-01-01

Diagnostics is an important concept in system health and monitoring of space operations. Many of the existing diagnostic algorithms utilize system knowledge in the form of diagnostic matrix (D-matrix, also popularly known as diagnostic dictionary, fault signature matrix or reachability matrix) gleaned from physical models. But, sometimes, this may not be coherent to obtain high diagnostic performance. In such a case, it is important to modify this D-matrix based on knowledge obtained from other sources such as time-series data stream (simulated or maintenance data) within the context of a framework that includes the diagnostic/inference algorithm. A systematic and sequential update procedure, diagnostic modeling evaluator (DME) is proposed to modify D-matrix and wrapper logic considering least expensive solution first. This iterative procedure includes conditions ranging from modifying 0s and 1s in the matrix, or adding/removing the rows (failure sources) columns (tests). We will experiment this framework on datasets from DX challenge 2009.

Triggering radiation alarm at security checks. Patients should be informed even after diagnostic nuclear medicine procedures.

Science.gov (United States)

Palumbo, Barbara; Neumann, Irmgard; Havlik, Ernst; Palumbo, Renato; Sinzinger, Helmut

2009-01-01

During the last few years an increasing number of nuclear medicine patients in various countries evoked a radiation alarm after therapeutic or diagnostic procedures, and even after passive exposure. A prospective calculation of activity retention in the patient's body is difficult due to extremely high variation of uptake and kinetics. Furthermore, different sensitivities and distances of the detectors make a prospective calculation even more difficult. In this article a number of cases are being reported, related problems are discussed and the surprisingly very limited literature reviewed. In order to minimize problems after eventually triggering alarms, we strongly recommend that each patient receives a certificate providing personal data, tracer, dose, half-life of the radionuclide, type and date of procedure applied as well as the nuclear medicine unit to contact for further information. Furthermore, a closer cooperation and exchange of information between the authorities and local nuclear medicine societies, would be welcome.

The impact of altering filling pressures in diagnostic outpatient hysteroscopy on the procedure completion rates and associated pain: a randomised double-blind controlled trial.

Science.gov (United States)

Haggag, Hisham M; Hassan, AbdelGany M A

2016-02-01

Several studies have compared different distension media and analgesics to optimise the efficiency of outpatient hysteroscopy. However, studies comparing different uterine filling pressures are scarce. The objective of this study was to evaluate and compare different uterine filling pressures during diagnostic outpatient hysteroscopy in an attempt to find the optimal pressure allowing adequate visualisation while minimising pain and increasing patient satisfaction. This was a double-blind randomised controlled trial. A total of 240 women who had diagnostic outpatient hysteroscopy were randomly divided into three equal groups: the uterine filling pressure was 30 mm Hg in group 1, 50 mm Hg in group 2 and 80 mm Hg in group 3. The primary outcome was adequate visualisation, and secondary outcomes were the proportion of completed procedures, pain perceived during the procedure, immediately after the procedure and 30 min later. Adequate visualisation was lower in group 1 (88.7% vs 97.5% and 98.7%; P = 0.009), but was not different between groups 2 and 3 (P > 0.999). The proportion of completed procedures was not different among the groups. There was a progressive increase in pain scores from the lower to the higher pressure groups during the procedure, immediately after the procedure and 30 min after completing the procedure. Uterine filling pressure of 50 mm Hg was associated with better visualisation than 30 mm Hg and lower pain scores than that of 80 mmHg with no difference in the proportion of completed procedures. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Estimate of the Effective Dose Equivalent to the Cypriot Population due to Diagnostic Nuclear Medicine Procedures in the Public Sector

Energy Technology Data Exchange (ETDEWEB)

Christofides, S [Medical Physics Department, Nicosia General Hospital (Cyprus)

1994-12-31

The Effective Dose Equivalent (EDE) to the Cypriot population due to Diagnostic Nuclear Medicine procedures has been estimated from data published by the Government of Cyprus, in its Health and Hospital Statistics Series for the years 1990, 1991, and 1992. The average EDE per patient was estimated to be 3,09, 3,75 and 4,01 microSievert for 1990, 1991 and 1992 respectively, while the per caput EDE was estimated to be 11,75, 15,16 and 17,09 microSieverts for 1990, 1991 and 1992 respectively, from the procedures in the public sector. (author). 11 refs, 4 tabs.

Estimate of the Effective Dose Equivalent to the Cypriot Population due to Diagnostic Nuclear Medicine Procedures in the Public Sector

International Nuclear Information System (INIS)

Christofides, S.

1994-01-01

The Effective Dose Equivalent (EDE) to the Cypriot population due to Diagnostic Nuclear Medicine procedures has been estimated from data published by the Government of Cyprus, in its Health and Hospital Statistics Series for the years 1990, 1991, and 1992. The average EDE per patient was estimated to be 3,09, 3,75 and 4,01 microSievert for 1990, 1991 and 1992 respectively, while the per caput EDE was estimated to be 11,75, 15,16 and 17,09 microSieverts for 1990, 1991 and 1992 respectively, from the procedures in the public sector. (author)

CT fluoroscopy-guided renal tumour cutting needle biopsy: retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure.

Science.gov (United States)

Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu

2018-01-01

To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. • CT fluoroscopy-guided renal tumour biopsy has a high diagnostic yield. • CT fluoroscopy-guided renal tumour biopsy is safe. • Small tumour size (≤1.5 cm) is a risk factor for diagnostic failure.

Differentiating subluxation from developmental dislocation of the hip

Directory of Open Access Journals (Sweden)

Joao O. Tavares

2012-02-01

Full Text Available The radiological and clinical picture of a developmental hip dislocation and a severe subluxation are identical. According to Leveuf and Wiberg the diagnosis can only be made by arthrography. The differential diagnosis is critical, as treatment differs dependent on the diagnosis. In this study, the diagnosis of subluxation was based on a plain radiograph of the pelvis. A radiograph of the pelvis with the hips abducted at least 45° and internally rotated (AIR view was used to differentiate these two entities. In subluxations, the femoral head will relocate into the acetabulum with perfect or near perfect reconstitution of the Shenton’s line. It will fail to do so in true dislocations. Five patients, mean age 14.6 months (range 9 to 20 months, presented with delayed diagnosis of hip dysplasia. The examination revealed minimal or no limitation of hip abduction, a leg length discrepancy, and a Trendelenburg gait in the three walking age girls. The radiograph suggested a hip dislocation. The diagnosis of hip subluxation was based on the relocation of the femoral head with the abduction/internal rotation radiograph. All were successfully treated with an Ilfeld abduction splint. None had examination with general anesthesia, arthrograms, traction or immobilization in spica cast. Avoiding over diagnosis of hip dislocation in cases of subluxation is important. This is necessary to prevent overtreatment and to accurately assess the results of treatment. The abduction/internal rotation view may achieve this goal while avoiding diagnostic and therapeutic procedures, such as arthrograms, cast immobilization and surgery.

Rotator cuff tears: should abduction and external rotation (ABER) positioning be performed before image acquisition? A CT arthrography study

Energy Technology Data Exchange (ETDEWEB)

Cochet, Hubert [Hopital Cardiologique du Haut-Leveque, CHU Bordeaux, Unite d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Couderc, Stephane; Pele, Eric; Moreau-Durieux, Marie-Helene; Hauger, Olivier [Hopital Pellegrin, CHU Bordeaux, Unite d' Imagerie Osteo-articulaire, Bordeaux (France); Amoretti, Nicolas [CHU Archet, Unite d' Imagerie Osteo-articulaire, Nice (France)

2010-05-15

To evaluate the impact of abduction and external rotation (ABER) positioning performed before image acquisition on the assessment of rotator cuff tears. Twenty-seven consecutive patients with clinically suspected rotator cuff tears underwent an initial CT arthrogram of the shoulder in neutral position, immediately followed by temporary ABER positioning, before a second CT acquisition in neutral position. Two observers blinded to potential pre-procedure ABER positioning independently analysed the randomly distributed images. Lesions were classified into partial-thickness (PT) and full-thickness (FT) tear subtypes. Lesion detection and measurements of pre- and post-ABER studies were compared. We found no influence of pre-test ABER positioning on FT detection or measurements. Every PT detected on pre-ABER study was also detected on post-ABER study (28/28 for reader 1, and 32/32 for reader 2). Seven and eight additional PT were found by readers 1 and 2, respectively, on post-ABER study. Lesion size increased after ABER in terms of area (P < 0.001 for both readers) and Ellman's grade (P = 0.02 and 0.002 for reader 1 and 2, respectively). ABER positioning before CT is associated with improved delineation of partial tears, a higher number of detected tears and modification of treatment planning. (orig.)

21 CFR 886.1380 - Diagnostic condensing lens.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic condensing lens. 886.1380 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1380 Diagnostic condensing lens. (a) Identification. A diagnostic condensing lens is a device used in binocular indirect ophthalmoscopy (a procedure...

Exposure to rays and radiation hazards in connection with diagnostic X-ray procedures in children

International Nuclear Information System (INIS)

Protzer, K.

1988-01-01

In this study, figures and data about radiation exposures for diagnostic purposes are surveyed that were collected in connection with X-ray procedures in children. The data were sorted according to body regions and techniques required for their examination so as to permit separate analyses of procedures in the urogenital tract (intravenous urogramme, micturition cystourethrography), thorax (angiocardiogramme, thoractic aortogramme, examinations using cardiac catheters), gastrointestinal system (fluoroscopy and contrast-enhanced irrigoscopy), pelvis (survey radiography), skull (computed tomography) as well as in miscellaneous group of further origins. The second part of the report discusses the uncertainties surrounding the assessment of radiation hazards and indicated radiation doses. A formula is represented for the calculation of life-time reductions that can be applied to any type of cancer and embraces a number of factors like life expectancy at age X, the patient's age at the time of radiotherapy, the five-year-survival rate for the condition under investigation and the diseased organ. At the end of the study, some methods are pointed out that may be helpful in limiting radiation exposure. (KST) [de

A case study of the abductive reasoning processes of pre-service elementary education students in a role playing setting concerning a mock senate hearing on global climate change

Science.gov (United States)

Petty, Michael Eugene

Science education has a rich history of studies into the impact of analogical reasoning upon researcher and student alike. These have focused on how induction and deduction are utilized in determining the appropriateness of the analogy being scrutinized. Research in artificial intelligence has demonstrated that human cognition cannot be modeled with only inductive and deductive forms of logic. Charles S. Peirce proposed abduction as a form of logic central to the process of inquiry and discovery. This involves reasoning from observation to best explanation or hypothesis. Peirce's Theory of Signs provided the theoretical foundation and a model of abduction developed by Shank and Cunningham from Peirce's theory offered the conceptual basis for the study. This study uses discourse analysis to attempt to understand the abductive reasoning processes of two groups of students as they interpret new information concerning the political and scientific perspective of the Greening Earth Society and the Center for Disease Control in an authentic, undergraduate-level classroom setting. The five students were members of a capstone course in science education for pre-service elementary education majors who had an interest in science education. The entire class was comprised of fourteen students partitioned into five groups for the culminating exercise for the course. Analysis was carried out using journal entries, audiotapes of planning sessions, a brief summary of their understanding, and videotapes of the mock Senate hearings. The results demonstrated that different members of the group arrived at their understanding using different pathways suggested by the model. While some proceeded linearly, others skipped some stages and later came back to find supportive evidence to strengthen their beliefs. The model is useful in understanding their abductive processes and may provide insight into how we might consider the process in the design of future curriculum for elementary science

Sedation with detomidine and acepromazine influences the endoscopic evaluation of laryngeal function in horses.

Science.gov (United States)

Lindegaard, C; Husted, L; Ullum, H; Fjeldborg, J

2007-11-01

Endoscopy of the upper airways of horses is used as a diagnostic tool and at purchase examinations. On some occasions it is necessary to use sedation during the procedure and it is often speculated that the result of the examination might be influenced due to the muscle-relaxing properties of the most commonly used sedatives. To evaluate the effect of detomidine (0.01 mg/kg bwt) and acepromazine (0.05 mg/kg bwt) on the appearance of symmetry of rima glottidis, ability to abduct maximally the arytenoid cartilages and the effect on recurrent laryngeal neuropathy (RLN) grade. Forty-two apparently normal horses underwent endoscopic examination of the upper airways on 3 different occasions, under the influence of 3 different treatments: no sedation (control), sedation with detomidine and sedation with acepromazine. All examinations were performed with a minimum of one week apart. The study was performed as an observer-blind cross-over study. Sedation with detomidine had a significant effect on the RLN grading (OR = 2.91) and ability maximally to abduct the left arytenoid cartilages (OR = 2.91). Sedation with acepromazine resulted in OR = 2.43 for the RLN grading and OR = 2.22 for the ability to abduct maximally. The ability to abduct maximally the right arytenoid cartilage was not altered. Sedating apparently healthy horses with detomidine or acepromazine significantly impairs these horses' ability to abduct fully the left but not the right arytenoid cartilage. This resulted in different diagnosis with respect to RLN when comparing sedation to no sedation. Since the ability to abduct the right arytenoid cartilage fully is not altered by sedation, it is speculated that horses changing from normal to abnormal laryngeal function when sedated, might be horses in an early stage of the disease. To confirm or reject these speculations, further studies are needed. Until then sedation during endoscopy should be used with care.

Costs, charges, and revenues for hospital diagnostic imaging procedures: differences by modality and hospital characteristics.

Science.gov (United States)

Sistrom, Christopher Lee; McKay, Niccie L

2005-06-01

This study examined financial data reported by Florida hospitals concerning costs, charges, and revenues related to imaging services. Financial reports to the Florida Hospital Uniform Reporting System by all licensed acute care facilities for fiscal year 2002 were used to calculate four financial indices on a per procedure basis. These included charge, net revenue, operating expense (variable cost), and contribution margin. Analysis, stratified by cost center (imaging modality), tested the effects of bed size, ownership, teaching status, and urban or rural status on the four indices. The mean operating expense and charge per procedure were as follows: computed tomography (CT): $51 and $1565; x-ray and ultrasound: $55 and $410; nuclear medicine (NM): $135 and $1138; and magnetic resonance imaging (MRI): $165 and $2048. With all four modalities, for-profit hospitals had higher charges than not-for-profit and public facilities. Excepting NM, however, the difference by ownership disappeared when considering net revenue. Operating expense did not differ by ownership type or bed size. Operating expense (variable cost) per procedure is considerably lower for CT than for MRI. Consequently, when diagnostically equivalent, CT is preferable to MRI in terms of costs for hospitals. If the cost structure of nonhospital imaging is at all similar to hospitals, the profit potential for performing CT and MRI seems to be substantial, which has relevance to the issue of imaging self-referral.

Procedural sedation analgesia

OpenAIRE

Sheta, Saad A

2010-01-01

The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA). The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interve...

Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain.

Science.gov (United States)

Cadogan, Angela; McNair, Peter J; Laslett, Mark; Hing, Wayne A

2016-01-01

The diagnosis of subacromial pathology is limited by the poor accuracy of clinical tests for specific pathologies. The aim of this study was to estimate the diagnostic accuracy of clinical examination and imaging features for identifying subacromial pain (SAP) defined by a positive response to diagnostic injection, and to evaluate the influence of imaging findings on the clinical diagnosis of SAP. In a prospective, diagnostic accuracy design, 208 consecutive patients presenting to their primary healthcare practitioner for the first time with a new episode of shoulder pain were recruited. All participants underwent a standardized clinical examination, shoulder x-ray series and diagnostic ultrasound scan. Results were compared with the response to a diagnostic block of xylocaineTM injected into the SAB under ultrasound guidance using ≥80% post-injection reduction in pain intensity as the positive anaesthetic response (PAR) criterion. Diagnostic accuracy statistics were calculated for combinations of clinical and imaging variables demonstrating the highest likelihood of a PAR. A PAR was reported by 34% of participants. In participants with no loss of passive external rotation, combinations of three clinical variables (anterior shoulder pain, strain injury, absence of symptoms at end-range external rotation (in abduction)) demonstrated 100% specificity for a PAR when all three were positive (LR+ infinity; 95%CI 2.9, infinity). A full-thickness supraspinatus tear on ultrasound increased the likelihood of a PAR irrespective of age (specificity 98% (95%CI 94, 100); LR+ 6.2; 95% CI 1.5, 25.7)). Imaging did not improve the ability to rule-out a PAR. Combinations of clinical examination findings and a full-thickness supraspinatus tear on ultrasound scan can help confirm, but not exclude, the presence of subacromial pain. Other imaging findings were of limited value for diagnosing SAP.

Competence and lastingness in specialized clinical laboratories: technical report about requirements concerning quality of users competence and used processes in immunochemical diagnostic procedures using isotopic and non-isotopic tracer technologies

International Nuclear Information System (INIS)

Wiegel, B.

2005-01-01

From the citizens view this technical report about immunochemical diagnostic procedures using radioactive and nonradioactive tracer technologies describes the requirements in special laboratory diagnostics concerning competency and process control. Governmental or administrational obligations of inspecting both skill and sites to guarantee patients security are pointed out. (orig.)

Dose evaluation in medical staff during diagnostics procedures in interventional radiology; Avaliacao da dose na equipe medica durante procedimentos diagnoticos de radiologia intervencionista

Energy Technology Data Exchange (ETDEWEB)

Bacchim Neto, Fernando A.; Alves, Allan F.F.; Rosa, Maria E.D.; Miranda, Jose R.A. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencias. Departamento de Fisica e Biofisica; Moura, Regina [Faculdade de Medicina de Botucatu, SP (Brazil). Departamento de Cirurgia e Ortopedia; Pina, Diana R., E-mail: bacchim@ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Doencas Tropicais e Diagnostico por Imagem

2014-08-15

Studies show that personal dosimeters may underestimate the dose values in interventional physicians, especially in extremities and crystalline. The objective of this work was to study the radiation exposure levels of medical staff in diagnostic interventional radiology procedures. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were placed in different regions of the physician body. When comparing with reference dose levels, the maximum numbers of annual procedures were found. This information is essential to ensure the radiological protection of those professionals. (author)

Contact mechanics of reverse total shoulder arthroplasty during abduction: the effect of neck-shaft angle, humeral cup depth, and glenosphere diameter.

Science.gov (United States)

Langohr, G Daniel G; Willing, Ryan; Medley, John B; Athwal, George S; Johnson, James A

2016-04-01

Implant design parameters can be changed during reverse shoulder arthroplasty (RSA) to improve range of motion and stability; however, little is known regarding their impact on articular contact mechanics. The purpose of this finite element study was to investigate RSA contact mechanics during abduction for different neck-shaft angles, glenosphere sizes, and polyethylene cup depths. Finite element RSA models with varying neck-shaft angles (155°, 145°, 135°), sizes (38 mm, 42 mm), and cup depths (deep, normal, shallow) were loaded with 400 N at physiological abduction angles. The contact area and maximum contact stress were computed. The contact patch and the location of maximum contact stress were typically located inferomedially in the polyethylene cup. On average for all abduction angles investigated, reducing the neck-shaft angle reduced the contact area by 29% for 155° to 145° and by 59% for 155° to 135° and increased maximum contact stress by 71% for 155° to 145° and by 286% for 155° to 135°. Increasing the glenosphere size increased the contact area by 12% but only decreased maximum contact stress by 2%. Decreasing the cup depth reduced the contact area by 40% and increased maximum contact stress by 81%, whereas increasing the depth produced the opposite effect (+52% and -36%, respectively). The location of the contact patch and maximum contact stress in this study matches the area of damage seen frequently on clinical retrievals. This finding suggests that damage to the inferior cup due to notching may be potentiated by contact stresses. Increasing the glenosphere diameter improved the joint contact area and did not affect maximum contact stress. However, although reducing the neck-shaft angle and cup depth can improve range of motion, our study shows that this also has some negative effects on RSA contact mechanics, particularly when combined. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc

Diagnostic Procedures to Detect Chlamydia trachomatis Infections

Directory of Open Access Journals (Sweden)

Thomas Meyer

2016-08-01

Full Text Available The intracellular life style of chlamydia and the ability to cause persistent infections with low-grade replication requires tests with high analytical sensitivity to directly detect C. trachomatis (CT in medical samples. Nucleic acid amplification tests (NAATs are the most sensitive assays with a specificity similar to cell culture and are considered the method of choice for CT detection. In addition, NAATs can be performed on various clinical specimens that do not depend on specific transport and storage conditions, since NAATs do not require infectious bacteria. In the case of lower genital tract infections, first void urine and vaginal swabs are the recommended specimens for testing males and females, respectively. Infections of anorectal, oropharyngeal and ocular epithelia should also be tested by NAAT analysis of corresponding mucosal swabs. In particular, anorectal infections of men who have sex with men (MSM should include evaluation of lymphogranuloma venereum (LGV by identification of genotypes L1, L2 or L3. Detection of CT antigens by enzyme immunoassay (EIAs or rapid diagnostic tests (RDTs are unsuitable due to insufficient sensitivity and specificity. Recent PCR-based RDTs, however, are non-inferior to standard NAATs, and might be used at the point-of-care. Serology finds application in the diagnostic work-up of suspected chronic CT infection but is inappropriate to diagnose acute infections.

Comparative studies of imaging procedures: What is the contribution of CT?

International Nuclear Information System (INIS)

Witte, G.; Buecheler, E.

1990-01-01

Within the field of diagnostic imaging, CT and MR are competing procedures, each of which has particular advantages in specific diagnostic situations. Knowledge of these advantages is helpful in deciding upon a diagnostic procedure. We evaluate the indications for CT according to area of examination. (orig.) [de

Magnetic resonance appearance of posterosuperior labral peel back during humeral abduction and external rotation.

Science.gov (United States)

Borrero, Camilo G; Casagranda, Bethany U; Towers, Jeffrey D; Bradley, James P

2010-01-01

To describe the magnetic resonance appearance of posterosuperior labral peel back and determine the reliability of MR in the abducted and externally rotated (ABER) position for the prospective diagnosis of arthroscopically proven cases of posterosuperior labral peel back. After approval by the institutional review board (IRB) of the University of Pittsburgh Medical Center, USA, databases of patients who underwent arthroscopy over a 2-year period for one of three clinical diagnoses [suspected type 2 superior labrum anterior to posterior (SLAP) tears, posterior instability, or multidirectional instability] were reviewed after anonymization by an honest broker. Sixty-three cases were selected by the following inclusion criteria: operative report documenting labral peel back in the ABER position, age position (n=34). Inclusion criteria for the control group differed from those for the case group insofar as the operative note documented the absence of posterosuperior labral peel back (n=29). Cases and controls were randomized in one list and evaluated independently by two fellowship-trained musculoskeletal radiologists unaware of the surgical results and using a three-point grading system (0 = posterosuperior labrum normally positioned lateral/craniad to glenoid articular plane in ABER; 1 = posterosuperior labral tissue flush with the glenoid articular plane in ABER; 2 = posterosuperior labral tissue identified medial/caudal to glenoid articular plane in ABER). Only one image in ABER showing abnormal posterosuperior labral position was required for a grade of 1 or 2 to be assigned. Sensitivity, specificity, and positive and negative predictive value were calculated as well as the level of agreement between readers (kappa). Both readers assigned a grade of 2 to 25 of 34 patients with surgically proven labral peel back. Of the patients with surgically proven SLAP tears with peel back in ABER, reader A assigned a grade of 1 to seven patients and a grade of 0 to two

Radiological, sonographic and radionuclide diagnostics in headache syndrome

International Nuclear Information System (INIS)

Scheibler, C.; Pink, V.; Luettschwager, L.; Zur, C.

1987-01-01

The complex diagnostics of the headache syndrome is taken as an example for the necessity to apply imaging procedures in a purposeful way in diagnostic strategy. Cooperation of the clinical partners involved is of particular importance in control of the diagnostic process

DYNAMIC HIP ADDUCTION, ABDUCTION AND ABDOMINAL EXERCISES FROM THE HOLMICH GROIN-INJURY PREVENTION PROGRAM ARE INTENSE ENOUGH TO BE CONSIDERED STRENGTHENING EXERCISES - A CROSS-SECTIONAL STUDY

DEFF Research Database (Denmark)

Krommes, Kasper; Bandholm, Thomas; Jakobsen, Markus D

2017-01-01

and external obliques during isometric adduction against a football placed between the ankles (IBA), isometric adduction against a football placed between the knees (IBK), folding knife (FK), cross-country skiing on one leg (CCS), adduction partner (ADP) and abduction partner (ABP). The EMG-signals were...

Diagnostic and therapeutic peroral cholangioscopy

Directory of Open Access Journals (Sweden)

Jong Ho Moon

2012-01-01

Full Text Available Peroral cholangioscopy (POC provides direct visualization of the bile duct and facilitates diagnostic or therapeutic intervention. The currently available single-operator POC systems are "Mother-baby" scope system, SpyGlass direct visualization system, and direct POC using a regular ultra-slim upper endoscope. Direct POC using an ultra-slim upper endoscope having a larger 2-mm working channel can provide a valuable and economic solution for evaluating bile-duct lesions. Main diagnostic procedures under direct POC are visual characterization and optically guided target biopsy for the indeterminate bile duct lesion. Image-enhanced endoscopy such as narrow-band imaging has shown promise for more detailed evaluation of mucosal abnormality and can be performed under direct POC. Intracorporeal lithotripsy such as electrohydraulic lithotripsy or laser lithotripsy is a main therapeutic intervention of direct POC for patients with bile duct stones that are resistant to conventional endoscopic stone-removal procedures. Besides, tumor ablation therapy, such as photodynamic therapy and argon plasma coagulation may be also performed using direct POC. Further developments of the endoscope and specialized accessories or devices are expected to facilitate diagnostic and therapeutic role of this cholangioscopic procedure.

A systematic review of the diagnostic performance of orthopedic physical examination tests of the hip.

Science.gov (United States)

Rahman, Labib Ataur; Adie, Sam; Naylor, Justine Maree; Mittal, Rajat; So, Sarah; Harris, Ian Andrew

2013-08-30

Previous reviews of the diagnostic performances of physical tests of the hip in orthopedics have drawn limited conclusions because of the low to moderate quality of primary studies published in the literature. This systematic review aims to build on these reviews by assessing a broad range of hip pathologies, and employing a more selective approach to the inclusion of studies in order to accurately gauge diagnostic performance for the purposes of making recommendations for clinical practice and future research. It specifically identifies tests which demonstrate strong and moderate diagnostic performance. A systematic search of Medline, Embase, Embase Classic and CINAHL was conducted to identify studies of hip tests. Our selection criteria included an analysis of internal and external validity. We reported diagnostic performance in terms of sensitivity, specificity, predictive values and likelihood ratios. Likelihood ratios were used to identify tests with strong and moderate diagnostic utility. Only a small proportion of tests reported in the literature have been assessed in methodologically valid primary studies. 16 studies were included in our review, producing 56 independent test-pathology combinations. Two tests demonstrated strong clinical utility, the patellar-pubic percussion test for excluding radiologically occult hip fractures (negative LR 0.05, 95% Confidence Interval [CI] 0.03-0.08) and the hip abduction sign for diagnosing sarcoglycanopathies in patients with known muscular dystrophies (positive LR 34.29, 95% CI 10.97-122.30). Fifteen tests demonstrated moderate diagnostic utility for diagnosing and/or excluding hip fractures, symptomatic osteoarthritis and loosening of components post-total hip arthroplasty. We have identified a number of tests demonstrating strong and moderate diagnostic performance. These findings must be viewed with caution as there are concerns over the methodological quality of the primary studies from which we have extracted our

Automatic fitting of Gaussian peaks using abductive machine learning

Science.gov (United States)

Abdel-Aal, R. E.

1998-02-01

Analytical techniques have been used for many years for fitting Gaussian peaks in nuclear spectroscopy. However, the complexity of the approach warrants looking for machine-learning alternatives where intensive computations are required only once (during training), while actual analysis on individual spectra is greatly simplified and quickened. This should allow the use of simple portable systems for fast and automated analysis of large numbers of spectra, particularly in situations where accuracy may be traded for speed and simplicity. This paper proposes the use of abductive networks machine learning for this purpose. The Abductory Induction Mechanism (AIM) tool was used to build models for analyzing both single and double Gaussian peaks in the presence of noise depicting statistical uncertainties in collected spectra. AIM networks were synthesized by training on 1000 representative simulated spectra and evaluated on 500 new spectra. A classifier network determines the multiplicity of single/double peaks with an accuracy of 5.8%. With statistical uncertainties corresponding to a peak count of 100, average percentage absolute errors for the height, position, and width of single peaks are 4.9, 2.9, and 4.2%, respectively. For double peaks, these average errors are within 7.0, 3.1, and 5.9%, respectively. Models have been developed which account for the effect of a linear background on a single peak. Performance is compared with a neural network application and with an analytical curve-fitting routine, and the new technique is applied to actual data of an alpha spectrum.

Automatic fitting of Gaussian peaks using abductive machine learning

International Nuclear Information System (INIS)

Abdel-Aal, R.E.

1998-01-01

Analytical techniques have been used for many years for fitting Gaussian peaks in nuclear spectroscopy. However, the complexity of the approach warrants looking for machine-learning alternatives where intensive computations are required only once (during training), while actual analysis on individual spectra is greatly simplified and quickened. This should allow the use of simple portable systems for fast and automated analysis of large numbers of spectra, particularly in situations where accuracy may be traded for speed and simplicity. This paper proposes the use of abductive networks machine learning for this purpose. The Abductory Induction Mechanism (AIM) tool was used to build models for analyzing both single and double Gaussian peaks in the presence of noise depicting statistical uncertainties in collected spectra. AIM networks were synthesized by training on 1,000 representative simulated spectra and evaluated on 500 new spectra. A classifier network determines the multiplicity of single/double peaks with an accuracy of 98%. With statistical uncertainties corresponding to a peak count of 100, average percentage absolute errors for the height, position, and width of single peaks are 4.9, 2.9, and 4.2%, respectively. For double peaks, these average errors are within 7.0, 3.1, and 5.9%, respectively. Models have been developed which account for the effect of a linear background on a single peak. Performance is compared with a neural network application and with an analytical curve-fitting routine, and the new technique is applied to actual data of an alpha spectrum

Quality control in diagnostic radiology - patient dosimetry

Energy Technology Data Exchange (ETDEWEB)

Prlic, I; Radalj, Z; Brumen, V; Cerovac, H [Institute for Medical Research and Occupational Health, Laboratory for Radiation Protection and Dosimetry, Zagreb (Croatia); Gladic, J [Institute for Physics, Laboratory for Solid State Physics, Zagreb (Croatia); Tercek, V [Clinical Hospital Sisters of Mercy, Health Physics Department, Zagreb (Croatia)

1997-12-31

In order to establish the Quality Criteria for diagnostic radiographic images in the radiology departments in Republic of Croatia we have started the several Quality Control projects on the field. The measurements are performed according to some methodology recommendations in our law but the methodology, measurement principles, measurement equipment, phantoms, measurable parameters for the good use by radiographers, statistical and numerical evaluation, dosimetric philosophy etc. where first recognized as a private/or group hazard of each person involved in the procedure of evaluation of diagnostic radiology images/diagnosis. The important quality elements of the imaging process are: the diagnostic quality of the radiographic image, the radiation dose to the patient and the choice of the radiographic technique. This depends on the x-ray unit (tube) radiation quality, image processing quality and final image evaluation quality. In this paper we will show how the Quality Control measurements can be easily connected to the dose delivered to the patient for the known diagnostic procedure and how this can be used by radiographers in their daily work. The reproducibility of the x-ray generator was checked before the service calibration and after the service calibration. The table of kV dependence and output dose per mAs was calculated and the ESD (entrance surface dose) was measured/calculated for the specific diagnostic procedure. After the phantom calculation were made and the dose prediction for the given procedure was done, measurements were done on the patients (digital dosemeters, TLD and film dosemeter combinations). We are claiming that there is no need to measure each patient if the proper Quality Control measurements are done and the proper table of ESD for each particular x-ray tube in diagnostic departments is calculated for the radiographers daily use. (author). 1 example, 1 fig., 13 refs.

Evaluation of diagnostic procedures in nuclear medicine services of Pernambuco and Alagoas states - Brazil

International Nuclear Information System (INIS)

Silva, Ricardo Braz F. da; Hazin, Clovis A.

2011-01-01

The medical use of ionizing radiation contributes significantly to population exposure to radiation. This study aimed to evaluate the diagnostic procedures carried out in nuclear medicine (SMN) in Pernambuco and Alagoas in order to gather data to subsidize the proposal of reference levels for nuclear medicine in Brazil. Data were collected of the SMN in Pernambuco and Alagoas in the period of 2005 to 2009, according by UNSCEAR. The study used data from IBGE. The results showed that the total number of examinations in the period 2005 to 2009 was 34.828 in Pernambuco and 27.700 in Alagoas, corresponding to 6.966 and 5.540 average annual examinations in Pernambuco and Alagoas, respectively. The total number of examinations performed in both states in 2009 was twice the number carried out in 2005. Scintigraphy is the cardiovascular examination most performed in both states, followed by bone scintigraphy. Tc-99m is the radionuclide used most often, followed by I-131. The number of tests using Tc-99m in 2009 doubled when compared with the examinations performed in 2005. The results indicate that there has been a significant increase in the number of examinations in MN, and that females outnumber males, as far as the use of this diagnostic resource is concerned. The study of the activities of the radionuclides administered to patients in the states of Pernambuco and Alagoas showed that they are high when compared to the values recommended by the IAEA in its Safety Report Series Document No. 40. (author)

Rak piersi w ciąży - odmienności procesu diagnostyki i leczenia = Breast cancer during pregnancy - differences in diagnostic and treatment procedures

Directory of Open Access Journals (Sweden)

Magdalena Sowa

2016-09-01

- differences in diagnostic and treatment procedures Abstract Introduction: Breast cancer during pregnancy is relatively rare. There has been an increasing trend for young women to delay childbearing for the last ten years. Presently the average age of first-time mothers is 30. Age is one of the factors increasing the risk of breast cancer. The defined clinical situation will appear more often considering the fact that women delay their motherhood where as the average age of breast cancer decreases. Objective: The purpose of this article is to present different diagnostic and treatment procedures of breast cancer diagnosed during pregnancy. Main text: The analysis of epidemiological data points the fact breast cancer is the most often appearing one in pregnant women. The fact that physiological changes in females during pregnancy first weeks may mask cancer is particularly dangerous and may essentially delay diagnostic procedures. Cancer diagnosed during pregnancy is always a traumatic and stressful situation for a woman and her family that is why its diagnostic and treatment procedures are considerably individualized whereas the maximum terapeutical effect with the protection of an unbornchild is the priority of activities. Summary: Therapeutic decisions are made after a review of a health condition of a patient, the extent of spread of cancer, gestational age and demands of the patient and her family. In the article, undertaking a literature review, alternative breast cancer diagnostic and treatment procedures during pregnancy were discussed in details.   Key words: brest cancer, pregnancy, diagnostics procedures, treatment

Magnetic resonance appearance of posterosuperior labral peel back during humeral abduction and external rotation

Energy Technology Data Exchange (ETDEWEB)

Borrero, Camilo G.; Casagranda, Bethany U.; Towers, Jeffrey D. [Department of Radiology, Pittsburgh, PA (United States); Bradley, James P. [Department of Orthopedics, Pittsburgh, PA (United States)

2010-01-15

To describe the magnetic resonance appearance of posterosuperior labral peel back and determine the reliability of MR in the abducted and externally rotated (ABER) position for the prospective diagnosis of arthroscopically proven cases of posterosuperior labral peel back. After approval by the institutional review board (IRB) of the University of Pittsburgh Medical Center, USA, databases of patients who underwent arthroscopy over a 2-year period for one of three clinical diagnoses [suspected type 2 superior labrum anterior to posterior (SLAP) tears, posterior instability, or multidirectional instability] were reviewed after anonymization by an honest broker. Sixty-three cases were selected by the following inclusion criteria: operative report documenting labral peel back in the ABER position, age <40 years, and preceding MR arthrogram evaluations with images in the ABER position (n = 34). Inclusion criteria for the control group differed from those for the case group insofar as the operative note documented the absence of posterosuperior labral peel back (n = 29). Cases and controls were randomized in one list and evaluated independently by two fellowship-trained musculoskeletal radiologists unaware of the surgical results and using a three-point grading system (0 = posterosuperior labrum normally positioned lateral/craniad to glenoid articular plane in ABER; 1 = posterosuperior labral tissue flush with the glenoid articular plane in ABER; 2 = posterosuperior labral tissue identified medial/caudal to glenoid articular plane in ABER). Only one image in ABER showing abnormal posterosuperior labral position was required for a grade of 1 or 2 to be assigned. Sensitivity, specificity, and positive and negative predictive value were calculated as well as the level of agreement between readers (kappa). Both readers assigned a grade of 2 to 25 of 34 patients with surgically proven labral peel back. Of the patients with surgically proven SLAP tears with peel back in ABER

Magnetic resonance appearance of posterosuperior labral peel back during humeral abduction and external rotation

International Nuclear Information System (INIS)

Borrero, Camilo G.; Casagranda, Bethany U.; Towers, Jeffrey D.; Bradley, James P.

2010-01-01

To describe the magnetic resonance appearance of posterosuperior labral peel back and determine the reliability of MR in the abducted and externally rotated (ABER) position for the prospective diagnosis of arthroscopically proven cases of posterosuperior labral peel back. After approval by the institutional review board (IRB) of the University of Pittsburgh Medical Center, USA, databases of patients who underwent arthroscopy over a 2-year period for one of three clinical diagnoses [suspected type 2 superior labrum anterior to posterior (SLAP) tears, posterior instability, or multidirectional instability] were reviewed after anonymization by an honest broker. Sixty-three cases were selected by the following inclusion criteria: operative report documenting labral peel back in the ABER position, age <40 years, and preceding MR arthrogram evaluations with images in the ABER position (n = 34). Inclusion criteria for the control group differed from those for the case group insofar as the operative note documented the absence of posterosuperior labral peel back (n = 29). Cases and controls were randomized in one list and evaluated independently by two fellowship-trained musculoskeletal radiologists unaware of the surgical results and using a three-point grading system (0 = posterosuperior labrum normally positioned lateral/craniad to glenoid articular plane in ABER; 1 = posterosuperior labral tissue flush with the glenoid articular plane in ABER; 2 = posterosuperior labral tissue identified medial/caudal to glenoid articular plane in ABER). Only one image in ABER showing abnormal posterosuperior labral position was required for a grade of 1 or 2 to be assigned. Sensitivity, specificity, and positive and negative predictive value were calculated as well as the level of agreement between readers (kappa). Both readers assigned a grade of 2 to 25 of 34 patients with surgically proven labral peel back. Of the patients with surgically proven SLAP tears with peel back in ABER

Children and young mothers' agency in the context of conflict: a review of the experiences of formerly abducted young people in Northern Uganda.

Science.gov (United States)

Ochen, Eric Awich

2015-04-01

This paper critically examines the experiences of formerly abducted young women during their captivity with the Lord Resistance Army rebels and in the resettlement and reintegration period. Special attention is given to their exercise of agency and choices. Using a qualitative design, narrative interviews were conducted with child mothers (N=21), local and civic actors (N=17), and the general community through focus groups (N=10). Data transcripts were analyzed using template analysis methods to derive meanings and increase understanding of the situation. Abducted children faced significant difficulties during their captivity and also during their resettlement and reintegration process, yet they continued to exhibit strong agency to cope with the new realities. Despite these difficulties, opportunities existed which were utilized by the young people, albeit to different degrees depending on each young person's ability and initiative (agency). Situational factors limiting the child mothers' agency were identified as embedded within the latter's environment. This study raises the importance of appreciation of the young women's agency in both the bush-captivity experience and resettlement and reintegration processes within the community, post-conflict. Copyright © 2015 Elsevier Ltd. All rights reserved.

Anesthesia for radiologic procedures

International Nuclear Information System (INIS)

Forestner, J.E.

1987-01-01

Anesthetic techniques for neurodiagnostic studies and radiation therapy have been recently reviewed, but anesthetic involvement in thoracic and abdominal radiology has received little attention. Patient reactions to radiologic contrast media may be of concern to the anesthesiologist, who is often responsible for injecting these agents during diagnostic procedures, and thus is included in this discussion. Finally, the difficulties of administering anesthesia for magnetic resonance imaging (MRI) scans are outlined, in an effort to help anesthesiologist to anticipate problems with this new technologic development. Although there are very few indications for the use of general anesthesia for diagnostic radiologic studies in adults, most procedures performed with children, the mentally retarded, or the combative adult require either heavy sedation or general anesthesia. In selecting an anesthetic technique for a specific procedure, both the patient's disease process and the requirements of the radiologist must be carefully balanced

Gonad shielding in diagnostic radiology

International Nuclear Information System (INIS)

Anon.

1975-01-01

The use of gonad shielding is an important radiation protection technique, intended to reduce unnecessary x-ray exposure of the gonads of patients from diagnostic x-ray procedures. The types of gonad shields in use are discussed as are the types of diagnostic examinations that should include gonad shielding. It was found that when properly used, most shields provided substantial gonad dose reductions

A retrospective study of relevant diagnostic procedures in vulvodynia

DEFF Research Database (Denmark)

Petersen, Christina Damsted; Kristensen, Ellids; Lundvall, Lene

2009-01-01

OBJECTIVE: To identify objective clinical signs of vulvodynia and determine specific diagnostic tests for vulvodynia in women referred to a vulvar outpatient clinic for vulval complaints. STUDY DESIGN: A retrospective study was performed of the medical records of 201 consecutive Danish patients s...

A pilot study of a family focused, psychosocial intervention with war-exposed youth at risk of attack and abduction in north-eastern Democratic Republic of Congo.

Science.gov (United States)

O'Callaghan, Paul; Branham, Lindsay; Shannon, Ciarán; Betancourt, Theresa S; Dempster, Martin; McMullen, John

2014-07-01

Rural communities in the Haut-Uele Province of northern Democratic Republic of Congo live in constant danger of attack and/or abduction by units of the Lord's Resistance Army operating in the region. This pilot study sought to develop and evaluate a community-participative psychosocial intervention involving life skills and relaxation training and Mobile Cinema screenings with this war-affected population living under current threat. 159 war-affected children and young people (aged 7-18) from the villages of Kiliwa and Li-May in north-eastern DR Congo took part in this study. In total, 22% of participants had been abduction previously while 73% had a family member abducted. Symptoms of post-traumatic stress reactions, internalising problems, conduct problems and pro-social behaviour were assessed by blinded interviewers at pre- and post-intervention and at 3-month follow-up. Participants were randomised (with an accompanying caregiver) to 8 sessions of a group-based, community-participative, psychosocial intervention (n=79) carried out by supervised local, lay facilitators or a wait-list control group (n=80). Average seminar attendance rates were high: 88% for participants and 84% for caregivers. Drop-out was low: 97% of participants were assessed at post-intervention and 88% at 3 month follow-up. At post-test, participants reported significantly fewer symptoms of post-traumatic stress reactions compared to controls (Cohen's d=0.40). At 3 month follow up, large improvements in internalising symptoms and moderate improvements in pro-social scores were reported, with caregivers noting a moderate to large decline in conduct problems among the young people. Trial Registration clinicalTrials.gov, Identifier: NCT01542398. Copyright © 2014 Elsevier Ltd. All rights reserved.

Advantages of digital imaging for radiological diagnostic

International Nuclear Information System (INIS)

Trapero, M. A.; Gonzalez, S.; Albillos, J. C.; Martel, J.; Rebollo, M.

2006-01-01

The advantages and limitations of radiological digital images in comparison with analogic ones are analyzed. We discuss three main topics: acquisition, post-procedure manipulation, and visualization, archive and communication. Digital acquisition with computed radiology systems present a global sensitivity very close to conventional film for diagnostic purposes. However, flat panel digital systems seems to achieve some advantages in particular clinical situations. A critical issue is the radiation dose-reduction that can be accomplished without reducing image quality nor diagnostic exactitude. The post-procedure manipulation allows, particularly in multiplanar modalities like CT or MR, to extract all implicit diagnostic information in the images: Main procedures are multiplanar and three-dimensional reformations, dynamic acquisitions, functional studies and image fusion. The use of PACS for visualization, archive and communication of images, improves the effectiveness and the efficiency of the workflow, allows a more comfortable diagnosis for the radiologist and gives way to improvements in the communication of images, allowing tele consulting and the tele radiology. (Author) 6 refs

Diagnostic information management system for the evaluation of medical images

Energy Technology Data Exchange (ETDEWEB)

Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina

1985-04-01

A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions.

Diagnostic information management system for the evaluation of medical images

International Nuclear Information System (INIS)

Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina.

1985-01-01

A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions. (author)

A Personal Computer as Diagnostic Aid for Strabismus

OpenAIRE

Albicki, A.; Cohen, G.H.; Metz, H.S.

1984-01-01

This paper describes a microcomputer aided strabismus diagnostic system STRABCON. Two goals were achieved: at any time during the diagnostic process a list of plausible disorders are produced, and an optimal procedure for arriving at a final diagnosis is determined. This publication deals primarily with a microcomputer implementation of the STRABCON diagnostic system.

The need for culture sensitive diagnostic procedures

NARCIS (Netherlands)

Zandi, Tekleh; Havenaar, Johan M.; Limburg-Okken, Annechien G.; van Es, Hans; Sidali, Salah; Kadri, Nadia; van den Brink, Wim; Kahn, Rene S.

Objective We examine the procedural validity of a standardized instrument for the diagnosis of psychotic disorders in Morocco. Method Twenty-nine patients from Casablanca, Morocco, with a psychotic or mood disorder were examined using the Comprehensive Assessment of Symptoms and History (CASH) an

Towards increase of diagnostic efficacy in gynecologic OCT

Science.gov (United States)

Kirillin, Mikhail; Panteleeva, Olga; Eliseeva, Darya; Kachalina, Olga; Sergeeva, Ekaterina; Dubasova, Lyubov; Agrba, Pavel; Mikailova, Gyular; Prudnikov, Maxim; Shakhova, Natalia

2013-06-01

Gynecologic applications of optical coherence tomography (OCT) are usually performed in combination with routine diagnostic procedures: laparoscopy and colposcopy. In combination with laparoscopy OCT is employed for inspection of fallopian tubes in cases of unrecognized infertility while in colposcopy it is used to identify cervix pathologies including cancer. In this paper we discuss methods for increasing diagnostic efficacy of OCT application in these procedures. For OCT-laparoscopy we demonstrate independent criteria for pathology recognition which allow to increase accuracy of diagnostics. For OCT-colposcopy we report on application of device for controlled compression allowing to sense the elasticity of the inspected cervix area and distinguish between neoplasia and inflammatory processes.

一种基于TC-CPN的城轨列车车门故障溯因诊断方法%An Abductive Diagnosis Method for Urban Rail Train Door Faults Based on Cyber Petri Net of Time Constraint

Institute of Scientific and Technical Information of China (English)

沈碧波; 佘维; 叶阳东; 贾利民

2016-01-01

本文针对城轨列车车门开门控制系统故障诊断问题,定义一种时间约束自控Petri网(TC-CPN),提出一种故障溯因诊断方法.该方法主要依据捕获的故障表征和监控系统采集的状态与时间信息进行诊断分析.该Petri网引入时序一致性判定函数,定义相对应的变迁触发规则.通过对捕获的时间信息进行计算和溯因推理,分析系统可能存在的故障源或隐患.应用算例表明,时间约束自控Petri网对城轨列车车门开门控制系统的建模有效,时间约束为系统故障溯因诊断提供了时间层面的有力证据.该方法对于此类控制系统故障诊断问题具有一定的普适性.%Aiming at the fault diagnosis of on-off control system of urban rail train doors ,an abductive fault di-agnosis method was proposed by defining a novel type of Cyber Petri Net of Time Constraint (TC-CPN) .Diag-nostic analysis was carried out with the proposed method ,based on the captured fault characterization and the status and time information collected by the monitoring system .The Petri net adopted the judgment function of temporal consistency and defined the corresponding transition firing rules .By calculation and abductive reason-ing of the captured time information ,the fault origins or the potential problems that may remain in the control system were analyzed .The sample application showed that the TC-CPN was effective to model the on-off con-trol system of the doors of urban rail trains ,while time constraint provided strong evidence for fault abductive diagnosis in terms of time .The proposed method suggested general applicability to such fault diagnosis prob-lems of control systems .

Degree of vertical integration between the undergraduate program and clinical internship with respect to lumbopelvic diagnostic and therapeutic procedures taught at the canadian memorial chiropractic college.

Science.gov (United States)

Vermet, Shannon; McGinnis, Karen; Boodham, Melissa; Gleberzon, Brian J

2010-01-01

The objective of this study was to determine to what extent the diagnostic and therapeutic procedures taught in the undergraduate program used for patients with lumbopelvic conditions are expected to be utilized by students during their clinical internship program at Canadian Memorial Chiropractic College or are being used by the clinical faculty. A confidential survey was distributed to clinical faculty at the college. It consisted of a list of diagnostic and therapeutic procedures used for lumbopelvic conditions taught at that college. Clinicians were asked to indicate the frequency with which they performed or they required students to perform each item. Seventeen of 23 clinicians responded. The following procedures were most likely required to be performed by clinicians: posture; ranges of motion; lower limb sensory, motor, and reflex testing; and core orthopedic tests. The following were less likely to be required to be performed: Waddell testing, Schober's test, Gillet tests, and abdominal palpation. Students were expected to perform (or clinicians performed) most of the mobilization (in particular, iliocostal, iliotransverse, and iliofemoral) and spinal manipulative therapies (in particular, the procedures referred to as the lumbar roll, lumbar pull/hook, and upper sacroiliac) taught at the college. This study suggests that there was considerable, but not complete, vertical integration between the undergraduate and clinical education program at this college.

Diagnostic system and diagnostic experiences at the Paks Nuclear Power Plant

International Nuclear Information System (INIS)

Katona, Tamas

1986-01-01

The major functions of the diagnostic system of the first two units of the Paks Nuclear Power Plant are as follows: monitoring the mechanical integrity of the reactor and the primary coolant circuit by means of vibration diagnostics; leakage detection of the primary coolant circuit by means of high frequency sonic analysis; loose parts monitoring based on the analysis of high frequency signals of acceleration detectors; and monitoring the vibration state of the turbines and rotary machines by the latter method or by a procedure based on the detection of mechanical vibrations. Up-to-date vibration diagnostics is based on the information supplied by either acceleration detectors or pressure fluctuation detectors, or in-core and ex-core neutron detectors. (V.N.)

40 CFR 85.2222 - On-board diagnostic test procedures.

Science.gov (United States)

2010-07-01

... on-board diagnostic systems on 1996 and newer light-duty vehicles and light-duty trucks shall consist... the unset readiness code(s) in question may be issued a passing certificate without being required to... lit malfunction indicator light (MIL) must be failed, though setting the unset readiness flags in...

Modern diagnostic procedures in disorders of the thyroid gland

International Nuclear Information System (INIS)

Grebe, S.F.; Mueller, H.

1984-01-01

For functional diagnostics the FT4 index is calculated from the T4 and T3U values. Hyperthyroidism is suggested or borderline values an found, the T3 test is carried out. An index of free iodine hormones (IFIH) can be calculated. (IFIH=T4+30 x T3(μg/100 ml)/ST3U). Hypothyroidism and borderline cases require TSH evaluation or even a TRH test. T4 and T3 autoantibodies can cause high or low values in spite of euthyroidism or hypothyroidism. Difference in FT4 values are found if the kits used were not made by the same manufacturer. These values help to determine hyperthyroidism in pregnancy. The FT3 value is better than the TT3 value in determining T3 hyperthyroidism in borderline cases. Autonomy can be guaranteed by the 123 I short test or the 20-min 99 m Tc uptake test before and after administration of T4. Location diagnostics by scintigraphy after administration of 99 m Tc or radioiodine determine localization, size, shape, and distribution of functioning thyroid tissue and metastases by iodine accumulation. This is imaging of biochemical processes. By ultrasonography, a physical method, cysts, disintegration cysts or parenchymal nodes can be recognized. X-ray films of the trachea can determine stenosis caused by a struma. In addition to the exact proof of an intrathoracal struma (front and back mediastine), a retrotracheal or retroesophageal thyroid gland can be seen in CT. RIA determination of the tumor markers calcitonin and TG support the diagnostics of medullar and follicular or papillary thyroid carcinoma. (orig.) [de

Diagnostic and interventional radiology

Energy Technology Data Exchange (ETDEWEB)

Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

2016-08-01

This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

Survey of prenatal counselling practices regarding aneuploidy risk modification, invasive diagnostic procedure risks, and procedure eligibility criteria in Canadian centres.

Science.gov (United States)

Hull, Danna; Davies, Gregory; Armour, Christine M

2012-07-01

To explore prenatal practices related to aneuploidy screening, risk modification, and invasive diagnostic procedures across Canadian centres. We conducted a survey of members of the Canadian Association of Genetic Counsellors, the Canadian College of Medical Genetics, and the Canadian Society of Maternal Fetal Medicine, who provide direct counselling or management of prenatal patients in Canada. Eighty-two of 157 respondents indicated that their centre's definition of advanced maternal age was ≥ 35 years, with 33/157 respondents reporting an advanced maternal age definition of ≥ 40 years. The majority of respondents reported that prenatal serum screening for aneuploidy is provincially funded in their province or territory (121/147). The majority of respondents who reported that prenatal screening is not provincially funded (17/147) were from Quebec (14/17). Thirty-nine of 123 respondents reported that their centre defines increased nuchal translucency as ≥ 3.0 mm, whereas 49/123 reported a definition of ≥ 3.5 mm. Sixty-four of 150 respondents reported that the aneuploidy risk provided by serum screening is modified by a soft marker likelihood ratio, whereas 46/150 respondents reported that both age-related and serum screening risks are modified. Fifty-nine of 124 respondents reported that their centre will modify aneuploidy risk after a normal ultrasound; the most commonly cited negative likelihood ratio was 0.5. The most commonly reported procedure-related risk for chorionic villus sampling was 1/100 (123/147) and for amniocentesis was 1/200 (73/142). This study demonstrates inconsistencies in prenatal practices and access to screening programs across Canada. The information gained from this study will inform policy advisors developing prenatal practice guidelines at both the provincial and national levels.

On Informatics Diagnostics and Informatics Therapeutics - Good Medical Informatics Research Is Needed Here.

Science.gov (United States)

Haux, Reinhold

2017-01-01

In the era of digitization some new procedures play an increasing role for diagnosis as well as for therapy: informatics diagnostics and informatics therapeutics. Challenges for such procedures are described. It is discussed, when research on such diagnostics and therapeutics can be regarded as good research. Examples are mentioned for informatics diagnostics and informatics therapeutics, which are based on health-enabling technologies.

[Diagnostic laparoscopy in acute abdomen].

Science.gov (United States)

Keller, R; Kleemann, M; Hildebrand, P; Roblick, U J; Bruch, H-P

2006-11-01

Acute abdomen is not a disease in itself but a description of a complex of symptoms combined with severe abdominal pain developed within a time frame of less than 24 h. All strategies for the management of acute abdomen underline the need for an interdisciplinary approach to diagnosis and therapy. This requires focused and intelligent use of efficient diagnostic procedures. Diagnostic laparoscopy may be a key to solving the diagnostic dilemma of unspecific acute abdomen. Furthermore, it allows not only direct inspection of the abdominal cavity but also surgical intervention, if needed. In particular the rate of negative laparotomies can be reduced.

Algorithm for Video Summarization of Bronchoscopy Procedures

Directory of Open Access Journals (Sweden)

Leszczuk Mikołaj I

2011-12-01

Full Text Available Abstract Background The duration of bronchoscopy examinations varies considerably depending on the diagnostic and therapeutic procedures used. It can last more than 20 minutes if a complex diagnostic work-up is included. With wide access to videobronchoscopy, the whole procedure can be recorded as a video sequence. Common practice relies on an active attitude of the bronchoscopist who initiates the recording process and usually chooses to archive only selected views and sequences. However, it may be important to record the full bronchoscopy procedure as documentation when liability issues are at stake. Furthermore, an automatic recording of the whole procedure enables the bronchoscopist to focus solely on the performed procedures. Video recordings registered during bronchoscopies include a considerable number of frames of poor quality due to blurry or unfocused images. It seems that such frames are unavoidable due to the relatively tight endobronchial space, rapid movements of the respiratory tract due to breathing or coughing, and secretions which occur commonly in the bronchi, especially in patients suffering from pulmonary disorders. Methods The use of recorded bronchoscopy video sequences for diagnostic, reference and educational purposes could be considerably extended with efficient, flexible summarization algorithms. Thus, the authors developed a prototype system to create shortcuts (called summaries or abstracts of bronchoscopy video recordings. Such a system, based on models described in previously published papers, employs image analysis methods to exclude frames or sequences of limited diagnostic or education value. Results The algorithm for the selection or exclusion of specific frames or shots from video sequences recorded during bronchoscopy procedures is based on several criteria, including automatic detection of "non-informative", frames showing the branching of the airways and frames including pathological lesions. Conclusions

Patient and staff doses in fluoroscopically guided invasive diagnostic and interventional urology procedures

International Nuclear Information System (INIS)

Ivanova, D.; Hristova-Popova, J.; Avramova-Cholakova, S.; Deyanova, Ts.; Dobrikov, R.

2015-01-01

Full text: The aim of this study is to evaluate patient and staff doses in fluoroscopically guided invasive diagnostic and interventional urology procedures. All the data were collected in the Emergency Hospital 'N. I. Pirogov'. While recording data for the patients, a real time dosimetry measurement of the medical staff was made. Air kerma-area product (KAP) was recorded for intravenous pyelogram (IVP), percutaneous nephrostomy (PN) and ureteral 'double-J' stenting. Patient data sex, age and weight were also taken. Staff doses were estimated with the system RaySafe i2. It contains four dosimeters, with a wireless connection to a real time display. The dosimeters were worn on the unprotected upper part of the body and measured the personal dose equivalent Hp(10). The mean KAP values for the procedures are: 3.21 Gy.cm 2 for IVP, 10.37 Gy.cm 2 for PN and 4.15 Gy.cm 2 for 'double-J' respectively. The highest staff dose for PN and 'double-J' is received by the urologist (160 μSv and 47.3 μSv, respectively), while for the IVP the radiographer has the highest exposure (20 μSv). Each member of the medical staff was on a different position in respect to the X-ray tube and the patient, which is the main reason for the differences in the staff doses. The variations in the mean patient and staff doses are mostly due to the interventions themselves, their complexity and the individual treatment of every patient. RaySafe i2 is very useful as guideline for making a choice of a better position and in the decreasing of radiation exposure to the staff

Radiation exposure in diagnostic medicine

International Nuclear Information System (INIS)

Haehnel, S.; Michalczak, H.; Reinoehl-Kompa, S.

1995-01-01

This volume includes the manuscripts of the papers read at the conference as well as a summary and assessment of its results. The scientific discussions were centred upon the following issues: - International surveys and comparisons of rdiation exposures in diagnostic radiology and nuclear medicine, frequency of the individual diagnostic procedures and age distribution of patients examined; - policies and regulations for the radiation protection of patients, charcteristic dosimetric values and practical usefulness of the effective dose concept during medical examinations; - assessments of the relative benefits and risks and measures to reduce the radiation exposure in the light of quality assurance aspects. The main objective of this conference not only was to evaluate the risks from diagnostic radiology and nuclear medicine but also to encourgage a critical analysis and adjustment of examination routines followed in everyday practice. Among the measures recommended were quality assurance, maintenace of international standards, development of guidelines, introduction of standard doses, improved training and professional education of personnel as well as surveys and analyses of certain examination procedures associated with substantial radiation exposure. (orig./MG) [de

I will follow him through woody mountains and water: Semantic-pragmatic analysis of a formula within the context of consensual abduction

Directory of Open Access Journals (Sweden)

Trubarac-Matić Đorđina

2014-01-01

Full Text Available The starting points for this paper are Vuk’s testimony about the bride kidnapping in the Serbia of his time and the formulaic parts of speech pronounced during the trials, which Vuk mentions. Through a semantic-pragmatic analysis of the formulae used in trials, the author draws attention to some indicators of faux archaism perceived in them. A special attention is paid to the formula I will follow him through woody mountains and water, which the girls would pronounce when they wanted to admit their willingness to abduction. In order to reach the full pragmatic function and meaning of this formula within the specific communication context of the trial, the author compares the relevant elements from the Vuk’s testimony with the historical and legal archive materials and traces them further on through the folk songs in which those elements appear. The results of the comparative analysis of those songs, within their own pragmatic contexts, point towards certain mythic patterns related to the idea of fertility. This leads the author to the hypothesis that in the past the marriage by consensual abduction was a recognized institution in the customary law and that this practice had its foothold in mythological ideas and beliefs. [Projekat Ministarstva nauke Republike Srbije, br. 47016: Interdisciplinarno istraživanje kulturnog i jezičkog nasleđa Srbije. Izrada multimedijalnog portala ‘Pojmovnik srpske kulture’

Patient dosimetry in diagnostic radiology

International Nuclear Information System (INIS)

Shrimpton, P.C.

2000-01-01

Full text: X-ray examinations remain an essential and widely used diagnostic tool in medicine and hence the most significant source of exposure to man-made radiation for populations. Patterns of practice in diagnostic radiology continue to evolve, with overall growth in the numbers of procedures worldwide and, particularly in developed countries, increasing importance for complex procedures such as computed tomography (CT) and interventional techniques. In order to maximise the benefits from x-rays relative to the associated radiation risks, there is a need to ensure the prior justification of all examinations and the optimisation of patient protection such that doses are as low as reasonably practicable to meet specific clinical requirements. Accordingly, patient dosimetry is a fundamental requirement in diagnostic radiology. Detailed measurements for the assessment of risks or comparison of different types of procedure require the estimation of organ and effective doses. Such comprehensive dosimetry necessarily involves the simulation of clinical practice using anthropomorphic phantoms, with either measurements in a physical phantom or calculations utilising a mathematical phantom. Simpler measurements for the routine monitoring of dose in x-ray departments can be based on practical quantities such as entrance surface dose, dose-area product and, for CT, weighted CT dose index and dose-length product. Widescale surveys reveal significant variations between departments in the typical doses for a given type of procedure and potential scope for dose reductions. In order to promote improvements in practice, the results of periodic dose surveys in departments should be compared with appropriate standards, such as diagnostic reference levels for adult and paediatric patients, that are set nationally or locally for the purposes of promoting critical review of the equipment and techniques in use. Patient dosimetry should form an essential element of routine quality

Diagnostic imaging in medicine. 2. ed.

International Nuclear Information System (INIS)

Reba, R.C.; Goodenough, D.J.

1984-01-01

This book describes to practitioners the evolutionary progression of new non-invasive diagnostic imaging techniques. The utility of the procedures is also described in a series of state-of-the-art lectures given by outstanding international clinical investigators from NATO countries. Subjects of the papers include the following: advances in source and detector technology, acoustical imaging, NMR and microwave imaging, positron and single photon emission tomography, digital radiography and image processing and display techniques. Fundamental papers describing the theory of non-invasive procedures are included along with papers describing clinical examinations. Examples of utility and studies of diseases of the abdomen and pelvis, heart and lung, and central nervous system are included. Cost-effective and cost-benefit assessment of the new high technology procedures, as well as the use of diagnostic imaging techniques in developing countries are also presented. An index of leading topics completes the volume. (orig.)

Diagnostics of machine parts by means of reverse engineering procedures

Directory of Open Access Journals (Sweden)

Jacek Rysinski

2015-05-01

Full Text Available In this article, an application of a three-dimensional scanner for building a special diagnostic stand is described. An experimental method of detection of material defects is discussed. The considered defects are connected with cooperation of particular surfaces of machine parts. In the discussed experiments, particularly the dimensions of pitting holes can be evaluated. Availability of laboratory facilities required that the investigations were performed using geared wheels. The three-dimensional model which represents a degenerated surface, obtained based upon the diagnostic measurements, was compared with the pattern of an undamaged surface. The latter was generated by means of our pre-processor. The pre-processor enables generation of files which are compatible with the majority of the computer-aided design system formats. Therefore, the analyses were performed by means of commercial system inventor and computer-aided three-dimensional interactive application.

Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations

International Nuclear Information System (INIS)

Linet, Martha S.; Rajaraman, Preetha; Kim, Kwang pyo

2009-01-01

While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)

Pediatric radiological diagnostics in suspected child abuse

International Nuclear Information System (INIS)

Erfurt, C.; Schmidt, U.; Hahn, G.; Roesner, D.

2009-01-01

Advanced and specialized radiological diagnostics are essential in the case of clinical suspicion of pediatric injuries to the head, thorax, abdomen, and extremities when there is no case history or when ''battered child syndrome'' is assumed on the basis of inadequate trauma. In particular, the aim of this sophisticated diagnostic procedure is the detection of lesions of the central nervous system (CNS) in order to initiate prompt medical treatment. If diagnostic imaging shows typical findings of child abuse, accurate documented evidence of the diagnostic results is required to prevent further endangerment of the child's welfare. (orig.) [de

Variation in radiation doses in paediatric cardiac catheterisation procedures

International Nuclear Information System (INIS)

Al-Haj, A. N.; Lobriguito, A. M.; Rafeh, W.

2008-01-01

Paediatric cardiac catheterisation involves diagnostic and therapeutic procedures that range from simple to complex and can subject paediatric patients to varying radiation doses. The study aims to determine the variation in entrance doses in patients in terms of dose-area product (DAP) values and to investigate the methods for optimising radiation protection. A total of 190 paediatric patients belonging to age groups 0, 1, 5 and 10 y who underwent diagnostic and six selected therapeutic procedures at King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia) were included in the study. Therapeutic procedures include coarctation (COA), patent ductus arteriosus (PDA), radiofrequency ablation, pulmonary, embolisation and septostomy. Fluoroscopy and cine radiography were used in all procedures. Patient demography (weight, age, gender and height), radiographic technique factors, fluoroscopy and cine time, frame rate, and DAP values were taken from patients records. Effective doses for each procedure were estimated from the DAP values. The mean DAP per procedure were analysed for correlation with patient equivalent cylindrical diameter, weight, fluoroscopy time and number of frames. Factors influencing the variation in doses were investigated. Initial results show that PDA occlusion has the highest mean DAP value of 23.21 Gy-cm 2 , while the diagnostic and septostomy procedures have the lowest value of 7.77 and 6.95 Gy-cm 2 , respectively. (authors)

The evaluation of diagnostic medical exposures in the Czech Republic

International Nuclear Information System (INIS)

Petrova, K.; Klener, V.; Heribanova, A.; Husak, V.; Masopust, J.

1998-01-01

Surveys were performed in the Czech Republic to evaluate diagnostic medical exposures. The results are presented in 4 tables: (i) burden from the use of radiopharmaceuticals (examination, radiopharmaceutical, no. of procedures, average administered activity, conversion factor, collective effective dose); (ii) use of radiopharmaceuticals at nuclear medicine departments (type of examination, type of radiopharmaceutical, no. of departments, average administered activity); (iii) reference levels of administered activity specified for some diagnostic procedures for the adult patient (examination, radionuclide, chemical form, administered activity); and (iv) X-ray examinations (examination, annual no. of procedures, effective dose, age distribution, sex distribution). (P.A.)

The Downside of Diagnostic Imaging

Science.gov (United States)

An article about radiation exposure during computed tomography and nuclear imaging procedures and the risk of cancer. Several studies released in 2009 have helped to quantify the risk and the growing use of these diagnostic imaging methods.

Adaptive techniques for diagnostics of vibrating structures

International Nuclear Information System (INIS)

Skormin, V.A.; Sankar, S.

1983-01-01

An adaptive diagnostic procedure for vibrating structures based on correspondence between current estimates of stiffness matrix and structure status is proposed. Procedure employs adaptive mathematical description of the vibrating structure in frequency domain, statistical techniques for detection and location of changes of structure properties, 'recognition' and prediction of defects. (orig.)

High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: is PFP itself a predictor for subsequent ACL injury?

Science.gov (United States)

Myer, Gregory D; Ford, Kevin R; Di Stasi, Stephanie L; Foss, Kim D Barber; Micheli, Lyle J; Hewett, Timothy E

2015-01-01

Identifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle. We evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury. The 'PFP cohort' consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The 'ACL cohort' included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts. KAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p15 Nm of knee abduction load

Hospital discharge diagnostic and procedure codes for upper gastro-intestinal cancer: how accurate are they?

Directory of Open Access Journals (Sweden)

Stavrou Efty

2012-09-01

Full Text Available Abstract Background Population-level health administrative datasets such as hospital discharge data are used increasingly to evaluate health services and outcomes of care. However information about the accuracy of Australian discharge data in identifying cancer, associated procedures and comorbidity is limited. The Admitted Patients Data Collection (APDC is a census of inpatient hospital discharges in the state of New South Wales (NSW. Our aim was to assess the accuracy of the APDC in identifying upper gastro-intestinal (upper GI cancer cases, procedures for associated curative resection and comorbidities at the time of admission compared to data abstracted from medical records (the ‘gold standard’. Methods We reviewed the medical records of 240 patients with an incident upper GI cancer diagnosis derived from a clinical database in one NSW area health service from July 2006 to June 2007. Extracted case record data was matched to APDC discharge data to determine sensitivity, positive predictive value (PPV and agreement between the two data sources (κ-coefficient. Results The accuracy of the APDC diagnostic codes in identifying site-specific incident cancer ranged from 80-95% sensitivity. This was comparable to the accuracy of APDC procedure codes in identifying curative resection for upper GI cancer. PPV ranged from 42-80% for cancer diagnosis and 56-93% for curative surgery. Agreement between the data sources was >0.72 for most cancer diagnoses and curative resections. However, APDC discharge data was less accurate in reporting common comorbidities - for each condition, sensitivity ranged from 9-70%, whilst agreement ranged from κ = 0.64 for diabetes down to κ  Conclusions Identifying incident cases of upper GI cancer and curative resection from hospital administrative data is satisfactory but under-ascertained. Linkage of multiple population-health datasets is advisable to maximise case ascertainment and minimise false

Advances in nucleic acid-based diagnostics of bacterial infections

DEFF Research Database (Denmark)

Barken, Kim Bundvig; Haagensen, Janus Anders Juul; Tolker-Nielsen, Tim

2007-01-01

Methods for rapid detection of infectious bacteria and antimicrobial-resistant pathogens have evolved significantly over the last decade. Many of the new procedures are nucleic acid-based and replace conventional diagnostic methods like culturing which is time consuming especially with fastidious...... of these pathogens is important to isolate patients and prevent further spreading of the diseases. Newly developed diagnostic procedures are superior with respect to turnaround time, sensitivity and specificity. Methods like multiplex real time PCR and different array-based technologies offer the possibility...

Quality Control in Diagnostic Radiology in the Netherlands (invited paper)

International Nuclear Information System (INIS)

Zoetelief, J.

1998-01-01

Application of the general principles of radiation protection to medical diagnostic radiology implies that each procedure using X rays or radionuclides is to be justified and optimised. Optimisation in diagnostic radiology implies that the radiation burden to the patient should be as low as possible, but compatible with the image quality necessary to obtain an adequate diagnosis or to guide treatment. Quality control of equipment is a prerequisite for achieving optimisation in diagnostic radiology. This was especially recognised for mammography as employed for breast cancer screening. Existing legislation in the Netherlands includes only a few criteria for equipment used in diagnostic radiology. In addition, the criteria are not all operational and measurement methods are lacking. Therefore, upon the initiative of the Dutch Ministry of Health, Welfare and Sports, the relevant professional societies, in collaboration with the former TNO Centre for Radiological Protection and Dosimetry, formulated eleven guidelines for quality control of equipment used in diagnostic radiology, including test procedures, test frequencies and limiting values. The implementation of quality control of equipment was included in the 1984 European Directive (84/466/Euratom) laying down basic measures for the radiation protection of persons undergoing medical examination or treatment. In the most recent European Directive on medical exposure (97/43/Euratom) the importance of quality control is stressed. In addition, the latter EC directive proposes the use of diagnostic reference levels for limiting the risks for patients undergoing diagnostic radiology. In the Netherlands preliminary reference levels for various procedures employed in diagnostic radiology are suggested. Finally, methods applied in the Netherlands for assessment of image quality are discussed. (author)

Nordic working group for medical x-ray diagnostics: Diagnostic reference levels within xray diagnostics - experiences in the Nordic countries

International Nuclear Information System (INIS)

Leitz, W.; Groen, P.; Servomaa, A.; Einarsson, G.; Olerud, H.

2003-01-01

Medical x-ray diagnostics is one of the few applications of ionising radiation where people are irradiated on purpose. The strategy for radiation protection is also different compared to that in other areas that have the zero-alternative as its ultimate goal, meaning that no human beings at all are exposed in these practices. The focus in x-ray diagnostics concerning radiation protection is justification and optimisation. Optimisation implies that the examination is performed in such a way that the radiation dose is as small as possible without jeopardising the diagnostic security. X- ray diagnostics is a complex method where many technical parameters and methodology factors together are interacting in the determination of radiation dose and image quality. The optimisation process is not a simple and uncomplicated procedure, this difficulty is reflected in many international and national surveys showing a large spread of patient doses for one and the same type of examination. The concept diagnostic reference levels (DRL) has been introduced as a tool for reducing this wide distribution that is obviously indicating a lack of optimisation, and for cutting the highest radiation doses. In this presentation the concept for DRL and the experience gained in the Nordic countries with DRL are described. (orig.)

SU-D-209-05: Sensitivity of the Diagnostic Radiological Index of Protection (DRIP) to Procedural Factors in Fluoroscopy

Energy Technology Data Exchange (ETDEWEB)

Jones, A [UT MD Anderson Cancer Center, Houston, TX (United States); Pasciak, A [University of Tennessee Medical Center, Knoxville, TN (United States); Wagner, L [UT Medical School, Houston, TX (United States)

2016-06-15

Purpose: To evaluate the sensitivity of the Diagnostic Radiological Index of Protection (DRIP) to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams (SMPB) to be used in measuring the DRIP. Methods: A series of clinical and factorial Monte Carlo simulations were conducted to determine the shape of the scattered X-ray spectra incident on the operator in different clinical fluoroscopy scenarios. Two clinical evaluations studied the sensitivity of the scattered spectrum to gantry angle and patient size while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial evaluations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size and beam quality for constant technical factors. Average energy was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affected the scattered spectrum indirectly through their effects on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in interventional cardiology, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusion: The scattered spectrum striking the operator in fluoroscopy, and therefore the DRIP, is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle. These results will help determine an appropriate set of SMPB to be used for measuring the DRIP.

A Self-Diagnostic System for the M6 Accelerometer

Science.gov (United States)

Flanagan, Patrick M.; Lekki, John

2001-01-01

The design of a Self-Diagnostic (SD) accelerometer system for the Space Shuttle Main Engine is presented. This retrofit system connects diagnostic electronic hardware and software to the current M6 accelerometer system. This paper discusses the general operation of the M6 accelerometer SD system and procedures for developing and evaluating the SD system. Signal processing techniques using M6 accelerometer diagnostic data are explained. Test results include diagnostic data responding to changing ambient temperature, mounting torque and base mounting impedance.

Office-based procedures for diagnosis and treatment of esophageal pathology.

Science.gov (United States)

Wellenstein, David J; Schutte, Henrieke W; Marres, Henri A M; Honings, Jimmie; Belafsky, Peter C; Postma, Gregory N; Takes, Robert P; van den Broek, Guido B

2017-09-01

Diagnostic and therapeutic office-based procedures under topical anesthesia are emerging in the daily practice of laryngologists and head and neck surgeons. Since the introduction of the transnasal esophagoscope, office-based procedures for the esophagus are increasingly performed. We conducted a systematic review of literature on office-based procedures under topical anesthesia for the esophagus. Transnasal esophagoscopy is an extensively investigated office-based procedure. This procedure shows better patient tolerability and equivalent accuracy compared to conventional transoral esophagoscopy, as well as time and cost savings. Secondary tracheoesophageal puncture, esophageal dilatation, esophageal sphincter injection, and foreign body removal are less investigated, but show promising results. With the introduction of the transnasal esophagoscope, an increasing number of diagnostic and therapeutic office-based procedures for the esophagus are possible, with multiple advantages. Further investigation must prove the clinical feasibility and effectiveness of the therapeutic office-based procedures. © 2017 Wiley Periodicals, Inc.

Quality control procedures of dental diagnostic radiology systems; Elaboracao de um procedimento para controle de qualidade em sistemas de radiodiagnostico odontologico

Energy Technology Data Exchange (ETDEWEB)

Andrade, Paula Serra Sasaki

2007-07-01

This work presents quality control reference procedures for dental diagnostic radiology systems, following the recommendations of the Publication 453 of the Brazilian Health Ministry (PF453), to be applied in dental clinics, in order to achieve an improvement in the radiological image qualities and the patient dose reduction. All tests were applied in an intraoral X rays system, following the methodology developed and the requirements of the PF 453. In order to verify the best quality of the image in relation to the smaller exposition time an object test was also developed in this work. The use of this object allowed the reduction of the exposition time of 0.5 seconds, the maximum value of the linear region of the characteristic curve, for 0.2 seconds. The tested X rays system showed a very good agreement with the applied procedures, detaching the reduction of the skin entrance dose using the film-holding devices. However, the size of the field increased and exceeded the maximum value of 6 cm recommended in the standard. The importance of the quality control in dental diagnostic radiology systems is essential due to the constant use of X radiation in dental clinics. The PF453 recommends the frequency of at least two years for the constancy tests. However, it is suggested that the professional, surgeon-dentist, should be responsible for the internal control of the image quality obtained from the X rays device. This can be done through monthly exposures of the object test developed in this work. (author)

Diagnostic imaging in internal medicine

International Nuclear Information System (INIS)

Eisenberg, R.L.

1985-01-01

This book examines medical diagnostic techniques. Topics considered include biological considerations in the approach to clinical medicines; infectious diseases; disorders of the heart; disorders of the vascular system; disorders of the respiratory system; diseases of the kidneys and urinary tract; disorders of the alimentary tract; disorders of the hepatobiliary system and pancreas; disorders of the hematopoietic system; disorders of bone and bone mineralization; disorders of the joints, connective tissues, and striated muscles; disorders of the nervous system; miscellaneous disorders; and procedures in diagnostic imaging

The value of scintigraphy in skeleton diagnostics

International Nuclear Information System (INIS)

Wickenhauser, J.

1976-01-01

The complex topic of diagnostics of the numerous skeleton diseases was enriched by nuclear medicine, for it is now possible to complete the static picture of morphologic changes resulting from radiologic examinations by its functional component, shown in scintigraphy. This shows that maximal information can only be obtained if the results of skeleton scintigraphy are, according to their importance, integrated into the total picture of the diagnostical decision procedure the centre of which is taken by radiology as was always the case. Because of the different results they lead to, none of the methods can be replaced by another, but they can only complete one another. For the reasons mentioned, the isolated use of skeleton scintigraphy, as it is usual in many places, does not seem not purposeful. Using 8 cases, the author tried to show the problems of skeleton scintigraphy and its position in the diagnostical decision procedure in osteology. (orig.) [de

Diagnostic imaging in medicine. 2nd ed

Energy Technology Data Exchange (ETDEWEB)

Reba, R C; Goodenough, D J; Davidson, H F

1984-01-01

This book describes to practitioners the evolutionary progression of new non-invasive diagnostic imaging techniques. The utility of the procedures is also described in a series of state-of-the-art lectures given by outstanding international clinical investigators from NATO countries. Subjects of the papers include the following: advances in source and detector technology, acoustical imaging, NMR and microwave imaging, positron and single photon emission tomography, digital radiography and image processing and display techniques. Fundamental papers describing the theory of non-invasive procedures are included along with papers describing clinical examinations. Examples of utility and studies of diseases of the abdomen and pelvis, heart and lung, and central nervous system are included. Cost-effective and cost-benefit assessment of the new high technology procedures, as well as the use of diagnostic imaging techniques in developing countries are also presented. An index of leading topics completes the volume.

Characteristics of Headache After an Intracranial Endovascular Procedure: A Prospective Observational Study.

Science.gov (United States)

Zhang, Linjing; Wu, Xiancong; Di, Hai; Feng, Tao; Wang, Yunxia; Wang, Jun; Cao, Xiangyu; Li, Baomin; Liu, Ruozhuo; Yu, Shengyuan

2017-03-01

Two editions of the International Classification of Headache Disorders (ICHD) diagnostic criteria for "Headache attributed to an intracranial endovascular procedure" have been published, in 2004 and 2013. 1,2 Despite studies that have suggested that the former is not very practical, the ICHD-3 beta did not contain major changes. Moreover, so far no consensus exists regarding characteristics of headache after intracranial endovascular procedure. Thus, there is a need for sound suggestions to improve the ICHD-3 beta diagnostic criteria. Using a prospective design, we identified consecutive patients with unruptured intracranial aneurysms (UIAs) with neuroendovascular treatment from January 2014 to December 2014. In total, 73 patients were enrolled, and 58 patients ultimately completed the 6-month follow-up. After the procedure, five of the 29 patients (17.2%) with pre-existing headache experienced marked worsening after the procedure, while seven of the 29 patients without prior headache developed new-onset headache post-procedurally. The headaches started within 24 hours, with a mean duration of 24-72 hours. The headaches were moderate to severe. The eligibility of these events to be considered headaches caused by neuroendovascular procedures according to the ICHD-3 beta diagnostic criteria for designation was far from ideal. Most cases of markedly worsening headaches and new-onset headaches started within 24 hours and persisted longer than that specified in the ICHD-3 beta diagnostic criteria. Moreover, considering that some items are not very practical, the ICHD-3 beta diagnostic criteria should be revised in the light of recent literature reports. © 2016 American Headache Society.

Pulmonary infiltrates in non-HIV immunocompromised patients: a diagnostic approach using non-invasive and bronchoscopic procedures

Science.gov (United States)

Rano, A; Agusti, C; Jimenez, P; Angrill, J; Benito, N; Danes, C; Gonzalez, J; Rovira, M; Pumarola, T; Moreno, A; Torres, A

2001-01-01

%); and TBAS 35/55 (65%). Bronchoscopic techniques led to the diagnosis of pulmonary infiltrates in 59% of the cases in which they were used: FBAS 16/28 (57%), BAL 68/135 (51%), and PSB 30/125 (24%). The results obtained with the different techniques led to a change in antibiotic treatment in 93 cases (46%). Although changes in treatment did not have an impact on the overall mortality, patients with pulmonary infiltrates of an infectious aetiology in whom the change was made during the first 7 days had a better outcome (29% mortality) than those in whom treatment was changed later (71% mortality; p=0.001).
CONCLUSIONS—Non-invasive and bronchoscopic procedures are useful techniques for the diagnosis of pulmonary infiltrates in immunocompromised patients. Bronchial aspirates (FBAS and TBAS) and BAL have the highest diagnostic yield and impact on therapeutic decisions.

 PMID:11312407

Controlling radiation exposure during interventional procedures in childhood cancer patients

International Nuclear Information System (INIS)

Racadio, John M.

2009-01-01

Many pediatric cancer patients undergo multiple diagnostic and therapeutic radiologic procedures over the course of their illnesses and are therefore at high risk for radiation exposure. There are a variety of measures that radiologists can employ to reduce this risk. These include limiting the use of radiation whenever possible, using specific strategies to reduce radiation exposure during interventional procedures, using quality assurance programs to ensure compliance, and maintaining continuing staff radiation safety educational programs. Some of the diagnostic and therapeutic interventional radiologic procedures that are performed in pediatric oncology patients are discussed here, along with specific tips for managing radiation exposure. (orig.)

Diagnostic strategies for urinary tract infections in French general practice.

Science.gov (United States)

Kinouani, S; de Lary de Latour, H; Joseph, J-P; Letrilliart, L

2017-10-01

We aimed to describe the diagnostic management procedures for detection of urinary tract infections in general practice and their correlated factors. We analyzed data from the ECOGEN study on urinary tract infections, collected in France between November 2011 and April 2012. This national cross-sectional study was carried out in general practices. Data was coded according to the International Classification of Primary Care. A total of 340 consultations or home visits were held for urinary tract infections. The five most frequent diagnostic procedures were (in descending order) clinical examination (67.6%), urine cytobacteriological examination (UCBE) (47.9%), urine dipstick test (15.6%), blood test (8.5%), and imaging (6.5%). No urine dipstick test or UCBE was performed in 43% of cases. Factors correlated with diagnostic procedures were age and gender of patients, annual number of consultations held by family physicians, and duration of consultation. Family physicians did not comply with guidelines on diagnostic management for detection of urinary tract infections. We hypothesized that this non-compliance could be due to the family physicians' environment and characteristics, and to clinical practice guidelines. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Office-Based Procedures for the Diagnosis and Treatment of Laryngeal Pathology.

Science.gov (United States)

Wellenstein, David J; Schutte, Henrieke W; Takes, Robert P; Honings, Jimmie; Marres, Henri A M; Burns, James A; van den Broek, Guido B

2017-09-18

Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear. Review of literature on office-based procedures in laryngology and head and neck oncology. Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia. These procedures demonstrate good patient tolerability and multiple advantages. Office-based procedures under topical anesthesia are currently an established method in the management of laryngeal pathology. These procedures offer medical and economic advantages compared with operating room-performed procedures. Furthermore, office-based procedures enhance the speed and timing of the diagnostic and therapeutic process. Copyright © 2017 The Voice Foundation. All rights reserved.

Piezo-sensor self-diagnostics using electrical impedance measurements.

Energy Technology Data Exchange (ETDEWEB)

Park, G. H. (Gyu Hae); Farrar, C. R. (Charles R.); Rutherford, A. C. (Amanda C.); Robertson, A. N. (Amy N.)

2004-01-01

This paper present the piezoelectric sensor self-diagnostic procedure that performs in-situ monitoring of the operational status of piezoelectric materials (PZT) used for sensors and actuators in structural health monitoring (SHM) applications. The use of active-sensing piezoelectric materials has received considerable attention in the SHM community. A critical aspect of the piezoelectric active-sensing technologies is that usually large numbers of distributed sensors and actuators are needed to perform the required monitoring process. The sensor/actuator self-diagnostic procedure, where the sensors/actuators are confirmed to be functioning properly during operation, is therefore a critical component to successfully complete the SHM process and to minimize the false indication regarding the structural health. The basis of this procedure is to track the changes in the capacitive value of piezoelectric materials resulting from the sensor failure, which is manifested in the imaginary part of the measured electrical admittances. Furthermore, through the analytical and experimental investigation, it is confirmed that the bonding layer between the PZT and a host structure significantly contributes to the measured capacitive values. Therefore, by monitoring the imaginary part of the admittances, one can quantitatively assess the degradation of the mechanical/electrical properties of the PZT and its attachment to a host structure. This paper concludes with an experimental example to demonstrate the feasibility of the proposed sensor-diagnostic procedure.

Abduction of children of political dissidents in Argentina and the role of human genetics in their restitution.

Science.gov (United States)

Penchaszadeh, V B

1992-01-01

Between 1976 and 1983 a brutal military dictatorship governed Argentina. The most basic human rights were severely violated and the method of forced disappearances of approximately 30,000 political dissidents was instituted. In this process, about 300 babies and children of the disappeared victims were also abducted by the military and given to childless families linked to the security forces. Women whose children and grandchildren had disappeared organized themselves as Grandmothers of Plaza de Mayo to search for their missing loved ones. This search was aided by human geneticists from different parts of the world who provided the scientific basis to establish the genetic identification through "grandpaternity testing," and by mental health professionals who provided the psychological theory supporting restitution of appropriated children to their legitimate families. Thus far, close to 50 children have been located, identified and restituted.

The IHS diagnostic X-ray equipment radiation protection program

International Nuclear Information System (INIS)

Knapp, A.; Byrns, G.; Suleiman, O.

1994-01-01

The Indian Health Service (IHS) operates or contracts with Tribal groups to operate 50 hospitals and approximately 165 primary ambulatory care centers. These facilities contain approximately 275 medical and 800 dental diagnostic x-ray machines. IHS environmental health personnel in collaboration with the Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) developed a diagnostic x-ray protection program including standard survey procedures and menu-driven calculations software. Important features of the program include the evaluation of equipment performance collection of average patient entrance skin exposure (ESE) measurements for selected procedures, and quality assurance. The ESE data, collected using the National Evaluation of X-ray Trends (NEXT) protocol, will be presented. The IHS Diagnostic X-ray Radiation Protection Program is dynamic and is adapting to changes in technology and workload

Utility of 18FDG-PET/CT in breast cancer diagnostics – a systematic review

DEFF Research Database (Denmark)

Warning, Karina; Hildebrandt, Malene; Christensen, Bent

2011-01-01

as a primary diagnostic procedure in breast cancer; but it has the potential to be useful for the detection of distant metastases and for monitoring response to chemotherapy in breast cancer patients. PET/CT should still be regarded as a supplement to conventional diagnostic procedures such as CT and MRI....

Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations

Energy Technology Data Exchange (ETDEWEB)

Linet, Martha S.; Rajaraman, Preetha [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kim, Kwang pyo [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kyung Hee University, Department of Nuclear Engineering, Yongin-si, Gyeonggi (Korea)

2009-02-15

While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)

Diagnostic guidlines for occupational epicondylitis

Directory of Open Access Journals (Sweden)

Patrycja Krawczyk-Szulc

2015-07-01

Full Text Available Making final decisions on the occupational etiology of musculoskeletal diseases is often difficult and problematic at every stage of the diagnostic procedure. Taking into account the need to facilitate decision-making about the causal relationship between the diagnosed disease entity and the working conditions guidelines for the recognition of work-related musculoskeletal diseases have been developed. This paper presents the guidelines for the diagnosis of occupational etiology of humeral epicondylitis, one of the most common occupational disease of the musculoskeletal system in Poland. The developed guidelines have been based on the literature data concerning occupational risk factors of humeral epicondylitis, workload classification, including repetitive movements, awkward postures, and force. Some criteria applied in ergonomic evaluation methods were also included. The presented diagnostic guidelines define approximate benchmarks for stating (after excluding non-occupational etiology that the identified humeral epicondylitis, is related to the way of working. Crucial work factors that should be analyzed include an operating time of movements overloading tendons connecting to the epicondyle, repetition and force used to perform occupational activities. The developed guidelines are aimed to facilitate occupational physicians diagnostic and certification procedures in case of humeral epicondylitis and determination whether there is a likelihood of its occupational etiology. Med Pr 2015;66(3:443–450

Health Risks of Diagnostic Radiology

International Nuclear Information System (INIS)

Al-Oraby, M.N.A.

2014-01-01

Exposure to ionizing radiation during diagnostic radiologic procedures carries small but real risks. Children, young adults and pregnant women are especially vulnerable. Exposure of patients to diagnostic energy levels of ionizing radiation should be kept to the minimum necessary to provide useful clinical information and allay patients concerns about radiation-related risks. Computerized Tomography (CT) accounts for two thirds of the cumulative patient dose from diagnostic radiological procedures and the cumulative dose from CT is rising as technological advances increase the number of indications and the capabilities of CT. Carcinogenesis and teratogenesis are the main concerns with ionizing radiation. The risk increases as the radiation dose increases. There is no minimum threshold and the risk is cumulative: a dose of 1 mSv once a year for 10 years is equivalent to a single dose of 10 mSv. Whenever practical, choose an imaging test that uses less radiation or no radiation and lengthen the periods between follow-up imaging tests. Some patients may avoid screening mammography because of fear of radiation-induced cancer, yet this test uses a very small radiation dose (0.6 mSv, much less than the annual dose from background radiation, 3.6 mSv). (author)

Gonad shielding in diagnostic radiology

International Nuclear Information System (INIS)

1975-06-01

The use of gonad shielding is an important radiation protection technique, intended to reduce unnecessary x-ray exposure of the gonads of patients from diagnostic x-ray procedures. This pamphlet will provide physicians and radiologic technologists with information which will aid their appropriate use of gonad shielding

Double- vs. single-balloon enteroscopy: single center experience with emphasis on procedural performance.

Science.gov (United States)

Lenz, Philipp; Roggel, Moritz; Domagk, Dirk

2013-09-01

This study aims to compare double- (DBE) and single-balloon enteroscopy (SBE) in small bowel disorders with respect to procedural performance and clinical impact. This retrospective analysis at a tertial referral center included 1,052 DBEs and 515 SBEs performed in 904 patients over 7 years. Procedural and patients' characteristics were precisely analyzed. Significantly more patients with anemia and gastrointestinal bleeding were investigated by DBE (P recent years of enteroscopy (2008-2011), no difference in small bowel visualization could be observed. The anal insertion depths and complete enteroscopy rates (CER) were comparable. Procedure times were significantly shorter within the SBE procedure (oral: 50 vs. 40 min; anal: 55 vs. 46 min, P Diagnostic yield was significantly higher in the SBE, compared to the DBE group (61.7 vs. 48.2 %; P diagnostic tools and proved to be indispensable in the daily gastroenterological practice. The lower insertion depths, but higher diagnostic yield, of SBE may reflect the more focused selection of patients scheduled for small bowel diagnostics in recent years.

Sagittal reconstruction computed tomography in metrizamide cisternography. Useful diagnostic procedure for malformations in craniovertebral junction and posterior fossa

Energy Technology Data Exchange (ETDEWEB)

Mochizuki, H.; Okita, N.; Fujii, T.; Yoshioka, M.; Saito, H. (Tohoku Univ., Sendai (Japan). School of Medicine)

1982-08-01

We studied the sagittal reconstruction technique in computed tomography with metrizamide. Ten ml of metrizamide, 170 mg iodine/ml in concentration, were injected by lumbar puncture. After diffusion of the injected metrizamide, axial computed tomograms were taken by thin slice width (5 mm) with overlapped technique. Then electrical sagittal reconstruction was carried out by optioned software. Injection of metrizamide, non-ionic water soluble contrast media, made clear contrasts among bone, brain parenchyma and cerebrospinal fluid with computed tomography. Sagittal reconstruction technique could reveal more precise details and accurate anatomical relations than ordinary axial computed tomography. This technique was applied on 3 cases (Arnold-Chiari malformation, large cisterna magna and partial agenesis cerebellar vermis), which demonstrated a useful diagnostic procedure for abnormalities of craniovertebral junction and posterior fossa. The adverse reactions of metrizamide were negligible in our series.

Comparative guide to emerging diagnostic tools for large commercial HVAC systems

Energy Technology Data Exchange (ETDEWEB)

Friedman, Hannah; Piette, Mary Ann

2001-05-01

This guide compares emerging diagnostic software tools that aid detection and diagnosis of operational problems for large HVAC systems. We have evaluated six tools for use with energy management control system (EMCS) or other monitoring data. The diagnostic tools summarize relevant performance metrics, display plots for manual analysis, and perform automated diagnostic procedures. Our comparative analysis presents nine summary tables with supporting explanatory text and includes sample diagnostic screens for each tool.

Simulation-based education leads to decreased use of fluoroscopy in diagnostic coronary angiography.

Science.gov (United States)

Prenner, Stuart B; Wayne, Diane B; Sweis, Ranya N; Cohen, Elaine R; Feinglass, Joe M; Schimmel, Daniel R

2017-08-02

The aim of this study is to determine whether simulation-based education (SBE) translates into reduced procedure time, radiation, and contrast use in actual clinical care. As a high volume procedure often performed by novice cardiology fellows, diagnostic coronary angiography represents an excellent target for SBE. Reports of SBE in interventional cardiology are limited and there is little understanding of the potential downstream clinical impact of these interventions. All diagnostic coronary angiograms performed at a single center between January 1, 2011 and June 30, 2015 were analyzed. Random effects linear regression models were used to compare outcomes between procedures performed by 12 cardiology fellows who underwent simulation-based training and those performed by 20 traditionally trained fellows. Thirty-two cardiology fellows performed 2,783 diagnostic coronary angiograms. Procedures performed by fellows trained with SBE were shorter (mean of 23.98 min vs. 24.94 min, P = 0.034) and were performed with decreased radiation (mean of 56,348 mGycm 2 vs. 66,120 mGycm 2 , P < 0.001). After controlling for year in training, procedure year, access site, and supervising attending physician, training on the simulator was independently associated with 117 fewer seconds of fluoroscopy time per procedure (P = 0.04). Diagnostic coronary angiography SBE is associated with decreased use of fluoroscopy in downstream clinical care. SBE may be a useful tool to reduce radiation exposure in the cardiac catheterization laboratory. © 2017 Wiley Periodicals, Inc.

Development of a diagnostic protocol for dizziness in elderly patients in general practice: a Delphi procedure.

NARCIS (Netherlands)

Maarsingh, O.R.; Dros, J.; Weert, H.C. van; Schellevis, F.G.; Bindels, P.J.; Horst, H.E. van der

2009-01-01

BACKGROUND: Dizziness in general practice is very common, especially in elderly patients. The empirical evidence for diagnostic tests in the evaluation of dizziness is scarce. Aim of our study was to determine which set of diagnostic tests should be part of a diagnostic protocol for evaluating

Evaluating Utility in Diagnostic Decision Making.

Science.gov (United States)

Harber, Jean R.

1981-01-01

The utility of the procedures special educators apply in making decisions about the identification of handicapped individuals has not been thoroughly studied. The paper examines the utility of diagnostic decision making from the perspective of receiver operating curve analysis. (Author)

Radiation safety in nuclear medicine procedures

International Nuclear Information System (INIS)

Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun

2017-01-01

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed

Radiation safety in nuclear medicine procedures

Energy Technology Data Exchange (ETDEWEB)

Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun [Dept. of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, Gwangju (Korea, Republic of)

2017-03-15

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

Improvement of Railroad Roller Bearing Test Procedures & Development of Roller Bearing Diagnostic Techniques. Volume 2.

Science.gov (United States)

1982-04-01

A comprehensive review of existing basic diagnostic techniques applicable to the railcar roller bearing defect and failure problem was made. Of the potentially feasible diagnostic techniques identified, high frequency vibration was selected for exper...

Visuomotor correction is a robust contributor to force variability during index finger abduction by older adults

Directory of Open Access Journals (Sweden)

Brian L Tracy

2015-12-01

Full Text Available We examined aging-related differences in the contribution of visuomotor correction to force fluctuations during index finger abduction via the analysis of two datasets from similar subjects. Study 1 Young (N= 27, 23+/-8 yrs and older adults (N=14, 72+/- 9 yrs underwent assessment of maximum voluntary contraction force (MVC and force steadiness during constant-force (CF index finger abduction (2.5, 30, 65% MVC. For each trial, visual feedback of the force (VIS was provided for 8-10 s and removed for 8-10s (NOVIS. Visual gain of the force feedback at 2.5% MVC was high; 12- and 26-fold greater than the 30% and 65% MVC targets. Mean force, standard deviation (SD of force, and coefficient of variation (CV of force was calculated for detrended (<0.5Hz drift removed VIS and NOVIS data segments. Study 2 A similar group of 14 older adults performed discrete, randomly-ordered VIS or NOVIS trials at low target forces (1-3% MVC and high visual gain. Study 1 For young adults the CV of force was similar between VIS and NOVIS for the 2.5% (4.8 vs. 4.3%, 30% (3.2 vs. 3.2% and 65% (3.5 vs. 4.2% target forces. In contrast, for older adults the CV of force was greater for VIS than NOVIS for 2.5% MVC (6.6 vs. 4.2%, P<0.001, but not for the 30% (2.4 vs. 2.4% and 65% (3.1 vs. 3.3% target forces. At 2.5% MVC, the increase in CV of force for VIS compared with NOVIS was significantly greater (age x visual condition P=0.008 for older than young adults. Study 2 Similarly, for older adults performing discrete, randomly ordered trials the CV of force was greater for VIS than NOVIS (6.04 vs. 3.81%, P=0.01. When visual force feedback was a dominant source of information at low forces, normalized force variability was ~58% greater for older adults, but only 11% greater for young adults. The significant effect of visual feedback for older adults was not dependent on the order of presentation of visual conditions. The results indicate that impaired processing of visuomotor

Diagnostic radiation and pregnancy

International Nuclear Information System (INIS)

Collins, L.; Fitzgerald, P.

1983-01-01

Accidental irradiation of the embryo or fetus in the first trimester is a problem which will occasionally occur. The value of a proper estimation of the radiation dose is emphasised. Very rarely does a single diagnostic procedure result in a uterine dose as high as 50 mGy. An accidental irradiation should rarely be cause for termination of a pregnancy

Diagnostic challenges of childhood asthma.

Science.gov (United States)

Bakirtas, Arzu

2017-01-01

Diagnosis of asthma in childhood is challenging. Both underdiagnosis and overdiagnosis of asthma are important issues. The present review gives information about challenging factors for an accurate diagnosis of childhood asthma. Although underdiagnosis of asthma in childhood has always been the most important diagnostic problem, overdiagnosis of asthma has also been increasingly recognized. This is probably due to diagnosis of asthma based on symptoms and signs alone. Demonstration of variable airflow obstruction by lung function tests is the most common asthma diagnostic tests used in practice and is therefore strongly recommended in children who can cooperate. Recently, an asthma guideline combining the clinical and economic evidences with sensitivity and specificity of diagnostic procedures was developed to improve accuracy of diagnosis and to avoid overdiagnosis. This guideline provided an algorithmic clinical and cost-effective approach and included fractional exhaled nitric oxide measurement as one of the diagnostic tests in addition to lung function. Diagnosis of asthma in children should be made by combining relevant history with at least two confirmatory diagnostic tests whenever possible. Diagnosis based on short-period treatment trials should be limited to young children who are unable to cooperate with these tests.

A decision support system based on hybrid knowledge approach for nuclear power plant operation

International Nuclear Information System (INIS)

Yang, J.O.; Chang, S.H.

1991-01-01

This paper describes a diagnostic expert system, HYPOSS (Hybrid Knowledge Based Plant Operation Supporting System), which has been developed to support operators' decision making during the transients of nuclear power plant. HYPOSS adopts the hybrid knowledge approach which combines shallow and deep knowledge to couple the merits of both approaches. In HYPOSS, four types of knowledge are used according to the steps of diagnosis procedure: structural, functional, behavioral and heuristic knowledge. Frames and rules are adopted to represent the various knowledge types. Rule-based deduction and abduction are used for shallow and deep knowledge based reasoning respectively. The event-based operational guidelines are provided to the operator according to the diagnosed results

[The "diagnosis" in the light of Charles S. Peirce, Sherlock Holmes, Sigmund Freud and modern neurobiology].

Science.gov (United States)

Adler, R H

2006-05-10

A diagnostic hypothesis is a causa ficta. It is an assumption, suitable to explain phenomena, which are not yet proven to be the only and valid explanation of the observed. One of Wilhelm Hauff's faitales illustrates how a hypothesis is generated. It is based on the interpretation of signs. Signs are of an ikonic, an indexical or a symbolic nature. According to S. Peirce, a hypothesis is created by abduction, to Conan Doyle's Sherlock Holmes by immersion into thoughts, and to S. Freud by free floating attention. The three procedures are alike. Neurobiological structures and functions, which correspond to these processes, are described; especially the emotional-implicite memory. The technique of hypothesis-generation is meaningful to clinical medicine.

78 FR 59701 - Medicare Program; Approval of Accrediting Organization for Suppliers of Advanced Diagnostic...

Science.gov (United States)

2013-09-27

...] Medicare Program; Approval of Accrediting Organization for Suppliers of Advanced Diagnostic Imaging... accredit suppliers seeking to furnish the technical component (TC) of advanced diagnostic imaging services... advanced diagnostic imaging (ADI) service and establish procedures to ensure that the criteria used by an...

Galactography: the diagnostic procedure of choice for nipple discharge

International Nuclear Information System (INIS)

Tabar, L.; Dean, P.B.; Pentek, Z.

1983-01-01

Galactogrpahy was performed in 204 women with a nipple discharge and the secretion confirmed histopathologically. All 116 intraductal tumors (papilloma, papillomatosis, carcinoma), which were associated with a serous or bloody discharge, were detected preoperatively. A palpable mass had little diagnostic significance, and exfoliative cytology was positive in only 11% (2/18) of the patients with carcinoma. The authors recommend that all patients with a spontaneous bloody or serous discharge from a single lactiferous orifice undergo galactography in addition to physical, cytological, and mammographic examination. Intraductal injection of methylene blue dye will demonstrate the affected duct system to the surgeon and can often make surgery less radical or even unnecessary

War-Related Abduction and History of Incarceration Linked to High Burden of HIV Among Female Sex Workers in Conflict-Affected Northern Uganda.

Science.gov (United States)

Goldenberg, Shira M; Muzaaya, Godfrey; Akello, Monica; Nguyen, Paul; Birungi, Josephine; Shannon, Kate

2016-09-01

Sex workers (SWs) in sub-Saharan Africa face a disproportionate HIV burden and growing concerns of severe human rights violations. Given the dearth of evidence on the burden and correlates of HIV among SWs in sub-Saharan Africa, particularly within conflict-affected settings, we examined the relationship between structural determinants (eg, war-related abduction, incarceration) and HIV infection among conflict-affected SWs in Northern Uganda. Cross-sectional community-based research study among female SWs in conflict-affected Gulu, Northern Uganda. Interview questionnaires and voluntary HIV testing were conducted with participants recruited through SW/peer-led outreach and time-location sampling from 2011 to 2012. HIV prevalence was calculated, and bivariable and multivariable logistic regression was used to identify independent associations with HIV seroprevalence. Of 400 SWs, 135 (33.75%) were HIV seropositive; of whom one-third were new/previously undiagnosed HIV infections. In multivariable analysis, after adjusting for age of sex work entry and education, lifetime incarceration (adjusted odds ratio: 1.93, 95% confidence interval: 1.17 to -3.20) was independently associated with HIV seroprevalence, and history of wartime abduction (adjusted odds ratio: 1.62, 95% confidence interval: 1.00 to 2.63) was marginally associated (P = 0.051). This study documented a high rate of undiagnosed HIV infections and associations between war-related human rights violations, incarceration, and a heavy HIV burden among SWs in conflict-affected Northern Uganda. These findings highlight the serious harms of conflict and criminalization of marginalized women in sub-Saharan African contexts. SW-led interventions that address conflict experiences and policy shifts to promote a rights-based approach to HIV prevention and care remain critically needed.

Radionuclide diagnostics in St. Petersburg: сurrent status and development challenges

Directory of Open Access Journals (Sweden)

I. A. Zvonova

2015-01-01

Full Text Available This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.Materials and methods. The radionuclide diagnostics temporal and structural changes’ analysis was based on Federal state statistical observation forms No.3-DOZ for St. Petersburg and on the results of radionuclide diagnostics subdivision surveys with radiology physicians’ questionnaires on the amount and composition of conducted examinations, dosages of introduced radioactivity of radiopharmaceticals and patients’ doses.The results. Since the end of 1990s until 2012 the amount of radionuclide diagnostics procedures had been steadily reducing. 74000 procedures were conducted in 2005 and 35500 in 2012. The number of radionuclide diagnostics procedures per one thousand residents reduced from 16 to 7.2. Both indicators slightly grew in 2013. In 2014 the total number of radiodiagnostic proceduress amounted up to 42000 and 8.2 tests per 1000 residents. Since 2011 the diagnostic equipment was upgraded. Four medical institutions received SPECT (single photon emission computed tomography or SPECT/CT, two new PET ( positron emission tomographs – centers were set up, three medical institutions had acquired positron emission tomographs (PET and are conducting PET – diagnostics receiving radiofarmaceuticals from external PET – center. At the same time one a third of radiodiagnostic units still has been operating obsolete and depreciated equipment dating back to 1980–1990 .Inspection results indicated that St. Petersburg

The effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics.

Science.gov (United States)

Verheul, R; Hartgers, C; Van den Brink, W; Koeter, M W

1998-03-01

OBJECTIVE. In a recent review of empirical studies on the prevalence of DSM-III-R personality disorders among substance abusers, wide ranges of prevalence rates for overall Axis II, antisocial personality disorder (APD) and borderline personality disorder (BPD) were shown. Utilizing subsamples from within a single study population, the current report explores the effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics. Personality disorders were assessed with the Personality Diagnostic Questionnaire Revised (PDQR) at two times of measurement (Time 1 n = 459; Time 2 n = 90). In addition, APD was measured with the Composite International Diagnostic Interview (CIDI; n = 587). Finally, an unselected subgroup (n = 136) was interviewed with the International Personality Disorder Examination (IPDE). There were few differences between inpatients or outpatients or between males and females. Using the IPDE, the exclusion of substance-related pathology did not affect the prevalence estimate. However, the prevalence rates according to the PDQR varied greatly across age groups. In a representative subsample (n = 109), the prevalence rates also varied greatly across assessment methods (PDQR, 52% vs IPDE, 31%). The prevalence estimate of APD according to the CIDI was related to setting, gender, age group and the applied time-frame. These findings indicate the examined factors to be necessary qualifiers of prevalence estimates and, consequently, support the use of a multiple-criteria/multimethod assessment battery in research as well as in clinical work.

Requirements for the special examination of isotope diagnostic specialists

International Nuclear Information System (INIS)

Csakany, Gyoergy

1986-01-01

Isotope diagnostic specialists are required to possess general paraclinical knowledge about nuclear physical principles, basic radiological measuring methods including up-to-date ones such as scintiscanning and tomography, as well as about radiopharmacology, radiation biology, health physics, radiation protection and organizational and economic aspects of the examinations. Clinical isotope diagnostic requirements comprise the proper selection among different radiological methods, the correct application of certain diagnostic procedures in practise, and the evaluation of the results in accordance with the symptoms on various fields of medical science. (V.N.)

Comparative guide to emerging diagnostic tools for large commercial HVAC systems; TOPICAL

International Nuclear Information System (INIS)

Friedman, Hannah; Piette, Mary Ann

2001-01-01

This guide compares emerging diagnostic software tools that aid detection and diagnosis of operational problems for large HVAC systems. We have evaluated six tools for use with energy management control system (EMCS) or other monitoring data. The diagnostic tools summarize relevant performance metrics, display plots for manual analysis, and perform automated diagnostic procedures. Our comparative analysis presents nine summary tables with supporting explanatory text and includes sample diagnostic screens for each tool

Chest X-ray : a cost-diagnostic benefit analysis

International Nuclear Information System (INIS)

Winter, L.H.L.

1991-01-01

Although plain chest radiography is one of the most useful diagnostic tools available to the physician, this procedure has not evolved into a consistent method. Two Large Field of View Image Intensifiers (LFOV-II) became available; the large imaging area makes them suitable for chest imaging. Both modalities supply 100 mm images to the radiologist. In this thesis the 'diagnostic benefits and 'costs' of these modalities are evaluated and related to the 'gold' standard (conventional full-size). The emphasis is on diagnostic image quality using phantoms for observer performance qualities. (author). 170 refs.; 21 figs.; 47 tabs

Knowledge acquisition for nuclear power plant unit diagnostic system

International Nuclear Information System (INIS)

Li Xiaodong; Xi Shuren

2003-01-01

The process of acquiring knowledge and building a knowledge base is critical to realize fault diagnostic system at unit level in a nuclear power plant. It directly determines whether the diagnostic system can be applied eventually in a commercial plant. A means to acquire knowledge and its procedures was presented in this paper for fault diagnostic system in a nuclear power plant. The work can be carried out step by step and it is feasible in a commercial nuclear power plant. The knowledge base of the fault diagnostic system for a nuclear power plant can be built after the staff finish the tasks according to the framework presented in this paper

Does MR imaging effectively replace diagnostic arthroscopy

International Nuclear Information System (INIS)

Ruwe, P.; McCarthy, S.; Wright, J.; Randall, L.; Lynch, K.; Jokyl, P.

1990-01-01

This paper determines if MR imaging reduces the number of diagnostic arthroscopic procedures required in patients with knee complaints and if MR imaging is cost-effective compared with diagnostic arthroscopy. The cohort analysis consists of 100 patients seen in a sports medicine clinic by two orthopedic surgeons who agreed on well-defined criteria for performing MR imaging and arthroscopy. Each orthopedic surgeon referring a patient for MR imaging checked a form regarding the plans for arthroscopy. Outcome analysis was conducted at 6 months

An edge over diagnostic setup

Directory of Open Access Journals (Sweden)

Sridhar Kannan

2017-01-01

Full Text Available Diagnostic setup proposed by H.D. Kingsley serves as a practical aid in treatment planning and diagnosis. These setups have some inherent shortcomings. A simple technique of duplication of the setups in dental stone can solve problems encountered before as well as provide many other advantages over the conventional procedure. The diagnostic setup is prepared by the conventional method [Figure 1]. An alginate impression is then taken of the setups and poured in dental stone to obtain the derived treatment model [Figure 2]. The same setup can now be further modified for alternate lines of treatment. Subsequently models could then be obtained as required [Figure 3].

Interventional diagnostic breast procedures; Diagnostische Mammainterventionen

Energy Technology Data Exchange (ETDEWEB)

Bick, U. [Inst. fuer Radiologie, Universitaetsklinikum Charite, Berlin (Germany); Dept. of Radiology, The Univ. of Chicago (United States); Diekmann, S.; Diekmann, F. [Inst. fuer Radiologie, Universitaetsklinikum Charite, Berlin (Germany)

2001-09-01

The comprehensive survey describes in great detail the indications, performance, and advantages and drawbacks of the various biopsy and localization techniques available today for interventional diagnostic evaluation of lesions of the breast. (orig./CB) [German] Die Feinnadelaspirationszytologie ist einfach und rasch durchfuehrbar, ist jedoch insbesondere in der Hand von unerfahrenen Untersuchern mit einer relativ hohen Rate von nicht auswertbaren und falsch-negativen Befunden verbunden. Das Verfahren wird am haeufigsten bei soliden oder zystischen Herdbefunden eingesetzt, die palpabel oder sonographisch nachweisbar sind. Bei inadaequatem Zellmaterial muss eine erneute Biopsie, ggf. mit einem anderen Verfahren, erfolgen. Die Nadelstanzbiopsie ist heutzutage das Verfahren der Wahl bei mammographisch oder sonographisch sichtbaren soliden Herdbefunden. Das Verfahren ist einfach und kostenguenstig durchfuehrbar und weist bei soliden Herdbefunden eine extrem hohe Sensitivitaet und Spezifitaet auf. Bei Mikroverkalkungen sollten immer ausreichend viele Stanzen (5 und mehr) entnommen werden. Bei Stanzbiopsien besteht grundsaetzlich die Gefahr einer Unterschaetzung des histologischen Befundes (ADH statt DCIS, in situ statt invasiv). Bei Diagnose ADH in der Stanzbiopsie sollte eine Exzision des Befundes erfolgen. Die vakuumassistierte Stanzbiopsie ist besonders beeignet zur Biopsie von unklaren Mikroverkalkungen, da durch die groessere entnommene Gewebemenge eine hoehere Spezifitaet und Sensitivitaet erreicht werden kann. Fuer MR-gesteuerte Biopsien hat dieses Verfahren den Vorteil, dass die Nadel nur einmal platziert werden muss. Die stereotaktische Exzisionsbiopsie ist ein relativ teures und invasives Verfahren, das insbesondere zur diagnostischen Abklaerung von unklaren Mikroverkalkungen eingesetzt wird. Hierbei steht das Verfahren in direkter Konkurrenz zur vakuumassistierten Stanzbiopsie. Inwieweit es fuer die stereotaktische Exzisionsbiopsie wirklich ein

Diagnostic radiation risks

Energy Technology Data Exchange (ETDEWEB)

Sherwood, T [Addenbrooke' s Hospital, Cambridge (UK)

1980-04-01

A brief discussion on diagnostic radiation risks is given. First some fundamental facts on the concepts and units of radiation measurement are clarified. Medical diagnostic radiation doses are also compared to the radiation doses received annually by man from natural background radiation. The controversy concerning the '10-day rule' in X-raying women of child-bearing age is discussed; it would appear that the risk of malformation in an unborn child due to X-radiation is very much less than the natural level of risk of malformation. The differences in the radiographic techniques and thus the different X-ray doses needed to make adequate X-ray images of different parts of the body are considered. The radiation burden of nuclear medicine investigations compared to X-ray procedures is also discussed. Finally, the problems of using volunteers in radiation research are aired.

Diagnostic CT and percutaneous procedures after pancreatic transplantation

International Nuclear Information System (INIS)

Letourneau, J.G.; Hunter, D.W.; Thompson, W.M.; Sutherland, D.E.R.

1987-01-01

CT evaluation of the abdomen and pelvis is of great value after pancreatic transplantation. The expected CT appearance after pancreas transportation with both enteric and bladder drainage of exocrine function are presented, as is the appearance of infected and ischemic grafts. The CT detection and CT- and US-guided percutaneous aspiration and drainage of abdominal fluid collections are described. At the authors' institution, such aspiration and drainage procedures have obviated transplant pancreatectomy or surgical abscess drainage in 29% of patients

Receiver operating characteristic analysis of eyewitness memory: comparing the diagnostic accuracy of simultaneous versus sequential lineups.

Science.gov (United States)

Mickes, Laura; Flowe, Heather D; Wixted, John T

2012-12-01

A police lineup presents a real-world signal-detection problem because there are two possible states of the world (the suspect is either innocent or guilty), some degree of information about the true state of the world is available (the eyewitness has some degree of memory for the perpetrator), and a decision is made (identifying the suspect or not). A similar state of affairs applies to diagnostic tests in medicine because, in a patient, the disease is either present or absent, a diagnostic test yields some degree of information about the true state of affairs, and a decision is made about the presence or absence of the disease. In medicine, receiver operating characteristic (ROC) analysis is the standard method for assessing diagnostic accuracy. By contrast, in the eyewitness memory literature, this powerful technique has never been used. Instead, researchers have attempted to assess the diagnostic performance of different lineup procedures using methods that cannot identify the better procedure (e.g., by computing a diagnosticity ratio). Here, we describe the basics of ROC analysis, explaining why it is needed and showing how to use it to measure the performance of different lineup procedures. To illustrate the unique advantages of this technique, we also report 3 ROC experiments that were designed to investigate the diagnostic accuracy of simultaneous versus sequential lineups. According to our findings, the sequential procedure appears to be inferior to the simultaneous procedure in discriminating between the presence versus absence of a guilty suspect in a lineup.

[EYECUBE as 3D multimedia imaging in macular diagnostics].

Science.gov (United States)

Hassenstein, Andrea; Scholz, F; Richard, G

2011-11-01

In the new generation of EYECUBE devices, the angiography image and the OCT are included in a 3D illustration as an integration. Other diagnostic procedures such as autofluorescence and ICG can also be correlated to the OCT. The aim was to precisely classify various two-dimensional findings in relation to each other. The new generation of OCT devices enables imaging with a low incidence of motion artefacts with very good fundus image quality - and with that, permits a largely automatic classification. The feature enabling the integration of the EYECUBE was further developed with new software, so that not only the topographic image (red-free, autofluorescence) can be correlated to the Cirrus OCT, but also all other findings gathered within the same time frame can be correlated to each other. These were brightened and projected onto the cube surface in a defined interval. The imaging procedures can be selected in a menu toolbar. Topographic volumetry OCT images can be overlayed. The practical application of the new method was tested on patients with macular disorders. By lightening up the results from various diagnostic procedures, it is possible of late to directly compare pathologies to each other and to the OCT results. In all patients (n = 45 eyes) with good single-image quality, the automated integration into the EYECUBE was possible (to a great extent). The application is not dependent on a certain type of device used in the procedures performed. The increasing level of precision in imaging procedures and the handling of large data volumes has led to the possibility of examining each macular diagnostics procedure from the comparative perspective: imaging (photo) with perfusion (FLA, ICG) and morphology (OCT). The exclusion of motion artefacts and the reliable scan position in the course of the imaging process increases the informative value of OCT. © Georg Thieme Verlag KG Stuttgart · New York.

Video integrated measurement system. [Diagnostic display devices

Energy Technology Data Exchange (ETDEWEB)

Spector, B.; Eilbert, L.; Finando, S.; Fukuda, F.

1982-06-01

A Video Integrated Measurement (VIM) System is described which incorporates the use of various noninvasive diagnostic procedures (moire contourography, electromyography, posturometry, infrared thermography, etc.), used individually or in combination, for the evaluation of neuromusculoskeletal and other disorders and their management with biofeedback and other therapeutic procedures. The system provides for measuring individual diagnostic and therapeutic modes, or multiple modes by split screen superimposition, of real time (actual) images of the patient and idealized (ideal-normal) models on a video monitor, along with analog and digital data, graphics, color, and other transduced symbolic information. It is concluded that this system provides an innovative and efficient method by which the therapist and patient can interact in biofeedback training/learning processes and holds considerable promise for more effective measurement and treatment of a wide variety of physical and behavioral disorders.

Cocoa swollen shoot virus in Ghana: A review of diagnostic ...

African Journals Online (AJOL)

A quick and more reliable diagnostic method has for a long time been identified as one input that will greatly enhance the control of the cocoa swollen shoot disease in Ghana. Many diagnostic procedures have been developed for detecting the virus that causes the disease; yet, the detection of latent infections is still ...

Acute abdomen. Diagnostic radiology according to principal signs

International Nuclear Information System (INIS)

Krestin, G.P.

1994-01-01

The acute abdomen is a frequent and very often dangerous syndrome which requires sophisticated diagnostic evaluation. A decisive factor determining the following case history is efficient and exact diagnosis, calling for experienced clinical and diagnostic experts for efficient application of available methods, and correct interpretation of findings. The book offers: 1. Practice-oriented diagnostic strategies, based on 13 principal signs and constellations derived from clinical experience, presented in each chapter as a combination of - suitable differential diagnostic procedures and methods,- exhaustive description of the clinical signs and diagnostic findings specific of the various symptoms,- algorithmic presentations. 2. A special chapter on the pediatric acute abdomen. 3. The most important findings shown in more than 250 original pictures. 4. A graphical design and presentation of the information which permits quick access to the important content. (orig./CB) [de

Metadata requirements for results of diagnostic imaging procedures: a BIIF profile to support user applications

Science.gov (United States)

Brown, Nicholas J.; Lloyd, David S.; Reynolds, Melvin I.; Plummer, David L.

2002-05-01

A visible digital image is rendered from a set of digital image data. Medical digital image data can be stored as either: (a) pre-rendered format, corresponding to a photographic print, or (b) un-rendered format, corresponding to a photographic negative. The appropriate image data storage format and associated header data (metadata) required by a user of the results of a diagnostic procedure recorded electronically depends on the task(s) to be performed. The DICOM standard provides a rich set of metadata that supports the needs of complex applications. Many end user applications, such as simple report text viewing and display of a selected image, are not so demanding and generic image formats such as JPEG are sometimes used. However, these are lacking some basic identification requirements. In this paper we make specific proposals for minimal extensions to generic image metadata of value in various domains, which enable safe use in the case of two simple healthcare end user scenarios: (a) viewing of text and a selected JPEG image activated by a hyperlink and (b) viewing of one or more JPEG images together with superimposed text and graphics annotation using a file specified by a profile of the ISO/IEC Basic Image Interchange Format (BIIF).

Combining principles of Cognitive Load Theory and diagnostic error analysis for designing job aids: Effects on motivation and diagnostic performance in a process control task.

Science.gov (United States)

Kluge, Annette; Grauel, Britta; Burkolter, Dina

2013-03-01

Two studies are presented in which the design of a procedural aid and the impact of an additional decision aid for process control were assessed. In Study 1, a procedural aid was developed that avoids imposing unnecessary extraneous cognitive load on novices when controlling a complex technical system. This newly designed procedural aid positively affected germane load, attention, satisfaction, motivation, knowledge acquisition and diagnostic speed for novel faults. In Study 2, the effect of a decision aid for use before the procedural aid was investigated, which was developed based on an analysis of diagnostic errors committed in Study 1. Results showed that novices were able to diagnose both novel faults and practised faults, and were even faster at diagnosing novel faults. This research contributes to the question of how to optimally support novices in dealing with technical faults in process control. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Diagnostic X-ray equipment evaluation in Brazil

International Nuclear Information System (INIS)

Campos de Araujo, A.M.; Peixoto, J.E.; Reis, V.R.G.

1980-01-01

A survey of the diagnostic X-ray equipment in use in Brazil is presented. Procedures for testing radiation quality (kilovoltage and filtration), tube output, beam collimation and protection devices are described and results of tests are tabulated. (H.K.)

Assessing Disease Class-Specific Diagnostic Ability: A Practical Adaptive Test Approach.

Science.gov (United States)

Papa, Frank J.; Schumacker, Randall E.

Measures of the robustness of disease class-specific diagnostic concepts could play a central role in training programs designed to assure the development of diagnostic competence. In the pilot study, the authors used disease/sign-symptom conditional probability estimates, Monte Carlo procedures, and artificial intelligence (AI) tools to create…

Efficacy of clinical diagnostic procedures utilized in nuclear medicine. Technical progress report, 1 December 1981-30 November 1982

International Nuclear Information System (INIS)

Saenger, E.L.

1982-07-01

The efficacy of nuclear medicine diagnostic procedures was measured. Three levels of efficacy were defined. However, two different methods of evaluating efficacy itself were first compared. Using two methods, logistic regression and entropy-minimax pattern detection, substantial agreement was found between them in several clinical observations. (1) There are no attributes that indicate that any grouping of symptoms, signs, and laboratory findings is capable of suggesting that a patient does or does not have a pulmonary embolus. (2) The lung scan test is the only reliable method which indicates that a patient may have a pulmonary embolus or does not have a pulmonary embolus. (3) The validity of these conclusions and the ability to apply them widely to ongoing clinical practice is based on the prospective design of the Study which included an appropriate distribution of institutions by type, size, and geographic location. Also, the only judgement samples was that of the referring physician

Patient dose with quality image under diagnostic reference levels

International Nuclear Information System (INIS)

Akula, Suresh Kumar; Singh, Gurvinder; Chougule, Arun

2016-01-01

Need to set Diagnostic Reference Level (DRL) for locations for all diagnostic procedures in local as compared to National. The review of DRL's should compare local with national or referenced averages and a note made of any significant variances to these averages and the justification for it. To survey and asses radiation doses to patient and reduce the redundancy in patient imaging to maintain DRLs

Absorbed dose to active red bone marrow from diagnostic and therapeutic uses of radiation

International Nuclear Information System (INIS)

Solomon, S.B.

1980-06-01

The bone-marrow dose arising from radiological procedures as carried out in Australia have been determined as part of a survey of population doses. This paper describes the method of calculation of the radiation doses to the active bone marrow from diagnostic radiography, fluoroscopy and radiotherapy. The results of the calculations are compared with the results of other models of bone-marrow dose for a number of diagnostic X-ray procedures

Deterministic effects of interventional radiology procedures

International Nuclear Information System (INIS)

Shope, Thomas B.

1997-01-01

The purpose of this paper is to describe deterministic radiation injuries reported to the Food and Drug Administration (FDA) that resulted from therapeutic, interventional procedures performed under fluoroscopic guidance, and to investigate the procedure or equipment-related factors that may have contributed to the injury. Reports submitted to the FDA under both mandatory and voluntary reporting requirements which described radiation-induced skin injuries from fluoroscopy were investigated. Serious skin injuries, including moist desquamation and tissues necrosis, have occurred since 1992. These injuries have resulted from a variety of interventional procedures which have required extended periods of fluoroscopy compared to typical diagnostic procedures. Facilities conducting therapeutic interventional procedures need to be aware of the potential for patient radiation injury and take appropriate steps to limit the potential for injury. (author)

Diagnostic pure transgastric NOTES in an intensive therapy unit patient

Directory of Open Access Journals (Sweden)

Maciej Michalik

2011-06-01

Full Text Available Natural orifice transluminal endoscopic surgery (NOTES is a natural consequence of evolution in minimally invasivesurgery. It allows one to reduce surgical trauma and the number of complications and to improve cosmetic outcomes.It also shortens the patient’s recovery time. So far there have been only nine NOTES procedures performed in Polandand around 200 NOTES interventions performed worldwide. In this paper a transgastric diagnostic NOTES procedurein a critically ill patient is described. A 60-year-old male patient with multi-organ failure (circulatory, respiratory andrenal insufficiency, with co-morbid hypothyroidism and diabetes mellitus hospitalized in the intensive therapy unit(ITU with unknown cause of his condition was qualified for transgastric diagnostic NOTES procedure. This interventionrevealed the diagnosis of metastatic neoplastic disease and allowed persistent therapy to be avoided. DiagnosticNOTES in selected patients seems to be a very useful. It provides fast diagnosis with relatively small perioperativetrauma. It is an easy procedure that requires a regular or operative endoscope, one surgeon and an endoscopic nurse.It can be done anywhere, including at the patient’s bedside. It provides specimens for histopathology and speeds updiagnostics and decision making, especially in terminally ill patients.

Application of diagnostic system for diesel engine

International Nuclear Information System (INIS)

Yoshinaga, Takeshi; Hayashi, Haruji; Usui, Hiromi; Tsuruzono, Atsuya; Matsuda, Takafumi

2008-01-01

The Japan Atomic Power Company (JAPC) began to implement Condition Based Maintenance (CBM) for rotating components (pumps, fans and electric motors) from 1999 and, also has begun to apply diesel engine diagnostic techniques at our three nuclear power plants since 2004. This paper provides a description of the CBM methods used for diesel engines in nuclear standby service, a summary of the procedures to introduce these diagnostic techniques to our nuclear power plants, and experience with the application of these methods to JAPC nuclear power plants. (author)

Evaluating the diagnostic device DETEC-PC for the thyroid uptakes

International Nuclear Information System (INIS)

Alonso Abad, Dolores; Arista Romeu, Eduardo; Alonso Abad, Ariel

2008-01-01

A study is presented for evaluating the diagnostic capacity of the DETEC-PC, detection measurement system for the Thyroid Uptakes. A clinical trial was designed for that effect and all the patients included were evaluated using the DETEC-PC and the well-known radioimmunoassay (RIA) standard diagnostic procedure known by acronym RIA. For the Thyroid Uptakes using the DETEC-PC patients received an oral administration of a solution of radioactive iodine. The radioactive substance is attracted chemically to the gland and ionising radiation detector captures their emissions. The iodine concentration in the Thyroid, as well as the variation of this concentration over time reflects the function of the gland. The RIA is based on the analysis of the values associated with the t3, t4 and tsh hormones, and when these three parameters are in a certain range the patients can be classified. The sample size was calculated in order to estimate the gross coincidence percent between both methods with a precision of 1 % at a confidence level of 95%. In total 110 patients were included in the trial. Mainly two types of statistical analysis were carried out, in the first analysis all the patients included in the study were considered whereas in the second analysis the patients with doubtful RIA results were not included. Ideally the performance of a diagnostic tool is evaluated through the estimation of its sensitivity and specificity. Nevertheless, in the present study the reference procedure (RIA) can not be considered a gold standard diagnostic device. In such a setting the international regulations advise to use measurements of agreement to evaluate the diagnostic capacity of the new method. In the present study we evaluated the level of diagnostic agreement between the DETEC-PC and the RIA using the Kappa statistics. Additionally, the confidence interval for the Kappa statistics and the corresponding significant test for the present of agreement were also computes. The obtained

Dosimetry in Diagnostic Radiology for Paediatric Patients

International Nuclear Information System (INIS)

2013-01-01

Concern about the radiation dose to children from diagnostic radiology examinations has recently been popularly expressed, particularly as related to computed tomography (CT) procedures. This involves the observation that children can receive doses far in excess of those delivered to adults, in part due to the digital nature of the image receptors that may give no warning to the operator of the dose to the patient. Concern for CT examinations should be extended to the broad range of paediatric diagnostic radiological procedures responsible for radiation doses in children, especially as factors, such as increased radiosensitivity and the longer life expectancy of children, increase the associated radiation risk. In all cases, owing to the added paediatric radiological examination factor of patient size and its associated impact on equipment selection, clinical examination protocol and dosimetric audit, the determination of paediatric dose requires a distinct approach from adult dosimetry associated with diagnostic radiological examinations. In response to this, there is a need to inform health professionals about standardized methodologies used to determine paediatric dose for all major modalities such as general radiography, fluoroscopy and CT. Methodologies for standardizing the conduct of dose audits and their use for the derivation and application of diagnostic reference levels for patient populations, that vary in size, are also required. In addition, a review is needed of the current knowledge on risks specific to non-adults from radiation, and also an analysis of the management of factors contributing to dose from paediatric radiological examinations. In 2007, the IAEA published a code of practice, Dosimetry in Diagnostic Radiology: An International Code of Practice, as Technical Reports Series No. 457 (TRS 457). TRS 457 recommends procedures for dosimetric measurement and calibration for the attainment of standardized dosimetry, and addresses requirements

Diagnostic ultrasound in pregnancy - ethical problems

International Nuclear Information System (INIS)

Sande, H.A.

1991-01-01

Foetal diagnostics has changed prenatal checkups beyond the point of no return. The practice of offering ultrasound screening involves great responsibility. Routine ultrasound screening requires a high level of competency. Four main ethical issues are discussed; life or death, malformations, the foetus as patient, and the feotus as donor. Other issues discussed are verifying the diagnosis of death, how to inform the parents, procedures in connection with pathological findings, procedures in connection with stillbirth, and the legal rights of the foetus, as well as three recommendations focussing on the above-mentioned issues. 9 refs

[Small-cell lung cancer: epidemiology, diagnostics and therapy].

Science.gov (United States)

Pešek, Miloš; Mužík, Jan

Authors present actual overview of information on diagnostic and therapeutic procedures in small-cell lung cancer (SCLC). This highly aggressive type of lung cancer is diagnosed in 14.8 % of Czech lung cancer patients. Vast majority of those patients (87 %) suffer from advanced and metastatic disease in the time of diagnosis. In this issue are presented prognostic factors, staging diagnostic procedures and therapeutic recommendations. The backbone of actual SCLC treatment is combined chemotherapy and radiotherapy and less frequently, carefully in selected cases, surgical procedures. SCLC should be have as chemosensitive, chemoresistent or chemorefractory disease. Actual cytostatic combinations used in 1st line treatment, different schedules of chemoradiotherapy, drugs used in second line treatment and schedules and timing of prophylactic brain irradiation are presented. In near future, perspectively, there are some promissible data on antitumour immunotherapy based on anti CTLA-4 and anti PD-1/PE-L1 antibodies also in SCLC patients.Key words: cancer immunotherapy - concomitant chemoradiotherapy - chemotherapy - chest radiotherapy - lung resections - prophylactic brain irradiation - small cell lung cancer.

Incidence and predictors of silent embolic cerebral infarction following diagnostic coronary angiography.

Science.gov (United States)

Kim, In-Cheol; Hur, Seung-Ho; Park, Nam-Hee; Jun, Dong-Hwan; Cho, Yun-Kyeong; Nam, Chang-Wook; Kim, Hyungseop; Han, Seong-Wook; Choi, Sae-Young; Kim, Yoon-Nyun; Kim, Kwon-Bae

2011-04-14

Coronary angiography (CAG) is an invasive diagnostic procedure, which could lead to procedure related complications. One of the well known post-procedural complications is cerebral embolic infarction with or without symptoms. Silent embolic cerebral infarction (SECI) has clinical significance because it can progress to a decline in cognitive function and increase the risk of dementia in the long term. The aim of this study was to detect the incidence and predictors of SECI after diagnostic CAG using diffusion-weighted magnetic resonance imaging (DW-MRI). A total of 197 patients with coronary artery disease who underwent DW-MRI for evaluation of intracranial vasculopathy before coronary artery bypass graft surgery were retrospectively enrolled in the present study. DW-MRI was performed within 48 h after diagnostic CAG. SECI was diagnosed as presence of focal bright high signal intensity in DW-MRI. Patients were divided into groups according to presence/absence of SECI (+ SECI vs. - SECI, respectively). The clinical and angiographic characteristics were analyzed and independent predictors were evaluated. Of the 197 patients, SECI occurred in 20 patients (10.2%) after diagnostic CAG. Age, female gender, frequency of underlying atrial fibrillation, extent of coronary disease, and fluoroscopic time during diagnostic CAG were not different between the + SECI and - SECI groups. Left ventricular ejection fraction was significantly lower in the + SECI group than in the - SECI group (45.9 ± 8.5% vs. 51.4 ± 13.1%, p=0.014) and performance rate of internal mammary artery (IMA) angiography was significantly higher in the + SECI group compared with the - SECI group (85% vs. 37.2%, pSECI (OR=14.642; 95% CI=3.201 to 66.980, p=0.001). The incidence of SECI after diagnostic CAG was not infrequent. Diagnostic CAG with IMA angiography may increase the risk of SECI. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Effects of radiation exposure from radiopharmaceuticals used in diagnostic studies

International Nuclear Information System (INIS)

Witcofski, R.L.

1981-01-01

In the United States about 90 percent of man-made radiation exposure to the general population is from the use of radiation in diagnostic medicine. Although the doses of radiation from these procedures to individuals are generally quite small, large numbers of people are exposed. Estimates of the radiation doses associated with such use in the healing arts are approximately 15 million person-rem to the general population from diagnostic x ray and 3.3 million person-rem from the diagnostic use of radiopharmaceuticals. The purpose of this paper is to present what is known about the possible effects of radiation from diagnostic radiopharmaceuticals

Occupational exposures from selected interventional radiological procedures

International Nuclear Information System (INIS)

Janeczek, J.; Beal, A.; James, D.

2001-01-01

The number of radiology and cardiology interventional procedures has significantly increased in recent years due to better diagnostic equipment resulting in an increase in radiation dose to the staff and patients. The assessment of staff doses was performed for cardiac catheterization and for three other non-cardiac procedures. The scattered radiation distribution resulting from the cardiac catheterization procedure was measured prior to the staff dose measurements. Staff dose measurements included those of the left shoulder, eye, thyroid and hand doses of the cardiologist. In non-cardiac procedures doses to the hands of the radiologist were measured for nephrostomy, fistulogram and percutaneous transluminal angioplasty procedures. Doses to the radiologist or cardiologist were found to be relatively high if correct protection was not observed. (author)

Children's exposure to ionizing radiations linked with diagnostic procedures in 2010 in France

International Nuclear Information System (INIS)

2013-01-01

The objective of this study was to characterize the medical exposure of the French pediatric population to ionizing radiations (IR) in 2010. It only includes diagnostic procedures. Data are mainly provided by the French Health Insurance (CNAM-TS), through a representative sample of about 1% of the French population (the so-called 'EGB' sample). In 2010, more than 100,000 children from 0 to 15 years old were included in this sample. About 600 examinations per 1000 children were performed: 55% are radiological examinations and 42% dental. CT examinations are rather rare (about 2%). Nuclear medicine and interventional radiology represent less than 1% of the examinations. Children from 10 to 15 years old and babies from new born to 1 year old are the most examined. Exposure of girls and boys are rather similar. From 10 to 15 years old, dental and limbs examinations are the most frequent. Chest and pelvic examinations are the most frequent examinations performed on babies. CT pediatric examinations concern mainly the head and the neck. In 2010, a third of the French children has been exposed to at least one examination using IR. The mean and median effective doses were respectively equal to 0.65 mSv and 0.025 mSv. These values were respectively 5.7 mSv and 1.7 mSv for the children exposed to at least one CT examination (about 1% of the studied population). This study brings reference data on pediatric exposure to IR, and makes them available for public health and epidemiological purposes. This analysis should be periodically carried out to assess the evolution of the pediatric exposure. (authors)

Procedural sedation analgesia

Directory of Open Access Journals (Sweden)

Sheta Saad

2010-01-01

Full Text Available The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA. The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interventions. The goals of PSA in four different multidisciplinary practices namely; emergency, dentistry, radiology and gastrointestinal endoscopy are discussed in this review article. Some procedures are painful, others painless. Therefore, goals of PSA vary widely. Sedation management can range from minimal sedation, to the extent of minimal anesthesia. Procedural sedation in emergency department (ED usually requires combinations of multiple agents to reach desired effects of analgesia plus anxiolysis. However, in dental practice, moderate sedation analgesia (known to the dentists as conscious sedation is usually what is required. It is usually most effective with the combined use of local anesthesia. The mainstay of success for painless imaging is absolute immobility. Immobility can be achieved by deep sedation or minimal anesthesia. On the other hand, moderate sedation, deep sedation, minimal anesthesia and conventional general anesthesia can be all utilized for management of gastrointestinal endoscopy.

MITG test procedure and results

International Nuclear Information System (INIS)

Eck, M.E.; Mukunda, M.

1983-01-01

Elements and modules for Radioisotope Thermoelectric Generator have been performance tested since the inception of the RTG program. These test articles seldom resembled flight hardware and often lacked adequate diagnostic instrumentation. Because of this, performance problems were not identified in the early stage of program development. The lack of test data in an unexpected area often hampered the development of a problem solution. A procedure for conducting the MITG Test was developed in an effort to obtain data in a systematic, unambiguous manner. This procedure required the development of extensive data acquisition software and test automation. The development of a facility to implement the test procedure, the facility hardware and software requirements, and the results of the MITG testing are the subject of this paper

Radiology of non-spinal pain procedures. A guide for the interventionalist

International Nuclear Information System (INIS)

Syed, Mubin I.; Shaikh, Azin

2011-01-01

Most interventionalists are not radiologists and most radiologists do not understand interventional pain procedures. Nevertheless, interventionalists order extensive diagnostic imaging in the workup prior to any intervention. Against this background, this handy, well-illustrated manual has been designed to meet the major need of interventional pain physicians to understand the radiologic imaging involved in the performance of non-spinal pain procedures. It provides information on such topics as radiologic anatomy, the radiologic manifestations of indications and contraindications to interventional procedures, and the radiologic appearance of complications that may arise from these procedures. In addition, it will be useful for the diagnostic radiologist, who may be unaware of many of the interventional pain procedures. The chosen format will ensure that the reader is quickly able to reference any given procedure. Sections are devoted to the head and neck, thorax, abdomen, pelvis, and the upper and lower extremities. As this is a guidebook, it does not encompass every single pathologic entity that may be encountered; however, the commonly performed non-spinal pain procedures are included. This text will prove essential for any interventionalist who does not have easy access to a radiologist and vice versa. (orig.)

Radiology of non-spinal pain procedures. A guide for the interventionalist

Energy Technology Data Exchange (ETDEWEB)

Syed, Mubin I. [Dayton Interventional Radiology, Dayton, OH (United States); Shaikh, Azin

2011-07-01

Most interventionalists are not radiologists and most radiologists do not understand interventional pain procedures. Nevertheless, interventionalists order extensive diagnostic imaging in the workup prior to any intervention. Against this background, this handy, well-illustrated manual has been designed to meet the major need of interventional pain physicians to understand the radiologic imaging involved in the performance of non-spinal pain procedures. It provides information on such topics as radiologic anatomy, the radiologic manifestations of indications and contraindications to interventional procedures, and the radiologic appearance of complications that may arise from these procedures. In addition, it will be useful for the diagnostic radiologist, who may be unaware of many of the interventional pain procedures. The chosen format will ensure that the reader is quickly able to reference any given procedure. Sections are devoted to the head and neck, thorax, abdomen, pelvis, and the upper and lower extremities. As this is a guidebook, it does not encompass every single pathologic entity that may be encountered; however, the commonly performed non-spinal pain procedures are included. This text will prove essential for any interventionalist who does not have easy access to a radiologist and vice versa. (orig.)

Acquiring, Representing, and Evaluating a Competence Model of Diagnostic Strategy.

Science.gov (United States)

Clancey, William J.

This paper describes NEOMYCIN, a computer program that models one physician's diagnostic reasoning within a limited area of medicine. NEOMYCIN's knowledge base and reasoning procedure constitute a model of how human knowledge is organized and how it is used in diagnosis. The hypothesis is tested that such a procedure can be used to simulate both…

General procedures in diagnosis of malignant diseases in dogs and cats

Directory of Open Access Journals (Sweden)

Jovanović Milan

2012-01-01

Full Text Available Tumors occur in all domestic and wild animals. They are most often diagnosed in dogs and cats, and their numbers increase from year to year. In the recent years, cancer is believed to be the most frequent cause of pet deaths. A speedy and reliable diagnosis is of paramount importance because it enables the veterinarian to begin therapy and make a prognosis. The objective of an early diagnosis is to enable the detection of neoplastic diseases before the tumor spreads throughout the organism, consequently enabling the timely administration of therapy and providing greater chances for curing the animal. A tumor is diagnosed on the grounds of the anamnesis, clinical picture, and special diagnostic procedures. The most frequently applied diagnostic procedures are laboratory diagnostics, cytology, biopsy and pathohistology, imaging diagnostics (roentgenography and roentgenoscopy, ultrasound diagnostics, endoscopy, computer tomography, magnetic resonance, and scintigraphy and molecular diagnostics. Each of these methods has its advantages and faults in connection with costs, availability, sensitivity, specificity and quality of anatomic vs functional pictures. Every one of these techniques has its own field of implementation and each one provides different and additional information in connection with the nature and position of the primary lesion and the presence of metastases.

Recent improvements of the JET lithium beam diagnostic.

Science.gov (United States)

Brix, M; Dodt, D; Dunai, D; Lupelli, I; Marsen, S; Melson, T F; Meszaros, B; Morgan, P; Petravich, G; Refy, D I; Silva, C; Stamp, M; Szabolics, T; Zastrow, K-D; Zoletnik, S

2012-10-01

A 60 kV neutral lithium diagnostic beam probes the edge plasma of JET for the measurement of electron density profiles. This paper describes recent enhancements of the diagnostic setup, new procedures for calibration and protection measures for the lithium ion gun during massive gas puffs for disruption mitigation. New light splitting optics allow in parallel beam emission measurements with a new double entrance slit CCD spectrometer (spectrally resolved) and a new interference filter avalanche photodiode camera (fast density and fluctuation studies).

Abduction and external rotation (ABER) MR arthrography of the shoulder. Benefits and limitations

International Nuclear Information System (INIS)

Mostafa, A.; Gokan, Takehiko; Munechika, Hirotsugu; Ogawa, Takashi; El-Feky, A.A.

2001-01-01

The purpose of this study was to show the benefits and limitations of using abduction and external rotation (ABER) positions of the arm during MR arthrography of the shoulder in the evaluation of the rotator-cuff tendon, the capsulolabral complex and the shoulder joint after surgery. Forty-seven patients complaining of either shoulder instability, chronic shoulder pain, pain of unknown cause or pain following shoulder surgery were studied using the direct MR arthrography technique in both the standard neutral position with the arm adducted as well as with the arm in the ABER position. A correlation was obtained between the MR arthrography findings and the surgical findings in 10 reports and clinical presentations of the examined patients. Three patients [6%] were unable to perform ABER positioning. ABER oblique axial images were better than standard oblique coronal images in revealing undersurface tears of the rotator cuff particularly of the grade I type. Four tears were missed in standard images. Oblique axial images were better than standard axial images in demonstrating non-displaced anterior labral tears. One tear was missed and two tears were suspected in the standard images. Oblique axial images were less sensitive than oblique coronal images in the diagnosis of superior labral tears. Two tears were missed in ABER images. The ABER oblique axial MR arthrogram is a useful adjunct to the standard axial and oblique coronal MR arthrograms for assessment of capsulolabral abnormalities and rotator-cuff tendon tears despite some limitations. (author)

Failure diagnostics of rotational machines and machine groups in the Paks Nuclear Power Plant

International Nuclear Information System (INIS)

Nagy, I.; Kiss, G.

1997-01-01

Machine failure diagnostic system based on vibration analysis is described. The design of the measurements, the measurement procedure, and the evaluation of the results are presented. The common diagnostic technology for groups of rotation machinery has several advantages. The rules used for the evaluation of three-directional vibration measurements are shown, and the identification criteria of some specific failures are demonstrated. The steps of expert decision making and the diagnosis procedure are discussed through practical examples. (R.P.)

Diagnostics of anterior eye segment in cats and dogs

Directory of Open Access Journals (Sweden)

Hadži-Milić Milan

2006-01-01

Full Text Available Diagnostics of the anterior segment of the eye present the most frequent diagnostics implemented in ophthalmology and by most veterinary practicians as well. This paper presents the complete diagnostics in the most concise form possible. The procedure with animals is presented first, followed by the equipment, and then anamnesis. The following diagnostic methods are presented: examination in a lighted room which include an examination from a distance, taking a smear, the Schirmer tear test (STT, an examination from close by, examination in a dark room which comprises the elementary examinations, such as the use of focal lighting and examination using a direct ophthalmoscope, and special examination in a dark room, such as biomicroscopy, gonioscopy and keratoscopy. Additional examination methods are also included.

Interventional chest procedures in pregnancy.

LENUS (Irish Health Repository)

Morgan, Ross K

2011-03-01

Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

Interventional chest procedures in pregnancy.

LENUS (Irish Health Repository)

Morgan, Ross K

2012-02-01

Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

Structured diagnostic imaging in patients with multiple trauma

International Nuclear Information System (INIS)

Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M.; Kanz, K.G.

2002-01-01

Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [de

Methodology for quantitative evaluation of diagnostic medical imaging

International Nuclear Information System (INIS)

Metz, C.

1980-01-01

This report deals with the evaluation of the performance of diagnostic medical imaging procedures using the Receiver Operating Characteristic or ROC analysis. The development of new tests for the statistical significance of apparent differences between ROC curves is discussed

Special report. Update on EAS (electronic article surveillance) systems: protecting against patient wandering, infant abduction, property theft.

Science.gov (United States)

1993-10-01

Concern about wandering patients and infant abduction on the part of hospitals has sparked renewed interest in Electronic Article Surveillance (EAS) systems. Such systems had their origins in department stores and libraries where they are almost universally used. They also have applications in hospitals for preventing the theft of supplies and equipment. A number of companies provide EAS products for the health care field. How do you select the system that is best for your needs? "Talk to users. Pick out a number of profit and non-profit hospitals to get their views," advises Ted Algaier, vice president, marketing and sales, Innovative Control Systems, Inc., Waukesha, WI. "Examine the history of the company or vendor to determine if it understands the health care market and find out if the product really works." In this report, we'll review a number of EAS systems currently on the market, and present information on how they work, how effective they are, and costs involved. Also included are comments from users who have installed such systems.

Nanotechnology based diagnostics for neurological disorders

Energy Technology Data Exchange (ETDEWEB)

Kurek, Nicholas S; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

2012-07-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

Nanotechnology based diagnostics for neurological disorders

Energy Technology Data Exchange (ETDEWEB)

Kurek, Nicholas S.; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

2012-07-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

Diagnostic imaging in intensive care patients

International Nuclear Information System (INIS)

Afione, Cristina; Binda, Maria del C.

2004-01-01

Purpose: To determine the role of imaging diagnostic methods in the location of infection causes of unknown origin in the critical care patient. Material and methods: A comprehensive medical literature search has been done. Recommendations for the diagnostic imaging of septic focus in intensive care patients are presented for each case, with analysis based on evidence. The degree of evidence utilized has been that of Oxford Center for Evidence-based Medicine. Results: Nosocomial infection is the most frequent complication in the intensive care unit (25 to 33%) with high sepsis incidence rate. In order to locate the infection focus, imaging methods play an important role, as a diagnostic tool and to guide therapeutic procedures. The most frequent causes of infection are: ventilation associated pneumonia, sinusitis, intra-abdominal infections and an acute acalculous cholecystitis. This paper analyses the diagnostic imaging of hospital infection, with the evaluation of choice methods for each one and proposes an algorithm to assess the septic patient. Conclusion: There are evidences, with different degrees of recommendation, for the use of diagnostic imaging methods for infectious focuses in critical care patients. The studies have been selected based on their diagnostic precision, on the capacity of the medical team and on the availability of resources, considering the risk-benefit balance for the best safety of the patient. (author)

Nanotechnology based diagnostics for neurological disorders

International Nuclear Information System (INIS)

Kurek, Nicholas S.; Chandra, Sathees B.

2012-01-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

Work procedures and risk factors for high rdiation exposure among radiologic technologists in South Korea

Energy Technology Data Exchange (ETDEWEB)

Kim, Jae Young; Choi, Yeong Chull [Dept. of Preventive Medicine, Keimyung University College of Medicine, Daegu (Korea, Republic of); Lee, Won Jin; Cha, Eun Shil [Dept. of Preventive Medicine, Korea University College of Medicine, Seoul (Korea, Republic of)

2016-12-15

Radiologic technologists currently consist of 31.5% among diagnostic radiation workers in South Korea. Among diagnostic radiation workers, radiologic technologists receive the highest annual and collective doses in South Korea. Comprehensive assessment of the work practices and associated radiation doses from diagnostic radiology procedures should be undertaken for effective prevention for radiologic technologists. Using the national survey, this study aimed (1) to explore the distribution of the work procedures performed by gender, (2) to evaluate occupational radiation exposure by work characteristics and safety compliance, (3) to identify the primary factors influencing high radiation exposure among radiologic technologists in South Korea. This study provided detailed information on work practices, number of procedures performed on weekly basis, and occupational radiation doses among radiologic technologists in South Korea. Average radiation dose for radiologic technologists is higher than other countries, and type of facility, work safety, and wearing lead apron explained quite a portion of increased risk in the association between radiology procedures and radiation exposure among radiologic technologists.

Work procedures and risk factors for high rdiation exposure among radiologic technologists in South Korea

International Nuclear Information System (INIS)

Kim, Jae Young; Choi, Yeong Chull; Lee, Won Jin; Cha, Eun Shil

2016-01-01

Radiologic technologists currently consist of 31.5% among diagnostic radiation workers in South Korea. Among diagnostic radiation workers, radiologic technologists receive the highest annual and collective doses in South Korea. Comprehensive assessment of the work practices and associated radiation doses from diagnostic radiology procedures should be undertaken for effective prevention for radiologic technologists. Using the national survey, this study aimed (1) to explore the distribution of the work procedures performed by gender, (2) to evaluate occupational radiation exposure by work characteristics and safety compliance, (3) to identify the primary factors influencing high radiation exposure among radiologic technologists in South Korea. This study provided detailed information on work practices, number of procedures performed on weekly basis, and occupational radiation doses among radiologic technologists in South Korea. Average radiation dose for radiologic technologists is higher than other countries, and type of facility, work safety, and wearing lead apron explained quite a portion of increased risk in the association between radiology procedures and radiation exposure among radiologic technologists.

X-ray diagnostics of thorax diseases; Roentgendiagnostik von Thoraxerkrankungen. Von der Deskription zur Diagnose

Energy Technology Data Exchange (ETDEWEB)

Kulke, H.M. [Wuerzburg Univ. (Germany). Universitaetsklinikum

2013-11-01

The book on X-ray diagnostics of thorax diseases covers the following issues: diagnostic procedures, inflammatory thorax diseases, malign thorax diseases, heart and large blood vessels, hear insufficiency, pulmonary congestion, pulmonary edema, interstitial pulmonary diseases, intensive care and traumatology.

CHRONIC MESENTERIC ISCHEMIA - DIAGNOSTIC CHALLENGES AND TREATMENT OPTIONS

NARCIS (Netherlands)

HOOGENBERG, K; VANESSEN, LH; VANDENDUNGEN, JJAM; LIMBURG, AJ; BOEVE, WJ; KLEIBEUKER, JH

Objectives. A description of the clinical presentation, diagnostic procedure and mode of therapy in three patients suffering from chronic mesenteric ischaemia. Design and interventions. In all cases, the diagnosis was made on the basis of abdominal complaints in combination with angiographic

Improved Temperature Diagnostic for Non-Neutral Plasmas with Single-Electron Resolution

Science.gov (United States)

Shanman, Sabrina; Evans, Lenny; Fajans, Joel; Hunter, Eric; Nelson, Cheyenne; Sierra, Carlos; Wurtele, Jonathan

2016-10-01

Plasma temperature diagnostics in a Penning-Malmberg trap are essential for reliably obtaining cold, non-neutral plasmas. We have developed a setup for detecting the initial electrons that escape from a trapped pure electron plasma as the confining electrode potential is slowly reduced. The setup minimizes external noise by using a silicon photomultiplier to capture light emitted from an MCP-amplified phosphor screen. To take advantage of this enhanced resolution, we have developed a new plasma temperature diagnostic analysis procedure which takes discrete electron arrival times as input. We have run extensive simulations comparing this new discrete algorithm to our existing exponential fitting algorithm. These simulations are used to explore the behavior of these two temperature diagnostic procedures at low N and at high electronic noise. This work was supported by the DOE DE-FG02-06ER54904, and the NSF 1500538-PHY.

Can the diagnostic accuracy of radionuclide ventriculography during exercise be improved by means of a step-up loading procedure?

International Nuclear Information System (INIS)

Ruegenberg, T.

1985-01-01

34 patients (31 of whom were coronary heart disease sufferers as proven by angiography) and further 3 patients failing to show symptoms of this disorder were subjected to radionuclide ventriculography carried out with the aid of 99m Tc-labelled erythrocytes in such a way that examinations at rest were directly followed by maximum loading tests. In a second series of examinations a step-up procedure was adopted where initial recordings at rest were followed by preliminary exercise tests using only 25% of the maximum load. The parameters chosen to evaluate the results were heart rate, ejection fraction, maximum velocity of changes in volume, endsystolic and enddiastolic volumes (ESV and EDV) as well as cardiac output. In 23 patients the preliminary exercise test revealed an insufficient increase or even decrease of the ejection fraction that was associated with delayed volume changes, increases in ESV and EDV as well as reductions in cardiac output and in 21 patients it became evident during those examinations that the onset of stenocardiac complaints was preceded by markedly pronounced function disorders in the left ventricle. It was concluded from these findings that the step-up procedure followed here may in some patients provide additional information on the level of myocardial performance. It can thus be assumed to contribute considerably to higher diagnostic accuracy, although it requires no more time than conventional exercise tests and is not associated with additional radiation exposure. (TRV) [de

Proposal of a survey of radiation protection procedures during breast feeding

International Nuclear Information System (INIS)

Santos, Liliane dos; Oliveira, Silvia M. Velasques de

2009-01-01

Contamination can occur by breast milk ingestion involving mothers subjected to diagnostic procedures or treatment with radiopharmaceuticals, which can reach high concentrations in milk causing significant absorbed doses to the children organs. Besides internal dose, close contact between the baby and his mother give rise to external exposures. In Brazil, 7% of diagnostic procedures use 131 I or 123 I for thyroid imaging and 84% of these were hold by women. For 131 I, 67 Ga and 201 Tl, is recommended breast feeding cessation. The present work proposes a survey of the state of the art of radiation protection to breast feeding infants. It was planned interviews with nuclear medicine staff applying a questionnaire in order to assess specific procedures to women in reproductive age. This is 'on progress work'. (author)

Utility of CT-guided abdominal aspiration procedures

International Nuclear Information System (INIS)

Sundaram, M.; Wolverson, M.K.; Heiberg, E.; Pilla, T.; Vas, W.G.; Shields, J.B.

1982-01-01

Over 200 consecutive diagnostic needle aspiration procedures of the abdomen were performed under computed tomographic (CT) guidance. Biopsies were done of the liver in 88 patients, the pancreas in 28, the kidney in 20, and the retroperitoneum in 32; 30 underwent an aspiration procedure for characterization of an intraabdominal fluid collection. Accuracy of diagnosis was very high for hepatic (99%) and renal (100%) biopsies and in characterization of fluid collections (100%). Accuracy for retroperitoneal biopsy was 87.5% and for pancreatic biopsy 82%. Overall accuracy for all sites was 95%. There were one false-negative diagnosis for the liver and five false-negative diagnoses for the pancreas. Insufficient material was obtained for diagnosis in four instances of retroperitoneal biopsy. There were no false positives. The technique is facilitated by rapid CT scan time, large aperture gantry, and rapid CT image reconstruction. Twenty gauge needles were used more frequently than 22 gauge needles because of their greater rigidity and ease of control. CT-guided diagnostic aspiration procedures are particularly useful for diagnosis of small, deep-seated lesions and in evaluation of lesions found in severely ill patients. An experienced cytologist is essential to the success of the technique

Bootstrap-based procedures for inference in nonparametric receiver-operating characteristic curve regression analysis.

Science.gov (United States)

Rodríguez-Álvarez, María Xosé; Roca-Pardiñas, Javier; Cadarso-Suárez, Carmen; Tahoces, Pablo G

2018-03-01

Prior to using a diagnostic test in a routine clinical setting, the rigorous evaluation of its diagnostic accuracy is essential. The receiver-operating characteristic curve is the measure of accuracy most widely used for continuous diagnostic tests. However, the possible impact of extra information about the patient (or even the environment) on diagnostic accuracy also needs to be assessed. In this paper, we focus on an estimator for the covariate-specific receiver-operating characteristic curve based on direct regression modelling and nonparametric smoothing techniques. This approach defines the class of generalised additive models for the receiver-operating characteristic curve. The main aim of the paper is to offer new inferential procedures for testing the effect of covariates on the conditional receiver-operating characteristic curve within the above-mentioned class. Specifically, two different bootstrap-based tests are suggested to check (a) the possible effect of continuous covariates on the receiver-operating characteristic curve and (b) the presence of factor-by-curve interaction terms. The validity of the proposed bootstrap-based procedures is supported by simulations. To facilitate the application of these new procedures in practice, an R-package, known as npROCRegression, is provided and briefly described. Finally, data derived from a computer-aided diagnostic system for the automatic detection of tumour masses in breast cancer is analysed.

TFTR diagnostic control and data acquisition system

International Nuclear Information System (INIS)

Sauthoff, N.R.; Daniels, R.E.; PPL Computer Division

1985-01-01

General computerized control and data-handling support for TFTR diagnostics is presented within the context of the Central Instrumentation, Control and Data Acquisition (CICADA) System. Procedures, hardware, the interactive man--machine interface, event-driven task scheduling, system-wide arming and data acquisition, and a hierarchical data base of raw data and results are described. Similarities in data structures involved in control, monitoring, and data acquisition afford a simplification of the system functions, based on ''groups'' of devices. Emphases and optimizations appropriate for fusion diagnostic system designs are provided. An off-line data reduction computer system is under development

Breast Cancer Diagnostic System Final Report CRADA No. TC02098.0

Energy Technology Data Exchange (ETDEWEB)

Rubenchik, A. M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); DaSilva, L. B. [BioTelligent, Inc., Livermore, CA (United States)

2017-09-06

This was a collaborative effort between Lawrence Livermore National Security, LLC (formerly The Regents of the University of California)/Lawrence Liver more National Laboratory (LLNL) and BioTelligent, Inc. together with a Russian Institution (BioFil, Ltd.), to develop a new system ( diagnostic device, operating procedures, algorithms and software) to accurately distinguish between benign and malignant breast tissue (Breast Cancer Diagnostic System, BCDS).

Patient Dose During Carotid Artery Stenting With Embolic-Protection Devices: Evaluation With Radiochromic Films and Related Diagnostic Reference Levels According to Factors Influencing the Procedure

International Nuclear Information System (INIS)

D’Ercole, Loredana; Quaretti, Pietro; Cionfoli, Nicola; Klersy, Catherine; Bocchiola, Milena; Rodolico, Giuseppe; Azzaretti, Andrea; Lisciandro, Francesco; Cascella, Tommaso; Zappoli Thyrion, Federico

2013-01-01

To measure the maximum entrance skin dose (MESD) on patients undergoing carotid artery stenting (CAS) using embolic-protection devices, to analyze the dependence of dose and exposure parameters on anatomical, clinical, and technical factors affecting the procedure complexity, to obtain some local diagnostic reference levels (DRLs), and to evaluate whether overcoming DRLs is related to procedure complexity. MESD were evaluated with radiochromic films in 31 patients (mean age 72 ± 7 years). Five of 33 (15 %) procedures used proximal EPD, and 28 of 33 (85 %) procedures used distal EPD. Local DRLs were derived from the recorded exposure parameters in 93 patients (65 men and 28 women, mean age 73 ± 9 years) undergoing 96 CAS with proximal (33 %) or distal (67 %) EPD. Four bilateral lesions were included. MESD values (mean 0.96 ± 0.42 Gy) were FR ) were 269 Gy cm 2 , 28 minutes, and 251, respectively. Only simultaneous bilateral treatment was associated with KAP (odds ratio [OR] 10.14, 95 % confidence interval [CI] 1–102.7, p FR overexposures (OR 10.8, 95 % CI 1.1–109.5, p FR overexposure (OR 2.8, 95 % CI 1.1–7.4, p = 0.040). At multivariable analysis, stenosis ≥ 90 % (OR 2.8, 95 % CI 1.1–7.4, p = 0.040) and bilateral treatment (OR 10.8, 95 % CI 1.1–109.5, p = 0.027) were associated with overexposure for two or more parameters. Skin doses are not problematic in CAS with EPD because these procedures rarely lead to doses >2 Gy.

Radiological protection of the patient in the diagnostic X-ray

International Nuclear Information System (INIS)

Araujo, A.M.C. de

1983-01-01

Measures and procedures are given in relation to the radiological protection of the patient in diagnostic radiology. Technical and physical factors of the patient protection are discussed, as radiation beam properties, size of the irradiation field, shieldings, control of the scattered radiation that reaches the imaging record system, films, ecrans and radiographic film processing. General recommendations about the radiation protection of the patient in diagnostic radiology are given. (M.A.) [pt

In-office diagnostic arthroscopy for knee and shoulder intra-articular injuries its potential impact on cost savings in the United States

Science.gov (United States)

2014-01-01

Background The purpose of this analysis was to determine whether in office diagnostic needle arthroscopy (Visionscope Imaging System [VSI]) can provide for improved diagnostic assessment and; more cost effective care. Methods Data on arthroscopy procedures in the US for deep seated pathology in the knee and shoulder were used (Calendar Year 2012). These procedures represent approximately 25-30% of all arthroscopic procedures performed annually. Sensitivities, specificities, positive predictive, and negative predictive values for MRI analysis of this deep seated pathology from systematic reviews and meta-analyses were used in assessing for false positive and false negative MRI findings. The costs of performing diagnostic and surgical arthroscopy procedures (using 2013 Medicare reimbursement amounts); costs associated with false negative findings; and the costs for treating associated complications arising from diagnostic and therapeutic arthroscopy procedures were then assessed. Results In patients presenting with medial meniscal pathology (ICD9CM diagnosis 836.0 over 540,000 procedures in CY 2012); use of the VSI system in place of MRI assessment (standard of care) resulted in a net cost savings to the system of $151 million. In patients presenting with rotator cuff pathology (ICD9CM 840.4 over 165,000 procedures in CY2012); use of VSI in place of MRI similarly saved $59 million. These savings were realized along with more appropriate care as; fewer patients were exposed to higher risk surgical arthroscopic procedures. Conclusions The use of an in-office arthroscopy system can: possibly save the US healthcare system money; shorten the diagnostic odyssey for patients; potentially better prepare clinicians for arthroscopic surgery (when needed) and; eliminate unnecessary outpatient arthroscopy procedures, which commonly result in surgical intervention. PMID:24885678

DIAGNOSTIC UTILITY OF USG-GUIDED FNAC IN HEPATIC LESIONS

Directory of Open Access Journals (Sweden)

Sudha P. Meena

2016-06-01

Full Text Available INTRODUCTION Guided fine-needle aspiration cytology (FNAC is an easy, rapid, minimally invasive and a cost effective diagnostic method for detecting benign and malignant lesions of liver. AIM The main aim of the present study was to establish the incidence of various hepatic lesions and to find out adequacy and utility of the procedure. MATERIAL AND METHOD A total of 174 cases were included in the study from Government Medical College, Kota and associated hospitals. All cases diagnosed to have single or multiple hepatic mass lesions on USG were included in the study. RESULTS Most common age group affected by hepatic lesion was 51-60 years (34.0%. 91.4% cases were having adequate aspirates. 95.6% of the total diagnosed cases were malignant and among malignant cases majority were metastatic. CONCLUSION USG-guided FNAC is a very useful procedure in the diagnosis of hepatic lesions as the procedure is simple and safe. Thus, FNAC is a simple and effective diagnostic tool in our hand.

Towards diagnostic metagenomics of Campylobacter in fecal samples

DEFF Research Database (Denmark)

Andersen, Sandra Christine; Kiil, Kristoffer; Harder, Christoffer Bugge

2017-01-01

The development of diagnostic metagenomics is driven by the need for universal, culture-independent methods for detection and characterization of pathogens to substitute the time-consuming, organism-specific, and often culture-based laboratory procedures for epidemiological source-tracing. Some...... of the challenges in diagnostic metagenomics are, that it requires a great next-generation sequencing depth and unautomated data analysis. DNA from human fecal samples spiked with 7.75 × 101-7.75 × 107 colony forming unit (CFU)/ml Campylobacter jejuni and chicken fecal samples spiked with 1 × 102-1 × 106 CFU...... Campylobacter in all the clinical samples. Sensitivity in diagnostic metagenomics is improving and has reached a clinically relevant level. There are still challenges to overcome before real-time diagnostic metagenomics can replace quantitative polymerase chain reaction (qPCR) or culture-based surveillance...

The safety and efficacy of the Angio-Seal closure device in diagnostic and interventional neuroangiography setting: a single-center experience with 1,443 closures

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Geyik, Serdar; Yavuz, Kivilcim; Akgoz, Ayca; Koc, Osman; Peynircioglu, Bora; Cil, Barbaros; Cekirge, Saruhan; Saatci, Isil [Hacettepe University Hospitals, Radiology Department, Ankara (Turkey)

2007-09-15

We evaluated the safety and efficacy of the Angio-Seal closure device used to close arterial puncture sites in patients who had undergone diagnostic cerebral angiography and neurointerventional procedures. A total of 1,443 Angio-Seal devices were placed in 1,099 patients in the Interventional Neuroradiology Unit between May 2005 and August 2006. Of these, 670 were interventional and 745 were diagnostic cerebral angiographic procedures. In 28 patients bilateral puncture of the femoral arteries was performed for endovascular treatment. In 167 patients 286 repeat diagnostic procedures were performed and 30 interventional procedures were followed by re-closure with an Angio-Seal device at the time of repeat puncture. The procedural success rate for antegrade closures was 99.7% for all procedures. The device failed in 5 of 745 diagnostic procedures (0.7%). Major complication occurred in one patient only (0.13%) in the diagnostic group. No minor complications were observed in this group. In the interventional group, the major complication rate was 1.4% (10 of 698 closures) and the minor complication rate was 2.4% (17 of 698 closures). However, in the subgroup of patients with cerebral aneurysms who received heparin in combination with antiplatelet agents after the procedure, the major complication rate was 5.3%, but in the carotid/vertebral stenting group it was 0.8%. Our experience in a relatively large series of patients shows that the use of the Angio-Seal STS vascular closure device is safe and effective in patients undergoing cerebral diagnostic angiography and neurointerventional procedures with an acceptable rate of complications, although the complication rate was higher in the group of patients who received heparin and/or antiplatelet medication. (orig.)

DYNAMIC HIP ADDUCTION, ABDUCTION AND ABDOMINAL EXERCISES FROM THE HOLMICH GROIN-INJURY PREVENTION PROGRAM ARE INTENSE ENOUGH TO BE CONSIDERED STRENGTHENING EXERCISES - A CROSS-SECTIONAL STUDY

DEFF Research Database (Denmark)

Krommes, Kasper; Bandholm, Thomas; Jakobsen, Markus D

2017-01-01

and external obliques during isometric adduction against a football placed between the ankles (IBA), isometric adduction against a football placed between the knees (IBK), folding knife (FK), cross-country skiing on one leg (CCS), adduction partner (ADP) and abduction partner (ABP). The EMG-signals were...... normalized (nEMG) to an isometric maximal voluntary contraction for each tested muscle. RESULTS: Adductor longus activity during IBA was 84% nEMG (95% CI: 70-98) and during IBK it was 118% nEMG (95% CI 106-130). For the dynamic exercises, ADP evoked 87% nEMG (95% CI 69-105) in adductor longus, ABP evoked 88...

Flexible fiberoptic bronchoscopy in respiratory care: Diagnostic yield ...

African Journals Online (AJOL)

Introduction: Flexible fiberoptic bronchoscopy (FOB) is a key diagnostic and therapeutic procedure in pulmonology. Experience with fiberoptic bronchoscopy is scanty in most developing countries. Objectives: The goal of this study was to report our experience and clinical utility of fiberoptic bronchoscopy. Methods: A review ...

Solitary fibrous tumor: A center's experience and an overview of the symptomatology, the diagnostic and therapeutic procedures of this rare tumor

Directory of Open Access Journals (Sweden)

Wolfgang Hohenforst-Schmidt

2017-01-01

Full Text Available Solitary Fibrous Tumor of the Pleura (SFTP is a rare tumor of the pleura. Worldwide about 800 patients diagnosed with this oncological entity have been described in the existing literature. We report our center's 13 year experience. During this time three patients suffering from this rare disease have been treated in our department. All patients were asymptomatic and their diagnosis was initially triggered by a random finding in a routine chest x-ray. The diagnosis was set preoperatively through a needle biopsy under computer tomography (CT guidance. The tumors were resected surgically though video-assisted thoracoscopic surgery (VATS or thoracotomy. Because of the lack of specific guidelines due to the rarity of the disease a long-term, systematic follow-up was recommended and performed. Parallel an overview of the diagnostic and therapeutic procedures of the rare tumor is made.

Quality assurance and gastrointestinal endoscopy: an audit of 500 colonoscopic procedures.

Science.gov (United States)

Denis, Bernard; Weiss, Anne-Marie; Peter, André; Bottlaender, Jacques; Chiappa, Pascale

2004-12-01

The aim of this study was to assess the quality of colonoscopic procedures in our endoscopy unit with the goal of improving performance. We prospectively audited 500 consecutive colonoscopic procedures and assessed sixty-two process or outcome indicators for each procedure. Most of the measured indicators were within standard limits: cecal intubation rate (92%), inadequate bowel preparations (24%), inappropriate procedures (9.7%), normal procedures (54%), yield for neoplasia (32%), morbidity (0.4%), and overall patient satisfaction (95.8%). Some indicators were outside standard limits suggesting our practices should be modified: endoscopy withdrawal time less than 6 minutes (78%), forceps removal of polyps (31%), resected polyps not recovered for pathological examination (12%), adenomas with villous elements (22%), patients unsatisfied because of time spent waiting for the procedure (19%), patients unsatisfied because of inadequate explanations (10%). There was no standard for a few indicators: patient discomfort (6.9%), diagnostic success (89%), therapeutic success (92%). Three new indicators were proposed: proportion of patients agedadvanced adenoma or cancer, and proportion of colonoscopic procedures causing discomfort. The diagnostic yield of colonoscopy was dependent on age, gender, indication and appropriateness of indication but not on the prescriber. This audit allowed us to evaluate our endoscopic practices and to detect certain shortcomings and deviations from standards. It enabled us to change some of our practices with the goal of improving the quality of our colonoscopic procedures.

Emergency Kausch-Whipple procedure: indications and experiences.

Science.gov (United States)

Standop, Jens; Glowka, Tim; Schmitz, Volker; Schaefer, Nico; Hirner, Andreas; Kalff, Jörg C

2010-03-01

Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

The utility of administrative diagnostic x rays. Final report

International Nuclear Information System (INIS)

Potchen, E.J.; Gard, J.W.; Gift, D.A.; Harris, G.I.; Alexander, G.P.

1982-08-01

A significant proportion of diagnostic medical procedures is used in response to public or private policy rather than individual patient/physician interaction. Such administrative use of diagnostic procedures illustrates the lack of accepted 'referral criteria.' This document reports results of a descriptive study of policy formulation and implementation regarding use of employment-related chest and lumbar-spine radiographs by employers in the State of Michigan. Major observations of the study are that: factors influencing policy formulation are diverse and largely nonmedical; organizational policies developed in similar environments are often very dissimilar and are highly subject to external influence; and perceptions of policy success and examination utility typically are subjective and uncertain. It is concluded that considerable opportunity exists to enhance the utility of policy-motivated x rays by modifying the processes of policy formulation and evaluation

Radiation exposure of population due to medical diagnostic procedures in the USSR

International Nuclear Information System (INIS)

Vorob'ev, E.I.; Stavitskij, R.V.; Knizhnikov, V.A.; Barkhudarov, R.M.; Korsunskij, V.N.; Popov, V.I.; Tarasenko, Yu.I.; Postnikov, V.A.; Frolov, N.V.; Sidorin, V.P.

1984-01-01

The evaluation of radiation doses to population in the ussr on the basis of the data on frequency of 12 main forms of X-ray examinations and the results of measuring absorbed doses on tissue-kquivalent main's phantom are given. The evaluation of radiation exposure due to radiopharmaceutical preparations is based on consumption of 26 types of compounds in 320 national laboratories and i is performed by the methods developed in the framework of the mird committee (usa). In thhe active bone marrow, lungs mammary, glands thyroid and other organs (stomach, liver, spleen, etc.) the equivalent doses are determined and on their base the effective equivalent doses (eed). The average eed from x ray diagnostic examinations is 1.4 mSv per year (140 mrem per year) of which 55.4% falls on X-ray examination, 26.9% on radiography, 17.7% on mass miniature radiography (fluorography). Radionuclide diagnostics contribution is 3.2x10 -2 mSv per year (3.8 mrem per year). Medicinal radiation exposure approximately doubles the natural background, it is comparable with exposure in premises and essentially exceeds the radiation doses to population from other sources

Diagnostic value of CT scanning in neuromuscular diseases

International Nuclear Information System (INIS)

Bulcke, J.A.L.; Leuven Univ.; Herpels, V.

1983-01-01

The diagnosis of myopathies has become easier since the CT technique is available. In this article the possibilities of CT for diagnostic procedures of neuromuscular diseases are pointed out. Density measurements increase differentiation of atrophy or hypertrophy of muscles as well as other pathological changes. (orig.)

Comparison of blood pool and extracellular gadolinium chelate for functional MR evaluation of vascular thoracic outlet syndrome

Energy Technology Data Exchange (ETDEWEB)

Lim, Ruth P., E-mail: ruthplim74@gmail.com [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Austin Health, Department of Radiology, Heidelberg, Victoria 3084 (Australia); The University of Melbourne, School of Medicine, Parkville, Victoria 3010 (Australia); Bruno, Mary, E-mail: mary.bruno@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Rosenkrantz, Andrew B., E-mail: Andrew.rosenkrantz@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Kim, Danny C., E-mail: danny.kim@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Mulholland, Thomas, E-mail: Thomas.mulholland@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Kwon, Jane, E-mail: jane.kwon@nyumc.org [New York University School of Medicine, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, 660 1st Avenue, New York, NY 10016 (United States); Palfrey, Amy P., E-mail: amy.pastva10@stjohns.edu [St John' s University, Department of Psychology, 8000 Utopia Parkway, Jamaica-Queens, NY 11439 (United States); Ogedegbe, Olugbenga, E-mail: Olugbenga.Ogedegbe@nyumc.org [New York University School of Medicine, Clinical and Translational Science Institute, 227 E30th St, 8th Floor, New York, NY 10016 (United States)

2014-07-15

Objective: To compare performance of single-injection blood pool agent (gadofosveset trisodium, BPA) against dual-injection extracellular contrast (gadopentetate dimeglumine, ECA) for MRA/MRV in assessment of suspected vascular TOS. Materials and methods: Thirty-one patients referred for vascular TOS evaluation were assessed with BPA (n = 18) or ECA (n = 13) MRA/MRV in arm abduction and adduction. Images were retrospectively assessed for: image quality (1 = non-diagnostic, 5 = excellent), vessel contrast (1 = same signal as muscle, 4 = much brighter than muscle) and vascular pathology by two independent readers, with a separate experienced reader providing reference assessment of vascular pathology. Results: Median image quality was diagnostic or better (score ≥3) for ECA and BPA at all time points, with BPA image quality superior at abduction late (BPA 4.5, ECA 4, p = 0.042) and ECA image quality superior at adduction-early (BPA 4.5; ECA 4.0, p = 0.018). High qualitative vessel contrast (mean score ≥3) was observed at all time points with both BPA and ECA, with superior BPA vessel contrast at abduction-late (BPA 3.97 ± 0.12; ECA 3.73 ± 0.26, p = 0.007) and ECA at adduction-early (BPA 3.42 ± 0.52; ECA 3.96 ± 0.14, p < 0.001). Readers readily identified arterial and venous pathology with BPA, similar to ECA examinations. Conclusion: Single-injection BPA MRA/MRV for TOS evaluation demonstrated diagnostic image quality and high vessel contrast, similar to dual-injection ECA imaging, enabling identification of fixed and functional arterial and venous pathology.

Consideration on the diagnostic ability of various imaging techniques in relation to renal tumor

International Nuclear Information System (INIS)

Ike, Katsushi

1984-01-01

Radiological diagnosis of renal tumors is being improved with the increased imaging accuracy which has resulted from advancement in the various equipment used and improvement in techniques. However, at the clinical level, diagnostic procedures based on the characteristics of the delineated images are not yet established and the diverse diagnostic procedures are being conducted currently in a stereotyped manner. In this study, the images of 61 cases diagnosed as renal tumor were analysed retrospectively with the purpose of establishing the imaging accuracy, capacity for diagnosis based on image characteristics and a subseguent proper diagnostic procedure. It was found that CT and Angio gave similar diagnostic accuracy. It was further revealed that US images enabled to differentiate renal tumors from the more commonly experienced renal cystic disease. For determination of tunica involucrum infiltration, which is essential to diagnose Stage I and II renal tumors, CT was proved to be superior to Angio. CT and US were also to be so in the determination of metastasis to para-aortic lymph nodes which is a Stage III criterion. In recent years, CT and US imaging accuracies have increased, hence the improvement in the capacity to diagnose non-observable renal tumors is highly expected. (author)

Measurement of patient radiation doses in certain urography procedures

International Nuclear Information System (INIS)

Sulieman, A.; Barakat, H.; Zailae, A.; Abuderman, A.; Theodorou, K.

2015-01-01

Patients are exposed to significant radiation doses during diagnostic and interventional urological procedures. This study aimed to measure patient entrance surface air kerma (ESAK) and to estimate the effective dose during intravenous urography (IVU), extracorporeal shock-wave lithotripsy (ESWL), and ascending urethrogram (ASU) procedures. ESAK was measured in patients using calibrated thermo luminance dosimeters, GR200A). Effective doses (E) were calculated using the National Radiological Protection Board (NRPB) software. A total of 179 procedures were investigated. 27.9 % of the patients underwent IVU procedures, 27.9 % underwent ESWL procedures and 44.2 % underwent ASU procedures. The mean ESAK was 2.1, 4.18 and 4.9 mGy for IVU, ESWL, and ASU procedures, respectively. Differences in patient ESAK for the same procedure were observed. The mean ESAK values were comparable with those in previous studies. (authors)

Application of diagnostic reference levels in medical practice

Energy Technology Data Exchange (ETDEWEB)

Bourguignon, Michel [Faculty of Medicine of Paris, Deputy Director General, Nuclear Safety Authority (ASN), Paris (France)

2006-07-01

Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

Application of diagnostic reference levels in medical practice

International Nuclear Information System (INIS)

Bourguignon, Michel

2006-01-01

Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

Diagnostic Approaches to Sjögren’s Syndrome: a Literature Review and Own Clinical Experience

Directory of Open Access Journals (Sweden)

Pedro de Sousa Gomes

2012-03-01

Full Text Available Objectives: The purpose of present paper is to critically address the recent advances on diagnostic procedures of Sjögren’s syndrome, taking into account the attained local and systemic features of the disease. Material and Methods: A comprehensive review of the available literature regarding to the diagnostic approaches to Sjögren’s syndrome was conducted. Eligible studies were identified by searching the electronic literature PubMed, Medline, Embase, and ScienceDirect databases for relevant reports (last search update January 2012 combining the MESH heading term “Sjögren’s syndrome”, with the words "diagnosis, diagnostic procedures, salivary gland function, ocular tests, histopathology, salivary gland imaging, serology". The authors checked the references of the selected articles to identify additional eligible publications and contacted the authors, if necessary. Results: Presented article addresses the established diagnostic criteria for Sjögren’s syndrome and critically evaluates the most commonly used diagnostic procedures, presenting data from author’s own clinical experience. Diagnostic criteria for Sjögren’s syndrome are required both by healthcare professionals and patients, namely in order to provide a rational basis for the assessment of the symptoms, establish an individual disease prognosis, and orientate the therapeutic intervention. Conclusions: Sjögren’s syndrome is quite a common autoimmune disease of which the diagnosis and treatment are not easily established. Due to its systemic involvement, it can exhibit a wide range of clinical manifestations that contribute to confusion and delay in diagnosis. The use of proper diagnostic modalities will help to reduce the time to diagnosis and preserve the health and quality of life of patients with Sjögren’s syndrome.

Exposure to Indian population from diagnostic radiology

International Nuclear Information System (INIS)

Supe, S.J.; Venkataraman, G.; Sasane, J.B.; Sawant, S.G.; Shirva, V.K.; Iyer, P.S.

1993-01-01

Many national and international agencies are actively engaged in taking stock of radiation safety status of radiation procedures which add to the population dose significantly. National survey is being conducted to collect data from various diagnostic X-ray institutions to assess radiation safety status and population dose arising from such practices in India. For this purpose 11 centres are collecting information on annual number of patients examined site wise and on their age and sex distribution. Patient doses are also measured for various diagnostic X-ray examinations in a few hospitals using CaSO 4 :Dy TLD dosimeters. Preliminary results of earlier study indicate that the country has about 50000 diagnostic X-ray units. The annual number of X-ray examinations is estimated to be 9x10 7 . Mean entrance skin dose for diagnostic X-rays are between 0.2 to 50 mGy depending on the type of examination. On the basis of experience gained in the earlier survey an exhaustive survey is undertaken for 1992-93 for improving the assessment of population dose. (author). 3 refs

Procedural learning and dyslexia.

Science.gov (United States)

Nicolson, R I; Fawcett, A J; Brookes, R L; Needle, J

2010-08-01

Three major 'neural systems', specialized for different types of information processing, are the sensory, declarative, and procedural systems. It has been proposed (Trends Neurosci., 30(4), 135-141) that dyslexia may be attributable to impaired function in the procedural system together with intact declarative function. We provide a brief overview of the increasing evidence relating to the hypothesis, noting that the framework involves two main claims: first that 'neural systems' provides a productive level of description avoiding the underspecificity of cognitive descriptions and the overspecificity of brain structural accounts; and second that a distinctive feature of procedural learning is its extended time course, covering from minutes to months. In this article, we focus on the second claim. Three studies-speeded single word reading, long-term response learning, and overnight skill consolidation-are reviewed which together provide clear evidence of difficulties in procedural learning for individuals with dyslexia, even when the tasks are outside the literacy domain. The educational implications of the results are then discussed, and in particular the potential difficulties that impaired overnight procedural consolidation would entail. It is proposed that response to intervention could be better predicted if diagnostic tests on the different forms of learning were first undertaken. 2010 John Wiley & Sons, Ltd.

Prenatal diagnostic procedures used in pregnancies with congenital malformations in 14 regions of Europe.

Science.gov (United States)

Garne, Ester; Loane, Maria; de Vigan, Catherine; Scarano, Gioacchino; de Walle, Hermien; Gillerot, Yves; Stoll, Claude; Addor, Marie-Claude; Stone, David; Gener, Blanca; Feijoo, Maria; Mosquera-Tenreiro, Carmen; Gatt, Miriam; Queisser-Luft, Annette; Baena, Neus; Dolk, Helen

2004-11-01

To investigate outcomes of ultrasound investigations (US) and invasive diagnostic procedures in cases of congenital malformations (CM), and to compare the use of invasive prenatal test techniques (amniocentesis (AC) versus chorionic villus sampling (CVS)) among European populations. Analysis of data from population-based registries of CM. 25 400 cases of CM recorded by 14 EUROCAT registries covering a total population of 1,013,352 births 1995-99. US were performed in 91% of cases, and positively detected CM in 35% of cases. AC was performed in 24% of the cases and CVS in 3% of cases. Thirty-eight percent of invasive tests gave positive results. Fifty-two percent of cases with maternal age > or = 35 years had an invasive test performed compared to 20% of cases with younger mothers. Considerable variation was found between registries in the uptake rate of invasive tests in cases with older maternal age and on the use of invasive tests with only four regions employing CVS techniques in at least a third of the cases having invasive tests. For chromosomal anomalies US gave positive results in 46% of cases with maternal age or = 35 years with US performed. Prenatal US was performed in 91% of all pregnancies with CM but the test was only positive in a third of the cases. There was large regional variation in the uptake rate of invasive tests with maternal age of 35 years or more. For every CVS carried out there were nine AC tests. US is an important tool in the prenatal diagnosis of chromosomal anomalies in Europe. Copyright 2004 John Wiley & Sons, Ltd.

Clinical dosimetry in diagnostic and interventional radiology

International Nuclear Information System (INIS)

Dimcheva, M.; Sergieva, S.; Jovanovska, A.

2012-01-01

Full text: Introduction: Diagnostic and interventional procedures involving x-rays are the most significant contributor to total population dose form man made sources of ionizing radiation. Purpose and aim: X-ray imaging generally covers a diverse range of examination types, many of which are increasing in frequency and technical complexity. Materials and methods: The European Directives 96/29 and 97/43 EURATOM stress the importance of accurate dosimetry and require calibration of all measuring equipment related to application of ionizing radiation in medicine. Results: The paper gives and overview of current system of dosimetry of ionizing radiations that is relevant for metrology and clinical applications. It also reflects recently achieved international harmonization in the field promoted by International Atomic Energy Agency (IAEA). Discussion: Objectives of clinical dose measurements in diagnostic and interventional radiology are multiple, as assessment of equipment performance, or assessment of risk emerging from use of ionizing radiation Conclusion: Therefore, from the clinical point of view, the requirements for dosimeters and procedures to assess dose to standard dosimetry phantoms and patients in clinical diverse modalities, as computed tomography are presented

Face-off: A new identification procedure for child eyewitnesses.

Science.gov (United States)

Price, Heather L; Fitzgerald, Ryan J

2016-09-01

In 2 experiments, we introduce a new "face-off" procedure for child eyewitness identifications. The new procedure, which is premised on reducing the stimulus set size, was compared with the showup and simultaneous procedures in Experiment 1 and with modified versions of the simultaneous and elimination procedures in Experiment 2. Several benefits of the face-off procedure were observed: it was significantly more diagnostic than the showup procedure; it led to significantly more correct rejections of target-absent lineups than the simultaneous procedures in both experiments, and it led to greater information gain than the modified elimination and simultaneous procedures. The face-off procedure led to consistently more conservative responding than the simultaneous procedures in both experiments. Given the commonly cited concern that children are too lenient in their decision criteria for identification tasks, the face-off procedure may offer a concrete technique to reduce children's high choosing rates. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Bayesian analysis of longitudinal Johne's disease diagnostic data without a gold standard test

DEFF Research Database (Denmark)

Wang, C.; Turnbull, B.W.; Nielsen, Søren Saxmose

2011-01-01

the posterior estimates of the model parameters that provide the basis for inference concerning the accuracy of the diagnostic procedure. Based on the Bayesian approach, the posterior probability distribution of the change-point onset time can be obtained and used as a criterion for infection diagnosis......-point process with a Weibull survival hazard function was used to model the progression of the hidden disease status. The model adjusted for the fixed effects of covariate variables and random effects of subject on the diagnostic testing procedure. Markov chain Monte Carlo methods were used to compute....... An application is presented to an analysis of ELISA and fecal culture test outcomes in the diagnostic testing of paratuberculosis (Johne's disease) for a Danish longitudinal study from January 2000 to March 2003. The posterior probability criterion based on the Bayesian model with 4 repeated observations has...

Sedation for procedures outside the operating room in children

International Nuclear Information System (INIS)

Molina Rodriguez, Ericka

2014-01-01

Sedation is defined in the pediatric population. An adequate preoperative assessment is established in patients subjected to a sedation. Fundamental characteristics of drugs used during a sedation are determined. Recommendations about surveillance and monitoring are established in a patient sedated. Principal characteristics of sedation are defined in patients exposed to radiological diagnostic and therapeutic procedures. Considerations in sedation are identified for procedures in the laboratory of digestive endoscopy. Alternatives of sedation are mentioned for oncological patients subjected to invasive procedures. Working conditions and specifications of anesthesia are determined in the cardiac catheterization room [es

Fractures of the cervical spine. Diagnostic procedures in patients with severe cranio-cervical trauma; HWS-Frakturen. Diagnostik bei polytraumatisierten Patienten

Energy Technology Data Exchange (ETDEWEB)

Link, T.M. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Schuierer, G. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Hufendiek, A. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Peters, P.E. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany)

1994-12-01

The purpose of our study was to analyze diagnostic procedures of the cervical spine in severely traumatized patients. Findings in plain radiographs and computer radiography of 234 patients were evaluated. The image quality of the plain radiographs was examined. Casualty reports were evaluated retrospectively. Frequency, distribution and morphology of cervical spine fractures were analyzed: 44 fractures in 35 patients were diagnosed, most of the fractures were located in C2 (20/44). Twenty of the fractures diagnosed in CT were not diagnosed in plain radiography and 7 fractures were uncertain findings; 5 fractures were not detected at the casualty site. A new screening procedure in patients with severe head injury is introduced. (orig.) [Deutsch] Ziel der vorliegenden Studie war, die Diagnostik der HWS beim polytraumatisierten Patienten zu analysieren. Retrospektiv wurden Roentgenaufnahmen und Computertomogramme der HWS von 234 polytraumatisierten Patienten analysiert. Konventionelle HWS-Aufnahmen wurden in bezug auf ihre Qualitaet untersucht und der Befund der konventionellen Aufnahmen mit dem der Computertomographie verglichen. Die Befunde vom Unfalltag wurden den retrospektiv validierten Befunden gegenuebergestellt. Haeufigkeit, Verteilung und Morphologie von HWS-Frakturen bei polytraumatisierten Patienten wurden untersucht: 44 Frakturen bei 35 Patienten waren nachweisbar, am haeufigsten Frakturen von HWK 2 (21/44). 20 der Frakturen konnten konventionelle radiologisch nicht und 7 nur fraglich diagnostiziert werden. 5 Frakturen wurden am Unfalltag nicht erkannt. Ein neues Untersuchungsprotokoll mit routinemaessiger computertomographischer Untersuchung von HWK 1 und 2 bei Schaedel-Hirn-Traumata wird vorgestellt. (orig.)

Assessment of the radiation risk from diagnostic radiology

International Nuclear Information System (INIS)

Streffer, C.; Mueller, W.U.

1995-01-01

In any assessment of radiation risks from diagnostic radiology the main concern is the possible induction of cancer. It now appears to be beyond all doubt that ionizing rays invite the development of cancer in humans. The radiation doses encountered in diagnostic radiology generally vary from 1 to 50 mSv. For this dose range, no measured values are available to ascertain cancer risks from ionizing rays. The effects of such doses must therefore be extrapolated from higher dose levels under consideration of given dose-effect relationships. All relevant figures for diagnostic X-ray measures are therefore mathematically determined approximate values. The stochastic radiation risk following non-homogeneous radiation exposure is assessed on the basis of the effective dose. This dose was originally introduced to ascertain the risk from radioactive substances incorporated at the working place. A secondary intention was to trigger further developmental processes in radiation protection. Due to the difficulties previously outlined and the uncertainties surrounding the determination and assessment of the effective dose from diagnostic X-ray procedures, this dose should merely be used for technological refinements and comaprisons of examination procedures. It appears unreasonable that the effective doses determined for the individual examinations are summed up to obtain a collective effective dose and to multiply this with a risk factor so as to give an approximation of the resulting deaths from cancer. A reasonable alternative is to inform patients subjected to X-ray examinations about the associated radiation dose and to estimate form this the magnitude of the probable radiation risk. (orig./MG) [de

Review on patients radiation dose and frequency of procedures during medical exposure in Sudan

International Nuclear Information System (INIS)

Abu Baker, Samah Mohamed Nasr

2015-09-01

The aim of this study was to estimate patient dose, the annual frequency and the number of staff and devices in the medical applications of ionizing radiation in Sudan. Survey was conducted on diagnostic radiology, nuclear medicine and radiotherapy. With respect to diagnostic radiology, only patient radiation dose was estimated. The data for diagnostic radiology was obtained from 24 peer reviewed scientific published literatures during the years ( 2006 - 2015). The collected publications included about 64 Sudanese hospitals covering different types of diagnostic exams. A values of the effective dose for pediatrics and adult patients were within the ranges of similar worldwide values published by UNSCEAR report in 2008 with exceptional to fluoroscopy hysterosalpingography for adult patients. For nuclear medicine procedures, questionnaires were distributed to five hospitals representing the whole existing NM department in Sudan at the time of of study. The estimated total annual frequency of diagnostic procedures was 0.2 per 1000 population. The estimated total annual collective and annual per caput effective dose from all NM procedures were 16.268 man Sv and 0.5 μSv, respectively. Comparing the annual per caput effective dose with UNSCEAR value our results was less than the worldwide value and greater than the value for heath care level 111-1 v countries. Questionnaires were also distributed to collect data on radiotherapy procedures performed in the two existing radioisotopes Sudanese hospitals. The prescribed dose and the number of fractions were comparable between the two hospitals. The minimum prescribed dose was 20 Gy with 5 fractions for nasopharynx (NPH) palliative and the maximum prescribed dose was 64 Gy with 32 fractions for prostate.(Author)

Optimal Combinations of Diagnostic Tests Based on AUC.

Science.gov (United States)

Huang, Xin; Qin, Gengsheng; Fang, Yixin

2011-06-01

When several diagnostic tests are available, one can combine them to achieve better diagnostic accuracy. This article considers the optimal linear combination that maximizes the area under the receiver operating characteristic curve (AUC); the estimates of the combination's coefficients can be obtained via a nonparametric procedure. However, for estimating the AUC associated with the estimated coefficients, the apparent estimation by re-substitution is too optimistic. To adjust for the upward bias, several methods are proposed. Among them the cross-validation approach is especially advocated, and an approximated cross-validation is developed to reduce the computational cost. Furthermore, these proposed methods can be applied for variable selection to select important diagnostic tests. The proposed methods are examined through simulation studies and applications to three real examples. © 2010, The International Biometric Society.

Methodology for quantitative evaluation of diagnostic performance

International Nuclear Information System (INIS)

Metz, C.

1981-01-01

Of various approaches that might be taken to the diagnostic performance evaluation problem, Receiver Operating Characteristic (ROC) analysis holds great promise. Further development of the methodology for a unified, objective, and meaningful approach to evaluating the usefulness of medical imaging procedures is done by consideration of statistical significance testing, optimal sequencing of correlated studies, and analysis of observer performance

Learning Diagnostic Diagrams in Transport-Based Data-Collection Systems

DEFF Research Database (Denmark)

Tran, Vu The; Eklund, Peter; Cook, Chris

2014-01-01

Insights about service improvement in a transit network can be gained by studying transit service reliability. In this paper, a general procedure for constructing a transit service reliability diagnostic (Tsrd) diagram based on a Bayesian network is proposed to automatically build a behavioural...

Chromatographic quality control procedures for /sup 99m/Tc-diagnostic agents

International Nuclear Information System (INIS)

Marinelli, M.; Pozzato, R.; Garuti, P.; Zucchini, G.L.

1986-01-01

The purpose of this work was to experiment simple and rapid chromatographic systems, based on paper and thin-layer techniques, to test the radiochemical purity of some common /sup 99m/Tc diagnostic agents, and select those systems able to prevent the anomalies due to oxidation and artifact production. The agents were examined under conditions which usually bring about the above mentioned anomalies, then the results were compared with those obtained under controlled conditions. Quali- and quantitative detection of the activity present on the chromatograms was carried out using the equipment available in nuclear medicine departments

Pediatric abdominal non-Hodgkin's lymphoma: diagnosis through surgical and non-surgical procedures.

Science.gov (United States)

Aguiar, Arthur Almeida; Lima, Luciana Cavalvanti; Araújo, Cláudia Corrêa de; Gallindo, Rodrigo Melo

2017-12-29

To describe the success rate and the complications after procedures to diagnose abdominal non-Hodgkin's lymphoma in children and adolescents. A retrospective cross-sectional study was conducted with a population consisting of children and adolescents with abdominal non-Hodgkin's lymphoma diagnosed between September 1994 and December 2012. The sample comprised of 100 patients who underwent 113 diagnostic procedures, including urgent surgery (n=21), elective surgery (n=36), and non-surgical diagnosis (n=56). The most frequent procedures were laparotomy (46.9%) and ultrasound-guided core biopsy (25.6%). The rate of diagnostic success was 95.2% for urgent surgeries; 100% for elective surgeries and 82.1% for non-surgical procedures (p<0.05). The rates of complication during the three diagnosis procedures considered were significant (p<0.001; 95.2% of the urgent surgeries, 83.8% of the elective surgeries, and 10.7% of the non-surgical procedures). The length of time before resuming a full diet and starting chemotherapy was significantly reduced for patients who underwent non-surgical procedures when compared with the other procedures (p<0.001). Non-surgical procedures for the diagnosis of pediatric abdominal non-Hodgkin's lymphoma are an effective option with low morbidity rate, allowing an earlier resumption of a full diet and chemotherapy initiation. Furthermore, non-surgical procedures should also be considered for obtaining tumor samples from patients with extensive disease. Copyright © 2017. Published by Elsevier Editora Ltda.

A study on the value of computer-assisted assessment for SPECT/CT-scans in sentinel lymph node diagnostics of penile cancer as well as clinical reliability and morbidity of this procedure.

Science.gov (United States)

Lützen, Ulf; Naumann, Carsten Maik; Marx, Marlies; Zhao, Yi; Jüptner, Michael; Baumann, René; Papp, László; Zsótér, Norbert; Aksenov, Alexey; Jünemann, Klaus-Peter; Zuhayra, Maaz

2016-09-07

Because of the increasing importance of computer-assisted post processing of image data in modern medical diagnostic we studied the value of an algorithm for assessment of single photon emission computed tomography/computed tomography (SPECT/CT)-data, which has been used for the first time for lymph node staging in penile cancer with non-palpable inguinal lymph nodes. In the guidelines of the relevant international expert societies, sentinel lymph node-biopsy (SLNB) is recommended as a diagnostic method of choice. The aim of this study is to evaluate the value of the afore-mentioned algorithm and in the clinical context the reliability and the associated morbidity of this procedure. Between 2008 and 2015, 25 patients with invasive penile cancer and inconspicuous inguinal lymph node status underwent SLNB after application of the radiotracer Tc-99m labelled nanocolloid. We recorded in a prospective approach the reliability and the complication rate of the procedure. In addition, we evaluated the results of an algorithm for SPECT/CT-data assessment of these patients. SLNB was carried out in 44 groins of 25 patients. In three patients, inguinal lymph node metastases were detected via SLNB. In one patient, bilateral lymph node recurrence of the groins occurred after negative SLNB. There was a false-negative rate of 4 % in relation to the number of patients (1/25), resp. 4.5 % in relation to the number of groins (2/44). Morbidity was 4 % in relation to the number of patients (1/25), resp. 2.3 % in relation to the number of groins (1/44). The results of computer-assisted assessment of SPECT/CT data for sentinel lymph node (SLN)-diagnostics demonstrated high sensitivity of 88.8 % and specificity of 86.7 %. SLNB is a very reliable method, associated with low morbidity. Computer-assisted assessment of SPECT/CT data of the SLN-diagnostics shows high sensitivity and specificity. While it cannot replace the assessment by medical experts, it can still provide substantial

Guidelines for Quality Control of Equipment Used in Diagnostic Radiology in the Netherlands

International Nuclear Information System (INIS)

Berg, L. van den; Aarts, C.N.M.; Beentjes, L.B.; Dalen, A. van; Elsakkers, P.; Julius, H.W.; Kicken, P.J.H.; Meer, F. van der; Teeuwisse, W.; Thijssen, M.A.O.; Zoetelief, J.

1998-01-01

The Dutch working group on 'Quality Criteria for Equipment Used in Diagnostic Radiology' has formulated guidelines providing technical criteria for equipment used in conventional diagnostic radiology. These guidelines are applicable to the technical parameters having a major impact on image quality and patient dose and include methods for testing. The following parameters are included: tube voltage, automatic exposure control, film processing, film-screen combination, light tightness and illumination of the dark room, half-value layer and filtration, light field, grid, focal spot size, viewing boxes and geometrical indicators. Each guideline consists of the following chapters: (1) Scope and field of application, (2) Background information, (3) Test procedure, (4) Test frequency, (5) Registration of observations, (6) Evaluation and interpretation, (7) Test report. Chapter 3 includes both the principles of the test method and a step by step description of the procedures. The principles of the test procedure provide a basis for adaptation to local circumstances. The step by step test procedure allows a quality control measurement to be performed with limited physical knowledge of the equipment. Chapter 6 includes limiting values. Draft guidelines were evaluated in practice in 20 hospitals. The final document has been accepted by the professional societies in the Netherlands and the Dutch Minister of Health as a reference set of tools to perform Quality Control of equipment used for conventional diagnostic radiology. (author)

Midazolam administration at a department of pediatric radiology: Conscious sedation for diagnostic imaging studies

International Nuclear Information System (INIS)

Madzik, J.; Marcinski, A.; Brzewski, M.; Jakubowska, A.; Roik, D.; Majkowska, Z.; Biejat, A.; Krzemien, G.

2006-01-01

The aims of the study were to evaluate the usefulness of midazolam administration for sedation prior to some diagnostic examinations in children and to present the requirements and rules for sedation in departments of pediatric radiology. From Oct. 2001 to Aug. 2005, two hundred children were investigated after conscious sedation with midazolam. The examinations were: voiding cystourethrography (129), voiding sonocystography (64), barium enema (3), ultrasonography (1), urography (1), X-ray of facial bone (1), and brain CT (1). The children's age-range was 4 months to 13 years 9 months. The decision for sedation was based on conversation with the child and/or parents, their experience with previous examinations, emotional status of the child, and exclusion of contraindications (renal insufficiency, hepatic failure, respiratory/circulatory insufficiency, allergy to benzodiazepines in anamnesis). Midazolam was given orally in a dose of 0.5 mg/kg body weight, 15-20 minutes before examination (already at the department of pediatric radiology). The parents were informed of the possible side effects and what to do after the procedure. All diagnostic procedures with conscious sedation were well tolerated by the children and accepted by the parents. The parents with experience from previous diagnostic procedures indicated that they would want their child to have midazolam again if the examination needed to be repeated. No significant complications were observed in the children receiving midazolam and few adverse effect on voiding during cystourethrography. In three children (2.5, 3, and 5 years old), paradoxical reactions occurred (psychomotor agitation) which disappeared spontaneously after some minutes and had no influence on the procedure. Application of midazolam for conscious sedation diminished anxiety and discomfort from diagnostic procedures and short anterograde amnesia protected the child's mind from painful experience. Conscious sedation should be widely used in

Appropriate use of diagnostic imaging

Energy Technology Data Exchange (ETDEWEB)

Palmer, P.E.S.; Cockshott, W.P.

1984-11-16

This article discusses ways in which more appropriate use can be made of roentgenography with a resulting decrease in radiation doses to the patient population. The authors recommend that fewer films be made and that traditional roentgenography be replaced with endoscopy, ultrasound, computerized tomography, or angiography where appropriate. They also recommend that medical schools and medical subspecialty groups study the World Health Organization document which provides indications for diagnostic imaging, the choice of procedure and the limitations of each.

Report on COTECH test procedure and characterization techniques

DEFF Research Database (Denmark)

Islam, Mohammad Aminul

that need to be attained for successful characterization of the planned demonstrators and it deals with the material characterization and prototype testing for the COTECH demonstrators. The summary of this report includes:  General description of COTECH industrial demonstrators  COTECH materials...... and material characterization techniques  Characterization techniques of the COTECH demonstrators  Functionality and lifecycle testing of the COTECH demonstrators Besides the general introduction and conclusion each section of the report is dedicated to the characterization techniques and test procedure.......Characterization techniques and test procedure requirements for innovative self-ligating dental brackets (EO) Section 5.Characterization techniques and test procedure requirements for smart diagnostic chips comprising a microfluidic channel system (GBO) Section 6.Characterization techniques and test procedure...

Headache following intracranial neuroendovascular procedures.

Science.gov (United States)

Baron, Eric P; Moskowitz, Shaye I; Tepper, Stewart J; Gupta, Rishi; Novak, Eric; Hussain, Muhammad Shazam; Stillman, Mark J

2012-05-01

Predicting who will develop post-procedure headache (PPH) following intracranial endovascular procedures (IEPs) would be clinically useful and potentially could assist in reducing the excessive diagnostic testing so often obtained in these patients. Although limited safety data exist, the use of triptans or dihydroergotamine (DHE) often raise concern when used with pre/post-coiled aneurysms. We sought to determine risk factors for PPH following IEP, to evaluate the utility of diagnostic testing in patients with post-coil acute headache (HA), and to record whether triptans and DHE have been used safely in this clinical setting. We conducted a retrospective chart review of adult patients undergoing IEPs. Bivariate analyses were conducted to compare patients who did and did not develop PPH. We reviewed records pertaining to 372 patients, of whom 263 underwent intracranial coil embolizations, 21 acrylic glue embolizations, and 88 stent placements. PPH occurred in 72% of coil patients, 33% of glue patients, and 14% of stent patients. Significant risk factors for post-coil HA were female gender, any pre-coil HA history, smoking, and anxiety/depression. A pre-stent history of HA exceeding 1 year's duration, and smoking were risk factors for post-stent HA. A pre-glue history of HA exceeding 1 year was the only risk factor for post-glue HA. In the small subgroup available for study, treatment with triptans or DHE was not associated with adverse events in pre/post-coiled aneurysms. Diagnostic testing was low yield. Occurrence of PPH was common after IEPs and especially so with coiling and in women, smokers, and those with anxiety/depression, and was often of longer duration than allowed by current International Classification of Headache Disorders-II criteria. The yield of diagnostic testing was low, and in a small subgroup treatment with triptans or DHE did not cause adverse events in pre/post-coiled aneurysms. Prospective studies are needed to confirm these findings. �

Digital image intensifier radiography: A new diagnostic procedure in traumatology?

International Nuclear Information System (INIS)

Schmidt, C.; Deininger, H.K.; Staedtische Kliniken Darmstadt

1990-01-01

Digital image intensifier radiography visualises all traumatological changes of clinical relevance and can therefore be used in traumatology. However, the quality of conventional radiographs cannot be attained as yet. Radiation exposure is markedly reduced, and radiographs are obtained directly after exposure, so that this is an extremely rapid radiographic procedure. Images can be quickly transmitted by video cable to the relevant departments and working places. (orig.) [de

Patient radiation doses from neuroradiology procedures

Energy Technology Data Exchange (ETDEWEB)

Garcia-Roman, M J; Abreu-Luis, J; Hernandez-Armas, J [Servicio de Fisica Medica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Prada-Martinez, E [Servicio de Radiodiagnostico, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain)

2001-03-01

Following the presentation of radiation-induced deterministic effects by some patients undergoing neuroradiological procedures during successive sessions, such as temporary epilation, in the 'Hospital Universitario de Canarias', measurements were made of dose to patients. The maximum dose-area product measured by ionization chamber during these procedures was 39617 cGy.cm{sup 2} in a diagnostic of aneurysm and the maximum dose to the skin measured by thermoluminescent dosemeters (TLDs) was 462.53 mGy. This can justify certain deterministic effects but it is unlikely that the patients will suffer serious effects from this skin dose. Also, measurements were made of effective dose about two usual procedures, embolisation of tumour und embolisation of aneurysm. These procedures were reproduced with an anthropomorphic phantom Rando and doses were measured with TLDs. Effective doses obtained were 3.79 mSv and 4.11 mSv, respectively. The effective dose valued by the program EFFDOSE was less than values measured with TLDs. (author)

Patient radiation doses from neuroradiology procedures

International Nuclear Information System (INIS)

Garcia-Roman, M.J.; Abreu-Luis, J.; Hernandez-Armas, J.; Prada-Martinez, E.

2001-01-01

Following the presentation of radiation-induced deterministic effects by some patients undergoing neuroradiological procedures during successive sessions, such as temporary epilation, in the 'Hospital Universitario de Canarias', measurements were made of dose to patients. The maximum dose-area product measured by ionization chamber during these procedures was 39617 cGy.cm 2 in a diagnostic of aneurysm and the maximum dose to the skin measured by thermoluminescent dosemeters (TLDs) was 462.53 mGy. This can justify certain deterministic effects but it is unlikely that the patients will suffer serious effects from this skin dose. Also, measurements were made of effective dose about two usual procedures, embolisation of tumour und embolisation of aneurysm. These procedures were reproduced with an anthropomorphic phantom Rando and doses were measured with TLDs. Effective doses obtained were 3.79 mSv and 4.11 mSv, respectively. The effective dose valued by the program EFFDOSE was less than values measured with TLDs. (author)

Patient doses from fluoroscopically guided cardiac procedures in pediatrics

International Nuclear Information System (INIS)

Martinez, L C; Vano, E; Gutierrez, F; Rodriguez, C; Gilarranz, R; Manzanas, M J

2007-01-01

Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for 2 respectively for the four age bands. These KAP values increase by a factor of 8 when moving through the four age bands. The probability of a fatal cancer per fluoroscopically guided cardiac procedure is about 0.07%. Median values of ESAK for the four age bands were 46, 50, 56 and 163 mGy, which lie far below the threshold for deterministic effects on the skin. These dose values are lower than those published in previous papers

Collective radiation dose from diagnostic x-ray examination in nine ...

African Journals Online (AJOL)

Bernt Lindtjorn

Conclusion: Although the use of ionizing radiation for diagnostic medical procedures is an acceptable ... It is estimated that the adoption of rare earth screen technology might reduce the ... coated in a smooth layer on a plastic support or card.

Comparative analysis of diagnostic accuracy of different brain biopsy procedures

OpenAIRE

Jain Deepali; Sharma Mehar; Sarkar Chitra; Gupta Deepak; Singh Manmohan; Mahapatra A

2006-01-01

Background: Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. Aims: The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different s...

Transthoracic CT-guided biopsy with multiplanar reconstruction image improves diagnostic accuracy of solitary pulmonary nodules

International Nuclear Information System (INIS)

Ohno, Yoshiharu; Hatabu, Hiroto; Takenaka, Daisuke; Imai, Masatake; Ohbayashi, Chiho; Sugimura, Kazuro

2004-01-01

Objective: To evaluate the utility of multiplanar reconstruction (MPR) image for CT-guided biopsy and determine factors of influencing diagnostic accuracy and the pneumothorax rate. Materials and methods: 390 patients with 396 pulmonary nodules underwent transthoracic CT-guided aspiration biopsy (TNAB) and transthoracic CT-guided cutting needle core biopsy (TCNB) as follows: 250 solitary pulmonary nodules (SPNs) underwent conventional CT-guided biopsy (conventional method), 81 underwent CT-fluoroscopic biopsy (CT-fluoroscopic method) and 65 underwent conventional CT-guided biopsy in combination with MPR image (MPR method). Success rate, overall diagnostic accuracy, pneumothorax rate and total procedure time were compared in each method. Factors affecting diagnostic accuracy and pneumothorax rate of CT-guided biopsy were statistically evaluated. Results: Success rates (TNAB: 100.0%, TCNB: 100.0%) and overall diagnostic accuracies (TNAB: 96.9%, TCNB: 97.0%) of MPR were significantly higher than those using the conventional method (TNAB: 87.6 and 82.4%, TCNB: 86.3 and 81.3%) (P<0.05). Diagnostic accuracy were influenced by biopsy method, lesion size, and needle path length (P<0.05). Pneumothorax rate was influenced by pathological diagnostic method, lesion size, number of punctures and FEV1.0% (P<0.05). Conclusion: The use of MPR for CT-guided lung biopsy is useful for improving diagnostic accuracy with no significant increase in pneumothorax rate or total procedure time

Foetal Radiation Dose and Risk from Diagnostic Radiology Procedures: A Multinational Study

International Nuclear Information System (INIS)

Osei, Ernest K.; Darko, Johnson

2012-01-01

In diagnostic radiology examinations there is a benefit that the patient derives from the resulting diagnosis. Given that so many examinations are performed each year, it is inevitable that there will be occasions when an examination(s) may be inadvertently performed on pregnant patients or occasionally it may become clinically necessary to perform an examination(s) on a pregnant patient. In all these circumstances it is necessary to request an estimation of the foetal dose and risk. We initiated a study to investigate fetal doses from different countries. Exposure techniques on 367 foetuses from 414 examinations were collected and investigated. The FetDoseV4 program was used for all dose and risk estimations. The radiation doses received by the 367 foetuses ranges: <0.001–21.9 mGy depending on examination and technique. The associated probability of induced hereditary effect ranges: <1 in 200000000 (5 × 10 −9 ) to 1 in 10000 (1 × 10 −4 ) and the risk of childhood cancer ranges <1 in 12500000 (8 × 10 −8 ) to 1 in 500 (2 × 10 −3 ). The data indicates that foetal doses from properly conducted diagnostic radiology examinations will not result in any deterministic effect and a negligible risk of causing radiation induced hereditary effect in the descendants of the unborn child

Establishing diagnostic reference levels in digital radiology

International Nuclear Information System (INIS)

Bana, Remy Wilson

2016-04-01

Medical application of radiation has gained wider study since diagnostic radiology plays a very important role in modern medicine. The need of the service seems to increase since the invention of digital radiology as a new technology that promises greater accuracy while minimizing patient dose. However, it is not exempted in the harmonization of doses delivered to the patient undergoing same radiologic examination in different institutions either regional or nationwide. The objective of this project was to review the establishment of Diagnostic Reference Levels (DRLs) in digital radiology at National level with the aim to reduce patient dose while maintaining appropriate image quality. A general discussion on digital radiology has been presented focusing on the optimization of patient dose as well as dosimetric quantities used for the establishment of DRLs. Recommendations have been provided for Rwanda to initiate steps to establish National Diagnostic Reference Levels for common procedures in digital radiology. (au)

Preliminary results of the analysis of the administered activities in diagnostic studies of nuclear medicine

International Nuclear Information System (INIS)

Lopez Bejerano, G.; Sed, L.J.

2001-01-01

The worldwide use of Nuclear Medicine diagnostic procedures and the tendency to its increment, infers an important exposure of the population to ionising radiation; it has motivated that the IAEA in the International Basic Safety Standards (BSS), emits recommendations for the establishment of guidance levels of activities administered to the patients in diagnostic procedures. Taking into account the above-mentioned and that in Cuba there exist 20 departments of Nuclear Medicine that in the majority possess equipment with more than 20 years of operation, which influences directly the medical exposure. A survey was designed and applied in 10 of these departments. The survey evaluates the compliance with the BSS requirements, and specifically, the activities administered to the patients in Nuclear Medicine diagnostic procedures are analysed. In the present work the obtained preliminary results of the statistical analysis carried out on the activity values used in Nuclear Medicine departments are presented, and comparisons made for a proposal of guidance levels for the national practice, which is compared with those recommended internationally. (author)

Real-time eye lens dose monitoring during cerebral angiography procedures

Energy Technology Data Exchange (ETDEWEB)

Safari, M.J.; Wong, J.H.D.; Kadir, K.A.A.; Ng, K.H. [University of Malaya, Department of Biomedical Imaging, Faculty of Medicine, Kuala Lumpur (Malaysia); University of Malaya, University of Malaya Research Imaging Centre (UMRIC), Faculty of Medicine, Kuala Lumpur (Malaysia); Thorpe, N.K.; Cutajar, D.L.; Petasecca, M.; Lerch, M.L.F.; Rosenfeld, A.B. [University of Wollongong, Centre for Medical Radiation Physics (CMRP), Wollongong, NSW (Australia)

2016-01-15

To develop a real-time dose-monitoring system to measure the patient's eye lens dose during neuro-interventional procedures. Radiation dose received at left outer canthus (LOC) and left eyelid (LE) were measured using Metal-Oxide-Semiconductor Field-Effect Transistor dosimeters on 35 patients who underwent diagnostic or cerebral embolization procedures. The radiation dose received at the LOC region was significantly higher than the dose received by the LE. The maximum eye lens dose of 1492 mGy was measured at LOC region for an AVM case, followed by 907 mGy for an aneurysm case and 665 mGy for a diagnostic angiography procedure. Strong correlations (shown as R{sup 2}) were observed between kerma-area-product and measured eye doses (LOC: 0.78, LE: 0.68). Lateral and frontal air-kerma showed strong correlations with measured dose at LOC (AK{sub L}: 0.93, AK{sub F}: 0.78) and a weak correlation with measured dose at LE. A moderate correlation was observed between fluoroscopic time and dose measured at LE and LOC regions. The MOSkin dose-monitoring system represents a new tool enabling real-time monitoring of eye lens dose during neuro-interventional procedures. This system can provide interventionalists with information needed to adjust the clinical procedure to control the patient's dose. (orig.)

Real-time eye lens dose monitoring during cerebral angiography procedures

International Nuclear Information System (INIS)

Safari, M.J.; Wong, J.H.D.; Kadir, K.A.A.; Ng, K.H.; Thorpe, N.K.; Cutajar, D.L.; Petasecca, M.; Lerch, M.L.F.; Rosenfeld, A.B.

2016-01-01

To develop a real-time dose-monitoring system to measure the patient's eye lens dose during neuro-interventional procedures. Radiation dose received at left outer canthus (LOC) and left eyelid (LE) were measured using Metal-Oxide-Semiconductor Field-Effect Transistor dosimeters on 35 patients who underwent diagnostic or cerebral embolization procedures. The radiation dose received at the LOC region was significantly higher than the dose received by the LE. The maximum eye lens dose of 1492 mGy was measured at LOC region for an AVM case, followed by 907 mGy for an aneurysm case and 665 mGy for a diagnostic angiography procedure. Strong correlations (shown as R 2 ) were observed between kerma-area-product and measured eye doses (LOC: 0.78, LE: 0.68). Lateral and frontal air-kerma showed strong correlations with measured dose at LOC (AK L : 0.93, AK F : 0.78) and a weak correlation with measured dose at LE. A moderate correlation was observed between fluoroscopic time and dose measured at LE and LOC regions. The MOSkin dose-monitoring system represents a new tool enabling real-time monitoring of eye lens dose during neuro-interventional procedures. This system can provide interventionalists with information needed to adjust the clinical procedure to control the patient's dose. (orig.)

Patient Dose During Carotid Artery Stenting With Embolic-Protection Devices: Evaluation With Radiochromic Films and Related Diagnostic Reference Levels According to Factors Influencing the Procedure

Energy Technology Data Exchange (ETDEWEB)

D' Ercole, Loredana, E-mail: l.dercole@smatteo.pv.it [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Quaretti, Pietro; Cionfoli, Nicola [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy); Klersy, Catherine [Fondazione IRCCS Policlinico San Matteo, Biometry and Clinical Epidemiology Service, Research Department, (Italy); Bocchiola, Milena [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Rodolico, Giuseppe; Azzaretti, Andrea [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy); Lisciandro, Francesco [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Cascella, Tommaso; Zappoli Thyrion, Federico [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy)

2013-04-15

To measure the maximum entrance skin dose (MESD) on patients undergoing carotid artery stenting (CAS) using embolic-protection devices, to analyze the dependence of dose and exposure parameters on anatomical, clinical, and technical factors affecting the procedure complexity, to obtain some local diagnostic reference levels (DRLs), and to evaluate whether overcoming DRLs is related to procedure complexity. MESD were evaluated with radiochromic films in 31 patients (mean age 72 {+-} 7 years). Five of 33 (15 %) procedures used proximal EPD, and 28 of 33 (85 %) procedures used distal EPD. Local DRLs were derived from the recorded exposure parameters in 93 patients (65 men and 28 women, mean age 73 {+-} 9 years) undergoing 96 CAS with proximal (33 %) or distal (67 %) EPD. Four bilateral lesions were included. MESD values (mean 0.96 {+-} 0.42 Gy) were <2 Gy without relevant dependence on procedure complexity. Local DRL values for kerma area product (KAP), fluoroscopy time (FT), and number of frames (N{sub FR}) were 269 Gy cm{sup 2}, 28 minutes, and 251, respectively. Only simultaneous bilateral treatment was associated with KAP (odds ratio [OR] 10.14, 95 % confidence interval [CI] 1-102.7, p < 0.05) and N{sub FR} overexposures (OR 10.8, 95 % CI 1.1-109.5, p < 0.05). Type I aortic arch decreased the risk of FT overexposure (OR 0.4, 95 % CI 0.1-0.9, p = 0.042), and stenosis {>=} 90 % increased the risk of N{sub FR} overexposure (OR 2.8, 95 % CI 1.1-7.4, p = 0.040). At multivariable analysis, stenosis {>=} 90 % (OR 2.8, 95 % CI 1.1-7.4, p = 0.040) and bilateral treatment (OR 10.8, 95 % CI 1.1-109.5, p = 0.027) were associated with overexposure for two or more parameters. Skin doses are not problematic in CAS with EPD because these procedures rarely lead to doses >2 Gy.

Quality systems in veterinary diagnostics laboratories.

Science.gov (United States)

de Branco, Freitas Maia L M

2007-01-01

Quality assurance of services provided by veterinary diagnostics laboratories is a fundamental element promoted by international animal health organizations to establish trust, confidence and transparency needed for the trade of animals and their products at domestic and international levels. It requires, among other things, trained personnel, consistent and rigorous methodology, choice of suitable methods as well as appropriate calibration and traceability procedures. An important part of laboratory quality management is addressed by ISO/IEC 17025, which aims to facilitate cooperation among laboratories and their associated parties by assuring the generation of credible and consistent information derived from analytical results. Currently, according to OIE recommendation, veterinary diagnostics laboratories are only subject to voluntary compliance with standard ISO/IEC 17025; however, it is proposed here that OIE reference laboratories and collaboration centres strongly consider its adoption.

Quantitative optical diagnostics in pathology recognition and monitoring of tissue reaction to PDT

Science.gov (United States)

Kirillin, Mikhail; Shakhova, Maria; Meller, Alina; Sapunov, Dmitry; Agrba, Pavel; Khilov, Alexander; Pasukhin, Mikhail; Kondratieva, Olga; Chikalova, Ksenia; Motovilova, Tatiana; Sergeeva, Ekaterina; Turchin, Ilya; Shakhova, Natalia

2017-07-01

Optical coherence tomography (OCT) is currently actively introduced into clinical practice. Besides diagnostics, it can be efficiently employed for treatment monitoring allowing for timely correction of the treatment procedure. In monitoring of photodynamic therapy (PDT) traditionally employed fluorescence imaging (FI) can benefit from complementary use of OCT. Additional diagnostic efficiency can be derived from numerical processing of optical diagnostics data providing more information compared to visual evaluation. In this paper we report on application of OCT together with numerical processing for clinical diagnostic in gynecology and otolaryngology, for monitoring of PDT in otolaryngology and on OCT and FI applications in clinical and aesthetic dermatology. Image numerical processing and quantification provides increase in diagnostic accuracy. Keywords: optical coherence tomography, fluorescence imaging, photod

Molecular diagnostic PCR handbook

International Nuclear Information System (INIS)

Viljoen, G.J.; Crowther, J.R.; Nel, L.H.

2005-01-01

The uses of nucleic acid-directed methods have increased significantly in the past five years and have made important contributions to disease control country programmes for improving national and international trade. These developments include the more routine use of PCR as a diagnostic tool in veterinary diagnostic laboratories. However, there are many problems associated with the transfer and particularly, the application of this technology. These include lack of consideration of: the establishment of quality-assured procedures, the required set-up of the laboratory and the proper training of staff. This can lead to a situation where results are not assured. This book gives a comprehensive account of the practical aspects of PCR and strong consideration is given to ensure its optimal use in a laboratory environment. This includes the setting-up of a PCR laboratory; Good Laboratory Practice and standardised PCR protocols to detect animal disease pathogens. Examples of Standard Operating Procedures as used in individual specialist laboratories and an outline of training materials necessary for PCR technology transfer are presented. The difficulties, advantages and disadvantages in PCR applications are explained and placed in context with other test systems. Emphasis is placed on the use of PCR for detection of pathogens, with a particular focus on diagnosticians and scientists from the developing world. It is hoped that this book will enable readers from various disciplines and levels of expertise to better judge the merits of PCR and to increase their skills and knowledge in order to assist in a more logical, efficient and assured use of this technology

Diagnostic reasoning strategies and diagnostic success.

Science.gov (United States)

Coderre, S; Mandin, H; Harasym, P H; Fick, G H

2003-08-01

Cognitive psychology research supports the notion that experts use mental frameworks or "schemes", both to organize knowledge in memory and to solve clinical problems. The central purpose of this study was to determine the relationship between problem-solving strategies and the likelihood of diagnostic success. Think-aloud protocols were collected to determine the diagnostic reasoning used by experts and non-experts when attempting to diagnose clinical presentations in gastroenterology. Using logistic regression analysis, the study found that there is a relationship between diagnostic reasoning strategy and the likelihood of diagnostic success. Compared to hypothetico-deductive reasoning, the odds of diagnostic success were significantly greater when subjects used the diagnostic strategies of pattern recognition and scheme-inductive reasoning. Two other factors emerged as independent determinants of diagnostic success: expertise and clinical presentation. Not surprisingly, experts outperformed novices, while the content area of the clinical cases in each of the four clinical presentations demonstrated varying degrees of difficulty and thus diagnostic success. These findings have significant implications for medical educators. It supports the introduction of "schemes" as a means of enhancing memory organization and improving diagnostic success.

Static dosimetry space image in which urology diagnostics are performed

International Nuclear Information System (INIS)

Banduka, M.S.; Vasic, D.D.

2002-01-01

Background. The effects of the dispersed radiation described theoretically imply complex picture of interaction of the photon beam with the patient's body, as well as its dispersion on other structures. Basic theoretical laws of this phenomenon are highlighted, thus giving the opportunity to model the effect in total. Material and methods. The measurements of the absorbed dose in the air give isodose curves that show distribution of the radiation dose. For the urological procedures standard urological diagnostic methods were being used. Results. Through a large series of measuring, we got the distribution of the radiation dose in space, where urology diagnostics is being made using the X-ray. The parameters determining this picture are the most frequent ones in the total number of 20 random cases taken in General Hospital in Doboj, Bosnia and Herzegovina. Conclusions. Static dosimetric picture of the space (radiation zone) in the general sense is useful before all for organisation of the diagnostic procedures utilising ionised radiation. Obtained in any way, this picture enables an insight into the three-dimensional distribution of the dosage on the basis of which it is possible to correct the organisation of the diagnostics being performed under these conditions. The values of the radiation dosage show it is necessary to use the protecting means prescribed by law. For more frequent exposure, it would be useful to make a dynamic dosimetric picture for professional exposure and assessment of the radiation risk of these persons. (author)

International differences in health care costs in Europe and the United States: Do these affect the cost-effectiveness of diagnostic strategies for pulmonary embolism?

International Nuclear Information System (INIS)

Erkel, A.R. van; Pattynama, P.M.T.; Hout, W.B. van den

1999-01-01

The aim of this study was to assess whether potential differences in costs for diagnostic procedures and treatment of pulmonary embolism (PE) among European and U. S. hospitals alter the optimal cost-effective diagnostic strategy for PE. A standardized questionnaire was used to obtain cost data for the diagnosis and treatment of PE in participating European and U. S. hospitals. Costs for diagnostic tests and treatment of PE were then calculated in a standardized manner for all participating hospitals, from the hospital perspective. Costs were used in an existing cost-effectiveness analysis (CEA) model to determine the most cost-effective diagnostic strategy in participating hospitals. There were considerable differences in costs for diagnostic and therapeutic procedures for PE among the participating centers. These differences, however, did not affect the most cost-effective strategy based on incremental cost-effectiveness. In all hospitals the most cost-effective strategy appeared to be ultrasound followed by helical CT. International differences in cost of diagnostic and therapeutic procedures certainly exist and should be considered before applying a published CEA. Nevertheless, despite these cost differences, the diagnostic strategy for PE of ultrasound followed by helical CT appears most cost-effective. (orig.)

Computer System For Diagnostics of Mobile Machinery Transmission

Directory of Open Access Journals (Sweden)

G. L. Antipenko

2004-01-01

Full Text Available A new method for diagnostics of mechanical transmissions of mobile machinery is proposed in the paper. The method presupposes an application of computing equipment and its purpose is to decrease labor-consumption of diagnostics procedure and increase diagnostics efficiency.The method is based on comparison of duration of impulse periods picked up at primary transducers which are installed at transmission input and output. A signal picked up at a flywheel ring gear is taken as a reference signal.While selecting clearances of one and then the direction in speed-up - braking transmission regime changes in number of reference impulses at output provide data on angular clearance value in every gearing. As data are supplied registration and processing of results and forecasting of residual resource are to be done with the help of a program on the basis of realized algorithms for every gearing.

Severe oligohydramnios with intact membranes: an indication for diagnostic amnioinfusion.

Science.gov (United States)

Pryde, P G; Hallak, M; Lauria, M R; Littman, L; Bottoms, S F; Johnson, M P; Evans, M I

2000-01-01