Design of a system of reference for positioning of patients in radiotherapy of breast cancer

International Nuclear Information System (INIS)

Nebot, P.; Reinado, D.; Salvador, R.; Gonzalez-Pena, R.; Dalmases, F.; Romero, C.; Rosello, J.; Diez, S.; Cibrian, R.

2013-01-01

The objective of this work is the design of a system of repositioning of the patient allowing to minimize errors both in everyday's the same placement as in the position held during the session, so that treatment would be intensified in the area to be treated, avoiding possible damage to other healthy areas. (Author)

Positioning devices for patients

International Nuclear Information System (INIS)

Heavens, M.

1981-01-01

It has been suggested that it is very important to position patients reproducibly at different stages of radiotherapy treatment planning and treatment, or similar procedures. Devices have been described for positioning a patient's upper and lower thorax. This invention provides reproducible positioning for a female patient's breasts, for example in planning treatment of and treating breast tumours. The patient is placed prone, using for example an upper thorax device. A support device is placed central to and beneath her breasts to partially displace them outwards. The device may be triangular in section with one apex contacting the chest wall at the sternum. Restraining straps may be provided to hold the breasts against the support device. Means may be provided to take a healthy breast from the path of radiation through the tumour. (author)

The influence of patient positioning in breast CT on breast tissue coverage and patient comfort

Energy Technology Data Exchange (ETDEWEB)

Roessler, A.C.; Althoff, F.; Kalender, W. [Erlangen Univ. (Germany). Inst. of Medical Physics; Wenkel, E. [University Hospital of Erlangen (Germany). Radiological Inst.

2015-02-15

The presented study aimed at optimizing a patient table design for breast CT (BCT) systems with respect to breast tissue coverage and patient comfort. Additionally, the benefits and acceptance of an immobilization device for BCT using underpressure were evaluated. Three different study parts were carried out. In a positioning study women were investigated on an MRI tabletop with exchangeable inserts (flat and cone-shaped with different opening diameters) to evaluate their influence on breast coverage and patient comfort in various positioning alternatives. Breast length and volume were calculated to compare positioning modalities including various opening diameters and forms. In the second study part, an underpressure system was tested for its functionality and comfort on a stereotactic biopsy table mimicking a future CT scanner table. In the last study part, this system was tested regarding breast tissue coverage. Best results for breast tissue coverage were shown for cone-shaped table inserts with an opening of 180 mm. Flat inserts did not provide complete coverage of breast tissue. The underpressure system showed robust function and tended to pull more breast tissue into the field of view. Patient comfort was rated good for all table inserts, with highest ratings for cone-shaped inserts. Cone-shaped tabletops appeared to be adequate for BCT systems and to allow imaging of almost the complete breast. An underpressure system proved promising for the fixation of the breast during imaging and increased coverage. Patient comfort appears to be adequate.

[Reduction of pressure sores during prone positioning of ventilated intensive care patients by the prone-head support system: a pilot study].

Science.gov (United States)

Prebio, Michael; Katz-Papatheophilou, Elfriede; Heindl, Werner; Gelbmann, Herbert; Burghuber, Otto C

2005-02-01

Prone positioning in patients with adult respiratory distress syndrome is a well-known method to improve oxygenation. The aim of our study was to evaluate a new device for prone positioning, the prone-head support system (PHS system), with regard to reduction of cutaneous pressure sores. In a pilot study we randomized 8 patients with ARDS in two groups: 180 degrees standard prone positioning (group without mask) and prone positioning with the PHS system (group with mask). The PHS system consists of a facemask support, which is connected to an adapted air suspension bed. The patients of both groups were intermittently proned for several days. We evaluated the pressure sores on head and neck before turning the patients prone for the first time and after each period of prone positioning. We documented the quantity, the size, the type and the localization of the pressure sores. There was no significant difference in the mean duration of prone positioning (27.1+/-14.7 hours in the group with mask versus 24.5+/-18.7 h in the group without mask). In the group with mask there were 1.5+/-0.8 new pressure sores by each proning, whereas in the group without mask there were 2.37+/-1.6 new pressure sores, which was lower, but not significantly. The overall area of pressure sores (798 mm2 versus 3184 mm2, p=0.004), the area of pressure sores per patient (199.5+/-104.7 mm2 versus 796+/-478 mm2, p=0.03) and the increase of the area of pressure sores per proning (79.8+/-52.0 mm2 versus 398.0+/-214.3 mm2, p=0.004) were significantly lower in the group with mask in comparison to the group without mask. The lips were the most effected localization in both groups. The pressure sores in the group with mask were less severe and showed a homogenous distribution in comparison to the group without mask. Blisters dominated in the group with mask in comparison to erosions, necrosis and ulcers in the group without mask. The PHS system with its face mask is able to reduce the extent and the

Determination of specificity and pattern of antinuclear antibodies (ana) in systemic rheumatic disease patients positive for ana testing

International Nuclear Information System (INIS)

Nawaz, H.; Bashir, M.M.; Iqbal, W.

2018-01-01

To determine probability of finding antinuclear antibodies (ANA) and anti extractable nuclear antigens (ENA) positive samples and associating ANA patterns with anti-ENA reactivities among a consecutive cohort of samples of systemic rheumatic disease patients referred for ANA testing. Study Design:Prospective cohort study. Place and Duration of Study:Immunology Department, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from January to June 2016. Methodology:All the samples referred for ANA testing with clinical suspicion of systemic rheumatic disease were included. After screening, ANA positive samples were subjected to anti-ENA antibodies testing (including anti-SSA, anti-SSB, anti-Sm, anti-RNP, anti-SCL-70 and anti-Jo-1 antibodies) and ANA pattern and titer determination. Results:Of 4,347 samples received, 397 were positive for ANA (9%). Of 397, 96 (24%) samples positive on ENA screen were tested for anti-ENA reactivity. Anti-SSA antibodies were found in 59 samples. Commonest ANA patterns were coarse and fine speckled (43 and 22 samples of 81 tested), while majority of samples carried ANA in titers of 1:40 and 1:80 (22 and 18 samples of 81 tested). No specific ANA pattern was associated with any particular anti-ENA reactivity. Conclusion:Among samples/patients referred for investigations of autoimmune disorders, probability of finding positive ANA is approximately 9%. Of these 9%, about 24% also show reactivity against ENA. Commonest ANA pattern is coarse speckled and majority of such patients carry ANA in titers ranging from 1:40 to 1:80. Commonest ENA reactivity was against SSA. (author)

Patient positioning and ventilator-associated pneumonia.

Science.gov (United States)

Hess, Dean R

2005-07-01

Rotational beds, prone position, and semi-recumbent position have been proposed as procedures to prevent ventilator-associated pneumonia (VAP). Rotational therapy uses a special bed designed to turn continuously, or nearly continuously, the patient from side to side; specific designs include kinetic therapy and continuous lateral rotation therapy. A meta-analysis of studies evaluating the effect of rotational bed therapy shows a decrease in the risk of pneumonia but no effect on mortality. Two studies reported a lower risk of VAP in patients placed in a prone position, with no effect on mortality. Studies using radiolabeled enteral feeding solutions in mechanically ventilated patients have reported that aspiration of gastric contents occurs to a greater degree when patients are in the supine position, compared with the semirecumbent position. One study reported a lower rate of VAP in patients randomized to semi-recumbent compared to supine position. Although each of the techniques discussed in this paper has been shown to reduce the risk of VAP, none has been shown to affect mortality. The available evidence suggests that semi-recumbent position should be used routinely, rotational therapy should be considered in selected patients, and prone position should not be used as a technique to reduce the risk of VAP.

Development of a phantom to evaluate the positioning accuracy of patient immobilization systems using thermoplastic mask and polyurethane cradle.

Science.gov (United States)

Inata, Hiroki; Semba, Takatoshi; Itoh, Yoshihiro; Kuribayashi, Yuta; Murayama, Suetoshi; Nishizaki, Osamu; Araki, Fujio

2012-07-01

The purpose of this study was to develop a new phantom to evaluate the positioning accuracy of patient immobilization systems. The phantom was made of papers formed into a human shape, paper clay, and filling rigid polyester. Acrylonitrile butadiene styrene (ABS) pipes were inserted at anterior-posterior (A-P) and right-left (R-L) directions in the phantom to give static load by pulling ropes through the pipes. First, the positioning precision of the phantom utilizing a target locating system (TLS) was evaluated by moving the phantom on a couch along inferior-superior (I-S), A-P, and R-L directions in a range from -5 mm to +5 mm. The phantom's positions detected with the TLS were compared with values measured by a vernier caliper. Second, the phantom movements in a tensile test were chosen from patient movements determined from 15 patients treated for intracranial lesions and immobilized with a thermoplastic mask and polyurethane cradle. The phantom movement was given by minimum or maximum values of patient movements in each direction. Finally, the relationship between phantom movements and the static load in the tensile test was characterized from measurements using the new phantom and the TLS. The differences in all positions between the vernier caliper measurement and the TLS detected values were within 0.2 mm with frequencies of 100%, 95%, and 90% in I-S, A-P, and R-L directions, respectively. The phantom movements according to patient movements in clinical application in I-S, A-P, and R-L directions were within 0.58 mm, 0.94 mm, and 0.93 mm from the mean value plus standard deviation, respectively. The regression lines between the phantom movements and static load were given by y = 0.359x, y = 0.241x, and y = 0.451x in I-S, A-P, and R-L directions, respectively, where x is the phantom movement (mm) and y is the static load (kgf). The relationship between the phantom movements and static load may represent the performance of inhibiting patient movements, so the

21 CFR 868.6820 - Patient position support.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6820 Patient position support. (a) Identification. A patient position support is a device intended to maintain the position of an anesthetized... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Patient position support. 868.6820 Section 868...

Design of a positioning system for a holographic otoscope

Science.gov (United States)

Dobrev, I.; Flores Moreno, J. M.; Furlong, C.; Harrington, E. J.; Rosowski, J. J.; Scarpino, C.

2010-08-01

Current ear examination procedures provide mostly qualitative information which results in insufficient or erroneous description of the patient's hearing. Much more quantitative and accurate results can be achieved with a holographic otoscope system currently under development. Various ways of accurate positioning and stabilization of the system in real-life conditions are being investigated by this project in an attempt to bring this new technology to the hospitals and clinics, in order to improve the quality of the treatments and operations of the human ear. The project is focused at developing a mechatronic system capable of positioning the holographic otoscope to the patient's ear and maintaining its relative orientation during the examination. The system will be able to be guided by the examiner, but it will maintain the chosen position automatically. To achieve that, various trajectories are being measured for existing otoscopes being guided by doctors in real medical conditions. Based on that, various kinematic configurations are to be synthesized and their stability and accuracy will be simulated and optimized with FEA. For simplification, the mechanism will contain no actuators, but only adjustable friction elements in a haptic feedback control system. This renders the positioning system safe and easily applicable to current examination rooms. Other means of stabilization of the system are being investigated such as custom designed packaging of all of the otoscope subsystems, interferometrically compensating for the heartbeat induced vibration of the tympanic membrane as well as methods for monitoring and active response to the motion of the patient's head.

Patient positioning in radiotherapy based on surface imaging using time of flight cameras

Energy Technology Data Exchange (ETDEWEB)

Gilles, M., E-mail: marlene.gilles@univ-brest.fr; Fayad, H.; Clement, J. F.; Bert, J.; Visvikis, D. [INSERM, UMR 1101, LaTIM, Brest 29609 (France); Miglierini, P. [Academic Radiotherapy Department, CHRU Morvan, Brest 29200 (France); Scheib, S. [Varian Medical Systems Imaging Laboratory GmbH, Baden-Daettwil 5405 (Switzerland); Cozzi, L. [Radiotherapy and Radiosurgery Department, Instituto Clinico Humanitas, Rozzano 20089 (Italy); Boussion, N.; Schick, U.; Pradier, O. [INSERM, UMR 1101, LaTIM, Brest 29609, France and Academic Radiotherapy Department, CHRU Morvan, Brest 29200 (France)

2016-08-15

Purpose: To evaluate the patient positioning accuracy in radiotherapy using a stereo-time of flight (ToF)-camera system. Methods: A system using two ToF cameras was used to scan the surface of the patients in order to position them daily on the treatment couch. The obtained point clouds were registered to (a) detect translations applied to the table (intrafraction motion) and (b) predict the displacement to be applied in order to place the patient in its reference position (interfraction motion). The measures provided by this system were compared to the effectively applied translations. The authors analyzed 150 fractions including lung, pelvis/prostate, and head and neck cancer patients. Results: The authors obtained small absolute errors for displacement detection: 0.8 ± 0.7, 0.8 ± 0.7, and 0.7 ± 0.6 mm along the vertical, longitudinal, and lateral axes, respectively, and 0.8 ± 0.7 mm for the total norm displacement. Lung cancer patients presented the largest errors with a respective mean of 1.1 ± 0.9, 0.9 ± 0.9, and 0.8 ± 0.7 mm. Conclusions: The proposed stereo-ToF system allows for sufficient accuracy and faster patient repositioning in radiotherapy. Its capability to track the complete patient surface in real time could allow, in the future, not only for an accurate positioning but also a real time tracking of any patient intrafraction motion (translation, involuntary, and breathing).

Precise positioning of patients for radiation therapy

International Nuclear Information System (INIS)

Verhey, L.J.; Goitein, M.; McNulty, P.; Munzenrider, J.E.; Suit, H.D.

1982-01-01

A number of immobilization schemes which permit precise daily positioning of patients for radiation therapy are discussed. Pretreatment and post-treatment radiographs have been taken with the patient in the treatment position and analyzed to determine the amount of intratreatment movement. Studies of patients in the supine, seated and decubitus positions indicate mean movements of less than 1 mm with a standard deviation of less than 1 mm. Patients immobilized in the seated position with a bite block and a mask have a mean movement of about 0.5 mm +/- 0.3 mm (s.d.), and patients immobilized in the supine position with their necks hyperextended for submental therapy evidence a mean movement of about 1.4 mm +/- 0.9 mm (s.d.). With the exception of those used for the decubitus position, the immobilization devices are simply fabricated out of thermoplastic casting materials readily available from orthopedic supply houses. A study of day-to-day reproducibility of patient position using laser alignment and pretreatment radiographs for final verification of position indicates that the initial laser alignment can be used to position a patient within 2.2 mm +/- 1.4 mm (s.d.) of the intended position. These results indicate that rigid immobilization devices can improve the precision of radiotherapy, which would be advantageous with respect to both tumor and normal tissue coverage in certain situations

Reproducibility of patient positioning during routine radiotherapy, as assessed by an integrated megavoltage imaging system

International Nuclear Information System (INIS)

Gildersleve, J.; Dearnaley, D.P.; Evans, P.M.; Swindell, W.

1995-01-01

A portal imaging system has been used, in conjunction with a movie measurement technique to measure set-up errors for 15 patients treated with radiotherapy of the pelvis and for 12 patients treated with radiotherapy of the brain. The pelvic patients were treated without fixation devices and the brain patients were treated with individually-moulded plastic shells. As would be expected the brain treatments were found to be more accurate than the pelvic treatments. Results are presented in terms of five error types: random error from treatment to treatment, error between mean treatment position and simulation position, random simulation error, systematic simulator-to-treatment errors and total treatment error. For the brain patients the simulation-to-treatment error predominates and random treatment errors were small (95% ≤ 3 mm, 77% ≤ 1.5 mm). Vector components of the systematic simulation-to-treatment errors were 1-2 mm with maximal random simulation error of ± 5 mm (2 S.D.). There is much interest in the number of verification films necessary to evaluate treatment accuracy. These results indicate that one check film performed at the first treatment is likely to be sufficient for set-up evaluation. For the pelvis the random treatment error is larger (95% ≤ 4.5 mm, 87% ≤ 3 mm). The systematic simulation-to-treatment error is up to 3 mm and the maximal random simulation error is ± 6 mm (2 S.D.). Thus corrections made solely on the basis of a first day check film may not be sufficient for adequate set-up evaluation

Three-dimensional accuracy and interfractional reproducibility of patient fixation and positioning using a stereotactic head mask system

International Nuclear Information System (INIS)

Karger, Christian P.; Jaekel, Oliver; Debus, Juergen; Kuhn, Sabine; Hartmann, Guenther H.

2001-01-01

Purpose: Conformal radiotherapy in the head and neck region requires precise and reproducible patient setup. The definition of safety margins around the clinical target volume has to take into account uncertainties of fixation and positioning. Data are presented to quantify the involved uncertainties for the system used. Methods and Materials: Interfractional reproducibility of fixation and positioning of a target point in the brain was evaluated by biplanar films. 118 film pairs obtained at 52 fractions in 4 patients were analyzed. The setup was verified at the actual treatment table position by diagnostic X-ray units aligned to the isocenter and by a stereotactic X-ray localization technique. The stereotactic coordinates of the treated isocenter, of fiducials on the mask, and of implanted internal markers within the patient were measured to determine systematic and random errors. The data are corrected for uncertainty of the localization method. Results: Displacements in target point positioning were 0.35±0.41 mm, 1.22±0.25 mm, and -0.74±0.32 mm in the x, y, and z direction, respectively. The reproducibility of the fixation of the patient's head within the mask was 0.48 mm (x), 0.67 mm (y), and 0.72 mm (z). Rotational uncertainties around an axis parallel to the x, y, and z axis were 0.72 deg., 0.43 deg., and 0.70 deg., respectively. A simulation, based on the acquired data, yields a typical radial overall uncertainty for positioning and fixation of 1.80±0.60 mm. Conclusions: The applied setup technique showed to be highly reproducible. The data suggest that for the applied technique, a safety margin between clinical and planning target volume of 1-2 mm along one axis is sufficient for a target at the base of skull

Efficient Use of Automatic Exposure Control Systems in Computed Tomography Requires Correct Patient Positioning

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Gudjonsdottir, J.; Jonsdottir, B. (Roentgen Domus Medica, Reykjavik (Iceland)); Svensson, J.R.; Campling, S. (Faculty of Health and Social Care, Anglia Ruskin Univ., Cambridge (United Kingdom)); Brennan, P.C. (Diagnostic Imaging, Biological Imaging Research, UCD School of Medicine and Medical Science, Univ. College Dublin, Belfield, Dublin (Ireland))

2009-11-15

Background: Image quality and radiation dose to the patient are important factors in computed tomography (CT). To provide constant image quality, tube current modulation (TCM) performed by automatic exposure control (AEC) adjusts the tube current to the patient's size and shape. Purpose: To evaluate the effects of patient centering on tube current-time product (mAs) and image noise. Material and Methods: An oval-shaped acrylic phantom was scanned in various off-center positions, at 30-mm intervals within a 500-mm field of view, using three different CT scanners. Acquisition parameters were similar to routine abdomen examinations at each site. The mAs was recorded and noise measured in the images. The correlation of mAs and noise with position was calculated using Pearson correlation. Results: In all three scanners, the mAs delivered by the AEC changed with y-position of the phantom (P<0.001), with correlation values of 0.98 for scanners A and B and -0.98 for scanner C. With x-position, mAs changes were 4.9% or less. As the phantom moved into the y-positions, compared with the iso-center, the mAs varied by up to +70%, -34%, and +56% in scanners A, B, and C, respectively. For scanners A and B, noise in two regions of interest in the lower part of the phantom decreased with elevation, with correlation factors from -0.95 to -0.86 (P<0.02). In the x-direction, significant noise relationships (P<0.005) were only seen in scanner A. Conclusion: This study demonstrates that patient centering markedly affects the efficacy of AEC function and that tube current changes vary between scanners. Tube position when acquiring the scout projection radiograph is decisive for the direction of the mAs change. Off-center patient positions cause errors in tube current modulation that can outweigh the dose reduction gained by AEC use, and image quality is affected

Mixing of multi-modal images for conformational radiotherapy: application to patient re positioning

International Nuclear Information System (INIS)

Vassal, P.

1998-01-01

This study shows a procedure of patient re positioning by comparative evaluation between the position of the patient and the theoretical expected position of the patient; the stagger between the two information gives the error of installation in translation and rotation. A correction is calculated and applied to the treatment environment (position and orientation of the patient, position and orientation of the irradiation source). The control system allows to determine the precise position of the tumor volume. The echography allows to determine the position of an organ.The surface captor is used to localize the tumors of the face or of the brain, with the respect to the face, the acquisition and the treatment of information take only few minutes. The X rays imager is applied for the localization of bones structures. (N.C.)

Positioning performance of a maglev fine positioning system

Energy Technology Data Exchange (ETDEWEB)

Wronosky, J.B.; Smith, T.G.; Jordan, J.D.; Darnold, J.R.

1996-12-01

A wafer positioning system was recently developed by Sandia National Laboratories for an Extreme Ultraviolet Lithography (EUVL) research tool. The system, which utilizes a magnetically levitated fine stage to provide ultra-precise positioning in all six degrees of freedom, incorporates technological improvements resulting from four years of prototype development experience. System enhancements, implemented on a second generation design for an ARPA National Center for Advanced Information Component Manufacturing (NCAICM) project, introduced active structural control for the levitated structure of the system. Magnetic levitation (maglev) is emerging as an important technology for wafer positioning systems in advanced lithography applications. The advantages of maglev stem from the absence of physical contact. The resulting lack of friction enables accurate, fast positioning. Maglev systems are mechanically simple, accomplishing full six degree-of-freedom suspension and control with a minimum of moving parts. Power-efficient designs, which reduce the possibility of thermal distortion of the platen, are achievable. Manufacturing throughput will be improved in future systems with the addition of active structural control of the positioning stages. This paper describes the design, implementation, and functional capability of the maglev fine positioning system. Specifics regarding performance design goals and test results are presented.

Investigations on uncertainties in patient positioning for prostate treatment with EPID

International Nuclear Information System (INIS)

Bakai, A.; Nuesslin, F.; Paulsen, F.; Plasswilm, L.; Bamberg, M.

2002-01-01

Background: Conformal radiotherapy techniques as used in prostate treatment allow to spare normal tissue by conforming the radiation fields to the shape of the planning target volume (PTV). To be able to fully utilize the advantages of these techniques correct patient positioning is an important prerequisite. This study employing an electronic portal imaging device (EPID) investigated the positioning uncertainties that occur in the pelvic region for different patient positioning devices. Patients and Methods: 15 patients with prostate cancer were irradiated with or without rectal balloon/pelvic mask at a linear accelerator with multileaf collimator (MLC). For each patient multiple portal images were taken from different directions and compared to the digitally reconstructed radiographs (DRRs) of the treatment planning system and to simulation films (Table 1, Figure 1). Results: In spite of different positioning devices, all patients showed comparable total positioning uncertainties of 4.0 mm (lateral), 4.5 mm (cranio-caudal) and 1.7 mm (dorso-ventral). The lateral positioning error was reduced for the pelvic mask patients while the cranio-caudal error increased (Table 2, Figure 2). A systematic and a random component sum up to the total positioning error, and a good estimate of the magnitudes of the two is possible from six to eight portal images (Figure 3). Conclusions: With a small number of portal images it is possible to find out the systematic and random positioning error of a patient. Knowledge of the random error can be used to resize the treatment margin which is clinically relevant since this error differs greatly for different patients (Figure 4). Image analysis with EPID is convenient, yet has some problems. For example, one only gets indirect information on the movement of the ventral rectum wall. The successful operation of positioning devices, although, needs further improvement - especially if one focuses on IMRT. (orig.) [de

Experiences with an application of industrial robotics for accurate patient positioning in proton radiotherapy.

Science.gov (United States)

Allgower, C E; Schreuder, A N; Farr, J B; Mascia, A E

2007-03-01

Protons beams deliver targeted radiation doses with greater precision than is possible with electrons or megavoltage X-ray photons, but to retain this advantage, patient positioning systems at proton clinics must meet tighter accuracy requirements. For this and other reasons, robots were incorporated into the treatment room systems at MPRI. The Midwest Proton Radiotherapy Institute (MPRI) is the first radiotherapy facility in the United States to use commercial robots with six degrees of freedom for patient positioning, rather than a traditional bed with four degrees of freedom. This paper outlines the ways in which robots are used at MPRI and attempts to distil insights from the experience of treating over 200 radiotherapy patients with a robotic system from February 2004 to late 2006. The system has performed well, and with great reliability, but there is room for future improvement, especially in ease of use and in reducing the time to get patients into position. Copyright 2006 John Wiley & Sons, Ltd.

Validity of an ankle joint motion and position sense measurement system and its application in healthy subjects and patients with ankle sprain.

Science.gov (United States)

Lin, Chueh-Ho; Chiang, Shang-Lin; Lu, Liang-Hsuan; Wei, Shun-Hwa; Sung, Wen-Hsu

2016-07-01

Ankle motion and proprioception in multiple axis movements are crucial for daily activities. However, few studies have developed and used a multiple axis system for measuring ankle motion and proprioception. This study was designed to validate a novel ankle haptic interface system that measures the ankle range of motion (ROM) and joint position sense in multiple plane movements, investigating the proprioception deficits during joint position sense tasks for patients with ankle instability. Eleven healthy adults (mean ± standard deviation; age, 24.7 ± 1.9 years) and thirteen patients with ankle instability were recruited in this study. All subjects were asked to perform tests to evaluate the validity of the ankle ROM measurements and underwent tests for validating the joint position sense measurements conducted during multiple axis movements of the ankle joint. Pearson correlation was used for validating the angular position measurements obtained using the developed system; the independent t test was used to investigate the differences in joint position sense task performance for people with or without ankle instability. The ROM measurements of the device were linearly correlated with the criterion standards (r = 0.99). The ankle instability and healthy groups were significantly different in direction, absolute, and variable errors of plantar flexion, dorsiflexion, inversion, and eversion (p ankle joint motion and position sense measurement system is valid and can be used for measuring the ankle ROM and joint position sense in multiple planes and indicate proprioception deficits for people with ankle instability. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Is outdoor use of the six-minute walk test with a global positioning system in stroke patients' own neighbourhoods reproducible and valid?

NARCIS (Netherlands)

Wevers, L.E.; Kwakkel, G.; van de Port, I.G.

2011-01-01

Objective: To examine the reproducibility, responsiveness and concurrent validity of the six-minute walk test (6MWT) when tested outdoors in patients' own neighbourhoods using a global positioning system (GPS) or a measuring wheel. Methods: A total of 27 chronic stroke patients, discharged to their

Is ExacTrac x-ray system an alternative to CBCT for positioning patients with head and neck cancers?

International Nuclear Information System (INIS)

Clemente, Stefania; Chiumento, Costanza; Fiorentino, Alba; Cozzolino, Mariella; Oliviero, Caterina; Califano, Giorgia; Caivano, Rocchina; Fusco, Vincenzo; Simeon, Vittorio

2013-01-01

Purpose: To evaluate the usefulness of a six-degrees-of freedom (6D) correction using ExacTrac robotics system in patients with head-and-neck (HN) cancer receiving radiation therapy.Methods: Local setup accuracy was analyzed for 12 patients undergoing intensity-modulated radiation therapy (IMRT). Patient position was imaged daily upon two different protocols, cone-beam computed tomography (CBCT), and ExacTrac (ET) images correction. Setup data from either approach were compared in terms of both residual errors after correction and punctual displacement of selected regions of interest (Mandible, C2, and C6 vertebral bodies).Results: On average, both protocols achieved reasonably low residual errors after initial correction. The observed differences in shift vectors between the two protocols showed that CBCT tends to weight more C2 and C6 at the expense of the mandible, while ET tends to average more differences among the different ROIs.Conclusions: CBCT, even without 6D correction capabilities, seems preferable to ET for better consistent alignment and the capability to see soft tissues. Therefore, in our experience, CBCT represents a benchmark for positioning head and neck cancer patients

Optimal management of cervical cancer in HIV-positive patients: a systematic review

International Nuclear Information System (INIS)

Ntekim, Atara; Campbell, Oladapo; Rothenbacher, Dietrich

2015-01-01

The clinical management of cervical cancer in HIV-positive patients has challenges mainly due to the concerns on immune status. At present, their mode of management is similar to HIV-seronegative patients involving the use of chemotherapy and radiotherapy concurrently as indicated. HIV infection, cancer, radiotherapy, and chemotherapy lower immunity through reduction in CD4 cell counts. At present there are no treatment guidelines for HIV-positive patients. This study was done to systematically review the literature on cervical cancer management in HIV-positive patients and treatment outcomes. A systematic literature search was done in the major databases to identify studies on the management of HIV-positive patients with cervical cancer. Identified studies were assessed for eligibility and inclusion in the review following the guidelines of The Cochrane Handbook for Systematic Reviews and CRD's (Centre for Reviews and Dissemination) guidance for undertaking reviews in health care. Eight eligible studies were identified from the literature. Three of them were prospective while five were retrospective studies. Notably, the average age at diagnosis of cervical cancer in HIV-positive patients was a decade lower than in seronegative patients. There was no difference in distribution of stages of disease at presentation between HIV-positive and negative patients. Mild acute toxicity (Grades 1 and 2) was higher in HIV-positive patients than in HIV-negative patients in hematopoietic system. In the grades 3 and 4 reactions, anemia was reported in 4% versus 2% while gastrointestinal reactions were reported in 5% versus 2% respectively. In general, patients who were started early on HAART had higher rates of treatment completion. The study supports the suggestion that HAART should be commenced early at cervical cancer diagnosis in HIV-positive patients diagnosed with cervical cancer to ensure less toxicity and better treatment compliance

Our trial to improve patient positioning during mammography

International Nuclear Information System (INIS)

Nakayama, Takashi; Kotsuma, Yoshikazu; Hiramatsu, Sawako

2007-01-01

For effective breast cancer screening, reading of high-quality mammograms is essential, and for this purpose proper patient positioning during mammography is important. At our Shin-Osaka Mammography Seminar, which includes eight institutions, a physician and nine radiology technicians get together weekly in order to critically review mammogram reading and techniques for obtaining good mammograms. We have recognized that patient positioning has a great effect on mammogram quality, particularly for women in their 40 s who have dense mammary glands, and we have adopted a digital mammography system, or comparative mammography for such patients. Since July 2005, we have critically reviewed positioning every 3 or 4 months with the aim of improving our technique. Eight institutions have participated in this trial, each contributing mammograms taken recently from 20 to 30 consecutive participants, and the grade of positioning has been determined according to the Institutional Mammogram Estimation Standard (6 items, each scoring a maximum of 4 points, total 24 points) proposed by the Central Committee for Quality Control of Mammography Screening. The estimation has been done by both ourselves and committee members. When a total of 20 points or more is obtained and all 6 items score 3 points or more, it is considered that the positioning has been good, and this is termed ''Positioning A'' (P-A). On the other hand, if the total score is less than 20 points, and any one of the 6 items scores less than 3 points, it is considered that positioning has been inadequate, and this is termed ''Positioning-D'' (P-D). At the first review meeting, which was held before our critical study, P-A accounted for 48% of cases, and this had improved to 72% at the second meeting, and to 66% at the third. P-D accounted for 41% of cases at the first meeting, 20% at the second, and 21% at the third. Thus our trial involving discussion between a physician and technicians to critically review good

Gastrointestinal diseases in HIV-positive patients: ultrasonography and computed tomography in a study of 85 patients

International Nuclear Information System (INIS)

Garcia, S.; Yague, D.; Garcia, C.; Villalon, M.; Pascual, A.; Artigas, J.M.

1998-01-01

Gastrointestinal diseases constitute the second most common group conditions affecting HIV-positive patients after respiratory diseases. Gastrointestinal involvement may even be the first sign of the disease, a facto which demonstrates the importance of its proper assessment. To demonstrate the utility of computed tomography and ultrasound in the study of gastrointestinal and hepatobiliary diseases in the HIV-positive patient. We review a series of 85 HIV-positive patients presenting gastrointestinal symptomatology who underwent ultrasonography and/or computed tomography. the definitive diagnosis was achieved in all the patients by microbiological or histopathological means. In our series 36.4% the patients had presented systemic TB, 23.52% CMV infection, 17.64% Cryptosporidium infection and 17.64% MAI infection. Much lower incidences were found for Mycobacterium xenopi. M. kansai and Leishmania infection. The presence of lymphoma was confirmed in 7.05% of the patients and Koposi's sarcoma in 0.95%. In these patients, the most common finding on imaging studies in lymph node involvement, followed by diffuse hepatosplenomegaly. Imaging techniques, especially ultrasonography and computed tomography, are useful in these patients: although they do not provide the diagnosis, they do contribute data of prognostic and therapeutic importance. (Author) 11 refs

Construction of a patient observation system using KINECTTM

International Nuclear Information System (INIS)

Miyaura, Kazunori; Kumazaki, Yu; Kato, Shingo; Fukushima, Chika; Saitoh, Hidetoshi

2014-01-01

Improvement in the positional accuracy of irradiation is expected by capturing patient motion (intra-fractional error) during irradiation. The present study reports the construction of a patient observation system using Microsoft® KINECT TM . By tracking movement, we made it possible to add a depth component to the acquired position coordinates and to display three-axis (X, Y, and Z) movement. Moreover, the developed system can be displayed in a graph which is constructed from the coordinate position at each time interval. Using the developed system, an observer can easily visualize patient movement. When the body phantom was moved a known distance in the X, Y, and Z directions, good coincidence was shown with each axis. We built a patient observation system which captures a patient's motion using KINECT TM .

SU-E-J-12: An Image-Guided Soft Robotic Patient Positioning System for Maskless Head-And-Neck Cancer Radiotherapy: A Proof-Of-Concept Study

International Nuclear Information System (INIS)

Ogunmolu, O; Gans, N; Jiang, S; Gu, X

2015-01-01

Purpose: We propose a surface-image-guided soft robotic patient positioning system for maskless head-and-neck radiotherapy. The ultimate goal of this project is to utilize a soft robot to realize non-rigid patient positioning and real-time motion compensation. In this proof-of-concept study, we design a position-based visual servoing control system for an air-bladder-based soft robot and investigate its performance in controlling the flexion/extension cranial motion on a mannequin head phantom. Methods: The current system consists of Microsoft Kinect depth camera, an inflatable air bladder (IAB), pressured air source, pneumatic valve actuators, custom-built current regulators, and a National Instruments myRIO microcontroller. The performance of the designed system was evaluated on a mannequin head, with a ball joint fixed below its neck to simulate torso-induced head motion along flexion/extension direction. The IAB is placed beneath the mannequin head. The Kinect camera captures images of the mannequin head, extracts the face, and measures the position of the head relative to the camera. This distance is sent to the myRIO, which runs control algorithms and sends actuation commands to the valves, inflating and deflating the IAB to induce head motion. Results: For a step input, i.e. regulation of the head to a constant displacement, the maximum error was a 6% overshoot, which the system then reduces to 0% steady-state error. In this initial investigation, the settling time to reach the regulated position was approximately 8 seconds, with 2 seconds of delay between the command start of motion due to capacitance of the pneumatics, for a total of 10 seconds to regulate the error. Conclusion: The surface image-guided soft robotic patient positioning system can achieve accurate mannequin head flexion/extension motion. Given this promising initial Result, the extension of the current one-dimensional soft robot control to multiple IABs for non-rigid positioning control

SU-E-J-12: An Image-Guided Soft Robotic Patient Positioning System for Maskless Head-And-Neck Cancer Radiotherapy: A Proof-Of-Concept Study

Energy Technology Data Exchange (ETDEWEB)

Ogunmolu, O; Gans, N [The University of Texas at Dallas, Richardson, TX (United States); Jiang, S; Gu, X [UT Southwestern Medical Center, Dallas, TX (United States)

2015-06-15

Purpose: We propose a surface-image-guided soft robotic patient positioning system for maskless head-and-neck radiotherapy. The ultimate goal of this project is to utilize a soft robot to realize non-rigid patient positioning and real-time motion compensation. In this proof-of-concept study, we design a position-based visual servoing control system for an air-bladder-based soft robot and investigate its performance in controlling the flexion/extension cranial motion on a mannequin head phantom. Methods: The current system consists of Microsoft Kinect depth camera, an inflatable air bladder (IAB), pressured air source, pneumatic valve actuators, custom-built current regulators, and a National Instruments myRIO microcontroller. The performance of the designed system was evaluated on a mannequin head, with a ball joint fixed below its neck to simulate torso-induced head motion along flexion/extension direction. The IAB is placed beneath the mannequin head. The Kinect camera captures images of the mannequin head, extracts the face, and measures the position of the head relative to the camera. This distance is sent to the myRIO, which runs control algorithms and sends actuation commands to the valves, inflating and deflating the IAB to induce head motion. Results: For a step input, i.e. regulation of the head to a constant displacement, the maximum error was a 6% overshoot, which the system then reduces to 0% steady-state error. In this initial investigation, the settling time to reach the regulated position was approximately 8 seconds, with 2 seconds of delay between the command start of motion due to capacitance of the pneumatics, for a total of 10 seconds to regulate the error. Conclusion: The surface image-guided soft robotic patient positioning system can achieve accurate mannequin head flexion/extension motion. Given this promising initial Result, the extension of the current one-dimensional soft robot control to multiple IABs for non-rigid positioning control

Patient support systems

International Nuclear Information System (INIS)

Braden, A.B.; McBride, T.R.; Styblo, D.J.; Taylor, S.K.; Richey, J.B.

1979-01-01

A patient support system for use in computerized tomography (CT) is described. The system is particularly useful for CT scanning of the brain and also of the abdominal area. The support system consists of two moveable tables which may be translated into position for X-ray scanning of the patient's body and which may be translated incrementally and automatically to obtain scans at adjacent locations. For use with brain scans, the second table is replaced by a detachable restraint assembly which is described in detail. The support system is so designed that only a small volume of low density material will intercept the X-ray beam. (UK)

Prevalence of positive autoimmune biomarkers in the brucellosis patients.

Science.gov (United States)

Ahmadinejad, Zahra; Abdollahi, Alireza; Ziaee, Vahid; Domiraei, Zeinab; Najafizadeh, Seyed-Reza; Jafari, Sirus; Ahmadinejad, Mahdi

2016-10-01

Brucellosis is a chronic infectious disease with articular involvement. Discrimination between brucellosis and rheumatologic disorders is difficult in regions endemic for brucellosis. There are few studies about the rate of positive autoantibodies as rheumatologic biomarkers in brucellosis, and the prevalence is variable. In this study, the rheumatologic tests were studied in brucellosis patients. This cross sectional study was performed in two teaching hospitals in Tehran, Iran. Forty-nine patients with brucella infection and 42 healthy participants were enrolled in this study. Brucellosis was diagnosed on the basis of the clinical symptoms and positive serology for brucellosis. Rheumatic factor (RF) and antinuclear antibodies (ANA) were evaluated in all patients. Cyclic citrullinated peptides antibody (ACPA) and anti-double strand DNA (anti-dsDNA) were checked in all patients and control groups. Out of 49 patients, 15 (30.6 %) were RF positive and 4 (8.2 %) were ANA positive. Anti-dsDNA was concurrently positive with ANA in 1 patient (2 %) but ACPA titer was positive in 8 patients (16.3 %). None of the patients with positive autoantibody biomarkers fulfilled the criteria for rheumatologic disorders. The rate of positive RF in healthy people was significantly lower than patient group (2.4 vs. 30.6 %), but the positiveness rate of other biomarkers did not have significant difference in two groups. Sixty percent of the patients with positive RF and 75 % with positive ACPA had skeletal involvement (P brucellosis. Rheumatologists should be aware of brucellosis in patients with musculoskeletal involvement and positive autoantibody biomarkers in endemic regions.

Vertigo in patients with benign paroxysmal positional vertigo.

Science.gov (United States)

Kentala, E; Pyykkö, I

2000-01-01

We retrieved information on 59 patients, 19 men and 40 women, with benign paroxysmal positional vertigo (BPPV) from the database of the otoneurologic expert system (ONE). The original number of patients was greater, but we excluded all those with hearing loss of any origin. The patients filled in a questionnaire concerning their symptoms, earlier diseases, accidents and tobacco and alcohol use. This information was then integrated with results of audiometric, otoneurologic and imaging studies. The mean age at onset of symptoms was 44 years. Most patients had had vertiginous spells for anxiety than the others [r(53) = 0.40, p floating sensation. The floating vertigo was most often provoked by pressure changes [r(54) = 0.41, p < 0.01] or changes in visual surroundings [r(54) = 0.52, p < 0.01].

Lateral positioning for critically ill adult patients.

Science.gov (United States)

Hewitt, Nicky; Bucknall, Tracey; Faraone, Nardene M

2016-05-12

Critically ill patients require regular body position changes to minimize the adverse effects of bed rest, inactivity and immobilization. However, uncertainty surrounds the effectiveness of lateral positioning for improving pulmonary gas exchange, aiding drainage of tracheobronchial secretions and preventing morbidity. In addition, it is unclear whether the perceived risk levied by respiratory and haemodynamic instability upon turning critically ill patients outweighs the respiratory benefits of side-to-side rotation. Thus, lack of certainty may contribute to variation in positioning practice and equivocal patient outcomes. To evaluate effects of the lateral position compared with other body positions on patient outcomes (mortality, morbidity and clinical adverse events) in critically ill adult patients. (Clinical adverse events include hypoxaemia, hypotension, low oxygen delivery and global indicators of impaired tissue oxygenation.) We examined single use of the lateral position (i.e. on the right or left side) and repeat use of the lateral position (i.e. lateral positioning) within a positioning schedule. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 5), MEDLINE (1950 to 23 May 2015), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1937 to 23 May 2015), the Allied and Complementary Medicine Database (AMED) (1984 to 23 May 2015), Latin American Caribbean Health Sciences Literature (LILACS) (1901 to 23 May 2015), Web of Science (1945 to 23 May 2015), Index to Theses in Great Britain and Ireland (1950 to 23 May 2015), Trove (2009 to 23 May 2015; previously Australasian Digital Theses Program (1997 to December 2008)) and Proquest Dissertations and Theses (2009 to 23 May 2015; previously Proquest Digital Dissertations (1980 to 23 May 2015)). We handsearched the reference lists of potentially relevant reports and two nursing journals. We included randomized and quasi-randomized trials examining effects of

Evaluation of a positive ventilation delivery system (PVDS) in administering technegas to the noncompliant patient

International Nuclear Information System (INIS)

Cook, P.; Bedford, B.; Bell, A.; Lang, P.; Leiper, C.; Prouse, A.

1998-01-01

Full text: Certain groups of patients have been excluded from ventilation lung scanning due to their inability to comply with instruction. Tetley Manufacturing have recently developed a Positive Ventilation Delivery System (PVDS) which assists in delivering Technegas to patients who are unable to cooperate fully. The aim of this study is to evaluate the PVDS in the clinical setting. Fifteen frail aged and psychogeriatric patients (n=l 5), mean age 78 years (range 60-93), were ventilated with Technegas using the PVDS. The decision to ventilate the patient with the PVDS was based on an initial assessment of the patients ability to comply with instructions, or failure of the conventional ventilation method, to produce an adequate count rate. Technegas was prepared in the usual manner and then delivered to the patients lungs by squeezing a black anesthetic bag synchronously with the patients breathing, until a count rate of approximately 1000 counts/second was obtained. All patients achieved a satisfactory count rate, mean 1500 counts/second (range 900 to 2300), allowing adequate ventilation images to be obtained. Time to reach this count rate varied between patients, mean 130 seconds (range 40 to 300). The number of assisted breaths also varied, mean 9 (range 3-15). In addition, four patients who required a switch from the conventional method to the PVDS, increased their initial count rate from a mean 200 ± 8% counts/second to a mean of 1300 ± 29% counts/second. This was statistically significant at p = 0.006. Our initial results demonstrate the ability of the PVDS to facilitate ventilation imaging in noncompliant patients such as the frail aged and psychogeriatric. Ventilation times and amounts of radioisotope used were acceptable, economical and practical within a busy department

Towards automatic patient positioning and scan planning using continuously moving table MR imaging.

Science.gov (United States)

Koken, Peter; Dries, Sebastian P M; Keupp, Jochen; Bystrov, Daniel; Pekar, Vladimir; Börnert, Peter

2009-10-01

A concept is proposed to simplify patient positioning and scan planning to improve ease of use and workflow in MR. After patient preparation in front of the scanner the operator selects the anatomy of interest by a single push-button action. Subsequently, the patient table is moved automatically into the scanner, while real-time 3D isotropic low-resolution continuously moving table scout scanning is performed using patient-independent MR system settings. With a real-time organ identification process running in parallel and steering the scanner, the target anatomy can be positioned fully automatically in the scanner's sensitive volume. The desired diagnostic examination of the anatomy of interest can be planned and continued immediately using the geometric information derived from the acquired 3D data. The concept was implemented and successfully tested in vivo in 12 healthy volunteers, focusing on the liver as the target anatomy. The positioning accuracy achieved was on the order of several millimeters, which turned out to be sufficient for initial planning purposes. Furthermore, the impact of nonoptimal system settings on the positioning performance, the signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) was investigated. The present work proved the basic concept of the proposed approach as an element of future scan automation. (c) 2009 Wiley-Liss, Inc.

HIV-positive patient with herpes zoster: a manifestation of the immune reconstitution inflammatory syndrome.

Science.gov (United States)

Lutwak, Nancy; Dill, Curt

2012-01-01

Herpes zoster is a common illness that can lead to serious morbidity. There is now evidence that HIV-infected patients who have been treated with antiretroviral therapy are at greater risk of developing herpes zoster not when they are severely immunocompromised but, paradoxically, when their immune system is recovering. This is a manifestation of the immune reconstitution inflammatory syndrome. The objectives of this report are to (1) inform health care providers that HIV-infected patients may develop multiple infectious, autoimmune, and oncological manifestations after treatment with antiretroviral medication, as they have immune system reconstitution, and (2) discuss herpes zoster, one of the possible manifestations. The patient is a 68-year-old HIV-positive man who presented with herpes zoster after being treated with highly active antiretroviral therapy (HAART) when his immune system was recovering, not when he was most immunosuppressed. Emergency department physicians should be aware that HIV-infected patients treated with HAART may have clinical deterioration despite immune system strengthening. This immune reconstitution inflammatory syndrome can present with infectious, autoimmune, or oncological manifestations. Our case patient, an HIV-positive man with immune system recovery after treatment with HAART, presented with an infectious manifestation, herpes zoster.

A randomized, open-label study to investigate the effect of belimumab on pneumococcal vaccination in patients with active, autoantibody-positive systemic lupus erythematosus.

Science.gov (United States)

Chatham, W; Chadha, A; Fettiplace, J; Kleoudis, C; Bass, D; Roth, D; Gordon, D

2017-12-01

Objective Intravenous belimumab 10 mg/kg is approved as an add-on therapy in patients with active, autoantibody-positive systemic lupus erythematosus. This study aimed to assess the impact of belimumab on immune response to pneumococcal vaccination in patients with systemic lupus erythematosus. Methods This was a Phase 4, open-label study (GSK BEL115470; NCT01597492) conducted in the United States. Patients were randomized (7:9) to receive a 23-valent pneumococcal vaccination four weeks prior to (pre-belimumab cohort) or 24 weeks after (belimumab-concurrent cohort) commencing four-weekly belimumab 10 mg/kg intravenous treatment plus standard systemic lupus erythematosus therapy. Analyses of vaccine titers were performed on the as-treated population (received ≥1 dose of belimumab). The primary endpoint was the proportion of patients with positive antibody responses (≥2-fold increase from pre-vaccination levels, or post-vaccination level ≥ 0.6 µg/mL if pre-vaccination levels were unquantifiable) to ≥1 of 23 pneumococcal vaccine serotypes, four weeks post vaccination. Other endpoints included the proportion of patients with positive antibody responses to ≥2 to ≥10, and ≥11-23 (post hoc analysis) of serotypes. Safety was assessed by monitoring adverse events. Results Seventy-nine patients received pneumococcal vaccination (pre-belimumab cohort, n = 34; belimumab-concurrent cohort, n = 45). The majority (87.3% [69/79]) completed the study; 10 (12.7%) withdrew (patient request, n = 3; adverse event, n = 3; lost to follow-up, n = 2; other, n = 2). At Week 4 post-vaccination, 97.0% (32/33) and 97.6% (40/41) of patients (pre-belimumab and concurrent belimumab cohorts, respectively) had a positive response to ≥1 of 23 pneumococcal serotypes. Over 85% of patients in both cohorts responded to ≥10 of serotypes, approximately 80% responded to ≥12 serotypes, and approximately two-thirds responded to ≥16 serotypes. Little

Croatian Recommendations for Dialysis of HIV-Positive Patients

Directory of Open Access Journals (Sweden)

Gulin Marijana

2016-06-01

Full Text Available Human immunodeficiency virus (HIV infection may be associated with renal impairment since about 0.4% of all HIV-positive patients develop end-stage renal disease. The share of patients with HIV infection in hemodialysis centers throughout the world ranges from 0.3% to as high as 38%. In Croatia, renal replacement therapy was needed by 1% of all the HIV-positive patients from 1985 until the end of 2014. Healthcare professionals (HP should be aware of the risks of occupational exposure to blood-borne infections in their daily work. Performing dialysis in HIV-positive patients increases the risk of exposure to HIV during the extracorporeal circulation of the infected blood. However, post-exposure prophylaxis (PEP with effective antiretroviral drugs significantly reduces the risk of infection after occupational exposure. On behalf of the Croatian Society of Nephrology, Dialysis and Transplantation, the authors of this paper have proposed recommendations for the management of HIVpositive patients on dialysis, which aim to prevent the transmission of HIV among patients and HPs. The important recommendations include the following: 1. when the need arises, it is necessary to provide HIV-positive patients with dialysis in the vicinity of their place of residence. 2. HIV-positive patients should be dialyzed with a separate hemodialysis machine in an isolated area. Alternatively, they can be dialyzed in an area for the hemodialysis of HCV-positive and/or HBVpositive patients. 3. Specialized and trained personnel should be provided during the hemodialysis procedure, together with strict compliance with the standard precautions for the prevention of blood-borne infections. 4. There should be a good and prompt cooperation with the National Referral Center for HIV infection.

Platform Architecture for Decentralized Positioning Systems

Directory of Open Access Journals (Sweden)

Zakaria Kasmi

2017-04-01

Full Text Available A platform architecture for positioning systems is essential for the realization of a flexible localization system, which interacts with other systems and supports various positioning technologies and algorithms. The decentralized processing of a position enables pushing the application-level knowledge into a mobile station and avoids the communication with a central unit such as a server or a base station. In addition, the calculation of the position on low-cost and resource-constrained devices presents a challenge due to the limited computing, storage capacity, as well as power supply. Therefore, we propose a platform architecture that enables the design of a system with the reusability of the components, extensibility (e.g., with other positioning technologies and interoperability. Furthermore, the position is computed on a low-cost device such as a microcontroller, which simultaneously performs additional tasks such as data collecting or preprocessing based on an operating system. The platform architecture is designed, implemented and evaluated on the basis of two positioning systems: a field strength system and a time of arrival-based positioning system.

Patient Posture Monitoring System Based on Flexible Sensors

Directory of Open Access Journals (Sweden)

Youngsu Cha

2017-03-01

Full Text Available Monitoring patients using vision cameras can cause privacy intrusion problems. In this paper, we propose a patient position monitoring system based on a patient cloth with unobtrusive sensors. We use flexible sensors based on polyvinylidene fluoride, which is a flexible piezoelectric material. Theflexiblesensorsareinsertedintopartsclosetothekneeandhipoftheloosepatientcloth. We measure electrical signals from the sensors caused by the piezoelectric effect when the knee and hip in the cloth are bent. The measured sensor outputs are transferred to a computer via Bluetooth. We use a custom-made program to detect the position of the patient through a rule-based algorithm and the sensor outputs. The detectable postures are based on six human motions in and around a bed. The proposed system can detect the patient positions with a success rate over 88 percent for three patients.

A prospective, randomized, controlled study of a suspension positioning system used with elderly bedridden patients with neurogenic fecal incontinence.

Science.gov (United States)

Su, Mei-Yin; Lin, Shi-Quan; zhou, Ye-Wen; Zhou, Ye-Wen; Liu, Si-Ya; Lin, Ai; Lin, Xi-Rong

2015-01-01

Elderly patients with acute neurological impairment are prone to severe disability, fecal incontinence (FI), and resultant complications. A suspension positioning system (SPS), based on the orthopedic suspension traction system commonly used for conservative treatment of pediatric femoral fracture and uncomplicated adult pelvic fracture, was developed to facilitate FI management in patients immobilized secondary to an acute neurological condition. To evaluate the effectiveness and safety of the system, a prospective, randomized, controlled study was conducted between October 2009 and July 2012. Two hundred (200) elderly, bedridden, hospitalized patients with acute, nonchronic neurological impairment were randomly assigned to receive routine FI nursing care (ie, individualized dietary modification, psychological support, health education, and social support for caregivers and family members [control group]) or routine incontinence care plus the SPS (experimental group) during the day. Rates of perianal fecal contamination, skin breakdown, incontinence associated dermatitis, pressure ulcer development, and lower urinary tract infection (LUTI) were significantly lower in the SPS than in the control group (P <0.05). Length of hospitalization and costs of care were also lower in the SPS group (P <0.05). Patient quality-of-life (QoL) and FI QoL scores were similar at baseline but significantly higher (better) at the 6-month follow-up interview in the SPS than in the control group (P <0.05). In this study, the rate of FI-associated morbidities was lower and 6-month patient QoL scores were higher in the SPS than in the control group. No adverse events were observed, and all patients completed the study. Further clinical studies are needed to examine the long-term effects of SPS use among neurologically impaired FI patients.

Verification of the Patient Positioning in the Bellyboard Pelvic Radiotherapy

International Nuclear Information System (INIS)

Kasabasic, M.; Faj, D.; Smilovic Radojcic, D.; Svabic, M.; Ivkovic, A.; Jurkovic, S.

2008-01-01

The size and shape of the treatment fields applied in radiotherapy account for uncertainties in the daily set-up of the patients during the treatment. We investigated the accuracy of daily patient positioning in the bellyboard pelvic radiotherapy in order to find out the magnitude of the patients movement during the treatment. Translational as well as rotational movements of the patients are explored. Film portal imaging is used in order to find patient positioning error during the treatment of the pelvic region. Patients are treated in the prone position using the bellyboard positioning device. Thirty six patients are included in the study; 15 patients were followed during the whole treatment and 21 during the first 5 consecutive treatment days. The image acquisition was completed in 85 percent and systematic and random positioning errors in 453 images are analyzed. (author)

Variability of centric relation position in TMD patients.

NARCIS (Netherlands)

Zonnenberg, A.J.J.; Mulder, J.

2006-01-01

Reproducibility of the centric relation position for patients with temporomandibular disorders (TMD) is not documented in the current literature. It was the objective of this study to assess clinical variability of the centric relation position for TMD patients with a muscle-determined technique by

The patient position for PNL: does it matter?

Science.gov (United States)

Cracco, Cecilia Maria; Scoffone, Cesare Marco; Poggio, Massimiliano; Scarpa, Roberto Mario

2010-03-01

Currently, PNL is the treatment of choice for large and/or otherwise complex urolithiasis. PNL was initially performed with the patient in a supine-oblique position, but later on the prone position became the conventional one for habit and handiness. The prone position provides a larger area for percutaneous renal access, a wider space for instrument manipulation, and a claimed lower risk of splanchnic injury. Nonetheless, it implies important anaesthesiological risks, including circulatory, haemodynamic, and ventilatory difficulties; need of several nurses to be present for intraoperative changes of the decubitus in case of simultaneous retrograde instrumentation of the ureter, implying evident risks related to pressure points; an increased radiological hazard to the urologist's hands; patient discomfort. To overcome these drawbacks, various safe and effective changes in patient positioning for PNL have been proposed over the years, including the reverse lithotomy position, the prone split-leg position, the lateral decubitus, the supine position, and the Galdakao-modified supine Valdivia (GMSV) position. Among these, the GMSV position is safe and effective, and seems profitable and ergonomic. It allows optimal cardiopulmonary control during general anaesthesia; an easy puncture of the kidney; a reduced risk of colonic injury; simultaneous antero-retrograde approach to the renal cavities (PNL and retrograde ureteroscopy = ECIRS, Endoscopic Combined IntraRenal Surgery), with no need of intraoperative repositioning of the anaesthetized patient, less need for nurses in the operating room, less occupational risk due to shifting of heavy loads, less risk of pressure injuries related to inaccurate repositioning, and reduced duration of the procedure; facilitated spontaneous evacuation of stone fragments; a comfortable sitting position and a restrained X-ray exposure of the hands for the urologist. But, first of all, GMSV position fully supports a new comprehensive

Long-term stability of the Leksell Gamma Knife® Perfexion™ patient positioning system (PPS)

International Nuclear Information System (INIS)

Novotny, J.; Bhatnagar, J. P.; Xu, Y.; Huq, M. S.

2014-01-01

Purpose: To assess the long-term mechanical stability and accuracy of the patient positioning system (PPS) of the Leksell Gamma Knife ® Perfexion™ (LGK PFX). Methods: The mechanical stability of the PPS of the LGK PFX was evaluated using measurements obtained between September 2007 and June 2011. Three methods were employed to measure the deviation of the coincidence of the radiological focus point (RFP) and the PPS calibration center point (CCP). In the first method, the onsite diode test tool with single diode detector was used together with the 4 mm collimator on a daily basis. In the second method, a service diode test tool with three diode detectors was used biannually at the time of the routine preventive maintenance. The test performed with the service diode test tool measured the deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. The third method employed the conventional film pin-prick method. This test was performed annually for the 4 mm collimator at the time of the routine annual QA. To estimate the effect of the patient weight on the performance of the PPS, the focus precision tests were also conducted with varying weights on the PPS using a set of lead bricks. Results: The average deviations measured from the 641 daily focus precision tests were 0.1 ± 0.1, 0.0 ± 0.0, and 0.0 ± 0.0 mm, respectively, for the 4 mm collimator in the X (left/right of the patient), Y (anterior/posterior of the patient), and Z (superior/inferior of the patient) directions. The average of the total radial deviations as measured during ten semiannual measurements with the service diode test tool were 0.070 ± 0.029, 0.060 ± 0.022, and 0.103 ± 0.028 mm, respectively for the central, long, and short diodes for the 4 mm collimator. Similarly, the average total radial deviations measured during the semiannual measurements for the 4, 8, and 16 mm collimators and using the central diode were 0.070 ± 0.029, 0.097 ± 0

Is outdoor use of the six-minute walk test with a global positioning system in stroke patients' own neighbourhoods reproducible and valid?

OpenAIRE

Wevers, L.E.; Kwakkel, G.; Port, van de, I.G.

2011-01-01

Objective: To examine the reproducibility, responsiveness and concurrent validity of the six-minute walk test (6MWT) when tested outdoors in patients' own neighbourhoods using a global positioning system (GPS) or a measuring wheel. Methods: A total of 27 chronic stroke patients, discharged to their own homes, were tested twice, within 5 consecutive days. The 6MWT was conducted using a GPS and an measuring wheel simultaneously to determine walking distance. Reproducibility was determined as te...

Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning

Science.gov (United States)

Lee, Su-Keon; Song, Kyung-Sub; Park, Byung-Moon; Lim, Sang-Youn; Jang, Geun; Lee, Beom-Seok; Moon, Seong-Hwan; Lee, Hwan-Mo

2016-01-01

Background To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondylolisthesis on lumbar lordosis after an intraoperative prone position. Methods Sixty-seven patients, who underwent spinal fusion at the Department of Orthopaedic Surgery of Gwangmyeong Sungae Hospital between May 2007 and February 2012, were included in this study. The study compared lumbar lordosis on preoperative upright, intraoperative prone and postoperative upright lateral X-rays between the simple stenosis (SS) group and spondylolisthesis group. The average age of patients was 67.86 years old. The average preoperative lordosis was 43.5° (± 14.9°), average intraoperative lordosis was 48.8° (± 13.2°), average postoperative lordosis was 46.5° (± 16.1°) and the average change on the frame was 5.3° (± 10.6°). Results Among all patients, 24 patients were diagnosed with simple spinal stenosis, 43 patients with spondylolisthesis (29 degenerative spondylolisthesis and 14 isthmic spondylolisthesis). Between the SS group and spondylolisthesis group, preoperative lordosis, intraoperative lordosis and postoperative lordosis were significantly larger in the spondylolisthesis group. The ratio of patients with increased lordosis on the OSI frame compared to preoperative lordosis was significantly higher in the spondylolisthesis group. The risk of increased lordosis on frame was significantly higher in the spondylolisthesis group (odds ratio, 3.325; 95% confidence interval, 1.101 to 10.039; p = 0.033). Conclusions Intraoperative lumbar lordosis on the OSI frame with a prone

[Determine the patient's position towards psychiatric care: a simple tool to estimate the alliance and the motivation].

Science.gov (United States)

Versaevel, C; Samama, D; Jeanson, R; Lajugie, C; Dufeutrel, L; Defromont, L; Lebouteiller, V; Danel, T; Duhamel, A; Genin, M; Salleron, J; Cottencin, O

2013-09-01

For the brief systemic therapy (BST), the evaluation of the patient's position towards the care is a prerequisite to psychotherapy. Three positions of the patient are described. The "tourist's" position: the patient claims to have no problem and doesn't suffer. Someone asks him to make an appointment, sometimes with threats. The "complaint's" position: the patient claims to suffer, but attributes the responsibility of this suffering to others. These two positions are not good for beginning a therapy. The "customer's" position differs from both previous positions. The "customer" considers that he has a psychological problem which depends on him and he is motivated in the resolution of it. In theory, the "customer" is more motivated and the therapeutic alliance is better. It is for this reason that the BST estimates the position of the patient at first, to bring the patient to the "customer's" position. The objective of this study is to assess an interview which identifies the patient's position towards the care, and to validate the theoretical elaborations of the brief systemic therapy. The study concerns the follow-up of outpatients who consult a psychiatrist for the first time. The evaluation of the patients checks their position towards care using the Tourist-Complaint-Customer (TCC) inventory, how they suffer, the therapeutic alliance (scale Haq-2) and the compliance during care. The evaluation by the psychiatrists checks the suffering perceived, the motivation perceived and the diagnoses according to the DSM. The typology of these patients is made up of one half "complaint", a quarter of "tourist" and a quarter of "customer". The "customer's" position is correlated with the therapeutic alliance and the motivation perceived by the psychiatrist. The motivation perceived by the psychiatrist is correlated with the therapeutic alliance. These results correspond to the theoretical elaborations of the BST. the TCC inventory provides information on the motivation and

Development of an Automatic Identification System Autonomous Positioning System

Directory of Open Access Journals (Sweden)

Qing Hu

2015-11-01

Full Text Available In order to overcome the vulnerability of the global navigation satellite system (GNSS and provide robust position, navigation and time (PNT information in marine navigation, the autonomous positioning system based on ranging-mode Automatic Identification System (AIS is presented in the paper. The principle of the AIS autonomous positioning system (AAPS is investigated, including the position algorithm, the signal measurement technique, the geometric dilution of precision, the time synchronization technique and the additional secondary factor correction technique. In order to validate the proposed AAPS, a verification system has been established in the Xinghai sea region of Dalian (China. Static and dynamic positioning experiments are performed. The original function of the AIS in the AAPS is not influenced. The experimental results show that the positioning precision of the AAPS is better than 10 m in the area with good geometric dilution of precision (GDOP by the additional secondary factor correction technology. This is the most economical solution for a land-based positioning system to complement the GNSS for the navigation safety of vessels sailing along coasts.

Determination of tolerances in the positioning of the treatment table from an image-guided system

International Nuclear Information System (INIS)

Perez Moreno, J. M.; Zucca Aparicio, D.; Fernandez leton, P.; Garcia Ruiz-Zorrilla, J.; Minanbres Moro, A.

2011-01-01

The use of techniques of image-guided radiotherapy (TGRT) aims to reduce the uncertainties associated with patient positioning. One of the techniques more recent development is the cone beam CT (CBCT), consisting of the acquisition of volumetric images of the patient by a detector integrated into the linear accelerator. By analyzing the results of all sessions of treatment to all patients in which the positioning has been carried out with image-guided system MV CBCT have been determined tolerance tables for translational coordinates of the table treatment based on pathology and immobilization system used. (Author)

Echocardiographic evaluation of patients with systemic lupus erythematosus

International Nuclear Information System (INIS)

Hameed, S.; Malik, L.M.

2007-01-01

Cardiac disease occurs in various forms and is a common cause of death in systemic lupus erythematosus. The objective was to detect cardiac abnormalities by transthoracic echocardiography and determine their association in SLE patients. We conducted a transthoracic echocardiographic study in 48 inpatients with systemic lupus erythematosus. Clinical and serological evaluation to confirm the diagnosis of lupus was done in all patients. There were 44 women (91.6%) and 4 men with a mean age of 26 years. Anti ds DNA was positive in 34 patients (68.75%). Transthoracic echocardiography revealed abnormality in 28 patients (58.33%). Of these, 16 patients (57%) had pericardial involvement with variable amount of effusion. Twelve patients (43%) had some valvular involvement and some degree of myocardial systolic dysfunction was found in 12 patients (43%). Only 4 patients (14%) had all three abnormalities. Anti ds DNA was positive in 71% of patients with cardiac abnormalities. Cardiac involvement is common in patients with systemic lupus erythematosus. Serological abnormalities had an association with cardiac abnormalities, and were found to be more prevalent in young patients. (author)

Positional reference system for ultraprecision machining

International Nuclear Information System (INIS)

Arnold, J.B.; Burleson, R.R.; Pardue, R.M.

1982-01-01

A stable positional reference system for use in improving the cutting tool-to-part contour position in numerical controlledmultiaxis metal turning machines is provided. The reference system employs a plurality of interferometers referenced to orthogonally disposed metering bars which are substantially isolated from machine strain induced position errors for monitoring the part and tool positions relative to the metering bars. A microprocessor-based control system is employed in conjunction with the plurality of position interferometers and part contour description data inputs to calculate error components for each axis of movement and output them to corresponding axis drives with appropriate scaling and error compensation. Real-time position control, operating in combination with the reference system, makes possible the positioning of the cutting points of a tool along a part locus with a substantially greater degree of accuracy than has been attained previously in the art by referencing and then monitoring only the tool motion relative to a reference position located on the machine base

Positional reference system for ultraprecision machining

Science.gov (United States)

Arnold, J.B.; Burleson, R.R.; Pardue, R.M.

1980-09-12

A stable positional reference system for use in improving the cutting tool-to-part contour position in numerical controlled-multiaxis metal turning machines is provided. The reference system employs a plurality of interferometers referenced to orthogonally disposed metering bars which are substantially isolated from machine strain induced position errors for monitoring the part and tool positions relative to the metering bars. A microprocessor-based control system is employed in conjunction with the plurality of positions interferometers and part contour description data input to calculate error components for each axis of movement and output them to corresponding axis driven with appropriate scaling and error compensation. Real-time position control, operating in combination with the reference system, makes possible the positioning of the cutting points of a tool along a part locus with a substantially greater degree of accuracy than has been attained previously in the art by referencing and then monitoring only the tool motion relative to a reference position located on the machine base.

a Continuous-Time Positive Linear System

Directory of Open Access Journals (Sweden)

Kyungsup Kim

2013-01-01

Full Text Available This paper discusses a computational method to construct positive realizations with sparse matrices for continuous-time positive linear systems with multiple complex poles. To construct a positive realization of a continuous-time system, we use a Markov sequence similar to the impulse response sequence that is used in the discrete-time case. The existence of the proposed positive realization can be analyzed with the concept of a polyhedral convex cone. We provide a constructive algorithm to compute positive realizations with sparse matrices of some positive systems under certain conditions. A sufficient condition for the existence of a positive realization, under which the proposed constructive algorithm works well, is analyzed.

5th International Symposium on Positive Systems

CERN Document Server

Farina, Lorenzo; Setola, Roberto; Germani, Alfredo

2017-01-01

This book presents high-quality original contributions on positive systems, including topics such as: monotone dynamical systems in mathematical biology and game theory; mathematical developments for networked systems in biology, chemistry and the social sciences; linear and nonlinear positive operators; dynamical analysis, observation and control of positive distributed parameter systems; stochastic realization theory; biological systems with positive variables and positive controls; iterated function systems; nonnegative dynamic processes; and dimensioning problems for collaborative systems. The book comprises a selection of the best papers presented at the POSTA 2016, the 5th International Symposium on Positive Systems, which was held in Rome, Italy, in September 2016. This conference series represents a targeted response to the growing need for research that reports on and critically discusses a wide range of topics concerning the theory and applications of positive systems.

Multiple applications of the Boussignac continuous positive airway pressure system

NARCIS (Netherlands)

Dieperink, Willem

2008-01-01

Continuous positive airway pressure, (CPAP) is a form of treatment to support patients with dyspnea. For the application of CPAP a mechanical ventilator or complex CPAP apparatus is mostly used. The Boussignac CPAP (BCPAP) system developed by George Boussignac does not need such apparatus. The BCPAP

HDV Seroprevalence in HBsAg Positive Patients

International Nuclear Information System (INIS)

Abbasi, A.; Bhutto, A. R.; Mahmood, K.; Butt, N.

2014-01-01

Objective: To find out the frequency of HDV seroprevalence and the demographic characteristics or HBsAg-HDV positive patients. Study Design: Cross-sectional analytical study. Place and Duration of Study: Jinnah Postgraduate Medical Centre and Civil Hospital, Medical Unit-III, Karachi, from March 2007 to April 2011. Methodology: Patients with positive HBsAg were included in the study. Those having co-infection with HCV or HIV, autoimmune hepatitis, alcoholic hepatitis, Wilson's disease and haemochromatosis were excluded. After detailed history and physical examination all the patients underwent laboratory workup including complete blood count, liver function test, viral profile (HAV, HCV, HIV and anti-HDV) and prothrombin time. While in selected patients, HBc (core) antibodies, ultrasound abdomen, serum iron profile, ANA and liver biopsy were also carried out whenever needed to establish a clinical stage of liver disease. Results: There were 374 patients with 266 (71.1%) males and 108 (28.9%) females with overall mean age of 31.64 +- 8.66 years. Overall frequency of anti-HDV antibodies positivity was found in 28.1% (n = 105) patients. HDV seropositivity was slightly more prevalent in males as compared to females (28.57% vs. 26.57%). HDV seropositivity frequency was significantly higher in patients who presented with acute hepatitis/hepatic failure as compared to other clinical diagnoses (p = 0.027) and in those sub-sets of patients who had raised ALT levels (p = 0.012). Conclusion: There was a high frequency of HDV seropositivity in the studied population particularly in males with acute hepatitis or hepatic failure, having raised ALT levels. The emphasis should be on preventive measures taken by other countries to reduce the prevalence of these treatment challenging infections. (author)

Indoor Positioning System using Bluetooth

OpenAIRE

Sahil Puri

2015-01-01

This Paper on Bluetooth Indoor Positioning System is the intersection of Bluetooth Technology and Indoor Positioning Systems. Almost every smartphone today is Bluetooth enabled, making the use of the technology more flexible. We aim at using the RSSI value of Bluetooth signals to track the location of a device.

Design, development, and performance of an adapter for simulation of ocular melanoma patients in supine position for proton beam therapy

International Nuclear Information System (INIS)

Daftari, I.; Phillips, T.L.

2003-01-01

A patient assembly adapter system for ocular melanoma patient simulation was developed and its performance evaluated. The aim for the construction of the apparatus was to simulate the patients in supine position using a commercial x-ray simulator. The apparatus consists of a base plate, head immobilization holder, patient assembly system that includes fixation light and collimator system. The reproducibility of the repeated fixation was initially tested with a head phantom. Simulation and verification films were studied for seven consecutive patients treated with proton beam therapy. Patient's simulation was performed in a supine position using a dental fixation bite block and a thermoplastic head mask immobilization device with a patient adapter system. Two orthogonal x rays were used to obtain the x, y, and z coordinates of sutured tantalum rings for treatment planning with the EYEPLAN software. The verification films were obtained in treatment position with the fixation light along the central axis of the eye. The results indicate good agreement within 0.5 mm deviations. The results of this investigation showed that the same planning accuracy could be achieved by performing simulation using the adapter described above with a patient in the supine position as that obtained by performing simulation with the patient in the seated, treatment position. The adapter can also be attached to the head of the chair for simulating in the seated position using a fixed x-ray unit. This has three advantages: (1) this will save radiation therapists time; (2) it eliminates the need for arranging access to the treatment room, thus avoiding potential conflicts in treatment room usage; and (3) it allows the use of a commercial simulator

Design, development, and performance of an adapter for simulation of ocular melanoma patients in supine position for proton beam therapy

Science.gov (United States)

Daftari, I.; Phillips, T. L.

2003-06-01

A patient assembly adapter system for ocular melanoma patient simulation was developed and its performance evaluated. The aim for the construction of the apparatus was to simulate the patients in supine position using a commercial x-ray simulator. The apparatus consists of a base plate, head immobilization holder, patient assembly system that includes fixation light and collimator system. The reproducibility of the repeated fixation was initially tested with a head phantom. Simulation and verification films were studied for seven consecutive patients treated with proton beam therapy. Patient's simulation was performed in a supine position using a dental fixation bite block and a thermoplastic head mask immobilization device with a patient adapter system. Two orthogonal x rays were used to obtain the x, y, and z coordinates of sutured tantalum rings for treatment planning with the EYEPLAN software. The verification films were obtained in treatment position with the fixation light along the central axis of the eye. The results indicate good agreement within 0.5 mm deviations. The results of this investigation showed that the same planning accuracy could be achieved by performing simulation using the adapter described above with a patient in the supine position as that obtained by performing simulation with the patient in the seated, treatment position. The adapter can also be attached to the head of the chair for simulating in the seated position using a fixed x-ray unit. This has three advantages: (1) this will save radiation therapists time; (2) it eliminates the need for arranging access to the treatment room, thus avoiding potential conflicts in treatment room usage; and (3) it allows the use of a commercial simulator.

Prostate immobilization can be achieved with patient positioning

International Nuclear Information System (INIS)

Huang, David T.; Silverman, Larry N.; Tercilla, Oscar F.; Lutz, Stephen T.

1995-01-01

Purpose/Objective: With advances in 3D conformal therapy, daily variation in the position of the prostate poses increasing problems for radiation oncologists. In this study we attempt to define the optimal treatment position for patients with prostate cancer by measuring the range of movement of the prostate. Materials and Methods: Ten patients with biopsy proven adenocarcinoma of the prostate underwent prone and supine CT scans with IV and oral contrast. Foley catheters (FC) were placed in the urinary bladder, and renograffin was used to make the balloon radiopaque. AP/PA and lateral radiographs were taken for patients in the supine and prone position with either empty bladder (EB) or partially filled bladder (PFB, containing 60 cc of contrast medium). Measurements were taken from the Foley catheter (represents prostatic urethra), to the anterior rectal wall and pubic symphysis (PS). The rectal gas pattern was analyzed to evaluate the rectum-sparing effect. The false table top was not used. Results: For radiographs taken in the supine position, the FC was located 1.4 ± 0.5 cm from the PS in the case of PFB versus EB. In the prone position the variation was significantly less, with an increase in FC to PS distance of only 0.5 ± 0.3 cm for a PFB versus EB. The rectal gas pattern was also noted to vary, with a more expanded and rounded shape in the prone position. Conclusion: Most institutions treat patients with prostate cancer in the supine position. The previous rationale for treatment in the prone position has been small bowel sparing. Here, however, we show that prone treatment also minimizes the motion of the prostate. With less posterior margin required, 3D conformal treatment could be delivered with an additional 30-50% rectal sparing

SU-E-J-134: An Augmented-Reality Optical Imaging System for Accurate Breast Positioning During Radiotherapy

International Nuclear Information System (INIS)

Nazareth, D; Malhotra, H; French, S; Hoffmann, K; Merrow, C

2014-01-01

Purpose: Breast radiotherapy, particularly electronic compensation, may involve large dose gradients and difficult patient positioning problems. We have developed a simple self-calibrating augmented-reality system, which assists in accurately and reproducibly positioning the patient, by displaying her live image from a single camera superimposed on the correct perspective projection of her 3D CT data. Our method requires only a standard digital camera capable of live-view mode, installed in the treatment suite at an approximately-known orientation and position (rotation R; translation T). Methods: A 10-sphere calibration jig was constructed and CT imaged to provide a 3D model. The (R,T) relating the camera to the CT coordinate system were determined by acquiring a photograph of the jig and optimizing an objective function, which compares the true image points to points calculated with a given candidate R and T geometry. Using this geometric information, 3D CT patient data, viewed from the camera's perspective, is plotted using a Matlab routine. This image data is superimposed onto the real-time patient image, acquired by the camera, and displayed using standard live-view software. This enables the therapists to view both the patient's current and desired positions, and guide the patient into assuming the correct position. The method was evaluated using an in-house developed bolus-like breast phantom, mounted on a supporting platform, which could be tilted at various angles to simulate treatment-like geometries. Results: Our system allowed breast phantom alignment, with an accuracy of about 0.5 cm and 1 ± 0.5 degree. Better resolution could be possible using a camera with higher-zoom capabilities. Conclusion: We have developed an augmented-reality system, which combines a perspective projection of a CT image with a patient's real-time optical image. This system has the potential to improve patient setup accuracy during breast radiotherapy, and could possibly be

SU-E-J-134: An Augmented-Reality Optical Imaging System for Accurate Breast Positioning During Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Nazareth, D; Malhotra, H; French, S [Roswell Park Cancer Institute, Buffalo, NY (United States); Hoffmann, K [Neurosurgery at SUNY at Buffalo, Buffalo, NY (United States); Merrow, C [Bassett Healthcare, Oneonta, NY (United States)

2014-06-01

Purpose: Breast radiotherapy, particularly electronic compensation, may involve large dose gradients and difficult patient positioning problems. We have developed a simple self-calibrating augmented-reality system, which assists in accurately and reproducibly positioning the patient, by displaying her live image from a single camera superimposed on the correct perspective projection of her 3D CT data. Our method requires only a standard digital camera capable of live-view mode, installed in the treatment suite at an approximately-known orientation and position (rotation R; translation T). Methods: A 10-sphere calibration jig was constructed and CT imaged to provide a 3D model. The (R,T) relating the camera to the CT coordinate system were determined by acquiring a photograph of the jig and optimizing an objective function, which compares the true image points to points calculated with a given candidate R and T geometry. Using this geometric information, 3D CT patient data, viewed from the camera's perspective, is plotted using a Matlab routine. This image data is superimposed onto the real-time patient image, acquired by the camera, and displayed using standard live-view software. This enables the therapists to view both the patient's current and desired positions, and guide the patient into assuming the correct position. The method was evaluated using an in-house developed bolus-like breast phantom, mounted on a supporting platform, which could be tilted at various angles to simulate treatment-like geometries. Results: Our system allowed breast phantom alignment, with an accuracy of about 0.5 cm and 1 ± 0.5 degree. Better resolution could be possible using a camera with higher-zoom capabilities. Conclusion: We have developed an augmented-reality system, which combines a perspective projection of a CT image with a patient's real-time optical image. This system has the potential to improve patient setup accuracy during breast radiotherapy, and could

Liver transplantation in HIV-positive patients: the position of the Brazilian groups.

Science.gov (United States)

Brandão, Ajacio Bandeira de Mello; Mariante-Neto, Guilherme

2005-01-01

Patients infected with the human immunodeficiency virus (HIV) have generally been excluded from consideration for liver transplantation. Recent advances in the management and prognosis of these patients suggest that this policy must be reevaluated. To identify the current position of Brazilian transplant centers concerning liver transplantation in asymptomatic HIV-infected patients with end-stage liver disease. A structured questionnaire was submitted by e-mail to Brazilian groups who perform liver transplantation and were active in late 2003, according to the Brazilian Association of Organ Transplantation. Of the 53 active groups, 30 e-mail addresses have been found of professionals working in 41 of these groups. Twenty-one responses (70%) were obtained. Most of the professionals (62%) reported that they do not include HIV-infected patients in waiting lists for transplants, primarily on account of the limited world experience. They also reported, however, that this issue will soon be discussed by the group. Those who accept these patients usually follow the guidelines provided by the literature: patients must fulfill the same inclusion criteria as the other patients with end-stage liver diseases, present low or undetectable HIV viral load, and a CD4 count above 250/mm3. They reported that there are 10 HIV-infected patients in waiting list and that only one patient has received a liver transplant in the country. Most centers do not accept in waiting lists for liver transplantation patients with HIV infection, even asymptomatic ones. However, advances in the management of HIV-infected patients suggest that this policy must be reevaluated. In Brazil, there is practically no experience in liver transplantation in HIV-positive patients.

Development of the patient setting system for BNCT at JRR-4

International Nuclear Information System (INIS)

Kumada, H.; Yamamoto, K.; Torii, Y.

2000-01-01

A new treatment planning software: Computational Dosimetry System (JCDS) is in progress its development for BNCT with epithermal neutron beam in JAERI. Irradiation conditions such as beam angle to a patient are calculated by JCDS. In order to implement these conditions, it is necessary to precisely set the patient to actual irradiation position simulated by JCDS beforehand. Therefore, the Patient Setting System, which accurately and quickly sets the patient to the irradiation position, is being developed with JCDS concurrently. In this report, the current status of the development of JCDS and the Patient Setting System in JAERI will be described. (author)

Comparison of oxygen saturation levels in patients receiving Technegas by the conventional unassisted method vs. the positive ventilation delivery system (PVDS)

International Nuclear Information System (INIS)

Dobson, M.P.; Leiper, C.A.; Lee, K.; Dixson, H.

2000-01-01

Full text: The purpose of this study is to compare oxygen saturation levels (SaO 2 ) in 289 patients undergoing conventional lung ventilation scintigraphy (control group) and 27 patients undergoing Positive Ventilation Delivery System (PVDS). The 27 patients where selected as their conventional method of inhalation proved to be inadequate or non-diagnostic. The patients underwent a second ventilation using PVDS, which improved the diagnostic quality of the ventilation image and assisted in clinical management decisions. Some patients in both the PVDS and the control group experienced a transient lowering in their SaO 2 . The mean initial SaO 2 in the control group did not fall below 94.9% and in the PVDS group measured 90.6%. 93% (25/27) of patients in the PVDS group were assessed as non CO 2 retaining, and received oxygen at 10L/min during Technegas inhalation. The mean trough saturation in the PVDS group was 91.7% which was significantly higher than that of the control group (86.9%). No patient in either group experienced any significant complication attributed to the transient tall in SaO 2 during technegas administration. We conclude that oxygen supplied as part of the PVDS system ameliorates the transient reduction in SaO 2 seen during standard Technegas administration. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

Effect of patient position on the lordosis and scoliosis of patients with degenerative lumbar scoliosis.

Science.gov (United States)

Fei, Han; Li, Wei-Shi; Sun, Zhuo-Ran; Jiang, Shuai; Chen, Zhong-Qiang

2017-08-01

This study aimed to analyze the effect of patient positions on the lordosis and scoliosis of patients with degenerative lumbar scoliosis (DLS).Seventy-seven patients with DLS were retrospectively analyzed. We measured lordosis and Cobb's angle on preoperative upright x-rays and magnetic resonance imagings in supine position. The lordosis and scoliosis of surgical segments in intraoperative prone position were measured on intraoperative radiographs of 20 patients to compare with that in standing position. Paired t tests were performed to investigate the parameters of the sample.From standing to supine position the whole lordosis increased (29.2 ± 15.7 degree vs. 34.9 ± 11.2 degree), and the whole scoliosis decreased (24.3 ± 11.8 degree vs. 19.0 ± 10.5 degree); 53 of 77 (68.8%) cases had increased lordosis, and 67 of 77 (87%) cases had decreased scoliosis. The lordosis of surgical segments in standing position had no difference with that in intraoprerative prone position. But in changing from supine/standing position to intraoprerative prone position, the scoliosis of surgical segments decreased (14.7 ± 9.4 degree vs. 11.4 ± 7.0 degree; 19.0 ± 11.8 degree vs. 11.4 ± 7.0 degree, respectively), and 18 of 20 (90%) cases had decreased scoliosis in intraoperative prone position than that in standing position.Compared with standing position in DLS patients, supine position increased lordosis and reduced scoliosis, and intraoperative prone position reduced scoliosis significantly. When evaluating the severity of DLS and making preoperative surgical plans, lumbar lordosis in supine position should also be evaluated in addition to upright x-ray, and the effects of different positions should be taken into consideration to reduce deviation.

Cerebral perfusion imaging in HIV positive patients

International Nuclear Information System (INIS)

Kundley, Kshama; Chowdhury, D.; Lele, V.R.; Lele, R.D.

1998-01-01

Full text: Twelve human immunodeficiency virus (HIV) positive patients were studied by SPECT cerebral perfusion imaging 1 hour post injection of 15 mCi of 99m Tc-ECD under ideal conditions with a triple head gamma camera (Prism 3000 X P LEUHR), fanbeam collimators followed by Folstein Mini Mental Status Examination (FMMSE) and AIDS dementia complex (ADC) staging on the same day. All 12 patients were male, in the age range of 23-45 y (mean 31 y). The infected status was diagnosed by ELISA (10 patients) or Western blot (5 patients). The interval between diagnosis and imaging ranged from 1 month - 35 months (mean 15.3 months). Two patients were alcoholic and 2 were smokers. None of them had CNS disorder clinically. ADC staging and FMMSE could be performed in 4 patients. Two patients were normal (stage 0) and 2 were subclinical (stage 0.5) on ADC staging. FMMSE revealed normal or near normal status (mean score 35; maximum score 36). Cerebral perfusion images were interpreted simultaneously by 3 observers blind towards history and examination using semi-quantitative and quantitative methods by consensus. It revealed multiple areas of hypoperfusion, viz. temporal (11 patients (91 %), parietal 10 patients (83%), frontal 9 patients (75%, pre and post central gyrus 7 patients (58%), occipital 6 patients (50%) cingulate gyrus and cerebellum 5 patients (41%) and thalamic in 2 patients (16%). Hyper perfusion in caudate nuclei was noted in 10 patients (83%). The study reveals presence of multiple perfusion abnormalities on cerebral perfusion imaging in HIV positive patients who have normal/near normal mental status suggesting precedence of perfusion abnormality over clinically apparent mental deficit

Navigation and Positioning System Using High Altitude Platforms Systems (HAPS)

Science.gov (United States)

Tsujii, Toshiaki; Harigae, Masatoshi; Harada, Masashi

Recently, some countries have begun conducting feasibility studies and R&D projects on High Altitude Platform Systems (HAPS). Japan has been investigating the use of an airship system that will function as a stratospheric platform for applications such as environmental monitoring, communications and broadcasting. If pseudolites were mounted on the airships, their GPS-like signals would be stable augmentations that would improve the accuracy, availability, and integrity of GPS-based positioning systems. Also, the sufficient number of HAPS can function as a positioning system independent of GPS. In this paper, a system design of the HAPS-based positioning system and its positioning error analyses are described.

HIV-positive migrants’ encounters with the Swedish health care system

DEFF Research Database (Denmark)

Mehdiyar, Manijeh; Andersson, Rune; Hjelm, Katarina

2016-01-01

of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated......Background: There is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients....... Objective: The aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden. Design: This is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years. Results: ‘A hybrid...

Two-dimensional approach to relativistic positioning systems

International Nuclear Information System (INIS)

Coll, Bartolome; Ferrando, Joan Josep; Morales, Juan Antonio

2006-01-01

A relativistic positioning system is a physical realization of a coordinate system consisting in four clocks in arbitrary motion broadcasting their proper times. The basic elements of the relativistic positioning systems are presented in the two-dimensional case. This simplified approach allows to explain and to analyze the properties and interest of these new systems. The positioning system defined by geodesic emitters in flat metric is developed in detail. The information that the data generated by a relativistic positioning system give on the space-time metric interval is analyzed, and the interest of these results in gravimetry is pointed out

Mixing of multi-modal images for conformational radiotherapy: application to patient re positioning; Fusion d`images multi-modales pour la radiotherapie conformationnelle: application au repositionnement du patient

Energy Technology Data Exchange (ETDEWEB)

Vassal, P

1998-06-29

This study shows a procedure of patient re positioning by comparative evaluation between the position of the patient and the theoretical expected position of the patient; the stagger between the two information gives the error of installation in translation and rotation. A correction is calculated and applied to the treatment environment (position and orientation of the patient, position and orientation of the irradiation source). The control system allows to determine the precise position of the tumor volume. The echography allows to determine the position of an organ.The surface captor is used to localize the tumors of the face or of the brain, with the respect to the face, the acquisition and the treatment of information take only few minutes. The X rays imager is applied for the localization of bones structures. (N.C.)

A system for diagnostic quality radiographic alignment of radiotherapy patients

International Nuclear Information System (INIS)

Gall, Kenneth P.; Zygmanski, Piotr; Thornton, Allan F.

1996-01-01

Purpose In order to achieve highly accurate positioning of radiotherapy patients treated on a standard fractionation schedule we have developed a digital imaging system and associated repositioning algorithms. The system is efficient enough that it is usable on a routine basis. The system is intended to allow stereotactic level precision of patient positioning in fractionated therapy which in turn allows treatment fields to be designed with tighter margins. This may allow higher target doses to be delivered and thereby higher local control to be achieved for certain classes of patients. Materials and Methods Patients to be treated under a standard fractionation schedule for intracranial or head and neck targets have a set of three radiopaque fiducial markers implanted in the outer table of the skull. As part of the 3 dimensional treatment plan the locations of the fiducial markers is determined on the planning CT scan. The positions of the markers relative to the beam direction and isocenter constitute a 3 dimensional position prescription for the treatment. At the time of treatment a pair of orthogonal images is obtained with diagnostic xray tubes aligned to isocenter and a digital imaging system. The imaging system consists of a thermoelectrically cooled CCD camera which views a Gadolinium based xray intensifying screen. The field of view of the imager is 30 x 30 cm which gives a 1.5 lp/mm spatial resolution at isocenter using a 1.5 xray magnification geometry. The user identifies the approximate position of the fiducial markers on the digital image using a mouse and a standard PC computer running an imaging software routine. The identified area is then analyzed to determine the projected position of the marker with sub-pixel (<0.5mm) accuracy. An algorithm based on rigid body transformations computes the three dimensional realignment motions necessary to bring the patient to the desired position for treatment. Results We have been using a system to reposition

Changes of TSH-Stimulation Blocking Antibody (TSBAb and Thyroid Stimulating Antibody (TSAb Over 10 Years in 34 TSBAb-Positive Patients with Hypothyroidism and in 98 TSAb-Positive Graves’ Patients with Hyperthyroidism: Reevaluation of TSBAb and TSAb in TSH-Receptor-Antibody (TRAb-Positive Patients

Directory of Open Access Journals (Sweden)

Nobuyuki Takasu

2012-01-01

Full Text Available Two TRAbs: TSBAb and TSAb. TSBAb causes hypothyroidism. TSAb causes Graves’ hyperthyroidism. TSBAb and TSAb block TSH-binding to cells as TRAb, measured as TSH-binding inhibitory immunoglobulin (TBII. We reevaluate TSBAb and TSAb. We studied TSBAb, TSAb, and TBII over 10 years in 34 TSBAb-positives with hypothyroidism and in 98 TSAb-positives with hyperthyroidism. Half of the 34 TSBAb-positives with hypothyroidism continued to have persistently positive TSBAb, continued to have hypothyroidism, and did not recover from hypothyroidism. Ten of the 98 TSAb-positives with hyperthyroidism continued to have positive TSAb and continued to have hyperthyroidism. TSBAb had disappeared in 15 of the 34 TSBAb-positives with hypothyroidism. With the disappearance of TSBAb, recovery from hypothyroidism was noted in 13 (87% of the 15 patients. TSAb had disappeared in 73 of the 98 TSAb-positives with hyperthyroidism. With the disappearance of TSAb, remissions of hyperthyroidism were noted in 60 (82% of the 73. Two of the 34 TSBAb-positives with hypothyroidism developed TSAb-positive Graves’ hyperthyroidism. Two of the 98 TSAb-positive Graves’ patients with hyperthyroidism developed TSBAb-positive hypothyroidism. TSBAb and TSAb are TRAbs. TSBAb-hypothyroidism and TSAb-hyperthyroidism may be two aspects of one disease (TRAb disease. Two forms of autoimmune thyroiditis: atrophic and goitrous. We followed 34 TSBAb-positive patients with hypothyroidism (24 atrophic and 10 goitrous over 10 years. All of the 10 TSBAb-positive goitrous patients recovered from hypothyroidism and 19 (79% of the 24 TSBAb-positive atrophic patients continued to have hypothyroidism.

Changes of TSH-Stimulation Blocking Antibody (TSBAb) and Thyroid Stimulating Antibody (TSAb) Over 10 Years in 34 TSBAb-Positive Patients with Hypothyroidism and in 98 TSAb-Positive Graves' Patients with Hyperthyroidism: Reevaluation of TSBAb and TSAb in TSH-Receptor-Antibody (TRAb)-Positive Patients

Science.gov (United States)

Takasu, Nobuyuki; Matsushita, Mina

2012-01-01

Two TRAbs: TSBAb and TSAb. TSBAb causes hypothyroidism. TSAb causes Graves' hyperthyroidism. TSBAb and TSAb block TSH-binding to cells as TRAb, measured as TSH-binding inhibitory immunoglobulin (TBII). We reevaluate TSBAb and TSAb. We studied TSBAb, TSAb, and TBII over 10 years in 34 TSBAb-positives with hypothyroidism and in 98 TSAb-positives with hyperthyroidism. Half of the 34 TSBAb-positives with hypothyroidism continued to have persistently positive TSBAb, continued to have hypothyroidism, and did not recover from hypothyroidism. Ten of the 98 TSAb-positives with hyperthyroidism continued to have positive TSAb and continued to have hyperthyroidism. TSBAb had disappeared in 15 of the 34 TSBAb-positives with hypothyroidism. With the disappearance of TSBAb, recovery from hypothyroidism was noted in 13 (87%) of the 15 patients. TSAb had disappeared in 73 of the 98 TSAb-positives with hyperthyroidism. With the disappearance of TSAb, remissions of hyperthyroidism were noted in 60 (82%) of the 73. Two of the 34 TSBAb-positives with hypothyroidism developed TSAb-positive Graves' hyperthyroidism. Two of the 98 TSAb-positive Graves' patients with hyperthyroidism developed TSBAb-positive hypothyroidism. TSBAb and TSAb are TRAbs. TSBAb-hypothyroidism and TSAb-hyperthyroidism may be two aspects of one disease (TRAb disease). Two forms of autoimmune thyroiditis: atrophic and goitrous. We followed 34 TSBAb-positive patients with hypothyroidism (24 atrophic and 10 goitrous) over 10 years. All of the 10 TSBAb-positive goitrous patients recovered from hypothyroidism and 19 (79%) of the 24 TSBAb-positive atrophic patients continued to have hypothyroidism. PMID:22655217

Systematic review of patient handling activities starting in lying, sitting and standing positions.

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Hignett, Sue

2003-03-01

Over the last 20 years a number of methods have been recommended in professional guidelines for moving patients. This review was undertaken as it was recognized that there was a need for clinical work involving handling patients (systems of work and equipment) to be based on scientific evidence. The aim of this paper is to report the methodology, search strategy and results relating to work involving the care, treatment and transfer of patients starting in lying, sitting and standing positions. An unusual philosophical stance has been taken by appraising studies within a study type rather than comparatively. This facilitated the inclusion of a wide range of study designs (quantitative and qualitative). A string search was run on eight databases and supplemented by other search strategies. A published checklist was selected and inter-rater reliability established before the main review commenced. A systematic process for inclusion, exclusion, appraisal, extraction and synthesis was undertaken. Thirty-two studies were included: nine for activities with the patient starting in a lying position and 23 for the sitting position. No studies were found with respect to patient handling activities starting in a standing position. These data were synthesized into evidence statements. The evidence statements support the use of hoists (for nonweight bearing patients), standaids, sliding sheets (double thickness rollers), lateral transfer boards, walking belts and adjustable height beds and baths. It is suggested that these items should constitute a minimum equipment list for any clinical environment where patient handling takes place on a regular basis. The lack of research relating to patient handling in standing is of particular concern and it is recommended that this area should be a high research priority to address concerns about patient handling in rehabilitation activities.

Patient obesity and the practical experience of the plain radiography professional: On everyday ethics, patient positioning and infelicitous equipment

International Nuclear Information System (INIS)

Woods, A.L.; Miller, P.K.; Sloane, C.

2016-01-01

Patient obesity is increasingly placing significant and multifaceted strain upon medical imaging departments, and professionals, in (particularly Western) healthcare systems. The majority of obesity-related studies in radiology are, however, primarily focused only upon the technical business of collecting diagnostically-efficacious images. This study, using Interpretative Phenomenological Analysis (IPA), qualitatively explores the everyday clinical experiences of eight expert UK diagnosticians working in plain radiography. Focus herein falls particularly upon (a) problems with patient positioning during examination, and (b) challenges arising around available equipment. In line with extant research, participants reported that difficulties with positioning obese patients could have negative impacts on image quality, and that insufficient table weight limits and widths, and inadequate detector sizes, can adversely affect examination. They also raised some more novel issues, such as how the impact of available gown sizes upon a patient's sense of dignity can cause practical and ethical dilemmas for a clinician in situ. The issue of how one might ‘train’ experience in positioning patients without bony landmarks as a reference point was also made salient, with strong implications for undergraduate radiography curricula. It is finally highlighted how the participating radiographers themselves seldom conceptualised any given problem as a purely ‘technical’ one, instead recurrently recognising the interlinking of material, socio-economic and moral matters in real healthcare contexts. By better understanding such nuance and complexity as lived by real radiographers, it is contended, a more context-sensitive and flexible path to effective training and guideline-production can be mapped. - Highlights: • Difficulties with positioning obese patients can have negative impacts on image quality. • Positioning patients without bony landmarks as a reference point is

Antiproton source beam position system

International Nuclear Information System (INIS)

Bagwell, T.; Holmes, S.; McCarthy, J.; Webber, R.

1984-05-01

The TeV I Beam Position Monitor (BPM) system is designed to provide a useful diagnostic tool during the commissioning and operational phases of the antiproton source. Simply stated the design goal is to provide single turn position information for intensities of > 1x10 9 particles, and multi-turn (clocked orbit) information for beam intensities of > 1x10 7 particles, both with sub-millimeter resolution. It is anticipated that the system will be used during commissioning for establishing the first turn through the Debuncher and Accumulator, for aligning injection orbits, for providing information necessary to correct closed orbits, and for measuring various machine parameters (e.g. tunes, dispersion, aperture, chromaticity). During normal antiproton operation the system will be used to monitor the beam position throughout the accumulation process

Creativity with dementia patients. Can creativity and art stimulate dementia patients positively?

Science.gov (United States)

Hannemann, Beat Ted

2006-01-01

Creative activities could be stimulating for dementia patients. This article gives a review of practical forms of treating dementia patients with art therapeutic indications. It is also a ground for long-term research objective: in brief, I take exception to such a view, contrary to the common belief in the society and some professionals in the healthcare of dementia patients, on the ground that the patients do not have the capacity to improve their own creativity. The theory of cognition tells us about the principle of being creative as a basis for human life. This specific principle is effective for the aged as well. In the long-term, the creative potential of old patients will be unblocked in individual and group therapy sessions. Creative activity has been shown to reduce depression and isolation, offering the power of choice and decisions. Towards the end of life, art and creativity offer a path of opening up the windows to people's emotional interiors. Creative- and art therapy provides possibilities that are mostly indicated to sharpen the capacity of the senses and the patients' propensity to act themselves. Nonverbal therapy methods, such as painting, music, etc., are able to influence the well-being of the patients positively, within the modern healthcare system in nursing homes. The elderly and some of the dementia patients take the initiative to combine creativity and arts and to define his/her feeling for aesthetical matters. Furthermore, group therapy sessions help against isolation and lack of life perspective and hope. Copyright 2006 S. Karger AG, Basel.

Cancer patients and positive sensory impressions in the hospital environment

DEFF Research Database (Denmark)

Timmermann, Connie; Uhrenfeldt, Lisbeth; Birkelund, Regner

2013-01-01

This study explores how cancer patients experience the meaning of positive sensory impressions in the hospital environment such as architecture, decoration and the interior. Data were obtained at a general hospital in Denmark by interviewing six cancer patients at two different wards. The analysis...... process was guided by the hermeneutical–phenomenological theory of interpretation as presented by the French philosopher Paul Ricoeur. Two main themes were identified: to preserve identity and positive thoughts and feelings. The participants experienced that positive sensory impressions in the hospital...... to recall some of their feelings of identity. This paper adds knowledge about how cancer patients experience sensory impressions in the hospital environment. An environment that provides homeliness and offers a view to nature seems to help some patients to preserve their identity. Furthermore, positive...

Classification of spondylolytic clefts in patients with spondylolysis or isthmic spondylolisthesis using positional MRI.

Science.gov (United States)

Niggemann, Pascal; Kuchta, Johannes; Hadizadeh, Dariusch; Pieper, Claus Christian; Schild, Hans Heinz

2017-02-01

Background Posterior instability is a pathologic movement occurring in the spondylolytic cleft. Purpose To present a new classification system for the evaluation of spondylolytic cleft by positional magnetic resonance imaging (MRI) and determine the prevalence of the different types. Material and Methods A total of 176 segments of the lumbar spine with spondylolysis or isthmic spondylolisthesis were examined using positional MRI. Scans were obtained in neutral sitting, flexion, and extension positions. No visible movement in the cleft was defined as type A, fluid displaced into the cleft as type BI, displacement of the flava ligaments at the level of the cleft as type BII, and intraspinal cysts arising from the spondylolytic cleft as type BIII. The movements were characterized by a radiologist and a neurosurgeon experienced in positional MRI. Clinical findings were correlated with the different types of instability. Results A high agreement was found between the two observers. In total, 131 segments were characterized as type A, six as type BI, 24 as type BII, and 10 as type BIII. In five segments, the type differed between the right and the left side. Two patients had a mixed type BI/II, another two patients had a mixed type BII/III, and one patient had a mixed type BI/III. Patients with type BII and BIII instabilities suffered more often from radicular symptoms compared to patients without any instability. Conclusion The presented classification might help to better understand and study changes encountered in the spondylolytic cleft in patients with spondylolysis and isthmic spondylolisthesis using positional MRI.

Relativistic positioning systems: perspectives and prospects

Science.gov (United States)

Coll Bartolomé

2013-11-01

Relativistic positioning systems are interesting technical objects for applications around the Earth and in the Solar system. But above all else, they are basic scientific objects allowing developing relativity from its own concepts. Some past and future features of relativistic positioning sys- tems, with special attention to the developments that they suggest for an epistemic relativity (relativistic experimental approach to physics), are analyzed. This includes relativistic stereometry, which, together with relativistic positioning systems, allows to introduce the general relativistic notion of (finite) laboratory (space-time region able to perform experiments of finite size).

Development of a Simple Radioactive marker System to Reduce Positioning Errors in Radiation Treatment

International Nuclear Information System (INIS)

William H. Miller; Dr. Jatinder Palta

2007-01-01

The objective of this research is to implement an inexpensive, quick and simple monitor that provides an accurate indication of proper patient position during the treatment of cancer by external beam X-ray radiation and also checks for any significant changes in patient anatomy. It is believed that this system will significantly reduce the treatment margin, provide an additional, independent quality assurance check of positioning accuracy prior to all treatments and reduce the probability of misadministration of therapeutic dose

Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus

International Nuclear Information System (INIS)

Hosenpud, J.D.; Montanaro, A.; Hart, M.V.; Haines, J.E.; Specht, H.D.; Bennett, R.M.; Kloster, F.E.

1984-01-01

Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined

X-ray beam-position feedback system with easy-to-use beam-position monitor.

Science.gov (United States)

Park, Jae Yeon; Kim, Yesul; Lee, Sangsul; Lim, Jun

2018-05-01

X-ray beam-position stability is indispensable in cutting-edge experiments using synchrotron radiation. Here, for the first time, a beam-position feedback system is presented that utilizes an easy-to-use X-ray beam-position monitor incorporating a diamond-fluorescence screen. The acceptable range of the monitor is above 500 µm and the feedback system maintains the beam position within 3 µm. In addition to being inexpensive, the system has two key advantages: it works without a scale factor for position calibration, and it has no dependence on X-ray energy, X-ray intensity, beam size or beam shape.

Novel electro-hydraulic position control system for primary mirror supporting system

Directory of Open Access Journals (Sweden)

Xiongbin Peng

2016-05-01

Full Text Available In the field of modern large-scale telescope, primary mirror supporting system technology faces the difficulties of theoretically uniform output force request and bias compensation. Therefore, a novel position control system combining hydraulic system with servo motor system is introduced. The novel system ensures uniform output force on supporting points without complicating the mechanical structure. The structures of both primary mirror supporting system and novel position system are described. Then, the mathematical model of novel position control system is derived for controller selection. A proportional–derivative controller is adopted for simulations and experiments of step response and triangle path tracking. The results show that proportional–derivative controller guarantees the system with micrometer-level positioning ability. A modified proportional–derivative controller is utilized to promote system behavior with faster response overshoot. The novel position control system is then applied on primary mirror supporting system. Coupling effect is observed among actuator partitions, and relocation of virtual pivot supporting point is chosen as the decoupling measurement. The position keeping ability of the primary mirror supporting system is verified by rotating the mirror cell at a considerably high rate. The experiment results show that the decoupled system performs better with smaller bias and shorter recovery time.

ESTRO ACROP guidelines for positioning, immobilisation and position verification of head and neck patients for radiation therapists

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Michelle Leech

2017-03-01

Full Text Available Background and purpose: Over the last decade, the management of locally advanced head and neck cancers (HNCs has seen a substantial increase in the use of chemoradiation. These guidelines have been developed to assist Radiation TherapisTs (RTTs in positioning, immobilisation and position verification for head and neck cancer patients. Materials and methods: A critical review of the literature was undertaken by the writing committee.Based on the literature review, a survey was developed to ascertain the current positioning, immobilisation and position verification methods for head and neck radiation therapy across Europe. The survey was translated into Italian, German, Greek, Portuguese, Russian, Croatian, French and Spanish.Guidelines were subsequently developed by the writing committee. Results: Results from the survey indicated that a wide variety of treatment practices and treatment verification protocols are in operation for head and neck cancer patients across Europe currently.The guidelines developed are based on the experience and expertise of the writing committee, remaining cognisant of the variations in imaging and immobilisation techniques used currently in Europe. Conclusions: These guidelines have been developed to provide RTTs with guidance on positioning, immobilisation and position verification of HNC patients. The guidelines will also provide RTTs with the means to critically reflect on their own daily clinical practice with this patient group. Keywords: Head and neck, Immobilisation, Positioning, Verification

Ad-Coop Positioning System (ACPS)

DEFF Research Database (Denmark)

Frattasi, Simone; Monti, Marco

2008-01-01

In this paper, we propose an innovative solution for positioning determination in 4G wireless networks by introducing the Ad-Coop Positioning System (ACPS). The ACPS is supported by a hybrid cellular ad-hoc architecture, where the cellular network has a centralized control over the ad-hoc connect......In this paper, we propose an innovative solution for positioning determination in 4G wireless networks by introducing the Ad-Coop Positioning System (ACPS). The ACPS is supported by a hybrid cellular ad-hoc architecture, where the cellular network has a centralized control over the ad...... method for the ACPS, which appropriately combines and weights the long- and short-range location information in a non-linear least square (NLLS) minimization procedure. The numerical results shown in the paper demonstrate that the ACPS enhances the location estimation accuracy with respect...

Systemic lupus erythematosus in a male patient

Science.gov (United States)

Sibarani, H.; Zubir, Z.

2018-03-01

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with a broad spectrum of clinical presentations. Female to male ratio is approximately 9:1.A 20 years old male was admitted to HAM Hospital 3 months ago with chief complaint pain in both knees joint. After anamneses, physical examination and laboratory test the patient was diagnosed with systemic lupus erythematosus. The patient tested positive for ANA and anti-ds-DNA antibody test. The patient was with giving non-biologic DMARDS @myfortic 360mg, methylprednisolone, chloroquine and other symptomatic drugs.

Tuberculosis treatment among smear positive tuberculosis patients

International Nuclear Information System (INIS)

Munir, M.K.; Iqbal, R.; Shabbir, I.; Chaudhry, K

2012-01-01

Tuberculosis is a major health problem in many parts of the world. Delay in initiation of the treatment may result in prolonged infectious state, drug resistance, relapse and death. Objectives: To determine the factors responsible for not starting tuberculosis treatment among smear positive tuberculosis patients. Study type, settings and duration: This cross sectional study was done at Pakistan Medical Research Council TB Research Center, King Edward Medical University, Lahore, from fifth March 2010 to fifth December 2010. Patients and Methods: Fifty sputum smear positive patients of tuberculosis who did not register themselves in treatment register and presumably did not initiate anti tuberculosis treatment were contacted using telephone or traced by their home addresses. Once contact was established, they were inquired about the reasons for not starting tuberculosis treatment. Results: Of 50 patients 38(76%)belonged to the lower socio economic class and 12(24%) to the lower middle class. Fourteen patients (28%) were illiterate and 23(46%) had only 8 years of education. Of the 50 cases 41(82%) were taking treatment from traditional healers and 4% did not go back to the DOTS program. Physical condition of the patient, social, domestic and religious issues also played some role in default. Conclusions: Lack of health education and poverty were the main factors responsible for non compliance from treatment. Policy message: Sputum testing sites should have a paramedic who should educate the patients about the benefits of treatment and the dangers of default or partial treatment. (author)

Pattern of neuropsychological performance among HIV positive patients in Uganda

Directory of Open Access Journals (Sweden)

Parsons Thomas D

2007-04-01

Full Text Available Abstract Background Few studies have examined cognitive functioning of HIV positive patients in sub-Saharan Africa. It cannot be assumed that HIV positive patients in Africa exhibit the same declines as patients in high-resource settings, since there are differences that may influence cognitive functioning including nutrition, history of concomitant disease, and varying HIV strains, among other possibilities. Part of the difficulty of specifying abnormalities in neuropsychological functioning among African HIV positive patients is that there are no readily available African normative databases. The purpose of the current study was to evaluate the pattern of neuropsychological performance in a sample of HIV positive patients in comparison to HIV negative control subjects in Uganda. Methods The neuropsychological test scores of 110 HIV positive patients (WHO Stage 2, n = 21; WHO Stage 3, n = 69; WHO Stage 4, n = 20 were contrasted with those of 100 control subjects on measures of attention/concentration, mental flexibility, learning/memory, and motor functioning. Results Analysis of covariance (ANCOVA revealed significant group differences on measures of verbal learning and memory, speed of processing, attention and executive functioning between HIV seropositive and seronegative subjects. Conclusion Ugandan patients with HIV demonstrated relative deficits on measures of verbal learning and memory, speed of processing, attention, and executive functioning compared to HIV negative controls. These results from a resource limited region where clades A and D are prevalent are consistent with previous findings in the developed world where clade B predominates.

Seroprevalence of Epstein-Barr virus among HIV positive patients moreover and its association with CD4 positive lymphocyte count.

Directory of Open Access Journals (Sweden)

Alireza Abdollahi

2014-12-01

Full Text Available Opportunistic infections are the leading cause of hospitalization and morbidity in human immunodeficiency virus (HIV positive patients and are the most common cause of death between them. We aimed to measure IgG antibody against EBV viral capsid antigen (EBV-VCA IgG to determine the seroprevalence of this infection in HIV-positive population. A case-control study between September 2011 and October 2012 was conducted in a teaching hospital enrolling 114 HIV-positive patients as case group and 114 healthy individuals as control with similar age and sex. Enzyme-linked immunosurbant assay (ELISA technique was used for determination of EBV-VAC IgG in obtained samples. Of 114 serum samples obtained from HIV-positive patients, 103 (90.4% samples were found positive for EBV-VCA IgG antibody. There was no significant difference in seroprevalence of EBV VCA IgG antibody between patients received antiretroviral therapy and naive patients (91.5% vs. 87.5%, P>0.05. There was no statistically significant difference in EBV-VCA IgG seroprevalence between three groups of CD4+ in HIV positive group. In conclusion current study showed that seroprevalence of EBV in HIV-positive patients is higher than HIV-negative healthy participants; however, administration of HAART and CD4+ lymphocyte count did not reveal a significant effect in seroprevalence of EBV. Due to the significance of this virus in mortality and morbidity and causing certain malignancies in patients with AIDS, these patients are strongly recommended to be tested for this virus.

Orofacial manifestations of histoplasmosis in HIV-positive patients: a case report.

Science.gov (United States)

Gomes Ferreira, O; Vieira Fernandes, A; Sebastião Borges, A; Simão Ferreira, M; Mota Loyola, A

2001-01-01

Amongst the main opportunistic diseases that affect the HIV-positive patient, histoplasmosis is found. This systemic mycosis caused by the fungus Histoplasma capsulatum has the capacity to disseminate from the lung to the skin and oral mucosa. Oral lesions of histoplasmosis can be found with ulcerated or nodular aspect, being always very painful and infiltrating the mucosa. When they are present in the mouth, they strongly indicate the presence of some kind of immunosuppression. This study shows the disease's evolution in an HIV-positive patient, who presented several ulcerated lesions in the oral cavity and facial skin. The symptomatology and clinical aspects of the lesions were not specific for the disease, and due to this, the diagnosis was obtained by cytological smear and oral biopsy. The results of the exams defined the disseminated picture of the infection. The treatment plan involved the use of amphotericin B for the lesions' remission, and, following this, itraconazole was administered in the maintenance phase.

Ascending colon rotation following patient positional change during CT colonography: a potential pitfall in interpretation

International Nuclear Information System (INIS)

Kim, Ji Yeon; Park, Seong Ho; Lee, Seung Soo; Kim, Ah Young; Ha, Hyun Kwon

2011-01-01

To investigate the degree and pattern of ascending colonic rotation as patients moved from supine to prone positions during CTC. A search of our CTC and colonoscopy database found 37 patients (43 eligible lesions) who fulfilled the following criteria: colonoscopy-proven sessile polyps ≥6 mm in the straight mid-ascending colon, lesion visualisation in both supine and prone CTC, and optimal colonic distension. A coordinate system was developed to designate the polyp radial location ( ) along the luminal circumference, unaffected by rotation of the torso. The degree/direction of polyp radial location change (i.e. ascending colonic rotation) between supine and prone positions correlated with anthropometric measurements. Movement from supine to prone positions resulted in a change in the radial polyp location of between -23 and 79 (median, 21 ), demonstrating external rotation of the ascending colon in almost all cases (2 to 79 in 36/37 patients and 42/43 lesions). The degree/direction of rotation mildly correlated with the degree of abdominal compression in the anterior-posterior direction in prone position (r = 0.427 [P = 0.004] and r = 0.404 [P = 0.007]). The ascending colon was usually found to rotate externally as patients moved from supine to prone positions, partly dependent on the degree of abdominal compression. (orig.)

Locoregional Recurrence Risk for Patients With T1,2 Breast Cancer With 1-3 Positive Lymph Nodes Treated With Mastectomy and Systemic Treatment

International Nuclear Information System (INIS)

McBride, Andrew; Allen, Pamela; Woodward, Wendy; Kim, Michelle; Kuerer, Henry M.; Drinka, Eva Katherine; Sahin, Aysegul; Strom, Eric A.; Buzdar, Aman; Valero, Vicente; Hortobagyi, Gabriel N.; Hunt, Kelly K.; Buchholz, Thomas A.

2014-01-01

Purpose: Postmastectomy radiation therapy (PMRT) has been shown to benefit breast cancer patients with 1 to 3 positive lymph nodes, but it is unclear how modern changes in management have affected the benefits of PMRT. Methods and Materials: We retrospectively analyzed the locoregional recurrence (LRR) rates in 1027 patients with T1,2 breast cancer with 1 to 3 positive lymph nodes treated with mastectomy and adjuvant chemotherapy with or without PMRT during an early era (1978-1997) and a later era (2000-2007). These eras were selected because they represented periods before and after the routine use of sentinel lymph node surgery, taxane chemotherapy, and aromatase inhibitors. Results: 19% of 505 patients treated in the early era and 25% of the 522 patients in the later era received PMRT. Patients who received PMRT had significantly higher-risk disease features. PMRT reduced the rate of LRR in the early era cohort, with 5-year rates of 9.5% without PMRT and 3.4% with PMRT (log-rank P=.028) and 15-year rates 14.5% versus 6.1%, respectively; (Cox regression analysis: adjusted hazard ratio [AHR] 0.37, P=.035). However, PMRT did not appear to benefit patients treated in the later cohort, with 5-year LRR rates of 2.8% without PMRT and 4.2% with PMRT (P=.48; Cox analysis: AHR 1.41, P=.48). The most significant factor predictive of LRR for the patients who did not receive PMRT was the era in which the patient was treated (AHR 0.35 for later era, P<.001). Conclusion: The risk of LRR for patients with T1,2 breast cancer with 1 to 3 positive lymph nodes treated with mastectomy and systemic treatment is highly dependent on the era of treatment. Modern treatment advances and the selected use of PMRT for those with high-risk features have allowed for identification of a cohort at very low risk for LRR without PMRT

Locoregional Recurrence Risk for Patients With T1,2 Breast Cancer With 1-3 Positive Lymph Nodes Treated With Mastectomy and Systemic Treatment

Energy Technology Data Exchange (ETDEWEB)

McBride, Andrew [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); University of Arizona School of Medicine, Phoenix, Arizona (United States); Allen, Pamela; Woodward, Wendy; Kim, Michelle [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kuerer, Henry M. [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Drinka, Eva Katherine; Sahin, Aysegul [Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Strom, Eric A. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buzdar, Aman; Valero, Vicente; Hortobagyi, Gabriel N. [Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A., E-mail: tbuchhol@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2014-06-01

Purpose: Postmastectomy radiation therapy (PMRT) has been shown to benefit breast cancer patients with 1 to 3 positive lymph nodes, but it is unclear how modern changes in management have affected the benefits of PMRT. Methods and Materials: We retrospectively analyzed the locoregional recurrence (LRR) rates in 1027 patients with T1,2 breast cancer with 1 to 3 positive lymph nodes treated with mastectomy and adjuvant chemotherapy with or without PMRT during an early era (1978-1997) and a later era (2000-2007). These eras were selected because they represented periods before and after the routine use of sentinel lymph node surgery, taxane chemotherapy, and aromatase inhibitors. Results: 19% of 505 patients treated in the early era and 25% of the 522 patients in the later era received PMRT. Patients who received PMRT had significantly higher-risk disease features. PMRT reduced the rate of LRR in the early era cohort, with 5-year rates of 9.5% without PMRT and 3.4% with PMRT (log-rank P=.028) and 15-year rates 14.5% versus 6.1%, respectively; (Cox regression analysis: adjusted hazard ratio [AHR] 0.37, P=.035). However, PMRT did not appear to benefit patients treated in the later cohort, with 5-year LRR rates of 2.8% without PMRT and 4.2% with PMRT (P=.48; Cox analysis: AHR 1.41, P=.48). The most significant factor predictive of LRR for the patients who did not receive PMRT was the era in which the patient was treated (AHR 0.35 for later era, P<.001). Conclusion: The risk of LRR for patients with T1,2 breast cancer with 1 to 3 positive lymph nodes treated with mastectomy and systemic treatment is highly dependent on the era of treatment. Modern treatment advances and the selected use of PMRT for those with high-risk features have allowed for identification of a cohort at very low risk for LRR without PMRT.

SU-E-J-243: Possibility of Exposure Dose Reduction of Cone-Beam Computed Tomography in An Image Guided Patient Positioning System by Using Various Noise Suppression Filters

International Nuclear Information System (INIS)

Kamezawa, H; Arimura, H; Ohki, M; Shirieda, K; Kameda, N

2014-01-01

Purpose: To investigate the possibility of exposure dose reduction of the cone-beam computed tomography (CBCT) in an image guided patient positioning system by using 6 noise suppression filters. Methods: First, a reference dose (RD) and low-dose (LD)-CBCT (X-ray volume imaging system, Elekta Co.) images were acquired with a reference dose of 86.2 mGy (weighted CT dose index: CTDIw) and various low doses of 1.4 to 43.1 mGy, respectively. Second, an automated rigid registration for three axes was performed for estimating setup errors between a planning CT image and the LD-CBCT images, which were processed by 6 noise suppression filters, i.e., averaging filter (AF), median filter (MF), Gaussian filter (GF), bilateral filter (BF), edge preserving smoothing filter (EPF) and adaptive partial median filter (AMF). Third, residual errors representing the patient positioning accuracy were calculated as an Euclidean distance between the setup error vectors estimated using the LD-CBCT image and RD-CBCT image. Finally, the relationships between the residual error and CTDIw were obtained for 6 noise suppression filters, and then the CTDIw for LD-CBCT images processed by the noise suppression filters were measured at the same residual error, which was obtained with the RD-CBCT. This approach was applied to an anthropomorphic pelvic phantom and two cancer patients. Results: For the phantom, the exposure dose could be reduced from 61% (GF) to 78% (AMF) by applying the noise suppression filters to the CBCT images. The exposure dose in a prostate cancer case could be reduced from 8% (AF) to 61% (AMF), and the exposure dose in a lung cancer case could be reduced from 9% (AF) to 37% (AMF). Conclusion: Using noise suppression filters, particularly an adaptive partial median filter, could be feasible to decrease the additional exposure dose to patients in image guided patient positioning systems

SU-E-J-243: Possibility of Exposure Dose Reduction of Cone-Beam Computed Tomography in An Image Guided Patient Positioning System by Using Various Noise Suppression Filters

Energy Technology Data Exchange (ETDEWEB)

Kamezawa, H [Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka (Japan); Fujimoto General Hospital, Miyakonojo, Miyazaki (Japan); Arimura, H; Ohki, M [Faculty of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka (Japan); Shirieda, K; Kameda, N [Fujimoto General Hospital, Miyakonojo, Miyazaki (Japan)

2014-06-01

Purpose: To investigate the possibility of exposure dose reduction of the cone-beam computed tomography (CBCT) in an image guided patient positioning system by using 6 noise suppression filters. Methods: First, a reference dose (RD) and low-dose (LD)-CBCT (X-ray volume imaging system, Elekta Co.) images were acquired with a reference dose of 86.2 mGy (weighted CT dose index: CTDIw) and various low doses of 1.4 to 43.1 mGy, respectively. Second, an automated rigid registration for three axes was performed for estimating setup errors between a planning CT image and the LD-CBCT images, which were processed by 6 noise suppression filters, i.e., averaging filter (AF), median filter (MF), Gaussian filter (GF), bilateral filter (BF), edge preserving smoothing filter (EPF) and adaptive partial median filter (AMF). Third, residual errors representing the patient positioning accuracy were calculated as an Euclidean distance between the setup error vectors estimated using the LD-CBCT image and RD-CBCT image. Finally, the relationships between the residual error and CTDIw were obtained for 6 noise suppression filters, and then the CTDIw for LD-CBCT images processed by the noise suppression filters were measured at the same residual error, which was obtained with the RD-CBCT. This approach was applied to an anthropomorphic pelvic phantom and two cancer patients. Results: For the phantom, the exposure dose could be reduced from 61% (GF) to 78% (AMF) by applying the noise suppression filters to the CBCT images. The exposure dose in a prostate cancer case could be reduced from 8% (AF) to 61% (AMF), and the exposure dose in a lung cancer case could be reduced from 9% (AF) to 37% (AMF). Conclusion: Using noise suppression filters, particularly an adaptive partial median filter, could be feasible to decrease the additional exposure dose to patients in image guided patient positioning systems.

A Prototype Wire Position Monitoring System

International Nuclear Information System (INIS)

Wang, Wei

2010-01-01

The Wire Position Monitoring System (WPM) will track changes in the transverse position of LCLS Beam Position Monitors (BPMs) to 1(micro)m over several weeks. This position information will be used between applications of beam based alignment to correct for changes in component alignment. The WPM system has several requirements. The sensor range must be large enough so that precision sensor positioning is not required. The resolution needs to be small enough so that the signal can be used to monitor motion to 1(micro)m. The system must be stable enough so that system drift does not mimic motion of the component being monitored. The WPM sensor assembly consists of two parts, the magnetic sensor and an integrated lock-in amplifier. The magnetic sensor picks up a signal from the alternating current in a stretched wire. The voltage v induced in the sensor is proportional to the wire displacement from the center of the sensor. The integrated lock-in amplifier provides a DC output whose magnitude is proportional to the AC signal from the magnetic sensor. The DC output is either read on a digital voltmeter or digitized locally and communicated over a computer interface.

SU-E-J-15: Automatically Detect Patient Treatment Position and Orientation in KV Portal Images

International Nuclear Information System (INIS)

Qiu, J; Yang, D

2015-01-01

Purpose: In the course of radiation therapy, the complex information processing workflow will Result in potential errors, such as incorrect or inaccurate patient setups. With automatic image check and patient identification, such errors could be effectively reduced. For this purpose, we developed a simple and rapid image processing method, to automatically detect the patient position and orientation in 2D portal images, so to allow automatic check of positions and orientations for patient daily RT treatments. Methods: Based on the principle of portal image formation, a set of whole body DRR images were reconstructed from multiple whole body CT volume datasets, and fused together to be used as the matching template. To identify the patient setup position and orientation shown in a 2D portal image, the 2D portal image was preprocessed (contrast enhancement, down-sampling and couch table detection), then matched to the template image so to identify the laterality (left or right), position, orientation and treatment site. Results: Five day’s clinical qualified portal images were gathered randomly, then were processed by the automatic detection and matching method without any additional information. The detection results were visually checked by physicists. 182 images were correct detection in a total of 200kV portal images. The correct rate was 91%. Conclusion: The proposed method can detect patient setup and orientation quickly and automatically. It only requires the image intensity information in KV portal images. This method can be useful in the framework of Electronic Chart Check (ECCK) to reduce the potential errors in workflow of radiation therapy and so to improve patient safety. In addition, the auto-detection results, as the patient treatment site position and patient orientation, could be useful to guide the sequential image processing procedures, e.g. verification of patient daily setup accuracy. This work was partially supported by research grant from

SU-E-J-15: Automatically Detect Patient Treatment Position and Orientation in KV Portal Images

Energy Technology Data Exchange (ETDEWEB)

Qiu, J [Washington University in St Louis, Taian, Shandong (China); Yang, D [Washington University School of Medicine, St Louis, MO (United States)

2015-06-15

Purpose: In the course of radiation therapy, the complex information processing workflow will Result in potential errors, such as incorrect or inaccurate patient setups. With automatic image check and patient identification, such errors could be effectively reduced. For this purpose, we developed a simple and rapid image processing method, to automatically detect the patient position and orientation in 2D portal images, so to allow automatic check of positions and orientations for patient daily RT treatments. Methods: Based on the principle of portal image formation, a set of whole body DRR images were reconstructed from multiple whole body CT volume datasets, and fused together to be used as the matching template. To identify the patient setup position and orientation shown in a 2D portal image, the 2D portal image was preprocessed (contrast enhancement, down-sampling and couch table detection), then matched to the template image so to identify the laterality (left or right), position, orientation and treatment site. Results: Five day’s clinical qualified portal images were gathered randomly, then were processed by the automatic detection and matching method without any additional information. The detection results were visually checked by physicists. 182 images were correct detection in a total of 200kV portal images. The correct rate was 91%. Conclusion: The proposed method can detect patient setup and orientation quickly and automatically. It only requires the image intensity information in KV portal images. This method can be useful in the framework of Electronic Chart Check (ECCK) to reduce the potential errors in workflow of radiation therapy and so to improve patient safety. In addition, the auto-detection results, as the patient treatment site position and patient orientation, could be useful to guide the sequential image processing procedures, e.g. verification of patient daily setup accuracy. This work was partially supported by research grant from

Anti-Jo-1 antibody-positive patients show a characteristic necrotizing perifascicular myositis.

Science.gov (United States)

Mescam-Mancini, Lénaig; Allenbach, Yves; Hervier, Baptiste; Devilliers, Hervé; Mariampillay, Kuberaka; Dubourg, Odile; Maisonobe, Thierry; Gherardi, Romain; Mezin, Paulette; Preusse, Corinna; Stenzel, Werner; Benveniste, Olivier

2015-09-01

Idiopathic inflammatory myopathies can be classified as polymyositis, dermatomyositis, immune-mediated necrotizing myopathy, sporadic inclusion body myositis or non-specific myositis. Anti-Jo-1 antibody-positive patients are assigned to either polymyositis or dermatomyositis suggesting overlapping pathological features. We aimed to determine if anti-Jo-1 antibody-positive myopathy has a specific morphological phenotype. In a series of 53 muscle biopsies of anti-Jo-1 antibody-positive patients, relevant descriptive criteria defining a characteristic morphological pattern were identified. They were tested in a second series of anti-Jo-1 antibody-positive patients and compared to 63 biopsies from patients suffering from other idiopathic inflammatory myopathies. In anti-Jo-1 antibody-positive patients, necrotic fibres, which strongly clustered in perifascicular regions, were frequently observed. Sarcolemmal complement deposition was detected specifically in perifascicular areas. Inflammation was mainly located in the perimysium and around vessels in 90.6%. Perimysial fragmentation was observed in 90% of cases. Major histocompatibility complex class I staining was diffusely positive, with a perifascicular reinforcement. Multivariate analysis showed that criteria defining perifascicular pathology: perifascicular necrosis, atrophy, and perimysial fragmentation allow the distinction of anti-Jo-1 antibody-positive patients, among patients suffering from other idiopathic inflammatory myopathies. Anti-Jo-1 antibody-positive patients displayed perifascicular necrosis, whereas dermatomyositis patients exhibited perifascicular atrophy. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The representitativeness of patient position during the first treatment fractions

DEFF Research Database (Denmark)

Bertelsen, Anders; Nielsen, Morten; Westberg, Jonas

2009-01-01

BACKGROUND: During external radiotherapy daily or even weekly image verification of the patient position might be problematic due to the resulting workload. Therefore it has been customary to perform image verification only at the first treatment fraction. In this study it is investigated whether...... the patient position uncertainty at the initial three treatment fractions is representative for the uncertainty throughout the treatment course. METHODS: Seventy seven patients were treated using Elekta Synergy accelerators. The patients were immobilized during treatment by use of a customized VacFix bag...... and a mask of AquaPlast. Cone beam CT (CBCT) scans were performed at fractions 1, 2, and 3 and at the 10th and 20th treatment fractions. Displacements in patient position, translational and rotational, have been measured by an image registration of the CBCT and the planning CT scan. The displacements data...

Airborne relay-based regional positioning system.

Science.gov (United States)

Lee, Kyuman; Noh, Hongjun; Lim, Jaesung

2015-05-28

Ground-based pseudolite systems have some limitations, such as low vertical accuracy, multipath effects and near-far problems. These problems are not significant in airborne-based pseudolite systems. However, the monitoring of pseudolite positions is required because of the mobility of the platforms on which the pseudolites are mounted, and this causes performance degradation. To address these pseudolite system limitations, we propose an airborne relay-based regional positioning system that consists of a master station, reference stations, airborne relays and a user. In the proposed system, navigation signals are generated from the reference stations located on the ground and are relayed via the airborne relays. Unlike in conventional airborne-based systems, the user in the proposed system sequentially estimates both the locations of airborne relays and his/her own position. Therefore, a delay due to monitoring does not occur, and the accuracy is not affected by the movement of airborne relays. We conducted several simulations to evaluate the performance of the proposed system. Based on the simulation results, we demonstrated that the proposed system guarantees a higher accuracy than airborne-based pseudolite systems, and it is feasible despite the existence of clock offsets among reference stations.

Relativistic positioning systems: Numerical simulations

Science.gov (United States)

Puchades Colmenero, Neus

The position of users located on the Earth's surface or near it may be found with the classic positioning systems (CPS). Certain information broadcast by satellites of global navigation systems, as GPS and GALILEO, may be used for positioning. The CPS are based on the Newtonian formalism, although relativistic post-Newtonian corrections are done when they are necessary. This thesis contributes to the development of a different positioning approach, which is fully relativistic from the beginning. In the relativistic positioning systems (RPS), the space-time position of any user (ship, spacecraft, and so on) can be calculated with the help of four satellites, which broadcast their proper times by means of codified electromagnetic signals. In this thesis, we have simulated satellite 4-tuples of the GPS and GALILEO constellations. If a user receives the signals from four satellites simultaneously, the emission proper times read -after decoding- are the user "emission coordinates". In order to find the user "positioning coordinates", in an appropriate almost inertial reference system, there are two possibilities: (a) the explicit relation between positioning and emission coordinates (broadcast by the satellites) is analytically found or (b) numerical codes are designed to calculate the positioning coordinates from the emission ones. Method (a) is only viable in simple ideal cases, whereas (b) allows us to consider realistic situations. In this thesis, we have designed numerical codes with the essential aim of studying two appropriate RPS, which may be generalized. Sometimes, there are two real users placed in different positions, which receive the same proper times from the same satellites; then, we say that there is bifurcation, and additional data are needed to choose the real user position. In this thesis, bifurcation is studied in detail. We have analyzed in depth two RPS models; in both, it is considered that the satellites move in the Schwarzschild's space

The monitoring system using laser light for the patient movement during radiation therapy

International Nuclear Information System (INIS)

Sano, Naoki; Onishi, Hiroshi; Yamaguchi, Motoshi; Kuriyama, Kengo; Akiyama, Saburou; Nakamura, Osamu; Araki, Tsutomu

1997-01-01

Purpose: The purpose of this study is to evaluate the usefulness of a newly developed real-time patient movement monitoring system built into the patient positioning light from the frontal and horizontal view. Materials and Techniques: This system is composed of 4 parts. They are a laser light projector, a retro-reflected tape, a sensor of photo-diode, and an alarm devise. First, this system projects a laser light for the patient movement monitor into the center of the crossed lines of the patient positioning light. The laser light (a diameter of 1.5mm and power of 0.5mW) for the patient movement monitor has a different wave length(633nm) from the patient positioning light. Then it is reflected into the direction of incidence with a retro-reflection tape affixed on three patient positioning points. And the system has a photo-diode which can sense the reflected laser light. This retro-reflected tape is made of tiny high reflective beads of glass which is fixed on a sheet with the thickness of 0.12mm and is able to be cut into any shape. This has a maximum retro-reflection angle of 70 degrees. We can select a tolerance of the patient movement by changing its shape and size. A buzzer strikes and a lamp is turned on to alarm for the error when the retro-reflected laser light is not sensed with the photo-diode. Results: The real-time monitoring accuracy of this system is only 0.17mm in the dimension of error for a selected tolerance of the phantom examination. Conclusion: This patient positioning system can be made simply and inexpensively and has a high monitoring accuracy. We can apply this system for a high-precision irradiation such as the three dimensional irradiation and small target irradiation

HIV positive patient with GBS-like syndrome.

Science.gov (United States)

Shepherd, Samantha J; Black, Heather; Thomson, Emma C; Gunson, Rory N

2017-08-01

Introduction. Guillain-Barré Syndrome (GBS) is an acute demyelinating polyneuropathy which can occur post-infection. Criteria of diagnosis of GBS include areflexia with progressive bilateral weakness in arms and legs. GBS can lead to severe respiratory and cardiac complications. The fatality rate can be up to 5 % in patients, depending on the severity of the symptoms. HIV can cause a range of neurological disorders including, on rare occasions, GBS. GBS can occur at any stage of HIV infection, highlighting the complexity of diagnosis of GBS within HIV patients. Case presentation. A 57 year old female with lumbar back pain radiating to the legs, poor mobility and tiredness, with reports of a viral-like illness four days previously, was initially diagnosed with a lower respiratory tract infection and discharged. Seventeen days later the patient was readmitted to hospital with progressive lower and upper limb weakness, areflexia and sensory loss. She was diagnosed with GBS and was unexpectedly discovered to be HIV-positive. HIV avidity was low indicating a recently acquired HIV infection. The patient was treated with intravenous immunoglobulin for five days for the GBS and commenced antriretrovirals for HIV. The patient was discharge from hospital 53 days after admission with walking aids and regular physiotherapy follow-up. . This case highlighted the need for all clinicians to be aware that patients with symptoms of GBS, regardless of clinical history should be offered an HIV test. GBS can be the first sign a patient is HIV-positive.

Markov Jump Linear Systems-Based Position Estimation for Lower Limb Exoskeletons

Directory of Open Access Journals (Sweden)

Samuel L. Nogueira

2014-01-01

Full Text Available In this paper, we deal with Markov Jump Linear Systems-based filtering applied to robotic rehabilitation. The angular positions of an impedance-controlled exoskeleton, designed to help stroke and spinal cord injured patients during walking rehabilitation, are estimated. Standard position estimate approaches adopt Kalman filters (KF to improve the performance of inertial measurement units (IMUs based on individual link configurations. Consequently, for a multi-body system, like a lower limb exoskeleton, the inertial measurements of one link (e.g., the shank are not taken into account in other link position estimation (e.g., the foot. In this paper, we propose a collective modeling of all inertial sensors attached to the exoskeleton, combining them in a Markovian estimation model in order to get the best information from each sensor. In order to demonstrate the effectiveness of our approach, simulation results regarding a set of human footsteps, with four IMUs and three encoders attached to the lower limb exoskeleton, are presented. A comparative study between the Markovian estimation system and the standard one is performed considering a wide range of parametric uncertainties.

Accuracy of an infrared marker-based patient positioning system (ExacTrac®) for stereotactic body radiotherapy in localizing the planned isocenter using fiducial markers

Science.gov (United States)

Montes-Rodríguez, María de los Ángeles; Hernández-Bojórquez, Mariana; Martínez-Gómez, Alma Angélica; Contreras-Pérez, Agustín; Negrete-Hernández, Ingrid Mireya; Hernández-Oviedo, Jorge Omar; Mitsoura, Eleni; Santiago-Concha, Bernardino Gabriel

2014-11-01

Stereotactic Body Radiation Therapy (SBRT) requires a controlled immobilization and position monitoring of patient and target. The purpose of this work is to analyze the performance of the imaging system ExacTrac® (ETX) using infrared and fiducial markers. Materials and methods: In order to assure the accuracy of isocenter localization, a Quality Assurance procedure was applied using an infrared marker-based positioning system. Scans were acquired of an inhouse-agar gel and solid water phantom with infrared spheres. In the inner part of the phantom, three reference markers were delineated as reference and one pellet was place internally; which was assigned as the isocenter. The iPlan® RT Dose treatment planning system. Images were exported to the ETX console. Images were acquired with the ETX to check the correctness of the isocenter placement. Adjustments were made in 6D the reference markers were used to fuse the images. Couch shifts were registered. The procedure was repeated for verification purposes. Results: The data recorded of the verifications in translational and rotational movements showed averaged 3D spatial uncertainties of 0.31 ± 0.42 mm respectively 0.82° ± 0.46° in the phantom and the first correction of these uncertainties were of 1.51 ± 1.14 mm respectively and 1.37° ± 0.61°. Conclusions: This study shows a high accuracy and repeatability in positioning the selected isocenter. The ETX-system for verifying the treatment isocenter position has the ability to monitor the tracing position of interest, making it possible to be used for SBRT positioning within uncertainty ≤1mm.

Accuracy of an infrared marker-based patient positioning system (ExacTrac®) for stereotactic body radiotherapy in localizing the planned isocenter using fiducial markers

Energy Technology Data Exchange (ETDEWEB)

Montes-Rodríguez, María de los Ángeles, E-mail: angy24538@yahoo.com; Mitsoura, Eleni [Medical Physics Graduate Programme, Universidad Autónoma del Estado de México, Facultad de Medicina, Paseo Tollocan esquina Jesús Carranza Colonia Moderna de la Cruz, C.P. 50180, Toluca, Estado de México (Mexico); Hernández-Bojórquez, Mariana; Martínez-Gómez, Alma Angélica; Contreras-Pérez, Agustín; Negrete-Hernández, Ingrid Mireya; Hernández-Oviedo, Jorge Omar; Santiago-Concha, Bernardino Gabriel [Centro de Cáncer ABC, The American British Cowdray Medical Center I.A.P. (CMABC), Calle Sur 136, no. 116, Colonia las Américas, C.P. 01120, México, D.F. (Mexico)

2014-11-07

Stereotactic Body Radiation Therapy (SBRT) requires a controlled immobilization and position monitoring of patient and target. The purpose of this work is to analyze the performance of the imaging system ExacTrac® (ETX) using infrared and fiducial markers. Materials and methods: In order to assure the accuracy of isocenter localization, a Quality Assurance procedure was applied using an infrared marker-based positioning system. Scans were acquired of an inhouse-agar gel and solid water phantom with infrared spheres. In the inner part of the phantom, three reference markers were delineated as reference and one pellet was place internally; which was assigned as the isocenter. The iPlan® RT Dose treatment planning system. Images were exported to the ETX console. Images were acquired with the ETX to check the correctness of the isocenter placement. Adjustments were made in 6D the reference markers were used to fuse the images. Couch shifts were registered. The procedure was repeated for verification purposes. Results: The data recorded of the verifications in translational and rotational movements showed averaged 3D spatial uncertainties of 0.31 ± 0.42 mm respectively 0.82° ± 0.46° in the phantom and the first correction of these uncertainties were of 1.51 ± 1.14 mm respectively and 1.37° ± 0.61°. Conclusions: This study shows a high accuracy and repeatability in positioning the selected isocenter. The ETX-system for verifying the treatment isocenter position has the ability to monitor the tracing position of interest, making it possible to be used for SBRT positioning within uncertainty ≤1mm.

Target volume shape variation during irradiation of rectal cancer patients in supine position: Comparison with prone position

International Nuclear Information System (INIS)

Nijkamp, Jasper; Jong, Rianne de; Sonke, Jan-Jakob; Vliet, Corine van; Marijnen, Corrie

2009-01-01

Purpose: To quantify the inter-fraction shape variation of the mesorectum for rectal cancer patients treated with 5 x 5 Gy in supine position and compare it to variation in prone position. Methods and materials: For 28 patients a planning CT (pCT) and five daily cone-beam-CT (CBCT) scans were acquired in supine position. The mesorectal part of the CTV (MesoRect) was delineated on all scans. The shape variation was quantified by the distance between the pCT- and the CBCT delineations and stored in surface maps after online setup correction. Data were analyzed for male and female patients separately and compared to prone data. Results: A large range of systematic, 1-8 mm (1SD), and random, 1-5 mm, shape variation was found, comparable to prone patients. Random-shape variation was comparable for male and female patients, while systematic variation was 3 mm larger for female patients. Conclusions: Shape variation of the MesoRect is substantial, heterogeneous and different between male and female patients. Differences between supine and prone orientation, however, are small. Clinical margins should be differentiated in position along the cranio-caudal axis, in anterior-posterior direction and for gender. Margins should also be increased, even when online setup correction is used. Due to the small margin differences between prone and supine treatments, the setup choice should be determined on dose to the organs at risk.

Measuring mobile patient safety information system success: an empirical study.

Science.gov (United States)

Jen, Wen-Yuan; Chao, Chia-Cheng

2008-10-01

The Health Risk Reminders and Surveillance (HRRS) system was designed to deliver critical abnormal test results of severely ill patients from Laboratory, Radiology, and Pathology departments to physicians within 5 min using cell phone text messages. This paper explores the success of the HRRS system. This study employed an augmented version of the DeLone and McLean IS success model. Seven variables (system quality, information quality, system use, user satisfaction, mobile healthcare anxiety, impact on the individual and impact on the organization) were used to evaluate the success of the HRRS system. The interrelationships between the seven variables were hypothesized and the hypotheses were empirically tested. The results indicate that the information quality of the HRRS system is positively associated with both system use and user satisfaction. In addition, system use is positively associated with user satisfaction, which is also positively associated with mobile healthcare anxiety. Moreover, results indicate that impact on the individual is positively associated with both user satisfaction and mobile healthcare anxiety. Finally, the impact of the organization is positively associated with impact on the individual. The results of the study provide an expanded understanding of the factors that contribute to mobile patient safety information system (IS) success. Implications of the relationship between system use and physician mobile healthcare anxiety are discussed.

[Paresthesia and spinal anesthesia for cesarean section: comparison of patient positioning].

Science.gov (United States)

Palacio Abizanda, F J; Reina, M A; Fornet, I; López, A; López López, M A; Morillas Sendín, P

2009-01-01

To determine the incidence of paresthesia during lumbar puncture performed with the patient in different positions. A single-blind prospective study of patients scheduled for elective cesarean section, randomized to 3 groups. In group 1 patients were seated in the direction of the long axis of the table, with heels resting on the table. In group 2 they were seated perpendicular to the long axis of the table, with legs hanging from the table. In group 3 they were in left lateral decubitus position. Lumbar punctures were performed with a 27-gauge Whitacre needle. One hundred sixty-eight patients (56 per group) were enrolled. Paresthesia occurred most often in group 3 (P = .009). We observed no differences in blood pressure after patients moved from decubitus position to the assigned position. Nor did we observe between-group differences in blood pressure according to position taken during puncture. Puncture undertaken with the patient seated, heels on the table and knees slightly bent, is associated with a lower incidence of paresthesia than puncture performed with the patient seated, legs hanging from the table. Placing the patient's heels on the table requires hip flexion and leads to anterior displacement of nerve roots in the dural sac. Such displacement would increase the nerve-free zone on the posterior side of the sac, thereby decreasing the likelihood of paresthesia during lumbar puncture. A left lateral decubitus position would increase the likelihood of paresthesia, possibly because the anesthetist may inadvertently not follow the medial line when inserting the needle.

The SSRL injector beam position monitoring systems

International Nuclear Information System (INIS)

Lavender, W.; Baird, S.; Brennan, S.; Borland, M.; Hettel, R.; Nuhn, H.D.; Ortiz, R.; Safranek, J.; Sebek, J.; Wermelskirchen, C.; Yang, J.

1991-01-01

The beam position monitoring system of the SSRL injector forms a vital component of its operation. Several different types of instrumentation are used to measure the position or intensity of the electron beam in the injector. These include current toroids, fluorescent screens, Faraday cups, the 'Q' meter, a synchrotron light monitor, and electron beam position monitors. This paper focuses on the use of the electron beam position monitors to measure electron trajectories in the injector transport lines and the booster ring. The design of the beam position monitors is described in another paper to be presented at this conference. There are three different beam position monitor systems in the injector. One system consists of a set of five BPMs located on the injection transport line from the linac to the booster (known as the LTB line). There is a second system of six BPMs located on the ejection transport line (known as the BTS line). Finally, there is an array of 40 BPMs installed on the main booster ring itself. This article describes the software and processing electronics of the systems used to measure electron beam trajectories for the new SSRL injector for SPEAR

Non-invasive ventilation in HIV positive patients with sepsis and ...

African Journals Online (AJOL)

Method: We conducted an observational prospective cohort study for the NIV arm (in the first half of 2016) with a retrospective chart review for the controls that focused on HIV positive patients with sepsis and hypoxaemic respiratory failure. 77 consecutive HIV positive patients with sepsis and respiratory distress meeting the ...

X-ray radiography equipment for patients in standing position

International Nuclear Information System (INIS)

Snijder, J.G.N.

1974-01-01

X-ray radiography equipment suited for patients in standing position is described. The patient's body centre of mass is indicated by its vertical projection line appearing on the X-ray image. To that end, an X-ray absorbing wire is positioned through the centre of mass by means of an electrical signal acting on a servomotor and derived from the pressure on three non-colinear points in the foot plate through an analogue computer

Why HIV Positive Patients on Antiretroviral Treatment and/or ...

African Journals Online (AJOL)

Why HIV Positive Patients on Antiretroviral Treatment and/or Cotrimoxazole Prophylaxis Use Traditional Medicine: Perceptions of Health Workers, Traditional Healers and Patients: A Study in Two Provinces of South Africa.

The Universal Patient Centredness Questionnaire: scaling approaches to reduce positive skew

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Bjertnaes O

2016-11-01

Full Text Available Oyvind Bjertnaes, Hilde Hestad Iversen, Andrew M Garratt Unit for Patient-Reported Quality, Norwegian Institute of Public Health, Oslo, Norway Purpose: Surveys of patients’ experiences typically show results that are indicative of positive experiences. Unbalanced response scales have reduced positive skew for responses to items within the Universal Patient Centeredness Questionnaire (UPC-Q. The objective of this study was to compare the unbalanced response scale with another unbalanced approach to scaling to assess whether the positive skew might be further reduced. Patients and methods: The UPC-Q was included in a patient experience survey conducted at the ward level at six hospitals in Norway in 2015. The postal survey included two reminders to nonrespondents. For patients in the first month of inclusion, UPC-Q items had standard scaling: poor, fairly good, good, very good, and excellent. For patients in the second month, the scaling was more positive: poor, good, very good, exceptionally good, and excellent. The effect of scaling on UPC-Q scores was tested with independent samples t-tests and multilevel linear regression analysis, the latter controlling for the hierarchical structure of data and known predictors of patient-reported experiences. Results: The response rate was 54.6% (n=4,970. Significantly lower scores were found for all items of the more positively worded scale: UPC-Q total score difference was 7.9 (P<0.001, on a scale from 0 to 100 where 100 is the best possible score. Differences between the four items of the UPC-Q ranged from 7.1 (P<0.001 to 10.4 (P<0.001. Multivariate multilevel regression analysis confirmed the difference between the response groups, after controlling for other background variables; UPC-Q total score difference estimate was 8.3 (P<0.001. Conclusion: The more positively worded scaling significantly lowered the mean scores, potentially increasing the sensitivity of the UPC-Q to identify differences over

Histological Features of Antiphospholipid Nephropathy in Patients with Systemic Lupus Erythematosus

International Nuclear Information System (INIS)

Naseeb, F.; Arfaj, A. A..; Hamdani, A.; Parvez, K.; Mogairen, S. A.; Kfoury, H.

2015-01-01

Objective:To determine the histological features of renal biopsies of Systemic Lupus Erythematosus (SLE) patients with and without antiphospholipid antibodies in Saudi population. Study Design: Cross-sectional, comparative study. Place and Duration of Study: King Khalid University Hospital, Riyadh, Saudi Arabia, from January to December 2013. Methodology: Consecutive SLE patients admitted to King Khalid University Hospital, Riyadh for renal biopsy for evaluation of proteinuria or deterioration of renal function were recruited. SLE patients with renal involvement were divided in two groups. Group one included patients with positive APS antibodies and group two included patients with negative APS antibodies. The histological features of renal biopsies of the two patients groups were compared. Data was analyzed using simple statistical analysis. Results: The mean age of APS antibodies-positive patients was 30.37 ± 10.714 years while mean age of APS negative patients was 33.62 ± 11.717 years (p=0.224). Twenty five (83.33 percentage) patients were females and 5 (16.67 percentage) patients were males in APS positive patients while 42 (89.36 percentage) were females and 5 (10.63 percentage) were males in group two. Acute lesions like thrombotic microangiopathy were in 2 (6.7 percentage) of APS positive patients while chronic lesions like focal cortical atrophy was found in 6 (20 percentage) and fibrous intimal hyperplasia was found in 9 (30 percentage). Other significant histological findings in APS antibodies positive group were glomerular basement membrane wrinkling in 12 (40 percentage), glomerular double wall contour in 17 (56.7 percentage), fibrous adhesions in 11 (36.7 percentage) patients with APS antibodies. Conclusion:Systemic Lupus Erythematosus (SLE) patients with positive APS antibodies has specific histological findings suggesting an important role of APS antibodies in the pathogenesis of APS nephropathy. (author)

Electromagnetic Tracking of Intrafraction Prostate Displacement in Patients Externally Immobilized in the Prone Position

International Nuclear Information System (INIS)

Bittner, Nathan; Butler, Wayne M.; Reed, Joshua L.; Murray, Brian C.; Kurko, Brian S.; Wallner, Kent E.; Merrick, Gregory S.

2010-01-01

Purpose: To evaluate intrafraction prostate displacement among patients immobilized in the prone position using real-time monitoring of implanted radiofrequency transponders. Methods and Materials: The Calypso localization system was used to track prostate motion in patients receiving external beam radiation therapy (XRT) for prostate cancer. All patients were treated in the prone position and immobilized with a thermoplastic immobilization device. Real-time measurement of prostate displacement was recorded for each treatment fraction. These measurements were used to determine the duration and magnitude of displacement along the three directional axes. Results: The calculated centroid of the implanted transponders was offset from the treatment isocenter by ≥2 mm, ≥3 mm, and ≥4 mm for 38.0%, 13.9%, and 4.5% of the time. In the lateral dimension, the centroid was offset from the treatment isocenter by ≥2 mm, ≥3 mm, and ≥4 mm for 2.7%, 0.4%, and 0.06% of the time. In the superior-inferior dimension, the centroid was offset from the treatment isocenter by ≥2 mm, ≥3 mm, and ≥4 mm for 16.1%, 4.7%, and 1.5% of the time, respectively. In the anterior-posterior dimension, the centroid was offset from the treatment isocenter by ≥2 mm, ≥3 mm, and ≥4 mm for 13.4%, 3.0%, and 0.5% of the time. Conclusions: Intrafraction prostate displacement in the prone position is comparable to that in the supine position. For patients with large girth, in whom the supine position may preclude accurate detection of implanted radiofrequency transponders, treatment in the prone position is a suitable alternative.

CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS

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Lona Jalini

2016-01-01

Full Text Available Background: Axillary lymph node status is the most important breast cancer prognostic factor. Preoperative axillary ultrasound examination (PAUS is used to triage patients for sentinel lymph node biopsy (SLNB or axillary lymph node dissection (ALND. We assessed the detection rate of lymph node metastases by PAUS in a screening unit and evaluated associations between clinicopathological factors and PAUS positivity. Patients and Methods: This was a single-centre retrospective analysis of data extracted from a hospital breast cancer database and clinical records. Clinical, radiological, and pathological and prognostic indices were compared between PAUS-positive and PAUS-negative patients subsequently found to have lymph node metastases on histopathological analysis. Results: Two hundred and two patients were eligible for analysis. 50.5% of lymph node-positive patients were correctly identified as PAUS positive. Patients with PAUS-positive lymph nodes had less favorable disease characteristics, namely clinically palpable lymph nodes, higher Nottingham prognostic (NPI index, high lymph node burden according to the European Society of Medical Oncology (ESMO group classification, and larger, grade 3 tumors with lymphovascular invasion and extranodal spread. Moreover, PAUS-positive patients had more macrometastases and lymph node involvement than PAUS-negative patients. Conclusion: PAUS-positive patients and PAUS-negative (SLNB-positive patients have different clinicopathological characteristics. The presence of LVI, extranodal spread, grade 3 histology, or large tumors with poor prognostic indices in PAUS-negative patients should be regarded with caution and perhaps prompt second-look ultrasound examination.

Global Positioning System Use in the Community to Evaluate Improvements in Walking After Revascularization

Science.gov (United States)

Gernigon, Marie; Le Faucheur, Alexis; Fradin, Dominique; Noury-Desvaux, Bénédicte; Landron, Cédric; Mahe, Guillaume; Abraham, Pierre

2015-01-01

Abstract Revascularization aims at improving walking ability in patients with arterial claudication. The highest measured distance between 2 stops (highest-MDCW), the average walking speed (average-WSCW), and the average stop duration (average-DSCW) can be measured by global positioning system, but their evolution after revascularization is unknown. We included 251 peripheral artery diseased patients with self-reported limiting claudication. The patients performed a 1-hour stroll, recorded by a global positioning system receiver. Patients (n = 172) with confirmed limitation (highest-MDCW the follow-up period were compared with reference patients (ie, with unchanged lifestyle medical or surgical status). Other patients (lost to follow-up or treatment change) were excluded (n = 89). We studied 44 revascularized and 39 reference patients. Changes in highest-MDCW (+442 vs. +13 m) and average-WSCW (+0.3 vs. −0.2 km h−1) were greater in revascularized than in reference patients (both P the groups. Among the revascularized patients, 13 (29.5%) had a change in average-WSCW, but not in highest-MDCW, greater than the mean + 1 standard deviation of the change observed for reference patients. Revascularization may improve highest-MDCW and/or average-WSCW. This first report of changes in community walking ability in revascularized patients suggests that, beyond measuring walking distances, average-WSCW measurement is essential to monitor these changes. Applicability to other surgical populations remains to be evaluated. Registration: http://www.clinicaltrials.gov/ct2/show/NCT01141361 PMID:25950694

Family correlates of depression among hiv positive patients ...

African Journals Online (AJOL)

Background information: HIV infection may impact negatively on family relationship and vice versa. Members of the family of HIV positive patients may become frustrated because of the stigma of having a family member with HIV infection, and the burden of having to care for the patient. This can result into the family ...

Positive Predictive Value of True Bacteremia according to the Number of Positive Culture Sets in Adult Patients.

Science.gov (United States)

Kitaura, Tsuyoshi; Chikumi, Hiroki; Fujiwara, Hiromitsu; Okada, Kensaku; Hayabuchi, Tatsuya; Nakamoto, Masaki; Takata, Miyako; Yamasaki, Akira; Igishi, Tadashi; Burioka, Naoto; Shimizu, Eiji

2014-12-01

Performing multiple blood culture sets simultaneously is a standard blood culture methodology, although it is often difficult to distinguish true bacteremia from contamination when only one of several blood culture sets is positive. This study clarified the relationship between the number of positive blood culture sets and clinical significance in patients with positive blood culture. Patients aged 18 years and over with at least 1 positive blood culture were enrolled. Positive blood culture episodes were categorized from clinical records as true bacteremia, contamination, or unknown clinical significance. The associations among episodes of true bacteremia, isolated bacteria, the number of positive blood culture sets from among the performed sets, and the clinical background of patients were analyzed. Among a total of 407 episodes, 262, 67 and 78 were true bacteremia, contamination and unknown clinical significance, respectively. The positive predictive values (PPVs) of 1 out of 1, 1 out of 2 and 2 out of 2 positive sets in cases of Staphylococcus aureus, were 81.3%, 50% and 100% respectively; those in cases of coagulase-negative Staphylococci were 20.5%, 10.8% and 63.5%, respectively. Almost all cases of Escherichia coli, Pseudomonas aeruginosa, Klebsiella species and Candida species were true bacteremia. The probability of true bacteremia was strongly associated with recent surgery in multivariate analysis (P sets from among the performed sets varies by microorganism. Therefore, PPVs calculated using this method may help physicians distinguish true bacteremia from contamination.

Delay in treatment seeking of smear positive tuberculous patients

International Nuclear Information System (INIS)

Bhatti, A.T.; Zahid, M.

2010-01-01

To assess and identify the causes and circumstances leading to delays in health seeking and diagnosis of tuberculosis patients as they often present with advance disease resulting in increased morbidity and mortality. Settings Department of Tuberculosis, DOTS clinic DHQ Hospital, Vehari. Methodology One (author) inspiration diagnosed smear positive pulmonary tuberculosis patients were included. Information was gathered through interviews and from TB-01 card. Results Maximum patients were in age group of 16-40 years. Median patient delay was 4-6 months; jobless, homeless personnel had longer delay. The main reason for delay was that the symptoms were not considered serious enough. Delay in presentation of smear positive cases may be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and awareness campaigns targeted at the population and involvement of private sector will improve TB control in Vehari. (author)

Comparison between Human Immunodeficiency Virus Positive and Negative Patients with Tuberculosis in Southern Brazil

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Lucélia Henn

1999-05-01

Full Text Available The objective of this study is to determine the different characteristics of human immunodeficiency virus (HIV positive and negative patients treated for tuberculosis (TBC in a tertiary hospital in Southern Brazil. We conducted a retrospective cohort study over a 5-year period, from January 1992 through December 1996. We reviewed medical charts of patients from our institution who received TBC treatment. We reviewed 167 medical charts of patients with confirmed TBC. HIV positivity was detected in 74 patients. There were statistically significant difference between HIV positive and negative patients in sex and age. HIV-infected patients showed significantly more signs of bacteremia than HIV-negative patients. Extra-pulmonary TBC was present respectively in 13 (17.6% and 21 (22.6% HIV positive and negative patients. There was a significant difference between chest radiograph presentation in HIV positive and negative patients. There were significantly lower hematocrit, hemoglobin, leukocyte and lymphocyte levels in HIV-positive compared to HIV-negative patients. Outcome was significantly different in the two groups with a death rate of 36.5% and 10.8% in HIV-positive and in HIV-negative patients. The difference between HIV positive and negative patients may have importance in the diagnosis, management and prognosis of patients with TBC.

Global positioning system use in the community to evaluate improvements in walking after revascularization: a prospective multicenter study with 6-month follow-up in patients with peripheral arterial disease.

Science.gov (United States)

Gernigon, Marie; Le Faucheur, Alexis; Fradin, Dominique; Noury-Desvaux, Bénédicte; Landron, Cédric; Mahe, Guillaume; Abraham, Pierre

2015-05-01

Revascularization aims at improving walking ability in patients with arterial claudication. The highest measured distance between 2 stops (highest-MDCW), the average walking speed (average-WSCW), and the average stop duration (average-DSCW) can be measured by global positioning system, but their evolution after revascularization is unknown.We included 251 peripheral artery diseased patients with self-reported limiting claudication. The patients performed a 1-hour stroll, recorded by a global positioning system receiver. Patients (n = 172) with confirmed limitation (highest-MDCW the follow-up period were compared with reference patients (ie, with unchanged lifestyle medical or surgical status). Other patients (lost to follow-up or treatment change) were excluded (n = 89).We studied 44 revascularized and 39 reference patients. Changes in highest-MDCW (+442 vs. +13 m) and average-WSCW (+0.3 vs. -0.2 km h) were greater in revascularized than in reference patients (both P the groups. Among the revascularized patients, 13 (29.5%) had a change in average-WSCW, but not in highest-MDCW, greater than the mean + 1 standard deviation of the change observed for reference patients.Revascularization may improve highest-MDCW and/or average-WSCW. This first report of changes in community walking ability in revascularized patients suggests that, beyond measuring walking distances, average-WSCW measurement is essential to monitor these changes. Applicability to other surgical populations remains to be evaluated. http://www.clinicaltrials.gov/ct2/show/NCT01141361.

Patient Position Verification and Corrective Evaluation Using Cone Beam Computed Tomography (CBCT) in Intensity modulated Radiation Therapy

International Nuclear Information System (INIS)

Do, Gyeong Min; Jeong, Deok Yang; Kim, Young Bum

2009-01-01

Cone beam computed tomography (CBCT) using an on board imager (OBI) can check the movement and setup error in patient position and target volume by comparing with the image of computer simulation treatment in real.time during patient treatment. Thus, this study purposed to check the change and movement of patient position and target volume using CBCT in IMRT and calculate difference from the treatment plan, and then to correct the position using an automated match system and to test the accuracy of position correction using an electronic portal imaging device (EPID) and examine the usefulness of CBCT in IMRT and the accuracy of the automatic match system. The subjects of this study were 3 head and neck patients and 1 pelvis patient sampled from IMRT patients treated in our hospital. In order to investigate the movement of treatment position and resultant displacement of irradiated volume, we took CBCT using OBI mounted on the linear accelerator. Before each IMRT treatment, we took CBCT and checked difference from the treatment plan by coordinate by comparing it with the image of CT simulation. Then, we made correction through the automatic match system of 3D/3D match to match the treatment plan, and verified and evaluated using electronic portal imaging device. When CBCT was compared with the image of CT simulation before treatment, the average difference by coordinate in the head and neck was 0.99 mm vertically, 1.14 mm longitudinally, 4.91 mm laterally, and 1.07 degrees in the rotational direction, showing somewhat insignificant differences by part. In testing after correction, when the image from the electronic portal imaging device was compared with DRR image, it was found that correction had been made accurately with error less than 0.5 mm. By comparing a CBCT image before treatment with a 3D image reconstructed into a volume instead of a 2D image for the patient's setup error and change in the position of the organs and the target, we could measure and

An image guidance system for positioning robotic cochlear implant insertion tools

Science.gov (United States)

Bruns, Trevor L.; Webster, Robert J.

2017-03-01

Cochlear implants must be inserted carefully to avoid damaging the delicate anatomical structures of the inner ear. This has motivated several approaches to improve the safety and efficacy of electrode array insertion by automating the process with specialized robotic or manual insertion tools. When such tools are used, they must be positioned at the entry point to the cochlea and aligned with the desired entry vector. This paper presents an image guidance system capable of accurately positioning a cochlear implant insertion tool. An optical tracking system localizes the insertion tool in physical space while a graphical user interface incorporates this with patient- specific anatomical data to provide error information to the surgeon in real-time. Guided by this interface, novice users successfully aligned the tool with an mean accuracy of 0.31 mm.

Triangulation positioning system network

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Sfendourakis Marios

2017-01-01

Full Text Available This paper presents ongoing work on localization and positioning through triangulation procedure for a Fixed Sensors Network - FSN.The FSN has to work as a system.As the triangulation problem becomes high complicated in a case with large numbers of sensors and transmitters, an adequate grid topology is needed in order to tackle the detection complexity.For that reason a Network grid topology is presented and areas that are problematic and need further analysis are analyzed.The Network System in order to deal with problems of saturation and False Triangulations - FTRNs will have to find adequate methods in every sub-area of the Area Of Interest - AOI.Also, concepts like Sensor blindness and overall Network blindness, are presented. All these concepts affect the Network detection rate and its performance and ought to be considered in a way that the network overall performance won’t be degraded.Network performance should be monitored contentiously, with right algorithms and methods.It is also shown that as the number of TRNs and FTRNs is increased Detection Complexity - DC is increased.It is hoped that with further research all the characteristics of a triangulation system network for positioning will be gained and the system will be able to perform autonomously with a high detection rate.

Augmentation of Quasi-Zenith Satellite Positioning System Using High Altitude Platforms Systems (HAPS)

Science.gov (United States)

Tsujii, Toshiaki; Harigae, Masatoshi

Recently, some feasibility studies on a regional positioning system using the quasi-zenith satellites and the geostationary satellites have been conducted in Japan. However, the geometry of this system seems to be unsatisfactory in terms of the positioning accuracy in north-south direction. In this paper, an augmented satellite positioning system by the High Altitude Platform Systems (HAPS) is proposed since the flexibility of the HAPS location is effective to improve the geometry of satellite positioning system. The improved positioning performance of the augmented system is also demonstrated.

The Impact of Systemic Lupus Erythematosus on the Clinical Phenotype of Antiphospholipid Antibody Positive Patients: Results from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository.

Science.gov (United States)

Unlu, Ozan; Erkan, Doruk; Barbhaiya, Medha; Andrade, Danieli; Nascimento, Iana; Rosa, Renata; Banzato, Alessandra; Pengo, Vittorio; Ugarte, Amaia; Gerosa, Maria; Ji, Lanlan; Efthymiou, Maria; Branch, D Ware; de Jesus, Guilherme Raires; Tincani, Angela; Belmont, H Michael; Fortin, Paul R; Petri, Michelle; Rodriguez, Esther; Pons-Estel, Guillermo J; Knight, Jason S; Atsumi, Tatsuya; Willis, Rohan; Zuily, Stephane; Tektonidou, Maria G

2018-04-18

Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist on the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with or without SLE. A secure web-based data capture system stores patient demographics, and aPL-related clinical and laboratory characteristics. Inclusion criteria include aPL positivity according to the Updated Sapporo Classification Criteria. Patients fulfilling the SLE Classification Criteria and those with no other autoimmune diseases were included in the analysis. 672 aPL-positive patients were recruited from 24 international centers; 426 were without other autoimmune diseases and 197 with SLE. The aPL with SLE group had higher rates of thrombocytopenia, hemolytic anemia, low complements, and IgA anti-β 2 glycoprotein-I antibodies (aβ₂GPI), whereas the aPL only group had higher rates of cognitive dysfunction and IgG aβ₂GPI. The frequency of arterial and venous thromboses (including recurrent) as well as the pregnancy morbidity were similar between the groups. The prevalence of cardiovascular disease risk factors at the registry entry did not differ between the two groups, except current smoking, which was more frequent in aPL with SLE group. Although the frequencies of thrombosis and pregnancy morbidity are similar between aPL-positive patients with or without SLE, the diagnosis of SLE in persistently aPL-positive patients is associated with an increased frequency of thrombocytopenia, hemolytic anemia, low complements, and IgA aβ₂GPI positivity. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A new system for the X-ray examination of casualties: easier, faster examnination without changing the patient's position by means of the Vertix 3 D

International Nuclear Information System (INIS)

Eisenscher, A.; Jaquemord, P.; Jeandeau, M.; Schweg-Toffler, E.; Murrmann, J.

1982-01-01

Due to the adjustment problems with the traditional overhead support, repeatedly the conventional radiation systems applied until today in emergency departments resulted to be disadvantageous. Another disadvantage is that the patient's position has often to be changed in order to photograph the individual sections to be examined. With a stirrup system attached to the overhead support and a patient table board with a thin plate vertically adjustable, these disadvantages can be eliminated. Since the system works with a fixed raster cassette with a high camera shaft ratio, a lighter constructional design and an easier operation without an impairment of image quality are rendered possible. This study describes the applicability of a new unit especially designed for emergency diagnostics, which is supplemented with a previously programmed generator, a table board with vertical adjustment and an exchangeable mobile sliding mattress. (orig.) [de

Treating depression in HIV-positive patients affects adherence

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M Y H Moosa

2012-08-01

Full Text Available Aim. To determine changes in adherence to antiretroviral therapy (ART in HIV-positive patients with depression, following treatment with an antidepressant or psychotherapy. Methods. The study was prospective, randomised and controlled. Consenting volunteers aged ≥18 years and stable on ART for ≥6 months were included in the study. Sociodemographic data were obtained, and a clinical diagnostic evaluation and the Hamilton Depression rating scale (HAMD were performed on all subjects at entry to and at the end of the study. Participants found to be depressed were randomly assigned antidepressant treatment (20 mg citalopram or interpersonal psychotherapy (IPT (5 sessions. Medication was dispensed at each visit and patients were asked to return all unused medication to determine ART adherence. The study was approved by the University of the Witwatersrand. Results. Sixty-two HIV-positive persons receiving ART participated; 30 were not depressed (control group and 32 were depressed (patient group. No significant differences in demographic characteristics existed between the control and patient groups. Mean ART adherence at the start of the study was 99.5% (standard error (SE ±0.46 and 92.1% (SE ±1.69 in the control and patients groups, respectively. Mean ART adherence at the end of the study changed marginally in the control group (99.7%; SE ±0.46 and increased significantly in the patient group (99.5%; SE± 0.13 (p>0.05. The mean ART adherence rate of patients who received pharmacotherapy increased from 92.8% to 99.5%, and of those who received psychotherapy increased from 91.1% to 99.6% (p>0.05. There was no significant association between the increased adherence in the patient group and baseline demographic and clinical characteristics, irrespective of antidepressant therapy or IPT (p>0.05. Conclusion. Successful treatment of depression with an antidepressant or psychotherapy was associated with improved ART adherence, independent of the type

Technical study of craniospinal irradiation in pediatric patients with patient position and field matching

Energy Technology Data Exchange (ETDEWEB)

Itoh, Masanori; Ise, Toshihide; Umezu, Mikio [Kangawa Children' s Medical Center, Yokohama (Japan); Hioki, Minoru

2000-05-01

Craniospinal irradiation (CSI) in leukemia and medulloblastoma patients is usually a three-field technique that involves parallel-opposed lateral cranial fields adjacent and orthogonal to a posterior spinal field. Since sedation is often necessary for pediatric patients, the supine position is more favorable than the prone position for respiratory monitoring. We practiced CSI in the supine position in one case of leukemia and three cases of medulloblastoma. Each location of the isocenter was determined by moving the couch to fit the center of the CSI on the basis of incisura intertragica. The angles of collimator rotation and couch rotation were calculated according to each treatment field size. The junction was also moved 2 cm day by day during the course of treatment so that over- and underdose at the junction would be prevented. The supine position did not allow us to visually confirm the proper junction between the lateral cranial fields and the spinal field. However, we succeeded in practicing complete conjunction between the fields by proper collimator and couch rotations on the assessment of the film-dose method. CSI in the supine position is naturally comfortable for pediatric patients and seems effective in pediatric treatments, which often require respiratory monitoring for sedation. (author)

Application of the NAVSTAR/GLOBAL positioning system on instrumented ranges

OpenAIRE

Reinhart, William L.

1981-01-01

Approved for public release; distribution is unlimited This report treats the application of the NAVSTAR/Global Positioning System as the Position/Location System in Real Time Casualty Assessment experiments. The desirable characteristics of a position/location system are listed. A current position/location system, the Range Measuring System, is used as a comparison reference for the Global Positioning System. Operation and parameters of the Global Positioning System are presented. A d...

Patient positioning and its influence on dose distribution

International Nuclear Information System (INIS)

Morrissey, J.; Moss, R.; Watkins, P.

2000-01-01

In comparison to conventional radiotherapy, the positioning of a patient for BNCT treatment has some unique aspects. In particular, the neutron beam coming from the core of a nuclear research reactor is fixed and horizontal. In particular, a head fixation mask, which is prepared at the patient referral hospital, is included in the CT images. The mask allows reproducible positioning for use during the treatment. Fiducial markers placed on the mask before imaging, provide reference points. The INEEL treatment planning code used in Petten produces a beam angle, and beam line entrance and exit co-ordinates. These are related to the fiducial marker co-ordinates. A spreadsheet, named COSINE, developed at Petten produces positioning co-ordinates from the data produced by the rtt MC code. These co-ordinates are related to a positioning frame, which allows the marking of the beams on the mask. In order to have reliable treatment data, the influence of small deviations of angle or target point on dose distribution must be known. To demonstrate this, a number of beams have been calculated with the Petten beam, with slight variations and compared with an approved plan. (author)

Using the prone position for ventilated patients with respiratory failure: a review.

Science.gov (United States)

Wright, Angie D; Flynn, Maria

2011-01-01

this review explored the evidence relating to prone positioning in ventilated patients diagnosed with respiratory failure, including acute lung injury (ALI) or adult respiratory distress syndrome (ARDS). mortality rates for ventilated patients with ALI or ARDS are high, and there is a growing body of evidence suggesting that the position these patients are nursed in may influence clinical outcomes. However, there are no guidelines to inform nursing practice in positioning these patients. Medline, Scopus, Cinahl and the Cochrane Library databases were searched for original research reports or systematic reviews of evidence between 2000 and 2009. Reference lists of retrieved papers were hand searched and included studies were analysed using the Critical Appraisal and Skills Programme framework. A narrative data synthesis considered the strengths and limitations of studies, and findings were collated and interpreted. Application of the search strategy identified a systematic review, currently underway, which has not yet reported and 14 relevant studies eligible for inclusion in this review. Analysis showed considerable variation in study design, but suggests that PaO(2) /FiO(2) ratio, incidence of VAP and mortality may be positively affected by prone positioning. evidence of the clinical benefits associated with prone positioning is inconclusive and provides little guidance for nursing practice. There is a need for further research into the clinical outcomes of prone positioning, and greater understanding of the practicalities of prone positioning critically ill patients is required. nurses have a central role to play in the continual assessment and management of this patient group, including the position they are nursed in, not only to ensure the best clinical outcomes but also to provide care and comfort to the patient and their family. It is therefore important that their nursing practice and interventions are informed by the best available evidence.

Predicting Likelihood of Having Four or More Positive Nodes in Patient With Sentinel Lymph Node-Positive Breast Cancer: A Nomogram Validation Study

International Nuclear Information System (INIS)

Unal, Bulent; Gur, Akif Serhat; Beriwal, Sushil; Tang Gong; Johnson, Ronald; Ahrendt, Gretchen; Bonaventura, Marguerite; Soran, Atilla

2009-01-01

Purpose: Katz suggested a nomogram for predicting having four or more positive nodes in sentinel lymph node (SLN)-positive breast cancer patients. The findings from this formula might influence adjuvant radiotherapy decisions. Our goal was to validate the accuracy of the Katz nomogram. Methods and Materials: We reviewed the records of 309 patients with breast cancer who had undergone completion axillary lymph node dissection. The factors associated with the likelihood of having four or more positive axillary nodes were evaluated in patients with one to three positive SLNs. The nomogram developed by Katz was applied to our data set. The area under the curve of the corresponding receiver operating characteristics curve was calculated for the nomogram. Results: Of the 309 patients, 80 (25.9%) had four or more positive axillary lymph nodes. On multivariate analysis, the number of positive SLNs (p < .0001), overall metastasis size (p = .019), primary tumor size (p = .0001), and extracapsular extension (p = .01) were significant factors predicting for four or more positive nodes. For patients with <5% probability, 90.3% had fewer than four positive nodes and 9.7% had four or more positive nodes. The negative predictive value was 91.7%, and sensitivity was 80%. The nomogram was accurate and discriminating (area under the curve, .801). Conclusion: The probability of four or more involved nodes is significantly greater in patients who have an increased number of positive SLNs, increased overall metastasis size, increased tumor size, and extracapsular extension. The Katz nomogram was validated in our patients. This nomogram will be helpful to clinicians making adjuvant treatment recommendations to their patients.

Side effects after myelography with Dimer Xsup(R) (Iocarmat) with subsequent positioning of the patients in the sitting or lying position

International Nuclear Information System (INIS)

Norstedt, M.

1982-01-01

92 patients were examined after lumbar myelography with the water-soluble contrast medium Iocarmat (Dimer Xsup(R)) in order to find out if side effects have any relation with the patient's position after the myelographic examination. In one group, the patients were laid with their upper part of the body positioned higher while the others were allowed to lie flat. The comparative investigation covering both groups of patients revealed the following results: 1) In 11% of the flat-lying patients there were generalised spasms which was not the case as far as the sitting patients were concerned. This is why the author advises against a flat positioning of the patient. 2) The frequency of headache decreased when the patients were lying flat which, however, does not mean a statistical significance. 3) Other side effects registered (myoclonus, tonic spasm in the legs, paraesthesia, increase in existing root pain and neck pain, nausea and vomiting) occurred in both groups nearly to the same extent, independently of the position of the patient. (orig./MG) [de

Context Aware Handover Algorithms For Mobile Positioning Systems

Directory of Open Access Journals (Sweden)

Sazid Z. Khan

2014-01-01

Full Text Available Abstract: This work proposes context aware handover algorithms for mobile positioning systems. The algorithms perform handover among positioning systems based on important contextual factors related to position determination with efficient use of battery. The proposed solution which consists of the algorithms is implemented in the form of an Android application named Locate@nav6. The performance of the proposed solution was tested in selected experimental areas. The handover performance was compared with other existing location applications. The proposed solution performed correct handover among positioning systems in 95% of cases studied while two other applications performed correct handover in only 50% of cases studied. Battery usage of the proposed solution is less than one third of the battery usage of two other applications. The analysis of the positioning error of the applications demonstrated that, the proposed solution is able to reduce positioning error indirectly by handing over the task of positioning to an appropriate positioning system. This kept the average error of positioning below 42.1 meters for Locate@nav6 while the average error for two other applications namely Google Latitude and Malaysia maps was between 92.7 and 171.13 meters.

Is there a positive bias in false recognition? Evidence from confabulating amnesia patients.

Science.gov (United States)

Alkathiri, Nura H; Morris, Robin G; Kopelman, Michael D

2015-10-01

Although there is some evidence for a positive emotional bias in the content of confabulations in brain damaged patients, findings have been inconsistent. The present study used the semantic-associates procedure to induce false recall and false recognition in order to examine whether a positive bias would be found in confabulating amnesic patients, relative to non-confabulating amnesic patients and healthy controls. Lists of positive, negative and neutral words were presented in order to induce false recall or false recognition of non-presented (but semantically associated) words. The latter were termed 'critical intrusions'. Thirteen confabulating amnesic patients, 13 non-confabulating amnesic patients and 13 healthy controls were investigated. Confabulating patients falsely recognised a higher proportion of positive (but unrelated) words, compared with non-confabulating patients and healthy controls. No differences were found for recall memory. Signal detection analysis, however, indicated that the positive bias for false recognition memory might reflect weaker memory in the confabulating amnesic group. This suggested that amnesia patients with weaker memory are more likely to confabulate and the content of these confabulations are more likely to be positive. Copyright © 2015 Elsevier Ltd. All rights reserved.

Diagnosis of pulmonary infection with Toxoplasma gondii in immunocompromised HIV-positive patients by real-time PCR

DEFF Research Database (Denmark)

Petersen, E.; Edvinsson, B.; Lundgren, Bettina

2006-01-01

. In positive samples, the genotype of the parasite was determined by sequence analysis of the GRA6 gene. Positive results were achieved for 2% (7/332) of the samples tested. Genotyping was possible in two samples and revealed GRA6 type II T. gondii. PCR for detecting T. gondii in BAL samples should...... be performed in all immunosuppressed HIV-positive patients with symptoms of a systemic infection of unknown etiology. Trimethoprim-sulfamethoxazole prophylaxis does not exclude concomitant infection with T. gondii....

Illness Representations of HIV Positive Patients Are Associated with Virologic Success.

Science.gov (United States)

Leone, Daniela; Borghi, Lidia; Lamiani, Giulia; Barlascini, Luca; Bini, Teresa; d'Arminio Monforte, Antonella; Vegni, Elena

2016-01-01

Introduction: It is important for HIV positive patients to be engaged in their care and be adherent to treatment in order to reduce disease progression and mortality. Studies found that illness representations influence adherence through the mediating role of coping behaviors. However, no study has ever tested if patient engagement to the visits mediate the relationship between illness perceptions and adherence. This study aimed to explore illness representations of HIV positive patients and test the hypothesis that illness representations predict adherence through the mediating role of a component of behavioral engagement. Methods: HIV-positive patients treated with highly active antiretroviral therapy (HAART) for at least one year and presenting to a check-up visit were eligible to participate in the study. Patients completed the Illness Perception Questionnaire-Revised. Behavioral engagement was measured based on the patients' clinical attendance to the check-up visits; adherence to HAART was measured by viral load. Undetectable viral load or HIV-RNA perception that the disease does not have serious consequences on patient's life and the prevalence of negative emotions toward HIV were associated with virologic success. On the contrary, the patient's perception that the disease has serious consequences on his/her life and the prevalence of positive emotions were associated with virologic failure. This model showed good fit indexes (CFI = 1; TLI = 1; RMSEA = 0.00; and WRMSR = 0.309). Discussion: Results do not support the mediating role of behavioral engagement in the relationship between illness representations and adherence. As perception of serious consequences coupled with positive emotions are directly associated with virologic failure, clinicians should take them into account to promote treatment adherence.

Real-time precision pedestrian navigation solution using Inertial Navigation System and Global Positioning System

OpenAIRE

Yong-Jin Yoon; King Ho Holden Li; Jiahe Steven Lee; Woo-Tae Park

2015-01-01

Global Positioning System and Inertial Navigation System can be used to determine position and velocity. A Global Positioning System module is able to accurately determine position without sensor drift, but its usage is limited in heavily urbanized environments and heavy vegetation. While high-cost tactical-grade Inertial Navigation System can determine position accurately, low-cost micro-electro-mechanical system Inertial Navigation System sensors are plagued by significant errors. Global Po...

1 nA beam position monitoring system

International Nuclear Information System (INIS)

Ursic, R.; Flood, R.; Piller, C.

1997-01-01

A system has been developed at Jefferson Lab for measuring transverse position of very low current beams delivered to the Experimental Hall B of the Continuous Electron Beam Accelerator Facility (CEBAF). At the heart of the system is a position sensitive cavity operating at 1497 MHz. The cavity utilizes a unique design which achieves a high sensitivity to beam position at a relatively low cavity Q. The cavity output RF signal is processed using a down-converter and a commercial lock-in amplifier operating at 100 kHz. The system interfaces with a VME based EPICS control system using the IEEE, 488 bus. The main features of the system are simple and robust design, and wide dynamic range capable of handling beam currents from 1 nA to 1000 nA with an expected resolution better than 100 μm. This paper outlines the design of the system

Mortality impact of positive blood cultures in patients with suspected community-acquired bacteraemia. A Danish population-based cohort study

DEFF Research Database (Denmark)

Søgaard, Mette; Nørgaard, Mette; Sørensen, Henrik Toft

2009-01-01

for age, gender, coexisting chronic diseases, marital status, use of immunosuppressives, and calendar period. Further, we conducted analyses restricted to patients a discharge diagnose of infectious diseases (ICD-10 codes A00-B99). Results: In total, 1,665 (8.2%) patients had positive blood culture...... System. We computed Kaplan-Meier curves and product limit estimates for the main study variables. Next, time-dependent Cox regression analyses was used to compare the risk of death in patients with positive blood cultures and patients with negative cultures at days 0-7, 8-30, and 31-180, controlling...

Reversible Thrombocytopenia after Gabapentin in an HIV-Positive Patient

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Mohammed Basith

2018-01-01

Full Text Available Gabapentin has become increasingly used in psychiatric practice specifically for anxiety disorders. Even though gabapentin is not approved by the US Food and Drug Administration to treat anxiety, physicians sometimes use it as an alternative to benzodiazepines in patients with a history of substance abuse. Gabapentin is also prescribed when individuals are at risk of thrombocytopenia which is not considered a side effect. Among patients at risk of thrombocytopenia are those positive for human immunodeficiency virus (HIV. Here we present a case of an HIV-positive man who presented for inpatient psychiatric care with severe anxiety and a history of alcohol and benzodiazepine abuse. In this patient, gabapentin worsened thrombocytopenia after repeated exposure to this medication. We suggest caution when considering gabapentin for patients with preexisting low platelet counts, as there seems to be a risk for worsening thrombocytopenia with this antiepileptic in the presence of HIV infection.

Prevalence of positive ppd in a cohort of rheumatoid arthritis patients.

Science.gov (United States)

Tamborenea, Maria Natalia; Tate, Guillermo; Mysler, Eduardo; Debonis, Jose; Schijedman, Adrian

2010-03-01

The main objective of this study is to determine the prevalence of positive and anergic tuberculin skin test (ppd) in a rheumatoid arthritis cohort of patients (RA) and assess the association among ppd results and clinical and treatment variables. Patients with RA diagnosis were included. The ppd was done by Mantoux method. Positive result was considered when indurations were equal or greater than 5 mm. Anergic reaction was defined when the indurations was 0 mm. We included 105 patients (N = 105). The prevalence of positive ppd was 12.4% (n = 13), while the 87.6% (n = 92) presented a negative result. The 69.5% (n = 73) of the population were anergic to ppd. Patients with negative result received higher steroids dosages than patients with positive ppd (p ppd (p = 0.021, OR 0.72, 95% CI 0.55-0.95). Anergic and non-anergic patients were separated in groups, and a new analysis was done. The higher dosage of methotrexate was associated to tuberculine anergy (p = 0.025). In the multivariable model, the methotrexate dosage was a significant and independent predictor of tuberculine anergy (p = 0.005, OR 1.14, 95% CIs 1.04-1.24). In conclusion, in our cohort, the prevalence of positive ppd was lower than others studies. Among analyzed variables, the high steroid dose was a significant and independent predictor of negative ppd. The methotrexate treatment and dose were associated with ppd anergy.

Beam Position and Phase Monitor - Wire Mapping System

International Nuclear Information System (INIS)

Watkins, Heath A.; Shurter, Robert B.; Gilpatrick, John D.; Kutac, Vincent G.; Martinez, Derwin

2012-01-01

The Los Alamos Neutron Science Center (LANSCE) deploys many cylindrical beam position and phase monitors (BPPM) throughout the linac to measure the beam central position, phase and bunched-beam current. Each monitor is calibrated and qualified prior to installation to insure it meets LANSCE requirements. The BPPM wire mapping system is used to map the BPPM electrode offset, sensitivity and higher order coefficients. This system uses a three-axis motion table to position the wire antenna structure within the cavity, simulating the beam excitation of a BPPM at a fundamental frequency of 201.25 MHz. RF signal strength is measured and recorded for the four electrodes as the antenna position is updated. An effort is underway to extend the systems service to the LANSCE facility by replacing obsolete electronic hardware and taking advantage of software enhancements. This paper describes the upgraded wire positioning system's new hardware and software capabilities including its revised antenna structure, motion control interface, RF measurement equipment and Labview software upgrades. The main purpose of the wire mapping system at LANSCE is to characterize the amplitude response versus beam central position of BPPMs before they are installed in the beam line. The wire mapping system is able to simulate a beam using a thin wire and measure the signal response as the wire position is varied within the BPPM aperture.

Communication-based positioning systems: past, present and prospects

International Nuclear Information System (INIS)

Ma Guanyi; Wan Qingtao; Gan Tong

2012-01-01

This paper reviews positioning systems in the context of communication systems. First, the basic positioning technique is described for location based service (LBS) in mobile communication systems. Then the high integrity global positioning system (iGPS) is introduced in terms of aspects of what it is and how the low Earth orbit (LEO) Iridium telecommunication satellites enhance the global positioning system (GPS). Emphasis is on the Chinese Area Positioning System (CAPS) which is mainly based on commercial geostationary (GEO) communication satellites, including decommissioned GEO and inclined geosynchronous communication satellites. Characterized by its low cost, high flexibility, wide-area coverage and ample frequency resources, a distinctive feature of CAPS is that its navigation messages are generated on the ground, then uploaded to and forwarded by the communication satellites. Fundamental principles and key technologies applied in the construction of CAPS are presented in detail from the CAPS validation phase to its experimental system setup. A prospective view of CAPS has concluded it to be a seamless, high accuracy, large capacity navigation and communication system which can be achieved by expanding it world wide and enhancing it with LEO satellites and mobile base stations. Hence, this system is a potential candidate for the next generation of radio navigation after GPS. (invited reviews)

INTRACRANIAL MASS LESIONS IN HIV-POSITIVE PATIENTS ...

African Journals Online (AJOL)

'encephalitis of obscure origin', brain abscess and tuberculoma / mycobacterial ... Studies of IML in HN-positive patients emanate primarily from the ... Fig. 3. Mass on this CT scan found to be due to toxoplasmosis. Table H. Histological findings in the operated cases. Total biopsied/operated. 38'. Diagnosis. 0. Toxoplasmosis.

An Autonomous Distributed Fault-Tolerant Local Positioning System

Science.gov (United States)

Malekpour, Mahyar R.

2017-01-01

We describe a fault-tolerant, GPS-independent (Global Positioning System) distributed autonomous positioning system for static/mobile objects and present solutions for providing highly-accurate geo-location data for the static/mobile objects in dynamic environments. The reliability and accuracy of a positioning system fundamentally depends on two factors; its timeliness in broadcasting signals and the knowledge of its geometry, i.e., locations and distances of the beacons. Existing distributed positioning systems either synchronize to a common external source like GPS or establish their own time synchrony using a scheme similar to a master-slave by designating a particular beacon as the master and other beacons synchronize to it, resulting in a single point of failure. Another drawback of existing positioning systems is their lack of addressing various fault manifestations, in particular, communication link failures, which, as in wireless networks, are increasingly dominating the process failures and are typically transient and mobile, in the sense that they typically affect different messages to/from different processes over time.

The relationship between skin manifestations and CD4 counts among hiv positive patients

International Nuclear Information System (INIS)

Rad, F.; Ghaderi, E.; Moradi, G.; Mafakheri, L.

2008-01-01

Skin manifestations are common clinical features among HIV positive patients. The aim of this study was to document skin manifestations and their relationships with CD4 cell counts among HIV positive patients in Sanandaj. This was a descriptive study. The patients were examined for skin disorders by a dermatologist and CD4 counts were obtained from the patient's medical records. Independent samples T test were used for data analysis. In this study 66 (94.3%) patients had at least one skin problem. Fungal infections were the most common cause. The eight most common types of mucocutaneous problems were gingivitis, pallor, itching, photosensitivity, seborrheic dermatitis, candidiasis, folliculitis and tinea versicolor. The most common manifestation was gingivitis. Mean CD4 cell counts were lower in individuals with viral and bacterial skin diseases (P <0.05). The results of this study indicated that skin problems were common among HIV positive patients. Patients with advanced stages of skin disorders had relatively lower CD4 counts. Therefore examination of skin is recommended for all HIV positive patients for early detection of skin disorders, as early diagnosis and management of dermatologic problems will improve the quality of life in HIV positive patients. (author)

Robust Position Control of Electro-mechanical Systems

OpenAIRE

Rong Mei; Mou Chen

2013-01-01

In this work, the robust position control scheme is proposed for the electro-mechanical system using the disturbance observer and backstepping control method. To the external unknown load of the electro-mechanical system, the nonlinear disturbance observer is given to estimate the external unknown load. Combining the output of the developed nonlinear disturbance observer with backstepping technology, the robust position control scheme is proposed for the electro-mechanical system. The stabili...

False positive seroreactivity to brucellosis in tuberculosis patients: a prevalence study

Directory of Open Access Journals (Sweden)

Mojtaba Varshochi

2011-03-01

Full Text Available Mojtaba Varshochi1,2, Jafar Majidi2, Marjan Amini1, Kamyar Ghabili3, Mohammadali M Shoja31Department of Infectious Disease, Tabriz University of Medical Sciences, Tabriz, Iran; 2Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: The rising worldwide incidence of tuberculosis (TB increases the demand for knowledge about its potential seroreactivity with other microbial agents. A few reports and the authors’ experiences indicate that tuberculosis may result in a false-positive brucellosis serology. This may cause a diagnostic challenge because of the close clinical resemblance of these two infections.Objective: The aim of the present prevalence study was to elucidate brucellosis seroreactivity in patients with active TB.Methods: Ninety-eight patients with newly diagnosed and active TB were studied using an enzyme-linked immunosorbent assay (ELISA and Wright’s and Coombs–Wright’s tests. Seventy-five healthy individuals were used as controls. The patients showed signs of recovery after starting a standard anti-TB regimen and had no clinical evidence of brucellosis at a subsequent 6-month follow-up. The data were analyzed statistically by Fisher’s exact test using SPSS 11.0.Results: We found that 9.2% of TB patients versus 1.3% of healthy controls had positive results on the anti-Brucella IgG ELISA (P = 0.04. Five TB patients were found to have agglutination on Wright’s tests, while none of the controls showed agglutination.Conclusion: Active TB patients may have some seroreactivity with Brucella antigens, and Brucella IgG ELISA may give a false positive in these patients. Clinicians should consider false positive brucellosis seroreactivity in patients with active TB.Keywords: false positive serology, ELISA, diagnosis

Pregnancy in HIV-Positive Patients: Effects on Vaginal Flora

Directory of Open Access Journals (Sweden)

Cristina Vallone

2012-01-01

Full Text Available A high proportion of HIV-infected pregnant women present pathogenic organisms in their lower genital tract. This has been associated with the development of postpartum morbility, HIV transmission to the partner and offspring, and other gynaecological conditions, such as cervical dysplasia or cancer. Vaginal flora alterations can range from 47% in Western countries to 89% in Africa in pregnant HIV-positive patients, much higher than about 20% of the general population. Pathogen organism retrieval is high. As peripartum complications due to vaginal infections seem higher in HIV-positive patients, accurate investigation and treatment of such infections are strongly mandatory.

[Medical errors from positions of mutual relations of patient-lawyer-doctor].

Science.gov (United States)

Radysh, Ia F; Tsema, Ie V; Mehed', V P

2013-01-01

The basic theoretical and practical aspects of problem of malpractice in the system of health protection Ukraine are presented in the article. On specific examples the essence of the term "malpractice" is expounded. It was considered types of malpractice, conditions of beginning and kinds of responsibility to assumption of malpractice. The special attention to the legal and mental and ethical questions of problem from positions of protection of rights for a patient and medical worker is spared. The necessity of qualification malpractices on intentional and unintentional, possible and impermissible is grounded.

A New Indoor Positioning System Architecture Using GPS Signals.

Science.gov (United States)

Xu, Rui; Chen, Wu; Xu, Ying; Ji, Shengyue

2015-04-29

The pseudolite system is a good alternative for indoor positioning systems due to its large coverage area and accurate positioning solution. However, for common Global Positioning System (GPS) receivers, the pseudolite system requires some modifications of the user terminals. To solve the problem, this paper proposes a new pseudolite-based indoor positioning system architecture. The main idea is to receive real-world GPS signals, repeat each satellite signal and transmit those using indoor transmitting antennas. The transmitted GPS-like signal can be processed (signal acquisition and tracking, navigation data decoding) by the general receiver and thus no hardware-level modification on the receiver is required. In addition, all Tx can be synchronized with each other since one single clock is used in Rx/Tx. The proposed system is simulated using a software GPS receiver. The simulation results show the indoor positioning system is able to provide high accurate horizontal positioning in both static and dynamic situations.

Breast Gangrene in an HIV-Positive Patient

Science.gov (United States)

Venkatramani, V; Pillai, S; Marathe, S; Rege, SA; Hardikar, JV

2009-01-01

Introduction Breast gangrene has been reported as a complication following puerperal sepsis, breast surgery, nipple piercings, warfarin toxicity, etc. We report a case of primary breast gangrene in an HIV-positive individual which, to the best of our knowledge, is the first of its kind. Case report A 40-year-old previously healthy woman presented with fulminating left breast gangrene. She was detected to be HIV positive. Mastectomy was performed. The detailed management of the condition is discussed. Conclusion Severe necrotising infections may be initial manifestations of HIV infection and patients with such infections should be screened for HIV. PMID:19622255

Advanced Pedestrian Positioning System to Smartphones and Smartwatches

Directory of Open Access Journals (Sweden)

Alejandro Correa

2016-11-01

Full Text Available In recent years, there has been an increasing interest in the development of pedestrian navigation systems for satellite-denied scenarios. The popularization of smartphones and smartwatches is an interesting opportunity for reducing the infrastructure cost of the positioning systems. Nowadays, smartphones include inertial sensors that can be used in pedestrian dead-reckoning (PDR algorithms for the estimation of the user’s position. Both smartphones and smartwatches include WiFi capabilities allowing the computation of the received signal strength (RSS. We develop a new method for the combination of RSS measurements from two different receivers using a Gaussian mixture model. We also analyze the implication of using a WiFi network designed for communication purposes in an indoor positioning system when the designer cannot control the network configuration. In this work, we design a hybrid positioning system that combines inertial measurements, from low-cost inertial sensors embedded in a smartphone, with RSS measurements through an extended Kalman filter. The system has been validated in a real scenario, and results show that our system improves the positioning accuracy of the PDR system thanks to the use of two WiFi receivers. The designed system obtains an accuracy up to 1.4 m in a scenario of 6000 m 2 .

Automatic multi-camera calibration for deployable positioning systems

Science.gov (United States)

Axelsson, Maria; Karlsson, Mikael; Rudner, Staffan

2012-06-01

Surveillance with automated positioning and tracking of subjects and vehicles in 3D is desired in many defence and security applications. Camera systems with stereo or multiple cameras are often used for 3D positioning. In such systems, accurate camera calibration is needed to obtain a reliable 3D position estimate. There is also a need for automated camera calibration to facilitate fast deployment of semi-mobile multi-camera 3D positioning systems. In this paper we investigate a method for automatic calibration of the extrinsic camera parameters (relative camera pose and orientation) of a multi-camera positioning system. It is based on estimation of the essential matrix between each camera pair using the 5-point method for intrinsically calibrated cameras. The method is compared to a manual calibration method using real HD video data from a field trial with a multicamera positioning system. The method is also evaluated on simulated data from a stereo camera model. The results show that the reprojection error of the automated camera calibration method is close to or smaller than the error for the manual calibration method and that the automated calibration method can replace the manual calibration.

Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients

Science.gov (United States)

Tam, Laura; Garvey, Gail; Meiklejohn, Judith; Martin, Jennifer; Adams, Jon; Walpole, Euan; Fay, Michael; Valery, Patricia

2018-01-01

Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. PMID:29342934

Ocular vestibular evoked myogenic potential in patients with benign paroxysmal positional vertigo

Directory of Open Access Journals (Sweden)

Mozhgan Masoom

2014-06-01

Full Text Available Background and Aim: Since utricle is the main damaged organ in benign paroxysmal positional vertigo (BPPV, ocular vestibular evoked myogenic potential (oVEMP may be an appropriate method to evaluate the utricule dysfunction and the effect of disease recurrence rate on it. This study aimed to record myogenic potential in patients with benign paroxysmal positional vertigo.Methods: In a cross-sectional study, ocular myogenic potential was recorded in 25 healthy subjects and 20 patients with benign paroxysmal positional vertigo using 500 Hz-tone bursts (95 dB nHL.Results: In the affected ear, mean amplitude was lower and mean threshold was higher than those in the unaffected ear and in the normal group (p<0.05. Mean amplitude asymmetry ratio of patients was more than the healthy subjects (p0.05. Frequencies of abnormal responses in the affected ears were higher than in unaffected ears and in the normal group (p<0.05. Furthermore, the patients with recurrent vertigo showed more abnormalities than the patients with non-recurrent (p=0.030.Conclusion: In the recurrent benign paroxysmal positional vertigo, ocular vestibular evoked myogenic potential showed more damage in the utricle, suggesting this response could be used to evaluate the patients with benign paroxysmal positional vertigo.

Positive real balancing for nonlinear systems

NARCIS (Netherlands)

Ionescu, Tudor C.; Scherpen, Jacquelien M.A.; Ciuprina, G; Ioan, D

2007-01-01

We extend the positive real balancing procedure for passive linear systems to the nonlinear systems case. We show that, just like in the linear case, model reduction based on this technique preserves passivity.

SU-E-J-21: Setup Variability of Colorectal Cancer Patients Treated in the Prone Position and Dosimetric Comparison with the Supine Position

Energy Technology Data Exchange (ETDEWEB)

Kim, A; Foster, J; Chu, W; Karotki, A [Sunnybrook Health Sciences Centre/Odette Cancer Centre, Toronto, Ontario (Canada)

2015-06-15

Purpose: Many cancer centers treat colorectal patients in the prone position on a belly board to minimize dose to the small bowel. That may potentially Result in patient setup instability with corresponding impact on dose delivery accuracy for highly conformal techniques such as IMRT/VMAT. Two aims of this work are 1) to investigate setup accuracy of rectum patients treated in the prone position on a belly board using CBCT and 2) to evaluate dosimetric impact on bladder and small bowel of treating rectum patients in supine vs. prone position. Methods: For the setup accuracy study, 10 patients were selected. Weekly CBCTs were acquired and matched to bone. The CBCT-determined shifts were recorded. For the dosimetric study, 7 prone-setup patients and 7 supine-setup patients were randomly selected from our clinical database. Various clinically relevant dose volume histogram values were recorded for the small bowel and bladder. Results: The CBCT-determined rotational shifts had a wide variation. For the dataset acquired at the time of this writing, the ranges of rotational setup errors for pitch, roll, and yaw were [−3.6° 4.7°], [−4.3° 3.2°], and [−1.4° 1.4°]. For the dosimetric study: the small bowel V(45Gy) and mean dose for the prone position was 5.6±12.1% and 18.4±6.2Gy (ranges indicate standard deviations); for the supine position the corresponding dose values were 12.9±15.8% and 24.7±8.8Gy. For the bladder, the V(30Gy) and mean dose for prone position were 68.7±12.7% and 38.4±3.3Gy; for supine position these dose values were 77.1±13.7% and 40.7±3.1Gy. Conclusion: There is evidence of significant rotational instability in the prone position. The OAR dosimetry study indicates that there are some patients that may still benefit from the prone position, though many patients can be safely treated supine.

Magnetic resonance angiography for patients with positional vertigo

Energy Technology Data Exchange (ETDEWEB)

Seo, Toru; Tominaga, Satoru; Fujiki, Hiroya (Takarazuka City Hospital, Hyogo (Japan)); Kumoi, Takeo

1993-11-01

Magnetic resonance angiography (MRA) can image the blood vessels without invasion. Using MRA, we studied the vascular morphology of the vertebral artery in patients with positional nystagmus and vertigo. Fifteen patients without vestibular disorder such as benign positional vertigo were examined. Six cases underwent conventional vertebral angiography, including digital subtraction angiography (DSA) for comparison with MRA. In all cases. we observed the vertebral artery from the bifurcation to the basilar artery with MRA. In 12 cases, abnormal findings of elongation, bending, narrowing or obstruction of the vertebral artery were found. In five cases, arterial compression and elongation increased in association with head rotation. A difference in the vessel diameter on each side was observed in 4 cases. Accordingly, some abnormal vessels were found in 14 of 15 cases in our study. This rate was very close to previous results obtained with conventional angiography. In two cases, MRA findings differed from conventional angiography due to peculiar artifacts of MRA. Therefore, MRA may be the first choice for the patients with vertigo, followed by conventional angiography, if necessary. (author).

Magnetic resonance angiography for patients with positional vertigo

International Nuclear Information System (INIS)

Seo, Toru; Tominaga, Satoru; Fujiki, Hiroya; Kumoi, Takeo.

1993-01-01

Magnetic resonance angiography (MRA) can image the blood vessels without invasion. Using MRA, we studied the vascular morphology of the vertebral artery in patients with positional nystagmus and vertigo. Fifteen patients without vestibular disorder such as benign positional vertigo were examined. Six cases underwent conventional vertebral angiography, including digital subtraction angiography (DSA) for comparison with MRA. In all cases. we observed the vertebral artery from the bifurcation to the basilar artery with MRA. In 12 cases, abnormal findings of elongation, bending, narrowing or obstruction of the vertebral artery were found. In five cases, arterial compression and elongation increased in association with head rotation. A difference in the vessel diameter on each side was observed in 4 cases. Accordingly, some abnormal vessels were found in 14 of 15 cases in our study. This rate was very close to previous results obtained with conventional angiography. In two cases, MRA findings differed from conventional angiography due to peculiar artifacts of MRA. Therefore, MRA may be the first choice for the patients with vertigo, followed by conventional angiography, if necessary. (author)

Stabilization of discrete-time LTI positive systems

Directory of Open Access Journals (Sweden)

Krokavec Dušan

2017-12-01

Full Text Available The paper mitigates the existing conditions reported in the previous literature for control design of discrete-time linear positive systems. Incorporating an associated structure of linear matrix inequalities, combined with the Lyapunov inequality guaranteing asymptotic stability of discrete-time positive system structures, new conditions are presented with which the state-feedback controllers and the system state observers can be designed. Associated solutions of the proposed design conditions are illustrated by numerical illustrative examples.

Optimation of patient positioning and irradiation field documentation when irradiating in oto-rhino-laryngological area

International Nuclear Information System (INIS)

Proske, H.

1992-01-01

The large mobility of head and neck requires, when irradiating in this area, positioning and fastening aids, which go beyond simple head bolsters or head moulds. This paper presented describes a positioning system developed by us for irradiating the neck-nose-throat area, which, due to its construction, consists of a non-slipping positioning ground plate and an individually adjustable masking system, which is physiological safe, can be proceeded quickly and exactly, is relatively inexpensive, and is accepted by patients without objections, furthermore since skin markings by drawing field limits onto the face mask are no longer necessary. Various technical aids allow the placement of satellites to spare those body parts which are not irradiated and to installed compensators for the direction of radiation. An integrated cartridge mount enables in a simple way easy production of field control documentation photos. (orig.) [de

Stereotactic Radiation Therapy can Safely and Durably Control Sites of Extra-Central Nervous System Oligoprogressive Disease in Anaplastic Lymphoma Kinase-Positive Lung Cancer Patients Receiving Crizotinib

Energy Technology Data Exchange (ETDEWEB)

Gan, Gregory N., E-mail: gregory.gan@ucdenver.edu [Department of Radiation Oncology, University of Colorado, Aurora, Colorado (United States); Weickhardt, Andrew J.; Scheier, Benjamin; Doebele, Robert C. [Department of Medical Oncology, University of Colorado, Aurora, Colorado (United States); Gaspar, Laurie E.; Kavanagh, Brian D. [Department of Radiation Oncology, University of Colorado, Aurora, Colorado (United States); Camidge, D. Ross [Department of Medical Oncology, University of Colorado, Aurora, Colorado (United States)

2014-03-15

Purpose: To analyze the durability and toxicity of radiotherapeutic local ablative therapy (LAT) applied to extra-central nervous system (eCNS) disease progression in anaplastic lymphoma kinase-positive non-small cell lung cancer (NSCLC) patients. Methods and Materials: Anaplastic lymphoma kinase-positive NSCLC patients receiving crizotinib and manifesting ≤4 discrete sites of eCNS progression were classified as having oligoprogressive disease (OPD). If subsequent progression met OPD criteria, additional courses of LAT were considered. Crizotinib was continued until eCNS progression was beyond OPD criteria or otherwise not suitable for further LAT. Results: Of 38 patients, 33 progressed while taking crizotinib. Of these, 14 had eCNS progression meeting OPD criteria suitable for radiotherapeutic LAT. Patients with eCNS OPD received 1-3 courses of LAT with radiation therapy. The 6- and 12-month actuarial local lesion control rates with radiation therapy were 100% and 86%, respectively. The 12-month local lesion control rate with single-fraction equivalent dose >25 Gy versus ≤25 Gy was 100% versus 60% (P=.01). No acute or late grade >2 radiation therapy-related toxicities were observed. Median overall time taking crizotinib among those treated with LAT versus those who progressed but were not suitable for LAT was 28 versus 10.1 months, respectively. Patients continuing to take crizotinib for >12 months versus ≤12 months had a 2-year overall survival rate of 72% versus 12%, respectively (P<.0001). Conclusions: Local ablative therapy safely and durably eradicated sites of individual lesion progression in anaplastic lymphoma kinase-positive NSCLC patients receiving crizotinib. A dose–response relationship for local lesion control was observed. The suppression of OPD by LAT in patients taking crizotinib allowed an extended duration of exposure to crizotinib, which was associated with longer overall survival.

Indoor Positioning System Using Depth Maps and Wireless Networks

Directory of Open Access Journals (Sweden)

Jaime Duque Domingo

2016-01-01

Full Text Available This work presents a new Indoor Positioning System (IPS based on the combination of WiFi Positioning System (WPS and depth maps, for estimating the location of people. The combination of both technologies improves the efficiency of existing methods, based uniquely on wireless positioning techniques. While other positioning systems force users to wear special devices, the system proposed in this paper just requires the use of smartphones, besides the installation of RGB-D sensors in the sensing area. Furthermore, the system is not intrusive, being not necessary to know people’s identity. The paper exposes the method developed for putting together and exploiting both types of sensory information with positioning purposes: the measurements of the level of the signal received from different access points (APs of the wireless network and the depth maps provided by the RGB-D cameras. The obtained results show a significant improvement in terms of positioning with respect to common WiFi-based systems.

17 Smear positive pulmonary tuberculosis among HIV patients ...

African Journals Online (AJOL)

conducted in February 2009 to assess the effect of the level of CD4 lymphocyte ... development of smear positive pulmonary TB (PTB) among HIV patients before ..... (2000) Impact of combination antiretroviral therapy on the risk of tuberculosis.

Evaluation of positioning errors of the patient using cone beam CT megavoltage

International Nuclear Information System (INIS)

Garcia Ruiz-Zorrilla, J.; Fernandez Leton, J. P.; Zucca Aparicio, D.; Perez Moreno, J. M.; Minambres Moro, A.

2013-01-01

Image-guided radiation therapy allows you to assess and fix the positioning of the patient in the treatment unit, thus reducing the uncertainties due to the positioning of the patient. This work assesses errors systematic and errors of randomness from the corrections made to a series of patients of different diseases through a protocol off line of cone beam CT (CBCT) megavoltage. (Author)

The influence of patient positioning uncertainties in proton radiotherapy on proton range and dose distributions

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Liebl, Jakob, E-mail: jakob.liebl@medaustron.at [EBG MedAustron GmbH, 2700 Wiener Neustadt (Austria); Francis H. Burr Proton Therapy Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States); Department of Therapeutic Radiology and Oncology, Medical University of Graz, 8036 Graz (Austria); Paganetti, Harald; Zhu, Mingyao; Winey, Brian A. [Francis H. Burr Proton Therapy Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States)

2014-09-15

Purpose: Proton radiotherapy allows radiation treatment delivery with high dose gradients. The nature of such dose distributions increases the influence of patient positioning uncertainties on their fidelity when compared to photon radiotherapy. The present work quantitatively analyzes the influence of setup uncertainties on proton range and dose distributions. Methods: Thirty-eight clinical passive scattering treatment fields for small lesions in the head were studied. Dose distributions for shifted and rotated patient positions were Monte Carlo-simulated. Proton range uncertainties at the 50%- and 90%-dose falloff position were calculated considering 18 arbitrary combinations of maximal patient position shifts and rotations for two patient positioning methods. Normal tissue complication probabilities (NTCPs), equivalent uniform doses (EUDs), and tumor control probabilities (TCPs) were studied for organs at risk (OARs) and target volumes of eight patients. Results: The authors identified a median 1σ proton range uncertainty at the 50%-dose falloff of 2.8 mm for anatomy-based patient positioning and 1.6 mm for fiducial-based patient positioning as well as 7.2 and 5.8 mm for the 90%-dose falloff position, respectively. These range uncertainties were correlated to heterogeneity indices (HIs) calculated for each treatment field (38% < R{sup 2} < 50%). A NTCP increase of more than 10% (absolute) was observed for less than 2.9% (anatomy-based positioning) and 1.2% (fiducial-based positioning) of the studied OARs and patient shifts. For target volumes TCP decreases by more than 10% (absolute) occurred in less than 2.2% of the considered treatment scenarios for anatomy-based patient positioning and were nonexistent for fiducial-based patient positioning. EUD changes for target volumes were up to 35% (anatomy-based positioning) and 16% (fiducial-based positioning). Conclusions: The influence of patient positioning uncertainties on proton range in therapy of small lesions

Predicting the short-term risk of diabetes in HIV-positive patients

DEFF Research Database (Denmark)

Petoumenos, Kathy; Worm, Signe W; Fontas, Eric

2012-01-01

HIV-positive patients receiving combination antiretroviral therapy (cART) frequently experience metabolic complications such as dyslipidemia and insulin resistance, as well as lipodystrophy, increasing the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Rates of DM and other...... glucose-associated disorders among HIV-positive patients have been reported to range between 2 and 14%, and in an ageing HIV-positive population, the prevalence of DM is expected to continue to increase. This study aims to develop a model to predict the short-term (six-month) risk of DM in HIV...

SU-E-T-261: Development of An Automated System to Detect Patient Identification and Positioning Errors Prior to Radiotherapy Treatment

Energy Technology Data Exchange (ETDEWEB)

Jani, S; Low, D; Lamb, J [UCLA, Los Angeles, CA (United States)

2015-06-15

Purpose: To develop a system that can automatically detect patient identification and positioning errors using 3D computed tomography (CT) setup images and kilovoltage CT (kVCT) planning images. Methods: Planning kVCT images were collected for head-and-neck (H&N), pelvis, and spine treatments with corresponding 3D cone-beam CT (CBCT) and megavoltage CT (MVCT) setup images from TrueBeam and TomoTherapy units, respectively. Patient identification errors were simulated by registering setup and planning images from different patients. Positioning errors were simulated by misaligning the setup image by 1cm to 5cm in the six anatomical directions for H&N and pelvis patients. Misalignments for spine treatments were simulated by registering the setup image to adjacent vertebral bodies on the planning kVCT. A body contour of the setup image was used as an initial mask for image comparison. Images were pre-processed by image filtering and air voxel thresholding, and image pairs were assessed using commonly-used image similarity metrics as well as custom -designed metrics. A linear discriminant analysis classifier was trained and tested on the datasets, and misclassification error (MCE), sensitivity, and specificity estimates were generated using 10-fold cross validation. Results: Our workflow produced MCE estimates of 0.7%, 1.7%, and 0% for H&N, pelvis, and spine TomoTherapy images, respectively. Sensitivities and specificities ranged from 98.0% to 100%. MCEs of 3.5%, 2.3%, and 2.1% were obtained for TrueBeam images of the above sites, respectively, with sensitivity and specificity estimates between 96.2% and 98.4%. MCEs for 1cm H&N/pelvis misalignments were 1.3/5.1% and 9.1/8.6% for TomoTherapy and TrueBeam images, respectively. 2cm MCE estimates were 0.4%/1.6% and 3.1/3.2%, respectively. Vertebral misalignment MCEs were 4.8% and 4.9% for TomoTherapy and TrueBeam images, respectively. Conclusion: Patient identification and gross misalignment errors can be robustly and

SU-E-T-261: Development of An Automated System to Detect Patient Identification and Positioning Errors Prior to Radiotherapy Treatment

International Nuclear Information System (INIS)

Jani, S; Low, D; Lamb, J

2015-01-01

Purpose: To develop a system that can automatically detect patient identification and positioning errors using 3D computed tomography (CT) setup images and kilovoltage CT (kVCT) planning images. Methods: Planning kVCT images were collected for head-and-neck (H&N), pelvis, and spine treatments with corresponding 3D cone-beam CT (CBCT) and megavoltage CT (MVCT) setup images from TrueBeam and TomoTherapy units, respectively. Patient identification errors were simulated by registering setup and planning images from different patients. Positioning errors were simulated by misaligning the setup image by 1cm to 5cm in the six anatomical directions for H&N and pelvis patients. Misalignments for spine treatments were simulated by registering the setup image to adjacent vertebral bodies on the planning kVCT. A body contour of the setup image was used as an initial mask for image comparison. Images were pre-processed by image filtering and air voxel thresholding, and image pairs were assessed using commonly-used image similarity metrics as well as custom -designed metrics. A linear discriminant analysis classifier was trained and tested on the datasets, and misclassification error (MCE), sensitivity, and specificity estimates were generated using 10-fold cross validation. Results: Our workflow produced MCE estimates of 0.7%, 1.7%, and 0% for H&N, pelvis, and spine TomoTherapy images, respectively. Sensitivities and specificities ranged from 98.0% to 100%. MCEs of 3.5%, 2.3%, and 2.1% were obtained for TrueBeam images of the above sites, respectively, with sensitivity and specificity estimates between 96.2% and 98.4%. MCEs for 1cm H&N/pelvis misalignments were 1.3/5.1% and 9.1/8.6% for TomoTherapy and TrueBeam images, respectively. 2cm MCE estimates were 0.4%/1.6% and 3.1/3.2%, respectively. Vertebral misalignment MCEs were 4.8% and 4.9% for TomoTherapy and TrueBeam images, respectively. Conclusion: Patient identification and gross misalignment errors can be robustly and

Anti-tuberculosis therapy-induced hepatotoxicity among Ethiopian HIV-positive and negative patients.

Directory of Open Access Journals (Sweden)

Getnet Yimer

2008-03-01

Full Text Available To assess and compare the prevalence, severity and prognosis of anti-TB drug induced hepatotoxicity (DIH in HIV positive and HIV negative tuberculosis (TB patients in Ethiopia.In this study, 103 HIV positive and 94 HIV negative TB patients were enrolled. All patients were evaluated for different risk factors and monitored biochemically and clinically for development of DIH. Sub-clinical hepatotoxicity was observed in 17.3% of the patients and 8 out of the 197 (4.1% developed clinical hepatotoxicity. Seven of the 8 were HIV positive and 2 were positive for HBsAg.Sub-clinical hepatotoxicity was significantly associated with HIV co-infection (p = 0.002, concomitant drug intake (p = 0.008, and decrease in CD4 count (p = 0.001. Stepwise restarting of anti TB treatment was also successful in almost all the patients who developed clinical DIH. We therefore conclude that anti-TB DIH is a major problem in HIV-associated TB with a decline in immune status and that there is a need for a regular biochemical and clinical follow up for those patients who are at risk.

PAS positivity of erythroid precursor cells is associated with a poor prognosis in newly diagnosed myelodysplastic syndrome patients.

Science.gov (United States)

Masuda, Kenta; Shiga, Shuichi; Kawabata, Hiroshi; Takaori-Kondo, Akifumi; Ichiyama, Satoshi; Kamikubo, Yasuhiko

2018-07-01

Myelodysplastic syndrome (MDS) is a group of clonal stem cell disorders characterized by hematopoietic insufficiency. The accurate risk stratification of patients with MDS is essential for selection of appropriate therapies. We herein conducted a retrospective cohort study to examine the prognostic value of periodic acid-Schiff (PAS) reaction-positive erythroblasts in MDS patients. We examined the PAS positivity of the bone marrow erythroblasts of 144 patients newly diagnosed with MDS; 26 (18.1%) of them had PAS-positive erythroblasts, whereas 118 (81.9%) did not. The PAS-positive group showed significantly poorer karyotypes as defined in the revised International Prognostic Scoring System (IPSS-R) and higher scores in age-adjusted IPSS-R (IPSS-RA) than the PAS-negative group. Overall survival (OS) and leukemia-free survival (LFS) were also significantly shorter in the PAS-positive group than in the PAS-negative group. Similar results were obtained when only high- and very high risk groups were analyzed using IPSS-RA. This retrospective study suggested that the PAS positivity of erythroblasts is an additional prognostic factor combined with other risk scores for OS and LFS in MDS, and our results may contribute to improved clinical decision-making and rapid risk stratification.

Towards a Decentralized Magnetic Indoor Positioning System

Science.gov (United States)

Kasmi, Zakaria; Norrdine, Abdelmoumen; Blankenbach, Jörg

2015-01-01

Decentralized magnetic indoor localization is a sophisticated method for processing sampled magnetic data directly on a mobile station (MS), thereby decreasing or even avoiding the need for communication with the base station. In contrast to central-oriented positioning systems, which transmit raw data to a base station, decentralized indoor localization pushes application-level knowledge into the MS. A decentralized position solution has thus a strong feasibility to increase energy efficiency and to prolong the lifetime of the MS. In this article, we present a complete architecture and an implementation for a decentralized positioning system. Furthermore, we introduce a technique for the synchronization of the observed magnetic field on the MS with the artificially-generated magnetic field from the coils. Based on real-time clocks (RTCs) and a preemptive operating system, this method allows a stand-alone control of the coils and a proper assignment of the measured magnetic fields on the MS. A stand-alone control and synchronization of the coils and the MS have an exceptional potential to implement a positioning system without the need for wired or wireless communication and enable a deployment of applications for rescue scenarios, like localization of miners or firefighters. PMID:26690145

Towards a Decentralized Magnetic Indoor Positioning System

Directory of Open Access Journals (Sweden)

Zakaria Kasmi

2015-12-01

Full Text Available Decentralized magnetic indoor localization is a sophisticated method for processing sampled magnetic data directly on a mobile station (MS, thereby decreasing or even avoiding the need for communication with the base station. In contrast to central-oriented positioning systems, which transmit raw data to a base station, decentralized indoor localization pushes application-level knowledge into the MS. A decentralized position solution has thus a strong feasibility to increase energy efficiency and to prolong the lifetime of the MS. In this article, we present a complete architecture and an implementation for a decentralized positioning system. Furthermore, we introduce a technique for the synchronization of the observed magnetic field on the MS with the artificially-generated magnetic field from the coils. Based on real-time clocks (RTCs and a preemptive operating system, this method allows a stand-alone control of the coils and a proper assignment of the measured magnetic fields on the MS. A stand-alone control and synchronization of the coils and the MS have an exceptional potential to implement a positioning system without the need for wired or wireless communication and enable a deployment of applications for rescue scenarios, like localization of miners or firefighters.

Prevalence and Determinants of Chronic periodontitis in HIV positive patients in Nigeria

Directory of Open Access Journals (Sweden)

Kehinde Adesola Umeizudike

2014-08-01

Full Text Available Objective: To determine the prevalence and determinants of chronic periodontitis in HIV positive patients. Methods: A total of 120 HIV positive patients attending the dedicated HIV outpatient clinic of the Lagos University Teaching Hospital, Nigeria were recruited for the study. Their periodontal status was assessed using the community periodontal index of treatment needs. Their CD4+ cell count was determined using the flow-cytometer method. The risk factors for periodontitis including age, gender, education, smoking, CD4+ cell counts, bleeding on probing (BOP were determined. Results: Prevalence of periodontitis was high (63.3% in the HIV positive patients. In a bivariate analysis, significant associations were observed between severity of periodontitis and age ≥35 years (P=0.021, male gender (P=0.005, smoking (P=0.040 and ≥3 community periodontal index of treatment needs sextants exhibiting BOP (P=0.004. In a binary logistic regression, independent predictors of periodontitis were ≥3 sextants exhibiting BOP (odds ratio 1.738, 95% CI 1.339 to 2.256, P=0.000 and age ≥35 years (odds ratio 1.057, 95% CI 1.005 to 1.111, P=0.030. The CD4+ cell counts were not associated with periodontitis in the HIV positive patients (P=0.988. Conclusions: A high prevalence of periodontitis was found among the HIV positive Nigerian patients in this study. Older age ≥35 years and BOP were the determinants of periodontitis. There is therefore a need for close periodontal monitoring of HIV positive Nigerian patients with emphasis on preventive, professional oral prophylaxis.

Human papilloma virus dermatosis in human immunodeficiency virus-positive patients: A 14-year retrospective study in 965 patients.

Science.gov (United States)

Nuno-Gonzalez, Almudena; Losa Garcia, Juan Emilio; López Estebaranz, José Luis; Martin-Rios, María Dolores

2017-05-10

The incidence of the human papilloma virus (HPV) has not dropped in HIV-positive patients despite the discovery of antiretroviral therapy (ART). Our goal is to assess the prevalence of HPV in HIV patients and its relationship with the epidemiological and virological characteristics of HIV patients. Retrospective cohort of 965 patients diagnosed with HIV from 1998 to 2012. We analyzed patients' demographic factors and factors related to the HPV. Of the 965 patients examined, 333 consulted a dermatologist. Of these, 52 patients had genital warts (15.6%), 43 had common warts (12.9%) and 8% had both conditions. In total, 28.5% of patients had a skin lesion caused by HPV. This is the first longitudinal observational study carried out on HIV-positive patients in the era of ART in which HPV infection is the most common skin pathology. We observed a similar trend in countries with access to ART. This study spreads awareness on the importance of preventing HPV and the difficulty of treating it in HIV-positive patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Does the Supine Position Affect the Nasal Profile in Rhinoplasty Patients? A Comparison of Nasal Anthropometric Measurements in Different Body Positions.

Science.gov (United States)

Kim, Su Jin; Ryu, In Yong; Kim, Sung Wan; Lee, Kun Hee

2017-10-16

Rhinoplasty surgeons are aware that the nasal profile differs according to body position, namely, the erect position in the consultation room vs the supine position on the operating table. It is not clear whether this difference is caused by an optical illusion or skin laxity due to positional change. To evaluate anthropometric measurements of the nose with different body positions and determine whether the supine position affects the nasal profile. In this retrospective study, 103 patients who underwent primary rhinoplasty were enrolled. Preoperatively, all patients underwent lateral cephalography in the erect position, and facial computed tomography (CT), in the supine position. We measured four nasal anthropometric parameters (the nasofrontal, nasolabial, and nasomental angles, and Simon's ratio) on lateral cephalograms and facial CT images, and compared these parameters between the two body positions. The nasofrontal angle was greater on facial CT than on cephalograms (P sex, or body mass index (P > 0.05 each). We found no significant difference (P > 0.05) between the two positions in the nasolabial angle, nasomental angle, or Simon's ratio. The supine position does affect the nasal profile, especially in the radix area. Surgeons need to consider this difference in patients undergoing rhinoplasty. 2. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Positive and Negative Perfectionism in Migrainus Patients Compaired with Control Group

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H Afshar

2008-01-01

Full Text Available ABSTRACT: Introduction & Objective: The positive and negative effects of perfectionism on human cognition, affection and behavior have been emphasized. Perfectionism has been conceptualized as a multidimensional construct, with both adaptive and maladaptive aspects, which is one of the common personality traits that cause lifelong stress in human and results in anxiety, depression and physical and mental distress.The aim of this study was to assess the positive and negative perfectionism in migrainus patients in comparison with control group. Materials & Methods: This is an analytical (Case-control study which was performed on 91 migraine patients and 88 healthy individuals. The pqtients and controls completed a standard 40 item questionnaire for perfectionism – PANPS (20 for positive and 20 for negative perfectionism . The patients in both groups were matched for gender and age. Mean of positive and negative perfectionism scores for two groups was statistically analysed using SPSS software. Results: Mean positive perfectionism score was 83.47±8.5 for migraine group and 65.47±7.54 for control group (p=0.0001. The difference between two groups was significant. Mean of negative perfectionism score was 74.12±10.6 for migraine group and 51.79±7.8 for control group(p=0.0001. Conclusion: The results show that migraine patients have higher mean of perfectionism scores than healthy individuals. Based on this study and other clinical experiences more attention to psychotherapy is necessary for better management of migraine and recognition of personality profile in migraine patient helps to reduce patient’s complaints.

Verification of the positioning of radiotherapy patients with two webcams

Energy Technology Data Exchange (ETDEWEB)

Píriz, Gustavo; Lucas, Manuela; Bertini, Diego; Doldán, Raquel, E-mail: oncosur@oncosur.com.uy [Oncosur, Florida (Uruguay); Banguero, Yolma; Frederico, Marcel, E-mail: ybanguero@cin.edu.uy [Unidad de Radioproteccion, Centro de Invetigaciones Nucleares, Universidad de la Republica, Montevideo (Uruguay)

2017-07-01

In radiotherapy, high doses are given to the volumes that are to be irradiated and the organs at risk have to be protected. This implies putting great care into the patient's position and the reproducibility of the patient during all treatment sections. In our center the position during the treatment is bounded with thermoplastic masks, and the reproducibility between different sections is checked with daily photos during the treatment. For the evaluation of the photos we stick spheres of 8 mm of diameter to the fixing masks. We captured photos with two webcams that are less than 90 cm from the isocenter, one from the left and the other from the right. A quick visual evaluation allows you to detect changes in the position of the radius of the sphere. We present an absolute calibration methodology of the position of the sphere with two webcams. (author)

An interactive beam position monitor system simulator

International Nuclear Information System (INIS)

Ryan, W.A.; Shea, T.J.

1993-03-01

A system simulator has been implemented to aid the development of the RHIC position monitor system. Based on the LabVIEW software package by National Instruments, this simulator allows engineers and technicians to interactively explore the parameter space of a system during the design phase. Adjustable parameters are divided into three categories: beam, pickup, and electronics. The simulator uses these parameters in simple formulas to produce results in both time-domain and frequencydomain. During the prototyping phase, these simulated results can be compared to test data acquired with the same software package. The RHIC position monitor system is presented as an example, but the software is applicable to several other systems as well

Markers to differentiate between Kaposi's sarcoma and tuberculous pleural effusions in HIV-positive patients.

Science.gov (United States)

Coleman, M; Finney, L J; Komrower, D; Chitani, A; Bates, J; Chipungu, G A; Corbett, E; Allain, T J

2015-02-01

Kaposi's sarcoma (KS) and tuberculosis (TB) commonly cause pleural effusions in high human immunodeficiency virus (HIV) burden resource-limited countries. Differentiating between them is challenging, as pleural biopsy and TB culture are rarely available. To identify markers to differentiate between TB effusions and KS effusions in HIV-positive patients, and to compare liquid culture and Xpert MTB/RIF in pleural fluid. Fifty HIV-positive patients with pleural effusions recruited in Malawi underwent pleural ultrasound and aspiration. Fluid visual inspection, cell count, bacterial culture, glucose/protein, solid and liquid TB culture and Xpert were performed. The mean age of the patients was 32 years; 30/50 (60%) were male and 29 (58%) had cutaneous/oral KS. Thirteen (26%) pleural fluid samples were liquid culture-positive for TB, while 9/13 (69%) were Xpert-positive. Three (10.3%) KS patients had culture-positive TB effusions; 17 (58.6%) had KS effusions. The relative risk of TB in KS patients increased with limited KS, loculated fluid and low glucose. Eleven (52.3%) non-KS patients had culture-positive TB effusions associated with male sex, straw-coloured fluid and fibrin stranding on ultrasound. KS patients were most likely to have KS effusion, but TB should be considered. Most non-KS patients had TB, supporting the use of World Health Organization guidelines. Xpert identified two thirds of liquid culture-positive results.

New approach to imaging HIV-positive patients with pyrexia of undetermined origin

International Nuclear Information System (INIS)

Buscombe, J.; Miller, R.; Lui, D.; Ell, P.J.

1990-01-01

This paper established if imaging with Tc-99m human immunoglobulin (HIG) in addition to Ga-67 citrate increased the diagnostic sensitivity in patients who have pyrexia of unknown origin (PUO) and who have tested positive for human immunodeficiency virus (HIV). The authors studied 18 HIV-positive patients with PUO for 3 or more weeks. Imaging was performed 4 and 20 hours after administration of 200 MBq of Tc-99m HIG and 24, 48, and (if indicated) 72 hours after administration of 300 MBq of Ga-67. Anterior whole body and relevant spot view were obtained for both agents. Twenty-four sites of infection were confirmed microbiologically in 12 patients. Ga-67 scan results were positive in 22 of these sites, and Tc-99m HIG results were positive in 13; the nine Ga-positive sites that were Tc-negative were intrathoracic (one Pneumocystis carinii, eight Mycobacterium intracellulare)

Positioning bedridden patients to reduce interface pressures over the sacrum and great trochanter.

Science.gov (United States)

Yoshikawa, Y; Maeshige, N; Sugimoto, M; Uemura, M; Noguchi, M; Terashi, H

2015-07-01

In this study, we evaluated the effect of hip-joint rotation on the interface pressure over the sacrum and greater trochanter with a new protocol for positioning of bedridden elderly patients. The interface pressure values over the sacrum and greater trochanter in bedridden patients were evaluated. These were collected in the supine position, 90° lateral position, and 30° and 40° laterally inclined positions with external rotation or neutral positioning of the hip joint. Each interface pressure was assessed with a device measuring pressure distribution, after which, the peak pressure index (PPI) was calculated. In the 17 patients examined, the PPI over the sacrum in the supine position was significantly greater than that in other positions. In the 30° and 40° laterally inclined positions, the PPIs over the greater trochanter were significantly lower in the neutral position of the hip joint compared with those in the external rotation position. Our findings revealed the effects of hip-joint rotation on the interface pressure for the greater trochanter, possibly due to the increased distance between the greater trochanter and the sacrum caused by neutral position of the hip joint. The results demonstrate that it is to best place the hip joint in a neutral position when the legs are in contact with the bed in order to distribute the pressure over the greater trochanter in the 30° and 40° laterally inclined positions. These results can be applied to the clinical setting to improve patient positioning and decrease pressure ulcers. The authors declare that they have no competing financial interests.

The Global Positioning System: Theory and operation

Science.gov (United States)

Tucker, Lester Plunkett

Scope and method of study. The purpose of this study is to document the theory, development, and training needs of the United States Global Positioning System for the United States Air Force. This subject area had very little information and to assess the United States Air Force training needs required an investigation into existing training accomplished on the Global Positioning System. The United States Air Force has only one place to obtain the data at Headquarters Air Education and Training Command. Findings and conclusion. The United States Air Force, at the time of this study, does not have a theory and operations course dealing with the newest technology advancement in world navigation. Although this new technology is being provided on aircraft in the form of new navigation hardware, no official course of study is provided by the United States Air Force to it's pilots and navigators dealing with theory and operation. Based on the latest reports dealing with the Global Positioning System, a course on the Global Positioning System was developed in the Instructional Systems Design format to provide background information and understanding of this new technology. Readers of this study must be aware that the information contained in this study is very dynamic. Technology is advancing so fast in this area that it might make this information obsolete in a short amount of time.

Modular Track System For Positioning Mobile Robots

Science.gov (United States)

Miller, Jeff

1995-01-01

Conceptual system for positioning mobile robotic manipulators on large main structure includes modular tracks and ancillary structures assembled easily along with main structure. System, called "tracked robotic location system" (TROLS), originally intended for application to platforms in outer space, but TROLS concept might also prove useful on Earth; for example, to position robots in factories and warehouses. T-cross-section rail keeps mobile robot on track. Bar codes mark locations along track. Each robot equipped with bar-code-recognizing circuitry so it quickly finds way to assigned location.

Positioning patient-perceived medical services to develop a marketing strategy.

Science.gov (United States)

Jung, Minsoo; Hong, Myung-Sun

2012-01-01

In today's medical market, marketing philosophy is being rapidly transformed from customer searching to patient satisfaction and service improvement. The principal objective of this study was to contribute to the establishment of a desirable medical marketing strategy, through the factors of customer satisfaction and the positioning of patients' perceptions by marketing institutions. The data were collected from 282 students of the College of Public Health and Medicine in Seoul. The survey tools were developed using the SERVQUAL scale. Analysis in this study involved both statistical and network analysis. The former was used to verify the determinants of service satisfaction as perceived by respondents, via factor analysis and multiple regression analysis. The latter was obtained using a positioning map and 2-mode network analysis with the matrix data converted from raw data. The determining factors for patient satisfaction were identified as facilities, accessibility, process, physicians, and medical staff. The regression equation was significant (R = 0.606), and the most influential variable was the service quality of physicians (β = .569). According to multidimensional scaling, the positioning of medical institutions indicated that patients' perceptions were affected by hospital size and specialization. By recognizing and managing patient satisfaction, medical institutions are able to foster customer loyalty and, in turn, to enhance service quality. It is necessary to develop an adequate marketing mix to provide better medical services and to overcome medical competition among institutions.

Exponential Stability of Switched Positive Homogeneous Systems

Directory of Open Access Journals (Sweden)

Dadong Tian

2017-01-01

Full Text Available This paper studies the exponential stability of switched positive nonlinear systems defined by cooperative and homogeneous vector fields. In order to capture the decay rate of such systems, we first consider the subsystems. A sufficient condition for exponential stability of subsystems with time-varying delays is derived. In particular, for the corresponding delay-free systems, we prove that this sufficient condition is also necessary. Then, we present a sufficient condition of exponential stability under minimum dwell time switching for the switched positive nonlinear systems. Some results in the previous literature are extended. Finally, a numerical example is given to demonstrate the effectiveness of the obtained results.

Factors that enable nurse-patient communication in a family planning context: a positive deviance study.

Science.gov (United States)

Kim, Young Mi; Heerey, Michelle; Kols, Adrienne

2008-10-01

Family planning programmes in developing countries need a better understanding of nurse-patient communication in order to improve the quality of counselling. To identify factors in the clinic and in the community that enable nurses and patients to communicate effectively with one another. The study explored the personal experiences of nurses and patients who communicate especially effectively during family planning consultations (so-called "positive deviants"). Sixty-four randomly selected public clinics located in East Java, Indonesia. Seven positive deviant nurses and 32 positive deviant patients were identified from among 64 nurses and 768 patients who participated in an earlier patient coaching study. Flooding prevented 5 patients from participating in the study, reducing their number to 27. Investigators conducted: (1) a content analysis of qualitative data collected by structured in-depth interviews and focus-group discussions (FGDs) with positive deviant nurses and patients, and (2) analyses of variance (ANOVA) of quantitative data on clinic, nurse, and patient characteristics. Positive deviant nurses identified four factors, listed in rough order of importance, that helped them communicate effectively: independent study to strengthen their knowledge and skills; communication aids; feedback from colleagues; and motivation stemming from a desire to help people, patients' appreciation, husband's support, and increased income. Positive deviant patients identified five enabling factors: motivation due to their need for a service; confidence in their own communication skills; positive feedback from nurses; belief in patients' right and responsibility to communicate with nurses; and communication aids. Insights from positive deviant nurses and patients suggest that efforts to improve nurse-patient communication should go beyond conventional communication skills training. Managers should consider a mix of clinic-based interventions (such as peer feedback

Breast cancer patients' narratives about positive and negative communication experiences

DEFF Research Database (Denmark)

Thomsen, Dorthe K; Pedersen, Anette F; Johansen, Mikael B

2007-01-01

. Thus, qualitative studies of communication are also needed. Fifteen breast cancer patients were interviewed 3 months after finishing adjuvant treatment. They were asked to tell a 10 minute narrative and recall five experiences from treatment. Themes were extracted using categories derived from previous...... research while at the same time being sensitive to new elaborations and categories. The participants reported both positive and negative communication-related experiences from a wide range of treatment situations. Two major themes emerged: Information giving as professional care-giving and meeting......Health staff-patient communication is increasingly considered an important issue in cancer research. However, questionnaires addressing satisfaction with communication limit the issues patients can raise, do not address the context of communication and often show a strong positive skew in responses...

Position and orientation determination system and method

Science.gov (United States)

Harpring, Lawrence J.; Farfan, Eduardo B.; Gordon, John R.; Jannik, Gerald T.; Foley, Trevor Q.

2017-06-14

A position determination system and method is provided that may be used for obtaining position and orientation information of a detector in a contaminated room. The system includes a detector, a sensor operably coupled to the detector, and a motor coupled to the sensor to move the sensor around the detector. A CPU controls the operation of the motor to move the sensor around the detector and determines distance and angle data from the sensor to an object. The method includes moving a sensor around the detector and measuring distance and angle data from the sensor to an object at incremental positions around the detector.

The Patient Protection and Affordable Care Act: The Role of the School Nurse. Position Statement

Science.gov (United States)

Combe, Laurie G.; Sharpe, Susan; Feeser, Cynthia Jo; Ondeck, Lynnette; Fekaris, Nina

2015-01-01

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) serves a vital role in the delivery of health care to our nation's students within the healthcare system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as…

Evaluation of irradiation position in respiratory-gated radiotherapy using a phantom system simulating patient respiration

International Nuclear Information System (INIS)

Oyama, Masaya; Ueda, Takashi; Kitoh, Satoshi; Tanaka, Takashi; Goka, Tomonori; Ogino, Takashi

2006-01-01

Respiratory-gated (RG) radiotherapy is useful for minimizing the irradiated volume of normal tissues resulting from the shifting of internal structures caused by respiratory movement. The present study was conducted to evaluate the treatment field in RG radiotherapy using a phantom system simulating patient respiration. A phantom system consisting of a 3-cm ball-shaped dummy tumor and film placed in a cork lung phantom was used (THK Co., Ltd.). RG radiotherapy was employed in the expiratory phase. The phantom movement distance was set to 2 cm, and the gating signals from a respiratory-gating system (AZ-733V, Anzai Medical) were varied. The settings used for irradiation were an X-ray energy of 6 MV (PRIMUS, Toshiba Medical Systems), treatment field of 5 cm x 7 cm, and X-ray dose of 100 MU. Images were acquired using an electric portal-imaging device (EPID, OPTIVUE 500), and the X-ray dose distribution was measured by the film method. In images acquired using the EPID, the tumor margins became less clear when the gating signals were increased, and the ITVs were determined to be 3.6 cm, 3.7 cm, 4.2 cm, and 5.1 cm at gating rates of 10%, 25%, 50%, and no gate, respectively. With regard to the X-ray dose distribution measured by the film method, the dose profile in the cephalocaudal direction was shifted toward the expiratory phase, and the degree of shift became greater when the gating signals were increased. In addition, the optimal treatment fields in the cephalocaudal direction were determined to be 5.2 cm, 5.2 cm, 5.6 cm, and 7.0 cm at gating rates of 10%, 25%, 50%, and no gating, respectively. Although RG radiotherapy is useful for improving the accuracy of radiotherapy, the characteristics of the RG radiotherapy technique and the radiotherapy system must be clearly understood when this method is to be employed in clinical practice. Image-guided radiotherapy (IGRT) is now assuming a central role in radiotherapy, and properly identifying internal margins is an

Initial clinical experience with infrared-reflecting skin markers in the positioning of patients treated by conformal radiotherapy for prostate cancer

International Nuclear Information System (INIS)

Soete, Guy; Steene, Jan van de; Verellen, Dirk; Vinh-Hung, Vincent; Berge, Dirk van den; Michielsen, Dirk; Keuppens, Frans; Roover, Patricia de; Storme, Guy

2002-01-01

Purpose: To evaluate an infrared (IR) marker-based positioning system in patients receiving conformal radiotherapy for prostate cancer. Methods and materials: During 553 treatments, the ability of the IR system to automatically position the isocenter was recorded. Setup errors were measured by means of orthogonal verification films and compared to conventional positioning (using skin drawings and lasers) in 184 treatments. Results: The standard deviation of anteroposterior (AP) and lateral setup errors was significantly reduced with IR marker positioning compared to conventional: 2 vs. 4.8 mm AP (p<0.01) and 1.6 vs. 3.5 mm laterally (p<0.01). Longitudinally, the difference was not significant (3.5 vs. 3.0 mm). Systematic errors were on the average smaller AP and laterally for the IR method: 4.1 vs. 7.8 mm AP (p=0.01) and 3.1 vs. 5.6 mm lateral (p=0.07). Longitudinally, the IR system resulted in somewhat larger systematic errors: 5.0 vs. 3.4 mm for conventional positioning (p=0.03). The use of an off-line correction protocol, based on the average deviation measured over the first four fractions, allowed virtual elimination of systematic errors. Inability of the IR system to correctly locate the markers, leading to an executional failure, occurred in 21% of 553 fractions. Conclusion: IR marker-assisted patient positioning significantly improves setup accuracy along the AP and lateral axes. Executional failures need to be reduced

Elekta Precise Table characteristics of IGRT remote table positioning

International Nuclear Information System (INIS)

Riis, Hans L.; Zimmermann, Sune J.

2009-01-01

Cone beam CT is a powerful tool to ensure an optimum patient positioning in radiotherapy. When cone beam CT scan of a patient is acquired, scan data of the patient are compared and evaluated against a reference image set and patient position offset is calculated. Via the linac control system, the patient is moved to correct for position offset and treatment starts. This procedure requires a reliable system for movement of patient. In this work we present a new method to characterize the reproducibility, linearity and accuracy in table positioning. The method applies to all treatment tables used in radiotherapy. Material and methods. The table characteristics are investigated on our two recent Elekta Synergy Platforms equipped with Precise Table installed in a shallow pit concrete cavity. Remote positioning of the table uses the auto set-up (ASU) feature in the linac control system software Desktop Pro R6.1. The ASU is used clinically to correct for patient positioning offset calculated via cone beam CT (XVI)-software. High precision steel rulers and a USB-microscope has been used to detect the relative table position in vertical, lateral and longitudinal direction. The effect of patient is simulated by applying external load on the iBEAM table top. For each table position an image is exposed of the ruler and display values of actual table position in the linac control system is read out. The table is moved in full range in lateral direction (50 cm) and longitudinal direction (100 cm) while in vertical direction a limited range is used (40 cm). Results and discussion. Our results show a linear relation between linac control system read out and measured position. Effects of imperfect calibration are seen. A reproducibility within a standard deviation of 0.22 mm in lateral and longitudinal directions while within 0.43 mm in vertical direction has been observed. The usage of XVI requires knowledge of the characteristics of remote table positioning. It is our opinion

System and method for acquisition management of subject position information

Science.gov (United States)

Carrender, Curt

2005-12-13

A system and method for acquisition management of subject position information that utilizes radio frequency identification (RF ID) to store position information in position tags. Tag programmers receive position information from external positioning systems, such as the Global Positioning System (GPS), from manual inputs, such as keypads, or other tag programmers. The tag programmers program each position tag with the received position information. Both the tag programmers and the position tags can be portable or fixed. Implementations include portable tag programmers and fixed position tags for subject position guidance, and portable tag programmers for collection sample labeling. Other implementations include fixed tag programmers and portable position tags for subject route recordation. Position tags can contain other associated information such as destination address of an affixed subject for subject routing.

System and method for acquisition management of subject position information

Energy Technology Data Exchange (ETDEWEB)

Carrender, Curt [Morgan Hill, CA

2007-01-23

A system and method for acquisition management of subject position information that utilizes radio frequency identification (RF ID) to store position information in position tags. Tag programmers receive position information from external positioning systems, such as the Global Positioning System (GPS), from manual inputs, such as keypads, or other tag programmers. The tag programmers program each position tag with the received position information. Both the tag programmers and the position tags can be portable or fixed. Implementations include portable tag programmers and fixed position tags for subject position guidance, and portable tag programmers for collection sample labeling. Other implementations include fixed tag programmers and portable position tags for subject route recordation. Position tags can contain other associated information such as destination address of an affixed subject for subject routing.

Hepatitis B Virus Infection and Anti-HBc (Total Positivity in CKD Patients before Dialysis

Directory of Open Access Journals (Sweden)

Fareha Jesmin Rabbi

2016-09-01

Full Text Available Background: CKD patients are associated with HBV infection both as a cause and complication of treatment. CKD patients before starting dialysis therapy are considered as a high risk group because of impaired immune response compared with healthy individuals and also other risk factors related with treatment and management. Only HBsAg marker does not always follow the presence or absence of HBV infection. Anti-HBc (total alone positivity indicates previous exposure to HBV infection, window period and even after reactivation of resolved HBV infection. In some cases only anti-HBc positivity is interpreted as possible chronic low dose HBV infection (chronic carriage. Predialytic CKD patients were tested with three serological markers [HBsAg, anti-HBc (total and anti-HBs] for screening HBV infection. Proper diagnosis before dialysis and knowing the infection status would help both the patient and doctor to choose proper treatment approach. Objective: This cross-sectional study was done in the CKD patients before starting dialysis therapy to find out the HBV infection and to evaluate the infection by minimal serological markers as for screening. Materials and Methods: A total of 211 patients with chronic kidney disease stage five (CKD-V before starting dialysis therapy were included as subjects of this cross-sectional study. Among the CKD patients HBsAg was tested to see the prevalence. Other serological markers, i.e., anti-HBc (total and anti-HBs were tested in combination with HBsAg in 89 randomly selected patients among the subjects. The patients were also tested for anti-HCV to assess co-infection. After collecting all the data of different test results analyses were done by SPSS version 15.0. Results: Among total study population 10 (4.7% patients were found HBsAg positive. No patient was found positive for both HBsAg and anti-HCV. Among the 89 CKD patients only 2 (2.2% patients were HBsAg positive, and only one patient (0.9% was found positive

Position indicating systems and reed contact unit assemblies for such systems

International Nuclear Information System (INIS)

Foxworthy, M.K.

1980-01-01

Specifications are given for a position indicating system for determining the position of a movable member inside a sealed container such as the position of a control rod in a nuclear reactor. The system comprises a magnetic flux producing member mounted to the movable member so as to move with it, a series of magnetic reed contact units mounted along the outside of the sealed container to be individually actuated by the flux producer as the movable member moves within the sealed container to indicate the position of this member. Each of the reed contact units is connected to a source of alternating electric current to produce a magnetic flux field to minimize the flux differential between the actuated and unactuated reed contact positions. A second aspect of the invention provides for a low operating flux differential reed contact unit assembly for a position indicating system such that it is actuated by the magnetic member at one magnetic flux level and deactivated at a second level. There is a source of alternating current connected to a coil surrounding the reed contact unit so as to produce an alternating magnetic flux with amplitude less than the difference between the two levels. Variations are given, also diagrams and benefits. (U.K.)

An intelligent operator support system for dynamic positioning

NARCIS (Netherlands)

Diggelen, J. van; Broek, J. van den; Schraagen, J.M.C.; Waa, J.S. van der

2018-01-01

This paper proposes a human-centered approach to Dynamic Position-ing systems which combines multiple technologies in an intelligent operator sup-port system (IOSS). IOSS allows the operator to be roaming and do other tasks in quiet conditions. When conditions become more demanding, the IOSS calls

The relationship between positive or negative phrasing and patients' coping with lateral epicondylitis.

Science.gov (United States)

Lee, Dong Oh; Gong, Hyun Sik; Kim, Jeong Hwan; Rhee, Seung Hwan; Lee, Young Ho; Baek, Goo Hyun

2014-04-01

Research suggests that phrases with negative content can affect patients' response to medical procedures and how they cope with medical illnesses. We hypothesized that patients with lateral epicondylitis who describe their condition in positive phrases cope better than those who do not. We prospectively followed up 91 patients with lateral epicondylitis for 12 months. The patients indicated their baseline coping status based on the Pain Catastrophizing Scale (PCS) and were discharged with a wait-and-see policy. During follow-up interviews, the patients described the nature of their condition in their own words and were then categorized into either positive or negative phrasing groups. We compared these two groups regarding current coping status and whether they had sought additional treatment. We also analyzed for the factors associated with these outcomes. There were no significant differences in baseline PCS scores between the two groups. At follow-up, patients in the positive phrasing group (n = 62) had significantly lower PCS scores and were less likely to seek additional treatment than those in the negative phrasing group (n = 29). Multivariable analyses showed that positive phrasing and low pain levels were independently associated with improvement in PCS scores and that negative phrasing and depression were independently associated with patients' seeking additional treatment. Patients' positive phrasing about their condition are associated with improvement in their coping status and with less use of medical resources in the case of lateral epicondylitis. This study suggests that patients with more positive attitudes toward their illness cope and comply better when a wait-and-see treatment is recommended by their physicians. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Development of Precise Point Positioning Method Using Global Positioning System Measurements

Directory of Open Access Journals (Sweden)

Byung-Kyu Choi

2011-09-01

Full Text Available Precise point positioning (PPP is increasingly used in several parts such as monitoring of crustal movement and maintaining an international terrestrial reference frame using global positioning system (GPS measurements. An accuracy of PPP data processing has been increased due to the use of the more precise satellite orbit/clock products. In this study we developed PPP algorithm that utilizes data collected by a GPS receiver. The measurement error modelling including the tropospheric error and the tidal model in data processing was considered to improve the positioning accuracy. The extended Kalman filter has been also employed to estimate the state parameters such as positioning information and float ambiguities. For the verification, we compared our results to other of International GNSS Service analysis center. As a result, the mean errors of the estimated position on the East-West, North-South and Up-Down direction for the five days were 0.9 cm, 0.32 cm, and 1.14 cm in 95% confidence level.

Anti-glomerular basement membrane glomerulonephritis in an HIV positive patient: case report

Directory of Open Access Journals (Sweden)

Eduardo José Bellotto Monteiro

Full Text Available We report on a case of a patient with HIV infection, diagnosed 18 months prior to the development of an anti-glomerular basement membrane (anti-GBM rapidly progressive glomerulonephritis; this is probably the first report of such an association. A 30-year-old white man presented with elevation of serum creatinine (1.3 - 13.5 mg/dL within one month. At admission, the urinalysis showed proteinuria of 7.2 g/L and 8,000,000 erythrocytes/mL. Renal biopsy corresponded to a crescentic diffuse proliferative glomerulonephritis mediated by anti-GBM, and serum testing for anti-GBM antibodies was positive; antinuclear antibodies (ANA and anti-neutrophilic cytoplasmic antibodies (ANCA were also positive. The patient underwent hemodyalisis and was treated with plasmapheresis, cyclophosphamide and prednisone. The association described here is not casual, as crescentic glomerulonephritis is not common in HIV-positive patients, anti-GBM glomerulonephritis is rare and anti-GBM antibodies are frequently observed in HIV-positive subjects when compared to the overall population. Based on the current case and on the elevated frequency of the positivity for such antibodies in this group of patients, it is advisable to be aware of the eventual association between these two conditions and to promote an active search for anti-GBM antibodies and early diagnosis of eventual urinary abnormalities in HIV-positive subjects, considering the severity of anti-GBM glomerulonephritis.

PLS beam position measurement and feedback system

International Nuclear Information System (INIS)

Huang, J.Y.; Lee, J.; Park, M.K.; Kim, J.H.; Won, S.C.

1992-01-01

A real-time orbit correction system is proposed for the stabilization of beam orbit and photon beam positions in Pohang Light Source. PLS beam position monitoring system is designed to be VMEbus compatible to fit the real-time digital orbit feedback system. A VMEbus based subsystem control computer, Mil-1553B communication network and 12 BPM/PS machine interface units constitute digital part of the feedback system. With the super-stable PLS correction magnet power supply, power line frequency noise is almost filtered out and the dominant spectra of beam obtit fluctuations are expected to appear below 15 Hz. Using DSP board in SCC for the computation and using an appropriate compensation circuit for the phase delay by the vacuum chamber, PLS real-time orbit correction system is realizable without changing the basic structure of PLS computer control system. (author)

Stochastic formulation of patient positioning using linac-mounted cone beam imaging with prior knowledge

International Nuclear Information System (INIS)

Hoegele, W.; Loeschel, R.; Dobler, B.; Hesser, J.; Koelbl, O.; Zygmanski, P.

2011-01-01

Purpose: In this work, a novel stochastic framework for patient positioning based on linac-mounted CB projections is introduced. Based on this formulation, the most probable shifts and rotations of the patient are estimated, incorporating interfractional deformations of patient anatomy and other uncertainties associated with patient setup. Methods: The target position is assumed to be defined by and is stochastically determined from positions of various features such as anatomical landmarks or markers in CB projections, i.e., radiographs acquired with a CB-CT system. The patient positioning problem of finding the target location from CB projections is posed as an inverse problem with prior knowledge and is solved using a Bayesian maximum a posteriori (MAP) approach. The prior knowledge is three-fold and includes the accuracy of an initial patient setup (such as in-room laser and skin marks), the plasticity of the body (relative shifts between target and features), and the feature detection error in CB projections (which may vary depending on specific detection algorithm and feature type). For this purpose, MAP estimators are derived and a procedure of using them in clinical practice is outlined. Furthermore, a rule of thumb is theoretically derived, relating basic parameters of the prior knowledge (initial setup accuracy, plasticity of the body, and number of features) and the parameters of CB data acquisition (number of projections and accuracy of feature detection) to the expected estimation accuracy. Results: MAP estimation can be applied to arbitrary features and detection algorithms. However, to experimentally demonstrate its applicability and to perform the validation of the algorithm, a water-equivalent, deformable phantom with features represented by six 1 mm chrome balls were utilized. These features were detected in the cone beam projections (XVI, Elekta Synergy) by a local threshold method for demonstration purposes only. The accuracy of estimation

Impact of Postmastectomy Radiation on Locoregional Recurrence in Breast Cancer Patients With 1-3 Positive Lymph Nodes Treated With Modern Systemic Therapy

Energy Technology Data Exchange (ETDEWEB)

Tendulkar, Rahul D., E-mail: tendulr@ccf.org [Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Rehman, Sana; Shukla, Monica E.; Reddy, Chandana A. [Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Moore, Halle; Budd, G. Thomas [Department of Solid Tumor Oncology, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Dietz, Jill; Crowe, Joseph P. [Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Macklis, Roger [Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio (United States)

2012-08-01

Purpose: Postmastectomy radiation therapy (PMRT) remains controversial for patients with 1-3 positive lymph nodes (LN+). Methods and Materials: We conducted a retrospective review of all 369 breast cancer patients with 1-3 LN+ who underwent mastectomy without neoadjuvant systemic therapy between 2000 and 2007 at Cleveland Clinic. Results: We identified 271 patients with 1-3 LN+ who did not receive PMRT and 98 who did receive PMRT. The median follow-up time was 5.2 years, and the median number of LN dissected was 11. Of those not treated with PMRT, 79% received adjuvant chemotherapy (of whom 70% received a taxane), 79% received hormonal therapy, and 5% had no systemic therapy. Of the Her2/neu amplified tumors, 42% received trastuzumab. The 5-year rate of locoregional recurrence (LRR) was 8.9% without PMRT vs 0% with PMRT (P=.004). For patients who did not receive PMRT, univariate analysis showed 6 risk factors significantly (P<.05) correlated with LRR: estrogen receptor/progesterone receptor negative (hazard ratio [HR] 2.6), lymphovascular invasion (HR 2.4), 2-3 LN+ (HR 2.6), nodal ratio >25% (HR 2.7), extracapsular extension (ECE) (HR 3.7), and Bloom-Richardson grade III (HR 3.1). The 5-year LRR rate was 3.4% (95% confidence interval [CI], 0.1%-6.8%] for patients with 0-1 risk factor vs 14.6% [95% CI, 8.4%-20.9%] for patients with {>=}2 risk factors (P=.0006), respectively. On multivariate analysis, ECE (HR 4.3, P=.0006) and grade III (HR 3.6, P=.004) remained significant risk factors for LRR. The 5-year LRR was 4.1% in patients with neither grade III nor ECE, 8.1% with either grade III or ECE, and 50.4% in patients with both grade III and ECE (P<.0001); the corresponding 5-year distant metastasis-free survival rates were 91.8%, 85.4%, and 59.1% (P=.0004), respectively. Conclusions: PMRT offers excellent control for patients with 1-3 LN+, with no locoregional failures to date. Patients with 1-3 LN+ who have grade III disease and/or ECE should be strongly considered

Power and resistance within the hospital's hierarchical system: the experiences of chronically ill patients.

Science.gov (United States)

Griscti, Odette; Aston, Megan; Warner, Grace; Martin-Misener, Ruth; McLeod, Deborah

2017-01-01

To explore experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings. Specifically, we explored how social and institutional discourses shape power relations during the negotiation process. The hospital system is embedded in a hierarchical structure where the voice of the healthcare provider as expert is often given more importance than the patient. This system has been criticised as being oppressive to patients who are perceived to be lower in the hierarchy. In this study, we illustrate how the hospital's hierarchical system is not always oppressing but can also create moments of empowerment for patients. A feminist poststructuralist approach informed by the teaching of Foucault was used to explore power relations between nurses and patients when negotiating patient care in hospital settings. Eight individuals who suffered from chronic illness shared their stories about how they negotiated their care with nurses in hospital settings. The interviews were tape-recorded. Discourse analysis was used to analyse the data. Patients recounted various experiences when their voices were not heard because the current hospital system privileged the healthcare provider experts' advice over the patients' voice. The hierarchical structure of hospital supported these dynamics by privileging nurses as gatekeepers of service, by excluding the patients' input in the nursing notes and through a process of self-regulation. However, patients in this study were not passive recipients of care and used their agency creatively to resist these discourses. Nurses need to be mindful of how the hospital's hierarchical system tends to place nurses in a position of power, and how their authoritative position may positively or adversely affect the negotiation of patient care. © 2016 John Wiley & Sons Ltd.

The Mathematics of the Global Positioning System.

Science.gov (United States)

Nord, Gail D.; Jabon, David; Nord, John

1997-01-01

Presents an activity that illustrates the application of mathematics to modern navigation and utilizes the Global Positioning System (GPS). GPS is a constellation of 24 satellites that enables receivers to compute their position anywhere on the earth with great accuracy. (DDR)

Metabolic syndrome in human immunodeficiency virus positive patients

Directory of Open Access Journals (Sweden)

Sarita Bajaj

2013-01-01

Full Text Available Aims and Objectives : To assess the prevalence of metabolic syndrome (MetS in human immunodeficiency virus (HIV positive patients. Prevalence of MetS was compared in patients who were not on highly active antiretroviral therapy (HAART to patients who were on HAART. Materials and Methods: Seventy HIV positive cases were studied. Pregnant and lactating women, patients on drugs other than HAART known to cause metabolic abnormalities and those having diabetes or hypertension were excluded. Cases were evaluated for MetS by using National Cholesterol Education Program Adult Treatment Panel-III. Results: 47 cases were on HAART and 23 cases were not on HAART. Fasting Blood Glucose ≥100 mg/dl was present in 28.6% cases, out of whom 27.7% were on HAART and 30.4% were not on HAART (P = 0.8089. 12.9% cases had BP ≥130/≥85 mm Hg, out of whom 14.9% were on HAART and 8.7% were not on HAART (P = 0.4666. 42.9% cases had TG ≥150 mg/dl, out of whom 44.7% were on HAART and 39.1% were not on HAART (P = 0.6894. HDL cholesterol was low (males <40 mg/dl, females <50 mg/dl in 50% cases, out of whom 55.3% were on HAART and 39.1% were not on HAART (P = 0.2035. Conclusions: Prevalence of MetS was 20%. Majority of patients had only one component of MetS (32.9%. Low HDL was present in 50%, followed by raised triglycerides in 42.9%. Waist circumference was not increased in any of the patients. There was no statistically significant difference between those on HAART and those not on HAART in distribution of risk factors and individual components of MetS.

Beam position monitor system for storage rings

International Nuclear Information System (INIS)

Nakamura, M.; Hinkson, J.A.

1985-05-01

Beam position monitors (BPM) for synchrotron light storage rings usually consist of beam pickup electrodes, coaxial relays and a narrowband receiver. While accurate, these systems are slow and of limited use in the commissioning of an accelerator. A beam position monitor is described which is intended to be a principal diagnostic during debug and routine running of a storage ring. It is capable of measuring the position of a single bunch on the first or nth orbit to an accuracy of a few percent. Stored beam position is more accurately measured with averaging techniques. Beam position changes can be studied in a bandwidth from DC to a few MHz. The beam monitor electronics consist of a separate amplification, detection, and sampling channel for each beam pickup electrode. Fast switches in each channel permit selection of the nth turn for measurement (single bunch mode). A calibration pulse is injected into each channel after beam measurement to permit gain offsets to be measured and removed from the final data. While initially more costly than the usual beam position monitor system, this sytem will pay for itself in reduced storage ring debug and trouble shooting time. 5 refs., 5 figs

PHYSICS UPDATE: The global positioning system

Science.gov (United States)

Walton, Alan J.; Black, Richard J.

1999-01-01

A hand-held global positioning system receiver displays the operator's latitude, longitude and velocity. Knowledge of GCSE-level physics will allow the basic principles of the system to be understood; knowledge of A-level physics will allow many important aspects of their implementation to be comprehended. A discussion of the system provides many simple numerical calculations relevant to school and first-year undergraduate syllabuses.

Effect of Positive Psychotherapy in Depression Symptoms and Character Strengths in Cancer Affected Patients

Directory of Open Access Journals (Sweden)

R Khodabakhash

2015-05-01

Full Text Available The purpose of this research was to study the effect of positive psychotherapy on depression symptoms and character strengths in cancer affected patients. Based on a quasi-experimental design by available sampling, 58 cancer patients were investigated. 30 patients were assigned in two groups: 15 patients in positive psychotherapy group (treatment and 15 patients as control group. In the present research, Oxford Happiness-Depression Questionnaire (OHDQ and Values In Action Inventory of Strengths (VIA-IS were used. The results showed that the positive psychotherapy was effective in reducing depression, increasing the character strengths and virtues, improving meaningful, pleasant and engaged life of cancer patients.

Joint positions matter for ultrasound examination of RA patients-increased power Doppler signal in neutral versus flat position of hands.

Science.gov (United States)

Husic, Rusmir; Lackner, Angelika; Stradner, Martin H; Hermann, Josef; Dejaco, Christian

2017-08-01

Position of joints might influence the result of US examination in patients with RA. The purpose of this work was to compare grey-scale (GS) and power Doppler (PWD) findings obtained in neutral vs flat position of hands. A cross-sectional study of 42 RA patients with active disease. Two dimensional and 3D sonography of wrists and MCP joints were conducted in two different joint positions: neutral position, which is a slight flexion of the fingers with relaxed extensor muscles; and flat position, where all palm and volar sides of fingers touch the Table. Two dimensional GS synovitis (GSS) and PWD signals were scored semi-quantitatively (0-3). For 3D sonography, the percentage of PWD voxels within a region of interest was calculated. GSS was not quantified using 3D sonography. Compared with neutral position, 2D PWD signals disappeared in 28.3% of joints upon flattening. The median global 2D PWD score (sum of all PWD scores of an individual patient) decreased from 8 to 3 ( P < 0.001), and the global 3D PWD voxel score from 3.8 to 0.9 ( P < 0.001). The reduction of PWD scores was similar in all joints (2D: minus 50%, 3D: minus 66.4-80.1%). Inter- and intrareader agreement of PWD results was good (intraclass correlation coefficient: 0.75-0.82). In RA, a neutral position of the hands is linked to a higher sensitivity of 2D and 3D sonography in detecting PWD signals at wrists and MCP joints, compared with a flat position. Standardization of the scanning procedure is essential for obtaining comparable US results in RA patients in trials and clinical routines. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

[Manegement and countermeasures against tuberculous patients with chronic positive sputum].

Science.gov (United States)

Sato, K

1996-01-01

We studied measures for the prevention and treatment of chronic positive-sputum tuberculosis. Most physicians treating chronic intractable pulmonary tuberculosis are concerned about treatment and control measures. However, both the medical and social aspects of the disease must be dealt with. The study of the medical aspects of tuberculosis used data on patients at the Tokyo National Chest Hospital and other sanitoria in Japan. The socioeconomic study employed data from a health center in Tokyo. Recently, new cases of tuberculosis are concentrated in socioeconomically high risk groups, such as the homeless and illegal aliens, in a few large cities. Patients in these groups often have multidrug-resistant tuberculosis (MDRTB), including many patients with relapsing tuberculosis. However, it is dificult to keep such patients under treatment because of poor compliance and patient dropout. The results of our study are summarized as follows: 1. Prevention and treatment of chronic intractable tuberculosis should involve both the medical and socioeconomic aspects of the disease. 2. Surgical treatment offers benefits for patients with chronically positive sputum. Therefore, surgery should be recommended to patients with chronic intractable MDRTB. 3. If resistance to both isoniazid and rifampin is demonstrated, it is better to replace all ineffective drugs with a new effective regimen than to add a single drug to a failing regimen.

An ultrasound-based comparative study on carotid plaques in HIV-positive patients vs. atherosclerotic and arteritis patients: atherosclerotic or inflammatory lesions?

Science.gov (United States)

Maggi, Paolo; Perilli, Francesco; Lillo, Antonio; Carito, Valentina; Epifani, Giuseppe; Bellacosa, Chiara; Pastore, Giuseppe; Regina, Guido

2007-02-01

We have previously described two cases of HIV-1-positive patients undergoing surgery for stenosis of the internal carotid arteries. Histology revealed an extensive inflammatory infiltration of the vascular wall and no evidence of atheromasic plaque. This unexpected pattern of carotid damage prompted us to perform a more accurate investigation of the characteristics of carotid plaques in a group of HIV-positive patients. The results were compared with those obtained from young patients affected by atherosclerosis of the epi-aortic vessels and patients with arteritis. The patients underwent ultrasonography of the epi-aortic vessels using one of the latest generation power color-Doppler with 7.5 MHz probes. The study population included 61 HIV-positive patients and 47 HIV-negative patients (37 atherosclerotic and 10 with arteritis). Compared with HIV-negative atherosclerotic patients, there were significantly higher proportions of HIV-positive patients with iso-hypoechogenic lesions (81.8 vs. 29%) that were homogeneous both in their parietal and endoluminal portions (96.7 vs. 21.6% and 88.5 vs. 54.0%, respectively), with a smooth or slightly irregular surface (99.0 vs. 56.7%) (P=0.001 for all differences). No statistically significant differences were seen between HIV-positive and arteritis patients. Our study evidenced that the ultrasonographic structure of the epi-aortic lesions in HIV-positive patients substantially differ from those of the plaques in atherosclerotic patients, although they share similar characteristics with patients affected by arteritis. Further investigations are warranted to better define the structure and the mechanism of onset of these lesions.

Comparison of clinico-radiological features of patients with positive cultures of nontuberculous mycobacteria and patients with tuberculosis

International Nuclear Information System (INIS)

Ba-Hammam, Ahmed; Sharif, Yasir; Masood, Mohammad; Isnani, Arthur; Youssef, Ismael; Kambal, Abdelmageed; Shaikh, Shaffi

2005-01-01

To identify the clinico-radiological features of patients with positive cultures for nontuberculous mycobacteria (NTM) and compare those to a sample of patients with tuberculosis (MTB). A laboratory database was used to retrieve all specimens submitted to King Khalid University Hospital, Riyadh, mycobacteriology laboratory for mycobacterial smears and cultures during the period from October 1999-April 2002. Using this database, the original records of the mycobacteriology laboratory and a review of the patient's health records, a standard proforma was completed that included demographic, clinical, radiological and laboratory information on patients included in this study. The patients were divided into 2 groups; the NTM group, which included patients with positive cultures for NTM and the MTB group, which included a sample of patients with documented tuberculosis. During the study period, 286 patients had positive mycobacterial cultures. Seventy patients (24.5%) grew NTM and 216 (75.5%) grew MTB. For patients with MTB, 54 patients were included as per the selection protocol of the study. There was no difference between the 2 groups in all measured demographic variables. The presence of weight loss and fever was significantly more in the MTB group. Radiologically, the presence of hilar adenopathy was more significant among patients with MTB than those with NTM (17% versus 4%, p=0.02). However, bronchiectatic changes were seen significantly more among NTM patients compared to patients with MTB (26% versus 11%, p=0.03). The isolation of NTM in the mycobacteriology laboratory is high. The clinico-radiological features were not sufficiently specific to differentiate patients with NTM from patients with MTB. Local studies are needed to explore NTM disease in various developing countries and identify the NTM species causing infections in non-immunosuppressed patients in each locality. (author)

LGBTQ relationally based positive psychology: An inclusive and systemic framework.

Science.gov (United States)

Domínguez, Daniela G; Bobele, Monte; Coppock, Jacqueline; Peña, Ezequiel

2015-05-01

Positive psychologists have contributed to our understandings of how positive emotions and flexible cognition enhance resiliency. However, positive psychologists' research has been slow to address the relational resources and interactions that help nonheterosexual families overcome adversity. Addressing overlooked lesbian, gay, bisexual, transgender, or queer (LGBTQ) and systemic factors in positive psychology, this article draws on family resilience literature and LGBTQ literature to theorize a systemic positive psychology framework for working with nonheterosexual families. We developed the LGBTQ relationally based positive psychology framework that integrates positive psychology's strengths-based perspective with the systemic orientation of Walsh's (1996) family resilience framework along with the cultural considerations proposed by LGBTQ family literature. We theorize that the LGBTQ relationally based positive psychology framework takes into consideration the sociopolitical adversities impacting nonheterosexual families and sensitizes positive psychologists, including those working in organized care settings, to the systemic interactions of same-sex loving relationships. (c) 2015 APA, all rights reserved).

Hypoactivation of reward motivational system in patients with newly diagnosed hypertension grade I-II.

Science.gov (United States)

Aftanas, L I; Brak, I V; Gilinskaya, O M; Korenek, V V; Pavlov, S V; Reva, N V

2014-08-01

In patients with newly diagnosed untreated grade I-II hypertension, EEG oscillations were recorded under conditions activation of the two basic motivational systems, defensive motivational system and positive reinforcement system, evoked by recall of personally meaningful emotional events. The 64-channel EEG and cardiovascular reactivity (beat-by-beat technology) were simultaneously recorded. At rest, hypertensive patients had significantly reduced platelet serotonin concentrations in comparison with healthy individuals. The patients experiencing emotional activation were characterized by significantly lower intensity of positive emotions associated with more pronounced suppression of EEG activity in the delta (2-4 Hz) and theta (ranges of frequency 4-6 and 6-8 Hz) oscillators in the parieto-occipital cortex (zones P and PO) in both hemispheres of the brain. The findings attest to insufficient function of the brain serotonin system and hypoactivation of the reward/reinforcement system in patients with primary hypertension.

Linear quadratic optimization for positive LTI system

Science.gov (United States)

Muhafzan, Yenti, Syafrida Wirma; Zulakmal

2017-05-01

Nowaday the linear quadratic optimization subject to positive linear time invariant (LTI) system constitute an interesting study considering it can become a mathematical model of variety of real problem whose variables have to nonnegative and trajectories generated by these variables must be nonnegative. In this paper we propose a method to generate an optimal control of linear quadratic optimization subject to positive linear time invariant (LTI) system. A sufficient condition that guarantee the existence of such optimal control is discussed.

Ipsilateral shoulder pain in patients following lung resection in the decubitus position.

Science.gov (United States)

Bando, Takae; Kondo, Kazuya; Onishi, Chiemi; Kajiura, Koichiro; Takizawa, Hiromitsu; Yamada, Kazuyo; Sato, Hiromi; Imai, Yoshie

2018-03-01

To examine the frequency, influencing factors and clinical course of shoulder pain in patients following lung resection. Thoracoscopes have been introduced in the surgical treatment of lung cancer and allow for less invasive surgery with a minimal incision. However, decubitus position-related shoulder pain on the operated side has not yet been investigated. A longitudinal descriptive study. Patients who underwent lung resection in the decubitus position. Patients were interviewed 2 days before surgery and once daily for 5 days after surgery. Interview items included background data, the concomitant use of epidural anaesthesia, operative duration, the presence of preoperative shoulder stiffness (excluding shoulder pain), type of surgery and site of operation. The intensity of pain was approximately 5 on an 11-point numerical rating scale. Descriptive statistics on patient backgrounds were obtained using SPSS Statistics 22 for Windows. Of the 74 patients who underwent lung resection in a decubitus position, 30 (40.5%) developed shoulder pain on the operated side. The highest rating occurred 1 day after surgery and decreased over time. The following two factors were found to influence shoulder pain on the operated side: operative duration (Z = -2.63; p = .01) and the presence of preoperative shoulder stiffness (excluding shoulder pain) (χ 2  = 4.16; p = .04). This study demonstrated that approximately 40% of patients who underwent lung resection in the decubitus position developed shoulder pain. The presence of postoperative shoulder pain was related to both the duration of the operation and to the presence of preoperative shoulder stiffness. Although the shoulder pain resolves within 4 days, it causes the patient additional discomfort and distress. Therefore, further research is needed on positioning for thoracotomy in order to investigate ways to reduce or eliminate this complication of lung surgery. © 2017 John Wiley & Sons Ltd.

Non-typhoidal Salmonella and Campylobacter infections among HIV-positive patients in Denmark

DEFF Research Database (Denmark)

Larsen, I.K.; Gradel, Kim Oren; Helms, M.

2011-01-01

Non-typhoidal Salmonella (NTS) and Campylobacter are common causes of diarrhoea in human immunodeficiency virus (HIV)-positive patients. To investigate if incidence has changed since the introduction of highly active antiretroviral therapy (HAART), we combined data from The Danish Surveillance Re...... population. Moreover our study suggests that there is an increased incidence of Campylobacter-related illness among homosexual men in the HIV-positive population.......Non-typhoidal Salmonella (NTS) and Campylobacter are common causes of diarrhoea in human immunodeficiency virus (HIV)-positive patients. To investigate if incidence has changed since the introduction of highly active antiretroviral therapy (HAART), we combined data from The Danish Surveillance...... Registry for Enteric Pathogens and The Danish National Hospital Registry. We found that the incidences of NTS- and Campylobacter-related illness among HIV-positive patients in Denmark have declined since the introduction of HAART, although the incidences remained higher compared to the background...

Intracranial stereotactic positioning systems: Report of the American Association of Physicists in Medicine Radiation Therapy Committee Task Group No. 68

International Nuclear Information System (INIS)

Lightstone, A.W.; Benedict, Stanley H.; Bova, Frank J.; Solberg, Timothy D.; Stern, Robin L.

2005-01-01

Intracranial stereotactic positioning systems (ISPSs) are used to position patients prior to precise radiation treatment of localized lesions of the brain. Often, the lesion is located in close proximity to critical anatomic features whose functions should be maintained. Many types of ISPSs have been described in the literature and are commercially available. These are briefly reviewed. ISPS systems provide two critical functions. The first is to establish a coordinate system upon which a guided therapy can be applied. The second is to provide a method to reapply the coordinate system to the patient such that the coordinates assigned to the patient's anatomy are identical from application to application. Without limiting this study to any particular approach to ISPSs, this report introduces nomenclature and suggests performance tests to quantify both the stability of the ISPS to map diagnostic data to a coordinate system, as well as the ISPS's ability to be realigned to the patient's anatomy. For users who desire to develop a new ISPS system, it may be necessary for the clinical team to establish the accuracy and precision of each of these functions. For commercially available systems that have demonstrated an acceptable level of accuracy and precision, the clinical team may need to demonstrate local ability to apply the system in a manner consistent with that employed during the published testing. The level of accuracy and precision required of an individual ISPS system is dependent upon the clinical protocol (e.g., fractionation, margin, pathology, etc.). Each clinical team should provide routine quality assurance procedures that are sufficient to support the assumptions of accuracy and precision used during the planning process. The testing of ISPS systems can be grouped into two broad categories, type testing, which occurs prior to general commercialization, and site testing, performed when a commercial system is installed at a clinic. Guidelines to help select

Rates of Amyloid Imaging Positivity in Patients With Primary Progressive Aphasia

Science.gov (United States)

Santos-Santos, Miguel A.; Rabinovici, Gil D.; Iaccarino, Leonardo; Ayakta, Nagehan; Tammewar, Gautam; Lobach, Iryna; Henry, Maya L.; Hubbard, Isabel; Mandelli, Maria Luisa; Spinelli, Edoardo; Miller, Zachary A.; Pressman, Peter S.; O’Neil, James P.; Ghosh, Pia; Lazaris, Andreas; Meyer, Marita; Watson, Christa; Yoon, Soo Jin; Rosen, Howard J.; Grinberg, Lea; Seeley, William W.; Miller, Bruce L.; Jagust, William J.; Gorno-Tempini, Maria Luisa

2018-01-01

IMPORTANCE The ability to predict the pathology underlying different neurodegenerative syndromes is of critical importance owing to the advent of molecule-specific therapies. OBJECTIVE To determine the rates of positron emission tomography (PET) amyloid positivity in the main clinical variants of primary progressive aphasia (PPA). DESIGN, SETTING, AND PARTICIPANTS This prospective clinical-pathologic case series was conducted at a tertiary research clinic specialized in cognitive disorders. Patients were evaluated as part of a prospective, longitudinal research study between January 2002 and December 2015. Inclusion criteria included clinical diagnosis of PPA; availability of complete speech, language, and cognitive testing; magnetic resonance imaging performed within 6 months of the cognitive evaluation; and PET carbon 11–labeled Pittsburgh Compound-B or florbetapir F 18 brain scan results. Of 109 patients referred for evaluation of language symptoms who underwent amyloid brain imaging, 3 were excluded because of incomplete language evaluations, 5 for absence of significant aphasia, and 12 for presenting with significant initial symptoms outside of the language domain, leaving a cohort of 89 patients with PPA. MAIN OUTCOMES AND MEASURES Clinical, cognitive, neuroimaging, and pathology results. RESULTS Twenty-eight cases were classified as imaging-supported semantic variant PPA (11 women [39.3%]; mean [SD] age, 64 [7] years), 31 nonfluent/agrammatic variant PPA (22 women [71.0%]; mean [SD] age, 68 [7] years), 26 logopenic variant PPA (17 women [65.4%]; mean [SD] age, 63 [8] years), and 4 mixed PPA cases. Twenty-four of 28 patients with semantic variant PPA (86%) and 28 of 31 patients with nonfluent/agrammatic variant PPA (90%) had negative amyloid PET scan results, while 25 of 26 patients with logopenic variant PPA (96%) and 3 of 4 mixed PPA cases (75%) had positive scan results. The amyloid positive semantic variant PPA and nonfluent/agrammatic variant PPA cases

The AGS Booster Beam Position Monitor system

International Nuclear Information System (INIS)

Ciardullo, D.J.; Abola, A.; Beadle, E.R.; Smith, G.A.; Thomas, R.; Van Zwienen, W.; Warkentien, R.; Witkover, R.L.

1991-01-01

To accelerate both protons and heavy ions, the AGS Booster requires a broadband (multi-octave) beam position monitoring system with a dynamic range spanning several orders of magnitude (2 x 10 10 to 1.5 x 10 13 particles per pulse). System requirements include the ability to acquire single turn trajectory and average orbit information with ± 0.1 mm resolution. The design goal of ± 0.5 mm corrected accuracy requires that the detectors have repeatable linear performance after periodic bakeout at 300 degree C. The system design and capabilities of the Booster Beam Position Monitor will be described, and initial results presented. 7 refs., 5 figs

Assessment of HIV-positive in-patients using the International ...

African Journals Online (AJOL)

version checklist was used to assess the impairments, activity limitations and participation restrictions experienced by a sample of HIV-positive in-patients admitted to Chris Hani Baragwanath Hospital in Johannesburg, South Africa. Laboratory ...

Positive predictive value of infective endocarditis in the Danish National Patient Registry: a validation study.

Science.gov (United States)

Østergaard, Lauge; Adelborg, Kasper; Sundbøll, Jens; Pedersen, Lars; Loldrup Fosbøl, Emil; Schmidt, Morten

2018-05-30

The positive predictive value of an infective endocarditis diagnosis is approximately 80% in the Danish National Patient Registry. However, since infective endocarditis is a heterogeneous disease implying long-term intravenous treatment, we hypothesiszed that the positive predictive value varies by length of hospital stay. A total of 100 patients with first-time infective endocarditis in the Danish National Patient Registry were identified from January 2010 - December 2012 at the University hospital of Aarhus and regional hospitals of Herning and Randers. Medical records were reviewed. We calculated the positive predictive value according to admission length, and separately for patients with a cardiac implantable electronic device and a prosthetic heart valve using the Wilson score method. Among the 92 medical records available for review, the majority of the patients had admission length ⩾2 weeks. The positive predictive value increased with length of admission. In patients with admission length value was 65% while it was 90% for admission length ⩾2 weeks. The positive predictive value was 81% for patients with a cardiac implantable electronic device and 87% for patients with a prosthetic valve. The positive predictive value of the infective endocarditis diagnosis in the Danish National Patient Registry is high for patients with admission length ⩾2 weeks. Using this algorithm, the Danish National Patient Registry provides a valid source for identifying infective endocarditis for research.

A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study

NARCIS (Netherlands)

Guérin, C.; Beuret, P.; Constantin, J. M.; Bellani, G.; Garcia-Olivares, P.; Roca, O.; Meertens, J. H.; Maia, P. Azevedo; Becher, T.; Peterson, J.; Larsson, A.; Gurjar, M.; Hajjej, Z.; Kovari, F.; Assiri, A. H.; Mainas, E.; Hasan, M. S.; Morocho-Tutillo, D. R.; Baboi, L.; Chrétien, J. M.; François, G.; Ayzac, L.; Chen, L.; Brochard, L.; Mercat, A.; Hajjej, Zied; Sellami, Walid; Ferjani, M.; Gurjar, Mohan; Assiri, Amer; Al Bshabshe, Ali; Almekhlafi, Ghaleb; Mandourah, Yasser; Hasan, Mohd Shahnaz; Rai, Vineya; Marzida, M.; Corcoles Gonzalez, Virgilio; Sanchez Iniesta, Rafael; Garcia, Pablo; Garcia-Montesinos de La Peña, Manuel; Garcia Herrera, Adriana; Roca, Oriol; Garcia-de-Acilu, Marina; Masclans Enviz, Joan Ramon; Mancebo, Jordi; Heili, Sarah; Artigas Raventos, Antonio; Blanch Torra, Lluís; Roche-Campo, Ferran; Schultz, Marcus

2018-01-01

While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low. This study aimed to determine the prevalence of use of PP in ARDS patients (primary

Morbidity and mortality of black HIV-positive patients with end-stage ...

African Journals Online (AJOL)

Methods. This retrospective study compared the incidences of vascular and infectious morbidity and mortality in black HIV-positive patients with those in a group of HIV-negative patients matched for ethnicity, age and gender. All the patients were receiving chronic haemodialysis in the medically insured healthcare sector of ...

The technique of craniospinal irradiation of paediatric patients in supine position

International Nuclear Information System (INIS)

Slampa, P.; Seneklova, Z.; Simicek, J.; Soumarova, R.; Burkon, P.; Burianova, L.

2001-01-01

Background. Postoperative radiation therapy has significant impact on local control and overall survival of paediatric patients with brain tumours but an irradiated volume is often a controversial issue. Our aim was to describe a new technique of craniospinal irradiation as a postoperative treatment in patients with the risk of relapse of brain tumours as well as to estimate the side effects of such craniospinal irradiation. Patients and methods. In the last 4 years, 17 paediatric patients under 15 years of age with medulloblastoma (8) ependymoma (6) and glioblastoma (3) received postoperative craniospinal axis radiotherapy by a new technique developed in our departments. This technique is based on irradiation in supine position with the use of asymmetric jaws of the linear accelerator. Results. Radiotherapy was well tolerated and dose-reduction was not needed in any case. Skin reactions were mild in all patients. The gastrointestinal and haematological toxicity was mild to moderate (WHO grade I-II). Conclusion. The proposed new technique of craniospinal irradiation is advantageous in terms of side effects and could be recommended to be widely used. Craniospinal irradiation in supine position is an alternative method to the treatment in prone position. The evaluation of the effectiveness was limited by a short follow-up interval. (author)

Breast calcifications. A standardized mammographic reporting and data system to improve positive predictive value

International Nuclear Information System (INIS)

Perugini, G.; Bonzanini, B.; Valentino, C.

1999-01-01

The purpose of this work is to investigate the usefulness of a standardized reporting and data system in improving the positive predictive value of mammography in breast calcifications. Using the Breast Imaging Reporting and Data System lexicon developed by the American College of Radiology, it is defined 5 descriptive categories of breast calcifications and classified diagnostic suspicion of malignancy on a 3-grade scale (low, intermediate and high). Two radiologists reviewed 117 mammographic studies selected from those of the patients submitted to surgical biopsy for mammographically detected calcifications from January 1993 to December 1997, and classified them according to the above criteria. The positive predictive value was calculated for all examinations and for the stratified groups. Defining a standardized system for assessing and describing breast calcifications helps improve the diagnostic accuracy of mammography in clinical practice [it

Lumbar microdiscectomy under epidural anaesthesia with the patient in the sitting position: a prospective study.

Science.gov (United States)

Nicassio, Nicola; Bobicchio, Paolo; Umari, Marzia; Tacconi, Leonello

2010-12-01

In a prospective study we compared the surgical outcome, length of hospital stay, complications and patient satisfaction for patients undergoing lumbar microdiscectomy (LM) under spinal anaesthesia (SA) in the sitting position (23 patients) to those of another cohort who underwent LM under general anaesthesia (GA) in the prone or genu-pectoral position during the same time period (238 patients). We aimed to determine: (i) if epidural anaesthesia is safe for lumbar microdiscectomy; and (ii) if placing the patient in a sitting position confers an advantage in performing the operation. For all patients we calculated the time from the end of the operation to the first spontaneous urination and to the first administration of analgesic drugs. Before being discharged, patients were asked to give an opinion on the quality of analgesia obtained by epidural anaesthesia and on the sitting position used. No patient had any complications linked to epidural anaesthesia and only one patient experienced a small dural tear as a surgical complication. Twenty of 23 patients expressed satisfaction with the level of analgesia obtained and only three considered it poor. All patients found the sitting position comfortable. Advantages of the sitting position for surgery include better comfort for the patient, potential to recreate a load condition similar to the one that takes place during orthostasis and a "cleaner" operative field that uses gravity to drain blood. Of greatest concern is the possibility of the patient developing a dural tear and subsequent leaking of cerebrospinal fluid, which could also be a source of surgical complications. Currently, epidural anaesthesia allows a reduction in anaesthetic and surgical times, anaesthetic complications and, consequently, hospitalization period. Further analysis of the sitting position for the patient during surgery is required to fully assess the advantages and disadvantages of this method. Copyright © 2010 Elsevier Ltd. All rights

Predicting the short-term risk of diabetes in HIV-positive patients

DEFF Research Database (Denmark)

Petoumenos, Kathy; Worm, Signe Westring; Fontas, Eric

2012-01-01

Introduction: HIV-positive patients receiving combination antiretroviral therapy (cART) frequently experience metabolic complications such as dyslipidemia and insulin resistance, as well as lipodystrophy, increasing the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Rates of DM ......). Factors predictive of DM included higher glucose, body mass index (BMI) and triglyceride levels, and older age. Among HIV-related factors, recent CD4 counts of...... and other glucose-associated disorders among HIV-positive patients have been reported to range between 2 and 14%, and in an ageing HIV-positive population, the prevalence of DM is expected to continue to increase. This study aims to develop a model to predict the short-term (six-month) risk of DM in HIV...

Influence of Lymphatic Invasion on Locoregional Recurrence Following Mastectomy: Indication for Postmastectomy Radiotherapy for Breast Cancer Patients With One to Three Positive Nodes

International Nuclear Information System (INIS)

Matsunuma, Ryoichi; Oguchi, Masahiko; Fujikane, Tomoko; Matsuura, Masaaki; Sakai, Takehiko; Kimura, Kiyomi; Morizono, Hidetomo; Iijima, Kotaro; Izumori, Ayumi; Miyagi, Yumi; Nishimura, Seiichiro; Makita, Masujiro; Gomi, Naoya; Horii, Rie; Akiyama, Futoshi; Iwase, Takuji

2012-01-01

Purpose: The indication for postmastectomy radiotherapy (PMRT) in breast cancer patients with one to three positive lymph nodes has been in discussion. The purpose of this study was to identify patient groups for whom PMRT may be indicated, focusing on varied locoregional recurrence rates depending on lymphatic invasion (ly) status. Methods and Materials: Retrospective analysis of 1,994 node-positive patients who had undergone mastectomy without postoperative radiotherapy between January 1990 and December 2000 at our hospital was performed. Patient groups for whom PMRT should be indicated were assessed using statistical tests based on the relationship between locoregional recurrence rate and ly status. Results: Multivariate analysis showed that the ly status affected the locoregional recurrence rate to as great a degree as the number of positive lymph nodes (p < 0.001). Especially for patients with one to three positive nodes, extensive ly was a more significant factor than stage T3 in the TNM staging system for locoregional recurrence (p < 0.001 vs. p = 0.295). Conclusion: Among postmastectomy patients with one to three positive lymph nodes, patients with extensive ly seem to require local therapy regimens similar to those used for patients with four or more positive nodes and also seem to require consideration of the use of PMRT.

Long term follow-up in patients with four or more positive lymph nodes treated with conservative surgery and radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Mehta, Kiran; Haffty, Bruce G

1995-07-01

Purpose: The purpose of this study was to review management strategies with respect to systemic therapy and radiation treatment techniques, and to assess patient outcome (local regional control, distant metastases and overall survival) in breast cancer patients undergoing conservative surgery and radiation therapy (CS+RT) who had four or more lymph nodes involved at the time of diagnosis. Methods and Materials: Of 1,040 patients undergoing CS+RT at our institution prior to 12/89, 579 patients underwent axillary lymph node dissection, 167 of whom had positive nodes. Fifty-one of these patients had four or more positive lymph nodes involved and serve as the patient population base for this study. The median age was 51 years (range 33-80), median number of nodes sampled was 16, and the median number of positive nodes was 7 (range 4-21). All patients received radiation therapy to the intact breast using tangential fields with electron beam boost to a total median dose of 6400 cGy. The majority of patients received regional nodal RT as follows: 40 patients received RT to the supraclav without axilla to a median dose of 4600 cGy, 10 patients received radiation to the supraclav and axilla to a median dose of 4600 cGy. Thirty-five of the 51 patients received a separate internal mammary port with a mixed beam of photons and electrons. One patient received radiation to the tangents alone without regional nodal irradiation. Adjuvant systemic therapy was employed in 49 of the 51 patients (96%) with 36 patients receiving chemotherapy (CTX) alone, six receiving tamoxifen alone and nine patients receiving both CTX and tamoxifen. Of 45 patients receiving CTX, 12 (27%) received RT prior to CTX, 22 (48%) received RT concurrently with CTX, 6 (14%) received RT sandwiched with CTX and 5 (11%) received RT following all systemic CTX (RT delay > 16 weeks). Results: As of 12/94, there have been 18 distant relapses, two nodal relapses and five breast relapses resulting in a 10-year distant

A metrology system for a high resolution cavity beam position monitor system

Science.gov (United States)

Walston, Sean; Boogert, Stewart; Chung, Carl; Fitsos, Pete; Frisch, Joe; Gronberg, Jeff; Hayano, Hitoshi; Hinton, Shantell; Honda, Yosuke; Khainovski, Oleg; Kolomensky, Yury; Loscutoff, Peter; Lyapin, Alexey; Malton, Stephen; May, Justin; McCormick, Douglas; Meller, Robert; Miller, David; Orimoto, Toyoko; Ross, Marc; Slater, Mark; Smith, Steve; Smith, Tonee; Terunuma, Nobuhiro; Thomson, Mark; Urakawa, Junji; Vogel, Vladimir; Ward, David; White, Glen

2013-11-01

International Linear Collider (ILC) interaction region beam sizes and component position stability requirements will likely be as small as a few nanometers. It is important to the ILC design effort to demonstrate that these tolerances can be achieved-ideally using a beam-based stability measurement. We developed a high resolution RF cavity Beam Position Monitor (BPM) system. A triplet of these BPMs, installed in the extraction line of the KEK Accelerator Test Facility (ATF) and tested with its ultra-low emittance beam, achieved a position measurement resolution of 15 nm. A metrology system for the three BPMs was subsequently installed. This system employed optical encoders to measure each BPM's position and orientation relative to a zero-coefficient of thermal expansion carbon fiber frame. We have demonstrated that the three BPMs behave as a rigid-body at the level of less than 5 nm.

Coordinated joint motion control system with position error correction

Science.gov (United States)

Danko, George L.

2016-04-05

Disclosed are an articulated hydraulic machine supporting, control system and control method for same. The articulated hydraulic machine has an end effector for performing useful work. The control system is capable of controlling the end effector for automated movement along a preselected trajectory. The control system has a position error correction system to correct discrepancies between an actual end effector trajectory and a desired end effector trajectory. The correction system can employ one or more absolute position signals provided by one or more acceleration sensors supported by one or more movable machine elements. Good trajectory positioning and repeatability can be obtained. A two joystick controller system is enabled, which can in some cases facilitate the operator's task and enhance their work quality and productivity.

Isolated HBsAg positivity in a Mexican patient with newly diagnosed lupus nephritis

Directory of Open Access Journals (Sweden)

Guillermo Delgado-García

2017-01-01

Conclusions: Isolated HBsAg positivity may result from multiple causes, one of which is cross-reactivity. To the best of our knowledge, this is the first report of a false-positive reading using CMIA technique in an active lupus patient. It is reasonable to stress that lupus patients with a positive screening for HBV should undergo a confirmatory assay (such as genomic detection, since this diagnosis may have important therapeutic implications.

Is patient confidentiality compromised with the electronic health record?: a position paper.

Science.gov (United States)

Wallace, Ilse M

2015-02-01

In order for electronic health records to fulfill their expected benefits, protection of privacy of patient information is key. Lack of trust in confidentiality can lead to reluctance in disclosing all relevant information, which could have grave consequences. This position paper contemplates whether patient confidentiality is compromised by electronic health records. The position that confidentiality is compromised was supported by the four bioethical principles and argued that despite laws and various safeguards to protect patients' confidentiality, numerous data breaches have occurred. The position that confidentiality is not compromised was supported by virtue ethics and a utilitarian viewpoint and argued that safeguards keep information confidential and the public feels relatively safe with the electronic health record. The article concludes with an ethically superior position that confidentiality is compromised with the electronic health record. Although organizational and governmental ways of enhancing the confidentiality of patient information within the electronic health record facilitate confidentiality, the ultimate responsibility of maintaining confidentiality rests with the individual end-users and their ethical code of conduct. The American Nurses Association Code of Ethics for nurses calls for nurses to be watchful with data security in electronic communications.

A Study of Vicon System Positioning Performance

Directory of Open Access Journals (Sweden)

Pierre Merriaux

2017-07-01

Full Text Available Motion capture setups are used in numerous fields. Studies based on motion capture data can be found in biomechanical, sport or animal science. Clinical science studies include gait analysis as well as balance, posture and motor control. Robotic applications encompass object tracking. Today’s life applications includes entertainment or augmented reality. Still, few studies investigate the positioning performance of motion capture setups. In this paper, we study the positioning performance of one player in the optoelectronic motion capture based on markers: Vicon system. Our protocol includes evaluations of static and dynamic performances. Mean error as well as positioning variabilities are studied with calibrated ground truth setups that are not based on other motion capture modalities. We introduce a new setup that enables directly estimating the absolute positioning accuracy for dynamic experiments contrary to state-of-the art works that rely on inter-marker distances. The system performs well on static experiments with a mean absolute error of 0.15 mm and a variability lower than 0.025 mm. Our dynamic experiments were carried out at speeds found in real applications. Our work suggests that the system error is less than 2 mm. We also found that marker size and Vicon sampling rate must be carefully chosen with respect to the speed encountered in the application in order to reach optimal positioning performance that can go to 0.3 mm for our dynamic study.

The impact of a focally positive resection margin on the local control in patients treated with breast-conserving therapy

International Nuclear Information System (INIS)

Park, Seho; Park, Hyung-Seok; Kim, Seung-ll; Koo, Ja-Seung; Park, Byeong-Woo; Lee, Kyong-Sik

2011-01-01

The aim of the study was to investigate the parameters affecting positive margin and the impact of positive margin on outcomes after breast-conserving therapy in patients with breast cancer. Characteristics and survival of 705 patients attempted breast-conserving therapy between January 1994 and December 2004 were retrospectively analyzed using χ 2 tests, the Kaplan-Meier methods and multivariate analyses. Ninety-five (13.5%) showed positive margins at initial resection. Among them, 28 (4.0%) had negative margin on the initial frozen section; however, they finally turned out a focally positive margin with intraductal carcinoma on the permanent pathology. Positive margin at initial resection was significantly associated with lobular histology (P=0.001), four or more involved lymph nodes (P=0.015) and the presence of extensive intraductal component (P<0.001). A focally positive margin did not influence local (P=0.250; 95% confidence interval, 0.612-6.592) or regional failure (P=0.756; 95% confidence interval, 0.297-5.311). Patients with a focally positive margin showed an advanced nodal stage and received a higher dose of irradiation and more systemic therapy. Nodal involvements were the most significant factor for locoregional failure. Although the achievement of negative margins is the best way to reduce local failure, patients with a focally positive margin and favorable risk factors such as node negativity and older age could have an option of close follow-up with adequate boost irradiation and adjuvant therapy instead of conversion to total mastectomy. (author)

Local Positioning Systems in (Game) Sports

Science.gov (United States)

Leser, Roland; Baca, Arnold; Ogris, Georg

2011-01-01

Position data of players and athletes are widely used in sports performance analysis for measuring the amounts of physical activities as well as for tactical assessments in game sports. However, positioning sensing systems are applied in sports as tools to gain objective information of sports behavior rather than as components of intelligent spaces (IS). The paper outlines the idea of IS for the sports context with special focus to game sports and how intelligent sports feedback systems can benefit from IS. Henceforth, the most common location sensing techniques used in sports and their practical application are reviewed, as location is among the most important enabling techniques for IS. Furthermore, the article exemplifies the idea of IS in sports on two applications. PMID:22163725

Position paper - primary ventilation system configuration

International Nuclear Information System (INIS)

Dalpiaz, E.L.

1994-06-01

The purpose of this paper is to develop and document a position on the configuration of the primary ventilation system. This configuration will be used on the waste storage tanks currently being designed for the Multi-Function Waste Tank Facility. The primary ventilation system provides a single treatment train and exhaust fan for each waste storage tank. The ventilation systems from each of two tanks are grouped with an additional treatment train and exhaust fan that function as backup to either of the two systems

Development of a computer-assisted system for model-based condylar position analysis (E-CPM).

Science.gov (United States)

Ahlers, M O; Jakstat, H

2009-01-01

Condylar position analysis is a measuring method for the three-dimensional quantitative acquisition of the position of the mandible in different conditions or at different points in time. Originally, the measurement was done based on a model, using special mechanical condylar position measuring instruments, and on a research scale with mechanical-electronic measuring instruments. Today, as an alternative, it is possible to take measurements with electronic measuring instruments applied directly to the patient. The computerization of imaging has also facilitated condylar position measurement by means of three-dimensional data records obtained by imaging examination methods, which has been used in connection with the simulation and quantification of surgical operation results. However, the comparative measurement of the condylar position at different points in time has so far not been possible to the required degree. An electronic measuring instrument, allowing acquisition of the condylar position in clinical routine and facilitating later calibration with measurements from later examinations by data storage and use of precise equalizing systems, was therefore designed by the present authors. This measuring instrument was implemented on the basis of already existing components from the Reference CPM und Cadiax Compact articulator and registration systems (Gamma Dental, Klosterneuburg, Austria) as well as the matching CMD3D evaluation software (dentaConcept, Hamburg).

Adult systemic Epstein-Barr virus-positive T-cell lymphoproliferative disease: A case report.

Science.gov (United States)

Wang, Youping; Liu, Xinyue; Chen, Yan

2015-09-01

Systemic Epstein-Barr virus (EBV)-positive T-cell lymphoproliferative disease (EBV + T-LPD) occurs mainly in Asia and South America and is extremely rare in adults. The disease is characterized by a clonal proliferation of EBV-infected T cells with a cytotoxic immunophenotype and is associated with a poor clinical outcome and can be life-threatening. The majority of the patients have evidence of systemic disease, often with lymph node, liver and spleen involvement. The present study describes a case of adult systemic EBV + T-LPD with high fever, systemic lymphadenopathy, hepatosplenomegaly, nose-pharynx neoplasm, pancytopenia, EB virus infection and proliferative bone marrow, with the aim of improving the understanding of the condition.

Patient positioning and its verification: justification and state of the art of conventional practices

International Nuclear Information System (INIS)

Maingon, P.; Giraud, J.Y.

2000-01-01

Patient immobilization is considered an important part of the quality control program in radiation therapy. The need for patient immobilization according to the symptoms, ensuring both reproducibility and comfort, is described in the recommendations for level 1 published by the SFPM (Societe francaise de physique medicale) and the SFRO (Societe francaise de radiotherapie oncologique). A customized device, associated with regular controls, is required for level 2. Customized procedures are mandatory in clinical practice for head and neck and brain treatments. Internal margins and movements of patients must be analyzed and controlled as deviations of CTV placement relative to the isocenter of linacs. They could be reduced with efficient positioning devices and accurate customized immobilization systems. Different devices could be used according to tumor locations. Except for sub-clavicular tumors, their efficacy remains controversial. (authors)

Fast time-of-flight camera based surface registration for radiotherapy patient positioning.

Science.gov (United States)

Placht, Simon; Stancanello, Joseph; Schaller, Christian; Balda, Michael; Angelopoulou, Elli

2012-01-01

This work introduces a rigid registration framework for patient positioning in radiotherapy, based on real-time surface acquisition by a time-of-flight (ToF) camera. Dynamic properties of the system are also investigated for future gating/tracking strategies. A novel preregistration algorithm, based on translation and rotation-invariant features representing surface structures, was developed. Using these features, corresponding three-dimensional points were computed in order to determine initial registration parameters. These parameters became a robust input to an accelerated version of the iterative closest point (ICP) algorithm for the fine-tuning of the registration result. Distance calibration and Kalman filtering were used to compensate for ToF-camera dependent noise. Additionally, the advantage of using the feature based preregistration over an "ICP only" strategy was evaluated, as well as the robustness of the rigid-transformation-based method to deformation. The proposed surface registration method was validated using phantom data. A mean target registration error (TRE) for translations and rotations of 1.62 ± 1.08 mm and 0.07° ± 0.05°, respectively, was achieved. There was a temporal delay of about 65 ms in the registration output, which can be seen as negligible considering the dynamics of biological systems. Feature based preregistration allowed for accurate and robust registrations even at very large initial displacements. Deformations affected the accuracy of the results, necessitating particular care in cases of deformed surfaces. The proposed solution is able to solve surface registration problems with an accuracy suitable for radiotherapy cases where external surfaces offer primary or complementary information to patient positioning. The system shows promising dynamic properties for its use in gating/tracking applications. The overall system is competitive with commonly-used surface registration technologies. Its main benefit is the

Fast time-of-flight camera based surface registration for radiotherapy patient positioning

International Nuclear Information System (INIS)

Placht, Simon; Stancanello, Joseph; Schaller, Christian; Balda, Michael; Angelopoulou, Elli

2012-01-01

Purpose: This work introduces a rigid registration framework for patient positioning in radiotherapy, based on real-time surface acquisition by a time-of-flight (ToF) camera. Dynamic properties of the system are also investigated for future gating/tracking strategies. Methods: A novel preregistration algorithm, based on translation and rotation-invariant features representing surface structures, was developed. Using these features, corresponding three-dimensional points were computed in order to determine initial registration parameters. These parameters became a robust input to an accelerated version of the iterative closest point (ICP) algorithm for the fine-tuning of the registration result. Distance calibration and Kalman filtering were used to compensate for ToF-camera dependent noise. Additionally, the advantage of using the feature based preregistration over an ''ICP only'' strategy was evaluated, as well as the robustness of the rigid-transformation-based method to deformation. Results: The proposed surface registration method was validated using phantom data. A mean target registration error (TRE) for translations and rotations of 1.62 ± 1.08 mm and 0.07 deg. ± 0.05 deg., respectively, was achieved. There was a temporal delay of about 65 ms in the registration output, which can be seen as negligible considering the dynamics of biological systems. Feature based preregistration allowed for accurate and robust registrations even at very large initial displacements. Deformations affected the accuracy of the results, necessitating particular care in cases of deformed surfaces. Conclusions: The proposed solution is able to solve surface registration problems with an accuracy suitable for radiotherapy cases where external surfaces offer primary or complementary information to patient positioning. The system shows promising dynamic properties for its use in gating/tracking applications. The overall system is competitive with commonly-used surface registration

The Position of Hyoici Bone in Skeletal Class I, II and III Patients

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Ravanmehr H

2000-06-01

Full Text Available In this investigation, the position of hyoid bone was compared in three skeletal groups of class I, II and III. The study was based on evaluating 77 lateral cephalometric radiographs, 40 girls and 37 boys, which were divided into 3 groups. Group 1, 2, and 3 consist of 26, 25, and 26 radiographs. 19 cephalometric landmarks and 10 planes were used in order to tracing the radiographs. In all patients, 9 skeletal and 4 cervical vertebrae parameters were measured to determine the hyoid bone. These parameters were compared between three skeletal groups regardless of sex and then, in another statistical analysis, parameters were compared based on patients sex. Statistical analysis showed that in class III patients, the hyoid bone was positioned more anteriorly than two other groups. Also in this group, the hyoid bone had less inclination and it was more horizontal in relation to mandibular plane. In skeletal class II patients this bone was positioned more superiorly than two other groups. Due to these findings it can be concluded that perimandibular muscles and bones could affect the growth of mandible. In addition, comparison of the parameters between two sexes revealed that the hyoid bone was positioned more anteriorly and inferiorly in boys. Also it was shown that in the girls, the position of hyoid bone was closer to the position of this bone in skeletal class I patients.

Environmental radiation monitoring system with GPS (global positioning system)

International Nuclear Information System (INIS)

Komoto, Itsuro

2000-01-01

This system combines a radiation monitoring car with GPS and a data processor (personal computer). It distributes the position information acquired through GPS to the data such as measured environmental radiation dose rate and energy spectrum. It also displays and edits the data for each measuring position on a map. Transmitting the data to the power station through mobile phone enables plan managers to easily monitor the environmental radiation dose rate nearby and proper emergency monitoring. (author)

Review of the patient positioning reproducibility in head-and-neck radiotherapy using Statistical Process Control.

Science.gov (United States)

Moore, Sarah J; Herst, Patries M; Louwe, Robert J W

2018-05-01

A remarkable improvement in patient positioning was observed after the implementation of various process changes aiming to increase the consistency of patient positioning throughout the radiotherapy treatment chain. However, no tool was available to describe these changes over time in a standardised way. This study reports on the feasibility of Statistical Process Control (SPC) to highlight changes in patient positioning accuracy and facilitate correlation of these changes with the underlying process changes. Metrics were designed to quantify the systematic and random patient deformation as input for the SPC charts. These metrics were based on data obtained from multiple local ROI matches for 191 patients who were treated for head-and-neck cancer during the period 2011-2016. SPC highlighted a significant improvement in patient positioning that coincided with multiple intentional process changes. The observed improvements could be described as a combination of a reduction in outliers and a systematic improvement in the patient positioning accuracy of all patients. SPC is able to track changes in the reproducibility of patient positioning in head-and-neck radiation oncology, and distinguish between systematic and random process changes. Identification of process changes underlying these trends requires additional statistical analysis and seems only possible when the changes do not overlap in time. Copyright © 2018 Elsevier B.V. All rights reserved.

Downsizing of health-system pharmacist positions.

Science.gov (United States)

Kahaleh, A A; Siganga, W; Holiday-Goodman, M; Lively, B T

1998-11-15

The effects of downsizing on institutional pharmacists were studied. A national mail survey was sent to a random sample of 533 members of ASHP in January 1997. The questionnaire was designed to determine (1) the influence of selected factors on the downsizing of pharmacist positions and (2) pharmacists' attitudes about downsizing. A total of 256 usable questionnaires were received, for a net response rate of 48%. Forty-four pharmacists, or 17%, had personally been affected by downsizing. Sixty-one percent of the pharmacists affected by downsizing had had administrative positions. After downsizing, only 32% of the pharmacists had an administrative position. Most of the pharmacists were currently employed. Thirty-five (79%) described their current job responsibilities as substantially changed. Two thirds made the same salaries or higher salaries. Pharmacists who had been downsized rated mergers, the impact of managed care, and the profit motive as the most influential causes of downsizing of pharmacist positions. The three most common negative comments about the impact of downsizing cited reduction in the quality of patient care, increased stress, and lowered morale. Most of the pharmacists believed that communication skills, education, cross-training, and clinical skills are keys to surviving downsizing. Most pharmacists whose positions were downsized said they went on to jobs with similar or higher salaries and substantially different responsibilities.

The value of level III clearance in patients with axillary and sentinel node positive breast cancer.

LENUS (Irish Health Repository)

Dillon, Mary F

2012-02-01

BACKGROUND: The value of level III axillary clearance is contentious, with great variance worldwide in the extent and levels of clearance performed. OBJECTIVE: To determine rates of level III positivity in patients undergoing level I-III axillary clearance, and identify which patients are at highest risk of involved level III nodes. METHODS: From a database of 2850 patients derived from symptomatic and population-based screening service, 1179 patients who underwent level I-III clearance between the years 1999-2007 were identified. The pathology, surgical details, and prior sentinel nodes biopsies of patients were recorded. RESULTS: Eleven hundred seventy nine patients had level I-III axillary clearance. Of the patients, 63% (n = 747) were node positive. Of patients with node positive disease, 23% (n = 168) were level II positive and 19% (n = 141) were level III positive. Two hundred fifty patients had positive sentinel node biopsies prior to axillary clearance. Of these, 12% (n = 30) and 9% (n = 22) were level II and level III positive, respectively. On multivariate analysis, factors predictive of level III involvement in patients with node positive disease were tumor size (P < 0.001, OR = 1.36; 95% CI: 1.2-1.5), invasive lobular disease (P < 0.001, OR = 3.6; 95% CI: 1.9-6.95), extranodal extension (P < 0.001, OR = 0.27; 95% CI: 0.18-0.4), and lymphovascular invasion (P = 0.04, OR = 0.58; 95% CI: 0.35-1). Lobular invasive disease (P = 0.049, OR = 4.1; 95% CI: 1-16.8), extranodal spread (P = 0.003, OR = 0.18; 95% CI: 0.06-0.57), and having more than one positive sentinel node (P = 0.009, OR = 4.9; 95% CI: 1.5-16.1) were predictive of level III involvement in patients with sentinel node positive disease. CONCLUSION: Level III clearance has a selective but definite role to play in patients who have node positive breast carcinoma. Pathological characteristics of the primary tumor are of particular use in identifying those who are at various risk of level III nodal

Digitized video subject positioning and surveillance system for PET

International Nuclear Information System (INIS)

Picard, Y.; Thompson, C.J.

1995-01-01

Head motion is a significant contribution to the degradation of image quality of Positron Emission Tomography (PET) studies. Images from different studies must also be realigned digitally to be correlated when the subject position has changed. These constraints could be eliminated if the subject's head position could be monitored accurately. The authors have developed a video camera-based surveillance system to monitor the head position and motion of subjects undergoing PET studies. The system consists of two CCD (charge-coupled device) cameras placed orthogonally such that both face and profile views of the subject's head are displayed side by side on an RGB video monitor. Digitized images overlay the live images in contrasting colors on the monitor. Such a system can be used to (1) position the subject in the field of view (FOV) by displaying the position of the scanner's slices on the monitor along with the current subject position, (2) monitor head motion and alert the operator of any motion during the study and (3) reposition the subject accurately for subsequent studies by displaying the previous position along with the current position in a contrasting color

The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea.

Science.gov (United States)

Pengo, Martino F; Czaban, Marcin; Berry, Marc P; Nirmalan, Prajeshan; Brown, Richard; Birdseye, Adam; Woroszyl, Asia; Chapman, Julia; Kent, Brian D; Hart, Nicholas; Rossi, Gian Paolo; Steier, Joerg

2018-01-01

Continuous positive airway pressure (CPAP), the best available treatment for obstructive sleep apnea (OSA), requires long-term compliance to be effective. Behavioral interventions may be used to improve adherence to CPAP. We aimed to investigate whether positive or negative message framing impacts on CPAP compliance in patients with OSA, when compared to standard care. Consenting patients with confirmed OSA were randomly allocated to receive along with their CPAP either positively or negatively framed messages (Pos; Neg), or standard care (Con). Standardized motivational messages were read out to patients during an initial teaching session and through weekly telephone calls. Patients' compliance data were reviewed 2 and 6 weeks following CPAP initiation. We randomized 112 patients to groups that were matched for age, BMI, and OSA severity. The positively framed group (Pos) showed greater CPAP usage after 2 weeks (total use 53.7±31.4 hours) as compared to the negatively framed and the control group (35.6±27.4 and 40.8±33.5 hours, Pframed groups (Pos n=5; Neg n=8; Con n=11; Pframed messages can improve CPAP adherence in patients with OSA in the short-term; however, strategies for implementing its long-term use need to be developed.

A metrology system for a high resolution cavity beam position monitor system

Energy Technology Data Exchange (ETDEWEB)

Walston, Sean, E-mail: walston2@llnl.gov [Lawrence Livermore National Laboratory, 7000 East Ave., L-181, Livermore, CA 94550 (United States); Boogert, Stewart [Royal Holloway, University of London, Egham (United Kingdom); Chung, Carl; Fitsos, Pete [Lawrence Livermore National Laboratory, 7000 East Ave., L-181, Livermore, CA 94550 (United States); Frisch, Joe [Stanford Linear Accelerator Center, Menlo Park, CA (United States); Gronberg, Jeff [Lawrence Livermore National Laboratory, 7000 East Ave., L-181, Livermore, CA 94550 (United States); Hayano, Hitoshi [High Energy Accelerator Research Organization (KEK), Tsukuba-shi, Ibaraki-ken (Japan); Hinton, Shantell [Stanford Linear Accelerator Center, Menlo Park, CA (United States); Honda, Yosuke [High Energy Accelerator Research Organization (KEK), Tsukuba-shi, Ibaraki-ken (Japan); Khainovski, Oleg; Kolomensky, Yury; Loscutoff, Peter [University of California and Lawrence Berkeley National Laboratory, Berkeley, CA (United States); Lyapin, Alexey; Malton, Stephen [University College London, London (United Kingdom); May, Justin; McCormick, Douglas [Stanford Linear Accelerator Center, Menlo Park, CA (United States); Meller, Robert [Cornell University, Ithaca, NY (United States); Miller, David [University College London, London (United Kingdom); Orimoto, Toyoko [University of California and Lawrence Berkeley National Laboratory, Berkeley, CA (United States); California Institute of Technology, Pasadena, CA (United States); Ross, Marc [Stanford Linear Accelerator Center, Menlo Park, CA (United States); Fermi National Accelerator Laboratory, Batavia, IL (United States); and others

2013-11-11

International Linear Collider (ILC) interaction region beam sizes and component position stability requirements will likely be as small as a few nanometers. It is important to the ILC design effort to demonstrate that these tolerances can be achieved–ideally using a beam-based stability measurement. We developed a high resolution RF cavity Beam Position Monitor (BPM) system. A triplet of these BPMs, installed in the extraction line of the KEK Accelerator Test Facility (ATF) and tested with its ultra-low emittance beam, achieved a position measurement resolution of 15 nm. A metrology system for the three BPMs was subsequently installed. This system employed optical encoders to measure each BPM's position and orientation relative to a zero-coefficient of thermal expansion carbon fiber frame. We have demonstrated that the three BPMs behave as a rigid-body at the level of less than 5 nm.

A Method for The Assessing of Reliability Characteristics Relevant to an Assumed Position-Fixing Accuracy in Navigational Positioning Systems

Directory of Open Access Journals (Sweden)

Specht Cezary

2016-09-01

Full Text Available This paper presents a method which makes it possible to determine reliability characteristics of navigational positioning systems, relevant to an assumed value of permissible error in position fixing. The method allows to calculate: availability , reliability as well as operation continuity of position fixing system for an assumed, determined on the basis of formal requirements - both worldwide and national, position-fixing accuracy. The proposed mathematical model allows to satisfy, by any navigational positioning system, not only requirements as to position-fixing accuracy of a given navigational application (for air , sea or land traffic but also the remaining characteristics associated with technical serviceability of a system.

Modeling and Positioning of a PZT Precision Drive System

Directory of Open Access Journals (Sweden)

Che Liu

2017-11-01

Full Text Available The fact that piezoelectric ceramic transducer (PZT precision drive systems in 3D printing are faced with nonlinear problems with respect to positioning, such as hysteresis and creep, has had an extremely negative impact on the precision of laser focusing systems. To eliminate the impact of PZT nonlinearity during precision drive movement, mathematical modeling and theoretical analyses of each module comprising the system were carried out in this study, a micro-displacement measurement circuit based on Position Sensitive Detector (PSD is constructed, followed by the establishment of system closed-loop control and creep control models. An XL-80 laser interferometer (Renishaw, Wotton-under-Edge, UK was used to measure the performance of the precision drive system, showing that system modeling and control algorithms were correct, with the requirements for precision positioning of the drive system satisfied.

Modeling and Positioning of a PZT Precision Drive System.

Science.gov (United States)

Liu, Che; Guo, Yanling

2017-11-08

The fact that piezoelectric ceramic transducer (PZT) precision drive systems in 3D printing are faced with nonlinear problems with respect to positioning, such as hysteresis and creep, has had an extremely negative impact on the precision of laser focusing systems. To eliminate the impact of PZT nonlinearity during precision drive movement, mathematical modeling and theoretical analyses of each module comprising the system were carried out in this study, a micro-displacement measurement circuit based on Position Sensitive Detector (PSD) is constructed, followed by the establishment of system closed-loop control and creep control models. An XL-80 laser interferometer (Renishaw, Wotton-under-Edge, UK) was used to measure the performance of the precision drive system, showing that system modeling and control algorithms were correct, with the requirements for precision positioning of the drive system satisfied.

Web-based audiovisual patient information system--a study of preoperative patient information in a neurosurgical department.

Science.gov (United States)

Gautschi, Oliver P; Stienen, Martin N; Hermann, Christel; Cadosch, Dieter; Fournier, Jean-Yves; Hildebrandt, Gerhard

2010-08-01

In the current climate of increasing awareness, patients are demanding more knowledge about forthcoming operations. The patient information accounts for a considerable part of the physician's daily clinical routine. Unfortunately, only a small percentage of the information is understood by the patient after solely verbal elucidation. To optimise information delivery, different auxiliary materials are used. In a prospective study, 52 consecutive stationary patients, scheduled for an elective lumbar disc operation were asked to use a web-based audiovisual patient information system. A combination of pictures, text, tone and video about the planned surgical intervention is installed on a tablet personal computer presented the day before surgery. All patients were asked to complete a questionnaire. Eighty-four percent of all participants found that the audiovisual patient information system lead to a better understanding of the forthcoming operation. Eighty-two percent found that the information system was a very helpful preparation before the pre-surgical interview with the surgeon. Ninety percent of all participants considered it meaningful to provide this kind of preoperative education also to patients planned to undergo other surgical interventions. Eighty-four percent were altogether "very content" with the audiovisual patient information system and 86% would recommend the system to others. This new approach of patient information had a positive impact on patient education as is evident from high satisfaction scores. Because patient satisfaction with the informed consent process and understanding of the presented information improved substantially, the audiovisual patient information system clearly benefits both surgeons and patients.

Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients

Directory of Open Access Journals (Sweden)

Eliana Teixeira Maranhão

2015-06-01

Full Text Available Benign paroxysmal positional vertigo (BPPV, the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%, the barbecue 360° maneuver in twelve patients (32.4%, both manoeuvers in four patients (10.8%, both manoeuvers plus head shaking in one patient (2.7%, and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0% on the initial visit.

Orthotopic Liver Transplantation in Human-Immunodeficiency-Virus-Positive Patients in Germany

Directory of Open Access Journals (Sweden)

E. Anadol

2012-01-01

Full Text Available Objectives. This summary evaluates the outcomes of orthotopic liver transplantation (OLT of HIV-positive patients in Germany. Methods. Retrospective chart analysis of HIV-positive patients, who had been liver-transplanted in Germany between July 1997 and July 2011. Results. 38 transplantations were performed in 32 patients at 9 German transplant centres. The reasons for OLT were end-stage liver disease (ESLD and/or liver failure due to hepatitis C (HCV (=19, hepatitis B (HBV (=10, multiple viral infections of the liver (=2 and Budd-Chiari-Syndrome. In July 2011 19/32 (60% of the transplanted patients were still alive with a median survival of 61 months (IQR (interquartile range: 41–86 months. 6 patients had died in the early post-transplantation period from septicaemia (=4, primary graft dysfunction (=1, and intrathoracal hemorrhage (=1. Later on 7 patients had died from septicaemia (=2, delayed graft failure (=2, recurrent HCC (=2, and renal failure (=1. Recurrent HBV infection was efficiently prevented in 11/12 patients; HCV reinfection occurred in all patients and contributed considerably to the overall mortality. Conclusions. Overall OLT is a feasible approach in HIV-infected patients with acceptable survival rates in Germany. Reinfection with HCV still remains a major clinical challenge in HIV/HCV coinfection after OLT.

A digital position-indication system for control rods

International Nuclear Information System (INIS)

Nishizawa, Yukio; Hayakawa, Toshifumi

1979-01-01

Systems that detect and indicate the position of the control rods that regulate the thermal output of a nuclear reactor play a particularly important role in monitoring its operational status. Conventionally, control rod position indication in pressurized water reactors has been of the analog type, utilizing the principle of the differential transformer. The present digital system was developed with the objective of achieving greater stability, greater accuracy, and higher reliability. The article gives a general description of the system and describes its advantages. (author)

Women's Status and World-System Position: An Exploratory Analysis

Directory of Open Access Journals (Sweden)

Richard York

2015-08-01

Full Text Available Our aim here is to strengthen the links between the world-systems perspective and research ongender inequality. Grounding our analysis in theories assessing the connections between genderrelationships and world-system processes, we empirically explore (] the extent to whichwomen's status in nations overlaps with the world-system position of those nations and (2 theinfluence of women's status within nations on a variety of national characteristics. We find thatwomen's status has a moderately strong association with world-system position, which suggeststhat macro-comparative research may confound the respective effects on a variety of socialcharacteristics of women's status and world-system position if indicators of both factors are notincluded in analyses. We also find that, controlling for world-system position, GDP per capita,and urbanization, in nations where women have higher status (variously measured, total fertilityrates, infant mortality rates, military expenditures, and inflows of foreign direct investinent arelower, and public health care expenditures and per capita meat consumption are higher. Theseresults suggest that women's status likely has social effects that can be seen on the macro-level,and that world-systems analysts should pay more attention to theories of gender in their research.

[Effect of 45 degree angle semirecumbent position on ventilator-associated pneumonia in mechanical ventilated patients: a meta-analysis].

Science.gov (United States)

Leng, Yu-xin; Song, Ya-han; Yao, Zhi-yuan; Zhu, Xi

2012-10-01

To systemically analyze the effect of 45 degree angle semirecumbent position on the incidence of ventilator-associated pneumonia (VAP) and other outcomes in mechanical ventilated patients, and to evaluate whether 45 degree angle semirecumbent position is superior to 25 degree angle-30 degree angle head of bed (HOB). The randomized controlled trials (RCTs) comparing the effect of different HOB on the outcomes of mechanical ventilated patients were searched (from 1st January 1990 to 20th July 2012) from five databases including the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, China Knowledge Resource Integrated Database (CNKI), and Wanfang Database. Meta analysis was conducted using RevMan 5.0 software. Data extracted from five RCTs with a total of 427 patients were analyzed. The risks of developing clinically diagnosed VAP were significantly lower among the patients in semirecumbent 45 degree angle position compared to the patients in lower position [15.96% (34/213) vs. 26.64% (57/214), relative risk (RR)=0.57, 95% confidence interval (95%CI) 0.39 to 0.83, P=0.003], while no significant differences were detected between the two groups regarding the mortality rate [27.04% (53/196) vs. 28.22% (57/202), RR=0.93, 95%CI 0.68 to 1.27, P=0.66], the length of intensive care unit (ICU) stay [weighted mean difference (WMD)=-0.45, 95%CI -1.08 to 0.18, P=0.16] and the percentage of antibiotics treatment [71.11% (32/45) vs. 60.87% (28/46), RR=1.14, 95%CI 0.85 to 1.53, P=0.37]. Two of the five trials (91 patients) were included in the sub-analysis between 45 degree angle group (45 patients) and 25 degree angle-30 degree angle group (46 patients). The results showed that comparing with 25 degree angle-30 degree angle, 45 degree angle semirecumbent position had no significance in improving patients' clinical outcomes. This study proved that the clinically preferred semirecumbent 45 degree angle position did have effect in reducing the incidence of VAP

CPT-11/bevacizumab for the treatment of refractory brain metastases in patients with HER2-neu-positive breast cancer.

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Sengupta, S; Rojas, R; Mahadevan, A; Kasper, E; Jeyapalan, S

2015-04-01

Nervous system relapse of patients with advanced HER2-neu-positive breast cancer is an increasing problem, with one-third of women developing brain metastases. Standard therapies using steroids, surgery and radiotherapy do not provide a lasting response. We evaluated CPT-11 and bevacizumab, which can both cross the blood-brain barrier, as combination therapy to treat HER2-neu-positive breast cancer with brain metastases.

Item Banks for Substance Use from the Patient-Reported Outcomes Measurement Information System (PROMIS®): Severity of Use and Positive Appeal of Use*

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Pilkonis, Paul A.; Yu, Lan; Dodds, Nathan E.; Johnston, Kelly L.; Lawrence, Suzanne; Hilton, Thomas F.; Daley, Dennis C.; Patkar, Ashwin A.; McCarty, Dennis

2015-01-01

Background Two item banks for substance use were developed as part of the Patient-Reported Outcomes Measurement Information System (PROMIS®): severity of substance use and positive appeal of substance use. Methods Qualitative item analysis (including focus groups, cognitive interviewing, expert review, and item revision) reduced an initial pool of more than 5,300 items for substance use to 119 items included in field testing. Items were written in a first-person, past-tense format, with 5 response options reflecting frequency or severity. Both 30-day and 3-month time frames were tested. The calibration sample of 1,336 respondents included 875 individuals from the general population (ascertained through an internet panel) and 461patients from addiction treatment centers participating in the National Drug Abuse Treatment Clinical Trials Network. Results Final banks of 37 and 18 items were calibrated for severity of substance use and positive appeal of substance use, respectively, using the two-parameter graded response model from item response theory (IRT). Initial calibrations were similar for the 30-day and 3-month time frames, and final calibrations used data combined across the time frames, making the items applicable with either interval. Seven-item static short forms were also developed from each item bank. Conclusions Test information curves showed that the PROMIS item banks provided substantial information in a broad range of severity, making them suitable for treatment, observational, and epidemiological research in both clinical and community settings. PMID:26423364

Fluorescence In Situ Hybridization and Immunohistochemistry as Diagnostic Methods for ALK Positive Non-Small Cell Lung Cancer Patients

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Martinez, Pablo; Hernández-Losa, Javier; Cedrés, Susana; Castellví, Josep; Martinez-Marti, Alex; Tallada, Natalia; Murtra-Garrell, Nuria; Navarro-Mendivill, Alejandro; Rodriguez-Freixinos, Victor; Canela, Mercedes; Ramon y Cajal, Santiago; Felip, Enriqueta

2013-01-01

Background Anaplastic Lymphoma Kinase (ALK) positivity represents a novel molecular target in a subset of Non-Small Cell Lung Cancers (NSCLC). We explore Fluorescence in situ Hybridization (FISH) and Immunohistochemistry (IHC) as diagnostic methods for ALK positive patients and to describe its prevalence and outcomes in a population of NSCLC patients. Methods NSCLC patients previously screened for Epidermal Growth Factor Receptor (EGFR) at our institution were selected. ALK positive patients were identified by FISH and the value of IHC (D5F3) was explored. Results ninety-nine patients were identified. Median age was 61.5 years (range 35–83), all were caucasians, eighty percent were adenocarcinomas, fifty-one percent were male and thirty-eight percent were current smokers. Seven (7.1%) patients were ALK positive by FISH, thirteen (13.1%) were EGFR mutant, and 65 (65.6%) were negative/Wild Type (WT) for both ALK and EGFR. ALK positivity and EGFR mutations were mutually exclusive. ALK positive patients tend to be younger than EGFR mutated or wt patients. ALK positive patients were predominantly never smokers (71.4%) and adenocarcinoma (71.4%). ALK positive and EGFR mutant patients have a better outcome than negative/WT. All patients with ALK FISH negative tumours were negative for ALK IHC. Out of 6 patients positive for ALK FISH with more tissue available, 5 were positive for ALK IHC and 1 negative. Conclusions ALK positive patients represent 7.1% of a population of selected NSCLC. ALK positive patients have different clinical features and a better outcome than EGFR WT and ALK negative patients. IHC is a promising method for detecting ALK positive NSCLC patients. PMID:23359795

Serum specimens with double HBsAg/HBsAb (s-system) or HBeAg/HBeAb (e-system) positive markers (by ELISA) cross-checked with RIA or ECLIA--a comparison

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Tao Hongqun; Li Xiaolong; Ye Wei

2005-01-01

Objective: To cross-check the unusually high double positive rate of s- or e-system tested with ELISA in sera specimens from hepatitis B patients with two other methods of assay (RIA or ECLIA). Methods: Double positive s- or e-system sera specimens (tested with ELISA) were randomly selected to be cross-checked with RIA or ECLIA. Results: The double positive rate in the specimens checked with RIA was only 31.8% for s-system and 3.37% for e- system. In the case of ECLIA, the double positive rate was 17.65% and 9.09% respectively. The results obtained with both RIA and ECLIA were significantly lower than the results with ELISA (P 0.05). Conclusion: The unusually high double positive rate of s- or e- system in HBVM detection with ELISA was due to false positiveness and results from RIA were more consistent with the results from ECLIA. (authors)

Impulse position control algorithms for nonlinear systems

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Sesekin, A. N., E-mail: sesekin@list.ru [Ural Federal University, 19 S. Mira, Ekaterinburg, 620002 (Russian Federation); Institute of Mathematics and Mechanics, Ural Division of Russian Academy of Sciences, 16 S. Kovalevskaya, Ekaterinburg, 620990 (Russian Federation); Nepp, A. N., E-mail: anepp@urfu.ru [Ural Federal University, 19 S. Mira, Ekaterinburg, 620002 (Russian Federation)

2015-11-30

The article is devoted to the formalization and description of impulse-sliding regime in nonlinear dynamical systems that arise in the application of impulse position controls of a special kind. The concept of trajectory impulse-sliding regime formalized as some limiting network element Euler polygons generated by a discrete approximation of the impulse position control This paper differs from the previously published papers in that it uses a definition of solutions of systems with impulse controls, it based on the closure of the set of smooth solutions in the space of functions of bounded variation. The need for the study of such regimes is the fact that they often arise when parry disturbances acting on technical or economic control system.

Impulse position control algorithms for nonlinear systems

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Sesekin, A. N.; Nepp, A. N.

2015-11-01

The article is devoted to the formalization and description of impulse-sliding regime in nonlinear dynamical systems that arise in the application of impulse position controls of a special kind. The concept of trajectory impulse-sliding regime formalized as some limiting network element Euler polygons generated by a discrete approximation of the impulse position control This paper differs from the previously published papers in that it uses a definition of solutions of systems with impulse controls, it based on the closure of the set of smooth solutions in the space of functions of bounded variation. The need for the study of such regimes is the fact that they often arise when parry disturbances acting on technical or economic control system.

Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position.

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Buget, Mehmet Ilke; Atalar, Ata Can; Edipoglu, Ipek Saadet; Sungur, Zerrin; Sivrikoz, Nukhet; Karadeniz, Meltem; Saka, Esra; Kucukay, Suleyman; Senturk, Mert N

2016-01-01

The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0). After the intubation, doppler-ultrasonography of the patients' internal carotid and vertebral arteries were evaluated to acquire cerebral blood flow values from the formula. In supine position, mean arterial pressure, patient state index and cerebral blood flow values were recorded (T1) and the patient was positioned to beach chair position. After 5min all measurements were repeated (T2). Measurements of patient state index and mean arterial pressure were repeated after 20 (T3), and 40 (T4)min. There was a significant decrease between T0 and T1 in heart rate (80.5±11.6 vs. 75.9±14.4beats/min), MAP (105.8±21.9 vs. 78.9±18.4mmHg) and PSI (88.5±8.3 vs. 30.3±9.7) (all pstate index values (T1-T4) showed no significant change; however, comparing only T1 and T2 resulted in a statically significant decrease in patient state index. There was a significant decrease in cerebral blood flow after beach chair position. Beach chair position was associated with a decrease in cerebral blood flow and patient state index values. Patient state index was affected by the gravitational change of the cerebral blood flow; however, both factors were not directly correlated to each other. Moreover, the decrease in patient state index value was transient and returned to normal values within 20min. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

[Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position].

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Buget, Mehmet Ilke; Atalar, Ata Can; Edipoglu, Ipek Saadet; Sungur, Zerrin; Sivrikoz, Nukhet; Karadeniz, Meltem; Saka, Esra; Kucukay, Suleyman; Senturk, Mert N

2016-01-01

The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0). After the intubation, doppler-ultrasonography of the patients' internal carotid and vertebral arteries were evaluated to acquire cerebral blood flow values from the formula. In supine position, mean arterial pressure, patient state index and cerebral blood flow values were recorded (T1) and the patient was positioned to beach chair position. After 5min all measurements were repeated (T2). Measurements of patient state index and mean arterial pressure were repeated after 20 (T3), and 40 (T4)min. There was a significant decrease between T0 and T1 in heart rate (80.5±11.6 vs. 75.9±14.4beats/min), MAP (105.8±21.9 vs. 78.9±18.4mmHg) and PSI (88.5±8.3 vs. 30.3±9.7) (all pstate index values (T1-T4) showed no significant change; however, comparing only T1 and T2 resulted in a statically significant decrease in patient state index. There was a significant decrease in cerebral blood flow after beach chair position. Beach chair position was associated with a decrease in cerebral blood flow and patient state index values. Patient state index was affected by the gravitational change of the cerebral blood flow; however, both factors were not directly correlated to each other. Moreover, the decrease in patient state index value was transient and returned to normal values within 20min. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Diffusion tensor MR imaging of white matter integrity in HIV-positive patients with planning deficit

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Correa, Diogo Goulart; Doring, Thomas M.; Wilner, Nina Ventura; Cabral, Rafael Ferracini; Gasparetto, Emerson Leandro [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil); Zimmermann, Nicolle; Fonseca, Rochele Paz [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Pontifical Catholic University of Rio Grande do Sul, Department of Psychology, Rio Grande do Sul (Brazil); Leite, Sarah C.B.; Bahia, Paulo R.V. [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil)

2015-05-01

The aim of this study was to evaluate whether normal controls and human immunodeficiency virus (HIV) patients with and without planning deficits differ on white matter integrity. A total of 34 HIV-positive patients with planning deficits were compared with 13 HIV-positive patients without planning deficits and 19 gender-, age-, and education-matched control subjects. Diffusion tensor imaging (DTI) was performed along 30 noncolinear directions in a 1.5-T scanner. For tract-based spatial statistics analysis, a white matter skeleton was created, and a permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The median, radial, and axial diffusivities were also projected onto the mean FA skeleton. Compared with controls, HIV-positive patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu and splenium of the corpus callosum, bilateral superior longitudinal fascicule, and bilateral uncinate fasciculi. Compared to HIV-positive patients without planning deficits, patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu of the corpus callosum, bilateral superior longitudinal fascicule, and right uncinate fascicule. DTI can detect extensive white matter abnormalities in the normal-appearing white matter of HIV-positive patients with planning deficits compared with controls and HIV-positive patients without planning deficits. (orig.)

Diffusion tensor MR imaging of white matter integrity in HIV-positive patients with planning deficit

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Correa, Diogo Goulart; Doring, Thomas M.; Wilner, Nina Ventura; Cabral, Rafael Ferracini; Gasparetto, Emerson Leandro; Zimmermann, Nicolle; Fonseca, Rochele Paz; Leite, Sarah C.B.; Bahia, Paulo R.V.

2015-01-01

The aim of this study was to evaluate whether normal controls and human immunodeficiency virus (HIV) patients with and without planning deficits differ on white matter integrity. A total of 34 HIV-positive patients with planning deficits were compared with 13 HIV-positive patients without planning deficits and 19 gender-, age-, and education-matched control subjects. Diffusion tensor imaging (DTI) was performed along 30 noncolinear directions in a 1.5-T scanner. For tract-based spatial statistics analysis, a white matter skeleton was created, and a permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The median, radial, and axial diffusivities were also projected onto the mean FA skeleton. Compared with controls, HIV-positive patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu and splenium of the corpus callosum, bilateral superior longitudinal fascicule, and bilateral uncinate fasciculi. Compared to HIV-positive patients without planning deficits, patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu of the corpus callosum, bilateral superior longitudinal fascicule, and right uncinate fascicule. DTI can detect extensive white matter abnormalities in the normal-appearing white matter of HIV-positive patients with planning deficits compared with controls and HIV-positive patients without planning deficits. (orig.)

Neurological manifestations in HIV positive patients in Tehran, Iran

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Minoo Mohraz

2014-02-01

Full Text Available Objective: To evaluate the neurological complications among Iranian HIV-positive patients. Methods: This cross-sectional study was conducted among 428 patients diagnosed with HIV infection between 2006 and 2009 at Imam Khomeini hospital, Tehran, Iran. Demographic and clinical variables as well as laboratory tests were extracted and analyzed. Also, another 100 patients refereed to Voluntary Counseling and Testing center of the hospital were visited and evaluated for neurological complications. Results: Among the patients, neurologic manifestations were observed in 34 (7.94% patients. Twenty three percent of the patients received antiretroviral therapy. Identified causes included brain toxoplasmosis (14.7%, progressive multi-focal leuko encephalopathy (5.9%, HIV encephalopathy (5.9%, TB meningitis (5% and unknown etiologies (11.8%. Also, among 100 patients who were admitted and visited at the Voluntary Counseling and Testing center, no one was diagnosed for any neurological manifestations. Conclusions: According to our results, toxoplasmosis is the most frequent cause of neurological conditions among Iranian HIV infected patients and should be considered in any HIV/AIDS patient with neurological manifestations.

A Prospective Open-label Pilot Study of Fluvastatin on Pro-inflammatory and Pro-thrombotic Biomarkers in Antiphospholipid Antibody Positive Patients

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Erkan, Doruk; Willis, Rohan; Murthy, Vijaya L.; Basra, Gurjot; Vega, JoAnn; Ruiz Limón, Patricia; Carrera, Ana Laura; Papalardo, Elizabeth; Martínez-Martínez, Laura Aline; González, Emilio B.; Pierangeli, Silvia S.

2014-01-01

Objective: To determine if pro-inflammatory and pro-thrombotic biomarkers are differentially upregulated in persistently antiphospholipid antibody (aPL)-positive patients, and to examine the effects of fluvastatin on these biomarkers. Methods: Four groups of patients (age 18-65) were recruited: a) Primary Antiphospholipid Syndrome (PAPS); b) Systemic Lupus Erythematosus (SLE) with APS (SLE/APS); c) Persistent aPL positivity without SLE or APS (Primary aPL); and d) Persistent aPL positivity with SLE but no APS (SLE/aPL). The frequency-matched control group, used for baseline data comparison, was identified from a databank of healthy persons. Patients received fluvastatin 40 mg daily for three months. At three months, patients stopped the study medication and they were followed for another three months. Blood samples for 12 pro-inflammatory and pro-thrombotic biomarkers were collected monthly for six months. Results: Based on the comparison of the baseline samples of 41 aPL-positive patients with 30 healthy controls, 9/12 (75%) biomarkers (interleukin [IL]-6, IL1β, vascular endothelial growth factor [VEGF], tumor necrosis factor [TNF]-□α, interferon [IFN]-α, inducible protein-10 [IP10], soluble CD40 ligand [sCD40L], soluble tissue factor [sTF], and intracellular cellular adhesion molecule [ICAM]-1) were significantly elevated. Twenty-four patients completed the study; fluvastatin significantly and reversibly reduced the levels of 6/12 (50%) biomarkers (IL1β, VEGF, TNFα, IP10, sCD40L, and sTF). Conclusion: Our prospective mechanistic study demonstrates that pro-inflammatory and pro-thrombotic biomarkers, which are differentially upregulated in persistently aPL-positive patients, can be reversibly reduced by fluvastatin. Thus, statin-induced modulation of the aPL effects on target cells can be a valuable future approach in the management of aPL-positive patients. PMID:23933625

Verification of patient position and delivery of IMRT by electronic portal imaging

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Fielding, Andrew L.; Evans, Philip M.; Clark, Catharine H.

2004-01-01

Background and purpose: The purpose of the work presented in this paper was to determine whether patient positioning and delivery errors could be detected using electronic portal images of intensity modulated radiotherapy (IMRT). Patients and methods: We carried out a series of controlled experiments delivering an IMRT beam to a humanoid phantom using both the dynamic and multiple static field method of delivery. The beams were imaged, the images calibrated to remove the IMRT fluence variation and then compared with calibrated images of the reference beams without any delivery or position errors. The first set of experiments involved translating the position of the phantom both laterally and in a superior/inferior direction a distance of 1, 2, 5 and 10 mm. The phantom was also rotated 1 and 2 deg. For the second set of measurements the phantom position was kept fixed and delivery errors were introduced to the beam. The delivery errors took the form of leaf position and segment intensity errors. Results: The method was able to detect shifts in the phantom position of 1 mm, leaf position errors of 2 mm, and dosimetry errors of 10% on a single segment of a 15 segment IMRT step and shoot delivery (significantly less than 1% of the total dose). Conclusions: The results of this work have shown that the method of imaging the IMRT beam and calibrating the images to remove the intensity modulations could be a useful tool in verifying both the patient position and the delivery of the beam

[Effects of recruitment maneuver in prone position on hemodynamics in patients with severe pulmonary infection].

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Fan, Yuan-hua; Liu, Yuan-fei; Zhu, Hua-yong; Zhang, Min

2012-02-01

To evaluate effects of recruitment maneuver in prone position on hemodynamics in patients with severe pulmonary infection, based on the protective pulmonary ventilation strategy. Ninety-seven cases with severe pulmonary infection admitted to intensive care unit (ICU) of Ganzhou City People's Hospital undergoing mechanical ventilation were involved. Volume controlled ventilation mode with small tidal volume (8 ml/kg) and positive end-expiratory pressure (PEEP) of 6 cm H(2)O [1 cm H(2)O = 0.098 kPa] was conducted. Each patient underwent recruitment maneuver in supine position and then in prone position [PEEP 20 cm H(2)O+pressure control (PC) 20 cm H(2)O]. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation [SpO(2)] and blood gas analysis data were recorded before and after recruitment maneuver in either position. A double-lumen venous catheter was inserted into internal jugular vein or subclavian vein, and a pulse index contour cardiac output (PiCCO) catheter was introduced into femoral artery. Cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index (SVRI), intra-thoracic blood volume index (ITBVI), extra vascular lung water index (EVLWI), global end-diastolic volume index (GEDVI), global ejection fraction (GEF), stroke volume variation (SVV) and central vein pressure (CVP) were monitored. (1) Compared with data before recruitment maneuver, there were no significant differences in HR and MAP after supine position and prone position recruitment maneuver, but significant differences in SpO(2) were found between before and after recruitment maneuver when patients' position was changed (supine position: 0.954 ± 0.032 vs. 0.917 ± 0.025, P recruitment maneuver (P recruitment maneuver, CI [L×min(-1)×m(-2)], SVI (ml/m(2)), GEDVI (ml/m(2)) and GEF were decreased significantly during recruitment maneuver (supine position: CI 3.2 ± 0.4 vs. 3.8 ± 0.6, SVI 32.4 ± 5.6 vs. 38.8 ± 6.5, GEDVI 689 ± 44 vs. 766 ± 32, GEF 0.267 ± 0

Stability Tests of Positive Fractional Continuous-time Linear Systems with Delays

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Tadeusz Kaczorek

2013-06-01

Full Text Available Necessary and sufficient conditions for the asymptotic stability of positive fractional continuous-time linear systems with many delays are established. It is shown that: 1 the asymptotic stability of the positive fractional system is independent of their delays, 2 the checking of the asymptotic stability of the positive fractional systems with delays can be reduced to checking of the asymptotic stability of positive standard linear systems without delays.

[A case of anti-LKM 1 positive autoimmune hepatitis accompanied by systemic lupus erythematosus].

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Choi, Dae Han; Kim, Hae Kyung; Park, Tae Il; John, Byung Min; Kang, Sung Hwan; Lee, Yoon Serk; Kim, Tae Hyun; Lee, Uh Joo; Lee, Tae Seung; Yoon, Gwi Ok

2008-03-01

Overlap of autoimmune hepatitis and systemic lupus erythematosus (SLE) is a comparatively rare condition. Although both autoimmune hepatitis and SLE can share common autoimmune features such as polyarthralgia, hypergammaglobulinemia and positive ANA, it has been considered as two different entities. We report a case of anti-LKM1 positive autoimmune hepatitis who developed SLE two years later. The presence of interface hepatitis with lymphoplasma cell infiltrates and rosette formation points to the autoimmune hepatitis rather than SLE hepatitis. Autoimmune hepatitis is infrequently accompanied by SLE, therefore, it could be recommended to investigate for SLE in patients with autoimmune hepatitis.

Identification and characterization of microsporidia from fecal samples of HIV-positive patients from Lagos, Nigeria.

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Oladele Teslim Ojuromi

Full Text Available BACKGROUND: Microsporidia are obligate intracellular parasites that infect a broad range of vertebrates and invertebrates. They have been increasingly recognized as human pathogens in AIDS patients, mainly associated with a life-threatening chronic diarrhea and systemic disease. However, to date the global epidemiology of human microsporidiosis is poorly understood, and recent data suggest that the incidence of these pathogens is much higher than previously reported and may represent a neglected etiological agent of more common diseases indeed in immunocompetent individuals. To contribute to the knowledge of microsporidia molecular epidemiology in HIV-positive patients in Nigeria, the authors tested stool samples proceeding from patients with and without diarrhea. METHODOLOGY/PRINCIPAL FINDINGS: Stool samples from 193 HIV-positive patients with and without diarrhea (67 and 126 respectively from Lagos (Nigeria were investigated for the presence of microsporidia and Cryptosporidium using Weber's Chromotrope-based stain, Kinyoun stain, IFAT and PCR. The Weber stain showed 45 fecal samples (23.3% with characteristic microsporidia spores, and a significant association of microsporidia with diarrhea was observed (O.R. = 18.2; CI: 95%. A similar result was obtained using Kinyoun stain, showing 44 (31,8% positive samples with structures morphologically compatible with Cryptosporidium sp, 14 (31.8% of them with infection mixed with microsporidia. The characterization of microsporidia species by IFAT and PCR allowed identification of Enterocytozoon bieneusi, Encephalitozoon intestinalis and E. cuniculi in 5, 2 and 1 samples respectively. The partial sequencing of the ITS region of the rRNA genes showed that the three isolates of E.bieneusi studied are included in Group I, one of which bears the genotype B. CONCLUSIONS/SIGNIFICANCE: To our knowledge, this is the first report of microsporidia characterization in fecal samples from HIV-positive patients from

HLA-A29-POSITIVE BIRDSHOT CHORIORETINOPATHY IN AN AFRICAN AMERICAN PATIENT.

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Knezevic, Alexander; Munk, Marion R; Pappas, Frankie; Merrill, Pauline T; Goldstein, Debra A

2016-01-01

To report the first documented case of HLA-A29-positive birdshot chorioretinopathy in an African American patient. A 51-year-old African American woman presented with a 10-year history of photopsia, progressive decrease in visual acuity, metamorphopsia, and new nyctalopia. Both fundi showed evidence of periphlebitis, arterial attenuation, macular edema, and diffuse chorioretinal atrophy. Fluorescein angiography revealed diffuse vascular leakage, and indocyanine green showed evenly distributed and symmetrical hypofluorescent spots, which were difficult to appreciate on fundoscopy. Workup revealed a positive HLA-A29 and was negative for sarcoid, tuberculosis, and syphilis. Birdshot chorioretinopathy overwhelmingly affects non-Hispanic Caucasians, but there have been rare reported cases in other ethnicities including Hispanics and African Americans. This patient's ethnicity may have contributed to the 10-year delay in diagnosis. To our knowledge, this is the first documented HLA-A29 positive case of birdshot chorioretinopathy in an African American. HLA-A29 may be a useful supportive test in cases with classic clinical presentation in non-Caucasian patients to enable the correct diagnose in a timely manner.

Epidemiological and clinical features of hepatitis delta in HBsAg-positive patients by HIV status.

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Nicolini, Laura A; Taramasso, Lucia; Schiavetti, Irene; Giannini, Edoardo G; Beltrame, Andrea; Feasi, Marcello; Cassola, Giovanni; Grasso, Alessandro; Bartolacci, Valentina; Sticchi, Laura; Picciotto, Antonino; Viscoli, Claudio

2015-01-01

The epidemiology of HBV-associated hepatitis has changed in recent years, especially after the introduction of anti-HBV vaccination, with a consequent decrease in the incidence of HDV-associated hepatitis. However, HDV remains of concern in non-vaccinated people and in immigrants. The aim of this retrospective survey has been to assess prevalence and clinical characteristics of HDV infection in Liguria, a region in Northern Italy, in both HIV-positive and negative patients. During the year 2010, 641 patients chronically infected with HBV entered an observational study of HBV infection conducted in eight tertiary care centres belonging to the 'Ligurian HBV Study Group'. Of 641 patients, 454 (70.8%) were evaluated for HDV serology and 26 (5.7%) were found positive. Among them, 16 were also HIV-positive and 10 were not. Of the 428 HDV-negative patients, only 313 were tested for HIV and 33 (10.5%) were positive. At the time point of study entry there was no age difference between HIV-positive or negative patients, but HIV-positive patients were 10 years younger than HIV-negative (mean age 34.25 ±6.16 versus 41.50 ±8.89 years; P=0.021) at the time point of their first visit in each centre and they were also more frequently intravenous drug users (P=0.009). Despite a similar rate of cirrhosis in the two groups, no HIV-positive patient received an HDV-active therapy (that is, interferon), versus 4 of 10 HIV-negative patients (P=0.014). HDV infection is still a problem in patients not covered by HBV vaccination. Both HDV and HIV testing were frequently overlooked in our setting.

Prone position as prevention of lung injury in comatose patients: a prospective, randomized, controlled study.

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Beuret, Pascal; Carton, Marie-Jose; Nourdine, Karim; Kaaki, Mahmoud; Tramoni, Gerard; Ducreux, Jean-Claude

2002-05-01

Comatose patients frequently exhibit pulmonary function worsening, especially in cases of pulmonary infection. It appears to have a deleterious effect on neurologic outcome. We therefore conducted a randomized trial to determine whether daily prone positioning would prevent lung worsening in these patients. Prospective, randomized, controlled study. Sixteen-bed intensive care unit. Fifty-one patients who required invasive mechanical ventilation because of coma with Glascow coma scores of 9 or less. In the prone position (PP) group: prone positioning for 4 h once daily until the patients could get up to sit in an armchair; in the supine position (SP) group: supine positioning. The primary end point was the incidence of lung worsening defined by an increase in the Lung Injury Score of at least 1 point since the time of randomization. The secondary end point was the incidence of ventilator-associated pneumonia (VAP). A total of 25 patients were randomly assigned to the PP group and 26 patients to the SP group. The characteristics of the patients from the two groups were similar at randomization. The incidence of lung worsening was lower in the PP group (12%) than in the SP group (50%) ( p=0.003). The incidence of VAP was 20% in the PP group and 38.4% in the SP group ( p=0.14). There was no serious complication attributable to prone positioning, however, there was a significant increase of intracranial pressure in the PP. In a selected population of comatose ventilated patients, daily prone positioning reduced the incidence of lung worsening.

Gender Reassignment Surgery in Human Immunodeficiency Virus-Positive Patients: A Report of Two Cases

Directory of Open Access Journals (Sweden)

Seok-Kwun Kim

2015-11-01

Full Text Available It is believed that surgery on human immunodeficiency virus (HIV-positive patients is dangerous and should be avoided due to the possibility of postoperative infection of the patients or HIV occupational transmission to the medical staff. We discuss here the preparations and measures needed to conduct surgery safely on HIV-positive patients, based on our experience. We performed sex reassignment surgery on two HIV-positive patients from January 2013 to January 2015. Both of them were receiving highly active antiretroviral therapy and were asymptomatic, with a normal CD4 count (>500 cells/µL. The HIV-RNA was undetectable within the bloodstream. All the staff wore protective clothing, glasses, and three pairs of protective gloves in the operating room because of the possibility of transmission. Prophylactic antibiotics were administered to the patients, and antiviral therapy was performed during their perioperative course. Neither of the patients had postoperative complications, and none of the medical staff experienced accidental exposure. Both patients had satisfactory surgery outcomes without complications. HIV-positive patients can undergo surgery safely without increased risk of postoperative complications or HIV transmission to the staff through the proper use of antibiotics, active antiretroviral therapy, and supplemental protective measures with post-exposure prophylaxis for the staff in case of HIV exposure.

Preliminary Results on Setup Precision of Prone-Lateral Patient Positioning for Whole Breast Irradiation

International Nuclear Information System (INIS)

Veldeman, Liv; Speleers, Bruno; Bakker, Marlies; Jacobs, Filip; Coghe, Marc; De Gersem, Werner; Impens, Aline; Nechelput, Sarah; De Wagter, Carlos

2010-01-01

Purpose: The aim of this study was to develop a rapid and reproducible technique for prone positioning and to compare dose-volume indices in prone and supine positions. Methods and Materials: Eighteen patients underwent computed tomography imaging for radiotherapy planning in prone and supine position. Experience was gained in the first eight patients, which lead to modifications of the Horizon prone breast board (Civco Medical Solutions, Orange City, Iowa, USA) and the patient setup technique. A unilateral breast holder (U-BH) was developed (Van de Velde, Schellebelle, Belgium) to retract the contralateral breast away from the treated breast. The technique was then applied to an additional 10 patients. The setup precision was evaluated using daily cone-beam CT. Results: Modifications to the breast board were made to secure a prone-lateral rather then a pure prone position. We evolved from a classical setup using laser marks on the patients' body to a direct breast setup using marks on the breast only. The setup precision of the direct positioning procedure with the modified breast board and the U-BH is comparable to supine setup data in the literature. Dose-volume indices for heart and lung show significantly better results for prone than for supine position, and dose homogeneity within the treated breast did not differ according to the treatment position. Conclusions: The setup precision of our prone-lateral positioning technique is comparable to supine data in literature. Our data show the advantage of prone radiotherapy to spare the lung and heart. Further research is necessary to reduce the duration of prone setup.

Resting position of the head and malocclusion in a group of patients with cerebral palsy

Science.gov (United States)

Martinez-Mihi, Victoria; Orellana, Lorena M.; Silvestre-Rangil, Javier

2014-01-01

Cerebral palsy are found as a result of these disorders, along with associated neuromuscular functional alterations that affect the resting position of the head. In this context, the resting position of the head could be responsible for several skeletal and dental occlusal disorders among patients with cerebral palsy. Objective: To assess the presence of malocclusions in patients with cerebral palsy, define the most frequent types of malocclusions, and evaluate how the resting position of the head may be implicated in the development of such malocclusions. Study design: Forty-four patients aged between 12-55 years (18 males and 26 females) were studied. Occlusal conditions, the Dental Aesthetic Index (DAI), changes in the resting position of the head, and breathing and swallowing functions were assessed. Results: Orthodontic treatment was required by 70.8% of the patients, the most frequent malocclusions being molar class II, open bite and high overjet. These individuals showed altered breathing and swallowing functions, as well as habit and postural disorders. The resting position of the head, especially the hyperextended presentation, was significantly correlated to high DAI scores. Conclusions: The results obtained suggest that patients with cerebral palsy are more susceptible to present malocclusions, particularly molar class II malocclusion, increased open bite, and high overjet. Such alterations in turn are more common in patients with a hyperextended position of the head. Key words:Cerebral palsy, malocclusion, head position, disabled patients. PMID:24596627

Effects of treatment position and patient immobilization on the variability of patient motion in the treatment of prostate cancer patients

International Nuclear Information System (INIS)

Nguyen, A.; Washington, M.; Wyman, B.; Song, P.; Bauml, J.; Tobias, R.; Vaida, F.; Chen, G.; Vijayakumar, S.; Reese, Michael

1995-01-01

Purpose/Objective: As dose-escalation is being attempted in the treatment of prostate cancer, uncertainties in patient position due to day-to-day setup has become increasingly critical. We present results from an ongoing study of the variability of patient positioning in prone versus supine treatment positions, as well as with and without immobilization using an aquaplast cast. Materials and Methods: We compared the probability and the amount of day-to-day movement of patients with prostate cancer. Patients were divided into three groups: (a) those treated supine without immobilization, (b) those treated supine and immobilized with an aquaplast cast over the abdomen and pelvis, and (c) those treated prone and similarly immobilized in aquaplast. The three components of patient motion - cephalo-caudad, anterior-posterior, and lateral - were examined separately. Portal films, taken at least once a week during treatment, were compared to simulation films and appropriate changes were made on the next day before treatment. This film record was used in our retrospective analysis of patient motion. To study the probability of movement we carried out a Likelihood Ratio test (LR) on a sample of 43 patients (20, 15, and 8 in treatment positions (a), (b), and (c) respectively). To study the amount of movement, templates with outlines of bony landmarks were generated based on the simulation film and overlaid on the portal film to measure the displacement. Results: Our measurements are summarized in the table below, where the p values for the difference in probability of movement (leftmost three columns) comes from the LR test and the amount of movement (rightmost three columns) is expressed as an average accompanied by a root-mean-square, in millimeters. Conclusions: From the data so far analyzed, patients treated supine and immobilized in an aquaplast cast -- group (b) -- exhibit the lowest probability of cephalo-caudad and anterior-posterior movement. In addition, although

Investigations on uncertainties in patient positioning for prostate treatment with EPID; Untersuchungen zur Positionierungsgenauigkeit bei Prostatakonformationsbestrahlungen mittels Portal-Imaging

Energy Technology Data Exchange (ETDEWEB)

Bakai, A.; Nuesslin, F. [Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany). Abt. Medizinische Physik; Paulsen, F.; Plasswilm, L.; Bamberg, M. [Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany). Abt. Strahlentherapie

2002-02-01

Background: Conformal radiotherapy techniques as used in prostate treatment allow to spare normal tissue by conforming the radiation fields to the shape of the planning target volume (PTV). To be able to fully utilize the advantages of these techniques correct patient positioning is an important prerequisite. This study employing an electronic portal imaging device (EPID) investigated the positioning uncertainties that occur in the pelvic region for different patient positioning devices. Patients and Methods: 15 patients with prostate cancer were irradiated with or without rectal balloon/pelvic mask at a linear accelerator with multileaf collimator (MLC). For each patient multiple portal images were taken from different directions and compared to the digitally reconstructed radiographs (DRRs) of the treatment planning system and to simulation films (Table 1, Figure 1). Results: In spite of different positioning devices, all patients showed comparable total positioning uncertainties of 4.0 mm (lateral), 4.5 mm (cranio-caudal) and 1.7 mm (dorso-ventral). The lateral positioning error was reduced for the pelvic mask patients while the cranio-caudal error increased (Table 2, Figure 2). A systematic and a random component sum up to the total positioning error, and a good estimate of the magnitudes of the two is possible from six to eight portal images (Figure 3). Conclusions: With a small number of portal images it is possible to find out the systematic and random positioning error of a patient. Knowledge of the random error can be used to resize the treatment margin which is clinically relevant since this error differs greatly for different patients (Figure 4). Image analysis with EPID is convenient, yet has some problems. For example, one only gets indirect information on the movement of the ventral rectum wall. The successful operation of positioning devices, although, needs further improvement - especially if one focuses on IMRT. (orig.) [German] Hintergrund

Detection of drug-induced dyslipidaemia in HIV-positive patients ...

African Journals Online (AJOL)

Purpose: To determine whether protease inhibitors (PIs) cause hypercholesterolaemia and hypertriglyceridaemia, and to assess the influence of sex and age on serum total cholesterol (TC) and triglycerides (TG), and the level of adherence to therapeutic laboratory monitoring guidelines in HIV positive patients in the ...

HOSPITAL INFORMATION SYSTEMS: A STUDY OF ELECTRONIC PATIENT RECORDS

Directory of Open Access Journals (Sweden)

Pedro Luiz Cortês

2011-05-01

Full Text Available The importance of patient records, also known as medical records, is related to different needs and objectives, as they constitute permanent documents on the health of patients. With the advancement of information technologies and systems, patient records can be stored in databases, resulting in a positive impact on patient care. Based on these considerations, a research question that arises is “what are the benefits and problems that can be seen with the use of electronic versions of medical records?” This question leads to the formulation of the following hypothesis: although problems can be identified during the process of using electronic record systems, the benefits outweigh the difficulties, thereby justifying their use. To respond to the question and test the presented hypothesis, a research study was developed with users of the same electronic record system, consisting of doctors, nurses, and administrative personnel in three hospitals located in the city of São Paulo, Brazil. The results show that, despite some problems in their usage, the benefits of electronic patient records outweigh possible disadvantages.

Double-blind trial of bestatin in HIV-positive patients

DEFF Research Database (Denmark)

Hørding, M; Gøtzsche, P C; Dalh Christensen, L

1990-01-01

Twenty-two HIV-positive homosexual men with a moderately impaired immune system were randomized to bestatin capsules 60 mg a day or placebo for 4 weeks. None suffered from opportunistic infections. The immunomodulating effect of bestatin was investigated by lymphocyte proliferation assay with pok......Twenty-two HIV-positive homosexual men with a moderately impaired immune system were randomized to bestatin capsules 60 mg a day or placebo for 4 weeks. None suffered from opportunistic infections. The immunomodulating effect of bestatin was investigated by lymphocyte proliferation assay...

Clinical characteristics differentiating bacteriologically positive pulmonary tuberculosis patients from negative ones in Mongolia.

Science.gov (United States)

Toyota, M; Yasuda, N; Koda, S; Ohara, H; Enkhbat, S; Tsogt, G

1998-06-01

The objective of this study is to clarify clinical characteristics which differentiate bacteriologically positive pulmonary tuberculosis patients from negative ones in Mongolia. The subjects include 338 patients aged 16 years and older who had undergone bacteriological examinations. Of them, 107 patients (31.7%) were confirmed bacteriologically. The proportion of bacteriological positive results increased significantly among patients who had cavities in the roentgenographic examination, cough at diagnosis and the family history of tuberculosis. Addressing these clinical characteristics will contribute to raising not only the sensitivity of the sputum examination, but also the specificity of the roentgenographic examination in the diagnostic process of tuberculosis.

Management of mental health disorders in HIV-positive patients

African Journals Online (AJOL)

Mental Health Guidelines Committee, Southern African HIV Clinicians Society, ... triple diagnosis (HIV/mental disorder/substance use disorder), or mental .... fatigue or loss of energy .... between 20% and 60% of HIV-positive adults suffer from some form ... patients on complex regimens should be reviewed regularly with a.

Predicting biochemical recurrence-free survival for patients with positive pelvic lymph nodes at radical prostatectomy.

Science.gov (United States)

von Bodman, Christian; Godoy, Guilherme; Chade, Daher C; Cronin, Angel; Tafe, Laura J; Fine, Samson W; Laudone, Vincent; Scardino, Peter T; Eastham, James A

2010-07-01

We evaluated predictors of freedom from biochemical recurrence in patients with pelvic lymph node metastasis at radical prostatectomy. Of 207 patients with lymph node metastasis treated with radical prostatectomy and bilateral pelvic lymph node dissection 45 received adjuvant androgen deprivation therapy and 162 did not. Cox proportional hazards regression models were used to investigate predictors of biochemical recurrence after radical prostatectomy. Recurrence probability was estimated using the Kaplan-Meier method. A median of 13 lymph nodes were removed. Of the patients 122 had 1, 44 had 2 and 41 had 3 or greater positive lymph nodes. Of patients without androgen deprivation therapy 103 had 1, 35 had 2 and 24 had 3 or greater positive lymph nodes while 69 experienced biochemical recurrence. Median time to recurrence in patients with 1, 2 and 3 or greater lymph nodes was 59, 13 and 3 months, respectively. Only specimen Gleason score and the number of positive lymph nodes were independent predictors of biochemical recurrence. Recurrence-free probability 2 years after prostatectomy in men without androgen deprivation with 1 positive lymph node and a prostatectomy Gleason score of 7 or less was 79% vs 29% in those with Gleason score 8 or greater and 2 or more positive lymph nodes. Prognosis in patients with lymph node metastasis depends on the number of positive lymph nodes and primary tumor Gleason grade. Of all patients with lymph node metastasis 80% had 1 or 2 positive nodes. A large subset of those patients had a favorable prognosis. Full bilateral pelvic lymph node dissection should be done in patients with intermediate and high risk cancer to identify those likely to benefit from metastatic node removal. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A prospective observational study of ICU patient position and frequency of turning.

Science.gov (United States)

Goldhill, D R; Badacsonyi, A; Goldhill, A A; Waldmann, C

2008-05-01

Positioning and turning critically ill patients may be beneficial but there are little data on current practice. We prospectively recorded patient position every hour over two separate days in 40 British intensive care units and analysed 393 sets of observation. Five patients were prone at any time and 3.8% (day 1) and 5% (day 2) were on rotating beds. Patients were on their back for 46.1% of observations, turned left for 28.4% and right for 25.5%, and head up for 97.4%. A turn was defined as a change between on back, turned left or turned right. The average time (SD) between turns was 4.85 (3.3) h. There was no significant association between the average time between turns and age, weight, height, gender, respiratory diagnosis, intubated and ventilated, sedation score, day of week or nurse:patient ratio. There was a significant difference between hospitals in the frequency with which patients were turned.

Global Positioning System: Observations on Quarterly Reports from the Air Force

Science.gov (United States)

2016-10-17

Positioning System : Observations on Quarterly Reports from the Air Force The satellite-based Global Positioning System (GPS) provides positioning , navigation...infrastructure, and transportation safety. The Department of Defense (DOD)—specifically, the Air Force—develops and operates the GPS system , which...programs, including the most recent detailed assessment of the next generation operational control system (OCX)

Long range position and orientation tracking system

International Nuclear Information System (INIS)

Armstrong, G.A.; Jansen, J.F.; Burks, B.L.; Bernacki, B.E.; Nypaver, D.J.

1995-01-01

The long range position and orientation tracking system (LRPOTS) will consist of two measurement pods, a VME-based computer system, and a detector array. The system is used to measure the position and orientation of a target that may be attached to a robotic arm, teleoperated manipulator, or autonomous vehicle. The pods have been designed to be mounted in the man-ways of the domes of the Fernald K-65 waste silos. Each pod has two laser scanner subsystems as well as lights and camera systems. One of the laser scanners will be oriented to scan in the pan direction, the other in the tilt direction. As the lasers scan across the detector array, the angles of incidence with each detector are recorded. Combining measurements from each of the four lasers yields sufficient data for a closed-form solution of the transform describing the location and orientation of the Content Mobilization System (CMS). Redundant detectors will be placed on the CMS to accommodate occlusions, to provide improved measurement accuracy, and to determine the CMS orientation

Long-range position and orientation tracking system

International Nuclear Information System (INIS)

Armstrong, G.A.; Jansen, J.F.; Burks, B.L.

1995-01-01

The long-range position and orientation tracking system will consist of two measurement pods, a VME-based computer system, and a detector array. The system is used to measure the position and orientation of a target that may be attached to a robotic arm, teleoperated manipulator, or autonomous vehicle. The pods have been designed to be mounted in the manways of the domes of the Fernald K-65 waste silos. Each pod has two laser scanner subsystems as well as lights and camera systems. One of the laser scanners will be oriented to scan in the pan direction, the other in the tilt direction. As the lasers scan across the detector array, the angles of incidence with each detector are recorded. Combining measurements from each of the four lasers yields sufficient data for a closed-form solution of the transform describing the location and orientation of the content mobilization system (CMS). Redundant detectors will be placed on the CMS to accommodate occlusions, to provide improved measurement accuracy, and to determine the CMS orientation

A Short Tutorial on Inertial Navigation System and Global Positioning System Integration

Science.gov (United States)

Smalling, Kyle M.; Eure, Kenneth W.

2015-01-01

The purpose of this document is to describe a simple method of integrating Inertial Navigation System (INS) information with Global Positioning System (GPS) information for an improved estimate of vehicle attitude and position. A simple two dimensional (2D) case is considered. The attitude estimates are derived from sensor data and used in the estimation of vehicle position and velocity through dead reckoning within the INS. The INS estimates are updated with GPS estimates using a Kalman filter. This tutorial is intended for the novice user with a focus on bringing the reader from raw sensor measurements to an integrated position and attitude estimate. An application is given using a remotely controlled ground vehicle operating in assumed 2D environment. The theory is developed first followed by an illustrative example.

Echocardiographic assessment of systolic pulmonary arterial pressure in HIV-positive patients.

Directory of Open Access Journals (Sweden)

Mehrnaz Rasoulinejad

2014-11-01

Full Text Available Pulmonary hypertension is rare but is one of the complications that occur due to HIV infection. Symptoms of HIV-associated pulmonary arterial hypertension are often non-specific but the main symptom of the disease is dyspnea. In this cross-sectional study, we measured systolic pulmonary arterial pressure (SPAP by echocardiographic methods among HIV-positive patients who received ART. This research is a descriptive, cross-sectional study of 170 HIV-positive patients that was conducted in Imam-Khomeini hospital, Tehran, Iran during 2011-2013. All patients regularly received antiretroviral therapy at least for recent 2 years. There were not any cardiopulmonary symptoms (cough, dyspnea, exertional fatigue and chest discomfort in these patients. All participants underwent echocardiography to estimate SPAP. The participants comprised 108 males (63.5% and 62 females (46.5%. The mean age of patients was 41 years old, and the mean duration of HIV infection was 5.5 years. The mean CD4 cell count was 401 cell/µl. The principal regimen of antiretroviral therapy included two nucleoside reverse transcriptase inhibitor (NRTI and one non-nucleoside reverse transcriptase inhibitor (NNRTI in the hospital. The mean of systolic pulmonary arterial pressure was 25 mmHg in the participants; 156 (93.4% of them had SPAP ≤ 30 mmHg (normal, six (3.6% had SPAP: 31-35 mmHg (borderline and five (3% had SPAP > 35 mmHg (pulmonary hypertension. Our results indicated a significant increase of pulmonary hypertension in asymptomatic HIV-positive patients that had no association with any other risk factor. Also, antiretroviral therapy was not a risk factor for pulmonary hypertension in this study.

Study of positional dependence of dose to bladder, pelvic wall and rectal points in High-Dose-Rate Brachytherapy in cervical cancer patients

International Nuclear Information System (INIS)

Talluri, Anil Kumar; Alluri, Krishnam Raju; Gudipudi, Deleep Kumar; Ahamed, Shabbir; Sresty, Madhusudhana M.; Reddy, Aparna Yarrama

2013-01-01

The objective of the study is to examine the variation in doses to, Bladder, pelvic wall and Rectal Points when a patient is simulated in Supine (S Position) and Lithotomy M shaped positions (LM Position), respectively as part of Intracavitary Brachytherapy in Cervical Cancer patients. Patients (n = 19) were simulated and orthogonal images were taken in S Position and LM Positions on a physical simulator. Digital orthogonal X-ray images were transferred to Brachyvision Treatment Planning System via Dicom to generate treatment plans. Radio opaque dye of 7 ml was injected into the Foley bulb for identification and digitization of International Commission on Radiological Units and Measurements (ICRU) Bladder point. Pelvic side wall points were marked in accordance with ICRU 38 recommendations. A Rectal tube containing dummy source marker wire was used to identify Rectal Point. Students' t-test was used to analyze the results. Doses in LM Position were lower and statistically significant when compared to S Position for ICRU Bladder Point, pelvic walls and Rectal Point. It was observed that movement of applicator could be the reason for the variations in doses between the two positions. Bladder, pelvic wall and rectal points systematically registered lower doses in LM Position as compared to S Position. (author)

How does arm positioning of polytraumatized patients in the initial computed tomography (CT) affect image quality and diagnostic accuracy?

International Nuclear Information System (INIS)

Kahn, Johannes; Grupp, Ulrich; Maurer, Martin

2014-01-01

Purpose: To evaluate the influence of different arm positions on abdominal image quality during initial whole-body CT (WBCT) in polytraumatized patients and to assess the risk of missing potentially life-threatening injuries due to arm artifacts. Materials and methods: Between July 2011 and February 2013, WBCT scans of 203 patients with arms in the abdominal area during initial WBCT were analyzed. Six different arms-down positions were defined: patients with both (group A)/one arm(s) (group B) down alongside the torso, patients with both (group C)/one arm(s) (group D) crossed in front of the upper abdomen, patients with both (group E)/one arm(s) (group F) crossed in front of the pelvic area. A group of 203 patients with elevated arms beside the head served as a control group. Two observers jointly evaluated image quality of different organ regions using a 4-point scale system. Follow-up examinations (CT scans and/or ultrasound) were analyzed to identify findings missed during initial WBCT due to reduced image quality. Results: Image quality for most of the organ regions analyzed was found to be significantly different among all groups (p < 0.05). Image quality was most severely degraded in group A, followed by groups E and C. Positioning with one arm up resulted in significantly better image quality than both arms down (p < 0.05). Overall, arms-up positioning showed significantly better image quality than arms-down positions (p < 0.05). In one case, liver hemorrhage missed in the initial WBCT because of arm artifacts, was revealed by follow-up CT. Conclusion: In WBCT arms-down positioning significantly degrades abdominal image quality and artifacts might even conceal potentially life-threatening injuries. If the patient's status does not allow elevation of both arms, image quality can benefit from raising at least one arm. Otherwise, arms should be placed in front of the upper abdomen instead of alongside the torso

The effect of patient position on dose in radiation therapy of liver cancer

International Nuclear Information System (INIS)

Jung, Won Seok; Shin, Ryung Mi; Oh, Jeong Hun; Jeong, Geon A; Jo, Jun Young; Kim, Gi Chul; Choi, Tae Kyu; Kim, Ju Ho; Kim, Young Jae

2014-01-01

To analyze tumors movement and volume change from changing position in order to minimize movement caused by breathing. We conducted survey of 14 patients with HCC(Hepatocellular carcinoma). Patient immobilization device was made in two ways(Supine position, prone position) and from image acquisition, tumors movement, volume and dose are analyzed. The mean movement of target(LR, Left-right) in supine position and prone position was 2.76±1.25 mm, 2.21±0.93 mm. AP(Anterior-posterior) and SI(Superior-inferior) was 4.02±1.63 mm, 11.56±3.08 mm, and 3.36±1.17 mm, 7.45±1.96 mm. Treatment volume was decreased and normal liver volume was increased in prone position. We could reduce the margin of the treatment volume by minimizing the movement of liver caused by breathing. Especially in prone position, it is considered to be able to decrease the movement of the liver and increase normal liver volume

The effect of patient position on dose in radiation therapy of liver cancer

Energy Technology Data Exchange (ETDEWEB)

Jung, Won Seok; Shin, Ryung Mi; Oh, Jeong Hun; Jeong, Geon A; Jo, Jun Young; Kim, Gi Chul; Choi, Tae Kyu [Dept. of Radiation Oncology, Kyunghee College Hospital, Seoul (Korea, Republic of); Kim, Ju Ho [Dept. of Radiation Oncology, Yonsei Cancer Center, Seoul (Korea, Republic of); Kim, Young Jae [Dept. of Radiation Technology, Daegu Health College, Daegu (Korea, Republic of)

2014-06-15

To analyze tumors movement and volume change from changing position in order to minimize movement caused by breathing. We conducted survey of 14 patients with HCC(Hepatocellular carcinoma). Patient immobilization device was made in two ways(Supine position, prone position) and from image acquisition, tumors movement, volume and dose are analyzed. The mean movement of target(LR, Left-right) in supine position and prone position was 2.76±1.25 mm, 2.21±0.93 mm. AP(Anterior-posterior) and SI(Superior-inferior) was 4.02±1.63 mm, 11.56±3.08 mm, and 3.36±1.17 mm, 7.45±1.96 mm. Treatment volume was decreased and normal liver volume was increased in prone position. We could reduce the margin of the treatment volume by minimizing the movement of liver caused by breathing. Especially in prone position, it is considered to be able to decrease the movement of the liver and increase normal liver volume.

Bluetooth Indoor Positioning System using Fingerprinting

DEFF Research Database (Denmark)

Frost, Christian; Jensen, Casper Svenning; Luckow, Kasper Søe

2011-01-01

Indoor Positioning has been an active research area in the last decade, but so far, commercial Indoor Positioning Systems (IPSs) have been sparse. The main obstacle towards widely available IPSs has been the lack of appropriate, low cost technologies, that enable indoor positioning. While Wi-Fi...... infrastructures are ubiquitous, consumer-oriented Wi-Fi enabled mobile phones have been missing. Conversely, while Bluetooth technology is present in the vast majority of consumer mobile phones, Bluetooth infrastructures have been missing. Bluetooth infrastructures have typically been installed as part...... of complete hardware/software IPSs that often incur a substantial hardware cost. Furthermore, Bluetooth has low power consumption compared to Wi-Fi devices, which promotes longer battery life-time on mobile phones. In this paper, we present a Bluetooth IPS based entirely on commodity-grade products...

The Effect of Balance Training on Postural Control in Patients with Parkinson's Disease Using a Virtual Rehabilitation System.

Science.gov (United States)

Albiol-Pérez, Sergio; Gil-Gómez, José-Antonio; Muñoz-Tomás, María-Teresa; Gil-Gómez, Hermenegildo; Vial-Escolano, Raquel; Lozano-Quilis, José-Antonio

2017-03-23

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our purpose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention. Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients' pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions. There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness. Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control