Accuracy of 11 formulae to guide umbilical arterial catheter tip placement in newborn infants

2017 ◽  
Vol 103 (4) ◽  
pp. F364-F369 ◽  
Author(s):  
Wei Ling Lean ◽  
Jennifer A Dawson ◽  
Peter G Davis ◽  
Christiane Theda ◽  
Marta Thio
Keyword(s):  
Gold Standard ◽  
Newborn Infants ◽  
Body Part ◽  
Accurate Method ◽  
Arterial Catheter ◽  
X Rays ◽  
Success Rates ◽  
Common Procedure ◽  
Optimal Position ◽  
Umbilical Arterial Catheter

BackgroundUmbilical arterial catheter (UAC) insertion is a common procedure in the neonatal intensive care unit (NICU). Correct placement of the tip of the UAC at first attempt minimises handling of the infant and reduces the risk of infection and complications. We aimed to determine the accuracy of 11 published formulae to guide UAC placement.MethodsThis was a one-year prospective observational study in a tertiary NICU. Clinicians used their preferred formula for UAC insertion, with X-rays performed immediately post-procedure to check the tip position. Birth weight and measurements included in the 11 formulae were recorded within 48 hours. The gold standard insertion distance was defined as the distance from the abdominal wall to the mid-descending aorta, at T8 level on X-ray (range T6–T10). Insertion length using the 11 formulae was calculated and compared with this gold standard distance.ResultsOne hundred and three infants were included, with median (IQR) gestational age and weight of 28 (26–33.5) weeks and 980 (780–2045) g, respectively. The predicted value of the 11 formulae to place the UAC in correct position ranged from 51.0% to 73.8%. Formulae that involved direct body part measurements showed the highest predicted success rates, smallest mean difference from T8 and narrowest limits of agreement using the Bland-Altman method.ConclusionSuccess rates for accurate UAC placement are highest when formulae that involve body measurements are used. However, even the most accurate method would result in more than 25% of UACs needing manipulation to achieve an optimal position.

scholarly journals Determination of the Vertical Dimension and the Position of the Occlusal Plane in a Removable Prosthesis Using Cephalometric Analysis and Golden Proportion

2021 ◽  
Vol 11 (15) ◽  
pp. 6948
Author(s):  
Gabriele Cervino ◽  
Sergio Sambataro ◽  
Chiara Stumpo ◽  
Salvatore Bocchieri ◽  
Fausto Murabito ◽  
...  
Keyword(s):  
Vertical Dimension ◽  
Occlusal Plane ◽  
X Rays ◽  
Common Procedure ◽  
Lower Incisor ◽  
Golden Proportion ◽  
The Face ◽  
Removable Prosthesis ◽  
Edentulous Patients

The aim of this study is to demonstrate the use and the effectiveness of cephalometry and golden proportions analysis of the face in planning prosthetic treatments in totally edentulous patients. In order to apply this method, latero-lateral and posterior-anterior X-rays must be performed in addition to the common procedure. Two main concerns for totally edentulous patients are the establishment of the vertical dimension and the new position of the occlusal plane. The divine proportion analysis was carried out by the use of a golden divider. The prosthetic protocol was divided into three steps and a case was selected for better understanding. Referring to the golden relations, if the distance from the chin to the wing of the nose is 1.0, the distance from the nose to eye is 0.618. This proportion is useful and effective in determining the correct prosthetic vertical dimension. The incisal margin of the lower incisor must be positioned between Point A (A) and protuberance menti (Pm) according to the gold ratio 0.618 of the total height A-Pm. Posteriorly the occlusal plane must be placed 2 mm below the divine occlusal plane (traced from the incisal margin of lower incisors to Xi point). A prosthesis made in accordance with cephalometric parameters and divine proportions of the face helps to improve the patient’s aesthetics, function and social personality.

scholarly journals Short Plate with Screw Angle over 20 Degrees Improves the Radiologic Outcome in ACDF: Clinical Study

2021 ◽  
Vol 10 (9) ◽  
pp. 2034
Author(s):  
Kathryn-Anne Jimenez ◽  
Jihyeon Kim ◽  
Jaenam Lee ◽  
Hwan-Mo Lee ◽  
Seong-Hwan Moon ◽  
...  
Keyword(s):  
P Value ◽  
X Rays ◽  
Common Procedure ◽  
Fusion Surgery ◽  
Post Surgery ◽  
Plate Group ◽  
Vas Scores ◽  
Short Plate ◽  
Degenerative Cervical Spine ◽  
Screw Group

Background: Anterior cervical discectomy and fusion surgery is a common procedure for degenerative cervical spine. This describes allospacer and implant-related outcomes, comparing medium plate–low screw angle and short plate–high screw angle techniques. Methods: From January 2016 to June 2019, 79 patients who underwent ACDF were prospectively enrolled. Patients were divided, depending on the plate–screw system used: medium plate–low screw angle (12.3 ± 2.5 to 13.2 ± 3.2 degrees), and short plate–high screw angle (22.8 ± 5.3 to 23.3 ± 4.7 degrees). Subsidence, ALOD, and sagittal cervical balance were analyzed using lateral cervical X-rays. NDI and VAS scores were also evaluated. Results: Age for medium plate–low-angled screw group is 58.0 ± 11.3 years, and 55.3 ± 12.0 in the short plate–high-angled screw group (p-value = 0.313). Groups were comparable in mean NDI (p-value = 0.347), VAS (p-value = 0.156), C2–C7 SVA, (p-value = 0.981), and lordosis angle (p-value = 0.836) at 1-year post-surgery. Subsidence was higher in the medium plate–low-angled screw than in the short plate–high-angled screw (25% and 8.5%, respectively, p-value = 0.045). ALOD is also more common in the medium plate group (p-value = 0.045). Conclusion: Use of a short plate and insertion of high-angled screws (more than 20 degrees) has less chance of subsidence and occurrence of ALOD than the traditional technique of using medium plate and low angle.

ASSESSMENT OF OSTEOARTHRITIS INITIATIVE–KELLGREN AND LAWRENCE SCORING PROJECTS QUALITY USING COMPUTER ANALYSIS

2010 ◽  
Vol 13 (04) ◽  
pp. 197-201 ◽  
Author(s):  
Lior Shamir ◽  
David T. Felson ◽  
Luigi Ferrucci ◽  
Ilya G. Goldberg
Keyword(s):  
Image Analysis ◽  
Gold Standard ◽  
Population Studies ◽  
Detection Accuracy ◽  
X Rays ◽  
Analysis Method ◽  
Image Analysis Method ◽  
X Ray ◽  
Osteoarthritis Initiative ◽  
Kellgren And Lawrence

The detection of knee osteoarthritis (OA) is a subjective task, and even two highly experienced and well-trained readers might not always agree on a specific case. This problem is noticeable in OA population studies, in which different scoring projects provide significantly different scores for the same knee X-rays. Here we propose a method for quantitative assessment and comparison of knee X-ray scoring projects in OA population studies. The method works by applying an image analysis method that automatically detects OA in knee X-ray images, and comparing the consistency of the scores when using each of the scoring projects as "gold standard." The method was applied to compare the osteoarthritis initiative (OAI) clinic reading derived Kellgren and Lawrence (K&L) scores to central reading, and showed that when using the derived K&L scores the automatic image analysis method was able to accurately differentiate between healthy joints and moderate OA joints in ~70% of the cases. When the OAI central reading scores were used as gold standard, the detection accuracy was elevated to ~77%. These results show that the OAI central readings scores are more consistent with the X-rays, indicating that the central reading better reflects the radiographic features associated with OA, compared to the OAI K&L scores derived from clinic readings.

Dacryolithiasis diagnosis and treatment: a 25-year experience using nasal endoscopy

2021 ◽  
pp. bjophthalmol-2021-319671
Author(s):  
Alexis Khorrami Kashi ◽  
Chafik Keilani ◽  
Thien-Huong Nguyen ◽  
Pierre Keller ◽  
Sina Elahi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Gold Standard ◽  
Nasolacrimal Duct ◽  
Success Rates ◽  
Radiological Findings ◽  
Endoscopic Findings ◽  
Lacrimal System ◽  
Secondary Endpoints ◽  
Endonasal Dcr ◽  
Nasolacrimal Ducts

BackgroundDacryolith-induced epiphora is caused by a chronic obstruction of the nasolacrimal duct whose aetiology is often specified peroperatively. Dacryocystorhinostomy (DCR) has been often regarded as the gold standard to treat dacryolithiasis. Hasner’s valve (HV) incision is a technique to evacuate lithiasis through its physiological track. The purpose of this study was to describe clinical and radiological findings associated with presence of dacryoliths in patients who underwent surgery and to assess the efficacy of these two procedures.MethodsThis study was a comparative interventional multicentric retrospective study including patients referred for an epiphora. The primary endpoint was to determine clinical and endoscopic findings associated with dacryoliths. The secondary endpoints were to evaluate the performance of CT dacryocystography (CT-DG) in the diagnosis of dacryoliths and the success rate of the surgical treatment 6 months postoperatively.Results4677 nasolacrimal ducts (NLDs) (78.0% female, mean age 59.2) were included in the study. 3913 underwent DCR, and 764 underwent HV incision. 291 out of 4677 NLDs (6.2%) were found to have dacryoliths. Presence of mucocele associated to a permeable lacrimal system (OR 8.17 (95% 4.62 to 14.44), p<0.01) was associated with presence of lithiasis peroperatively. Success rates at 6 months were 95.6% for endonasal DCR and 94.6% for incision of HV in dacryolithiasis group (p<0.01). CT-DG had a negative predictive value of 96.3% to detect lithiasis (p<0.01).ConclusionStrong clinical and endoscopic findings may improve the imputability of dacryoliths in epiphora. Evacuation of dacryolithiasis through its physiological track was first described in this study in adults with similar results to DCR in patients presenting with dacryolithiasis.

High Success Rate of Prehospital and En Route Cricothyroidotomy Performed in the Israel Defense Forces: 20 Years of Experience

2021 ◽  
pp. 1-6
Author(s):  
Eran Beit Ner ◽  
Avishai M. Tsur ◽  
Roy Nadler ◽  
Elon Glassberg ◽  
Avi Benov ◽  
...  
Keyword(s):  
Success Rate ◽  
Body Part ◽  
Salvage Procedure ◽  
Care Providers ◽  
Success Rates ◽  
Exact Test ◽  
Medical Teams ◽  
Israel Defense Forces ◽  
Different Levels ◽  
Overall Mortality

Abstract Introduction: Securing the airway is a crucial stage of trauma care. Cricothyroidotomy (CRIC) is often addressed as a salvage procedure in complicated cases or following a failed endotracheal intubation (ETI). Nevertheless, it is a very important skill in prehospital settings, such as on the battlefield. Hypothesis/Problem: This study aimed to review the Israel Defense Forces (IDF) experience with CRIC over the past two decades. Methods: The IDF Trauma Registry (IDF-TR) holds data on all trauma casualties (civilian and military) cared for by military medical teams since 1997. Data of all casualties treated by IDF from 1998 through 2018 were extracted and analyzed to identify all patients who underwent CRIC procedures. Variables describing the incident scenario, patient’s characteristics, injury pattern, treatment, and outcome were extracted. The success rate of the procedure was described, and selected variables were further analyzed and compared using the Fisher’s-exact test to identify their effect on the success and failure rates. Odds Ratio (OR) was further calculated for the effect of different body part involvement on success and for the mortality after failed ETI. Results: One hundred fifty-three casualties on which a CRIC attempt was made were identified from the IDF-TR records. The overall success rate of CRIC was reported at 88%. In patients who underwent one or two attempts, the success rate was 86%. No difference was found across providers (physician versus paramedic). The CRIC success rates for casualties with and without head trauma were 80% and 92%, respectively (P = .06). Overall mortality was 33%. Conclusions: This study shows that CRIC is of merit in airway management as it has shown to have consistently high success rates throughout different levels of training, injuries, and previous attempts with ETI. Care providers should be encouraged to retain and develop this skill as part of their tool box.

scholarly journals Cardiac catheterization and percutaneus catheter in grown-up congenital heart diseases: single center experience at developing country

2018 ◽  
Vol 27 (1) ◽  
pp. 38-43
Author(s):  
Luh G.A.P. Dewi ◽  
Ni P.V.K. Yantie ◽  
Eka Gunawijaya
Keyword(s):  
Success Rate ◽  
Developing Country ◽  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Success Rates ◽  
Common Procedure ◽  
Diagnostic Catheter

Background: Grown-up congenital heart disease (GUCH) patients are unique and challenges especially at developing country. The numbers of diagnostic as well as interventional cardiac catheterization procedures in GUCH patients are growing. The aim of this study was to report the outcome of cardiac catheterization including intervention procedure in GUCH.Methods: The descriptive study was conducted at Sanglah Hospital, Denpasar, Bali, Indonesia. All patients (age of more than 12 years) who underwent cardiac catheterization from 2011 until 2017 were included in this study. Patients, characteristic, types of catheter procedures, immediate complications, and outcomes were documented.Results: A total 54 subjects were included with median age of 23 years and 70% were female. The first symptom that brought patients to hospital is dyspnea 46% and palpitation 32%. Five subjects underwent a diagnostic catheter procedure and 49 (91%) diagnostic and catheter based interventions. Transcatheter interventions procedures included atrial septal defect (ASD) (success rate of 20 per 21), patent ductus arteriosus (PDA) (success rate of 16 per16), ventricular septal defect (VSD) (success rate of  9 per 9), pulmonal stenosis (PS) (success rate of 1 per 2), and aortic stenosis (AS) (success rate of 1 per 1). The complications encountered were transient dysrhythmias in 15 subjects, device embolization in 4 subjects, massive bleeding in 1 subject, and overall mortality in 2 subjects.Conclusion: The number of the catheterization interventions in GUCH was 91% and ASD device closure was the most common procedure. Transcatheter intervention has a high procedural success rates (96%) and low procedural-related complications.

Electrical Impedance Tomography (EIT)

2014 ◽  
pp. 235-273 ◽  
Author(s):  
Tushar Kanti Bera ◽  
J. Nagaraju
Keyword(s):  
Medical Imaging ◽  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Optical Tomography ◽  
Body Part ◽  
Imaging Modalities ◽  
X Rays ◽  
Science And Engineering ◽  
Impedance Tomography ◽  
Anatomy And Physiology

Looking into the human body is very essential not only for studying the anatomy and physiology, but also for diagnosing a disease or illness. Doctors always try to visualize an organ or body part in order to study its physiological and anatomical status for understanding and/or treating its illness. This necessity introduced the diagnostic tool called medical imaging. The era of medical imaging started in 1895, when Roentgen discovered the magical powerful invisible rays called X-rays. Gradually the medical imaging introduced X-Ray CT, Gamma Camera, PET, SPECT, MRI, USG. Recently medical imaging field is enriched with comparatively newer tomographic imaging modalities like Electrical Impedance Tomography (EIT), Diffuse Optical Tomography (DOT), Optical Coherence Tomography (OCT), and Photoacaustic Tomography (PAT). The EIT has been extensively researched in different fields of science and engineering due to its several advantages. This chapter will present a brief review on the available medical imaging modalities and focus on the need of an alternating method. EIT will be discussed with its physical and mathematical aspects, potentials, and challenges.

scholarly journals Design and Accuray of an Instrumented Insole Using Pressure Sensors for Step Count

Sensors ◽  
2019 ◽  
Vol 19 (5) ◽  
pp. 984 ◽  
Author(s):  
Armelle Ngueleu ◽  
Andréanne Blanchette ◽  
Laurent Bouyer ◽  
Désirée Maltais ◽  
Bradford McFadyen ◽  
...  
Keyword(s):  
Microelectromechanical Systems ◽  
Pressure Sensors ◽  
Accurate Method ◽  
Step Count ◽  
Detection Accuracy ◽  
Success Rates ◽  
Calculation Methods ◽  
Cumulative Sum ◽  
Step Counts ◽  
Walking Speeds

Despite the accessibility of several step count measurement systems, count accuracy in real environments remains a major challenge. Microelectromechanical systems and pressure sensors seem to present a potential solution for step count accuracy. The purpose of this study was to equip an insole with pressure sensors and to test a novel and potentially more accurate method of detecting steps. Methods: Five force-sensitive resistors (FSR) were integrated under the heel, the first, third, and fifth metatarsal heads and the great toe. This system was tested with twelve healthy participants at self-selected and maximal walking speeds in indoor and outdoor settings. Step counts were computed based on previously reported calculation methods, individual and averaged FSR-signals, and a new method: cumulative sum of all FSR-signals. These data were compared to a direct visual step count for accuracy analysis. Results: This system accurately detected steps with success rates ranging from 95.5 ± 3.5% to 98.5 ± 2.1% (indoor) and from 96.5 ± 3.9% to 98.0 ± 2.3% (outdoor) for self-selected walking speeds and from 98.1 ± 2.7% to 99.0 ± 0.7% (indoor) and 97.0 ± 6.2% to 99.4 ± 0.7% (outdoor) for maximal walking speeds. Cumulative sum of pressure signals during the stance phase showed high step detection accuracy (99.5 ± 0.7%–99.6 ± 0.4%) and appeared to be a valid method of step counting. Conclusions: The accuracy of step counts varied according to the calculation methods, with cumulative sum-based method being highly accurate.

scholarly journals Use of laser fluorescence (DIAGNOdentTM) for in vivo diagnosis of occlusal caries: a systematic review

2004 ◽  
Vol 12 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Isauremi Vieira de Assunção Pinheiro ◽  
Maria Cristina dos Santos Medeiros ◽  
Maria Ângela Fernandes Ferreira ◽  
Kenio Costa de Lima
Keyword(s):  
Systematic Review ◽  
Gold Standard ◽  
Visual Inspection ◽  
Accurate Method ◽  
Laser Fluorescence ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Occlusal Caries ◽  
In Vivo Diagnosis

This systematic review was conducted to assess the accuracy of laser fluorescence (DIAGNOdentTM) for diagnosis of occlusal caries in permanent teeth, using any sort of gold standard. The MEDLINE, LILACS, BBO and Cochrane library databases accessed by BIREME were searched for English, Spanish and Portuguese-language papers published between 1982 and 2003. Four works in English were selected. DIAGNOdentTM was found to be an accurate method for diagnosis of occlusal caries, mainly if employed simultaneously with visual inspection.

Sign in / Sign up

Export Citation Format

Share Document