O-025 Value of hysteroscopy

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Haimovich
Keyword(s):  
Operating Room ◽  
Large Diameter ◽  
Office Procedure ◽  
Ivf Failure ◽  
Uterine Anomalies ◽  
Endometrial Cavity ◽  
Patient’S Outcome ◽  
Indispensable Tool ◽  
Infertility Patients ◽  
The Right

Abstract text The 3 main characters in any ART are the uterus, the endometrium, and the embryo. With the rutinary use of 2D US and especially 3D US in infertile patients we are able to assess most of the uterine anomalies and intrauterine pathologies. Until recently, the assessment of the endometrial cavity with hysteroscopy was reserved only for cases of IVF failure, as a complementary evaluation to ensure that nothing was missed during the ultrasound scan. We also need to remember how hysteroscopy was performed in the past and, unfortunately, in some cases even today. In the old days, to assess the endometrial cavity, it was required to take the patient to the operating room and under general anesthesia, dilate the cervix to then introduce a large diameter hysteroscope only for diagnostic purposes. The prevalent working model in ART today is in close collaboration between Fertility specialists, Ultrasound and Hysteroscopy units in order to improve patient’s outcome. In our center, a diagnostic hysteroscopy is performed as part of the diagnostic workup of the infertility patient. It is performed in office setting and without anesthesia, by the staff of the reproduction and infertility unit. When we look at hysteroscopy as an in-office procedure and no longer as a procedure performed in operating room, we appreciate that it is something that all infertility patients can benefit from. The right question to ask now would be “Is there a benefit in performing a hysteroscopy to all our patients?”. Ultrasound is not perfect, especially when evaluating the endometrium. The gold standard and the only modality that we have to assess the endometrium with direct visualization is hysteroscopy. Chronic endometritis, adhesions and adenomyosis are only a few examples of what can be assessed by direct vision of the endometrial cavity. The advantages of a simple, inexpensive, office procedure such as hysteroscopy outweigh any other consideration against it. During my talk all these points will be presented helping to understand why hysteroscopy is becoming an indispensable tool in every assisted fertility unit.

scholarly journals Evaluation of role of laparoscopy in determining etiology of infertility

2017 ◽  
Vol 6 (12) ◽  
pp. 5322
Author(s):  
Hema K. R. ◽  
Lalitha H. S.
Keyword(s):  
Diagnostic Laparoscopy ◽  
Secondary Infertility ◽  
Peritoneal Disease ◽  
College Hospital ◽  
Medical College ◽  
Uterine Anomalies ◽  
Morphological Defects ◽  
Indispensable Tool ◽  
Infertility Patients

Background: Although population explosion is a major problem in India, infertility appears to be a problem in 5-15% of Indian population. All these patients require evaluation. Laparoscopy plays a valuable role in the diagnosis of infertility. After thorough clinical examination and specific investigations, diagnostic laparoscopy is performed to detect patency of tubes, morphological defects in uterus, ovaries and tuboperitoineal factors. This study was conducted to assess the role of diagnostic laparoscopy in the investigation of female infertility and to evaluate the various causes of infertility like endometriosis, PCOD tubal and peritoneal factors, uterine anomalies, tuberculosis etc. by using diagnostic laparoscopy.Methods: Study was carried out in 60 infertile patients attending outpatient department of hospitals attached to Sri Siddhartha Medical College Hospital, Tumkur.  Both primary and secondary infertility patients who were anxious to conceive and undergo diagnostic laparoscopy were evaluated. Those who were not willing and who were contraindicated for the procedure were excluded.Results: Diagnostic laparoscopy was performed in 72% of primary and 28% of secondary infertility patients. Majority of the patients of primary infertility were in age group 21-25 years and that of secondary were between 26-30 years. Majority of patients in both the groups had duration of 1-5 year of infertility. In our study tubal factors (50%) contributed to majority of the infertility causes. Complication rate was minimum and was comparable to other standard studies.Conclusions: Laparoscopic is the gold standard for diagnosing tubal and peritoneal disease, endometriosis and other pelvic pathology, because no other imaging technique gives the same degree of sensitivity or specificity. Hence diagnostic laparoscopy is an indispensable tool in the evaluation in the evaluation infertility.

Access and Logistics Challenges in Mountain Terrain Pipeline Projects

2014 ◽  
Author(s):  
Mark McDougall ◽  
Ken Williamson
Keyword(s):  
Construction Projects ◽  
Large Scale ◽  
Oil And Gas ◽  
Large Diameter ◽  
Gas Production ◽  
Additional Time ◽  
Oil And Gas Production ◽  
Road Design ◽  
Regulatory Constraints ◽  
The Right

Oil and gas production in Canada’s west has led to the need for a significant increase in pipeline capacity to reach export markets. Current proposals from major oil and gas transportation companies include numerous large diameter pipelines across the Rocky Mountains to port locations on the coast of British Columbia (BC), Canada. The large scale of these projects and the rugged terrain they cross lead to numerous challenges not typically faced with conventional cross-country pipelines across the plains. The logistics and access challenges faced by these mountain pipeline projects require significant pre-planning and assessment, to determine the timing, cost, regulatory and environmental impacts. The logistics of pipeline construction projects mainly encompasses the transportation of pipe and pipeline materials, construction equipment and supplies, and personnel from point of manufacture or point of supply to the right-of-way (ROW) or construction area. These logistics movement revolve around the available types of access routes and seasonal constraints. Pipeline contractors and logistics companies have vast experience in moving this type of large equipment, however regulatory constraints and environmental restrictions in some locations will lead to significant pre-planning, permitting and additional time and cost for material movement. In addition, seasonal constraints limit available transportation windows. The types of access vary greatly in mountain pipeline projects. In BC, the majority of off-highway roads and bridges were originally constructed for the forestry industry, which transports logs downhill whereas the pipeline industry transports large equipment and pipeline materials in both directions and specifically hauls pipe uphill. The capacity, current state and location of these off-highway roads must be assessed very early in the process to determine viability and/or potential options for construction access. Regulatory requirements, environmental restrictions, season of use restrictions and road design must all be considered when examining the use of or upgrade of existing access roads and bridges. These same restrictions are even more critical to the construction of new access roads and bridges. The logistics and access challenges facing the construction of large diameter mountain pipelines in Western Canada can be managed with proper and timely planning. The cost of the logistics and access required for construction of these proposed pipeline projects will typically be greater than for traditional pipelines, but the key constraint is the considerable time requirement to construct the required new access and pre-position the appropriate material to meet the construction schedule. The entire project team, including design engineers, construction and logistics planners, and material suppliers must be involved in the planning stages to ensure a cohesive strategy and schedule. This paper will present the typical challenges faced in access and logistics for large diameter mountain pipelines, and a process for developing a comprehensive plan for their execution.

scholarly journals Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

2018 ◽  
Vol 47 (2) ◽  
pp. 1005-1009
Author(s):  
Taehee Pyeon ◽  
Jeong-Yeon Hwang ◽  
HyungYoun Gong ◽  
Sang-Hyun Kwak ◽  
Joungmin Kim
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Present Report ◽  
Large Diameter ◽  
Venous Catheter ◽  
Venous Access ◽  
Central Venous ◽  
The Right ◽  
Gain Access

Central venous catheters are used for various purposes in the operating room. Generally, the use of ultrasound to insert a central venous catheter is rapid and minimally complicated. An advanced venous access (AVA) catheter is used to gain access to the pulmonary artery and facilitate fluid resuscitation through the internal jugular vein. The present report describes a case in which ultrasound was used in a 43-year-old man to avoid complications during insertion of an AVA catheter with a relatively large diameter. The sheath of the catheter was so thin that a dilator was essential to prevent it from folding upon insertion. Despite the use of ultrasound guidance, the AVA catheter sheath became folded within the patient’s internal jugular vein. Mechanical complications of central venous catheter insertion are well known, but folding of a large-bore catheter in the internal jugular vein has rarely been reported.

Bilateral Gluteal Compartment Syndrome: A Rare but Potentially Morbid Entity

2010 ◽  
Vol 76 (7) ◽  
pp. 752-754 ◽  
Author(s):  
Jose Castro-Garcia ◽  
Brian R. Davis ◽  
Miguel A. Pirela-Cruz
Keyword(s):  
Compartment Syndrome ◽  
Operating Room ◽  
Illicit Drug ◽  
Early Recognition ◽  
Lumbar Pain ◽  
Interstitial Pressure ◽  
Sensory Deficits ◽  
Illicit Drug Abuse ◽  
The Right ◽  
Gluteal Compartment Syndrome

Compartment syndrome is caused by elevated interstitial pressure within the myofascial compartment. It rarely presents bilaterally in the gluteal region. A 49-year-old man fell 10 feet from a roof on his buttocks. He presented 10 hours after the injury with intense lumbar pain. Both glutei were exceptionally tense. There were no vascular injuries or sensory deficits. Compartmental pressures measured 60 mm Hg on the left side and 50 mm Hg on the right side. The patient was taken to the operating room for decompressive fasciotomy. The glutei compartments were released. He was taken once more to the operating room, requiring only minimal debridement. He was discharged the next week with no neurological deficit. Bilateral gluteal compartment syndrome is very rare with few cases reported in the literature. It has been associated with trauma, prolonged recumbence, surgical instrumentation, and illicit drug abuse. Early recognition is required to avoid the potential severe metabolic and physical deficits.

Heart and aorta morphology of the deep-diving hooded seal (Cystophora cristata)

2002 ◽  
Vol 80 (11) ◽  
pp. 2030-2036 ◽  
Author(s):  
Charles M Drabek ◽  
Jennifer M Burns
Keyword(s):  
Right Ventricle ◽  
Large Diameter ◽  
Ascending Aorta ◽  
The Body ◽  
Diving Behavior ◽  
Hooded Seal ◽  
Descending Aorta ◽  
Deep Diving ◽  
Cystophora Cristata ◽  
The Right

An investigation of the heart morphology of 8 male and 15 female hooded seals (Cystophora cristata) revealed that the heart is proportionately large and the aortic bulb is larger than that reported for most seals. Hooded seals of all ages have large hearts (0.64% of the body mass) and the right ventricle is proportionately longer and more muscular than reported for other seals. The bulb of the ascending aorta shows the large-diameter characteristic of seals capable of making long deep dives, and is constricted to a diameter of less than one-third in the descending aorta. In addition, the ascending aorta has a much greater concentration of elastin fibers than does the descending aorta. In combination with the large right ventricle, these features probably serve to increase lung perfusion during the hooded seal's surface recovery, and to maintain a high blood pressure throughout the cardiac cycle during diving bradycardia. That there was no substantive difference in the heart morphology of pups, yearlings, and adults, suggests that these features are important in the development of diving behavior, and agrees with the rapid behavioral and physiological development of hooded seal neonates.

Multimodal team interactions in Robot-Assisted Surgery

2016 ◽  
Vol 60 (1) ◽  
pp. 518-522 ◽  
Author(s):  
Judith Tiferes ◽  
Ann M. Bisantz ◽  
Matthew L. Bolton ◽  
D. Jeffery Higginbotham ◽  
Ryan P. O’Hara ◽  
...  
Keyword(s):  
Operating Room ◽  
Nonverbal Communication ◽  
Communication Strategies ◽  
Team Communication ◽  
Robot Assisted ◽  
Multimodal Interactions ◽  
Team Interactions ◽  
Initial Work ◽  
The Right ◽  
Robot Assisted Surgery

Communication gaps have been systematically linked to failures during surgery; however few studies have addressed challenges related to the remoteness of the surgeon during robot-assisted surgery (RAS). While studies on team communication in the Operating Room (OR) rarely report on nonverbal aspects, our initial work has shown that the vast majority of interaction events between the console surgeon and the right bed side assistant is nonverbal. This study focuses on improving our understanding of the nature of the multimodal interactions between surgeons and right bed side assistants. Six robot-assisted radical prostatectomies were recorded and the interaction events between the surgeon and the right bed side assistant were categorized by type (verbal/nonverbal), topic, and sender. The proportion of verbal and nonverbal events varied with the topic of the interaction. Strategies to improve team communication during surgery should take into account both the use of nonverbal communication means and the change in communication strategies based on purpose.

Centrifuge testing to simulate buried reinforced concrete pipe joints subjected to traffic loading

2015 ◽  
Vol 52 (11) ◽  
pp. 1762-1774 ◽  
Author(s):  
Boris Rakitin ◽  
Ming Xu
Keyword(s):  
Reinforced Concrete ◽  
Large Diameter ◽  
Traffic Load ◽  
Surface Loading ◽  
Traffic Loading ◽  
Centrifuge Testing ◽  
Geotechnical Centrifuge ◽  
State Highway ◽  
Concrete Pipe ◽  
The Right

Pipeline water leakage has become a serious problem in many countries. It has been widely noted that most of the damage to the pipelines occurs in the joints where two pipes are connected to each other. This paper presents the results of a geotechnical centrifuge testing program in which the response of a 12 m long (in prototype scale) large-diameter reinforced concrete pipeline with gasketed bell-and-spigot joints subjected to three standard American Association of State Highway and Transportation Officials design load configurations has been investigated. The results show that most vertical pipe movements occurred during the first 10 cycles of traffic loading. Under design tandem loading, the pipe joint displacements were significantly higher than those under the other two traffic load configurations. An increase of soil cover depth resulted in a reduced influence of surface loading, the effect of which was the most significant for two single pairs of wheels of design trucks in passing mode. Furthermore, two pipes on the left side and two pipes on the right side from the tested joint were influenced significantly by the surface loading, while the pipeline movements were not symmetrical. Although the joint directly under the load experienced the largest rotation, the possibility of leakage in the second joint in the spigot-to-bell direction was also high, due to large differential displacement between the pipes.

scholarly journals Diagnostic Delay of Pulmonary Embolism in COVID-19 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Federica Melazzini ◽  
Margherita Reduzzi ◽  
Silvana Quaglini ◽  
Federica Fumoso ◽  
Marco Vincenzo Lenti ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Diagnostic Delay ◽  
Time Lapse ◽  
Medical Examination ◽  
Life Threatening ◽  
Patient’S Outcome ◽  
The Right ◽  
Specific Symptoms ◽  
The Impact ◽  
Rule Out

Pulmonary embolism (PE) is a frequent, life-threatening COVID-19 complication, whose diagnosis can be challenging because of its non-specific symptoms. There are no studies assessing the impact of diagnostic delay on COVID-19 related PE. The aim of our exploratory study was to assess the diagnostic delay of PE in COVID-19 patients, and to identify potential associations between patient- or physician-related variables and the delay. This is a single-center observational retrospective study that included 29 consecutive COVID-19 patients admitted to the San Matteo Hospital Foundation between February and May 2020, with a diagnosis of PE, and a control population of 23 non-COVID-19 patients admitted at our hospital during the same time lapse in 2019. We calculated the patient-related delay (i.e., the time between the onset of the symptoms and the first medical examination), and the physician-related delay (i.e., the time between the first medical examination and the diagnosis of PE). The overall diagnostic delay significantly correlated with the physician-related delay (p < 0.0001), with the tendency to a worse outcome in long physician-related diagnostic delay (p = 0.04). The delay was related to the presence of fever, respiratory symptoms and high levels of lactate dehydrogenase. It is important to rule out PE as soon as possible, in order to start the right therapy, to improve patient's outcome and to shorten the hospitalization.

scholarly journals Cost-effective ultrasonic inspection of large diameter pipelines

2020 ◽  
Vol 4 (2) ◽  
pp. 108-116
Author(s):  
Ries Augustijn ◽  
◽  
João Gonçalves ◽  
Joost Haaksman ◽  
◽  
...  
Keyword(s):  
High Resolution ◽  
Large Diameter ◽  
Ultrasonic Inspection ◽  
Real Life ◽  
Cost Effective ◽  
Operating Conditions ◽  
Limiting Factor ◽  
Technological Capabilities ◽  
High Salinity Water ◽  
The Right

To be successful in the ILI business, organization require the right mix of technological capabilities, operational agility and quality standards. The business is fairly competitive, and often technological capabilities are pivotal in the customer proposition of the company. However, the best technologies are not solely required for successful ILI companies. Robustness of the system, operability by the ILI inspector, fitness of the product with commercial route to the market all contribute to a rapid return on investment. Providing a robust, versatile, high-resolution and cost-effective method to inspect large diameter pipelines was recognized as a challenge and opportunity. For that, a Large Diameter Ultrasonic Inspection tool capable of inspecting pipelines of 20 inch to 64 inch with high resolution was developed. The tool is always bi-directional and capable of mitigating 1.5D bends. Gathered data can be reviewed real-time during the inspection. The operating envelope of the tool is such that it can cope with various products in the pipeline, varying from (high salinity) water, crude oil and a multitude of refined products. Despite the fact that product properties (e.g. speed of sound, attenuation, temperature, etc) vary, the tool is designed such that this is not a limiting factor for the operating envelope. The application of advanced ultrasonic beam forming methodologies and signal generation and -processing ensure that the system is versatile and robust for these types of real-life operating conditions. This presentation will provide an overview of the utilization of these technologies, the validation program that has been used to demonstrate tool specifications and the experiences gained at successful projects.

Sign in / Sign up

Export Citation Format

Share Document