Towards the definition of a patient-specific rehabilitation program for TKA: A new MRI-based approach for the easy volumetric analysis of thigh muscles *

2021 ◽  
Author(s):  
M. Azimbagirad ◽  
G. Dardenne ◽  
D. Ben Salem ◽  
O. Remy-Neris ◽  
V. Burdin
Keyword(s):  
Volumetric Analysis ◽  
Rehabilitation Program ◽  
Patient Specific ◽  
Thigh Muscles ◽  
Definition Of

A 3D Shoulder Scan Compatible Humeral Coordinate System for Glenohumeral Joint Kinematics

2009 ◽  
Author(s):  
Hippolite O. Amadi
Keyword(s):  
Coordinate System ◽  
Radiation Exposure ◽  
Glenohumeral Joint ◽  
Patient Specific ◽  
Body Region ◽  
Radiographic Images ◽  
Volume Of Interest ◽  
Patient Specific Modeling ◽  
Definition Of

Advanced surgical planning techniques often require modeling the functional characteristics of the affected body region. Most patient-specific modeling in vivo relies on medical image scans that are expensive and may also allow patient’s exposure to ionizing radiation. This poses a challenge for the modeling of the kinematics of the glenohumeral joint (GHJ) based on the tissue geometries of the affected patients. The humeral morphology uniquely presents its canal (HC) and epicondyle (EC) axes as the two longest axes that are nearly orthogonal. This gives them the mathematical advantages as best axes for the definition of humeral coordinate system (HCS), especially from 2D radiographic images. This is however limited in 3D in vivo kinematics as minimization of radiation exposure may not allow medical imaging of the whole volume of interest all the way down to the distal epicondyles. It is therefore necessary that landmarks for use are captured within the field of view (FOV) of standard shoulder scans. This would avoid extra radiation exposure to patients and imaging cost as the scan might have been used earlier for traditional diagnosis. The aims of this study were to (1) confirm that HC-axis quantified from a ‘stack of discs (SOD)’ technique was the most reliable and consistent (2) identify the most closely oriented or most inter-subject related axis to the EC-axis for its replacement or prediction respectively from 3D proximal humeral scan and (3) use these to propose a HCS definition procedure that can be applied to a standard shoulder scan.

Meta-Analysis of Parenteral Clindamycin Dosing Regimens

1995 ◽  
Vol 29 (9) ◽  
pp. 852-858 ◽  
Author(s):  
John P Rovers ◽  
A Lane Ilersich ◽  
Thomas R Einarson
Keyword(s):  
English Language ◽  
Meta Analysis ◽  
Patient Specific ◽  
Success Rates ◽  
Cure Rate ◽  
Data Synthesis ◽  
Study Selection ◽  
Dosing Regimens ◽  
Definition Of ◽  
Cure Rates

Objective: We used meta-analysis to compare clinical cure and success rates for parenteral clindamycin 600 mg q8h or 900 mg q8h therapy to treat adult intraabdominal or female pelvic infections. Data Sources: We located English-language articles describing clindamycin use in humans using MEDLINE, International Pharmaceutical Abstracts, and Embase and from personal and drug information center files, plus all article references. Study Selection: Eligible studies used parenteral clindamycin 600 mg q8h or 900 mg q8h to treat intraabdominal or pelvic infection in at least I aim of a study and provided a definition of clinical outcome. Accepted were comparative trials in adults who were not critically ill or expected to die. Data Synthesis: The DerSimonian and Laird method was used to calculate weighted overall success rates for cure and success (cure plus improved) rates along with 95% confidence intervals for each dosage in intraabdominal and pelvic infections. Regimens were compared with respect to both cure and success rates using the Mann-Whitney U test. Main Results: Twenty-three articles were eligible for inclusion. Abdominal cure rates were 75.6% and 90.5% for clindamycin 600 mg q8h and 900 mg q8h, respectively (p = 0.03); success rates were 89.8% and 92.5%, respectively (p = 0.29). Pelvic cure rates were 82.8% and 89.4%, respectively (p = 0.51); success rates were 87.2% and 89.9%, respectively (p = 0.51). Conclusions: In pelvic infections, a dosage of clindamycin 600 mg q8h appears to be clinically acceptable for all patients. Although clinical outcomes for intraabdominal infections are generally similar for both regimens, the significantly higher cure rate with a dosage of clindamycin 900 mg q8h suggests that dosage recommendations should be patient specific.

3D preoperative assessment for locally advanced pancreatic cancer undergoing modified-Appleby procedure with reversed autologous arterial graft reconstruction: A case report

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Christian Cotsoglou ◽  
◽  
Stefano Granieri ◽  
Sissi Paleino ◽  
Andrea Chierici ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Specific Treatment ◽  
Preoperative Assessment ◽  
Ductal Adenocarcinoma ◽  
Patient Specific ◽  
Arterial Graft ◽  
Appleby Procedure ◽  
Definition Of

Advanced pancreatic ductal adenocarcinoma represents one of the most challenging oncologic diseases nowadays for many reasons: it is burdened by one of the poorest prognoses, it is often diagnosed when in an advanced stage and it demands a multimodal approach which is necessary to assign the proper patient-specific treatment. When feasible, surgical resection combined with systemic treatment is still the best curative choice and can require complex vascular resections and reconstructions to obtain R0 margins. In these cases, a detailed preoperative assessment made of blood tests, thoracoabdominal imaging and histological definition of the tumor is fundamental. Unfortunately, the current imaging techniques are not completely reliable in defining the extension of the contact between the neoplasm and the surrounding arteries and veins, especially when considering borderline and locally advanced diseases. The use of 3D reconstructions can improve the perception of crucial anatomical details for the diagnostic evaluation and the surgical procedure.

scholarly journals Monitoring of Unfractionated Heparin in Severe COVID-19: An Observational Study of Patients on CRRT and ECMO

TH Open ◽  
2020 ◽  
Vol 04 (04) ◽  
pp. e365-e375
Author(s):  
Alexander S. Streng ◽  
Thijs S.R. Delnoij ◽  
Mark M.G. Mulder ◽  
Jan Willem E.M. Sels ◽  
Rick J.H. Wetzels ◽  
...  
Keyword(s):  
Observational Study ◽  
Unfractionated Heparin ◽  
Detection Methods ◽  
Patient Specific ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Heparin Resistance ◽  
Specific Association ◽  
Definition Of ◽  
Treatment Dosage

Abstract Objective Severe cases of coronavirus disease 2019 (COVID-19) can require continuous renal replacement therapy (CRRT) and/or extracorporeal membrane oxygenation (ECMO). Unfractionated heparin (UFH) to prevent circuit clotting is mandatory but monitoring is complicated by (pseudo)-heparin resistance. In this observational study, we compared two different activated partial thromboplastin time (aPTT) assays and a chromogenic anti-Xa assay in COVID-19 patients on CRRT or ECMO in relation to their UFH dosages and acute phase reactants. Materials and Methods The aPTT (optical [aPTT-CS] and/or mechanical [aPTT-STA] clot detection methods were used), anti-Xa, factor VIII (FVIII), antithrombin III (ATIII), and fibrinogen were measured in 342 samples from 7 COVID-19 patients on CRRT or ECMO during their UFH treatment. Dosage of UFH was primarily based on the aPTT-CS with a heparin therapeutic range (HTR) of 50–80s. Associations between different variables were made using linear regression and Bland–Altman analysis. Results Dosage of UFH was above 35,000IU/24 hours in all patients. aPTT-CS and aPTT-STA were predominantly within the HTR. Anti-Xa was predominantly above the HTR (0.3–0.7 IU/mL) and ATIII concentration was >70% for all patients; mean FVIII and fibrinogen were 606% and 7.5 g/L, respectively. aPTT-CS correlated with aPTT-STA (r 2 = 0.68) with a bias of 39.3%. Correlation between aPTT and anti-Xa was better for aPTT-CS (0.78 ≤ r 2 ≤ 0.94) than for aPTT-STA (0.34 ≤ r 2 ≤ 0.81). There was no general correlation between the aPTT-CS and ATIII, FVIII, fibrinogen, thrombocytes, C-reactive protein, or ferritin. Conclusion All included COVID-19 patients on CRRT or ECMO conformed to the definition of heparin resistance. A patient-specific association was found between aPTT and anti-Xa. This association could not be explained by FVIII or fibrinogen.

scholarly journals Designing Hydrogel-Based Bone-On-Chips for Personalized Medicine

2021 ◽  
Vol 11 (10) ◽  
pp. 4495
Author(s):  
Gabriele Nasello ◽  
Mar Cóndor ◽  
Ted Vaughan ◽  
Jessica Schiavi
Keyword(s):  
Three Dimensional ◽  
In Vitro Models ◽  
Patient Specific ◽  
Specific Situation ◽  
Culture Chamber ◽  
Definition Of ◽  
And Function ◽  
Tissue Matrix ◽  
Hematopoietic Niche

The recent development of bone-on-chips (BOCs) holds the main advantage of requiring a low quantity of cells and material, compared to traditional In Vitro models. By incorporating hydrogels within BOCs, the culture system moved to a three dimensional culture environment for cells which is more representative of bone tissue matrix and function. The fundamental components of hydrogel-based BOCs, namely the cellular sources, the hydrogel and the culture chamber, have been tuned to mimic the hematopoietic niche in the bone aspirate marrow, cancer bone metastasis and osteo/chondrogenic differentiation. In this review, we examine the entire process of developing hydrogel-based BOCs to model In Vitro a patient specific situation. First, we provide bone biological understanding for BOCs design and then how hydrogel structural and mechanical properties can be tuned to meet those requirements. This is followed by a review on hydrogel-based BOCs, developed in the last 10 years, in terms of culture chamber design, hydrogel and cell source used. Finally, we provide guidelines for the definition of personalized pathological and physiological bone microenvironments. This review covers the information on bone, hydrogel and BOC that are required to develop personalized therapies for bone disease, by recreating clinically relevant scenarii in miniaturized devices.

scholarly journals Vital activity limitations and social isolation in psychiatric patients

2018 ◽  
Vol 3 (3) ◽  
pp. e0303143
Author(s):  
Glib Prib
Keyword(s):  
Social Isolation ◽  
Psychiatric Patients ◽  
Social Assistance ◽  
Rehabilitation Program ◽  
Activity Limitations ◽  
Vital Activity ◽  
Scientific Publications ◽  
Analysis And Synthesis ◽  
Professional Assessment ◽  
Definition Of

Background: Medical, social, and professional assessment of patients and the development of a rehabilitation program based on that assessment are important issue in mental and behavioral disorders. However, insufficient consideration of the basic principles of medical and social expertise leads to the inadequate  according to patient’s planning and implementation into rehabilitation interventions. Aim: to study the essence and understanding of the concept of "limitation of life" and "social isolation" in the practice of mental health care and rehabilitation. Materials and methods: theoretical analysis and synthesis of scientific sources regarding medical and social rehabilitation of the mentally ill, with disabilities and social isolation. Results: The author expounds his view on development of vital activity limitations and social isolation in psychiatric patients; and on different aspects of using this categories in the medical and social assistance and rehabilitation practice. Conclusion: general trend inherent in both foreign and Ukrainian scientific publications was identified, it highlights the need to build medical and social assistance in accordance with definition of disability and social isolation.

Beyond Status Code 26: Development of an Instrument to Measure the Quality of Placements in the State-Federal Program

1998 ◽  
Vol 29 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Dennis D. Gilbride ◽  
J. Ressler Thomas ◽  
Robert Stensrud
Keyword(s):  
Consumer Satisfaction ◽  
Operational Definition ◽  
Rehabilitation Program ◽  
Rehabilitation Professionals ◽  
Comprehensive Picture ◽  
Definition Of ◽  
The Impact ◽  
Training Opportunities ◽  
Status Code

The purpose of this study was to develop and test an instrument that measures the quality of job placements of State-Federal Vocational Rehabilitation program consumers. A four part operational definition of quality placement was developed that included: (1) income and satisfaction with salary; (2) benefits provided, and consumer satisfaction with benefits; (3) potential for training opportunities and career development; and (4) satisfaction with job and personal life after placement. The “Rehabilitation Success Survey” was developed by a panel of rehabilitation professionals and consumers to measure these 4 components of placement quality. The instrument was piloted in one state, revised, and then administered in a second state. Results indicated that broadening the definition of successful placement beyond status code 26 closure, provides a more comprehensive picture of the impact of employment and rehabilitation services on consumers' lives.

scholarly journals Outcomes with Myeloid Malignancies

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 381-389 ◽  
Author(s):  
Bart L. Scott ◽  
Brenda M. Sandmaier
Keyword(s):  
Retrospective Studies ◽  
Conditioning Regimen ◽  
Patient Specific ◽  
Reduced Intensity Conditioning ◽  
Multicenter Studies ◽  
Subsequent Increase ◽  
Myeloid Malignancies ◽  
Specific Factors ◽  
Definition Of ◽  
Related Mortality

Abstract Reduced-intensity conditioning (RIC) regimens were initially introduced to provide allogeneic stem cell transplantation (HCT), a potentially curative procedure for myeloid malignancies, for patients who were not considered eligible for conventional myeloablative HCT either because of advanced age or excessive comorbidities. A variety of RIC regimens have been studied. The exact definition of RIC remains arbitrary and generally depends upon the perceived toxicity of a given regimen rather than the actual dose of chemotherapy or radiotherapy administered. In several published series, RIC regimens have demonstrated a reduction in non-relapse mortality (NRM), thereby accomplishing the initial goal of expanding the patient population eligible for this potentially curative procedure. Most retrospective studies performed to date have shown a decrease in NRM and an increase in relapse-related mortality with the use of RIC as opposed to conventional myeloablative HCT in myeloid malignancies. This appears to be particularly true for patients who are in relapse at the time of HCT. In contrast, patients who are in remission at time of HCT appear to have a reduction in NRM without a subsequent increase in relapse-related mortality. There is interest in applying RIC to younger patients and to patients with fewer comorbidities as they may have a reduction in NRM without a concomitant increase in relapse. Prospective multicenter studies are needed to define the optimal conditioning regimen, which is likely dependent upon a variety of disease-specific and patient-specific factors.

scholarly journals Patient Specific Component Alignment in Total Hip Arthroplasty

2016 ◽  
Vol 6 (4) ◽  
Author(s):  
James William Pierrepont ◽  
Catherine Zoe Stambouzou ◽  
Brad Peter Miles ◽  
Peter Bede O'Connor ◽  
Leonard Walter ◽  
...  
Keyword(s):  
Patient Specific ◽  
Target Component ◽  
Component Alignment ◽  
Functional Activities ◽  
Total Hip ◽  
Patient Specific Instrumentation ◽  
Definition Of ◽  
Alignment Analysis ◽  
Standard Radiographs ◽  
Safe Zones

Appropriate component alignment is critical for reducing instability, maximising bearing performance and restoring native anatomy after Total Hip Replacement (THR). Due to the large variation in patient kinematics between functional activities, current technologies lack definition of what constitutes correct target alignment. Analysis of a large series of symptomatic THR patients confirm that apparently well-orientated components on standard radiographs can still fail due to functional component malalignment. Evidently, previously defined “safe zones” are not appropriate for all patients as they don’t consider the dynamic behaviour of the hip joint.The Optimized Positioning SystemTM (OPSTM) comprises preoperative planning based on a patient-specific dynamic analysis, and patient-specific instrumentation for delivery of the target component alignment. This paper presents the application of OPSTM in three case studies.

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