scholarly journals Detection of Postoperative Intestinal Ischemia in Small Bowel Transplants

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Hanne Birke-Sorensen
Keyword(s):  
Blood Flow ◽  
Small Bowel ◽  
Abdominal Cavity ◽  
Small Bowel Transplantation ◽  
Neck Region ◽  
Monitoring Methods ◽  
Monitoring Method ◽  
Individual Surgeon ◽  
The Individual ◽  
The Ideal

Small bowel transplantation is acknowledged as auto- and allotransplantation. In both instances, there is up to a 4%–10% risk of postoperative ischemia, and as the small bowel is extremely susceptible to ischemia, the timely diagnosis of ischemia is important. The location of the transplant, whether it is buried in the abdominal cavity or in the neck region, increases the challenge, as monitoring becomes more difficult and the consequences of neglect more dangerous. All methods for the early detection of postoperative ischemia in small bowel transplants are described together with the requirements of the ideal monitoring method. A small bowel transplant can be inspected directly or indirectly; the blood flow can be monitored by Doppler or by photoplethysmography, and the consequences of the blood flow can be monitored. The ideal monitoring method should be reliable, fast, minimally invasive, safe, objective, easy, cheap, and comfortable. No monitoring methods today fulfill the criteria of the ideal monitoring method, and evidence-based guidelines regarding postoperative monitoring cannot be made. The choice of whether to implement monitoring of ischemia—and if so, which method to choose—has to be made by the individual surgeon or center.

Using complementary remote detection methods for retrofitted eco-passages: a case study for monitoring individual koalas in south-east Queensland

2016 ◽  
Vol 43 (5) ◽  
pp. 369 ◽  
Author(s):  
C. E. Dexter ◽  
R. G. Appleby ◽  
J. P. Edgar ◽  
J. Scott ◽  
D. N. Jones
Keyword(s):  
Road Construction ◽  
Primary Objective ◽  
Correlated Data ◽  
Camera Traps ◽  
Detection Methods ◽  
Urban Landscapes ◽  
Monitoring Methods ◽  
Monitoring Method ◽  
Phascolarctos Cinereus ◽  
The Individual

Context Vehicle-strike has been identified as a key threatening process for koala (Phascolarctos cinereus) survival and persistence in Australia. Roads and traffic act as barriers to koala movement and can impact dispersal and metapopulation dynamics. Given the high cost of wildlife mitigation structures such as purpose-built fauna-specific underpasses or overpasses (eco-passages), road construction and management agencies are constantly seeking cost-effective strategies that facilitate safe passage for fauna across roads. Here we report on an array of detection methods trialled to verify use of retrofitted road infrastructure (existing water culverts or bridge underpasses) by individual koalas in fragmented urban landscapes in south-east Queensland. Aims The study examined whether the retrofitting of existing road structures at six sites facilitated safe passage for koalas across roads. Our primary objective was to record utilisation of retrofitted infrastructure at the level of the individual. Methods We used a combination of existing monitoring methods such as GPS/VHF collars, camera traps, sand plots, and RFID tags, along with a newly developed animal-borne wireless identification (WID) tag and datalogging system, specifically designed for this project, to realise the study aims. Key results We were able to verify 130 crossings by koalas involving a retrofitted structure or a road surface over a 30-month period by using correlated data from complementary methods. We noted that crossings were generally uncommon and mostly undertaken by only a subset of our tagged individuals at each site (21% overall). Conclusions An important element of this study was that crossing events could be accurately determined at the level of the individual. This allowed for detailed assessment of eco-passage usage, rather than the more usual approach of simply recording species’ presence. Implications This study underscores the value of identifying the constraints of each individual monitoring method in relation to site conditions. It also highlights the benefits of contingency planning to limit data loss (i.e. using more than one method to collect data). We suggest an approach that uses complementary monitoring methods has significant advantages for researchers, particularly with reference to improving understanding of whether eco-passages are meeting their prescribed conservation goals.

scholarly journals Intravesical Tension-Free Vaginal Tape Removal: Is There a Single Solution?

ISRN Urology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Rhana H. Zakri ◽  
Amit K. Patel ◽  
Babbin S. John ◽  
Nitin C. Shrotri
Keyword(s):  
Urinary Incontinence ◽  
Full Range ◽  
Common Interest ◽  
Optimal Management ◽  
Number Of Patients ◽  
Single Solution ◽  
Individual Surgeon ◽  
History Of ◽  
The Individual ◽  
The Ideal

Stress urinary incontinence (SUI) affects 10–20% of women in the general population. Surgery for stress incontinence has been performed on women for over a century, but with the advent of new urogynaecological sling procedures for its management, urological surgeons are having to deal with an increasing number of patients presenting with associated complications. With no clarity on the full range of possible complications or certain consensus on their optimal management, the ideal treatment remains a decision for the individual surgeon. In view of this, we felt it of common interest to review the literature for the history of sling procedures, present commonly arising complications, and seek to answer the question in the title.

scholarly journals Continuous Blood Pressure Monitoring Method Based on Multiple Photoplethysmography Features

2021 ◽  
Author(s):  
Yang Xu ◽  
Zhipei Huang ◽  
Jiankang Wu ◽  
Zhongdi Liu
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Blood Pressure Monitoring ◽  
Flow Characteristics ◽  
Test Results ◽  
Monitoring Methods ◽  
Pressure Monitoring ◽  
Monitoring Method ◽  
Instrumentation Error ◽  
Continuous Blood Pressure

Continuous blood pressure monitoring is of great significance for the prevention and early diagnosis of cardiovascular diseases. However, the existing continuous blood pressure monitoring methods, especially the sleeveless blood pressure monitoring methods, are complex and computationally heavy. In this paper, we propose a method, using plethysmography (PPG) signals alone, to estimate continuous blood pressure by extracting multiple PPG features related to intravascular blood flow characteristics. The performance of our method was evaluated using ten minutes synchronized PPG signals and continuous blood pressure from 21 healthy volunteers and 19 patients with hypertension and diabetes. The test results have shown that the absolute mean errors and standard deviation errors between the estimated and referenced blood pressure are 3.22±0.66 mmHg for systolic blood pressure and 2.11±1.11 mmHg for diastolic blood pressure, which meet AAMI (the association for the advancement of medical instrumentation) error acceptance.

scholarly journals Value of the ultrasound research in the diagnostic of acute strangulated small bowel obstruction

2021 ◽  
Vol 25 (3) ◽  
pp. 31-42
Author(s):  
N. V. Shavrina ◽  
P. A. Yartsev ◽  
A. G. Lebedev ◽  
V. D. Levitsky ◽  
M. N. Drаyer ◽  
...  
Keyword(s):  
Blood Flow ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Intestinal Ischemia ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Intestinal Wall ◽  
Adhesive Small Bowel Obstruction ◽  
Intestinal Necrosis

Purpose. To identify and evaluate the effectiveness of sonographic signs of intestinal ischemia in patients with strangulated small bowel obstruction.Materials and methods. For the period 2017–2019, 115 patients with SIO were treated at the N.V. Sklifosovsky Federal Research Institute of Emergency Medicine. There were 64 women (55.6%) and 51 men (44.4%). The mean age was 62 ± 15 years. In all patients, the diagnosis was verified intraoperatively. All patients underwent ultrasound examination of the abdominal cavity in B-mode with the assessment of blood flow of the intestinal wall in the mode of CDI. Patients were divided on the basis of intraoperative data into 2 groups. The first group: 63 (54.8%) patients with signs of ischemia of the strangulated loop of the intestine. The second group consisted of 21 (18.1%) patients in whom intestinal necrosis was detected. The comparison group included 31 (26.7%) patients with adhesive small bowel obstruction without intestinal strangulation.Results. The most informative signs of ischemia of the strangulated intestine of the loop are infiltrative changes of its mesentery. In the second and third groups 9 (14.3%) and 12 (57.1%) participants, respectively, showed severity of intestinal ischemia, compared with 1 participant (3.2%) in the first group. The next informative criterion is the thickening of more than 0.4 cm and edema of the intestinal wall. In the second and third groups 30 (47.6%) and 14 (66.6%), in the comparison group 4 (12.9%), akinesis of the strangulated loop and paresis of the entire small intestine also directly correlated with intestinal ischemia. The absence of differentiation of intestinal wall layers occurs in (23.8%), the absence of blood flow in the intestinal wall in the CDI mode (19%), gas inclusions in the intestinal wall (4.3%).Conclusion. The assessment of sonographic symptoms allows to diagnose the presence of ischemic changes in the intestinal wall and perform surgery before the development of necrosis in the early period. In cases of late admission of the patient to the hospital, with the onset of intestinal necrosis and the associated erased clinical picture, ultrasound allows to establish indications for surgery before the development of peritonitis.

Fit Vs Faint: Assessing Work Causation in “Idiopathic Fall” Cases

2014 ◽  
Vol 19 (5) ◽  
pp. 3-12
Author(s):  
Lorne Direnfeld ◽  
David B. Torrey ◽  
Jim Black ◽  
LuAnn Haley ◽  
Christopher R. Brigham
Keyword(s):  
Blood Flow ◽  
Electrical Activity ◽  
Loss Of Consciousness ◽  
Brain Electrical Activity ◽  
Medical Terminology ◽  
Scientific Analysis ◽  
Medical Causation ◽  
The Individual ◽  
The Brain ◽  
Current Science

Abstract When an individual falls due to a nonwork-related episode of dizziness, hits their head and sustains injury, do workers’ compensation laws consider such injuries to be compensable? Bearing in mind that each state makes its own laws, the answer depends on what caused the loss of consciousness, and the second asks specifically what happened in the fall that caused the injury? The first question speaks to medical causation, which applies scientific analysis to determine the cause of the problem. The second question addresses legal causation: Under what factual circumstances are injuries of this type potentially covered under the law? Much nuance attends this analysis. The authors discuss idiopathic falls, which in this context means “unique to the individual” as opposed to “of unknown cause,” which is the familiar medical terminology. The article presents three detailed case studies that describe falls that had their genesis in episodes of loss of consciousness, followed by analyses by lawyer or judge authors who address the issue of compensability, including three scenarios from Arizona, California, and Pennsylvania. A medical (scientific) analysis must be thorough and must determine the facts regarding the fall and what occurred: Was the fall due to a fit (eg, a seizure with loss of consciousness attributable to anormal brain electrical activity) or a faint (eg, loss of consciousness attributable to a decrease in blood flow to the brain? The evaluator should be able to fully explain the basis for the conclusions, including references to current science.

Complicated gastrointestinal CMV disease after small bowel transplantation

2013 ◽  
Vol 51 (08) ◽  
Author(s):  
Y Avsar ◽  
V Cicinnati ◽  
I Kabar ◽  
H Wolters ◽  
C Anthoni ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Transplantation ◽  
Cmv Disease

The Republic

2019 ◽  
pp. 205-229
Author(s):  
Dominic Scott
Keyword(s):  
Political Theory ◽  
Left Behind ◽  
Ideal State ◽  
The Republic ◽  
Individual Justice ◽  
The Individual ◽  
Political Right ◽  
First Time ◽  
The Ideal

This chapter presents a reading of Plato’s Republic. The Republic is among Plato’s most complex works. From its title, the first-time reader will expect a dialogue about political theory, yet the work starts from the perspective of the individual, coming to focus on the question of how, if at all, justice contributes to an agent’s happiness. Only after this question has been fully set out does the work evolve into an investigation of politics—of the ideal state and of the institutions that sustain it, especially those having to do with education. But the interest in individual justice and happiness is never left behind. Rather, the work weaves in and out of the two perspectives, individual and political, right through to its conclusion. All this may leave one wondering about the unity of the work. The chapter shows that, despite the enormous range of topics discussed, the Republic fits together as a coherent whole.

scholarly journals Cost-efficiency assessments of marine monitoring methods lack rigor—a systematic mapping of literature and an end-user view on optimal cost-efficiency analysis

2021 ◽  
Vol 193 (7) ◽  
Author(s):  
Heini Hyvärinen ◽  
Annaliina Skyttä ◽  
Susanna Jernberg ◽  
Kristian Meissner ◽  
Harri Kuosa ◽  
...  
Keyword(s):  
Comparative Studies ◽  
Cost Efficiency ◽  
Cost Benefit ◽  
Marine Ecosystems ◽  
Actual Cost ◽  
Monitoring Methods ◽  
Monitoring Method ◽  
Marine Monitoring ◽  
The Status ◽  
The Cost

AbstractGlobal deterioration of marine ecosystems, together with increasing pressure to use them, has created a demand for new, more efficient and cost-efficient monitoring tools that enable assessing changes in the status of marine ecosystems. However, demonstrating the cost-efficiency of a monitoring method is not straightforward as there are no generally applicable guidelines. Our study provides a systematic literature mapping of methods and criteria that have been proposed or used since the year 2000 to evaluate the cost-efficiency of marine monitoring methods. We aimed to investigate these methods but discovered that examples of actual cost-efficiency assessments in literature were rare, contradicting the prevalent use of the term “cost-efficiency.” We identified five different ways to compare the cost-efficiency of a marine monitoring method: (1) the cost–benefit ratio, (2) comparative studies based on an experiment, (3) comparative studies based on a literature review, (4) comparisons with other methods based on literature, and (5) subjective comparisons with other methods based on experience or intuition. Because of the observed high frequency of insufficient cost–benefit assessments, we strongly advise that more attention is paid to the coverage of both cost and efficiency parameters when evaluating the actual cost-efficiency of novel methods. Our results emphasize the need to improve the reliability and comparability of cost-efficiency assessments. We provide guidelines for future initiatives to develop a cost-efficiency assessment framework and suggestions for more unified cost-efficiency criteria.

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