scholarly journals DUETS (Dallas UtErus Transplant Study): The role of imaging in uterus transplantation

2019 ◽  
Vol 7 ◽  
pp. 205031211987560 ◽  
Author(s):  
Soran Mahmood ◽  
Liza Johannesson ◽  
Giuliano Testa ◽  
Gregory de Prisco
Keyword(s):  
Imaging Techniques ◽  
Vascular Anatomy ◽  
Evaluation Process ◽  
Living Donors ◽  
Important Variable ◽  
Donor Selection ◽  
Preoperative Imaging ◽  
Uterus Transplantation ◽  
Contrast Enhanced Ct

Objective: Uterus transplantation is rapidly becoming a viable clinical option for women with uterine-factor infertility and a desire for parenthood. Radiological imaging plays a central role in selecting the optimal living donors for uterus transplantation and serves to exclude any pathology and evaluate the uterine vasculature. The latter is the most important variable in the ultimate technical success of the uterus transplant. In this first report of imaging in the setting of uterus transplantation, we report our experience with living-donor selection, and the evolution of the imaging techniques that ultimately allowed a significant improvement in donor selection and transplant outcome. We also suggest a framework for preoperative imaging in uterus transplantation. Methods: Between 2016 and 2018, 27 potential living donors were evaluated by imaging prior to uterine donation for uterus transplantation. Predonation imaging included a screening chest radiograph, dual-phase computed tomography (CT) angiograms of the abdomen and pelvis in the arterial and venous phases and pelvic sonography with Doppler. Seventeen potential donors additionally underwent multiphasic pelvic MR angiograms. The imaging performed was meant to display features of the vascular anatomy relevant for uterus transplantation. Results: Out of the 27 potential live donors who were evaluated by imaging, 9 eventually donated their uterus for transplantation. The most frequent reason for exclusion was suboptimal quality of the vessels (33%), including small uterine arteries, the presence of atherosclerosis or small size/poor quality of the uterine or utero-ovarian veins, or both. The next most common reason was voluntary patient withdrawal or failure to complete the evaluation process (28%). Three potential donors (16.6%) were rejected for uterine factors, fibroids, and/or adenomyosis. Other reasons for donor rejection included ABO incompatibility and unfavorable psychological evaluation. Conclusion: Diagnostic imaging plays a crucial role in selecting appropriate potential donors, screening prospective recipients, planning the graft procedure, and following up on any graft or nongraft-related complications in both the donor and recipient after the transplantation procedure is performed. Contrast-enhanced CT and MR angiographies have complementary roles, especially when evaluating the donor for adequacy of the arterial and venous supply to the uterine graft and the experience gained from our series indicates that the inclusion of both modalities contributed directly to successful uterus transplant graft survival by selecting patients with favorable arterial and venous vasculature.

scholarly journals Imaging methods of the parathyroid glands in primary hyperparathyroidism. Literature review

2020 ◽  
Vol 13 (4) ◽  
pp. 153-174
Author(s):  
Konstantin Y. Slashchuk ◽  
Michail V. Degtyarev ◽  
Pavel O. Rumyantsev ◽  
Ekaterina A. Troshina ◽  
Galina A. Melnichenko
Keyword(s):  
Nuclear Medicine ◽  
Literature Review ◽  
Primary Hyperparathyroidism ◽  
European Society ◽  
Imaging Techniques ◽  
Parathyroid Glands ◽  
Preoperative Imaging ◽  
Surgical Removal ◽  
Medicine Physician

Primary hyperparathyroidism (PHPT) is a common endocrine disease that occurs with multiple profiles in which no classical manifestation. Diagnosis revolves around routine measurement of serum calcium and parathyroid hormone more than in half cases. The understanding of clinical presentation, epidemiology and management tactics of patients with hyperparathyroidism has significantly changed by virtue of the use of biochemical calcium screening. The successful diagnosis and treatment are possible with the cooperation of a multidisciplinary team of endocrinologist, endocrine surgeon, radiologist, nuclear medicine physician and pathomorphologist. The only radical method of treatment is the surgical removal of abnormal parathyroid glands. In this regard, there is necessary to improve the parathyroid glands imaging algorithms. Early treatment of hyperparathyroidism allows to avoid severe damage to the bones, kidneys, heart, other organs, improving the quality of life and reducing the incidence of disability. For a systematic literature review, more than 100 articles published from 2000 to the present time were used, on following resources: PubMed, Embase, SciSearch, Scopus, Cochrane Databases, Research Gate, Google Scholar. Including recommendations from the American Association of Endocrinologists and Endocrine Surgeons (AACE/AAES), European Society of Nuclear Medicine (EANM), European Society ofEndocrinologists (ESE), Russian Association of Endocrinologists (RAE) and several other organizations. The main goal of this review is to summarize and present relevant information and a new look on preoperative imaging techniques, methods of intraoperative navigation, surgery, control quality of treatment in patients with primary hyperparathyroidism.

EVALUASI PROGRAM/PROYEK PENGEMBANGAN KAWASAN EKONOMI KHUSUS SEI MANGKE DALAM RANGKA PELAKSANAAN KEBIJAKAN MP3EI 2011-2025 DI KORIDOR EKONOMI SUMATERA

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Firrean Firrean
Keyword(s):  
Local Government ◽  
Evaluation Process ◽  
Spatial Arrangement ◽  
Policy Program ◽  
Evaluative Research ◽  
Policy Optimization ◽  
Economic Zones ◽  
North Sumatra

Special Economic Zones (SEZ) is a region with certain limits within the jurisdiction of Indonesia which is set to perform economic functions and obtain certain facilities. One SEZ developed in North Sumatra Province and included in the National Strategic Area (KSN) Medan - Binjai - Deli Serdang - Karo is SEZ Sei Mangke. SEZ Sei Mangke is defined in PP 29 of 2012 on 27 February 2012 and is the first KEK in Indonesia which was inaugurated its operation by President Joko Widodo on January 27, 2015. KSN Mebidangro itself is an area of priority spatial arrangement because it has a very important influence nationally against state sovereignty, defense and state security, economic, social, cultural, and / or environment, including areas designated as world heritage. This research is an evaluative research intended to find out the end of a policy program in order to determine recommendation of last policy by using CIPO model which includes four stages: (1) context, (2) input, (3) process, and (4) output. The research method used is case study by applying qualitative research that aims to make an accurate interpretation of the characteristics of the object under study. Findings on the evaluation context indicate that the program is generally running well, but some aspects of synergy and policy optimization as well as financing support from central and local government need to be improved. In the input evaluation, and evaluation process some aspects need to be improved because the findings show the weakness of some aspects is the result of lack of synergy and optimization of policy and support from local government. Interesting from the evaluation of ouput is that with some weaknesses in the input and process components, it turns out the evaluation findings ouput show Seek Mangke SEZ development can still run well. The recommendation of this research is to improve the quality of policy synergy / program of SEZ Seek development by improving several aspects that are categorized in each stage of evaluation

scholarly journals Quality of Life: Changes in Self-Perception in People with down Syndrome as a Result of Being Part of a Football/Soccer Team. Self-Reports and External Reports

2021 ◽  
Vol 11 (2) ◽  
pp. 226
Author(s):  
Rocío Camacho ◽  
Cristina Castejón-Riber ◽  
Francisco Requena ◽  
Julio Camacho ◽  
Begoña Escribano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Down Syndrome ◽  
Personal Development ◽  
Social Inclusion ◽  
Evaluation Process ◽  
Well Being ◽  
Self Perception ◽  
Football Team ◽  
Soccer Team

The hypothesis posed was whether being part of a football/soccer team influenced the quality of life (QL) of the people who participated in it since their perception of themselves is enhanced by factors, such as self-determination, social inclusion, emotional well-being, physical well-being, material well-being, rights, personal development, and internal relationships. The objective was to evaluate the QL of people with Down Syndrome (DS) using their self-perception (n = 39) and the perception of the informants (family members, teachers) (n = 39). The KidsLife-Down Scale, with a few modifications, was used. In general, differences of opinion between the subgroups of participants with DS and informants showed that results were higher in terms of perception for participants in the DS subgroup. Scores for all variables were higher for those participants with DS who said they did engage in practicing competitive football/soccer. Although the perception of informants provides a great deal of information regarding the QL of participants with DS, participants with DS should also be involved in the evaluation process and their self-perceptions taken into account. It is not participating in a football team that causes the conclusions of the study, but training (which includes the friendly matches that are played), the cause correlated with the improvements detected in the athlete’s DS.

scholarly journals Surgical management of brain metastases

2007 ◽  
Vol 22 (3) ◽  
pp. 1-7 ◽  
Author(s):  
Moksha G. Ranasinghe ◽  
Jonas M. Sheehan
Keyword(s):  
Brain Tumors ◽  
Systemic Disease ◽  
Postoperative Management ◽  
Study Data ◽  
Preoperative Imaging ◽  
Metastatic Brain Tumors ◽  
Patients With Cancer ◽  
Proper Patient Selection ◽  
Positive Effect

✓Metastatic brain tumors continue to increase in incidence as patients with cancer live longer. The options for management continue to evolve as well, with advances in radiation-based treatment, chemotherapy, and surgery. Although metastatic brain tumors are frequently treated without surgical intervention, there continues to be a significant role for surgery in caring for patients with these lesions. Study data have proven that surgery has a positive effect on survival and quality of life in properly selected patients. Those with a suitable age, functional status, systemic disease control, and several metastases may be suitable for surgical treatment. Advances in preoperative imaging and planning as well as intraoperative surgical adjuncts have lowered the morbidity associated with resection. With proper patient selection and operative and postoperative management, resection continues to play a significant and evolving role in the care of patients with metastatic brain tumor.

What Does Imaging Add to the Management of Alzheimer's Disease?

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S5) ◽  
pp. 20-23 ◽  
Author(s):  
Gary W. Small
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Imaging Techniques ◽  
Screening Tools ◽  
Surrogate Markers ◽  
Genetic Disposition ◽  
Number Of Patients

AbstractThe prevalence of Alzheimer's disease (AD) and dementia continues to rise. However, a significant number of patients are undiagnosed or untreated. Given the complexities of detecting cognitive impairment and the early signs of AD, this review discusses how advances in brain imaging can help assist in improving overall management. Imaging techniques and surrogate markers may provide unique opportunities to diagnose accurately AD in presymptomatic stages with practical consequences for patients, caregivers, and physicians. The possible outcomes for using imaging and surrogate markers as adjuncts to clinical examination and as screening tools for AD, as well as tangible and intangible advantages to early diagnosis and treatment, will be discussed. The specific value of using advanced serial imaging in patients with a genetic disposition to AD will be evaluated. If neurons can be protected from neurodegenerative damage in early stages, this may preserve patient cognition, function, and quality of life, and may confer considerable societal healthcare benefits.

Low Environmental Impact Machining Processes of Composite Materials Applied to the Aerospace Sector

2010 ◽  
Vol 107 ◽  
pp. 15-19 ◽  
Author(s):  
Miguel Álvarez ◽  
Moisés Batista ◽  
Jorge Salguero ◽  
Manuel Sánchez-Carrilero ◽  
Mariano Marcos Bárcena
Keyword(s):  
Evaluation Process ◽  
Advanced Materials ◽  
Surface Finishing ◽  
Matrix Composites ◽  
Machining Processes ◽  
Tool Materials ◽  
Industrial Sectors ◽  
Aerospace Sector ◽  
Aeronautical Industry

In the last decades, technologically innovative processes performed in advanced materials such as Carbon Fibre (CF) and Metal Matrix Composites (MMC) have continuously increased because of these materials find increasingly applications in the most of the industrial sectors, particularly in aeronautical industry. This is caused by their excellent relationship weight/mechanical properties. Although there is a high trend to apply and develop non-conventional technologies and methods for machining CF and MMC, other common machining processes are commonly applied for working these materials. Thus, in aeronautical industry, mechanical drilling processes are usually applied for preparing the manufactured elements to be assembled. However, drilling of CF based materials can carry on troubles related to a loss of surface finishing quality and/or quick and high tool wear. This work reports on the results about an evaluation process of the surface quality of drilled CF samples as a function of the cutting conditions and the tool materials.

scholarly journals Baukultur, Culture and Recreation-led Economic Development: The value of developing Sundre, Alberta’s qualities of living and place

2019 ◽  
Vol 18 ◽  
pp. 124
Author(s):  
Jonathan Allan
Keyword(s):  
Economic Development ◽  
Development Strategy ◽  
Direct Investment ◽  
Important Variable ◽  
Development Economic ◽  
Economic Diversification ◽  
Economic Development Strategy ◽  
Quality Of Place ◽  
Quality Of Living

<p>What are the most important factors related to economic development? This paper explores the essential variables necessary for destination development and inward direct investment. These variables include: quality of living, quality of infrastructure, and quality of workforce. Quality of living is considered the most important of these to spur on economic development. Many business operators would rather live where they invest making quality of place an equally important variable that is intrinsically linked to quality of living. Destination development through place-building techniques, informed by the concept of <em>baukultur,</em>is assessed using quality of living, economic development and economic diversification as markers. Quality of living and quality of place are inherently connected when attracting business and growing employment, therefore, these two terms will be referred to as QLP throughout this paper..  Intended to help program and policy planners understand these concepts, this paper will explore cases of successful exercises of destination development that involve recreation and culture-oriented place building. The paper will then look at how to apply learned QLP concepts toward a culture- and recreation-led economic development strategy for the small foothills community of Sundre, Alberta. </p><p><strong>Keywords: </strong>place building, quality of place, quality of living, <em>baukultur</em>, QLP, development, economic development, destination development, inward direct investment, creative class</p>

scholarly journals Assessment of Myocardial Viability: A Review of Current Non Invasive Imaging Techniques

2015 ◽  
Vol 1 (3) ◽  
pp. 113 ◽  
Author(s):  
Ahmed Talib
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Ventricular Dysfunction ◽  
Imaging Techniques ◽  
Left Ventricular ◽  
Common Cause ◽  
Non Invasive ◽  
Artery Disease ◽  
Impaired Quality

Coronary artery disease (CAD) is the most prevalent and<br />single most common cause of morbidity and mortality1 with<br />the resulting left ventricular dysfunction (LVD) an important<br />complication2. Worldwide, CAD accounts for 5.7 million new<br />cases per year, of these 1.3 million in Europe alone3. In addition,<br />it imposes a substantial share of health service resources and<br />expenses, an impaired quality of life, disability and high social<br />cost3,4. Furthermore, LVD itself has been shown to be a powerful<br />determinant of survival2, 5.

scholarly journals The Assessment of the Innovativeness of a New Medicine in Italy

2021 ◽  
Vol 8 ◽  
Author(s):  
Filomena Fortinguerra ◽  
Serena Perna ◽  
Roberto Marini ◽  
Alessandra Dell'Utri ◽  
Maurizio Trapanese ◽  
...  
Keyword(s):  
Decision Process ◽  
Classification Tree ◽  
Orphan Drugs ◽  
Important Variable ◽  
Medical Product ◽  
Chi Square ◽  
New Approach ◽  
Exact Test ◽  
Therapeutic Value

Objectives: Starting from April 2017, the Italian Medicine Agency (AIFA) has approved new criteria for defining any new medicinal product with an innovative indication. The purpose of the study is to analyze the activity of innovativeness evaluation according to the new approach, to estimate the weight of each criterion considered for innovativeness definition, and to evaluate how the new approach works in terms of consistency and reproducibility.Methods: A retrospective analysis was performed on the final reports evaluating the drug innovativeness assessment published on the AIFA's website between April 2017 and January 2021. Descriptive statistics, chi-square test, whether the conditions were respected, or Fisher's exact test was used to explore the association between characteristics of drugs and the innovativeness status and the association between the three criteria. Profiles of the decision process and their relationship with innovativeness response were described. In order to evaluate the weight of each criterion in predicting the innovativeness status, a Classification Tree (CT) algorithm was applied.Results: Overall, of the 109 published drugs reports, 37 (33.9%) were recognized as fully innovative, 29 (26.6%) were considered conditionally innovative, while for 43 (39.4%) reports innovativeness was not recognized. Considering the three criteria of the decision process, the added therapeutic value was the only criterion statistically associated with a drug's degree of innovation (p &lt; 0.001). The therapeutic need and the quality of clinical evidence were statistically associated (p = 0.008) even if only a mild association was observed. The added therapeutic value was the most important variable in predicting the innovativeness status according to the classification tree (CT) model applied, achieving an accuracy of 89.4%. No difference was found between orphans and non-orphan drugs or oncological and non-oncological drugs.Discussion: The added therapeutic value is the most important criterion of the multidimensional approach for the innovativeness status definition of a new medical product. A mild association was found between the therapeutic need and the quality of evidence. Overall, similar decision profiles bring the same evaluation of innovativeness status, indicating a good consistency and reproducibility between decisions.

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