scholarly journals Use of artisanal simulators in the ultrasound training for invasive procedures in nephrology: venous access and renal biopsy

2019 ◽  
Vol 41 (3) ◽  
pp. 423-426
Author(s):  
Marcus Gomes Bastos ◽  
Ramon de Oliveira Dalamura ◽  
Ana Luisa Silveira Vieira ◽  
José Pazeli Jr.
Keyword(s):  
Image Quality ◽  
Renal Biopsy ◽  
Low Cost ◽  
Venous Access ◽  
Chicken Breast ◽  
Invasive Procedures ◽  
Anatomical Structures ◽  
Pig Kidney ◽  
Hand Eye Coordination ◽  
Biopsy Methods

ABSTRACT Introduction: Vascular access and renal biopsy are common procedures in nephrology. In this study, two artisanal simulators of very low cost and excelent image quality are (prented) presented to guide, by ultrasound, the venous access and renal biopsy. Methods: The simulators are constructed using chicken breast slices, Penrose drain, plastic milk shake straw and pig kidney. Results: Both simulators enable immediate identification of the anatomical structures of interest, vessels and kidney, and enable spatial orientation and hand-eye coordination, essential for the development of the necessary skills to safely carry out invasive procedures. Conclusion: The simulators described, were extremely useful for simulating venous access and renal biopsy guided by ultrasonography, enabling training to reduce the failure rate in punctures and the potential complications associated with the described procedures.

A newly designed total implantable venous access device in rats for research with high efficiency and low cost

2014 ◽  
Vol 187 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Hsin-Lin Tsai ◽  
Jei-Wen Chang ◽  
Chin-Su Liu ◽  
Tai-Wai Chin ◽  
Chou-Fu Wei ◽  
...  
Keyword(s):  
High Efficiency ◽  
Low Cost ◽  
Venous Access ◽  
Access Device ◽  
Venous Access Device

scholarly journals Estudo comparativo entre duas técnicas radiográficas transcranianas para estudo da ATM

2012 ◽  
Vol 11 (2) ◽  
pp. 189
Author(s):  
Marcus Vinicius Linhares de Oliveira ◽  
Paulo Sergio Flores Campos
Keyword(s):  
Image Quality ◽  
Anatomical Structure ◽  
Glenoid Fossa ◽  
Font Size ◽  
Anatomical Structures ◽  
Mandibular Joint ◽  
Radiographic Interpretation ◽  
Exposure Methods ◽  
Pathological Assessment

<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabela normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> <p class="MsoNormal" style="margin: 0cm 22.7pt 0.0001pt; text-align: justify;"><strong><span style="font-size: 8pt; color: black;">Introdução</span></strong><span style="font-size: 8pt;">: Estudos através das imagens da ATM apresentam-se como auxílio ao diagnóstico especifico de determinadas patologias relacionadas a essa estrutura anatômica. De modo a oferecer mais informações possíveis, visualização mais clara, redução das dificuldades de interpretação radiográfica, é imperativa a boa execução das técnicas radiográficas e o desenvolvimento de novos métodos de exposição. <strong>Objetivo</strong>: Avaliar duas incidências radiográficas convencionais que possibilitam o estudo da ATM e relacioná-las com a qualidade da imagem, de acordo com a visualização das estruturas anatômicas. <strong>Materiais e métodos</strong> : O estudo foi realizado através da execução de duas técnicas radiográficas (SCHULLER e LAW modificado), utilizadas para estudo da ATM em um simulador com ossos do crânio e mandíbula humana recoberta com resina. A qualidade da imagem foi <span style="color: black;">avaliada por três radiologistas com experiência, que atribuíram escores (01 –<span>  </span>inadequado; 02 – aceitável com restrições; 03 – aceitável sem restrições) relacionados à sobreposição das estruturas, à visualização da fossa mandibular e à definição do côndilo. <strong>Resultados</strong>: Para os três avaliadores, a técnica B apresentou a concordância em 75% dos pontos analisados, observou-se que para a técnica A os avaliadores 1 e 3 concordaram em 75%, enquanto que os indicies kappa foram considerados moderados para a técnica B . </span><strong>Conclusão</strong>: As técnicas transcranianas permitem a avaliação anatômica e patológica da ATM como forma simples e mais acessível ao paciente sendo a técnica de Law modificado a que apresenta maior concordância entre os avaliadores. </span></p> <p class="MsoNormal" style="margin: 0cm 22.7pt 0.0001pt; text-align: justify;"><strong><span style="font-size: 8pt; color: black;" lang="EN-US"> </span></strong></p> <p class="MsoNormal" style="margin: 0cm 22.7pt 0.0001pt; text-align: justify;"><strong><span style="font-size: 8pt; color: black;" lang="EN-US">Abstract</span></strong></p> <p class="MsoNormal" style="margin: 0cm 22.7pt 0.0001pt; text-align: justify;"><strong><span style="font-size: 8pt; color: black;" lang="EN-US">Introduction</span></strong><span style="font-size: 8pt;" lang="EN-US">: Image studies of the temporal mandibular joint (TMJ) are presented as an assistance to the diagnosis of certain specific pathologies related to this anatomical structure. In order to provide as much information as possible, a clearer view and a reduction in the difficulty of the radiographic interpretation it is imperative a good performance of the radiographic techniques and the development of new exposure methods. <strong>Objective</strong>: Evaluate two conventional radiographic views that allow the study of TMJ and relate them with the image quality according to the visualization of anatomical structures <strong>Materials and Methods</strong>: The study was conducted by running two radiographic techniques (SCHULLER and modified LAW) used to the TMJ study in a phantom containing cranial bones and a human mandibular covered with resin. The image quality was evaluated by three experienced radiologists assigning scores (01 - inappropriate, 02 - acceptable with restrictions, 03-acceptable without restrictions) related to overlapping structures, visualization of the glenoid fossa and condyle definition. <strong>Results:</strong> For three evaluators, B technique presented an agreement on 75% of the points analyzed. It was observed that for technique A, evaluators 1 and 3 evaluators agreed on 75% while the kappa indexwere considered moderated for B technique. <strong>Conclusion</strong>: Transcranial techniques allow anatomical and pathological assessment of the TMJ in a simple and more accessible way to the patient and the technique of modified Law presents the best agreement between raters.</span></p>

scholarly journals Development and application of a swine model for training ultrasonography-guided central venous access

2020 ◽  
Vol 47 ◽  
Author(s):  
JACKSON VINÍCIUS DE LIMA BERTUOL ◽  
NATASHA LURE BUENO CAMARGO ◽  
FERNANDO ANTONIO CAMPELO SPENCER NETTO ◽  
ANDRÉ PEREIRA WESTPHALEN
Keyword(s):  
Porcine Model ◽  
Low Cost ◽  
Central Venous Access ◽  
Training Session ◽  
Hospital Setting ◽  
Venous Access ◽  
Human Anatomy ◽  
Swine Model ◽  
Central Venous ◽  
Hands On

ABSTRACT Introduction: simulation based teaching is a powerful tool in medical education, allowing hands on practice under a controlled environment and with repeated maneuvers. Central venous access venipuncture is one of the most frequent procedures carried out in the hospital setting, due to its various clinical indications and, when performed with the help of ultrasonography, the risk of adverse events is minimized. Aim: to develop, to describe and to test a porcine model that simulates the central venous access puncture aided by ultrasonography. Method: a low cost porcine model was developed to train medical students and residents on central venous access guided by ultrasonography. Both students and medical residents underwent a theoretical training regarding the model, followed by a hands-on training session. Afterwards, the participants assessed the model by answering a questionnaire. Results: there were 51 participants. The average score regarding the similarity between the model and the human anatomy was 9.15. When the characteristics were separately assessed, the mean scores regarding the similarity of the vessels, anatomic disposition and ultrasonographic characteristics as well as the venipuncture were, respectively, 9.27; 9.31; 9.54 and 8.86. Conclusion: The model was approved and considered appropriate for the training of central venous venipuncture by all the participants. Furthermore, it is a low cost, simple and reproducible model, that presents high similarity with the human anatomy. Therefore, it may be used as an aid to train people on ultrasonography guided central venous access.

scholarly journals Relationship between CNR and visibility of anatomical structures of cone-beam computed tomography images under different exposure parameters

2020 ◽  
Vol 49 (5) ◽  
pp. 20190336
Author(s):  
Miss Fei Wang ◽  
Xiaoyan Xie ◽  
Gang Li ◽  
Zuyan Zhang
Keyword(s):  
Image Quality ◽  
Change Point ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Physical Factors ◽  
Anatomical Structures ◽  
Subjective Image Quality ◽  
Computed Tomography Images ◽  
Tissue Equivalent ◽  
Imagej Software

Objectives: The purpose of this study was to investigate the image quality of cone beam CT (CBCT) under different exposure parameters and the relationship between contrast-to-noise and visibility of eight anatomical structures. Methods: CBCT images for the evaluation of subjective image quality were acquired on an anthropopathic phantom containing a human skeleton embedded in soft tissue equivalent materials using 25 exposure protocols. Visibility of eight anatomical structures was evaluated by five independent observers. Using the SEDENTEXCT IQ Image Quality phantom, the contrast-to-noise ratio (CNR) was calculated by ImageJ software. Results: A reduction on the visibility of anatomical structures was seen under lower exposure parameters. However, for 84% of the protocols, visibility of anatomical structures remained acceptable even under some lower parameter settings. As CNR increased, the visibility of anatomical structures also increased correspondingly. A change point could be found in the CNR interval 29.42–36.51 after which the visibility of anatomical structures no longer increases with the increase of CNR. Conclusions: Although CNR decrease under a lower exposure parameter, the image quality often remained acceptable at exposure levels below the manufacture’s recommended settings. It is possible to standardize subjective image quality by physical factors. Currently, it is not possible to predetermine a change point CNR value due to different CBCT machine and variation of diagnostic tasks.

scholarly journals Toward Respiratory Support of Critically Ill COVID-19 Patients Using Repurposed Kidney Hollow Fiber Membrane Dialysers to Oxygenate the Blood

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
David M. Rubin ◽  
Neil T. Stacey ◽  
Tonderayi Matambo ◽  
Claudia Do Vale ◽  
Martin J. Sussman ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Hollow Fiber ◽  
Oxygen Transfer ◽  
Resource Constraints ◽  
Hollow Fiber Membrane ◽  
Low Cost ◽  
Venous Access ◽  
Respiratory Support ◽  
Fiber Membrane ◽  
Polysulfone Membrane

The COVID-19 pandemic has highlighted resource constraints in respiratory support. The oxygen transfer characteristics of a specific hollow fiber membrane dialyser was investigated with a view to repurposing the device as a low-cost, readily available blood oxygenator. Oxygen transfer in a low-flux hollow fiber dialyser with a polysulfone membrane was studied by passing first water and then blood through the dialyser in countercurrent to high-purity oxygen. Oxygen transfer rates of about 15% of the nominal 250 ml (STP)/min of a typical adult oxygen consumption rate were achieved for blood flow rates of 500 ml/min. Using two such dialysis devices in parallel could provide up to 30% of the nominal oxygen consumption. Specific hollow fiber dialysis devices operating with suitable pumps in a veno-venous access configuration could provide a cost-effective and readily available supplementation of respiratory support in the face of severe resource constraints.

scholarly journals Smartphone-based low-cost microscope with monolithic focusing mechanism

2018 ◽  
Vol 4 (1) ◽  
pp. 267-270
Author(s):  
Max B. Schäfer ◽  
David Reichert ◽  
Kent Stewart ◽  
Alois M. Herkommer ◽  
Carsten Reichert ◽  
...  
Keyword(s):  
Image Quality ◽  
Injection Molding ◽  
Low Cost ◽  
Functional Integration ◽  
High Order ◽  
Number Of Components

AbstractMicroscopy enables fast and effective diagnostics. However, its functionality is not accessible to everyone. Smartphone-based low-cost microscopes could be a powerful tool for diagnostics and educational purposes. Current smartphone-based microscopy approaches struggle with high cost, poor image quality and/or insufficient smartphone compatibility. In this paper, a very feasible and effective lowcost microscope is presented which addresses these issues. To minimize cost, a monolithic foldable structure is designed for production by injection molding. The design has a high order of functional integration, minimizing the number of components, while still enabling a micrometer focusing accuracy.

The Multi-lumen Catheter: Proposed Guidelines for Its Use

1988 ◽  
Vol 9 (5) ◽  
pp. 206-208 ◽  
Author(s):  
Bruce F. Farber
Keyword(s):  
Jugular Vein ◽  
Venous Access ◽  
Infusion Therapy ◽  
Blood Products ◽  
Invasive Procedures ◽  
Intravenous Catheter ◽  
Nosocomial Bacteremia ◽  
Lumen Catheter ◽  
Minimal Data ◽  
Risk Cost

Infusion therapy for the administration of blood products, fluids, and parenteral nutrition are essential parts of medical practice. The risks associated with such therapy are well documented but frequently unappreciated. Intravascular infusions are the single most common cause of nosocomial bacteremia.’ Many studies have focused on the epidemiology, microbiology, and pathophysiology of these infections.In recent years, several companies have introduced a multi-lumen intravenous catheter that is placed through the subclavian or internal jugular vein. Unlike a multi-lumen pulmonary artery catheter, the multi-lumen intravenous catheter is designed solely for intravenous access. The first of these catheters was introduced in 1983, and it was soon followed by several others. These catheters have been designed to allow multiple infusions to be given simultaneously. In addition, one of the ports can be used for venous access. The advantages of these catheters are obvious. The clinician is given three ports for use instead of one. The catheter may be used to simplify infusion therapy. In some instances, cut-downs and other invasive procedures (Hickmans, Broviacs, Mediports) may be avoided. It is not surprising that the use of these catheters has grown. In many institutions, multi-lumen catheters account for a majority of all centrally placed catheters, and in some intensive care units, they are used almost exclusively. The enormous growth of the use of the multi-lumen catheter has occurred despite minimal data regarding risk, cost, and the proper procedures needed for its care.

Closure of Large Percutaneous Femoral Venous access using a Modified “Figure-of-Eight” Suture

2018 ◽  
Vol 13 (2) ◽  
pp. 147-151 ◽  
Author(s):  
Christophe A. Wyss ◽  
Oliver Anliker ◽  
Oliver Gämperli ◽  
Daniel Sürder ◽  
Patric Biaggi ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Low Cost ◽  
Academic Research ◽  
Early Mobilization ◽  
Bed Rest ◽  
Bleeding Risk ◽  
Venous Access ◽  
Suture Technique ◽  
Bleeding Complications ◽  
Compression Bandage

Recent advances in different percutaneous treatments made insertion of large-caliber sheaths in the femoral veins more common. Venous punctures are historically managed by initial manual compression with subsequent application of a compression bandage and bed rest. We describe a modified “figure-of-eight” suture technique for minimizing the risk of accidental puncture of the vein while grabbing the subcutaneous tissue. We examined the safety and feasibility of this technique combined with early mobilization in a real-world setting. We performed a retrospective analysis on 56 consecutive patients undergoing percutaneous mitral valve repair using large femoral venous access. The patient population was heterogeneous and bleeding risk characteristics were common. Bleeding Academic Research Consortium Consensus (BARC)-classifiable bleeding complications occurred in eight patients (14%), BARC of two events or more in five patients (8.9%), and BARC of three or more event in only one patient (1.8%), which is a comparable success rate to large venous access closure with suture-mediated closure devices. No BARC Type 3b or BARC Type 5 bleeding occurred. During routine clinical follow-up, no groin-related problems were reported in all patients. Closure of large femoral venous access using a modified temporary subcutaneous figure-of-eight suture in combination of a light compression bandage and bed rest for 2 to 4 hours provides a safe and low-cost alternative to closure devices for early mobilization.

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