scholarly journals A Free Virtual Reality Experience to Prepare Pediatric Patients for Magnetic Resonance Imaging: Cross-Sectional Questionnaire Study (Preprint)

2018 ◽  
Author(s):  
Jonathan Ashmore ◽  
Jerome Di Pietro ◽  
Kelly Williams ◽  
Euan Stokes ◽  
Anna Symons ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Magnetic Resonance ◽  
Pediatric Patients ◽  
Low Cost ◽  
Routine Care ◽  
Ease Of Use ◽  
Median Score ◽  
General Anesthetic ◽  
Cross Sectional ◽  
Staff Members

BACKGROUND A magnetic resonance image (MRI) is a diagnostic test that requires patients to lie still for prolonged periods within a claustrophobic and noisy environment. This can be difficult for children to tolerate, and often general anesthetic (GA) is required at considerable cost and detriment to patient safety. Virtual reality (VR) is a newly emerging technology that can be implemented at low cost within a health care setting. It has been shown to reduce fear associated with a number of high-anxiety situations and medical procedures. OBJECTIVE The goal of the research was to develop a VR resource to prepare pediatric patients for MRI, helping to reduce anxieties in children undergoing the procedure. METHODS A freely accessible VR preparation resource was developed to prepare pediatric patients for their upcoming MRI. The resource consists of an app and supporting preparation book and used a series of panoramic 360 degree videos of the entire MRI journey, including footage from within the bore of the scanner. The app, deployed via the Android Play Store and iOS App Store, can be viewed on most mobile phones, allowing a child to experience an MRI in VR using an inexpensive Google Cardboard headset. The app contains 360 degree videos within an animated, interactive VR interface designed for 4 to 12-year-olds. The resource was evaluated as part of a clinical audit on 23 patients (aged 4 to 12 years), and feedback was obtained from 10 staff members. In 5 patients, the resource was evaluated as a tool to prepare patients for an awake MRI who otherwise were booked to have an MRI under GA. RESULTS The VR preparation resource has been successfully implemented at 3 UK institutions. Of the 23 patients surveyed, on a scale of 1 to 10, the VR resource was rated with a median score of 8.5 for enjoyment, 8 for helpfulness, and 10 for ease of use. All patients agreed that it made them feel more positive about their MRI, and all suggested they would recommend the resource to other children. When considering their experiences using the resource with pediatric patients, on a scale of 1 to 10, the staff members rated the VR resource a median score of 8.5 for enjoyment, 9 for helpfulness, and 9 for ease of use. All staff believed it could help prepare children for an awake MRI, thus avoiding GA. A successful awake MRI was achieved in 4 of the 5 children for whom routine care would have resulted in an MRI under GA. CONCLUSIONS Our VR resource has the potential to relieve anxieties and better prepare patients for an awake MRI. The resource has potential to avoid GA through educating the child about the MRI process.

A Virtual Reality Environment to Visualize Three-Dimensional Patient-Specific Models by a Mobile Head-Mounted Display

2019 ◽  
Vol 26 (3) ◽  
pp. 359-370 ◽  
Author(s):  
Maurizio Vertemati ◽  
Simone Cassin ◽  
Francesco Rizzetto ◽  
Angelo Vanzulli ◽  
Marco Elli ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Open Source ◽  
Open Source Software ◽  
Preoperative Planning ◽  
Low Cost ◽  
Anatomical Variations ◽  
Ease Of Use ◽  
Patient Specific ◽  
Cross Sectional ◽  
Head Mounted Display

Introduction. With the availability of low-cost head-mounted displays (HMDs), virtual reality environments (VREs) are increasingly being used in medicine for teaching and clinical purposes. Our aim was to develop an interactive, user-friendly VRE for tridimensional visualization of patient-specific organs, establishing a workflow to transfer 3-dimensional (3D) models from imaging datasets to our immersive VRE. Materials and Methods. This original VRE model was built using open-source software and a mobile HMD, Samsung Gear VR. For its validation, we enrolled 33 volunteers: morphologists (n = 11), trainee surgeons (n = 15), and expert surgeons (n = 7). They tried our VRE and then filled in an original 5-point Likert-type scale 6-item questionnaire, considering the following parameters: ease of use, anatomy comprehension compared with 2D radiological imaging, explanation of anatomical variations, explanation of surgical procedures, preoperative planning, and experience of gastrointestinal/neurological disorders. Results in the 3 groups were statistically compared using analysis of variance. Results. Using cross-sectional medical imaging, the developed VRE allowed to visualize a 3D patient-specific abdominal scene in 1 hour. Overall, the 6 items were evaluated positively by all groups; only anatomy comprehension was statistically significant different among the 3 groups. Conclusions. Our approach, based on open-source software and mobile hardware, proved to be a valid and well-appreciated system to visualize 3D patient-specific models, paving the way for a potential new tool for teaching and preoperative planning.

scholarly journals A Free Virtual Reality Experience to Prepare Pediatric Patients for Magnetic Resonance Imaging: Cross-Sectional Questionnaire Study

10.2196/11684 ◽  
2019 ◽  
Vol 2 (1) ◽  
pp. e11684 ◽  
Author(s):  
Jonathan Ashmore ◽  
Jerome Di Pietro ◽  
Kelly Williams ◽  
Euan Stokes ◽  
Anna Symons ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Virtual Reality ◽  
Magnetic Resonance ◽  
Pediatric Patients ◽  
Questionnaire Study ◽  
Resonance Imaging ◽  
Cross Sectional

Effect of Combined Mouth Closure and Chin Lift on Upper Airway Dimensions during Routine Magnetic Resonance Imaging in Pediatric Patients Sedated with Propofol

1999 ◽  
Vol 90 (6) ◽  
pp. 1617-1623. ◽  
Author(s):  
Adrian Reber ◽  
Stephan G. Wetzel ◽  
Karl Schnabel ◽  
Georg Bongartz ◽  
Franz J. Frei
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Palate ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Propofol Sedation ◽  
Routine Magnetic Resonance Imaging ◽  
Airway Dimensions

Background In pediatric patients, obstruction of the upper airway is a common problem during general anesthesia. Chin lift is a commonly used technique to improve upper airway patency. However, little is known about the mechanism underlying this technique. Methods The authors studied the effect of the chin lift maneuver on airway dimensions in 10 spontaneously breathing children (aged 2-11 yr) sedated with propofol during routine magnetic resonance imaging. The minimal anteroposterior and corresponding transverse diameters of the pharynx were determined at the levels of the soft palate, dorsum of the tongue, and tip of the epiglottis before and during the chin lift maneuver. Additionally, cross-sectional areas were calculated at these sites, including tracheal areas 2 cm below the glottic level. Results Minimal anteroposterior diameter of the pharynx increased significantly during chin lift at all three levels in all patients. The diameters of the soft palate, tongue, and epiglottis increased from 6.7+/-2.8 mm (SD) to 9.9+/-3.6 mm, from 9.6+/-3.6 mm to 16.5+/-3.1 mm, and from 4.6+/-2.5 mm to 13.1+/-2.8 mm, respectively. The corresponding transverse diameter of the pharynx also increased significantly at all three levels in all patients but without significant predominance. The diameters at the levels of the soft palate, tongue, and epiglottis increased from 15.8+/-5.1 mm to 22.8+/-4.5 mm, from 13.5+/-4.9 mm to 18.7+/-5.3 mm, and from 17.2+/-3.9 mm to 21.2+/-3.7 mm, respectively. Cross-sectional pharyngeal areas increased significantly at all levels (soft palate, from 0.88+/-0.58 cm2 to 1.79+/-0.82 cm2; tongue, from 1.15+/-0.45 cm2 to 2.99+/-1.30 cm2; epiglottis, from 1.17+/-0.70 cm2 to 3.04+/-0.99 cm2), including the subglottic level (from 0.44+/-0.15 cm2 to 0.50+/-0.14 cm2). Conclusions This study shows that all children had a preserved upper airway at all measured sites during propofol sedation. Chin lift caused a widening of the entire pharyngeal airway that was most pronounced between the tip of the epiglottis and the posterior pharyngeal wall. In pediatric patients, chin lift may be used as a standard procedure during propofol sedation.

scholarly journals Factors involved in sustained use of point-of-use water disinfection methods: a field study from Flores Island, Indonesia

2014 ◽  
Vol 12 (3) ◽  
pp. 573-583 ◽  
Author(s):  
E. Roma ◽  
T. Bond ◽  
P. Jeffrey
Keyword(s):  
Water Treatment ◽  
Low Cost ◽  
Qualitative Evaluation ◽  
Ease Of Use ◽  
Water Disinfection ◽  
Cross Sectional ◽  
Household Water Treatment ◽  
Implementation Phase ◽  
Point Of Use ◽  
Sustained Use

Many scientific studies have suggested that point-of-use water treatment can improve water quality and reduce the risk of infectious diseases. Despite the ease of use and relatively low cost of such methods, experience shows the potential benefits derived from provision of such systems depend on recipients' acceptance of the technology and its sustained use. To date, few contributions have addressed the problem of user experience in the post-implementation phase. This can diagnose challenges, which undermine system longevity and its sustained use. A qualitative evaluation of two household water treatment systems, solar disinfection (SODIS) and chlorine tablets (Aquatabs), in three villages was conducted by using a diagnostic tool focusing on technology performance and experience. Cross-sectional surveys and in-depth interviews were used to investigate perceptions of involved stakeholders (users, implementers and local government). Results prove that economic and functional factors were significant in using SODIS, whilst perceptions of economic, taste and odour components were important in Aquatabs use. Conclusions relate to closing the gap between factors that technology implementers and users perceive as key to the sustained deployment of point-of-use disinfection technologies.

scholarly journals Design Strategies for Virtual Reality Interventions for Managing Pain and Anxiety in Children and Adolescents: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Naseem Ahmadpour ◽  
Melanie Keep ◽  
Anna Janssen ◽  
Anika Saiyara Rouf ◽  
Michael Marthick
Keyword(s):  
Virtual Reality ◽  
Scoping Review ◽  
Pediatric Patients ◽  
Low Cost ◽  
Health Sector ◽  
Dynamic Feedback ◽  
Design Strategies ◽  
Eligibility Criteria ◽  
Holistic Model ◽  
Product Experience

BACKGROUND Virtual reality (VR) technology has been explored in the health sector as a novel tool for supporting treatment side effects, including managing pain and anxiety. VR has recently become more available with the launch of low-cost devices and apps. OBJECTIVE This study aimed to provide an updated review of the research into VR use for pain and anxiety in pediatric patients undergoing medical procedures. Specifically, we wanted to gain an understanding of the techniques and goals used in selecting or designing VR apps in this context. METHODS We performed a scoping review. To identify relevant studies, we searched three electronic databases. Two authors screened the titles and abstracts for relevance and eligibility criteria. RESULTS Overall, 1386 articles published between 2013 and 2018 were identified. In total 18 articles were included in the review, with 7 reporting significant reduction in pediatric pain or anxiety, 3 testing but finding no significant impact of the VR apps employed, and the rest not conducting any test of significance. We identified 9 articles that were based on VR apps specifically designed and tailored for pediatric patients. The findings were analyzed to develop a holistic model and describe the product, experience, and intervention aspects that need to be considered in designing such medical VR apps. CONCLUSIONS VR has been demonstrated to be a viable choice for managing pain and anxiety in a range of medical treatments. However, commercial products lack diversity and meaningful design strategies are limited beyond distraction techniques. We propose future VR interventions to explore skill-building goals in apps characterized by dynamic feedback to the patient and experiential and product qualities that enable them to be an active participant in managing their own care. To achieve this, design must be part of the development.

scholarly journals Methods of diagnosis of acute epiphyseal osteomyelitis in children

2017 ◽  
Vol 5 (2) ◽  
pp. 59-64
Author(s):  
Dmitry S. Labuzov ◽  
Anna B. Salopenkova ◽  
Yaroslav N. Proshchenko
Keyword(s):  
Magnetic Resonance ◽  
Early Diagnosis ◽  
Pediatric Patients ◽  
Low Cost ◽  
Magnetic Resonance Tomography ◽  
Diagnostic Methods ◽  
Widespread Availability ◽  
Bone Scans ◽  
The Moment ◽  
Reliable Methods

Summary. The article presents the analysis of different method for diagnosis of epiphyseal osteomyelitis, including radiography, ultrasonography, computed tomography, magnetic resonance tomography, and radioisotope bone scans. We address the advantages, disadvantages, and possibilities of each method from the standpoint of early diagnosis of osteomyelitis in children. Based upon the literature, the most effective and reliable methods for early diagnosis of epiphyseal osteomyelitis in pediatric patients are magnetic resonance and ultrasound. The present diagnostic methods involve no radiation exposure. Using an ultrasonic diagnostic method does not require complete immobility of the patient, can be used from the moment of birth, has widespread availability, and has a relative low cost to allow its use in any medical institution.

scholarly journals The Relevance between Fecal Tumor M2 Pyruvate Kinase and Colonoscopy for the Detection of Cancer Colon

2021 ◽  
pp. 54-63
Author(s):  
Muhammed Essam Genedy ◽  
Sherif El-Sayed Ezzat ◽  
Sahar Mohey Eldin Hazzaa ◽  
Mohamed Mohamed Elbedewy
Keyword(s):  
Colorectal Neoplasms ◽  
Pyruvate Kinase ◽  
Low Cost ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Ease Of Use ◽  
P Value ◽  
Cross Sectional ◽  
Bleeding Per Rectum ◽  
Group 2

Background: Colorectal cancer (CRC) determination is focused on clinical, serological and endoscopic observations These methods are considered as non-invasive, cost-effective and convenient clinical examination methods. A direct association between M2 Pyruvate Kinase (M2-PK) and separate oncoprotein is the product of dissociation of tetrameric form from dimeric structure in tumor cells. The aim of this analysis is to assess the sensitivity in high risk or symptomatic populations of fecal tumor M2-PK. Methods: This study is a cross sectional study carried out on 50 patients who were categorized into two groups: 25 patients with colorectal neoplasms (group 1). 25 patients symptomatizing of: diarrhea, persistent abdominal discomfort or bleeding per rectum, without colorectal neoplasms (group 2). Results: The median value of stool M2-PK showed statistically significance. At cut-off ≥ 70 of stool M2-PK to predict activity, sensitivity was 88%, specificity was 84%, PPV was 84.6% and NPV was 87.5%. AUC was 0.907 and P value was <0.001. Conclusions: Fecal M2-PK can be used as a pre colonoscopy screening test for CRC patients and is superior to other tumor markers (CEA and CA19.9) as it is more sensitive and specific. As a result of its low cost and ease of use, it is a viable tool for pre-selecting individuals who undergo colonoscopy.

Relationship of Scabies With Pioderma: As a Risk Factor

2018 ◽  
Vol 1 (1) ◽  
pp. 33-42
Author(s):  
Yulia Farida Yahya ◽  
Fifa Argentina ◽  
Rusmawardiana Rusmawardiana
Keyword(s):  
Staphylococcus Aureus ◽  
Elementary School ◽  
Risk Factor ◽  
Low Income ◽  
Primary Schools ◽  
Pediatric Patients ◽  
Group A Streptococcus ◽  
Cross Sectional ◽  
The Government ◽  
Scabies Infestation

Scabies is a parasitic infestation of the skin, that is affecting on the low income and crowded community in many tropical countries, especially developing countries such as Indonesia. Scabies infestation increases the incidence of secondary pyoderma include impetigo, folliculitis, cellulitis, ecthyma, abscess. Secondary pyoderma is a skin infection disease mainly caused by     group A Streptococcus (GAS) and Staphylococcus aureus (SA). Pyoderma is a risk factor for the glomerulonephritis infection, rheumatic diseases, which significantly increases morbidity and mortality, causing the government burden. The aim of this study is  determining the etiology and correlation of pyoderma infection in scabies patient. To determine sosio-demographic included sex, age in pediatric patients in primary schools (SD) in the district of Kertapati Palembang. The study design was cross sectional, and study samples were new scabies patients in the elementary school (age 6-14-year-old) with or without pyoderma. Clinical findings included history, physical examination and diagnostic procedure, which was investigation of skin scraping specimen material (SSB = skin surface biopsy) in confirmation with dermoscopic polar examination (DS) to show Sarcoptes scabiei mites. Microbiological examination with Gram stain identified the etiology of pyoderma.  Results of this study shows that there was a significance relationship between scabies infestation and pyoderma in children in elementary school. Staphylococcus aureus dan GAS are the most common caused of pyoderma in pediatric patients with scabies. Conclusion is there is a significant correlation between scabies and pyoderma. There is  a need to provide scabies and pyoderma medication at primary care health center as well as counseling for prevention in Palembang area with crowded population periodically.  

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