scholarly journals NEUROPHYSIOLOGY AND ULTRASOUND IN THE EVALUATION OF PHRENIC NERVE IN NORMAL AND PATHOLOGIC CONDITIONS

Author(s):  
V. B. Voitenkov ◽  
V. N. Komantsev ◽  
E. V. Ekusheva ◽  
A. V. Klimkin ◽  
N. V. Skripchenko

We provide data on neurophysiology and ultrasound of phrenic nerve. In the visualization of the phrenic nerve the main role is played by ultrasound. Conduction study of the phrenic nerve, if performed properly, is a simple and reliable method. In pediatric population, though, age dynamic and wide range of normative parameters has to be taken into the consideration. Ultrasound of the phrenic nerve allows visualization of the anatomical continuity of the nerve trunk of the nerve at the level of the neck and objectively assess the thickness of the nerve, which provides additional information to the doctor in clinical practice.

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Paola Paradies ◽  
Manuela Schnyder ◽  
Antonio Capogna ◽  
Riccardo Paolo Lia ◽  
Mariateresa Sasanelli

Canine angiostrongylosis is an increasingly reported disease in Europe which can be fatal if left untreated. The wide range of clinical presentation along with the absence of pathognomonic alterations can make the diagnosis challenging; thus any additional information that may provide clues to an early diagnosis may be of value, in order to ensure adequate anthelmintic treatment. Aim of the study was to assess a clinicopathological scoring system associated with naturalAngiostrongylus vasoruminfection diagnosed in canine patients during clinical practice, to clinically and paraclinically monitor infected dogs after treatment, and to monitor the presence of L1 larvae in faecal samples by Baermann's test. Of the total 210 enrolled animalsA. vasoruminfection was diagnosed in 7 dogs. These dogs were clinically and paraclinically investigated and monitored after specific treatment. Further 3 symptomatic dogs were retrospectively included in the monitoring. Results suggest that the computed scoring system can help to increase the clinical suspicion of infection particularly in asymptomatic dogs before the onset of potentially lethal lesions. Data of faecal monitoring suggested that treatment may control parasite burden but be unable to eradicate infection. Thus, a continued faecal monitoring after treatment is advisable for identification of still infected or reinfected dogs.


2020 ◽  
Author(s):  
Evalien Veldhuijzen ◽  
Iris Walraven ◽  
Jose Belderbos

BACKGROUND The Patient Reported Outcomes Version of the Common Terminology Criteria of Adverse Events (PRO-CTCAE) item library covers a wide range of symptoms relevant for oncology care. To enable implementation of PRO-CTCAE-based symptom monitoring in clinical practice, there is a need to select a subset of items relevant for specific patient populations. OBJECTIVE The aim of this study was to develop a PRO-CTCAE subset relevant for patients with lung cancer. METHODS The PRO-CTCAE-based subset for lung cancer patients was generated using a mixed methods approach based on the European Organization for Research and Treatment of Cancer (EORTC) guidelines for developing questionnaires, consisting of a literature review and semi-structured interviews with both lung cancer patients and health care practitioners (HCPs). Both patients and HCPs were queried on the relevance and impact of all PRO-CTCAE items. Results were summarized and, after a final round of expert review, a selection of clinically relevant items for lung cancer patients was made. RESULTS A heterogeneous group of lung cancer patients (n=25) from different treatment modalities and HCPs (n=22) participated in the study. A final list of eight relevant PRO-CTCAE items was created: decreased appetite, cough, shortness of breath, fatigue, constipation, nausea, sadness, and pain (general). CONCLUSIONS Based on literature and both professional and patient input, a subset of PRO-CTCAE items has been identified for use in lung cancer patients in clinical practice. Future work is needed to confirm the validity and effectiveness of this PRO-CTCAE lung cancer subset internationally, and in the real-world clinical practice setting.


2021 ◽  
Vol 10 (11) ◽  
pp. 2457
Author(s):  
Birgit J. Gerecke ◽  
Rolf Engberding

Noncompaction cardiomyopathy (NCCM) has gained increasing attention over the past twenty years, but in daily clinical practice NCCM is still rarely considered. So far, there are no generally accepted diagnostic criteria and some groups even refuse to acknowledge it as a distinct cardiomyopathy, and grade it as a variant of dilated cardiomyopathy or a morphological trait of different conditions. A wide range of morphological variants have been observed even in healthy persons, suggesting that pathologic remodeling and physiologic adaptation have to be differentiated in cases where this spongy myocardial pattern is encountered. Recent studies have uncovered numerous new pathogenetic and pathophysiologic aspects of this elusive cardiomyopathy, but a current summary and evaluation of clinical patient management are still lacking, especially to avoid mis- and overdiagnosis. Addressing this issue, this article provides an up to date overview of the current knowledge in classification, pathogenesis, pathophysiology, epidemiology, clinical manifestations and diagnostic evaluation, including genetic testing, treatment and prognosis of NCCM.


Author(s):  
Adi Prasetio ◽  
Soyeon Kim ◽  
Muhammad Jahandar ◽  
Dong Chan Lim

AbstractIncorporating localized surface plasmon resonance (LSPR) into organic solar cells (OSCs) is a popular method for improving the power conversion efficiency (PCE) by introducing better light absorption. In this work, we designed a one-pot synthesis of Ag@SiO2@AuNPs dual plasmons and observed an immense increase in light absorption over a wide range of wavelengths. Ag@SiO2 plays the main role in enhancing light absorption near the ultraviolet band. The silica shell can also further enhance the LSP resonance effect and prevent recombination on the surface of AgNPs. The AuNPs on the Ag@SiO2 shell exhibited strong broad visible-light absorption due to LSP resonance and decreased light reflectance. By utilizing Ag@SiO2@AuNPs, we could enhance the light absorption and photoinduced charge generation, thereby increasing the device PCE to 8.57% and Jsc to 17.67 mA cm−2, which can be attributed to the enhanced optical properties. Meanwhile, devices without LSPR nanoparticles and Ag@SiO2 LSPR only showed PCEs of 7.36% and 8.18%, respectively.


Author(s):  
Graham R. Thew ◽  
Louise Fountain ◽  
Paul M. Salkovskis

AbstractWhile the benefits of routine outcome measurement have been extolled and to some degree researched, it is surprising that service user opinions on this common therapy practice have largely not been investigated. This study aimed to assess service users’ experiences of completing measures during psychological therapy, with a view to exploring how therapists can maximize how helpful measures are in therapy. Fifteen participants completed surveys about the use of measures in their current episode of care. Ten clinicians also completed a survey about their use of, and views about, measures. Results showed that despite mixed experiences in how measures were explained and used, service users showed generally favourable attitudes towards their use in therapy, with them being perceived as most helpful when well integrated into sessions by their therapists. Clinicians reported using a wide range of measures, and generally endorsed positive beliefs about measures more strongly than negative ones. Implications for clinical practice, service development, and further research are discussed.


2021 ◽  
Vol 25 (01) ◽  
pp. 167-175
Author(s):  
Michael S. Furman ◽  
Ricardo Restrepo ◽  
Supika Kritsaneepaiboon ◽  
Bernard F. Laya ◽  
Domen Plut ◽  
...  

AbstractInfants and children often present with a wide range of musculoskeletal (MSK) infections in daily clinical practice. This can vary from relatively benign superficial infections such as cellulitis to destructive osseous and articular infections and life-threatening deep soft tissue processes such as necrotizing fasciitis. Imaging evaluation plays an essential role for initial detection and follow-up evaluation of pediatric MSK infections. Therefore, a clear and up-to-date knowledge of imaging manifestations in MSK infections in infants and children is imperative for timely and accurate diagnosis that, in turn, can result in optimal patient management. This article reviews an up-to-date practical imaging techniques, the differences between pediatric and adult MSK infections, the spectrum of pediatric MSK infections, and mimics of pediatric MSK infections encountered in daily clinical practice by radiologists and clinicians.


2018 ◽  
Vol 12 (2) ◽  
pp. 88 ◽  
Author(s):  
Flavio Tangianu ◽  
Antonino Mazzone ◽  
Franco Berti ◽  
Giuliano Pinna ◽  
Irene Bortolotti ◽  
...  

There are many feasible tools for the assessment of clinical practice, but there is a wide consensus on the fact that the simultaneous use of several different methods could be strategic for a comprehensive overall judgment of clinical competence. Multiple-choice questions (MCQs) are a well-established reliable method of assessing knowledge. Constructing effective MCQ tests and items requires scrupulous care in the design, review and validation stages. Creating high-quality multiple-choice questions requires a very deep experience, knowledge and large amount of time. Hereby, after reviewing their construction, strengths and limitations, we debate their completeness for the assessment of professional competence.


2020 ◽  
Vol 14 ◽  
pp. 117954682095341 ◽  
Author(s):  
Todd C Villines ◽  
Mark J Cziraky ◽  
Alpesh N Amin

Real-world evidence (RWE) provides a potential rich source of additional information to the body of data available from randomized clinical trials (RCTs), but there is a need to understand the strengths and limitations of RWE before it can be applied to clinical practice. To gain insight into current thinking in clinical decision making and utility of different data sources, a representative sampling of US cardiologists selected from the current, active Fellows of the American College of Cardiology (ACC) were surveyed to evaluate their perceptions of findings from RCTs and RWE studies and their application in clinical practice. The survey was conducted online via the ACC web portal between 12 July and 11 August 2017. Of the 548 active ACC Fellows invited as panel members, 173 completed the survey (32% response), most of whom were board certified in general cardiology (n = 119, 69%) or interventional cardiology (n = 40, 23%). The survey results indicated a wide range of familiarity with and utilization of RWE amongst cardiologists. Most cardiologists were familiar with RWE and considered RWE in clinical practice at least some of the time. However, a significant minority of survey respondents had rarely or never applied RWE learnings in their clinical practice, and many did not feel confident in the results of RWE other than registry data. These survey findings suggest that additional education on how to assess and interpret RWE could help physicians to integrate data and learnings from RCTs and RWE to best guide clinical decision making.


2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Marcos Fabietti ◽  
Mufti Mahmud ◽  
Ahmad Lotfi

AbstractAcquisition of neuronal signals involves a wide range of devices with specific electrical properties. Combined with other physiological sources within the body, the signals sensed by the devices are often distorted. Sometimes these distortions are visually identifiable, other times, they overlay with the signal characteristics making them very difficult to detect. To remove these distortions, the recordings are visually inspected and manually processed. However, this manual annotation process is time-consuming and automatic computational methods are needed to identify and remove these artefacts. Most of the existing artefact removal approaches rely on additional information from other recorded channels and fail when global artefacts are present or the affected channels constitute the majority of the recording system. Addressing this issue, this paper reports a novel channel-independent machine learning model to accurately identify and replace the artefactual segments present in the signals. Discarding these artifactual segments by the existing approaches causes discontinuities in the reproduced signals which may introduce errors in subsequent analyses. To avoid this, the proposed method predicts multiple values of the artefactual region using long–short term memory network to recreate the temporal and spectral properties of the recorded signal. The method has been tested on two open-access data sets and incorporated into the open-access SANTIA (SigMate Advanced: a Novel Tool for Identification of Artefacts in Neuronal Signals) toolbox for community use.


2020 ◽  
Author(s):  
Oliver Maassen ◽  
Sebastian Fritsch ◽  
Julia Gantner ◽  
Saskia Deffge ◽  
Julian Kunze ◽  
...  

BACKGROUND The increasing development of artificial intelligence (AI) systems in medicine driven by researchers and entrepreneurs goes along with enormous expectations for medical care advancement. AI might change the clinical practice of physicians from almost all medical disciplines and in most areas of healthcare. While expectations for AI in medicine are high, practical implementations of AI for clinical practice are still scarce in Germany. Moreover, physicians’ requirements and expectations of AI in medicine and their opinion on the usage of anonymized patient data for clinical and biomedical research has not been investigated widely in German university hospitals. OBJECTIVE Evaluate physicians’ requirements and expectations of AI in medicine and their opinion on the secondary usage of patient data for (bio)medical research e.g. for the development of machine learning (ML) algorithms in university hospitals in Germany. METHODS A web-based survey was conducted addressing physicians of all medical disciplines in 8 German university hospitals. Answers were given on Likert scales and general demographic responses. Physicians were asked to participate locally via email in the respective hospitals. RESULTS 121 (39.9%) female and 173 (57.1%) male physicians (N=303) from a wide range of medical disciplines and work experience levels completed the online survey. The majority of respondents either had a positive (130/303, 42.9%) or a very positive attitude (82/303, 27.1%) towards AI in medicine. A vast majority of physicians expected the future of medicine to be a mix of human and artificial intelligence (273/303, 90.1%) but also requested a scientific evaluation before the routine implementation of AI-based systems (276/303, 91.1%). Physicians were most optimistic that AI applications would identify drug interactions (280/303, 92.4%) to improve patient care substantially but were quite reserved regarding AI-supported diagnosis of psychiatric diseases (62/303, 20.5%). 82.5% of respondents (250/303) agreed that there should be open access to anonymized patient databases for medical and biomedical research. CONCLUSIONS Physicians in stationary patient care in German university hospitals show a generally positive attitude towards using most AI applications in medicine. Along with this optimism, there come several expectations and hopes that AI will assist physicians in clinical decision making. Especially in fields of medicine where huge amounts of data are processed (e.g., imaging procedures in radiology and pathology) or data is collected continuously (e.g. cardiology and intensive care medicine), physicians’ expectations to substantially improve future patient care are high. However, for the practical usage of AI in healthcare regulatory and organizational challenges still have to be mastered.


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