scholarly journals PROVE—Pre-Eclampsia Obstetric Adverse Events: Establishment of a Biobank and Database for Pre-Eclampsia

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 959
Author(s):  
Lina Bergman ◽  
Karl Bergman ◽  
Eduard Langenegger ◽  
Ashley Moodley ◽  
Stephanie Griffith-Richards ◽  
...  
Keyword(s):  
South Africa ◽  
Clinical Data ◽  
Drug Evaluation ◽  
Brain Mri ◽  
University Hospital ◽  
Middle Income ◽  
Low Middle Income Countries ◽  
Future Drug ◽  
Magnetic Resonance Imaging Mri ◽  
Organ Complications

Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality. The burden of disease lies mainly in low-middle income countries. The aim of this project is to establish a pre-eclampsia biobank in South Africa to facilitate research in the field of pre-eclampsia with a focus on phenotyping severe disease.The approach of our biobank is to collect biological specimens, detailed clinical data, tests, and biophysical examinations, including magnetic resonance imaging (MRI) of the brain, MRI of the heart, transcranial Doppler, echocardiography, and cognitive function tests.Women diagnosed with pre-eclampsia and normotensive controls are enrolled in the biobank at admission to Tygerberg University Hospital (Cape Town, South Africa). Biological samples and clinical data are collected at inclusion/delivery and during the hospital stay. Special investigations as per above are performed in a subset of women. After two months, women are followed up by telephonic interviews. This project aims to establish a biobank and database for severe organ complications of pre-eclampsia in a low-middle income country where the incidence of pre-eclampsia with organ complications is high. The study integrates different methods to investigate pre-eclampsia, focusing on improved understanding of pathophysiology, prediction of organ complications, and potentially future drug evaluation and discovery.

scholarly journals Penetrating Orbital-Cranial Injuries Management in a Limited Resource Hospital in Latin America

2015 ◽  
Vol 8 (4) ◽  
pp. 356-362 ◽  
Author(s):  
Glyn Estebanez ◽  
Diana Garavito ◽  
Laura López ◽  
JuanCarlos Ortiz ◽  
Andrés M. Rubiano
Keyword(s):  
Ct Angiography ◽  
Case Series ◽  
Limited Resource ◽  
University Hospital ◽  
Retrospective Case ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Occipital Lobes ◽  
Difficult Cases

Penetrating orbital-cranial injuries (POCIs) are difficult cases especially in hospitals in low-middle-income countries (LMIC) where resources are limited. We present a case series of POCI managed in a university hospital in such scenario. A retrospective case series was conducted including patients with POCI in 2011. Mechanism of injury, Glasgow Coma Scale score, imaging, medical and surgical management, complications, and Glasgow Outcome Scale (GOS) score were analyzed. A total of 30 patients with penetrating orbital injuries were admitted from March 2011 to December 2011. Of this group, only four patients were diagnosed with cranial penetration. Computed tomography (CT) angiography revealed orbital fractures and injury to frontal, temporal, or occipital lobes. Urgent craniotomy with isolation of ipsilateral carotid artery was performed. GOS score at discharge was 5 in three patients and 4 in one patient. POCIs are not uncommon in hospitals of LMIC. In such scenarios, a standard approach with CT angiography and early neurosurgical intervention results in good outcome.

scholarly journals Impact of Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI) in LMICs

Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011105 ◽  
Author(s):  
Fatima Ali ◽  
Mohammad Qasim Mehdi ◽  
Saleem Akhtar ◽  
Nadeem Aslam ◽  
Rashid Abbas ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cardiac Catheterization ◽  
Improve Patient Care ◽  
Cardiac Catheterisation ◽  
University Hospital ◽  
System Level ◽  
Middle Income ◽  
Reduce Radiation Exposure ◽  
Low Middle Income Countries ◽  
Before And After

BackgroundThe importance of registries for collaborative quality improvement has been overlooked in low/middle-income countries (LMIC). Aga Khan University Hospital (AKUH) in Pakistan joined the Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI) in March 2017 with the goal of leveraging international collaboration to improve patient care and institutional standards.MethodsThe C3PO-QI key driver-based approach was used, with certain modifications, for process re-engineering in AKUH’s congenital cardiac catheterisation laboratory (CCL) to reduce radiation exposure during cardiac catheterisation procedures (the primary outcome of C3PO- QI). Educating staff and standardising procedural documentation were the principal goals of the process re-engineering. Data survey was used to assess staff knowledge, attitude and practice before and after the initiative. Additionally, case demographics and outcomes were compared between AKUH and C3PO-QI centres.ResultsThere was an increase in appropriate recording of radiation surrogates (0%–100%, p=0.00) and in the percentage of cases that met the established benchmark of ‘Ideal documentation’ (35% vs 95%, p=0.001). There was also an increase in self-reported staff interest during the case (25% vs 75%, p=0.001). AKUH versus C3PO-QI data showed similar demographic characteristics. There was a slight over-representation of diagnostic cases (42% vs 32%) as compared with interventional (58% vs 68%) at AKUH. Furthermore, interventional procedures were predominately PDA and ASD device closures (n=19 and 15, respectively). The frequency of adverse events were the same between AKUH and collaborative sites.ConclusionCollaborative efforts between developed and LMIC CCL are significant in advancing system-level processes.

scholarly journals Thermal Index for early non-invasive assessment of brain injury in newborns treated with therapeutic hypothermia: preliminary report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
W. Walas ◽  
A. Mączko ◽  
Z. Halaba ◽  
M. Bekiesińska-Figatowska ◽  
I. Miechowicz ◽  
...  
Keyword(s):  
Brain Injury ◽  
Therapeutic Hypothermia ◽  
Perinatal Asphyxia ◽  
Brain Mri ◽  
Inversion Recovery ◽  
University Hospital ◽  
Thermal Index ◽  
Fluid Attenuated Inversion Recovery ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Score

AbstractPerinatal asphyxia (PA) is the 3rd most common cause of neonatal death and one of the most common causes of severe neurological impairments in children. Current tools and measurements mainly based on the analysis of clinical evaluation and laboratory and electrophysiological tests do not give consistent data allowing to predict the severity of hypoxic-ischemic encephalopathy (HIE) until a magnetic resonance imaging (MRI) score is performed. The aim of this work is to evaluate the usefulness of the new index, called Thermal Index (TI) in the assessment of the degree of brain damage in newborns in the course of therapeutic hypothermia (TH) due to PA. This was a prospective, observational, pilot study which did not require any changes in the applicable procedures. Analysis has been applied to six newborn babies treated with TH in Neonatal/Paediatric ICU in University Hospital in Opole in 2018 due to PA. They all met criteria for TH according to the current recommendations. Brain MRI was performed after the end of TH when the children were brought back to normal temperature, with the use of a 1.5 T scanner, using T1-, T2-weighted images, fluid-attenuated inversion recovery (FLAIR), inversion recovery (IR), susceptibility-weighted imaging (SWI), and diffusion-weighted imaging (DWI). The images were assessed using MRI score according to the scoring system proposed by Weeke et al. The Thermal Index assessing endogenous heat production was calculated according to the formula proposed in this paper. A high, statistically significant positive correlation was found between MRI scores and TI values (0.98; p = 0.0003) in the 1st hour of therapy. High correlation with MRI assessment, the non-invasiveness of measurements and the availability of results within the first few hours of treatment, allow authors to propose the Thermal Index as a tool for early evaluating of the brain injury in newborns treated with TH. Further research is required to confirm the usefulness of the proposed method.

scholarly journals Post-trauma coping in the context of significant adversity: a qualitative study of young people living in an urban township in South Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016560 ◽  
Author(s):  
Rachel M Hiller ◽  
Sarah L Halligan ◽  
Mark Tomlinson ◽  
Jackie Stewart ◽  
Sarah Skeen ◽  
...  
Keyword(s):  
Social Support ◽  
South Africa ◽  
Young People ◽  
Qualitative Interviews ◽  
Well Being ◽  
Developed Countries ◽  
Middle Income ◽  
Black South African ◽  
Low Middle Income Countries ◽  
Increased Risk

ObjectiveCompared with knowledge of the post-trauma needs of young people living in developed countries, little is known about the needs of those in low-middle-income countries. Such information is crucial, particularly as young people in these environments can be at increased risk of experiencing trauma, coupled with less available resources for formal support. The aim of this study was to explore post-trauma coping and support-seeking of young people living in a high-adversity settlement in South Africa.DesignSemistructured qualitative interviews analysed using thematic analysis.SettingAn urban settlement (‘township’) in Cape Town, South Africa.Participants25 young people, aged 13–17 years, who had experienced trauma. Events included serious car accidents, hearing of a friend’s violent death, and rape, and all reported having experienced multiple traumatic events. All participants identified as black South African and spoke Xhosa as their first language.ResultsSocial support was considered key to coping after trauma, although the focus of the support differed depending on the source. Parents would most commonly provide practical support, particularly around safety. Peers often provided an avenue to discuss the event and young person’s emotional well-being more openly. Outside of social support another key theme was that there were numerous community-level barriers to participants receiving support following trauma. Many young people continued to be exposed to the perpetrator of the event, while there was also the realistic concern around future traumas and safety, community stigma and a perceived lack of justice.ConclusionThis study provides insight into how young people cope and seek support following trauma when they are living in a context of significant adversity and risk. Overall, most young people identified helpful sources of support and thought talking about the event was a useful strategy, but concerns around safety and trust could impede this process.

Utility of Magnetic Resonance Imaging (MRI) in Children With Strabismus

2019 ◽  
Vol 34 (10) ◽  
pp. 574-581 ◽  
Author(s):  
Lira Yoon ◽  
Hye-Young Kim ◽  
Min Jung Kwak ◽  
Kyung Hee Park ◽  
Mi Hye Bae ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brain Mri ◽  
University Hospital ◽  
Fundus Examination ◽  
Resonance Imaging ◽  
Structural Abnormalities ◽  
National University ◽  
Speech Delays ◽  
Magnetic Resonance Imaging Mri

Purpose: Magnetic resonance imaging (MRI) of the brain can provide valuable information about structural abnormalities in strabismus. The aim of this study was to evaluate the utility of MRI in this regard and to identify risk factors for abnormal MRI results in children with strabismus. Methods: A retrospective analysis of children <18 years of age presenting with strabismus, who underwent brain MRI at Pusan National University Hospital (Busan, Korea) between January 2012 and March 2017, was performed. Clinical characteristics, MRI results, and ophthalmologic findings were reviewed. Findings were classified as normal or abnormal according to MRI results. Additionally, patients were divided according to age to compare characteristics of infantile and childhood strabismus. Results: A total of 90 patients (47 [52.2%] male, 43 [47.8%] female; mean age, 2.19 ± 0.53 years) were enrolled. Of those, 64 (71.1%) presented with normal and 26 (28.9%) with abnormal MRI results. The age at presentation was lower and abnormal findings on fundus examination were more common in the abnormal MRI group ( P = .002 and P = .008, respectively). Among the patients, 46 (51.1%) had infantile strabismus and 44 (48.9%) had childhood strabismus. Global developmental delays, speech delays, and MRI abnormalities were more common in patients with infantile than in those with childhood strabismus. Ptosis and headaches were more common in patients with childhood strabismus ( P = .025, P = .025, respectively). Conclusion: Brain MRI was helpful for accurate diagnosis and treatment of strabismus in younger children, those with abnormal findings on fundus examination, and infants with developmental, especially speech, delays.

scholarly journals Approaches in cooling of resistive coil-based low-field Magnetic Resonance Imaging (MRI) systems for application in low resource settings

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Faith Natukunda ◽  
Theodora M. Twongyirwe ◽  
Steven J. Schiff ◽  
Johnes Obungoloch
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Image Quality ◽  
Cooling System ◽  
Superconducting Magnets ◽  
Resonance Imaging ◽  
Middle Income ◽  
Low Field ◽  
Low Middle Income Countries ◽  
Magnetic Resonance Imaging Mri

AbstractMagnetic Resonance Imaging (MRI), a non-invasive method for the diagnosis of diverse health conditions has experienced growing popularity over other imaging modalities like ultrasound and Computer Tomography. Initially, proof-of-concept and earlier MRI systems were based on resistive and permanent magnet technology. However, superconducting magnets have long held monopoly of the market for MRI systems with their high-field (HF) strength capability, although they present high construction, installation, and siting requirements. Such stringent prerequisites restrict their availability and use in low-middle income countries. Resistive coil-based magnet, albeit low-field (LF) in capacity, represent a plausible boost for the availability and use of MRI systems in resource constrained settings. These systems are characterized by low costs coupled with substantial image quality for diagnosis of some conditions such as hydrocephalus common is such regions. However, the nature of resistive coils causes them to heat up during operation, thus necessitating a dedicated cooling system to improve image quality and enhance system longevity. This paper explores a range of cooling methods as have been applied to resistive magnets, citing their pros and cons and areas for improvement.

User Evaluation of an Integrated Medical Workstation for Clinical Data Analysis

1993 ◽  
Vol 32 (05) ◽  
pp. 365-372 ◽  
Author(s):  
T. Timmeis ◽  
J. H. van Bemmel ◽  
E. M. van Mulligen
Keyword(s):  
Data Analysis ◽  
Clinical Research ◽  
Clinical Data ◽  
University Hospital ◽  
User Evaluation ◽  
Scientific Staff ◽  
Medical Institutions ◽  
Clinical Data Analysis ◽  
Research Problems ◽  
The University

AbstractResults are presented of the user evaluation of an integrated medical workstation for support of clinical research. Twenty-seven users were recruited from medical and scientific staff of the University Hospital Dijkzigt, the Faculty of Medicine of the Erasmus University Rotterdam, and from other Dutch medical institutions; and all were given a written, self-contained tutorial. Subsequently, an experiment was done in which six clinical data analysis problems had to be solved and an evaluation form was filled out. The aim of this user evaluation was to obtain insight in the benefits of integration for support of clinical data analysis for clinicians and biomedical researchers. The problems were divided into two sets, with gradually more complex problems. In the first set users were guided in a stepwise fashion to solve the problems. In the second set each stepwise problem had an open counterpart. During the evaluation, the workstation continuously recorded the user’s actions. From these results significant differences became apparent between clinicians and non-clinicians for the correctness (means 54% and 81%, respectively, p = 0.04), completeness (means 64% and 88%, respectively, p = 0.01), and number of problems solved (means 67% and 90%, respectively, p = 0.02). These differences were absent for the stepwise problems. Physicians tend to skip more problems than biomedical researchers. No statistically significant differences were found between users with and without clinical data analysis experience, for correctness (means 74% and 72%, respectively, p = 0.95), and completeness (means 82% and 79%, respectively, p = 0.40). It appeared that various clinical research problems can be solved easily with support of the workstation; the results of this experiment can be used as guidance for the development of the successor of this prototype workstation and serve as a reference for the assessment of next versions.

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