scholarly journals Indirect Calorimetry in Clinical Practice

2019 ◽  
Vol 8 (9) ◽  
pp. 1387 ◽  
Author(s):  
Marta Delsoglio ◽  
Najate Achamrah ◽  
Mette M. Berger ◽  
Claude Pichard
Keyword(s):  
Indirect Calorimetry ◽  
Cost Benefit ◽  
Nutrition Therapy ◽  
Nutrition Support ◽  
Invasive Technique ◽  
Gas Exchanges ◽  
Non Invasive ◽  
Technical Developments ◽  
The Cost ◽  
Spontaneously Breathing

Indirect calorimetry (IC) is considered as the gold standard to determine energy expenditure, by measuring pulmonary gas exchanges. It is a non-invasive technique that allows clinicians to personalize the prescription of nutrition support to the metabolic needs and promote a better clinical outcome. Recent technical developments allow accurate and easy IC measurements in spontaneously breathing patients as well as in those on mechanical ventilation. The implementation of IC in clinical routine should be promoted in order to optimize the cost–benefit balance of nutrition therapy. This review aims at summarizing the latest innovations of IC as well as the clinical indications, benefits, and limitations.

New technical developments in cardiac CT

2015 ◽  
pp. 99-106
Author(s):  
Stephan Achenbach
Keyword(s):  
Ct Angiography ◽  
Coronary Ct Angiography ◽  
Cardiac Ct ◽  
Three Dimensional ◽  
Invasive Technique ◽  
Clinical Tool ◽  
Non Invasive ◽  
Technical Developments ◽  
Coronary Ct ◽  
Luminal Narrowing

Computed tomography (CT), in the context of cardiac imaging, faces numerous challenges. The heart is a complex, three-dimensional organ, which moves very rapidly and has small dimensions. Especially the coronary arteries, the main target of cardiac CT imaging, are difficult to visualize by any non-invasive technique. Technology progress has made the use of CT for cardiac and coronary diagnosis possible. For selected applications, including ruling out coronary artery stenoses in low-risk individuals, CT has become a clinical tool. The technical progress of cardiac CT, and especially coronary CT angiography, is continuous and rapid. One major aim is to improve image quality and broaden the applicability of coronary CT angiography, while at the same time achieving lower radiation doses. The other major aim is to extract more than purely anatomic information out of the dataset and to complement the information in luminal narrowing with information on downstream ischaemia.

Effectiveness of treatment with carbamide peroxide and hydrogen peroxide in subjects affected by dental fluorosis: a clinical trial

2004 ◽  
Vol 28 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Juan Pablo Loyola-Rodriguez ◽  
Amaury de Jesus Pozos-Guillen ◽  
Felipe Hernandez-Hernandez ◽  
Rocio Berumen-Maldonado ◽  
Nuria Patiño-Marin
Keyword(s):  
Hydrogen Peroxide ◽  
Dental Fluorosis ◽  
Clinical Success ◽  
Dental Health ◽  
Cost Benefit ◽  
Clinical Effectiveness ◽  
Tooth Surface ◽  
Invasive Technique ◽  
Carbamide Peroxide ◽  
Non Invasive

Dental fluorosis is an endemic dental health problem around the world; so, it is important to develop clinical alternatives that are non-invasive and inexpensive. In this study, nightguard vital bleaching technique (NVBT), using carbamide and hydrogen peroxide as active agents, has shown itself to be effective in whitening teeth affected by dental fluorosis. Carbamide peroxide at 10 and 20% and hydrogen peroxide at 7.5% showed good clinical effectiveness in improving clinical appearence, but it is important to point out that clinical success is only in cases of class 1 to 3 of the Tooth Surface Index of Fluorosis. When comparing 10 and 20% concentrations of carbamide peroxide, there was no difference in the clinical effectiveness (p>0.05); but when comparing both concentrations of carbamide peroxide against hydrogen peroxide, results showed that carbamide peroxide was more effective in whitening in cases of dental fluorosis, the difference being statistically significant (p<0.05). NVBT has two advantages: it is a non-invasive technique and the relationship cost/benefit is excellent; only a few patients reported tenderness or mild tooth sensitivity.

New technical developments in cardiac CT: Anatomy, fractional flow reserve (FFR), and machine learning

2021 ◽  
pp. 145-158
Author(s):  
Stephan Achenbach ◽  
Jonathan Leipsic ◽  
James Min
Keyword(s):  
Cardiac Ct ◽  
Three Dimensional ◽  
Invasive Technique ◽  
Ct Scanner ◽  
Clinical Tool ◽  
Fractional Flow ◽  
Non Invasive ◽  
Technical Developments ◽  
Flow Reserve ◽  
Ct Technology

Computed tomography (CT), in the context of cardiac imaging, faces numerous challenges. The heart is a complex, three-dimensional organ, which moves very rapidly and has small dimensions. The coronary arteries, the main target of cardiac CT imaging, are especially difficult to visualize by any non-invasive technique. All the same, technology progress has made the use of CT for cardiac and coronary diagnosis possible. For selected applications, including ruling out coronary artery stenoses in low-risk individuals, CT has become a clinical tool. This chapter describes the progress of CT technology, from the first commercially available CT scanner that permitted visualization of the heart with high temporal and spatial resolution in the late 1980s, to today’s incarnations that utilize radiomics and artificial intelligence.

scholarly journals Prevention and early diagnosis of oral cancer – a literature review

2018 ◽  
Vol 32 (4) ◽  
pp. 204
Author(s):  
Manoela Garcia Dias ◽  
Ana Cláudia Figueiró ◽  
Vera Lucia Luiza
Keyword(s):  
Oral Cancer ◽  
Early Diagnosis ◽  
Secondary Prevention ◽  
Cost Benefit ◽  
Great Majority ◽  
Diagnostic Methods ◽  
Epidemiological Surveillance ◽  
Non Invasive ◽  
Oral Neoplasms ◽  
The Cost

INTRODUCTION: The present study identified and described scientific production on primary and secondary prevention of oral cancer worldwide. This is an integrative review of the literature, focusing on the description of oral cancer prevention experiences.METHODS: The search was performed in the Virtual Health Library (VHL), using the descriptors: early diagnosis, oral neoplasms, primary prevention and secondary prevention. We found 225 articles and selected 22 after evaluation, divided into three themes.RESULTS: Four articles awareness-raising and population-tracking campaigns with the valorization of the role of the dental surgeon and the involvement of health teams. The non-invasive diagnostic methods, considered in fifteen articles, addressed the implementation of new strategies for the early detection of this pathology by different diagnostic methods. The reorganization of the health system (3 articles) encompassed the permanent education of oral health professionals, epidemiological surveillance and reorganization of health services with integration of health care levels. The great majority of the reviewed experiences showed positive results in the prevention of oral cancer. An exception was the active search for suspected cases in the population, since the cost benefit did not compensate the expenditure with human resources for this purpose. The non-invasive methods reported are useful for screening but do not substitute the biopsia for diagnosis.

scholarly journals The Intertemporal Role of Respiratory Support in Improving Neonatal Outcomes: A Narrative Review

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 883
Author(s):  
Kosmas Sarafidis ◽  
William Chotas ◽  
Eleni Agakidou ◽  
Paraskevi Karagianni ◽  
Vasiliki Drossou
Keyword(s):  
Invasive Mechanical Ventilation ◽  
Cost Benefit ◽  
Respiratory Support ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Future Challenges ◽  
Key Factor ◽  
The Cost ◽  
Administration Methods

Defining improvements in healthcare can be challenging due to the need to assess multiple outcomes and measures. In neonates, although progress in respiratory support has been a key factor in improving survival, the same degree of improvement has not been documented in certain outcomes, such as bronchopulmonary dysplasia. By exploring the evolution of neonatal respiratory care over the last 60 years, this review highlights not only the scientific advances that occurred with the application of invasive mechanical ventilation but also the weakness of the existing knowledge. The contributing role of non-invasive ventilation and less-invasive surfactant administration methods as well as of certain pharmacological therapies is also discussed. Moreover, we analyze the cost–benefit of neonatal care-respiratory support and present future challenges and perspectives.

Energy requirements and the use of predictive equations versus indirect calorimetry in critically ill patients

2015 ◽  
Vol 40 (2) ◽  
pp. 207-210 ◽  
Author(s):  
Sanit Wichansawakun ◽  
Liisa Meddings ◽  
Cathy Alberda ◽  
Sarah Robbins ◽  
Leah Gramlich
Keyword(s):  
Energy Expenditure ◽  
Critically Ill ◽  
Indirect Calorimetry ◽  
Critically Ill Patients ◽  
Positive Impact ◽  
Energy Requirement ◽  
Nutrition Therapy ◽  
Nutrition Support ◽  
Predictive Equations ◽  
Energy Assessment

Nutrition support has been shown to have a positive impact on critically ill patients who meet their defined goals of nutrition therapy. However, inappropriate energy assessment can contribute to under- or overfeeding resulting in deleterious effects. Thus, assessment of energy expenditure in critically ill patients is crucial to prevent negative impacts from inappropriate feeding. Currently, the optimal energy requirement and appropriate energy assessment in these patients is controversial. Indirect calorimetry or predictive equations have been suggested to evaluate energy expenditure in critically ill patients. Indirect calorimetry is a gold standard for evaluating energy expenditure, but it is not always available and has some limitations. Many predictive equations, therefore, have been developed to predict energy expenditure in critically ill patients. However, these equations cannot be used generally in these patients since they were developed in a unique patient population. Many studies compared measured energy expenditure with predictive energy expenditure, but the data regarding accuracy is not robust. Therefore, clinicians should consider using these equations carefully based on the current supporting data. Indirect calorimetry is recommended for use in evaluating energy expenditure in critically ill patients if it is available.

Hostile Takeovers and Anti-takeover Defenses in the Russian Corporate Market

2007 ◽  
pp. 70-84 ◽  
Author(s):  
E. Demidova
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Hostile Takeovers ◽  
Russian Market ◽  
Takeover Defenses ◽  
The Cost ◽  
European Markets

This article analyzes definitions and the role of hostile takeovers at the Russian and European markets for corporate control. It develops the methodology of assessing the efficiency of anti-takeover defenses adapted to the conditions of the Russian market. The paper uses the cost-benefit analysis, where the costs and benefits of the pre-bid and post-bid defenses are compared.

The Evolutionary Psychology of Scientific Publishing: Cost-Benefit Optimization of Players in the Game

2019 ◽  
Author(s):  
Milind Watve
Keyword(s):  
Peer Review ◽  
Current System ◽  
Critical Mass ◽  
Cost Benefit ◽  
Active Role ◽  
Scientific Publishing ◽  
Collective Goal ◽  
The Cost ◽  
Collective Goals ◽  
Innate Tendency

Peer reviewed scientific publishing is critical for communicating important findings, interpretations and theories in any branch of science. While the value of peer review is rarely doubted, much concern is being raised about the possible biases in the process. I argue here that most of the biases originate in the evolved innate tendency of every player to optimize one’s own cost benefits. Different players in the scientific publishing game have different cost-benefit optima. There are multiple conflicts between individual optima and collective goals. An analysis of the cost-benefit optima of every player in the scientific publishing game shows how and why biases originate. In the current system of publishing, by optimization considerations, the probability of publishing a ‘bad’ manuscript is relatively small but the probability of rejecting a ‘good’ manuscript is very high. By continuing with the current publishing structure, the global distribution of the scientific community would be increasingly clustered. Publication biases by gender, ethnicity, reputation, conformation and conformity will be increasingly common and revolutionary concepts increasingly difficult to publish. Ultimately, I explore the possibility of designing a peer review publishing system in which the conflicts between individual optimization and collective goal can be minimized. In such a system, if everyone behaves with maximum selfishness, biases would be minimized and the progress towards the collective goal would be faster and smoother. Changing towards such a system might prove difficult unless a critical mass of authors take an active role to revolutionize scientific publishing.

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