scholarly journals Needle Placement for Piriformis Injection Using 3-D Imaging

2013 ◽  
Vol 3;16 (3;5) ◽  
pp. E301-E310 ◽  
Author(s):  
Steven R. Clendenen
Keyword(s):  
Ultrasound Image ◽  
Pain Syndrome ◽  
Leg Pain ◽  
Computer Assisted ◽  
Piriformis Syndrome ◽  
Ultrasound Probe ◽  
Tracked Ultrasound ◽  
The Mean ◽  
The Magnetic Field

Piriformis syndrome is a pain syndrome originating in the buttock and is attributed to 6% – 8% of patients referred for the treatment of back and leg pain. The treatment for piriformis syndrome using fluoroscopy, computed tomography (CT), electromyography (EMG), and ultrasound (US) has become standard practice. The treatment of Piriformis Syndrome has evolved to include fluoroscopy and EMG with CT guidance. We present a case study of 5 successful piriformis injections using 3-D computer-assisted electromagnet needle tracking coupled with ultrasound. A 6-degree of freedom electromagnetic position tracker was attached to the ultrasound probe that allowed the system to detect the position and orientation of the probe in the magnetic field. The tracked ultrasound probe was used to find the posterior superior iliac spine. Subsequently, 3 points were captured to register the ultrasound image with the CT or magnetic resonance image scan. Moreover, after the registration was obtained, the navigation system visualized the tracked needle relative to the CT scan in real-time using 2 orthogonal multi-planar reconstructions centered at the tracked needle tip. Conversely, a recent study revealed that fluoroscopically guided injections had 30% accuracy compared to ultrasound guided injections, which tripled the accuracy percentage. This novel technique exhibited an accurate needle guidance injection precision of 98% while advancing to the piriformis muscle and avoiding the sciatic nerve. The mean (± SD) procedure time was 19.08 (± 4.9) minutes. This technique allows for electromagnetic instrument tip tracking with realtime 3-D guidance to the selected target. As with any new technique, a learning curve is expected; however, this technique could offer an alternative, minimizing radiation exposure. Key words: Piriformis, electromagnetic, ultrasound, fluoroscopy, injection, 3-D imaging.

scholarly journals A case study of the plasma in the magneto-sheath using the numerical magnetosheath-magnetosphere model and THEMIS measure-ments

2018 ◽  
Vol 145 ◽  
pp. 03004
Author(s):  
Polya Dobreva ◽  
Olga Nitcheva ◽  
Monio Kartalev
Keyword(s):  
Magnetic Field ◽  
Field Model ◽  
Specific Aspect ◽  
Plasma Parameters ◽  
Ion Density ◽  
Magnetic Field Model ◽  
Wind Spacecraft ◽  
The Mean ◽  
The Magnetic Field

This paper presents a case study of the plasma parameters in the magnetosheath, based on THEMIS measurements. As a theoretical tool we apply the self-consistent magnetosheath-magnetosphere model. A specific aspect of the model is that the positions of the bow shock and the magnetopause are self-consistently determined. In the magnetosheath the distribution of the velocity, density and temperature is calculated, based on the gas-dynamic theory. The magnetosphere module allows for the calculation of the magnetopause currents, confining the magnetic field into an arbitrary non-axisymmetric magnetopause. The variant of the Tsyganenko magnetic field model is applied as an internal magnetic field model. As solar wind monitor we use measurements from the WIND spacecraft. The results show that the model quite well reproduces the values of the ion density and velocity in the magnetosheath. The simlicity of the model allows calulations to be perforemed on a personal computer, which is one of the mean advantages of our model.

scholarly journals Sequential U-Net Architecture for Automatic Femoral Artery Segmentation in Ultrasound Images

2021 ◽  
Vol 7 (1) ◽  
pp. 158-161
Author(s):  
Ana Estrada Lugo ◽  
Niclas Bockelmann ◽  
Felix von Haxthausen
Keyword(s):  
Femoral Artery ◽  
Automatic Segmentation ◽  
Ultrasound Image ◽  
Ultrasound Images ◽  
Segmentation Result ◽  
Ultrasound Probe ◽  
Sequential Structure ◽  
Tracked Ultrasound ◽  
Vessel Volume ◽  
2D Ultrasound

Abstract This work compares three different approaches to automatically segment the femoral artery from 2D ultrasound images. Two of the architectures follow a sequential structure, where each ultrasound image is considered a slice of the whole vessel volume, and its previous segmentation result will be part of the input, thus leading to a spatial prior. The Dice score on test data show a better performance on the baseline U-Net (0.819) compared to the sequential U-Net approaches (0.633, 0.725) for the femoral artery segmentation. This could be attributed to the misalignment of the slices being used in those networks. A possible improvement could be assumed in the implementation of a spatially calibrated and tracked ultrasound probe. Overall, these results indicate promising approaches for an automatic segmentation of the femoral artery using 2D ultrasound data.

Teaching Computer Based Historical Data Analysis

1994 ◽  
Vol 6 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Charles Anderson ◽  
Robert J. Morris
Keyword(s):  
Data Analysis ◽  
Social History ◽  
Historical Data ◽  
Good Practice ◽  
Computer Assisted ◽  
Historical Data Analysis ◽  
University Of Edinburgh ◽  
Computer Based ◽  
The University

A case study ofa third year course in the Department of Economic and Social History in the University of Edinburgh isusedto considerandhighlightaspects of good practice in the teaching of computer-assisted historical data analysis.

scholarly journals Ex vivo evaluation of a multilayered sealant patch for watertight dural closure: cranial and spinal models

2021 ◽  
Vol 32 (8) ◽  
Author(s):  
A. Kinaci ◽  
S. van Thoor ◽  
S. Redegeld ◽  
M. Tooren ◽  
T. P. C. van Doormaal
Keyword(s):  
Ex Vivo ◽  
Resistance Test ◽  
Burst Pressure ◽  
Cerebrospinal Fluid Leakage ◽  
Computer Assisted ◽  
Dural Defect ◽  
Test Results ◽  
Physiological Conditions ◽  
Dural Attachment ◽  
The Mean

AbstractCerebrospinal fluid leakage is a frequent complication after cranial and spinal surgery. To prevent this complication and seal the dura watertight, we developed Liqoseal, a dural sealant patch comprising a watertight polyesterurethane layer and an adhesive layer consisting of poly(DL-lactide-co-ε-caprolactone) copolymer and multiarmed N-hydroxylsuccinimide functionalized polyethylene glycol. We compared acute burst pressure and resistance to physiological conditions for 72 h of Liqoseal, Adherus, Duraseal, Tachosil, and Tisseel using computer-assisted models and fresh porcine dura. The mean acute burst pressure of Liqoseal in the cranial model (145 ± 39 mmHg) was higher than that of Adherus (87 ± 47 mmHg), Duraseal (51 ± 42 mmHg) and Tachosil (71 ± 16 mmHg). Under physiological conditions, cranial model resistance test results showed that 2 of 3 Liqoseal sealants maintained dural attachment during 72 hours as opposed to 3 of 3 for Adherus and Duraseal and 0 of 3 for Tachosil. The mean burst pressure of Liqoseal in the spinal model (233 ± 81 mmHg) was higher than that of Tachosil (123 ± 63 mmHg) and Tisseel (23 ± 16 mmHg). Under physiological conditions, spinal model resistance test results showed that 2 of 3 Liqoseal sealants maintained dural attachment for 72 hours as opposed to 3 of 3 for Adherus and 0 of 3 for Duraseal and Tachosil. This novel study showed that Liqoseal is capable of achieving a strong watertight seal over a dural defect in ex vivo models.

scholarly journals Complex Regional Pain Syndrome: Current Practice Management and Referral Trends in a Closed Healthcare System

Osteology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 39-47
Author(s):  
Connor Zale ◽  
Joshua Hansen ◽  
Paul Ryan
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Complex Regional Pain Syndrome ◽  
Healthcare System ◽  
Pain Syndrome ◽  
Occupational Outcomes ◽  
Mean Delay ◽  
Significant Difference ◽  
The Mean ◽  
Over Time

Background: Complex regional pain syndrome (CRPS) is a neurologic condition that can present with severe pain and dysfunction. Delay in treatment adversely affects outcomes. The purpose of this study is to evaluate patient outcomes as they relate to the time from diagnosis to pain management referral once the diagnosis of CRPS has been made in a closed healthcare system. Methods: A retrospective record review from a closed healthcare system was utilized for CRPS cases from 2010–2019. Demographics, injury pattern, surgeries, pain score, treatment modalities, occupational outcomes, and time to pain management referral were recorded. Results: There were 26 cases of CRPS that met inclusion criteria. The mean time from diagnosis to treatment was 55 days. 16/26 (61.5%) were medically discharged from the military. 23/26 (88.5%) were unable to return to full duty due to CRPS. There was no significant difference in the reported pain scores over time regardless of treatment (p = 0.76). A linear regression demonstrated a significantly higher Visual Analog Scale Pain Score (VAS) over time in patients that were medically discharged (p = 0.022). Conclusions: The mean delay in referral to the pain service was 55 days. The majority of patients (88.5%) did not return to full duty secondary to the diagnosis of CRPS, and 61.5% of patients required medical separation from active duty. Due to the negative impact that the diagnosis of CRPS has on occupational outcomes with a mean delay in referral of 55 days, clinics and providers should set up referral criteria and establish early pain pathways for patients diagnosed with CRPS.

scholarly journals AB1325-HPR THE TRANSITION FROM PEDIATRIC TO ADULT RHEUMATOLOGY OF 347 PATIENTS AT A SINGLE CENTER

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1951.2-1952
Author(s):  
S. Ugurlu ◽  
B. H. Egeli ◽  
A. Adrovic ◽  
K. Barut ◽  
S. Sahin ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Hip Prosthesis ◽  
Transition Process ◽  
Current Treatment ◽  
Left Knee ◽  
Leg Pain ◽  
Rheumatology Clinic ◽  
Treatment Information ◽  
The Mean

Background:Pediatric to adult rheumatology transition can be a challenge for both the patient and the clinician, especially in rheumatology as it includes chronic diseases with close follow-up.Objectives:The objective of this study is to understand our tertiary rheumatology center patient demographic transitioning from pediatric to adult rheumatology in order to design prospective studies enhancing the evidence of transition recommendations.Methods:Patients included in this study are regularly followed-up in our adult rheumatology clinic and were regularly followed up in our pediatric rheumatology clinic in the past. They were all diagnosed with a rheumatologic condition receiving treatment. The patient files were assessed to have a better understanding of their demographic, disease and treatment information.Results:Our cohort includes 347 patients diagnosed with a variety of conditions that are Familial Mediterranean Fever (FMF) (n=216), Juvenile Idiopathic Arthritis (JIA) (n=56), Juvenile Spondyloarthritis (jSPA) (n=39), Systemic Lupus Erythematosus (SLE) (n=20), Behçet’s Disease (n=7) and the rest of the rheumatologic conditions with less than 5 patients each. The mean age of the patients during transition, mean age of diagnosis, and follow-up duration are 21.34±1.7, 10.4±4.18, and 10.82±4.4 in respective order. The treatment regimens the patients received are summarized in Table 1.Table 1.Current Treatment Information of the PatientsCurrent Treatment InformationDMARD26Colchicine23Adalimumab21Etanercept10NSAID4Tocilizumab3Cyclophosphamide3Rituximab2Prednisolone7Mycophenolate Mofetil1Canakinumab1Seven patients had FMF related attacks. In addition to attacks, one FMF patient had bilateral ankle pain and one patient had leg pain. One patient out of three diagnosed with Takayasu’s disease was still symptomatic. One patient had uveitis-related symptoms. One patient diagnosed with SLE had skin dryness. Furthermore, there were patients with sequelae formation. One patient diagnosed with oligoarticular JIA (oJIA) had bilateral hip sequela with the additional left hip prosthesis. One oJIA patient had micrognathia, and one had left knee sequela. One pJIA patient had small joint sequelae. One sJIA patient had bilateral hip sequelae. One jSPA patient had enthesopathy. One FMF patient had proteinuria due to amyloidosis formation. Another FMF patient had hip surgery due to sequela.Conclusion:Our center had patients with a variety of conditions with different natures of diseases. EULAR recommends the transition process to start no later than 14 years of age; however, this process started at the mean age of 21 in our patients. In most of these patients, especially the ones diagnosed with FMF, the control of disease activity was maintained. The transition of these different clinical entities might require certain amendments to the standard of care. For future references, we will be able to understand more about the adulthood prognosis of these clinical entities.Disclosure of Interests:None declared

Clinical overlap of functional neurologic symptom disorder and complex regional pain syndrome in pediatrics: A case report

2021 ◽  
pp. 1-8
Author(s):  
Heidi Kempert
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Gait Pattern ◽  
Rehabilitation Program ◽  
Neurologic Symptom ◽  
Physical Mobility ◽  
Unsteady Gait ◽  
Full Day

This case study documents a 13-year-old female who presented to our intensive inpatient chronic pain rehabilitation program with complex regional pain syndrome (CRPS) of her left leg, which was significantly interfering with her normal daily functioning. She participated in a full day of traditional interdisciplinary therapies, including physical and occupational therapy for 3 hours daily. As assistive equipment was altered or weaned her physical mobility, balance, and tremors worsened and/or increased. As she began advancing her legs more independently (versus requiring physical assist), she demonstrated more variable functional strength and stability, inconsistent balance reactions, and a more unsteady gait pattern. The team was treating her according to her incoming CRPS diagnosis; however, as treatment progressed, her physical and psychological presentation seemed more aligned with diagnostic criteria of functional neurologic symptom disorder (FND). Staff then treated according to the FND diagnosis resulting in successful long-term outcomes. The clinical impact from this case study includes highlighting the commonalities between CPRS and FND clinically, discussing differentiating treatment suggestions depending on the diagnosis, and emphasizing key components of family/patient education.

scholarly journals Factors Influencing Smallholder Crop Diversification: A Case Study of Manicaland and Masvingo Provinces in Zimbabwe

2016 ◽  
Vol 3 (2) ◽  
pp. 1 ◽  
Author(s):  
Lighton Dube
Keyword(s):  
Smallholder Farmers ◽  
Diversity Index ◽  
Tobit Model ◽  
Crop Diversification ◽  
Factors Associated ◽  
Head Of Household ◽  
The Mean ◽  
Female Headed Households ◽  
Extension Support

<p>This study analyzes the degree of crop diversification and factors associated with crop diversification among 479 smallholder farmers in Manicaland and Masvingo provinces of Zimbabwe. The Herfindahl index used to estimate diversification, while the Tobit model evaluated factors associated with crop diversification.  The mean crop diversity index is 0.54. On average households in Nyanga and Bikita are the most diversified with indices of 0.48 and 0.49 respectively. The most specialized households are in Mutasa and Chiredzi with indices of 0.62. An analysis by gender shows that male headed households are slightly more diversified than female headed households. The Tobit model indicates that gender of head of household, education, number of livestock units, access to irrigation, membership to a farmers group, access to markets, farming experience, farms on flat terrain, farmer to farm extension, routine extension, agro-ecological zone and household income are significant contributors to increasing crop diversification. In turn, crop specialization is significantly associated with off-farm employment, soil fertility, farmers who are happy with extension contacts per year, farmers trained using the farmer field school approach and farmers who receive NGO extension support.</p>

scholarly journals The Computer-Assisted Web Interview Method as Used in the National Study of ICT Use in Primary Healthcare in Poland – Reflections on a Case Study

2015 ◽  
Vol 43 (1) ◽  
pp. 137-146 ◽  
Author(s):  
Paweł Sowa ◽  
Bartosz Pędziński ◽  
Michalina Krzyżak ◽  
Dominik Maślach ◽  
Sylwia Wójcik ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
National Study ◽  
Computer Assisted ◽  
Web Surveys ◽  
Technical Aspects ◽  
Interview Method ◽  
Advantages And Disadvantages ◽  
Ict Use ◽  
Aforementioned Study

Abstract The development and widespread use of ICT in society are reflected by the way research is designed and conducted. The Computer Assisted Web Interview method is becoming more attractive and is a frequently used method in health sciences. The National Study of ICT Use in Primary Healthcare in Poland was conducted using this method. The aim of this paper is to present the major advantages and disadvantages of web surveys. Technical aspects of methodology and important stages of the aforementioned study, as well as key elements for its procedure, are mentioned. The authors also provide reflections based on their analysis of this national study, conducted between January and April 2014.

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