scholarly journals Imaging strategy for South African children with their first proven UTI in a tertiary hospital setting

2001 ◽  
Vol 5 (1) ◽  
pp. 4-8
Author(s):  
S. Andronikou ◽  
C. Welman ◽  
E. Kader ◽  
M. McCulloch
Keyword(s):  
South African ◽  
Renal Scarring ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Posterior Urethral Valves ◽  
Imaging Method ◽  
Imaging Methods ◽  
Advantages And Disadvantages ◽  
Imaging Strategy ◽  
Benign Course

Urinary tract infection (UTI) is the most common invasive childhood bacterial infection. While it has a benign course in most children, there is a risk that some will develop renal scarring, hypertension and chronic renal failure. There are no simple clinical means to identify those at risk and who would benefit from treatment and so all children with first proven UTI are subjected to imaging. Imaging is directed at detecting vesico-ureteric reflux (VUR), obstruction from pelviureteric junction (PUJ) obstruction or posterior urethral valves (PUV) and kidneys that are scarred or at a risk for scarring. Unfortunately, no single imaging method is able to detect all of the above. Also, the advantages and limitations of many of the imaging methods are not clearly appreciated. This article presents the uses, advantages and disadvantages of current imaging methods and outlines a strategy that attempts to limit the radiation dose and invasiveness of the procedure.

scholarly journals Short-term outcomes of submuscular bridge plating of length-unstable paediatric femoral shaft fractures in children - Insights from a South African tertiary hospital setting

2020 ◽  
Vol 19 (3) ◽  
Author(s):  
J Du Toit ◽  
R Salkinder ◽  
MC Burger ◽  
G Du Preez ◽  
RP Lamberts
Keyword(s):  
South African ◽  
Hospital Setting ◽  
Femoral Fractures ◽  
Tertiary Hospital ◽  
Lower Limbs ◽  
Leg Length ◽  
Post Surgery ◽  
Paediatric Orthopaedic ◽  
Bridge Plating ◽  
Unstable Fractures

ABSTRACT BACKGROUND: Femoral diaphyseal fracture is a common paediatric orthopaedic injury; however, the management of these fractures remains controversial in children between the ages of 6 and 13 years. The preferred approach for children appears to be surgical, enabling early mobilisation. Some studies have reported that submuscular bridge plating (SBP) might be a good alternative treatment method with favourable outcomes. The aim of this study was to determine whether SBP a) leads to union in length-unstable fractures with a low complication rate; b) leads to reasonable alignment and leg length equality; and c) has acceptable clinical outcomes in a South African tertiary hospital setting. METHODS: All patients with predominantly length-unstable femoral diaphyseal fractures who were treated between 1 January 2011 and 31 December 2012 were included in this study. Patients were treated with SBP using standard of care techniques, and hardware removal was performed at approximately eight months post-operatively. The nine months post-operative assessment between the affected and unaffected leg was used to assess the effectiveness of the SBP intervention RESULTS: A total of 29 patients (mean age 9±2 years) were included. The majority of the fractures (n=27, 93%) were length-unstable. Two patients (7%) had transverse fractures with >2 cm overlap and/or weighing >45 kg. All fractures healed within expected time frames. No overall leg length discrepancy (p=0.94) or coronal mechanical axis deviation (p=0.51) was observed between the affected and unaffected lower limbs at nine months post-surgery. No differences between the operated and non-operated sides were observed for hip flexion (p=0.88), hip external rotation (p=0.36), hip internal rotation (p=0.12) or knee flexion (p=0.96 CONCLUSION: SBP provides reliable outcomes in children with diaphyseal femoral fractures and is our preferred method of fixation for a) length-unstable fractures; b) fractures close to the metaphysis; and c) children weighing more than 45 kg Level of evidence: Level 4 Keywords: femoral fractures, paediatric, orthopaedic surgery, children

Living With Both a Total Ankle Replacement and an Ankle Fusion: A Qualitative Study From the Patients’ Perspective

2021 ◽  
pp. 107110072110044
Author(s):  
Catherine Conlin ◽  
Ryan M. Khan ◽  
Ian Wilson ◽  
Timothy R. Daniels ◽  
Mansur Halai ◽  
...  
Keyword(s):  
Hospital Setting ◽  
Case Series ◽  
Total Ankle Replacement ◽  
Qualitative Description ◽  
Level Of Evidence ◽  
Foot Placement ◽  
Advantages And Disadvantages ◽  
Ankle Fusion ◽  
Ankle Replacement ◽  
Patient Reported

Background: Total ankle replacement (TAR) and ankle fusion are effective treatments for end-stage ankle arthritis. Comparative studies elucidate differences in treatment outcomes; however, the literature lacks evidence demonstrating what outcomes are important to patients. The purpose of this study was to investigate patients’ experiences of living with both a TAR and ankle fusion. Methods: This research study used qualitative description. Individuals were selected from a cohort of patients with TAR and/or ankle fusion (n = 1254). Eligible patients were English speaking with a TAR and contralateral ankle fusion, and a minimum of 1 year since their most recent ankle reconstruction. Surgeries were performed by a single experienced surgeon, and semistructured interviews were conducted by a single researcher in a private hospital setting or by telephone. Ankle Osteoarthritis Scale (AOS) scores, radiographs, and ancillary surgical procedures were collected to characterize patients. Themes were derived through qualitative data analysis. Results: Ten adults (8 men, 2 women), ages 59 to 90 years, were included. Average AOS pain and disability scores were similar for both surgeries for most patients. Participants discussed perceptions of each reconstructed ankle. Ankle fusions were considered stable and strong, but also stiff and compromising balance. TARs were considered flexible and more like a “normal ankle,” though patients expressed concerns about their TAR “turning” on uneven ground. Individuals applied this knowledge to facilitate movement, particularly during a first step and transitioning between positions. They described the need for careful foot placement and attention to the environment to avoid potential challenges. Conclusion: This study provides insight into the experiences of individuals living with a TAR and ankle fusion. In this unusual but limited group of patients, we found that each ankle reconstruction was generally perceived to have different characteristics, advantages, and disadvantages. Most participants articulated a preference for their TAR. These findings can help clinicians better counsel patients on expectations after TAR and ankle fusion, and improve patient-reported outcome measures by better capturing meaningful outcomes for patients. Level of Evidence: Level IV, case series.

scholarly journals Visual loss from mismanaged ocular injury with foreign body impaction: A Case Report

2018 ◽  
Vol 4 (2) ◽  
pp. 198-204
Author(s):  
Ifedayo O. Akintoye ◽  
Caroline O. Adeoti
Keyword(s):  
Foreign Body ◽  
Health Workers ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Health Concern ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Health Extension Workers ◽  
Foreign Body Impaction ◽  
Upper Lid

Ocular injury occurs commonly and it may lead to visual impairment if it is not properly managed. We report the case of a 35-year old man with a retained infected ocular foreign body in his right eye following an injury. The foreign body was not discovered despite consulting non-ophthalmologists at a Maternity Centre and an Optical Shop over a period of ten days.  At presentation at the Specialist Hospital, he was unable to see with swelling of the eyelid, red eye and discharge. On examination, the visual acuity in the affected eye was NLP and an infected stick that penetrated the eyeball was discovered in the superonasal aspect of sclera covered by the swollen upper lid. This resulted in endophthalmitis, cataract and blindness of that eye. Ocular injuries must be promptly referred to the ophthalmologist for appropriate care and to prevent complications. The case clearly showed a diagnostic and therapeutic challenge for paramedics who encounter eye injuries outside the tertiary hospital setting. Therefore, this report raises public health concern intended to increase awareness on the management of eye injuries. The incorporation of Primary Eye Health into Primary Health Care along with training and re-training of Community Health Extension Workers, General Practitioners and other rural health workers cannot be overemphasized.

scholarly journals Comparison contact and thermal imaging methods measure the temperatures of the turning blades during cutting

Mechanik ◽  
2017 ◽  
Vol 90 (3) ◽  
pp. 214-216
Author(s):  
Karol Grochalski ◽  
Piotr Jabłoński
Keyword(s):  
Tool Wear ◽  
Thermal Imaging ◽  
Cutting Tool ◽  
Processing Parameters ◽  
Machining Process ◽  
Influence Of Temperature ◽  
Imaging Methods ◽  
Advantages And Disadvantages ◽  
Influence Of Temperature On ◽  
Materials Used

The paper presents a method of measuring the temperature during cutting and its impact on the machining process. The influence of temperature on the intensity of the cutting tool wear cutting and durability. Shows the measuring position, the materials used and the cutting tool. We present the results of the processing parameters, during which the measurements are made. This paper presents methods for measuring the temperature of the blade using a thermocouple and methods of radiation. It lists the advantages and disadvantages of each method.

scholarly journals Building a patient blood management program in a large-volume tertiary hospital setting: Problems and solutions

2020 ◽  
Vol 28 (3) ◽  
pp. 560-569
Author(s):  
Serdar Serdar Günaydın
Keyword(s):  
Large Volume ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Management Program ◽  
Successful Implementation ◽  
Patient Blood Management ◽  
Blood Management ◽  
Specific Patient ◽  
Management Protocol ◽  
Problems And Solutions

Successful implementation of a patient blood management program necessitates the collaboration of a strong organization and a multidisciplinary approach. We organized a meeting with broad participation in our center to establish a consensus for implementation of a specific patient blood management program. International and domestic experiences were shared, the importance of coordination and execution of different pillars in patient blood management were discussed, and the problems about the blood transfusion system were also investigated with the proposal for solutions. The data obtained from this meeting are presented to be a guide for similar large-volume tertiary hospitals for integration of a patient blood management protocol.

scholarly journals Graphene-Based Nanosystems: Versatile Nanotools for Theranostics and Bioremediation

2021 ◽  
Author(s):  
Marlene Lúcio ◽  
Eduarda Fernandes ◽  
Hugo Gonçalves ◽  
Sofia Machado ◽  
Andreia C. Gomes ◽  
...  
Keyword(s):  
Biomedical Applications ◽  
Quantum Physics ◽  
Single Layer ◽  
The Body ◽  
Diagnostic Tools ◽  
Honeycomb Lattice ◽  
Two Dimensional ◽  
Advantages And Disadvantages ◽  
Broad Variety ◽  
Imaging Strategy

Since its revolutionary discovery in 2004, graphene— a two-dimensional (2D) nanomaterial consisting of single-layer carbon atoms packed in a honeycomb lattice— was thoroughly discussed for a broad variety of applications including quantum physics, nanoelectronics, energy efficiency, and catalysis. Graphene and graphene-based nanomaterials (GBNs) have also captivated the interest of researchers for innovative biomedical applications since the first publication on the use of graphene as a nanocarrier for the delivery of anticancer drugs in 2008. Today, GBNs have evolved into hybrid combinations of graphene and other elements (e.g., drugs or other bioactive compounds, polymers, lipids, and nanoparticles). In the context of developing theranostic (therapeutic + diagnostic) tools, which combine multiple therapies with imaging strategies to track the distribution of therapeutic agents in the body, the multipurpose character of the GBNs hybrid systems has been further explored. Because each therapy and imaging strategy has inherent advantages and disadvantages, a mixture of complementary strategies is interesting as it will result in a synergistic theranostic effect. The flexibility of GBNs cannot be limited to their biomedical applications and, these nanosystems emerge as a viable choice for an indirect effect on health by their future use as environmental cleaners. Indeed, GBNs can be used in bioremediation approaches alone or combined with other techniques such as phytoremediation. In summary, without ignoring the difficulties that GBNs still present before being deemed translatable to clinical and environmental applications, the purpose of this chapter is to provide an overview of the remarkable potential of GBNs on health by presenting examples of their versatility as nanotools for theranostics and bioremediation.

Measurement Tools for Non-Invasive Monitoring of the Plants Growth Conditions by Using Hyperspectral Imaging Methods: a Review

2021 ◽  
Vol 2 (43) ◽  
pp. 54-61
Author(s):  
Dmitriy A. Burynin ◽  
◽  
Aleksandr A. Smirnov
Keyword(s):  
Hyperspectral Imaging ◽  
Physiological State ◽  
Effective Means ◽  
Research Problem ◽  
High Spectral Resolution ◽  
Research Purpose ◽  
Imaging Method ◽  
Invasive Monitoring ◽  
Imaging Methods ◽  
Non Invasive

Portable spectroradiometers and hyperspectral cameras are increasingly being used to quickly assess the physiological state of plants. The operation of these devices is based on the registration of reflection or reflection and transmission spectra. (Research purpose) The research purpose is in analyzing the technical means and methods of non-invasive monitoring of the plant state based on the registration of the reflection spectra of leaves. (Materials and methods) The article presents a review of the work on the application of hyperspectral imaging methods. Authors classified and analyzed materials on spectroscopic radiometers and hyperspectral cameras, and outlined the prospects for implementation. Authors applied the methods of a systematic approach to the research problem. (Results and discussion) Hyperspectral imaging methods serve as an effective means of monitoring plants. It is possible to determine the pigment composition of plants, lack of nutrition, and detect biotic stress through hyperspectral imaging. The article presents methods of application of portable spectroradiometers and hyperspectral cameras. With the help of these devices it is possible to carry out measurements with high spectral resolution. The difficulty of accurately detecting the content of pigments in the leaves lies in the mutual overlap of the areas of light absorption by them. The main drawback of spectroradiometers is that they measure only at one point on a single sheet. The article presents the difficulties encountered in interpreting the results obtained by the hyperspectral camera. The background reflectivity of the soil, the geometry of the vegetation cover, and the uneven lighting can make errors in the measurements. (Conclusions) The article presents the disadvantages of the hyperspectral imaging method when using only the reflection spectrum. In order to increase the accuracy of the determination of pigments and stresses of various origins, it is necessary to develop a portable device that combines the methods of recording reflection and fluorescence.

Spread of NDM-producing Klebsiella pneumoniae in a tertiary Greek hospital

2021 ◽  
Author(s):  
Κonstantina Kontopoulou ◽  
Georgios Meletis ◽  
Styliani Pappa ◽  
Sofia Zotou ◽  
Katerina Tsioka ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Rapd Analysis ◽  
Random Amplified Polymorphic Dna ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Whole Genome Sequence ◽  
Health Concern ◽  
Resistant Bacteria ◽  
New Delhi ◽  
Whole Genome

AbstractBacterial carbapenem resistance, especially when mediated by transferable carbapenemases, is of important public health concern. An increased number of metallo-β-lactamase (MBL)-producing Klebsiella pneumoniae strains isolated in a tertiary hospital in Thessaloniki, Greece, called for further genetic investigation.The study included 29 non-repetitive carbapenem resistant K. pneumoniae isolates phenotypically characterized as MBL-producers collected in a tertiary hospital in Greece. The isolates were screened for the detection of carbapenemase genes (K. pneumoniae carbapenemase (blaKPC), Verona-integron-encoded MBL-1 (blaVIM-1), imipenemase (blaIMP), oxacillinase-48 (blaOXA-48) and New Delhi MBL (blaNDM)). The genetic relationship of the isolates was determined by Random Amplified Polymorphic DNA (RAPD) analysis. The whole genome sequences (WGS) from two NDM-positive K. pneumoniae isolates were further characterized.The presence of New Delhi MBL (blaNDM) gene was confirmed in all K. pneumoniae isolates, while blaKPC and blaVIM-1 genes were co-detected in one and two isolates, respectively. The RAPD analysis showed that the isolates were clustered into two groups. The whole genome sequence analysis of two K. pneumoniae isolates revealed that they belonged to the sequence type 11, they carried the blaNDM-1 gene, and exhibited differences in the number and type of the plasmids and the resistant genes.All MBL-producing K. pneumoniae isolates of the study harbored a blaNDM gene, while WGS analysis revealed genetic diversity in resistance genes. Continuous surveillance is needed to detect the emergence of new clones in a hospital setting, while application of antimicrobial stewardship is the only way to reduce the spread of multi-resistant bacteria.

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