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At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Successful treatment of intimal hyperplasia in renal arteries by endovascular brachytherapy.

PURPOSE: The present study shows the possibility of preventing restenosis of renal arteries by endovascular brachytherapy. METHODS AND MATERIALS: We present a patient suffering from rapid restenosis of both renal arteries with decreasing renal function. Percutaneous transluminal angioplasty (PTA) and stent implantation were unable to stop hypertension and to stabilize renal function. Both renal arteries and the right pole artery were treated by endovascular brachytherapy in one session. RESULTS: Six months after intervention, intraarterial digital subtraction angiography (DSA) showed no evidence of recurrence, and the blood pressure remained normal without medical treatment. CONCLUSION: Endovascular brachytherapy can help to prevent restenosis in renal arteries. It is possible to treat both renal arteries and one pole artery in one session without any disadvantage.

Angiography, Digital Subtraction↗
PubMed2003

Patterns of maxillary alveolar arch growth changes of infants with unilateral cleft lip and palate: preliminary findings.

OBJECTIVE: Because of significant differences in pathomorphology at birth, it may be that a better treatment outcome prognosis exists for patients with incomplete versus complete cleft forms. Can reaction patterns be extracted from changes in maxillary dimensions of different cleft forms within the first year of life to support this hypothesis? SUBJECTS: Chronologically consecutive casts of the maxilla (1 week and 3, 6, and 12 months of life) of 15 patients with complete unilateral cleft lip and palate (cUCLP) and 13 patients with incomplete unilateral cleft lip and palate (iUCLP). All patients were treated with passive palatal plates. Cheiloplasty was performed at 6 months of age. No primary osteoplastic surgery was carried out. INTERVENTIONS: Following digitizing with a three-dimensional laser scanner, all cast surfaces were computer reconstructed, aligned, and superimposed. Distances between the surfaces were determined and expressed graphically. Computer-aided determination of defined maxillary dimensions was performed. The volumes of segmented surfaces were determined and compared. RESULTS: Within the first year of life, decreased sagittal but increased transverse alveolar growth for patients with iUCLP was found. The increase in alveolar crest length in patients with iUCLP was 50% less within the first year of life than in patients with cUCLP. In the same patients, the volumes of the molar segments were, on average, larger at each registration stage and the increase in these volumes larger within the first year of life. CONCLUSION: Conclusions regarding the direction and extent of growth cannot be drawn from the visible level of severity of the malformation.

Alveolar Process↗
PubMed2000

Helping women quit smoking: results of a community intervention program.

OBJECTIVES: This intervention was implemented to reduce the prevalence of cigarette smoking among women. METHODS: We used community organization approaches to create coalitions and task forces to develop and implement a multicomponent intervention in 2 counties in Vermont and New Hampshire, with a special focus on providing support to help women quit smoking. Evaluation was by pre-intervention and post-intervention random-digit-dialed telephone surveys in the intervention counties and the 2 matched comparison counties. RESULTS: In the intervention counties, compared with the comparison counties, the odds of a woman being a smoker after 4 years of program activities were 0.88 (95% confidence interval = 0.78, 1.00) (P = .02, 1-tailed); women smokers' perceptions of community norms about women smoking were significantly more negative (P = .002, 1-tailed); and the quit rate in the past 5 years was significantly greater (25.4% vs 21.4%; P = .02, 1-tailed). Quit rates were significantly higher in the intervention counties among younger women (aged 18 to 44 years); among women with household annual incomes of $25,000 or less; and among heavier smokers (those who smoked 25 or more cigarettes daily). CONCLUSIONS: In these rural counties, community participation in planning and implementing interventions was accompanied by favorable changes in women's smoking behavior.

Adolescent↗
PubMed1997

Virtual reality in endonasal surgery.

Virtual environments provide a new dimension of graphic simulation. The interaction between the human and the computer is now intuitive for the user. The use of virtual reality (VR) gives the user the feeling of participating in a (computer generated) scenario very much like reality. This feeling is an essential requirement for simulation of surgical interventions using digital data. Especially in the fields of sinus and skull-base surgery, computer assisted simulation could present a valuable and effective alternative method for honing endoscopic skills. Traditionally, surgeons gain experience through anatomic preparation and education by more experienced colleagues. Landmarks like skull base, carotid arteria or optical nerve have to be identified intraoperatively in order to orientate in this critical region. Highly sensitive structures can be damaged most easily. The quality of surgical skills can be characterized as the sum of knowledge, individual experience and manual dexterity. It is conceivable that a surgeon's level of training and experience could be significantly increased by use of VR. With this in mind, a VR-based simulator for procedures in sinus surgery will improve most of these parts. To provide the virtual environment, a realistic representation of the region of interest with all relevant anatomical structures is required. Based on data from tomographic imaging studies, a three-dimensional representation of the paranasal sinuses is semiautomatically reconstructed. Textures derived from endoscopic images are superimposed on the virtual anatomic structures and provide better realism. Two main components of the VR interface can be distinguished: the 3-D interaction to guide the surgical instruments and the 2-D graphical user interface for visual feedback and control of the session. Moreover, the 3-D interaction has to be realized by means of Virtual Reality techniques providing a simulation of an endoscope and an intuitive handling of other surgical instruments.

Computer Simulation↗
PubMed2006

Treatment of refractory facial pain diagnosed as atypical trigeminal neuralgia: a case report.

This case report describes an effective treatment protocol, the healing process, and the recovery of the patient to a pain-free status after more than 25 years of failed treatment for facial pain. Features of this case report include: 1. A procedure to produce a phenomenon useful as a pathognomonic sign of autonomic nervous system neuropathy, as a determination of the location of the origin of pain, and as a monitoring device for the effectiveness of treatment. 2. A digital pressure intervention procedure that appears effective as a treatment modality to relieve pain and to effect healing. 3. A method to improve posture of the body affecting the relationship of the maxilla to the mandible, the dental occlusion, and the etiology of facial pain. 4. A description of the nature and intensity of the different levels of the pain experienced in the face from the most severe state of pain to a no-pain condition. 5. A diagnosis using a diagnostic term that has developed since the initial diagnosis of atypical trigeminal neuralgia in this case.

Chronic Disease↗
PubMed1997

[Problem list in computer-based patient records].

Computer-based clinical information systems are capable of effectively processing even large amounts of patient-related data. However, physicians depend on rapid access to summarized, clearly laid out data on the computer screen to inform themselves about a patient's current clinical situation. In introducing a clinical workplace system, we therefore transformed the problem list-which for decades has been successfully used in clinical information management-into an electronic equivalent and integrated it into the medical record. The table contains a concise overview of diagnoses and problems as well as related findings. Graphical information can also be integrated into the table, and an additional space is provided for a summary of planned examinations or interventions. The digital form of the problem list makes it possible to use the entire list or selected text elements for generating medical documents. Diagnostic terms for medical reports are transferred automatically to corresponding documents. Computer technology has an immense potential for the further development of problem list concepts. With multimedia applications sound and images will be included in the problem list. For hyperlink purpose the problem list could become a central information board and table of contents of the medical record, thus serving as the starting point for database searches and supporting the user in navigating through the medical record.

Electronic Data Processing↗
PubMed2002

Closing the digital divide in HIV/AIDS care: development of a theory-based intervention to increase Internet access.

Advances in information technology are revolutionizing medical patient education and the Internet is becoming a major source of information for people with chronic medical conditions, including HIV/AIDS. However, many AIDS patients do not have equal access to the Internet and are therefore at an information disadvantage, particularly minorities, persons of low-income levels and individuals with limited education. This paper describes the development and pilot testing of a workshop-style intervention designed to close the digital divide in AIDS care. Grounded in the Information-Motivation-Behavioral Skills (IMB) model of health behaviour change, we developed an intervention for persons with no prior history of using the Internet. The intervention included instruction in using hardware and search engines, motivational enhancement to increase interest and perceived relevance of the Internet, and skills for critically evaluating and using health information accessed via the Internet. Participants were also introduced to communication and support functions of the Internet including e-mail, newsgroups and chat groups. Pilot testing demonstrated feasibility, acceptability and promise for closing the digital divide in HIV/AIDS care using a relatively brief and intensive theory-based intervention that could be implemented in community settings.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Radiation exposure to interventional radiologists during manual-injection digital subtraction angiography.

PURPOSE: We investigated the relationship between the amount of radiation exposure to the operator during table-side manual-injection angiographic procedures including digital subtraction angiography (DSA) and the operator's position, as well as a simple means to decrease radiation exposure. METHODS: Measurement of radiation exposure was carried out with thermoluminescent dosimeters (TLDs) in nine abdominal angiographies. In the first study, radiation exposure during DSA or during fluoroscopy was measured using TLDs placed near the angiographic table. In the second study, radiation exposure to the interventional radiologist was measured during manual-injection DSA at a near and a far operator position. RESULTS: Radiation exposure to the operator received during manual-injection DSA accounted for more than 90% of the total procedural exposure. The exposure to the operator markedly decreased at the far position compared with that at the near position when performing DSA. CONCLUSION: Manual-injection DSA is the largest contributor to radiation exposure received by the interventional radiologist, therefore, the use of a power injector is always recommended when performing DSA. When manual-injection DSA is necessary, radiologists should position themselves as far away from the patient as possible.

Angiography, Digital Subtraction↗
PubMed2004

Dose performance evaluation of a charge coupled device and a flat-panel digital fluoroscopy system recently installed in an interventional cardiology laboratory.

The purpose of the study was to evaluate the dose performance of a flat-panel (FP) and an image intensifier (II) charge coupled device (CCD) digital fluoroscopy X-ray systems newly installed in an Interventional Cardiology (IC) department. Filter entrance dose rate, detector dose rate (during fluoroscopy) and filter entrance dose per image were measured at 70 cm from the focus using 2 mm copper sheets to mimic normal size patient. Image quality was also evaluated. The patient dose survey included 277 patients, which had either a Coronary Angiography (CA) or a Percutaneous Transluminal Coronary Angioplasty (PTCA). Dose area product (DAP), fluoroscopy time (T) and total number of frames (F) values were also collected. The results showed that both systems performed within international recommendations with the exception of higher cine radiation doses, stressing the fact that neither specific protocols of measurement nor reference values for digital equipment were provided by the official bodies.

Cardiology↗
PubMed2002

Radiation dose and image quality in diagnostic radiology. Optimization of the dose-image quality relationship with clinical experience from scoliosis radiography, coronary intervention and a flat-panel digital detector.

UNLABELLED: X-rays are known to cause malignancies, skin damage and other side effects and they are thus potentially dangerous. Therefore, it is essential and in fact mandatory to reduce the radiation dose in diagnostic radiology as far as possible. This is also known as the ALARA (as low as reasonably achievable) principle. However, the dose is linked to image quality and the image quality may not be lowered so far that it jeopardizes the diagnostic outcome of a radiographic procedure. The process of reaching this balance between dose and image quality is called optimization. The aim of this thesis was to propose and evaluate methods for optimizing the radiation dose-image quality relationship in diagnostic radiography with a focus on clinical usefulness. The work was performed in three main parts. OPTIMIZATION OF SCOLIOSIS RADIOGRAPHY: In the first part, two recently developed methods for digital scoliosis radiography (digital exposure and pulse fluoroscopy) were evaluated and compared to the standard screen-film method. Radiation dose was measured as kerma area-product (KAP), entrance surface dose (ESD) and effective dose; image quality was assessed with a contrast-detail phantom and through visual grading analysis. Accuracy in angle measurements was also evaluated. The radiation dose for digital exposure was nearly twice as high as the screen-film method at a comparable image quality while the dose for pulsed fluoroscopy was very low but with a considerably lower image quality. The variability in angle measurements was sufficiently low for all methods. Then, the digital exposure protocol was optimized to a considerably lower dose with a slightly lower image quality compared to the baseline. FLAT-PANEL DETECTOR: In the second part, an amorphous-silicon direct digital flat-panel detector was evaluated using a contrast-detail phantom, measuring dose as entrance dose. The flat-panel detector yielded a superior image quality at a lower dose than both storage phosphor plates and screen-film. Equivalent image quality compared to storage phosphor plates was reached at about one-third of the dose. OPTIMIZATION OF PERCUTANEOUS CORONARY INTERVENTION (PCI): In the third part, influence of various settings on radiation dose and image quality in coronary catheterisation and PCI was investigated. Based on these findings, the dose rate for fluoroscopy was reduced to one-third. The dose reduction was evaluated in a clinical series of 154 PCI procedures before and 138 after the optimization. Through this optimization, the total KAP was significantly reduced to two-thirds of the original value. IN SUMMARY: This thesis indicates the possibility of dose reduction in diagnostic radiology through optimization of the radiographic process.

Coronary Angiography↗
PubMed2003

Evaluation of radiation risk and work practices during cerebral interventions.

This study was intended to evaluate radiation risk to patients during cerebral interventions and the contribution to this risk from work practices. Thirty nine patients undergoing cerebral interventions in a digital subtraction angiography suite were included in this study. Patients who underwent cerebral interventions were categorised into two groups according to the number of cerebral interventions performed on them, and their effective doses were calculated. The effective dose for patients undergoing a single cerebral intervention (group A) varied from 1.55 to 15.9 mSv and for multiple cerebral interventions (group B) varied from 16.52 to 43.52 mSv. Two patients who underwent multiple cerebral interventions (group B) had alopecia of the irradiated scalp.

Angiography, Digital Subtraction↗
PubMed2026

AI-Driven Precision Medicine in Alzheimer's Disease: Drug Repurposing, Digital Therapeutics and Clinical Decision Support.

Alzheimer's Disease (AD) is a neurodegenerative disease that causes significant clinical, social, and economic burden worldwide. Despite improvements in understanding its multifaceted pathogenesis, current treatments are mostly symptomatic and ineffective across varied patient populations. To overcome these constraints, AI-driven precision medicine allows tailored risk assessment, treatment selection, and disease monitoring. This review covers AI's role in AD precision medicine, focusing on drug repurposing, digital therapies and clinical decision support systems. Machine and deep learning models are used to predict medication response, integrate heterogeneous data sources such as genomics, transcriptomics, neuroimaging and electronic health records, and uncover pharmacogenomic treatment success factors. The paper covers AIenabled precision pharmacology, including tailored dosing algorithms, adaptive therapeutic monitoring, and adverse drug reaction prediction. Bioinformatics-based target identification, network pharmacology, graphbased AI models, virtual screening, and real-world and clinical data validation are emphasized in AI-driven medication repurposing. AI-powered digital treatments like personalized cognitive training platforms, wearable- derived digital biomarkers, virtual and mixed reality interventions, adherence monitoring, and digital twins for therapy optimization have been discussed. AI-based clinical decision support systems are also thoroughly assessed for clinical value, accuracy, and explainability in disease subtyping, trajectory prediction, and risk stratification in preclinical and prodromal AD. Despite these promises, data heterogeneity, algorithmic bias, legal barriers, and privacy concerns exist. Federated learning enables safe multi-center collaboration and hybrid AI-human approaches, and it represents the future. AI's ability to alter AD care opens the door to precision medicine paradigms that use repurposed medications, digital tools and intelligent decision-making to improve patient outcomes.

Alzheimer’s disease↗
PubMed1983

[Intravenous digital subtraction angiography following surgical vascular interventions and percutaneous transluminal angioplasty].

I.V.D.S.A. was performed as a follow-up after a surgical vascular procedure or a percutaneous transluminal angioplasty in 157 patients. The quality of the intravenous angiography was excellent in 91% of the patients. In 6,6% the examination was sub-optimal with possible error and in 2.4% the examination was not diagnostic. The inherent limitations of the technique are less important in these follow-up examinations because a limited region only has to be examined. A more accurate follow-up of vascular procedures is possible with I.V.D.S.A.

Angiography↗
PubMed2004

Telelearning standards and their application in medical education.

Medial education, both on the graduate and postgraduate levels, has become a real challenge nowadays. The volume of information in medical sciences grows so rapidly that many health professionals experience essential problems in keeping track of the state of the art in this domain. e-learning offers important advantages to medical education continuation due to its universal availability and opportunity for implementation of flexible patterns of training. An important trace of medical education is developing practical skills. Some examples of standardization efforts include: the CEN/ISSS Workshop on Learning Technology (WSLT), the Advanced Learning Infrastructure Consortium (ALIC), Education Network Australia (EdNA) and PROmoting Multimedia access to Education and Training in European Society (PROMETEUS). Sun Microsystems' support (Sun ONE, iPlanetTM ) for many of the above-mentioned standards is described as well. Development of a medical digital video library with recordings of invasive procedures incorporating additional information and commentary may improve the efficiency of the training process in interventional medicine. A digital video library enabling access to videos of interventional procedures performed in the area of thoracic medicine may be a valuable element for developing practical skills. The library has been filled with video resources recorded at the Department of Interventional Pulmonology; it enhances training options for pulmonologists and thoracic surgeons. The main focus was put on demonstration of bronchofiberoscopic and videothoracoscopic procedures. The opportunity to browse video recordings of procedures performed in the specific field also considerably enhances the options for training in other medical specialties. In the era of growing health consumer awareness, patients are also perceived as the target audience for medical digital libraries. As a case study of Computer-Based Training systems, the Medical Digital Video Library is presented.

Education, Distance↗
PubMed1983

[Significance of digital subtraction angiography (DSA) in the evaluation of reconstructive vascular interventions].

The author examined 160 patients by means of digital subtraction angiography (DSA) after reconstructive vascular surgery. The checkup aimed to controlling the functional capacity of arterial and venous bypasses, of thrombal endarterectomy (TEA) and percutaneous transluminal angioplasty (PTA). The image quality of the examinations was good or very good in 138 cases and satisfactory in 19 cases in respect of the questions to be solved. In 3 cases, no information of diagnostic value was obtained. Vascular wall irregularities, stenoses, occlusions, dissections and aneurysms could be assessed with satisfactory display of anatomic details. Evidently DSA yielded a higher percentage of better results in the assessment of reconstructive vascular surgery than was obtained by pretherapeutic diagnosis in the region of the vessels, head, trunk and body periphery.

Angiography↗