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At least 109 records · Page 6Linked to original sources
PubMed2004

Does digital acquisition reduce patients' skin dose in cardiac interventional procedures? An experimental study.

OBJECTIVE: It is necessary to reduce the exposure doses from both fluoroscopy and angiocardiography. Pulsed fluoroscopy clearly reduces patients' exposure. By contrast, whether digital acquisition reduces patients' exposure is not clear. This study simulated the skin radiation doses of patients in cardiac catheterization laboratories with various radiography systems used in percutaneous transluminal coronary angioplasty to determine whether digital acquisition reduces patient exposure as compared with cine film recording. MATERIALS AND METHODS: The entrance surface doses with cineangiography and fluoroscopy of acrylic phantoms were compared for 11 radiography systems at seven facilities; each performs more than 100 cardiac intervention procedures per year. The entrance surface dose for an acrylic plate (20 cm thick) was measured using a skin-dose monitor. RESULTS: The maximum dose exceeded the minimum dose by 6.44 times for cineangiography and by 3.42 times for fluoroscopy. The entrance surface dose with acrylic plate was lower with digital-only acquisition (mean +/- SD, 3.07 +/- 0.84 mGy/sec) than with film recording (6.00 +/- 3.04 mGy/sec). By contrast, the entrance surface frame dose, after correction for the cine frame rate, tended to be higher with digital acquisition than with film recording (0.210 +/- 0.053 vs 0.179 +/- 0.058 mGy/frame, respectively). CONCLUSION. The entrance surface dose was approximately 50% less with digital-only acquisition than with film recording. However, after correcting the dose for cine frame rate, filmless acquisition did not in itself reduce the exposure. For the surface dose to be reduced for cardiac interventional radiography, even with digital filmless radiography systems, a low recording speed is necessary for angiocardiography.

Angioplasty, Balloon, Coronary↗
PubMed2026

A Preventive Social Media Intervention for Perinatal Depression and Anxiety in Regional, Rural, and Remote Communities: Participatory Co-Design Study.

BACKGROUND: Perinatal depression and anxiety are significant public health concerns, affecting up to 1 in 5 women globally, with disproportionate burden carried by women in regional, rural, and remote communities where structural and social inequities amplify vulnerability. Access to perinatal mental health support in these settings is severely constrained by geographical isolation, workforce shortages, financial barriers, and a lack of culturally safe services. Prevention is recognized as critical to reducing this burden, with evidence suggesting that effective preventive approaches can reduce population-level illness by up to 40% and alleviate downstream demand on overstretched services. Digital mental health interventions hold promise for improving access to support, yet few are co-designed with underserved perinatal populations. OBJECTIVE: This study aimed to identify the mental health needs of perinatal women in regional, rural, and remote communities and to co-design a framework for a preventive social media-based intervention informed by platform-specific affordances and constraints, using Northern Queensland, Australia, as an exemplar. METHODS: Using a participatory co-design approach, 26 perinatal women (21 postnatal and 5 antenatal) and 8 mental health care professionals from regional, rural, and remote Northern Queensland participated in focus groups or interviews, supplemented by ongoing consultation with a community advisory group comprising lived experience representatives, clinicians, and local community leaders. Qualitative data were analyzed using reflexive thematic analysis to identify core community mental health needs. Identified needs were then examined through a needs-affordances framework to determine how specific platform features could address, enable, or constrain those needs in the context of a preventive intervention. RESULTS: Five core mental health needs were identified: (1) social connection and support; (2) personalized and respectful health care; (3) information that empowers; (4) place-based and culturally safe support; and (5) accessible, low-burden digital formats. Participants viewed social media as a potentially useful platform for fostering peer connection, normalizing perinatal experiences, and providing timely psychoeducation. However, both mothers and professionals expressed concerns about misinformation, harmful social comparison, and privacy risks that must be proactively addressed in program design. These insights were synthesized into a set of prototype design guidelines specifying recommended content, features, tone, and delivery formats to inform subsequent intervention development. CONCLUSIONS: This study provides a place-based, co-designed needs-affordances framework to guide the development of a preventive social media-based intervention for perinatal mental health support in regional, rural, and remote communities. The findings demonstrate that social media is an acceptable and promising platform for preventive perinatal mental health support in these settings, provided that design is driven by community need, platform affordances are systematically analyzed, and known risks are explicitly mitigated. These findings address a significant gap in the literature and offer a replicable methodological approach for co-designing contextually relevant digital mental health interventions with underserved populations.

Humans↗
PubMed1989

[Status of the technic of angiography procedures].

Angiocardiography continues to expand inspite of competitive non-invasive imaging techniques (echocardiography, CT, nuclear magnetic resonance). Only angiography yields images of sufficient spatial and temporal resolution as they are needed for coronary diagnostic work and interventional catheter therapy. Angiographic systems are mono- or biplane with high degree of mobility and flexibility for oblique and angulated projections. Currently available systems do not fulfill the requirements. Image resolution and contrast are today satisfactory, however, still not sufficient for interventional techniques. Only digital image processing will allow further improvement, thereby enhancing contrast and detail while reducing radiation dose (pulsed, high-contrast fluoroscopy, on-line image processing). Cine-filming seems not needed in all cases. In the future, angiocardiography will hardly be needed for study of cardiac chambers, valves or great vessels. Instead, specialized systems of extreme mobility and flexibility with high resolution and digital image processing for image improvement and documentation, radiation reduction for coronary and general arterial diagnostic and therapeutic interventions will be developed.

Angiocardiography↗
PubMed2002

Effect of radiographic techniques (kVp and mAs) on image quality and patient doses in digital subtraction angiography.

We investigated how varying the x-ray tube voltage and image receptor input exposure affected image quality and patient radiation doses in interventional neuroradiologic imaging. Digital subtraction angiography (DSA) images were obtained of a phantom with 1 mm diameter vessels containing iodine at concentrations between 4.5 and 50 mg/cc. The detection threshold concentration of iodine was determined by inspecting DSA images obtained at a range of x-ray tube voltages and input exposure levels. Surface doses were obtained from measured x-ray tube output data, and corresponding values of energy imparted were determined using the exposure-area product incident on the phantom. In one series of experiments, the air kerma at the image intensifier (X) was varied between 0.44 microGy per frame and 8.8 microGy per frame at a constant x-ray tube voltage of 70 kVp. In a second series of experiments, the tube voltage was varied between 50 and 100 kVp, and the mAs adjusted to maintain a constant exposure level at the input of the image intensifier. At a constant x-ray tube voltage, the surface dose and energy imparted were directly proportional to the input exposure per frame used to acquire the DSA images. On our DSA system operated below 2.2 microGy per frame, the threshold iodine concentration was found to be proportional to X(-0.57), which is in reasonable agreement with the theoretical prediction for a quantum noise limited imaging system. Above 2.2 microGy per frame, however, the threshold iodine concentration was proportional to X(-0.26), indicating that increasing the input exposure above this value will only achieve modest improvements in image quality. At a constant image intensifier input exposure level, increasing the x-ray tube voltage from 50 kVp to 100 kVp reduced the surface dose by a factor of 6.1, and the energy imparted by a factor of 3.5. The detection threshold iodine concentration was found to be proportional to kVp(n), where n was 2.1 at 1.1 microGy per frame, and 1.6 at 3.9 microGy per frame. For clinical situations that can be modeled by a uniform phantom, reducing the x-ray tube voltage rather than increasing the exposure level would best achieve improvements on our DSA imaging system performance.

Angiography, Digital Subtraction↗
PubMed2026

Enhancing Self Care Among Oral Cancer Survivors Using a Digital Approach: The Empowered Survivor Trial.

BACKGROUND: Oral and oropharyngeal cancer survivors experience debilitating physical and psychosocial challenges. Little knowledge exists on the efficacy of interventions to enhance self-efficacy in managing these challenges, increase survivorship preparedness, and improve health-related quality of life (HRQoL). METHODS: Individuals (n&#xa0;=&#xa0;643) diagnosed with oral or oropharyngeal cancer diagnosed within past 3&#xa0;years were randomized to a digital intervention, Empowered Survivor (ES) or a Generic Online Intervention (GO). Primary (self-efficacy, preparedness, HRQoL) and secondary outcomes (self-care activities) were measured at Baseline, 2-months, and 6-months. RESULTS: Participants assigned to ES reported greater self-efficacy and increased self-care activities of oral self-exams, swallowing, and mobility exercises than those assigned to GO (self-efficacy: 2&#xa0;months, p&#xa0;=&#xa0;0.003, 6-months, p&#xa0;<&#xa0;0.001; self-care activities). CONCLUSIONS: The ES enhanced self-efficacy and increased self-care activities. Further examinations of survivorship preparedness and HRQoL in oral and oropharyngeal cancer are warranted. TRIAL REGISTRATION: Registered on clinicaltrials. gov as NCT04713449.

Humans↗
PubMed2026

Efficacy of prescription-eligible digital health applications for depression and generalized anxiety disorder in Germany: a systematic review and meta-analysis.

In Germany, prescription-eligible digital mental health applications (DiGA) were introduced in 2020 as promising interventions to address, among others, depression and anxiety disorders, two of the most prevalent mental health conditions worldwide. Despite growing interest in DiGAs, their overall efficacy remains uncertain. This study aimed to systematically evaluate and quantify the efficacy of prescription-eligible digital interventions for depression and generalized anxiety disorder by synthesizing evidence from randomized controlled trials (19 trials; total N&#x2009;=&#x2009;4,078; pooled mean age&#x2009;=&#x2009;38.7 years, SD&#x2009;=&#x2009;12.1). Here we show that prescription-eligible digital applications for depression and generalized anxiety disorder reduce symptom severity compared with control conditions. For depression, effects were observed both immediately after the intervention (number of apps&#x2009;=&#x2009;5; k&#x2009;=&#x2009;17; SMD = -&#x2009;0.49; 95% CI -&#x2009;0.65 to -&#x2009;0.32) and at follow-up (number of apps&#x2009;=&#x2009;1; k&#x2009;=&#x2009;4; SMD = -&#x2009;0.35; 95% CI -&#x2009;0.46 to -&#x2009;0.29), while evidence for generalized anxiety disorder was limited due to a small number of available studies (number of studies&#x2009;=&#x2009;2). These findings support the integration of evidence-based digital tools into mental health treatment strategies in Germany. However, the available evidence is currently dominated by a small number of applications, particularly Deprexis, and should therefore not be interpreted as equally representative of all DiGAs currently listed for depression in Germany. The findings also highlight methodological limitations of current research and underscore the need for real-world evaluations, which address not only efficacy but also the effectiveness, content, quality and implementation.

Generalized Anxiety Disorder↗
PubMed1991

[Is intravenous digital subtraction angiography sufficient for planning radiologic interventions in acute and chronic arterial obstructions of the pelvis and leg vascular systems?].

The therapeutical procedure in acute and chronic arterial obstructions of the pelvic and upper leg arteries may often be based on the results of intravenous DSA (i.v. DSA). In patients with peripheral arterial disease and before interventions below the knee are contemplated, i.v. DSA is not sufficient and has to be replaced by arterial DSA (IA DSA). I.v. DSA facilitates technical planning and performance of radiological vascular interventions and has the potential to reduce the complication rates. Nevertheless, the definitive decision to perform PTA and the choice of the appropriate technique continue to be made on the results of the arteriography/i.a. DSA, which has to be routinely obtained at the beginning of any procedure.

Angiography, Digital Subtraction↗
PubMedDate not supplied

[Recurrent parotiditis in adults: review and new therapeutic options].

Our experience in the management of 20 patients with recurrent parotitis (RP) as an isolated symptom is reported. The clinical manifestations in all patients were pain, infection and swelling of the parotid gland on at least three separate occasions. The presence of obvious tumor or specific inflammation were exclusion criteria. Three patients benefited from radiological interventional treatment: two stones were removed from the main duct with a Dormia basket and one parotid duct stricture was dilated with a balloon catheter. The role of conventional or digital sialography and interventional radiology procedures in the diagnosis and management of RP is discussed. We proposed this approach as a therapeutic alternative to surgery, which is more aggressive and carries a risk of facial nerve damage.

Calculi↗
PubMed2026

A pragmatic randomized controlled trial of self-directed online writing interventions for posttraumatic stress symptoms in a real-world digital setting.

Background: Public health and other large-scale crises, such as the COVID-19 pandemic, have intensified the global mental health burden, creating unprecedented demand for accessible interventions for posttraumatic stress symptoms (PTSS).Objective: We evaluated the feasibility and effectiveness of two self-directed online writing interventions embedded within China's WeChat ecosystem during the COVID-19 pandemic through a pragmatic randomised controlled trial.Methods: Between December 2021 and August 2022, 1,526 adults were screened for PTSS via a Tencent Medinfo Mini-Program. Eligible participants (n&#x2009;=&#x2009;211) were randomised to Guided Narrative Technique-Writing (GNT-W, n&#x2009;=&#x2009;100) or Expressive Writing (EW, n&#x2009;=&#x2009;111). Both interventions comprised three self-directed daily writing sessions delivered entirely online without human support. Primary outcome was PTSD symptom severity (PTSD Checklist-Short), assessed at baseline, post-intervention, 2-week, and 1-month follow-ups.Results: While initial engagement followed typical digital health patterns (64.5% overall attrition), participants who initiated treatment showed strong adherence (77% completion). Both interventions were associated with significant within-group reductions in PTSS severity (GNT-W: b&#x2009;=&#x2009;-0.43, p&#x2009;=&#x2009;.023, d&#x2009;=&#x2009;-0.43; EW: b&#x2009;=&#x2009;-0.60, p&#x2009;=&#x2009;.001, d&#x2009;=&#x2009;-0.58), with no significant between-group difference (group &#xd7; time: b&#x2009;=&#x2009;0.18, p&#x2009;=&#x2009;.48). GNT-W did not confer additional benefit over EW protocol on PTSS severity.Conclusions: Both self-directed writing interventions were associated with within-group reductions in PTSS; without an inactive control condition, however, these changes cannot be firmly attributed to the interventions. GNT-W showed no advantage over the simpler EW protocol. These findings offer preliminary support for embedding scalable, low-barrier writing interventions in widely used digital platforms.Chinese Clinical Trial Registry: ChiCTR2000034836.

Humans↗
PubMed2004

Diagnostic accuracy of patients in performing skin self-examination and the impact of photography.

OBJECTIVE: To determine the sensitivity and specificity of skin self-examination (SSE) to detect new and changing moles with and without the aid of baseline digital photographs in patients with dysplastic nevi. DESIGN AND INTERVENTION: Patients had baseline digital photography and mole counts of their back, chest, and abdomen and were instructed to perform a baseline SSE. Print copies of the images were provided to the patient. Following the baseline examination, the appearance of existing moles was altered and new moles were created using cosmetic eyeliner. The number of moles altered and/or created totaled approximately 10% of each patients' absolute mole count. SETTING AND PATIENTS: Fifty patients with 5 or more dysplastic nevi from the outpatient clinic at Memorial Sloan-Kettering Cancer Center, New York, NY. MAIN OUTCOME MEASURE: Skin self-examinations with and without access to the baseline photographs to identify the number of new and altered moles. RESULTS: The sensitivity and specificity of SSE for detection of both altered and new moles without photography were 60.2% and 96.2%, respectively. Skin self-examination with photography yielded a sensitivity and specificity of 72.4% and 98.4%, respectively. The findings were similar when stratified by site (back vs chest or abdomen). The sensitivity and specificity for new moles were higher compared with altered moles. CONCLUSIONS: Access to baseline photography improved the diagnostic accuracy of SSE on the back and chest or abdomen and improved detection of changing and new moles. Our results suggest that baseline digital photography in tandem with SSE may be effective in improving the diagnostic accuracy of patients performing SSE.

Adult↗
PubMed1998

Creating a digital video-based teaching file for interventional procedures using CT fluoroscopy.

A computerized radiology education teaching file application, MRW (Multimedia Radiology Workstation), was produced in our department as a collaboration of faculty, fellows and a doctoral student. This inexpensive and flexible system is novice-programmable and is capable of capturing images from multiple modalities (including still and cine image) and organizing them into individual electronic teaching cases. Help and tutorial functions support the main case display functions.

Computer-Assisted Instruction↗
PubMedDate not supplied

Cone-beam CT with flat-panel-detector digital angiography system: early experience in abdominal interventional procedures.

We developed a cone-beam computed tomography (CBCT) system equipped with a large flat-panel detector. Data obtained by 200 degree rotation imaging are reconstructed by means of CBCT to generate three-dimensional images. We report the use of CBCT angiography using CBCT in 10 patients with 8 liver malignancies and 2 hypersplenisms during abdominal interventional procedures. CBCT was very useful for interventional radiologists to confirm a perfusion area of the artery catheter wedged on CT by injection of contrast media through the catheter tip, although the image quality was slightly degraded, scoring as 2.60 on average by streak artifacts. CBCT is space-saving because it does not require a CT system with a gantry, and it is also time-saving because it does not require the transfer of patients.

Aged↗
PubMed2002

Is digital subtraction flouroscopy a useful tool for the interventional pain physician?

Most interventional pain physicians are experts in the use of fluoroscopy and understand its importance in improving the safety, accuracy and efficacy of diagnostic and therapeutic procedures. The addition of digital subtraction may enhance the utility of radiography and improve the accuracy of our interpretations. This article illustrates the use of the technique in several patients. The utility of this enhanced technique in clinical versus research application remains to be determined.

Journal Article↗
PubMed1996

Prevention of neuroma in elective digital amputations by utilization of neurovascular island flap.

Following hand surgery, painful neuromas may impair the quality of the functional result. In planned, elective digital amputation, neuroma formation is quasi-unavoidable because the nerve is cut. Several techniques have been proposed to prevent the formation of neuroma but, in our opinion, the only logical way to avoid it, is not to cut the nerve. For this purpose, we proposed, in cases of planned, elective digital amputation, an intervention inspired by the technique described by Littler in 1956. This technique consists of isolating as an island, the pulp of the amputated finger while preserving nerve continuity of both collateral pedicles. Once the amputation is completed, in cases of distal amputation, the pulp flap is used to cover the proximal stump and, in cases of ray amputation, the nerve loop is buried after its deepithelialization between the adjacent metacarpals. Since 1990, this technique has been used for nine-planned, elective amputations in eight patients. Postoperatively, no patient has developed painful neuroma except one patient who had a painful finger preoperatively and in whom the symptoms remained unchanged postoperatively. This simple technique must be part of the therapeutic armamentarium of planned, elective digital amputations in cases with intact collateral nerves.

Amputation, Surgical↗
PubMed1998

Diagnostic value of spiral-CT angiography in comparison with digital subtraction angiography before and after peripheral vascular intervention.

To evaluate spiral-computed tomography (CT) angiography in primary diagnosis and/or in noninvasive follow-up after vascular intervention, we compared spiral-CT angiography and conventional angiography before and after vascular intervention. Helical-CT examinations before and after percutaneous transluminal angioplasty (PTA) or stent implantation were performed in 10 patients (mean age 63 years) with symptomatic peripheral arteriosclerotic disease. Stenoses were located in the iliac, femoral, or popliteal artery. CT examinations were done with a spiral-CT in double detector technique (CT Twin, Elscint). The parameters were as follows: slice thickness: 5.5 mm, increment: 2.7 mm, pitch: 1.5, contrast medium: 150 mL, flow rate: 2.5 mL/second, delay: 30 seconds. For evaluation, transverse planes as well as maximum intensity projections and 3-D reconstructions were used. The possible scan length reached from the aortic bifurcation down to about 10 cm below the ankle trifurcation. Preinterventional digital subtraction angiography (DSA) was superior to CT angiography (CTA: 94%, maximum intensity projection [MIP] alone: 65%), although high-grade stenoses were detected by both methods. After intervention, a resolved stenosis and improved peripheral flow could be detected by helical-CT as well as by intraarterial angiography in every patient (100%). In the primary diagnosis of vascular changes, intraarterial DSA remains the method of choice. Nevertheless, spiral-CT angiography shows comparable results after percutaneous intervention and becomes a noninvasive alternative in the postinterventional follow-up.

Angiography↗