PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Digital intervention”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources
PubMed1998

Video-assisted thoracic surgery through a single skin incision.

OBJECTIVE: To develop a minimally invasive video-assisted thoracic surgery technique. DESIGN: Case series. SETTING: University referral center. PATIENTS: Six consecutive patients with a pneumothorax who underwent video-assisted thoracic surgery through a single skin incision. INTERVENTIONS: A flexible digital bronchoscope was placed in a scope guide. A single 2.0-cm skin incision was made in the midaxillary line. The entire lung was carefully explored. An endoscopic stapling device was then inserted, and the lung resection was performed through a single skin incision. PRIMARY OUTCOME MEASURES: Operative time, estimated amount of blood loss, operative complications, and postoperative air leakage were recorded. RESULTS: The video-assisted thoracic surgery procedure through a single incision was successful in all 6 patients. There were no associated complications at 1-year follow-up. CONCLUSIONS: We were able to perform the video-assisted thoracic surgery procedure through a single skin incision using a scope guide and a flexible scope that enables visualization of the entire pleural cavity, providing even laser ablation. This new technique can be used to treat patients with pneumothoraces without the need for additional skin incisions.

Adult↗
PubMed2002

Reflex sympathetic dystrophy of the left hand and motor impairments of the unaffected right hand: impaired central motor processing?

OBJECTIVE: To test whether central motor processing can be impaired in chronic reflex sympathetic dystrophy (RSD). DESIGN: Experimental 2-group analysis. SETTING: Tertiary care center in the Netherlands. PARTICIPANTS: Five patients with stage 3 RSD of the left forearm, free of symptoms and complaints in the right forearm; and 10 healthy control subjects. INTERVENTION: On a digitizer, RSD patients and controls had to draw 3 sequences of graphemes of different complexity with their (unaffected) dominant right hand. The drawing tracks were segmented in time periods between points of velocity minima of the pen tip. MAIN OUTCOME MEASURES: Mean velocity, coefficients of variation of both length and movement time per segment, and mean intersegmental pausing time were calculated for each sequence. RESULTS: A repeated-measures analysis of variance by using the multivariate method yielded a 35% lower mean velocity (F(1,13) = 5.83, P =.031), a 110% larger segment length variability (F(1,13) = 9.72, P =.008) and a 60% larger variability of movement time per segment (F(1,13) = 5.78, P =.032) in RSD patients. No group difference was found for intersegmental pausing time or any interaction effect with the type of task. CONCLUSION: Patients with chronic RSD have a normal ability to preprogram sequential movements of their unaffected hand; but with impaired temporospatial coding and movement execution. We concluded that cortical mechanisms may be involved in motor impairments in patients with chronic RSD.

Adult↗
PubMed2001

Dose displays and record keeping.

In digital diagnostic and interventional radiology, patient dosimetry is essential. When considering the display requirements for interventionalists it is necessary to consider the basis for their information needs. An interventionalist must be made aware of the potential for deterministic and non-deterministic effects. Thus a display is required which provides an indication of whether skin effects are likely and this predicates a display of maximum estimated skin entrance dose. For non-deterministic effects, a display of dose-area product is useful. Unfortunately, neither display is generally available to the interventionalist, so inevitably they will remain in the dark about the potential radiological consequences of the procedure. Given the need to follow up patients, who may receive a high dose, it is important that the patient notes contain relevant dosimetry data. One way of achieving this in the future would be to link electronically the patient dosimetry device to the patient record in the Radiological Information System. This dictates a need to develop patient dosimetry record minimum dataset and equipment connectivity standards.

Data Display↗
PubMed1995

The use of magnetic resonance angiography in stereotactic neurosurgery.

The authors discuss the advantages and disadvantages of the use of magnetic resonance (MR) angiography images in stereotactic neurosurgery. Current computer programs designed to assist the neurosurgeon in the planning of stereotactic neurosurgical interventions use intraarterial digital subtraction angiography images to visualize the blood vessels. Magnetic resonance angiography is a recent technique with a number of advantages over the digital subtraction method: it is less invasive and less prone to complications; it provides truly three-dimensional data sets that can be viewed from any direction; and it can visualize both stationary and flowing tissues with the same imaging device and localizer frame. Although digital subtraction images are still superior in contrast and vascular detail, state-of-the-art high-resolution MR angiography sequences provide sufficient vascular detail for planning surgery. Contrast-enhanced MR angiography images were acquired using adapted gradient-echo sequences to compensate for flow-induced distortions; postacquisition distortion correction was not necessary. Five methods to integrate and inspect a possible trajectory in the MR angiography data are discussed. Initial clinical experience with eight patients led to the conclusion that MR angiography is a valuable imaging modality that can be integrated reliably into a stereotactic neurosurgery planning procedure.

Adult↗
PubMed1998

Pancreatic tumor: DSA diagnosis and treatment.

AIM:To study the clinical significance of the diagnosis and catheterized interventional treatment of digital subtraction angiography (DSA) for pancreatic tumors.METHODS: Ninety-two patients with pancreatic tumor, 69 males and 23 females, aged from 41 to 70 years (mean 57.1 years) were diagnosed with DSA. Sixty-one patients with pancreatic cancer were treated with transcatheter celiac and superior mesenteric arterial anticancer agents (MMC 20mg, EADM 40mg and 5-FU 2.0g) infusion (TCSAI).RESULTS: The DSA diagnoses were confirmed by operations and pathological examinations, with a coincidence 82.6% rate of, and a therapeutic effective rate of 42.6%.CONCLUSION: DSA is of diagnostic value for pancreatic tumors, and helpful in understanding the course of the disease, judging the prognosis and selecting the therapeutic regimen, and could improve the chemotherapeutic effect as well.

Journal Article↗
PubMedDate not supplied

Total body MR angiography and atherosclerosis.

The early detection of atherosclerotic vascular lesions is very important for diagnostic and interventional purposes. Traditionally, Digital Subtraction Angiography (DSA) is considered the reference diagnostic technique, but recently several new non-invasive procedures have been developed, like Doppler US, CT-angiography and MR-Angiography (MRA). MRA has progressively gained acceptance as a valid alternative. At present, the use of fast sequence and contrast injection allows to acquire segmental volumes within a few seconds (10-20s), with high diagnostic quality and accuracy. The systemic distribution of atherosclerosis requires the use of techniques which can assess the arterial system as exhaustively as possible. A MRA scanning protocol including all arteries from the epiaortic branches to the calf has recently been proposed with encouraging preliminary results. In this article, the relevant technical concepts in MRA and the present most important clinical findings are reported and discussed, including the proposed technique for a whole-body MR angiographic assessment of the atherosclerotic patient.

Arteriosclerosis↗
PubMed1997

Segmentation of acoustic neuromas with magnetic resonance imaging and Eigen image filtering.

OBJECTIVE: This study aimed to determine whether magnetic resonance imaging with Eigen image filtering can segment acoustic neuromas as a preliminary requirement to the development and validation of a volumetric method of measuring tumor size and growth using Eigen image filtering. STUDY DESIGN: This was an observational study. SETTING: The study was performed in an academic, comprehensive multi-specialty group practice. PATIENTS: Patients were a convenience sample of adults of both sexes who had acoustic neuromas identified by magnetic resonance imaging. Tumors ranged widely in size. INTERVENTION: Magnetic resonance imaging with digital image analysis using Eigen image filtering was the intervention. MAIN OUTCOME MEASURE: Observation and analysis of magnetic resonance images was the main outcome measure. RESULTS: The ability of magnetic resonance imaging with Eigen image filtering to segment acoustic neuromas of various sizes and shapes is illustrated. CONCLUSIONS: Magnetic resonance imaging with digital image analysis using Eigen image filtering is a promising method for volumetric measurement of acoustic neuroma size and growth. The potential for acoustic neuromas to grow may be underestimated by linear methods because of their relative lack of precision and of the geometric error that occurs in representing the volumetric growth of a three-dimensional tumor as a linear diameter.

Adult↗
PubMed1992

[Combined use of real-time digital subtraction radioscopy and computerized tomography: potential advantages in diagnostic and interventional radiology].

The idea of combining fluoroscopy and CT arose from the daily practice in diagnostic and interventional radiology. A Diasonics OEC high-performance image intensifier complete with a digital subtraction system was connected to a Siemens Somatom-DRH CT scanner to work in tandem. CT is used for a localization in-depth and fluoroscopy for the subsequent maneuvers within an organ or body compartment. With this combination, complex procedures such as transarterial portography, percutaneous embolizations, pain treatment and manipulation for catheterization of the bile ducts and urinary tract could be performed in one place and in one session. CTF is especially useful when patients should not be moved about from room to room or undergo an examination in several sessions, as it happens with children or critically ill or contagious patients.

Adult↗
PubMed1996

On-site digital quantitative coronary angiography: comparison with visual readings in interventional procedures. Implications for decision and quality control.

In order to review the morphological criterion for an interventional procedure, diameter stenosis (%DS) of 226 coronary lesions in 200 patients undergoing elective coronary angiography with an option for 'prima vista' angioplasty (pPTCA), was assessed on-site by both visual 'eye balling' (EB) and independent digital quantitative coronary angiography (DQCA) by means of an angiographic workstation. Compared to DQCA, EB overestimated the %DS between 50 and 80% and accounted for the majority of discrepancies with overestimation up to 45%. Concordant estimates of %DS by both methods were observed in only 10 of the total of 226 stenotic segments; in 20 of 226 cases, EB underestimated %DS up to 20%. EB revealed a %DS > or = 60% in 166 stenoses (73.4%), an estimate that led to subsequent pPTCA. However, only 119 (52.6%) of these lesions had a %DS > or = 60% as assessed objectively by DQCA. With regard to the criterion for PTCA 47 of 166 performed pPTCA (28.3%) would not meet the indication criteria based on objective DQCA information. EB and DQCA (+/-5%DS) had concordant results and criteria for pPTCA only in 103 of 166 coronary lesions (62.1%). These results lead to the conclusion that, on-site and on-line DQCA by an independent cardiologist eliminates both under- and overestimation of stenoses as seen with EB. DQCA supports immediate decision-making and appears necessary for reliable evaluation of coronary morphology in an interventional catheterization laboratory setting and may eventually ensure intraprocedural quality control.

Aged↗
PubMedDate not supplied

Surgical treatment of congenital syndactyly of the hand.

Syndactyly is a congenital anomaly of the hand that is more common in males, is present bilaterally in 50% of affected patients, and often is associated with other musculoskeletal malformations or systemic syndromes. The goal of syndactyly release is to create a functional hand with the fewest surgical procedures while minimizing complications. For simple syndactyly, surgical reconstruction can begin at approximately 6 months, although many surgeons prefer to wait until the infant is 18 months old. Special situations, such as complex syndactyly and involvement of border digits, may warrant surgical intervention earlier than 6 months. Reconstruction of the web commissure is the most technically challenging part of the operation, followed by separation of the remaining digits. Full-thickness skin grafting is almost always required for soft-tissue coverage. Complex syndactyly and syndactyly associated with other hand anomalies warrant special consideration. After reconstruction, patients should be examined periodically until they have achieved skeletal maturity because late complications such as web creep can occur.

Hand Deformities, Congenital↗
PubMedDate not supplied

Multi-site interventional real-time procedure demonstrations with the use of integrated services digital network connections.

PURPOSE: To evaluate the effectiveness and cost of commercially available video conferencing units and standard Integrated Services Digital Network (ISDN) connections for real-time multi-site transmissions of interventional procedures. METHODS: A network of five separate interventional radiology departments-three in the Czech Republic and one each in Austria and the USA-was established using Polyspan (Polycom in the USA) View Stations and ISDN connections. This network was used for transmissions of 16 live interventional procedures to the Sixth International Workshop on Interventional Radiology in Prague, Czech Republic in June 2000. RESULTS: The transmissions were successful and of sufficient quality to contribute to the educational success of the workshop. The cost of the ISDN transmissions was a fraction of satellite transmission costs. CONCLUSION: Multi-site real-time interventional procedure transmissions using video conferencing Polyspan (Polycom) View Stations and ISDN connections are a promising means of improving interventional tele-education and decreasing its cost.

Austria↗
PubMed2001

Digital camera documentation system for facial nerve outcome assessment.

OBJECTIVE: To describe the use of a digital camera to document facial nerve function after skull base surgery. SETTING: Patients undergoing skull base surgery at a tertiary care otologic and neurotologic clinic were used in the study. INTERVENTIONS: None. RESULTS: A digital camera system provided still images and a video strip lasting less than a minute to document facial nerve motion. CONCLUSIONS: An inexpensive digital camera system can be used to capture still and moving images of facial nerve function on a floppy disk. The images can then be transferred to compact disks for storage of many patient files. Such a system allows documentation for research, exchange of data between offices, and patient education, and it can be used for medical-legal purposes among other uses.

Documentation↗
PubMed2026

Multicenter randomized effectiveness/implementation trial of a digital self-management support tool to improve the quality of life during adjuvant hormonal therapy for patients with early breast cancer: The HOPE trial.

BACKGROUND: For patients with hormone receptor (HR) positive early breast cancer (BC), adjuvant endocrine therapy (ET) represents the cornerstone of treatment. However, 75% of patients experience ET-related symptoms that negatively affect their quality of life (QOL). Despite their high prevalence, these symptoms are often underestimated and under-addressed during consultations. As a result, non-adherence to ET is common and remains a major barrier for optimal disease and survival outcomes. METHODS: National, prospective, randomized, open-label hybrid type 1 effectiveness/implementation trial conducted in France comparing a personalized digital health pathway plus standard of care (SoC) vs. SoC alone in patients with HR+ early BC reporting ET-related symptoms. 180 patients will be randomized 1:1 to receive either 12 weeks of the digital health pathway or 12 weeks of SoC. The intervention is anchored by the Resilience© digital companion including remote symptom and needs assessment, an introductory nurse-navigator phone call, and access to personalized, symptom-specific online educational and self-management programs (physical activity, yoga, meditation or cognitive behavioral therapy). In both arms, patients will be invited to wear a wearable device to objectively monitor behavioral parameters. The primary endpoint is the ET symptoms scale of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR45 over 12-weeks. Secondary endpoints include other QOL domains, self-reported ET adherence, eHealth literacy, self-efficacy, and evaluation of the implementation process. DISCUSSION: This study should provide evidence on the effectiveness and real-world implementation of a personalized digital health pathway to improve QOL in patients experiencing ET-related symptoms. TRIAL REGISTRATION: ClinicalTrials.gov NCT06781996; Protocol version 3.0.

Humans↗
PubMed1998

Surgical treatment of carpal tunnel syndrome and trigger digits in children with mucopolysaccharide storage disorders.

The role of surgical intervention for carpal tunnel syndrome (CTS) and trigger digits in children with mucopolysaccharide storage disorders (MPSDs) has not been clearly defined, particularly as the treatment of the underlying disease has advanced to include bone marrow transplantation. This study reviews our experience in the treatment of CTS and trigger digits in 22 children with MPSDs who were evaluated for CTS by electromyographic (EMG)/nerve conduction velocity (NCV) testing. Seventeen children were diagnosed with CTS by EMG/NCV testing and were treated with bilateral open surgical release with or without flexor tenosynovectomy. The EMG/NCV testing revealed normal results in 5 patients who are subsequently being monitored. Forty-five digits in 8 children were diagnosed clinically with trigger digits. Nineteen digits were treated by annular pulley release alone. Twenty-six digits were treated by annular pulley release with partial flexor digitorum superficialis tendon resection. The average age at the time of hand surgery was 6.3 years, and at the time of follow-up, 9.6 years. Postoperative EMG/NCV testing in 7 children showed 1 with improvement and 6 with normalization. None of the patients undergoing carpal tunnel release went on to develop thenar atrophy or absent sensibility, as has been reported in untreated cases. Patients were evaluated for triggering digits both by preoperative tendon palpation and by intraoperative flexor tendon excursion at the time of open carpal tunnel release. All patients undergoing trigger release had improved active digital flexion seen at the final follow-up visit. Because of the very high incidence of CTS and trigger digits in this population, the authors currently recommend routine screening of EMG/NCV for all children with MPSDs. Early surgical intervention for nerve compression and stenosing flexor tenosynovitis can maximize hand function in these children.

Age Factors↗
PubMed1995

X-ray imaging using amorphous selenium: feasibility of a flat panel self-scanned detector for digital radiology.

We investigate a concept for making a large area, flat-panel detector for digital radiology. It employs an x-ray sensitive photoconductor to convert incident x-radiation to a charge image which is then electronically read out with a large area integrated circuit. The large area integrated circuit, also called an active matrix, consists of a two-dimensional array of thin film transistors (TFTs). The potential advantages of the flat-panel detector for digital radiography include: instantaneous digital radiographs without operator intervention; compact size approaching that of a screen-film cassette and thus compatibility with existing x-ray equipment; high quantum efficiency combined with high resolution. Its potential advantages over the x-ray image intensifier (XRII)/video systems for fluoroscopy include: compactness; geometric accuracy; high resolution, and absence of veiling glare. The feasibility of the detector for digital radiology was investigated using the properties of a particular photoconductor (amorphous selenium) and active matrix array (with cadmium selenide TFTs). The results showed that it can potentially satisfy the detector design requirements for radiography (e.g., chest radiography and mammography). For fluoroscopy, the images can be obtained in real-time but the detector is not quantum noise limited below the mean exposure rate typically used in fluoroscopy. Possible improvements in x-ray sensitivity and noise performance for the application in fluoroscopy are discussed.

Cobalt Radioisotopes↗
PubMed1990

[An experimental study on the pathogenesis of congenital hand malformation--with reference to local disturbance in the limb bud and congenital constriction band syndrome].

In order to study congenital constriction band syndrome, we performed local cauterization of the lower limb buds of embryos in fertilized white leghorn eggs between hour 0 on day 4 (day 4-0) and day 7-0 of incubation. Constriction bands, acrosyndactyly, and amputation of digits, malformations characteristic of this syndrome, were all induced by intervention after day 5-0, when digital ray formation was first observed, indicating that they all develop after ray formation. Histological examination showed that encapsulation and shedding of the lesion containing hematoma and necrotic tissue at the distal end of a digital ray led to digit amputation. When the cells encapsulating this lesion extend over another digital ray, moreover, the ray tips fuse, while the rest of the two digits involved remain discrete-resulting in acrosyndactyly.

Animals↗
PubMed2005

Magnetic resonance-guided percutaneous angioplasty of femoral and popliteal artery stenoses using real-time imaging and intra-arterial contrast-enhanced magnetic resonance angiography.

OBJECTIVE: The aim of this study was to demonstrate the possibility of performing magnetic resonance (MR)-guided interventional therapy for femoral and popliteal artery stenoses with commercially available materials supported by MR real-time imaging and intra-arterial MR angiography. MATERIALS AND METHODS: A total of 15 patients suffering from symptomatic arterial occlusive disease of the lower limbs with 19 stenoses were included. Interventional intra-arterial digital subtraction angiography was performed before and after angioplasty on each patient as standard of reference. MR images were acquired on a 1.5-T MR scanner. A fast-low-angle shot (FLASH) 3D sequence was applied for a contrast enhanced MR-angiography (ceMRA). A total of 5 mL of diluted gadodiamide was injected via the arterial access. Maximum intensity projections (MIPs) were used as roadmaps and localizers for the interactive positioning of a continuously running 2D-FLASH sequence with a temporal solution of 2 images/second. The lesion was crossed by a balloon-catheter, which was mounted on a guidewire. The visibility was provided by the radiopaque markers on the balloon and was improved by injection of 1 mL of gadolinium into the balloon. Postinterventional control was performed by intra-arterial MR angiography and catheter angiography. RESULTS: Stenoses were localized by intra-arterial MR angiography. The guidewire/balloon combination was visible, and the balloon was placed correctly to cover the entire stenoses. Balloon dilation reduced the degree of stenosis by approximately 57% on average. No complications were observed. CONCLUSION: MR-guided balloon dilation of femoral and popliteal artery stenoses supported by real-time MR imaging and intra-arterial MR angiography is feasible with commercially available materials.

Aged↗