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At least 163 records · Page 9Linked to original sources
PubMed1996

Clinical application of region-of-interest techniques to radiologic imaging.

In region-of-interest (ROI) imaging, a filter with a central aperture is used to substantially reduce patient dose outside of an ROI while maintaining or improving image quality within the ROI. The benefits of ROI imaging can be realized by using standard imaging equipment. ROI imaging has been clinically applied to gastrointestinal radiology and interventional procedures. In gastrointestinal procedures, ROI fluoroscopy without image processing can be used without adversely affecting the procedure or interfering with spot radiography. ROI fluoroscopy can reduce the dose-area product by a factor of 1.7 for gastrointestinal procedures. In interventional neuroradiologic procedures, equalized display brightness is achieved with road mapping during fluoroscopy and with standard digital subtraction techniques during angiography. In interventional radiology, ROI filters can generally reduce the patient skin dose to levels below the threshold for skin effects, thus eliminating these effects across more than 85% of the field of view.

Central Nervous System↗
PubMed1985

Computer analysis of the optic cup in glaucoma.

This paper describes two complementary methods for computer analysis of the optic disc in glaucoma. The objective of both techniques is to detect and monitor changes in the optic disc through the use of digital image processing techniques that allow user intervention. In the first method, optic disc photographs from successive years are digitized, scaled and registered (aligned) with each other, and are then displayed in rapid sequence on a television monitor. Changes in the optic cup thus appear as localized movement on the display, while stable regions of the optic cup appear stationary. Both monocular and stereo photographs can be processed by this technique. In the second method, stereo optic disc photographs are digitized and processed by a new, robust, photogrammetric computer algorithm that quantifies optic cup depth information. Together, these two techniques may be valuable for both clinical and research purposes in the detection and monitoring of glaucomatous optic cupping.

Computers↗
PubMedDate not supplied

Impact of an HMO-based intervention to increase mammography utilization.

A health maintenance organization (HMO)-based program designed to increase breast cancer screening was evaluated, focusing on changes in mammography utilization. The program consisted of a multistage intervention aimed at women members and primary care physicians of the HMO. This report examines the effect of the intervention on mammography utilization. The program was evaluated using a quasiexperimental design in which a random sample of women aged 50-74 from the HMO (intervention) was compared to a similarly aged geographic control group selected through random digit dialing. From 1988 to 1990, 450 intervention women and 450 control women were sampled (without replacement) each year and surveyed about breast cancer screening practices and related knowledge. A clear increase in self-reported mammography utilization was associated with the intervention. The percentage of women who reported a mammogram in the 12 months prior to the survey increased from 41% in 1988 (baseline) to 68% in 1990 among HMO women, compared to a change from 39% to 49% among control women. Comparing postintervention rates of mammography in HMO versus control women yielded a rate ratio (RR) of 1.4. However, this effect was strongly modified by income and race. Women with annual incomes of $31,000 or more showed little (whites, RR = 1.2) or no (blacks, RR = 1.0) effect of the intervention. Among women with incomes less than $31,000, the effect among whites (RR = 1.9) was much stronger than among blacks (RR = 1.2).

Black or African American↗
PubMed2026

Psychological interventions to improve maternal mental health and resilience during pregnancy in the COVID-19 pandemic: a systematic review.

BACKGROUND: During the COVID-19 pandemic, pregnant women experienced increased psychological distress, while access to routine mental health care was often disrupted. Psychological interventions may provide an effective strategy to support maternal mental health under these circumstances. OBJECTIVE: This systematic review aimed to provide an overview of psychological interventions for pregnant women during the COVID-19 pandemic and to evaluate their effectiveness in reducing distress and enhancing resilience. METHODS: A systematic search of four databases was conducted up to 3 September 2025. Randomised and non-randomised studies evaluating psychological interventions during pregnancy were included. RESULTS: Sixteen studies met the inclusion criteria. Interventions included cognitive behavioural therapy, mindfulness-based interventions, psychoeducation, and other psychological approaches delivered through individual, group, digital, or hybrid formats. Most studies reported reductions in depression, anxiety, or stress, and some found improvements in resilience-related factors. However, the methodological quality was modest; with heterogeneous outcome measures and limited follow-up. CONCLUSIONS: Overall, psychological interventions adapted for digital or hybrid delivery show promise for improving maternal emotional well-being in times of crises. The findings suggest that accessible and scalable psychological interventions may support maternal mental health during crisis situations when routine care is disrupted. Future research should prioritize larger, methodologically rigorous trials with standardized outcomes, and longer follow-up periods.

Humans↗
PubMed2002

Image quality evaluation of flat panel and image intensifier digital magnification in x-ray fluoroscopy.

Interventional devices used in radiology often have dimensions on the order of a pixel, and radiologists resort to image magnification to better visualize such small devices. Traditional image intensifier (II) systems use analog magnification with x-ray exposure inversely proportional to the area of field of view (FOV) so as to maintain light output for the camera. Analog magnification is impossible with flat panel (FP) detectors, and images must be magnified using digital interpolation that does not reduce the pixel partial area effect for small devices. We quantitatively investigated image quality of digital and analog magnification using a clinically relevant task of detecting a partially deployed stent in x-ray fluoroscopy image sequences that were created using realistic detector models. Using the standard exposure strategy for II analog magnification, exposure was increased from a nominal 43.65 nGy (5.0 microR) per frame at 23 cm FOV to 79.9 nGy (9.15 microR) per frame and 117.81 nGy (13.49 microR) per frame at 17 cm and 14 cm FOV, respectively. Contrast sensitivity improved significantly (p<0.1) by 43.5+/-6.5% and 64.1+/-7.3% with the 17 cm and 14 cm FOV, respectively. Exposure for digitally magnified images was varied in an adaptive forced choice experiment so as to match performance with II analog magnification. For digital magnification, bilinear interpolation was used to give magnified stents sizes equivalent to those in the analog magnified images. For equivalent image quality, FP required 34.87+/-2.59, 80.16+/-5.37, and 84.08+/-5.59 nGy per frame at normal, and the two magnification modes, respectively. Hence, FP with digital magnification gives significant (p<0.1) dose savings of 20+/-6% and 27+/-5% at the normal and highest magnification modes, respectively. Digitally magnified II images required exposures of 110.85+/-8.07 and 103.34+/-5.90 nGy per frame for the two magnifications levels, respectively, giving no significant (p>0.1) dose savings. A spatiotemporal human observer model based on signal detection theory successfully predicted the human data and was used to predict other conditions associated with image magnification. Model predictions quantitatively showed that magnification is most useful when signal size is relatively small and that FP digital magnification can improve image quality for the stent deployment task without increasing exposure. In conclusion, the results show that FP digital magnification can be useful and dose efficient as compared to analog magnification.

Humans↗
PubMed2000

Radiology at the turn of the millennium.

Herein, the authors (a) review the status of the specialty; (b) report and analyze the various areas in which progress has occurred, namely, conventional radiology and picture archiving and communication systems (or PACS), ultrasonography, computed tomography, magnetic resonance imaging, interventional radiology, and nuclear medicine; and (c) discuss the problems radiology faces as it enters the new millennium. The problems are those facing medicine as a whole, as well as those threatening the future of radiology. These include the following: Will there be a need for radiologists in the future? Will radiology be too costly to be affordable? How can turf wars and fragmentation be solved? Possible remedies are suggested. Positive aspects are discussed in the light of the challenge to demonstrate value. Medical imaging is entering the new millennium with a solid record of recent advances in digital, cross-sectional, and interventional radiology. These advances have made the specialty indispensable in the treatment of patients. Careful statesmanship will be needed to solve the many problems that face medicine as a whole and radiology in particular.

Diagnostic Imaging↗
PubMed2026

USleep: efficacy of app-based audio interventions to improve sleep disturbance in working adults, a multi-arm randomized controlled trial.

STUDY OBJECTIVES: To evaluate the efficacy of three categories of standalone, audio-based sleep interventions (Bedtime Stories, Sleep Sounds, Sleep Skills) delivered via mental health application (MHapp) in improving sleep among working adults with sleep disturbance. METHODS: A multi-arm, parallel randomized controlled trial was conducted. Adults with self-reported sleep disturbances were recruited online and randomly allocated to Bedtime Stories, Sleep Sounds, Sleep Skills, or digital control. Participants completed self-report questionnaires on sleep disturbance and other related outcomes at baseline (t0) and after the 4-week intervention (t1). The primary analysis followed an intention-to-treat approach using mixed-effects models. RESULTS: A total of 495 working adults (mean age&#x2009;=&#x2009;32.7&#xa0;years; 55.8% female) were randomized. For sleep disturbance (primary outcome), the between-group Hedges' g effect sizes were very small and not statistically significant (Bedtimes stories vs. control: g&#x2009;=&#x2009;0.12, 95% CI -0.13 to 0.37, Sleep Sounds vs. control: g&#x2009;=&#x2009;0.14, 95% CI -0.11 to 0.39, Sleep Skills 0.07, 95% CI -0.07 to 0.29), with slightly greater reductions in sleep disturbance for the intervention groups than control. The same pattern was observed for sleep-related impairment, mental health, well-being, and pre-sleep arousal. CONCLUSION: Audio-based sleep interventions delivered via a MHapp did not demonstrate superior efficacy over a digital control condition in reducing self-reported sleep disturbance among working adults. Although safe and well-tolerated, their use as standalone treatments for sleep disturbance is not supported by these findings. Future research should explore effectiveness in real-world settings, including user content choice across categories, and use objective sleep measures. CLINICAL TRIAL REGISTRATION: Registered at https://www.isrctn.com/ under "Evaluating the efficacy of audio-based digital tools to improve sleep on the Unmind workplace well-being platform"; https://www.isrctn.com/ISRCTN13426045; registration number: 13426045.

Humans↗
PubMed1991

An evaluation of pulse oximetry in prehospital care.

STUDY OBJECTIVES: We performed this study to evaluate the accuracy of pulse oximetry oxygen saturation (SpO2) against direct measurements of arterial oxygen saturation (SaO2) in the field. DESIGN: Prospective, cross-sectional, paired measurements of SpO2 against SaO2. SETTING: This evaluation was done in the prehospital setting. INTERVENTIONS: A pulse oximeter with digital probe was used to measure SpO2 in 30 patients. Arterial blood gases were drawn in the field while the pulse oximeter was in use, and oxygen saturation (HbO2) was measured by CO-oximetry. MAIN RESULTS: There was no significant difference between SpO2 (94.6 +/- 5.4%) and HbO2 (94.9 +/- 5.1%) (P = .495, beta less than .2). There was a strong correlation between SpO2 and HbO2 (r = .898). The bias between SpO2 and HbO2 was -0.3, with a precision of 2.4. When SpO2 was 88% or more, HbO2 was 90% or more in every case. Mean carboxyhemoglobin was 1.3 +/- 0.9%, and mean methemoglobin was 0.9 +/- 0.3%. There was no significant difference between the pulse oximeter heart rate and the ECG heart rate (P = .223, beta less than .2). CONCLUSION: We conclude that pulse oximetry is sufficiently accurate to be useful in the field when SpO2 is more than 88%. It is potentially useful in patients with clinical signs of acute hypoxemia and in patients receiving interventions that may produce acute hypoxemia. Further work is needed to evaluate the accuracy of pulse oximetry in the settings of elevated carboxyhemoglobin, methemoglobin, and very low saturations.

Aged↗
PubMed1993

Revascularization of an ischemic replanted thumb using a lateral arm free fascial flap.

Digital ischemia and cold sensitivity after replantation are common. Occasionally they are severe enough to warrant intervention, including amputation of an otherwise functional digit. We present a patient with pregangrenous ischemia in a replanted thumb 10 years after multiple digit replantation. Angiography revealed vascular occlusion in the distal radial artery with no patent vessel in the thumb. The option of transposition of a spare neurovascular bundle from the adjacent radial digits was limited by their single-vessel supply resulting from previous replantation. We describe a method of revascularization by introduction of an arteriovenous pedicle, using a free fascial flap harvested from the lateral arm and based on terminal ramifications of the profunda brachii vessels. The flap was buried between the pulp and flexor tendon sheath and anastomosed to the radial artery and a wrist vein. This resulted in successful revascularization of the digit, clinically and radiologically, and 20 months later, the patient remains symptom free.

Adult↗
PubMed2006

PDA-assisted low glycemic index dietary intervention for type II diabetes: a pilot study.

BACKGROUND: Epidemiological and dietary intervention studies suggest that a low-glycemic index (GI) diet is beneficial for blood glucose control; however, long-term clinical utility of the low GI diet has not been fully investigated. OBJECTIVES: To evaluate the feasibility and efficacy of a nutritionist-delivered low-GI dietary intervention, with the support of a personal digital assistant (PDA), for adult patients with poorly controlled type II diabetes. METHOD: The low-GI intervention consisted of six counseling sessions and the use of a PDA-based food database with GI scores for 6 months. Study outcomes included feasibility measures, glycosylated hemoglobin levels (HbA1c), GI and glycemic load (GL) score of self-reported dietary intake, body weight, depression and quality of life (QOL). Measures were obtained at baseline, 3 and 6 months. RESULTS: Of 31 adult patients approached, 15 met study eligibility criteria and were enrolled in the study. Thirteen patients (87%) completed all study assessments. Findings included decreases in average HbA1c (-0.5% P = 0.02), body weight, hip circumference, blood pressure, dietary GI and daily caloric intake. Diabetes impact scores also decreased. All but one participant completed all components of the intervention. There were mixed reports regarding the usefulness of the PDAs; however, participants offered helpful suggestions for further development. CONCLUSIONS: Results of this pilot study support the feasibility of implementing a nutritionist-delivered, PDA-assisted low-GI dietary intervention for patients with poorly controlled type II diabetes. Encouraging initial efficacy data require further testing in the context of a randomized clinical trial.

Adult↗
PubMed2004

Juvenile colorectal polyps in children: experience in Pakistan.

Juvenile colorectal polyps are the most common cause of pediatric hematochezia and contribute to significant morbidity if not treated early. This report describes an experience with juvenile colorectal polyps in children (< or =14 years) from Pakistan. In a 3-year period, 154 polyps were documented in 129 children. The mean age at presentation was 5.2 years, with a male predominance. Most children presented with painless rectal bleeding (+/-13 months) associated with other symptoms, such as protrusion of a mass through the anus, diarrhea, and recurrent abdominal pain. Anemia was observed in 54 children, of whom 14 (26%) required blood transfusion before intervention. Diagnosis was made by digital rectal examination, proctosigmoidoscopy, and barium enema. The average distance of a colorectal polyp was 4 cm from the anal verge. In 108 (84%) children the polyps were solitary, whereas 21 patients had more than one polyp (maximum three) at different locations in the rectosigmoid area. All polyps were successfully removed by proctosigmoidoscopy. Histological examination revealed dysplastic changes in one case, while the rest were inflammatory. Recurrence occurred in seven children within 1 year of initial removal. Juvenile colorectal polyps contribute to a substantial morbidity in children and do carry a minimal risk of developing dysplastic changes, and therefore should be removed early.

Child, Preschool↗
PubMed2004

Automated EEG-sleep analyses and neonatal neurointensive care.

Clinical applications of neonatal EEG-sleep studies can improve neurointensive care for preterm and fullterm infants. Behavioral and physiologic assessments of neonatal sleep by nursing and physician personnel can result in more developmentally appropriate state regulation for infants, particularly for those who require medical care for many weeks to months in the intensive care unit. Secondly, prediction of altered expressions of EEG-sleep patterns for those children at higher risk for neurological sequelae can anticipate the need for aggressive interventional strategies. The application of digital analyses of specific cerebral and noncerebral physiologic measures for long-term monitoring periods can utilize efficient and novel strategies of automated EEG and sleep state identification which can also assist in daily medical care and prediction of neurodevelopmental outcome.

Brain Diseases↗
PubMed2026

Journey Mapping of the Patient Experience from Diagnosis to End of Life in Lung Cancer: A Qualitative Meta-Synthesis.

OBJECTIVES: This study aimed to systematically synthesize the lived experiences and journey narratives of lung cancer patients across disease stages, and identify key tasks and pain points during the disease course through patient journey mapping, providing evidence for comprehensive disease management throughout the patient journey. METHODS: Ten databases, including PubMed, Embase, Web of Science, Scopus, PsycINFO, CINAHL, Cochrane Library, CNKI, Wanfang, and SinoMed, were systematically searched, with a search period from database inception to August 15, 2025. The JBI Critical Appraisal Tool for qualitative studies was used to evaluate the quality of studies, and the results were integrated using a meta-aggregative approach. RESULTS: Thirteen studies were included. Based on the patient journey mapping, the lung cancer patient journey comprises four potential stages: evaluation and diagnosis, initial treatment, maintenance therapy, and end-of-life. A total of 30 themes emerged within three dimensions: tasks, emotions, and pain points. Each dimension of each stage consists of 2-3 themes. CONCLUSION: The journey of lung cancer patients is protracted and complex, characterized by stage-specific needs and challenges. Future management strategies should be tailored to these distinct phases, providing precision supportive care to optimize treatment outcomes and enhance patients' quality of life. IMPLICATIONS FOR NURSING PRACTICE: This Patient Journey Map integrates routine clinical pathways with patients' lived experiences across each stage, revealing stage-specific challenges and providing targets for tailored nursing interventions. The framework promotes multidisciplinary, digitally enabled supportive care and indicates the importance of including patients' social circles to enhance patient-centered outcomes.

Humans↗
PubMedDate not supplied

[Radiology, research and the future].

This subjective and polemic review of radiology reports and analyzes the status of the field today and discusses some of the positive aspects and some of the problems in routine imaging and in research, in both an individual/academic and an academic/commercial context. Topics approached include the position of radiology in medicine as a whole today; turf wars between radiologists and other disciplines despite the lack of radiologists; the position of non-radiologists in medical imaging and imaging research; the marginalization of radiologists in research; and the question whether radiologists will be needed in the future. Additional aspects are: How can recent advances in digital, cross-sectional, and interventional radiology be turned into real advantages for patient treatment and how should outcomes research influence imaging research? Who should enter imaging research, what is to be expected by and from researchers, and which major themes are promising in the future?

Biomedical Research↗
PubMed2002

Attention and the stages of pain processing.

OBJECTIVE: Explore the relationships between the four stages of pain processing and attention in chronic pain sufferers. DESIGN: A cross-sectional, retrospective study of 736 subjects participating in an outpatient university-based tertiary care pain treatment program. METHODS: Self-report measures of pain, pain-related unpleasantness, and suffering (Pain Experience Visual Analog Scales) in conjunction with a structured interview assessing illness behavior (adaptation of the Psychosocial Pain Inventory) and attention (Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised) were employed. OUTCOME MEASURES: Separate step-wise multiple regression analyses were conducted using variables that measure each of the four stages of pain processing as predictors, with Digit Span being the criterion variable. RESULTS: Multiple regression analyses showed that, of the four pain stages, only suffering and pain behavior were related to attentional performance. Specifically, an individual's perception of lifestyle interference due to pain, level of depression, and the degree of solicitous responses from others each uniquely contributed to Digit Span performance. CONCLUSIONS: Treatment interventions specifically targeting suffering and pain behavior may prove efficacious in addressing the attentional problems in chronic pain.

Journal Article↗
PubMed2001

[Navigation systems for image-guided therapy: A review].

Navigation systems for image-guided therapy: A review. Navigation is visually interactive targeting based on the simultaneous display of instrument position and of the corresponding two- or three-dimensional image data sets. In this way it unifies anatomic information and therapeutic action. Medical navigation systems (MNS) can simulate realtime image guidance and thereby reduce radiation exposure as well as provide the full range of digital image processing during an intervention. Navigation is based on the tracking of medical instruments in space and the transformation of image, patient, and instrument coordinates into a common reference system. If the patient coordinate system is used as the common base, the process is called patient-based navigation (PBN). If, however, the imaging modality is present in the interventional suite and its reference system is used, modality-based navigation (MBN) results. MBN does not need pre-interventional registration and inherently provides intra-operative imaging. In neurosurgery MNS's have been well established since years. They are in use for frameless biopsies and for minimizing the access morbidity in deeply situated pathologies. Currently there is a fast expansion of navigation into other surgical disciplines, e.g., orthopaedic surgery. The clinical accuracy of an MNS is hard to determine since an independent method of measurement is mostly not available during surgery. Normally, a deviation of below one up to about 5 mm between the display of the MNS and the actual position of an anatomic structure is reported. So far there have been only very few prospective randomized clinical trials between conventional and navigated interventions.

Forecasting↗