Search results

This paper aims to summarize the radiological interventions that can be used by obstetricians and gynecologists.

E-health systems apply in all hospital sectors in the world; interventional radiology (IR) now includes transcatheter and percutaneous techniques that can be applied to various organ systems, including the female reproductive system and pelvis. Interventional radiologists can now offer many services to obstetricians and gynecologists. With the advent of new procedures and refinement of existing techniques, there are now a number of procedures that can be used to treat both vascular and non-vascular diseases. This review summarizes the radiological interventions that can be used by obstetricians and gynecologists.

This review is intended to help gynecologists and obstetricians understand the role of IR in their specialty. Many valuable vascular and nonvascular interventional services can be provided by radiologists for both obstetric and gynecological indications. Many of these IR procedures are minimally invasive with less risk to the patients.

IR is now being used to treat some conditions encountered in obstetrics and gynecology, in particular, uterine leiomyomas, placenta accreta, postpartum hemorrhage and pelvic congestion syndrome. Moreover, with the help of IR, radiologists can also manage several nonvascular pathologies, including drainage of pelvic abscesses, fallopian tube recanalization, image-guided biopsy and fluid collections involving ovarian lesions. The major challenges faced when performing obstetric IR procedures are reduction of radiation exposure for the patient and fetus and preservation of fertility. This review highlights the role of IR in the treatment of various vascular and nonvascular pathologies encountered in obstetrics and gynecology.

Predictive models implemented in medical procedures can potentially bring great benefit to patients and represent a step forward in targeted treatments based on a patient’s physiological condition. It is the purpose of this paper to outline such a model.

A multi-scale 0D-3D model based on patient specific geometry combines a 0-dimensional lumped parameter model (LPM) with a 3D computational fluid dynamics (CFD) analysis coupled in time, to obtain physiologically viable flow parameters.

A comparison of physiological data gathered from literature with flow-field measurements in this model shows the viability of this method in relation to potential predictions of pathological flows repercussions and candidate treatments.

A limitation of the model is the absence of compliance in the walls in the CFD fluid domain; however, compliance of the peripheral vasculature is accounted for by the LPM. Currently, an attempt is in progress to extend this multi-scale model to account for the fluid-structure interaction of the ventricular assist device vasculature and hemodynamics.

This work reports on a predictive pulsatile flow model that can be used to investigate surgical alternatives to reduce strokes in LVADs.

This scientific article aims to evaluate the efficacy of the drug Doxorubicin for treating hepatocellular carcinoma (HCC) in Egypt. The study analyzes data from patients referred to a multi-disciplinary consultation at the National Cancer Institute, Cairo University. The study includes 40 intermediate-stage HCC patients who underwent treatment with either Doxorubicin-Lipiodol or Doxorubicin-loaded drug-eluting beads-trans-arterial chemoembolization (DEB-TACE).

Patients referred to a multi-disciplinary consultation at the National Cancer Institute, Cairo University with a possible diagnosis of HCC in the intermediate stage were eligible for the study.

The study finds that the plasma peak concentration of Doxorubicin is significantly higher in patients treated with Lipiodol compared to those treated with DEB-TACE. The median plasma peak concentration of patients treated with Lipiodol was significantly higher 424 (202.5–731) than the peak level of patients treated with beads 84.95 (26.6–156.5) with p-value = 0.036. However, there is no significant difference in other pharmacokinetic parameters between the two treatment groups. The research article also investigates the genetic polymorphisms in HCC patients treated with Doxorubicin-Lipiodol and Doxorubicin-loaded DEB-TACE. It identifies a significant association between the ABCB1 gene (C3435T) and the concentration of Doxorubicin in plasma. Patients with the CCand computed tomography (CT) genotypes of ABCB1 have higher concentrations of Doxorubicin compared to those with the TT genotype. Furthermore, the study examines the progression-free survival rates and tumour response in the two treatment groups. It demonstrates that DEB-TACE patients have a higher progression-free survival rate compared to cTACE patients. DEB-TACE also leads to better tumour regression.

The current study helps to increase the understanding of the genetic factors that may contribute to HCC susceptibility in the Egyptian population. However, it is essential to consider that genetic polymorphism is just one aspect of HCC risk, and other factors such as environment, lifestyle and viral infections also play crucial roles. Further research is needed to elucidate the complex interactions between genetic and environmental factors in HCC development among Egyptians.

The purpose of the paper is to provide healthcare organisations with an example of how the implementation of new interventional procedures and NICE guidance can be improved by adopting a synergistic approach.

The paper shows that following the introduction of the Interventional Procedure Programme (NICE) and the issue of Department of Health advice in 2003, it was considered that the hospital's process for implementing new interventional procedures should be revised and would be more effectively managed by integrating with the well established process for implementing NICE guidance. The strategy for implementing NICE guidance and the new interventional procedure ratification process at the Luton and Dunstable Hospital NHS Trust are outlined and describe individual and corporate roles and responsibilities that promote local ownership.

The paper provides information on how the Trust incorporated the national perspective into a local model, which ensures a well‐coordinated multidisciplinary approach to introducing innovative clinical practice safely.

This paper demonstrates a useful tool that may be adapted by other healthcare organisations and clinical governance professionals responsible for implementing new interventional procedures into local practice. The role of the Interventional Procedure Governance Committee in supporting the application, review, ratification and monitoring processes is explained.

The paper identifies a practical approach, ensuring that practice follows recommendations within guidance already published by NICE or are reported to the Interventional Procedure Programme if the procedure is not already included within the work programme.

The purpose of this paper is to provide a consolidated reference for the acute management of selected iatrogenic procedural injuries occurring in the emergency department (ED).

A literature search was performed utilizing PubMed, Scopus, Web of Science and Google Scholar for studies through March of 2017 investigating search terms “iatrogenic procedure complications,” “error management” and “procedure complications,” in addition to the search terms reflecting case reports involving the eight below listed procedure complications.

This may be particularly helpful to academic faculty who supervise physicians in training who present a higher risk to cause such injuries.

Emergent procedures performed in the ED present a higher risk for iatrogenic injury than in more controlled settings. Many physicians are taught error-avoidance rather than how to handle errors when learning procedures. There is currently very limited literature on the error management of iatrogenic procedure complications in the ED.

The purpose of this paper is to develop a ferromagnetic needle adaptable for a novel ablation cancer therapy; the heat generation ability of the mild steel rod embedded into the Ti‐tube having a different thickness was investigated in a high‐frequency output at 300 kHz.

The outer diameter and length of the Ti‐tubes were 1.8 and 20 mm, respectively, while the inner diameter was varied from 1.6 to 0 mm. The mild steel rod was embedded in a Ti‐tube for preparing the needle‐type specimen. Their heat generation ability was examined by changing the inclination angle to the magnetic flux direction in a high‐frequency coil.

When the thickness of the Ti surrounding the mild steel rod was as low as 0.1 mm, the heat generation ability was drastically different among the three inclination angles (θ=0°, 45°, and 90°) to the magnetic flux direction due to the effect of the shape‐induced magnetic anisotropy. However, the effect of the inclination angle was almost eliminated in the specimen surrounded by the 0.4 mm thick Ti, suggesting that the non‐oriented heat generation property is achieved for the needle‐type mild steel rod coated with Ti having the optimum thickness.

The prototype ablation needle having a complete non‐oriented heat generation ability was fabricated to use in subsequent animal experiments. It is considered that the newly designed Ti‐coated device is useful in ablation treatments using a high‐frequency induction heating.

Companies in the health field supplying drugs to government hospitals and medical services need to have accurate information on the relevant regulatory standards. This article describes a regulatory affairs and quality assurance programme instituted and operated by a major multinational drug manufacturer and supplier, referring to the appropriate British standards.

The cost of providing healthcare is spiralling up in recent times. On the one hand, patients expect the highest quality of service, while on the other hand, the managers of the healthcare services want to minimise the total operating expenses. Hence, healthcare organisations implement lean thinking (LT) to achieve these twin objectives. LT reduces the eight wastes that are prevalent in the healthcare processes and functions. In particular, if the wasteful inventories related to expensive medical supplies are reduced, the resulting cost savings can help in providing affordable and accessible healthcare.

Hence, in this paper, a case study of a hospital is presented where LT is implemented. One of the projects was related to inventory reduction in the store of the catheterisation laboratory (cath lab). A hybrid methodology called multi-unit selective inventory control (MUSIC) that combined these three dimensions (3D), namely, consumption value, criticality and lead time or ease of availability was used to classify the medical supplies into different categories.

Based on the results obtained, various inventory systems and the associated tools and techniques of LT were proposed. For example, a deep dive into the A-class items revealed that some of the medical supplies fell under both vital and scarce categories. Hence, it was recommended that the case hospital should follow the economic order quantity (EOQ) with safety stock approach as these items were to be shipped from other states in India. Subsequently, the focus should be on developing a local supplier and attempts should be made to establish a kanban system with adequate information sharing.

This study demonstrates the step-by-step methodology of MUSIC-3D which would guide the procurement managers to apply the same in their organisation. It also helps them in identifying appropriate elements of LT for inventory reduction before the actual deployment.

None of the papers has utilised the MUSIC-3D methodology as a precursor for inventory reduction, specifically within the domain of LT. Similarly, identifying and proposing different type of inventory systems and various LT practices based on this unique method is a novel attempt.

Additive manufacturing has rapidly developed in terms of technology and its application in various types of industries. With this rapid development, there has been significant research in the area of materials. This has led to the invention of Smart Materials (SMs). The 4D printing is basically 3D printing of these SMs. This paper aims to focus on novel materials and their useful application in various industries using the technology of 4D printing.

Research studies in 4D printing have increased since the time when this idea was first introduced in the year 2013. The present research study will deeply focus on the introduction to 4D printing, types of SMs and its application based on the various types of stimulus. The application of each type of SM has been explained along with its functioning with respect to the stimulus.

SMs have multiple functional applications pertaining to appropriate industries. The 4D printed parts have a distinctive capability to change its shape and self-assembly to carry out a specific function according to the requirement. Afterward, the fabricated part can recover to its 3D printed “memorized” shape once it is triggered by the stimulus.

The present study highlights the various capabilities of SMs, which is used as a raw material in 4D printing.