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Thermography by Specialty
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
A clinical picture of active phlebitis (erythema, tenderness) is a common finding in patients with indwelling intravenous catheters or lines. The etiology of the inflammation may be infectious in nature or caused by endothelial irritation from the substance being injected. The incidence of phlebitis increases with the time the catheter has been in place (the catheter “dwell time”). Superficial venous thrombophlebitis (SVT) in the arms most likely results from intravenous infusion causing localized redness, tenderness, and heat visible to thermography. By thermographically monitoring the temperature of the catheter insertion site and subtracting it from a distal reference skin site, a “delta-T” (ΔT) value can be computed (Figure 11.41). Negative ΔT values indicate no phlebitis, while a positive ΔT is associated with clinical signs of phlebitis. Even in the uncontrolled environment of an Intensive Care Unit, the ΔT is highly correlated with the clinical diagnosis of local phlebitis (p = 0.001).193 Thermography is useful in the early detection of phlebitis associated with indwelling intravascular catheters and other conditions.
Malone Complications and Troubleshooting
Published in Marc A. Levitt, Pediatric Colorectal Surgery, 2023
Patients receiving daily rectal enemas typically have a minimum dwell time of 10 minutes. Many children find it challenging to sit still for this length of time, and complicating the administration is the cumbersome gravity bag attached to the Foley catheter. It must remain at a greater height than the child, often “tethering” the child to an area.
Quality Assurance of Nuclear Medicine Systems
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Whole-body mode tests. Modern gamma cameras can perform sweeps of patients in so-called whole-body mode, where the detectors slowly move over the patient to produce an image larger than the detector field of view. This test requires software ramping and good mechanical control of the patient couch or detector, together with good positional information from the system to ensure that dwell times per row of the image are equal, and to ensure that the integrity of the spatial resolution in the image is maintained. Tests on whole body mode constancy to assess dwell time per row, and whole-body mode spatial resolution to assess feature positioning and detectability should be performed on an annual basis.
The Feasibility and Safety of No Placement of Urinary Catheter Following Lung Cancer Surgery: A Retrospective Cohort Study With 2,495 Cases
Published in Journal of Investigative Surgery, 2021
Yutian Lai, Xin Wang, Kun Zhou, Jianhuan Su, Guowei Che
Another essential issue is postoperative UTI, a common complication for surgical patients, which is involuted to treat with prolonged in hospital stay [22]. CAUTI is one of the most common healthcare-acquired conditions, which is related to adverse outcomes, and negatively affects public safety reporting and reimbursement [23–25]. Urinary catheter dwell time is a significant risk factor for patients presenting CAUTIs, and prompt removal of IUC at the earliest possibility has been a cornerstone for reducing CAUTIs [22]. In the study we presented, we also observed that in the UC group, the incidence of CAUTI was 4.4% (81/1,835), occupying 52.9% (81/153) of patients presenting UTI, indicating that CAUTI was prevalent in thoracic surgery. Moreover, our results showed that the incidence of UTI in the non-UC group was significantly lower than that in the UC group, and multivariable analysis of the risk factors of UTI revealed that absence of urinary catheter was the independent risk factor, thereby implying the contribution of avoiding urinary catheter insertion to decrease of UTI, which may be a critical reason for the implement of not performing urinary catheterization in lung cancer surgery. Meanwhile, multivariable analysis for the risk factors of CAUTI also indicated that advanced age, history of abdominal/pelvic surgery and prolonged surgery time were the independent risk factors, thereby necessitating attention to the prevention of CAUTIs after lung cancer surgery.
Prostate cancer high dose-rate brachytherapy: review of evidence and current perspectives
Published in Expert Review of Medical Devices, 2018
Sunil W. Dutta, Clayton E. Alonso, Bruce Libby, Timothy N. Showalter
HDR brachytherapy has technical advantages over LDR seed implantation that should allow for improved biochemical control. Needle catheters can be placed outside of the prostate gland, which allows for improved coverage in cases of extracapsular extension or seminal vesicle invasion (clinical T3 disease). In contrast, seed migration would be a concern if placed outside of prostate tissue, and therefore seeds are better suited for clinical T1-T2 disease. Furthermore, the radioactive source dwell-time positions can be programmed at the treating physician and physicists’ discretion. This allows for a customized, inhomogeneous dose distribution to the prostate, i.e. increased dose to areas of tumor, and reduced dose to organs at risk including urethra and rectum. By allowing for postinsertion modifications, small operator errors can be compensated by adjusting source dwell times. On the other hand, after placement of seeds, it is impossible to make adjustments to the isodose distribution. Direct comparisons between HDR and LDR brachytherapy are limited since HDR is often combined with EBRT for intermediate to high risk prostate cancer, whereas LDR is usually given as monotherapy for low risk prostate cancer. However, when given as monotherapy, a retrospective study shows HDR brachytherapy to have similar biochemical control with less late toxicities compared to LDR [15].
Toward a new age of patient centricity? The application of eye-tracking to the development of connected self-injection systems
Published in Expert Opinion on Drug Delivery, 2019
Quentin Lohmeyer, Andreas Schneider, Christoph Jordi, Jakob Lange, Mirko Meboldt
The third dimension of drug delivery tool’s usability – product ease of use – could also be assessed from the eye tracking data. Specifically, the analysis of mean dwell time on AOI – inversely related to the ease of use – allows one to draw conclusions as to how visual attention evolves over time per user interface element and use step. One the one hand, the study shows how mean dwell time decreased stepwise for selected user interface elements. These insights underscore that less visual attention and thus less cognitive effort was required to engage with certain user interface elements as the redesign of the connected self-injection device progressed. In so doing, the results illustrate how eye-tracking provides new approaches to ‘objectify’ evaluation procedures around product ease of use. On the other hand, the results show how visual attention was successfully directed toward those user interface elements that proved relevant for a given use step. As such, relative attention to the relevant AOIs incrementally increased for most of the use steps as a result of Design Iteration A and B, respectively. Furthermore, mean dwell time consistently decreased for certain AOIs and use steps. For instance, the dwell time of the AOI ‘primary LED’ (indicating injection status) decreased from 2.4 sec to 0.8 sec. Similarly, the dwell time on the AOI ‘housing’ decreased from 3.7 sec in ETS1 to 2.5 sec in ETS3. Due to the design modifications during design iterations A and B, less visual attention on certain AOIs was required to effectively complete a use step. These results thus indicate that ease of use could be step-wise improved for various user interface elements, which in turn improved overall product ease-of use.