Application Of Interventional Techniques Research Articles

UNI-axial dynamic tests on a stone masonry subassembly before and after interventions

The present study deals with the seismic response of three-leaf stone masonry subassemblies before and after the application of intervention techniques. In detail, shaking table tests are performed on a scaled substructure in the Laboratory for Earthquake Engineering, at the National Technical University of Athens (NTUA). The substructure consists of two parallel walls. One wall is of rectangular section, whereas the other is provided with a portion of transverse wall at its mid-length. A flexible timber floor rests on the top of the walls. Sine-sweep and dynamic tests are performed perpendicular to the two walls, before and after interventions. The aim of this work is to experimentally study the response of three leaf masonry walls against in-plane and out-of-plane seismic actions, to investigate the effect of the transverse wall to the out-of-plane behavior of walls (and vice versa) and to assess the effect of a selected set of interventions on the behavior of the substructure. The results of this study confirm the vulnerability of three leaf masonry structures, evidenced by the premature detachment of masonry leaves. They prove the significant role of the transverse wall, in reducing the width of the separation cracks observed in the walls subjected to out-of-plane actions followed by an increase of its in-plane damage, as well as the positive effect (in terms of load and deformation capacity) of grouting the walls and enhancing the diaphragm action of the floor. Additionally, the experimental results of this study can serve as a validation tool for the calibration of numerical models and as input for further analytical research. In this paper, the calibration of a smeared crack model that is based on macro-modeling approach is presented, along with a comparison between experimental and numerical results for the specimen before interventions, based on the performed calibration.

Postoperative Chylous Ascites: Application of Interventional Techniques

Moderate sedation in interventional radiology (IR) relies on registered nurses (RNs) with specific education to ensure the best patient outcomes. Research conducted during the previous decades has improved the understanding of nursing labor quality and the relationship to outcomes; yet, there is limited description related to specialty practice areas. Defining parameters for IR nursing allows the study of nurse-driven outcomes for patients receiving sedation. A 26-question survey was sent to a national sample of radiologic administrators (n=510). Statistics included frequency distributions, means, standard deviations, medians, interquartile ranges, chi-square and Mann-Whitney tests; statistical significance p<.05. The response rate was 16% (n = 82). Annual moderate sedation training for RNs was required at most institutions (94.9% 75 of 79) with variation in methods of delivery. Basic life saving (100%, 77 of 77) and advanced cardiac life saving (97.4%, 75 of 77) were primarily required; less than a fifth (17.9%, 10 of 56) noted critical care nursing, or certified radiology nurse certification (7.4%, 4 of 54). A BSN was the most commonly reported degree (median 60% of RNs, IQR = 45.8, 86.1). There is variation in how moderate sedation training is accomplished, its complexity, and the required degree attainment of nurses who participate in the administration of moderate sedation. These findings reflect the limited consensus statements available regarding competencies for moderate sedation nursing practice. Continued studies of moderate sedation and the workforce in IR is essential to understand the RN role in achieving high-quality, safe patient care.

Progress in the Application of Interventional Technique in Malignant Obstructive Jaundice

Malignant obstructive jaundice (MOJ) is usually due to the terminal stages of tumor, so there is no time for curative surgery. Hyperbilirubinemia caused by MOJ can cause damage to systems throughout the body and affect the survival prognosis. Symptomatic treatment is needed even in the advanced stage of the disease. Interventional therapy and surgery are the main means to relieve biliary obstruction, but patients have poor tolerance to surgery at this time, and the risk of surgery is high. At this time, the focus of treatment is to remove the obstruction of the biliary tract as early as possible to avoid the further aggravation of jaundice, progressive deterioration of liver function and other serious complications. Biliary interventional therapy has the special advantage of minimally invasive, and is an effective treatment for patients with advanced MOJ. Currently, bile duct interventional therapy mainly includes bile duct interventional drainage, biliary stent implantation, iodine-125 (¹²⁵ I) seed strand implantation, biliary radiofrequency ablation（RFA）and Intraluminal brachytherapy (ILBT), etc. Each of which has its own advantages and disadvantages in clinical application. With the progress of medical technology and the improvement and perfection of hardware equipment, the combination of multiple clinical departments and multiple operation methods will become a new trend of MOJ interventional therapy.

Theory-Based Digital Interventions to Improve Asthma Self-Management Outcomes: Systematic Review.

BackgroundAsthma is a chronic disease requiring effective self-management to control it and prevent mortality. The use of theory-informed digital interventions promoting asthma self-management is increasing. However, there is limited knowledge concerning how and to what extent psychological theory has been applied to the development of digital interventions, or how using theory impacts outcomes.ObjectiveThe study aimed to examine the use and application of theory in the development of digital interventions to enhance asthma self-management and to evaluate the effectiveness of theory-based interventions in improving adherence, self-management, and clinical outcomes.MethodsElectronic databases (CENTRAL, MEDLINE, EMBASE, and PsycINFO) were searched systematically using predetermined terms. Additional studies were identified by scanning references within relevant studies. Two researchers screened titles and abstracts against predefined inclusion criteria; a third resolved discrepancies. Full-text review was undertaken for relevant studies. Those meeting inclusion criteria were assessed for risk of bias using the Cochrane Collaboration tool. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Study outcomes were classified as medication adherence, self-management, asthma control, clinical markers of health, quality of life, other quality of life outcomes, and health care utilization. Effectiveness was calculated as an average outcome score based on the study’s reported significance. The Theory Coding Scheme (TCS) was used to establish the extent to which each intervention had applied theory and which theoretical constructs or behavioral determinants were addressed. Associations between TCS scores and asthma outcomes were described within a narrative synthesis.ResultsFourteen studies evaluating 14 different digital interventions were included in this review. The most commonly cited theories were Social Cognitive Theory, Health Belief Model, and Self-Efficacy Theory. A greater use of theory in the development of interventions was correlated with effective outcomes (r=.657; P=.01): only the 3 studies that met >60% of the different uses of theory assessed by the TCS were effective on all behavioral and clinical outcomes measured. None of the 11 studies that met ≤60% of the TCS criteria were fully effective; however, 3 interventions were partially effective (ie, the intervention had a significant impact on some, but not all, of the outcomes measured). Most studies lacked detail on the theoretical constructs and how they were applied to the development and application of the intervention.ConclusionsThese findings suggest that greater use of theory in the development and application of digital self-management interventions for asthma may increase their effectiveness. The application of theory alone may not be enough to yield a successful intervention, and other factors (eg, the context in which the intervention is used) should be considered. A systematic approach to the use of theory to guide the design, selection, and application of intervention techniques is needed.

Efectividad de programas formativos orientados al consumo de alcohol en atención primaria: revisión sistemática

ObjectiveTo evaluate the effectiveness of training activities directed at Primary Health Care personnel on the management of patients with alcohol consumption problems. DesignA systematic review of randomised controlled trials. Data sourcesTrip Database, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, EMBASE, CINAHL, Web of Science, Scopus, Alcohol and Alcohol Problems Science Database - ETOH and FAMILY RESOURCES DATABASE. The search was performed in June 2017. Study selectionThe final sample was n=3 studies. Randomised controlled trials, indexed until 30 May 2017, with the objective of assessing the effectiveness of training programs directed at Primary Care providers in the management of patients with alcohol abuse disorder were included. Data extractionThe main variables were expressed in terms of effectiveness of the training program: level of global implementation, screening of alcohol consumption, intervention in patients with a consumption risk, and level of support required. ResultsThree Randomised controlled trials, published from 1999 to 2004, were included. Both screening and short intervention techniques showed an increase of its application in the three studies after the development of the three training programs. Statistical significance in terms of effectiveness was achieved in 2 of the 3 selected trials: both in detection of risk consumers, and in short intervention. ConclusionThe development of training programs in the management of patients with alcohol abuse disorder is an effective strategy for Primary Care providers, allowing the implementation of population screening, as well as the application of intervention techniques.

Pediatric Interventional Radiology: Non-Vascular Interventions.

Pediatric interventional radiology (PIR), which includes variety of procedures done under image guidance has emerged as an essential adjunct to various surgical and medical conditions, plays a significant role in the delivery of safe and effective care by reducing surgical risks, decreasing the length of hospital stay and reducing costs. The application of interventional techniques in children has been delayed over years as compared to adults due to lack of special hardwares/equipments, lack of adequately trained physicians and also the lack of awareness among the pediatric practitioners. This situation is gradually changing now owing to the advancements in technology. In this review, authors will discuss various non-vascular interventional procedures undertaken in pediatric patients.

Application of interventional technique in surgical treatment for children congenital heart disease

PurposeTo evaluate the efficacy and ancenity of interventional technique combined with surgical treatment for children congenital heart disease.MethodsCoil embolisation to occlude aortopulmonary collateral vessels was attempted in 4 patients with...

23. Pain in Patients with Cancer

Pain in patients with cancer can be refractory to pharmacological treatment or intolerable side effects of pharmacological treatment may seriously disturb patients' quality of life. Specific interventional pain management techniques can be an effective alternative for those patients. The appropriate application of these interventional techniques provides better pain control, allows the reduction of analgesics and hence improves quality of life. Until recently, the majority of these techniques are considered to be a fourth consecutive step following the World Health Organization's pain treatment ladder. However, in cancer patients, earlier application of interventional pain management techniques can be recommended even before considering the use of strong opioids. Epidural and intrathecal medication administration allow the reduction of the daily oral or transdermal opioid dose, while maintaining or even improving the pain relief and reducing the side effects. Cervical cordotomy may be considered for patients suffering with unilateral pain at the level below the dermatome C5. This technique should only be applied in patients with a life expectancy of less than 1 year. Plexus coeliacus block or nervus splanchnicus block are recommended for the management of upper abdominal pain due to cancer. Pelvic pain due to cancer can be managed with plexus hypogastricus block and the saddle or lower end block may be a last resort for patients suffering with perineal pain. Back pain due to vertebral compression fractures with or without pathological tumor invasion may be managed with percutaneous vertebroplasty or kyphoplasty. All these interventional techniques should be a part of multidisciplinary patient program.

Looking back at the past and seeking for greater development: in commemoration of the 120th anniversary of the Chinese Medical Journal

Looking back at the past and seeking for greater development: in commemoration of the 120th anniversary of the Chinese Medical Journal

The Role of Guidelines in Interventional Pain Medicine: Let Us Separate Apples and Oranges

Practice guidelines are not only an ancient tradition, but they are a fact of life. The first guidelines were developed in the 1840s, shortly after the use of anesthesia was first demonstrated. Even though practice guideline development has spawned an impressive and over-aggressive literature of its own, many unanswered questions exist with regard not only to practice parameters and guidelines in general, but in particular with the application of interventional techniques in managing persistent pain. In spite of the great potential of clinical practice guidelines, and the involvement of numerous medical societies and physician groups, there is still a great debate within the profession not only about the pros and cons of the development and usage of the guidelines, but also conflicting and controversial opinions on both sides of the issue, i.e., providers and patients vs payors. This article discusses the development, usage, advantages, disadvantages and the implications of practice guidelines to interventional pain medicine specialists.

The endopass: an endovascular bypass for treatment of occlusion of the A. femoralis and A. poplitea –

Background: The implantation of a femoro-popliteal bypass graft represents the gold standard in the management of arteriosclerotic occlusive disease in the femoro-popliteal region. Application of interventional techniques has permitted the development of a novel, endovascular implantable bypass system. The device is placed within the lumen of the superficial femoral artery. The present study investigated the technical properties of the new system in cadavers, with subsequent evaluation of its application in humans. Methods: The endopass consists of a thin-wall polycarbourethane tube with a total length of 53 cm. The distal end is connected with a self-expanding stent prothesis 4 cm in length. Endovascular implantation is performed through a groin incision. Following antegrade ringstripper-TEA, the endopass is introduced into the femoral artery after placement of a guide wire. The proximal anastomosis is performed surgically. Results: The technical requirements and feasibility of the system were tested on 12 cadaver extremities. Implantation of the device proved technically successful in seven of eight extremities with significant occlusion of the superficial femoral artery. The most important problems included the complete ringstripper-TEA, the placement of the guide wire following the TEA, and the expansion of the endopass. Following approval by the ethics commission, the endopass was implanted in five patients between June 1997 and March 1998. In three patients, the endopass remained patent and has functioned well. One patient with poor vascular outflow suffered an early noncorrectable occlusion, while in the remaining case, perforation secondary to the ringstripper procedure forced us to abandon the attempt. Conclusion: Experience from the cadaver study and initial human applications confirm the feasibility of this method. Further development and methodological improvement, however, are necessary requiring additional, larger studies on patients.