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RoFo : Fortschritte Auf Dem Gebiete Der... Feb 2022In the light of the increasing importance of cardiovascular cross-sectional imaging in current guidelines, the goal of this study is to provide a comprehensive overview... (Review)
Review
PURPOSE
In the light of the increasing importance of cardiovascular cross-sectional imaging in current guidelines, the goal of this study is to provide a comprehensive overview of cardiovascular imaging (CVI) offered by radiological institutions across Germany.
MATERIALS AND METHODS
Data were extracted from the national certification program database of the German Roentgen Society (DRG) from 2015-2021. A nationwide online survey among radiology institutes (university hospitals, non-university hospitals, and private practices) was conducted for 2019, and data was extracted from the European Society of Cardiovascular Radiology (ESCR) registry. The data collection's key points included the number of centers and individuals certified for CVI, the number of cardiac CT and MRI examinations performed, the reporting habits, and the participation in the ESCR registry.
RESULTS
71 centers and 1278 persons, both with a substantial increase since 2015, were registered and certified by the DRG to perform CVI. According to the survey, a total of 69,286 CT and 64,281 MRI examinations were performed annually. Data from the survey and the ESCR registry indicated that reporting was mostly done solely by radiologists or, to a lesser degree, in joint consensus meetings with non-radiologists. The overall participation rate in the ESCR registry was 48 % among the survey's participants.
CONCLUSION
This comprehensive analysis demonstrates that high-quality CVI by radiologists is available nationwide. The current challenges are to provide the best medical and technical quality of CVI by radiology for patient care and to ensure economic sustainability in the German health care system to accommodate the predicted substantial need for CVI in the future.
KEY POINTS
· High-quality advanced CVI service by radiologists is available nationwide.. · Highly qualified specialist knowledge is widely represented from university to private practices.. · Certification programs successfully contribute to the dissemination & deepening of CVI expertise.. · The ESCR registry is an established international tool for the documentation of CVI..
CITATION FORMAT
· Sieren M, Maintz D, Gutberlet M et al. Current Status of Cardiovascular Imaging in Germany: Structured Data from the National Certification Program, ESCR Registry, and Survey among Radiologists. Fortschr Röntgenstr 2022; 194: 181 - 191.
Topics: Certification; Germany; Humans; Magnetic Resonance Imaging; Radiologists; Radiology; Registries
PubMed: 34384112
DOI: 10.1055/a-1554-9236 -
Journal of Breast Imaging 2023To identify causes of technical repeats, determine whether differences exist between mobile and fixed mammography units, and evaluate the rate of improvement on repeat...
OBJECTIVE
To identify causes of technical repeats, determine whether differences exist between mobile and fixed mammography units, and evaluate the rate of improvement on repeat imaging.
METHODS
IRB approval was obtained for retrospective review of Enhancing Quality Using the Inspection Program (EQUIP) logs of screening mammography technical repeats performed from March 2017 to December 2018 at a hospital breast imaging center and from April 2017 to December 2018 on mobile mammography units. Frequency tables and Fisher's exact tests were used for statistical analysis.
RESULTS
Technical deficiencies were reported in 483 cases and reviewed by two or three auditors. Auditors identified no technical deficiencies in 31 cases, which were excluded. The remaining 452 cases were assigned a technical recall category: motion, positioning/excluded tissue, skin folds, artifacts, undercompression, or contrast (under/overexposure). Motion was the most common technical recall category (253/452, 56.0%). Positioning/excluded tissue was the second most common reason (150/452, 33.2%). Statistically significant differences in technical deficiencies were identified between mammograms performed on mobile versus fixed mammography units for motion (94/143, 65.7% vs 159/309, 51.5%, respectively, = 0.0058), skin folds (16/143, 11.2% vs 15/309, 4.8%, respectively, = 0.02), and positioning/excluded tissue (30/143, 21% vs 120/309, 38.8%, respectively, = 0.00016). Most recalls improved with repeat imaging (auditor 1: 451/483, 93% and auditor 2: 387/483, 80%).
CONCLUSION
Motion and positioning/excluded tissue are the most common reasons for screening mammography technical recalls. The reasons for technical recall differ between patients imaged on mobile and fixed mammography units, likely because of differences in each location's patient population.
PubMed: 37520155
DOI: 10.1093/jbi/wbad039 -
Juntendo Iji Zasshi = Juntendo Medical... 2022The evolution of radiological technology is one of the most remarkable events of modern medical technology. Radiological examination has resulted in non-invasive,... (Review)
Review
BACKGROUND
The evolution of radiological technology is one of the most remarkable events of modern medical technology. Radiological examination has resulted in non-invasive, individual diagnostic imaging, which has contributed significantly to successful medical treatment of patients.
KEY CONCEPTS
This review summarizes past and current Japanese educational systems for radiological technologists with a historical perspective focusing on three periods. The first period begins with Roentgen's discovery of X-rays (1895), the second period begins with the establishment of the Radiological X-ray Technologist Act (1951), and the third period begins with the launch of the first university course for radiological technologists (1987). It is conceivable that those periods are in accordance with the technological paradigm shifts, including the development of contrast radiography and the application of CT and MRI to clinical practice. To maintain awareness of the most recent available technologies and maximize safety, educational programs teaching the latest knowledge were offered during each period.
CONCLUSIONS
The advanced technologies require highly skilled radiological technologists and highly established educational systems. At present, over 70% of Japanese educational programs for radiological technologists are university courses leading to a bachelor's degree. The increasing globalization of radiological technology requires future radiological education systems to have a global perspective.
PubMed: 38911006
DOI: 10.14789/jmj.JMJ21-0028-R -
Current Hematologic Malignancy Reports Sep 2014Primary mediastinal B-cell lymphoma (PMBCL) is a relatively rare lymphoma subtype affecting mainly young adults. Its molecular signature and clinical features resemble...
Primary mediastinal B-cell lymphoma (PMBCL) is a relatively rare lymphoma subtype affecting mainly young adults. Its molecular signature and clinical features resemble classical Hodgkin lymphoma. The optimal chemotherapy for this lymphoma subtype has not been established. The addition of rituximab to anthracycline based chemotherapy improved response rates and survival. Many centers use R-CHOP as standard treatment, but the role of the intensified regimens and consolidation radiotherapy has to be clarified. Recent data coming from retrospective analyses and an ongoing prospective study addressing the problem of consolidation radiotherapy will help to better identify risk groups and apply risk-adapted and effective treatment strategies. The latest research has helped to understand molecular mechanisms of PMBCL pathogenesis and indicated targets of directed therapy for the future.
Topics: Antibodies, Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Doxorubicin; Humans; Immunotherapy; Lymphoma, B-Cell; Positron-Emission Tomography; Prednisone; Prognosis; Rituximab; Stem Cell Transplantation; Vincristine
PubMed: 24952250
DOI: 10.1007/s11899-014-0219-0 -
Health and Quality of Life Outcomes Sep 2017Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and... (Review)
Review
BACKGROUND
Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies.
METHODS
We systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations.
RESULTS
Of a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered of intermediate quality.
DISCUSSION
This review provides a dataset of HSUVs systematically retrieved from published studies in head and neck cancer. There is currently a lack of research for some disease phases including recurrent and metastatic cancer, and treatment-related complications. In selecting HSUVs for cost-effectiveness modeling purposes, preference should be given to EQ-5D utility values; however, mapping to EQ-5D is a potentially valuable technique that should be further developed in this cancer population.
Topics: Cost-Benefit Analysis; Cross-Sectional Studies; Head and Neck Neoplasms; Health Status Indicators; Humans; Models, Economic; Quality of Life; Surveys and Questionnaires
PubMed: 28865475
DOI: 10.1186/s12955-017-0748-z -
International Journal of Molecular... Mar 2021Protein post-translational modifications (PTMs) play key roles in eukaryotes since they finely regulate numerous mechanisms used to diversify the protein functions and... (Review)
Review
Protein post-translational modifications (PTMs) play key roles in eukaryotes since they finely regulate numerous mechanisms used to diversify the protein functions and to modulate their signaling networks. Besides, these chemical modifications also take part in the viral hijacking of the host, and also contribute to the cellular response to viral infections. All domains of the human immunodeficiency virus type 1 (HIV-1) Gag precursor of 55-kDa (Pr55), which is the central actor for viral RNA specific recruitment and genome packaging, are post-translationally modified. In this review, we summarize the current knowledge about HIV-1 Pr55 PTMs such as myristoylation, phosphorylation, ubiquitination, sumoylation, methylation, and ISGylation in order to figure out how these modifications affect the precursor functions and viral replication. Indeed, in HIV-1, PTMs regulate the precursor trafficking between cell compartments and its anchoring at the plasma membrane, where viral assembly occurs. Interestingly, PTMs also allow Pr55 to hijack the cell machinery to achieve viral budding as they drive recognition between viral proteins or cellular components such as the ESCRT machinery. Finally, we will describe and compare PTMs of several other retroviral Gag proteins to give a global overview of their role in the retroviral life cycle.
Topics: Cell Membrane; Endosomal Sorting Complexes Required for Transport; HIV-1; Humans; Protein Precursors; Protein Processing, Post-Translational; RNA, Viral; Virus Assembly; Virus Replication; gag Gene Products, Human Immunodeficiency Virus
PubMed: 33799890
DOI: 10.3390/ijms22062871 -
Acta Bio-medica : Atenei Parmensis Jun 2017The main goals of the total knee arthroplasty (TKA) is to reduce the perceived pain and restore knee mobility and function in case of osteoarthritic knees joints....
BACKGROUND AND AIM
The main goals of the total knee arthroplasty (TKA) is to reduce the perceived pain and restore knee mobility and function in case of osteoarthritic knees joints. Literature shows how the three major causes of TKA failures are related to wear, loosening and instability and this is due to a problem of imbalance and malalignment. Intraoperative and postoperative kinematics analysis could be of benefit for improving surgery outcome. The aim of the present paper is to give an overview of the two set-up with the highest accuracy for intraoperative and postoperative TKA kinematics evaluation, currently in use at Istituto Ortopedico Rizzoli. Introperative and Postoperative Evaluation: For intraoperative evaluation it has been presented a navigation system with a specifically developed software, while for the postoperative it has been presented the roentgen stereophotogrammetric analysis (RSA). The navigation system consists in a laptop connected with an optoelectronic localizer (Polaris, Northern Digital Inc, Canada). Two reference arrays with passive optical markers and a marked probe are used to localize the knee joint in the 3D space and track the joint kinematics. The RSA is a radiographic technique used in orthopaedic field for measuring micromotion at bone/prosthesis interface or for joint kinematics evaluation. The RSA uses two X-ray sources synchronized with two digital flat-panels.
CONCLUSIONS
The present paper shows that using the navigation system allows the surgeon to easily perform kinematic and alignment evaluation during TKA surgery while the RSA allows a quantitative evaluation of the joint kinematics during the recovery time.
Topics: Arthroplasty, Replacement, Knee; Humans; Image Interpretation, Computer-Assisted; Monitoring, Intraoperative; Osteoarthritis, Knee; Radiostereometric Analysis; Range of Motion, Articular
PubMed: 28657561
DOI: 10.23750/abm.v88i2-S.6509 -
Virus Evolution 2023The Asian bush mosquito is rapidly invading North America and Europe. Due to its potential to transmit multiple pathogenic arthropod-borne (arbo)viruses including Zika...
The Asian bush mosquito is rapidly invading North America and Europe. Due to its potential to transmit multiple pathogenic arthropod-borne (arbo)viruses including Zika virus, West Nile virus, and chikungunya virus, it is important to understand the biology of this vector mosquito in more detail. In addition to arboviruses, mosquitoes can also carry insect-specific viruses that are receiving increasing attention due to their potential effects on host physiology and arbovirus transmission. In this study, we characterized the collection of viruses, referred to as the virome, circulating in populations in the Netherlands and France. Applying a small RNA-based metagenomic approach to , we uncovered a distinct group of viruses present in samples from both the Netherlands and France. These included one known virus, narnavirus 1 (AejapNV1), and three new virus species that we named totivirus 1 (AejapTV1), anphevirus 1 (AejapAV1) and bunyavirus 1 (AejapBV1). We also discovered sequences that were presumably derived from two additional novel viruses: bunyavirus 2 (AejapBV2) and rhabdovirus 1 (AejapRV1). All six viruses induced strong RNA interference responses, including the production of twenty-one nucleotide-sized small interfering RNAs, a signature of active replication in the host. Notably, AejapBV1 and AejapBV2 belong to different viral families; however, no RNA-dependent RNA polymerase sequence has been found for AejapBV2. Intriguingly, our small RNA-based approach identified an ∼1-kb long ambigrammatic RNA that is associated with AejapNV1 as a secondary segment but showed no similarity to any sequence in public databases. We confirmed the presence of AejapNV1 primary and secondary segments, AejapTV1, AejapAV1, and AejapBV1 by reverse transcriptase polymerase chain reaction (PCR) in wild-caught mosquitoes. AejapNV1 and AejapTV1 were found at high prevalence (87-100 per cent) in adult females, adult males, and larvae. Using a small RNA-based, sequence-independent metagenomic strategy, we uncovered a conserved and prevalent virome among mosquito populations. The high prevalence of AejapNV1 and AejapTV1 across all tested mosquito life stages suggests that these viruses are intimately associated with .
PubMed: 37636319
DOI: 10.1093/ve/vead041 -
Globalization and Health Dec 2022The vast investments that have been made in recent decades in new medicines, vaccines, and technologies will only lead to improvements in health if there are appropriate...
BACKGROUND
The vast investments that have been made in recent decades in new medicines, vaccines, and technologies will only lead to improvements in health if there are appropriate and well-functioning health systems to make use of them. However, despite the growing acceptance by major global donors of the importance of health systems, there is an enthusiasm gap when it comes to disbursing funds needed to understand the intricacies of how, why and when these systems deliver effective interventions. To understand the reasons behind this, we open up the black box of donor decision-making vis-à-vis Health Policy and Systems Research (HPSR) financing: what are the organizational processes behind the support for HPSR, and what are the barriers to increasing engagement?
METHODS
We conducted 27 semi-structured interviews with staff of major global health funders, asking them about four key issues: motivations for HPSR financing; priorities in HPSR financing; barriers for increasing HPSR allocations; and challenges or opportunities for the future. We transcribed the interviews and manually coded responses.
RESULTS
Our findings point to the growing appreciation that funders have of HPSR, even though it is often still seen as an 'afterthought' to larger programmatic interventions. In identifying barriers to funding HPSR, our informants emphasised the perceived lack of mandate and capacities of their organizations. For most funding organisations, a major barrier was that their leadership often voiced scepticism about HPSR's long time horizons and limited ability to quantify results.
CONCLUSION
Meeting contemporary health challenges requires strong and effective health systems. By allocating more resources to HPSR, global donors can improve the quality of their interventions, and also contribute to building up a stock of knowledge that domestic policymakers and other funders can draw on to develop better targeted programmes and policies.
Topics: Humans; Health Policy; Health Services Research; Government Programs; Financial Management; Investments
PubMed: 36564847
DOI: 10.1186/s12992-022-00896-4 -
Heliyon Jan 2024Esophageal cancer (EC) is a common and devastating tumor of the upper digestive tract. Unfortunately, by the time any symptoms have manifested, the disease has often... (Review)
Review
Esophageal cancer (EC) is a common and devastating tumor of the upper digestive tract. Unfortunately, by the time any symptoms have manifested, the disease has often progressed to an advanced stage and is accompanied by macro- and micrometastases, including in the bones. The treatment of esophageal cancer with bone metastases remains clinically challenging, given the poor prognosis associated with this condition. Effective prognostic biomarkers can help medical staff choose the appropriate operation and treatment plan, that is for most beneficial for making patients. Current treatments for esophageal cancer with bone metastases include pain-relieving drugs, surgical therapy, radiotherapy (RT), chemotherapy (CT, including molecular-targeted drug therapy), endocrine therapy (ET), bisphosphonates (BPs) and interventional therapy. Of these robust measures, radiotherapy has emerged as a particularly promising therapy for bone metastases from esophageal cancer. Substantial progress has been made in radiation therapy techniques since the discovery of X-rays by Roentgen in 1895. In its palliative capacity, the key goals of radiotherapy are to relieve the patients' bone pain and debilitate effects, including relieving spinal cord compression, correcting the spinal deformity and restoring spinal stability. However, it is worth mentioning that RT for esophageal cancer has various side effects. Currently, the available studies focused exclusively on radiotherapy for ECBM are too small to draw any definitive conclusions, and each of these studies has significant limitations. In this review, in addition to the epidemiology described at the beginning, we will explore the current prognostic biomarkers and radiotherapy for esophageal cancer, with a particular focus on those with bone metastases.
PubMed: 38170113
DOI: 10.1016/j.heliyon.2023.e23510