Real-Time, Video-Rate and Depth-Resolved Imaging of Radio-Frequency Ablation Using All-Optical Ultrasound

Radio-frequency (RF)ablation is an effective minimally invasive treatment for atrial fibrillation, where RF fields are delivered by a catheter within the heart. In current clinical practice, this procedure is performed without real-time feedback about the viability of tissue beneath the ablation lesion. As a result, it can be challenging to perform complete ablation of the target tissue whilst avoiding damage to adjacent structures. Recently, all-optical ultrasound imaging, where ultrasound is both generated and detected using light, has been demonstrated as a viable imaging modality exhibiting high image resolution, strong miniaturisation potential, and resilience to interfererence by electromagnetic (EM)fields from the RF ablation catheter. In this work, the suitability of all-optical ultrasound to monitoring RF ablation lesion delivery is investigated using a bench-top imaging system. This system is capable of real-time, video-rate 2D imaging at an image depth of 15 mm, a resolution of 100 μm, a dynamic range of 35 dB, and a sustained frame rate of 9 Hz. In this paper we present the first real-time, video-rate all-optical ultrasound images acquired during RF ablation, and demonstrate how the imaging system was able to clearly visualise the lesion growth at a contrast of up to 30 dB. In addition, we demonstrated how lesion growth in inhomogeneous tissue can progress in an erratic fashion. High-quality imaging during treatment will enable optimisation of the ablation parameters during treatment, and will minimise both treatment times and complication rates

A survey on clinical presentation and nutritional status of infants with suspected cow' milk allergy

<p>Abstract</p> <p>Background</p> <p>Cow's milk is the most common food allergen in infants and the diagnosis of cow's milk allergy is difficult, even with the use of several diagnostic tests. Therefore, elimination diets and challenge tests are essential for the diagnosis and treatment of this disorder. The aim of this study is to report the clinical presentation and nutritional status of children evaluated by pediatric gastroenterologists for the assessment of symptoms suggestive of cow's milk allergy.</p> <p>Methods</p> <p>An observational cross-sectional study was performed among 9,478 patients evaluated by 30 pediatric gastroenterologists for 40 days in 5 different geographical regions in Brazil. Clinical data were collected from patients with symptoms suggestive of cow's milk allergy. The nutritional status of infants (age ≤ 24 months) seen for the first time was evaluated according to z-scores for weight-for-age, weight-for-height, and height-for-age. Epi-Info (CDC-NCHS, 2000) software was used to calculate z-scores.</p> <p>Results</p> <p>The prevalence of suspected cow's milk allergy in the study population was 5.4% (513/9,478), and the incidence was 2.2% (211/9,478). Among 159 infants seen at first evaluation, 15.1% presented with a low weight-for-age z score (< -2.0 standard deviation - SD), 8.7% with a low weight-for-height z score (< -2.0 SD), and 23.9% with a low height-for-age z score (< -2.0 SD).</p> <p>Conclusion</p> <p>The high prevalence of nutritional deficits among infants with symptoms suggestive of cow's milk allergy indicates that effective elimination diets should be prescribed to control allergy symptoms and to prevent or treat malnutrition.</p

New materials and devices for preventing catheter-related infections

Catheters are the leading source of bloodstream infections for patients in the intensive care unit (ICU). Comprehensive unit-based programs have proven to be effective in decreasing catheter-related bloodstream infections (CR-BSIs). ICU rates of CR-BSI higher than 2 per 1,000 catheter-days are no longer acceptable. The locally adapted list of preventive measures should include skin antisepsis with an alcoholic preparation, maximal barrier precautions, a strict catheter maintenance policy, and removal of unnecessary catheters. The development of new technologies capable of further decreasing the now low CR-BSI rate is a major challenge. Recently, new materials that decrease the risk of skin-to-vein bacterial migration, such as new antiseptic dressings, were extensively tested. Antimicrobial-coated catheters can prevent CR-BSI but have a theoretical risk of selecting resistant bacteria. An antimicrobial or antiseptic lock may prevent bacterial migration from the hub to the bloodstream. This review discusses the available knowledge about these new technologies

Sprite tree: an efficient image-based representation for networked virtual environments

International audienceIn this paper we present a pipeline for automatic analysis of neuronal morphology: from detection, modeling to digital reconstruction. First, we present an automatic, unsupervised object detection framework using stochastic marked point process. It extracts connected neuronal networks by fitting special configuration of marked objects to the centreline of the neurite branches in the image volume giving us position, local width and orientation information. Semantic modeling of neuronal morphology in terms of critical nodes like bifurcations and terminals, generates various geometric and morphology descriptors such as branching index, branching angles, total neurite length, internodal lengths for statistical inference on characteristic neuronal features. From the detected branches we reconstruct neuronal tree morphology using robust and efficient numerical fast marching methods. We capture a mathematical model abstracting out the relevant position, shape and connectivity information about neuronal branches from the microscopy data into connected minimum spanning trees. Such digital reconstruction is represented in standard SWC format, prevalent for archiving, sharing, and further analysis in the neuroimaging community. Our proposed pipeline outperforms state of the art methods in tracing accuracy and minimizes the subjective variability in reconstruction, inherent to semi-automatic methods