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Savona-Ventura C, Mahmood T. Commercial Air And High-Altitude Travel by Pregnant Women: A scientific review commissioned by the European Board and College of Obstetrics and Gynaecology (EBCOG). Eur J Obstet Gynecol Reprod Biol 2022; 272:217-219. [PMID: 35381544 DOI: 10.1016/j.ejogrb.2022.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Air travel and long distance travel may have adverse effect on the pregnancy-induced physiology and these effects are more marked among those with pre-existing medical conditions. There are significantly increased risks of deep venous thrombosis, inflight transmission of infections, preterm labour, and other significant obstetric and medical complications that may be exacerbated by the flight and may require emergency care. Transient changes in cardiotocographic tracings during third trimester of pregnancy have been reported following air travel. It has been suggested that pregnant members of the flight crew may be at a slightly higher risk of spontaneous miscarriages. There are no contra-indications for healthy pregnant women on air travel. Those with underlying medical conditions should only embark on long distance travel following consultation with their obstetrician. Pregnant women should be advised to familiarise themselves with the healthcare system in the country/region they will be visiting and draw up an emergency plan of how they will contact the healthcare system at their destination.
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Affiliation(s)
- Charles Savona-Ventura
- University of Malta, Malta; EBCOG Standards of Care and Position Statements Group, Belgium.
| | - Tahir Mahmood
- Victoria Hospital, Kirkcaldy, Scotland; EBCOG Standards of Care and Position Statements Group, Belgium
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The utility of a handheld metal detector in detection and localization of pediatric metallic foreign body ingestion. Int J Pediatr Otorhinolaryngol 2017; 92:1-6. [PMID: 28012507 DOI: 10.1016/j.ijporl.2016.10.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 10/27/2016] [Accepted: 10/29/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To test the ability of a handheld metal detector (HHMD) to identify the presence and location of ingested metallic foreign bodies (MFBs) in children. METHODS Prospective case series enrolling children suspected of metallic foreign body ingestion presenting to the Emergency Department. Thirty-eight children were enrolled and the HHMD was used to detect the presence and location of a MFB. Results were compared to standard radiographic studies. RESULTS Thirty-seven of the 38 ingested foreign bodies were MFBs. Of the 37 MFBs, the HHMD positively identified 33, and 4 were missed by HHMD but identified on radiography. When positive, the location indicated by HHMD correlated 100% with radiograph. There were 33 true positives, 0 false positives, 4 false negatives, and 1 true negative. This resulted in a sensitivity of 89% (95% CI of 75%-96%) and specificity of 100% (95% CI of 2.5%-100%). CONCLUSION Our study demonstrates the accuracy of HHMD in the identification and localization of metallic foreign bodies. We propose an emergency room foreign body protocol that uses HHMD as an early screening tool in triage in order to expedite the process of obtaining Otolaryngology consultation and potentially shorten the wait time to the operating room or discharge. In instances were outside films are previously performed, HHMD use may be able to minimize the overall radiation exposure to children by obviating the need for repeat radiographs. As the sensitivity is not 100%, a negative HHMD screening does not negate the need for a standard radiograph in order to avoid missed MFBs. HHMD is best suited for detection of coins, which accounts for the majority of the MFB ingestions, and may not be suitable for all metallic objects since the amount of metal may decrease its sensitivity.
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Iacono MI, Neufeld E, Akinnagbe E, Bower K, Wolf J, Vogiatzis Oikonomidis I, Sharma D, Lloyd B, Wilm BJ, Wyss M, Pruessmann KP, Jakab A, Makris N, Cohen ED, Kuster N, Kainz W, Angelone LM. MIDA: A Multimodal Imaging-Based Detailed Anatomical Model of the Human Head and Neck. PLoS One 2015; 10:e0124126. [PMID: 25901747 PMCID: PMC4406723 DOI: 10.1371/journal.pone.0124126] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 03/04/2015] [Indexed: 11/25/2022] Open
Abstract
Computational modeling and simulations are increasingly being used to complement experimental testing for analysis of safety and efficacy of medical devices. Multiple voxel- and surface-based whole- and partial-body models have been proposed in the literature, typically with spatial resolution in the range of 1-2 mm and with 10-50 different tissue types resolved. We have developed a multimodal imaging-based detailed anatomical model of the human head and neck, named "MIDA". The model was obtained by integrating three different magnetic resonance imaging (MRI) modalities, the parameters of which were tailored to enhance the signals of specific tissues: i) structural T1- and T2-weighted MRIs; a specific heavily T2-weighted MRI slab with high nerve contrast optimized to enhance the structures of the ear and eye; ii) magnetic resonance angiography (MRA) data to image the vasculature, and iii) diffusion tensor imaging (DTI) to obtain information on anisotropy and fiber orientation. The unique multimodal high-resolution approach allowed resolving 153 structures, including several distinct muscles, bones and skull layers, arteries and veins, nerves, as well as salivary glands. The model offers also a detailed characterization of eyes, ears, and deep brain structures. A special automatic atlas-based segmentation procedure was adopted to include a detailed map of the nuclei of the thalamus and midbrain into the head model. The suitability of the model to simulations involving different numerical methods, discretization approaches, as well as DTI-based tensorial electrical conductivity, was examined in a case-study, in which the electric field was generated by transcranial alternating current stimulation. The voxel- and the surface-based versions of the models are freely available to the scientific community.
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Affiliation(s)
- Maria Ida Iacono
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, 20993, United States of America
| | - Esra Neufeld
- IT'IS Foundation for Research on Information Technologies in Society, Zurich, Switzerland
| | - Esther Akinnagbe
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, 20993, United States of America
| | - Kelsey Bower
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, 20993, United States of America
| | - Johanna Wolf
- IT'IS Foundation for Research on Information Technologies in Society, Zurich, Switzerland
- Swiss Federal Institute of Technology (ETH) Zurich, 8092 Zurich, Switzerland
| | - Ioannis Vogiatzis Oikonomidis
- IT'IS Foundation for Research on Information Technologies in Society, Zurich, Switzerland
- Swiss Federal Institute of Technology (ETH) Zurich, 8092 Zurich, Switzerland
| | - Deepika Sharma
- IT'IS Foundation for Research on Information Technologies in Society, Zurich, Switzerland
- Swiss Federal Institute of Technology (ETH) Zurich, 8092 Zurich, Switzerland
| | - Bryn Lloyd
- IT'IS Foundation for Research on Information Technologies in Society, Zurich, Switzerland
| | - Bertram J. Wilm
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Michael Wyss
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Klaas P. Pruessmann
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Andras Jakab
- Computational Imaging Research Laboratory, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
- Computer Vision Laboratory, ETH Zurich, Zurich, Switzerland
| | - Nikos Makris
- Athinoula A. Martinos Center For Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, 02129, United States of America
- Center for Morphometric Analysis, Department of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, 02129, United States of America
| | - Ethan D. Cohen
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, 20993, United States of America
| | - Niels Kuster
- IT'IS Foundation for Research on Information Technologies in Society, Zurich, Switzerland
- Swiss Federal Institute of Technology (ETH) Zurich, 8092 Zurich, Switzerland
| | - Wolfgang Kainz
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, 20993, United States of America
| | - Leonardo M. Angelone
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, 20993, United States of America
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Laakso I, Tsuchida S, Hirata A, Kamimura Y. Evaluation of SAR in a human body model due to wireless power transmission in the 10 MHz band. Phys Med Biol 2012; 57:4991-5002. [PMID: 22801053 DOI: 10.1088/0031-9155/57/15/4991] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study discusses a computational method for calculating the specific absorption rate (SAR) due to a wireless power transmission system in the 10 MHz frequency band. A two-step quasi-static method comprised of the method of moments and the scalar potential finite-difference method are proposed. The applicability of the quasi-static approximation for localized exposure in this frequency band is discussed by comparing the SAR in a lossy dielectric cylinder computed with a full-wave electromagnetic analysis and the quasi-static approximation. From the computational results, the input impedance of the resonant coils was affected by the existence of the cylinder. On the other hand, the magnetic field distribution in free space and considering the cylinder and an impedance matching circuit were in good agreement; the maximum difference in the amplitude of the magnetic field was 4.8%. For a cylinder-coil distance of 10 mm, the difference between the peak 10 g averaged SAR in the cylinder computed with the full-wave electromagnetic method and our quasi-static method was 7.8%. These results suggest that the quasi-static approach is applicable for conducting the dosimetry of wireless power transmission in the 10 MHz band. With our two-step quasi-static method, the SAR in the anatomically based model was computed for different exposure scenarios. From those computations, the allowable input power satisfying the limit of a peak 10 g averaged SAR of 2.0 W kg(-1) was 830 W in the worst case exposure scenario with a coil positioned at a distance of 30 mm from the chest.
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Affiliation(s)
- Ilkka Laakso
- Department of Computer Science and Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
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