137 research outputs found
Appendices -Supplemental material for A systematic review of paediatric deep venous thrombolysis
No full textSupplemental material, Appendices for A systematic review of paediatric deep venous thrombolysis by Mohamed AH Taha, Andrew Busuttil, Roshan Bootun and Alun H Davies in Phlebology</p
Appendix 1 and 2 -Supplemental material for A systematic review on the use of deep venous stenting for acute venous thrombosis of the lower limb
No full textSupplemental material, Appendix 1 and 2 for A systematic review on the use of deep venous stenting for acute venous thrombosis of the lower limb by Mohamed AH Taha, Andrew Busuttil, Roshan Bootun and Alun H Davies in Phlebology</p
Supplemental Material - The risk of harm whilst waiting for varicose veins proceduresj-pdf-1-phl-10.1177_02683555221141824
No full textSupplemental Material for The risk of harm whilst waiting for varicose veins procedure by Roshan Bootun, Mandy Burrows, Mohammed M Chowdhury, Philip W Stather, and Wissam Al-Jundi in Phlebology</p
Outcomes of patients with varicose veins
No full textIntroduction
Varicose vein disease is a common ailment affecting the population. It is associated with causing an adverse effect on the quality of life of patients, with treatment of the condition known to improve it. The introduction of endovenous ablation has enabled the cost-effective treatment of the condition with procedures being carried out as day cases with an earlier return to normal activities. However, with healthcare expenditure increasingly under scrutiny, newer pathways are needed to continue the evolution of varicose vein management.
Aim
1. To explore and compare the current and newer endovenous methods of treatment
2. To assess patients’ views of the current management of the condition
3. To evaluate a new referral and treatment pathway of varicose vein disease
4. To assess possible improvement in the post-procedural management of varicose veins
Methods
1. A randomised controlled trial was conducted to compare radiofrequency ablation to mechanochemical ablation as well as a pilot study evaluating the use of a new cyanoacrylate adhesive sealing system. In addition, a systematic review and cost-effectiveness analysis was undertaken to evaluate the newer endovenous ablation methods.
2. A patient survey was carried out to understand the reasons for their referral as well as exploring a new management pathway.
3. A pilot study was undertaken to evaluate the feasibility of a One Stop Vein Clinic, offering same day diagnosis and treatment.
4. A randomised controlled trial comparing the use of compression stockings following endovenous ablation.
Results
1. (a) With 170 patients recruited, the randomised controlled trial comparing radiofrequency and mechanochemical ablation shows that pain score during the procedure was less with the latter method, and that there were no other major differences between the two techniques.
(b) This pilot study of 20 patients in the use of the new cyanoacrylate demonstrates that it is a safe and effective method, though a larger study would be able to provide further evidence of efficacy.
(c) The systematic review shows that surgery and the endothermal methods seem to have lower re-intervention rates compared to foam sclerotherapy. However, a lack of comparative studies involving the non-thermal techniques meant that this analysis was unable to provide sufficient evidence as to their re-intervention rates and cost-effectiveness.
2. The patient survey of 106 patients revealed that they favoured less waiting time between appointments and their treatment. A high proportion of patients were also keen on attending a One Stop Clinic.
3. The early results of this pilot study of One Stop Vein Clinic shows that patients waited on average 4 weeks from being referred by their GP, but this study was hampered by unavailability of the treatment room for long periods and reduced possibility to add patients to the veins lists.
4. One hundred and nine patients have been recruited to the randomised controlled trial of the use of compression stockings. This shows that patients in the compression group had significantly less discomfort in the first few days following treatment, but there were no major differences by 2 weeks.
Conclusions
This work illustrates that varicose vein treatment is fast evolving. The newer technologies show promise, but currently, there is insufficient evidence to demonstrate their superiority over conventional endothermal methods. The One Stop Vein Clinic also shows potential, but may be difficult to incorporate into current practice without clear protocols between the different departments. The use of compression stockings following endothermal ablation indicates that it might be advantageous in the first few days, but may not necessarily have a long-term benefit.Open Acces
*Corresponding author
No full textAbstract: Accurate reconstruction of phylogenetic trees often involves solving hard optimisation problems, particularly the Maximum Parsimony (MP) and Maximum Likelihood (ML) problems. Various heuristics yield good results for these problems within reasonable time only on small datasets. This is a major impediment for large-scale phylogeny reconstruction. Roshan et al. introduced Rec-I-DCM3, an efficient and accurate meta-method for solving the MP problem on large datasets of up to 14,000 taxa. We improve the performance of Rec-I-DCM3 via parallelisation. The experiments demonstrate that our parallel method, PRec-I-DCM3, achieves significant improvements, both in speed and accuracy, over its sequential counterpart
Rapid coordinate system creation and mapping using Crickets
No full textThesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2004.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Includes bibliographical references (leaves 55-56).In this thesis, I describe a system that lays the foundation for context-aware applications. This system allows a user to set up a reference coordinate system in a room, using three Cricket listeners attached to a wooden frame. The system then assigns coordinates to Cricket beacons, which are placed on the ceiling. Finally, by using the frame in conjunction with a laser range finder, the user can generate a map of the room in the reference coordinate system, complete with features including doors, walls, and windows. This thesis also describes necessary changes we implemented that made the Cricket positioning system much more accurate.by Roshan Bantwal Baliga.M.Eng
Varicose veins
No full textVaricose veins affect a third of the general population and are found in the superficial fascia of the lower limbs. There is controversy as to their actual cause with the debate still ongoing as to whether it is primarily an ascending or descending condition. Several potential risk factors have been identified and the most likely risks are increasing age, family history, and pregnancy. They cause a variety of physical symptoms, the most severe of which is ulceration, and also have an adverse effect on the quality of life of patients. Treatment of varicose veins, in turn, has been shown to improve patients’ quality of life.</p
A systematic review of paediatric deep venous thrombolysis
No full textObjectives:
The aim was to assess the effectiveness and safety of Catheter Directed Thrombolysis (CDT) in children with deep venous thrombosis (DVTs) and to evaluate its long-term effect.
Method and Results:
EMBASE, Medline and Cochrane databases were searched to identify studies in which paediatric acute DVT patients received thrombolysis. Following title and abstract screening, 7cohort studies with total of 183 patients were identified. Technical success was 82%, and superior in regional rather than systemic thrombolysis (p< .00001). One cohort study identified significant difference in thrombus resolution at 1 year between thrombolytic and anticoagulant groups (p=0.01). The complication rate was low, with incidence rates of major bleeding, pulmonary embolism (PE) and others at 2.8%, 1.8% and 8.4%, respectively. The overall PTS rate was 12.7%. The incidence of re-thrombosis ranged from 12.3%-27%.
Conclusion:
Thrombolysis for paediatric DVT is an effective and relatively safe therapeutic option, lowering the incidence of PTS and DVT recurrence
A systematic review on the use of deep venous stenting for acute venous thrombosis of the lower limb
No full textObjectives:
The aim is to evaluate venous stent patency, the development of post thrombotic syndrome (PTS), recurrence, quality of life(QOL) and the optimal post-procedural anticoagulation regimen in the treatment of iliofemoral deep venous thrombosis (DVT).
Method and Results: EMBASE and Medline databases were interrogated to identify studies in which acute DVT patients were stented. Twenty-seven studies and 542 patients were identified. Primary, assisted primary and secondary patency rates 12 months after stent placement ranged from 74-95%,90-95% and 84-100% respectively. The observed PTS rate was 14.6%. The incidence of stent re-thrombosis was 8%. In 26% of studies, patients received additional antiplatelet therapy. QOL questionnaires employed in 11% of studies, demonstrating an improvement in the chronic venous insufficiency questionnaire (CIVIQ) (22.67±3.01 vs. 39.34±6.66).
Conclusion: Venous stenting appears to be an effective adjunct to early thrombus removal; however, further studies are needed to identify optimal anticoagulant regimen and effect on QOL
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