Little is known about the specific anaesthesiological and multidisciplinary management of high-intensity focused ultrasound (HIFU) in uterine fibroids. This observational single-center study is the first reporting on an interdisciplinary approach to optimize outcome following ultrasound (US)-guided HIFU in German-speaking countries. A sample of forty patients with symptomatic uterine fibroids was treated by HIFU. Relevant treatment parameters such as total treatment time for intervention, anaesthesia, and sonication time as well as total energy, body temperature, peri-interventional medication and complications were analyzed. Interventional variables did not correlate significantly either with opioid dose or with body temperature. The average fibroid volume reduction rate was 37.8% ± 23.5%, 48.5% ± 22.0% and 70.2% ± 25.5% after 3, 6 and 12 months, respectively. No major anaesthesiological complications occurred apart from an epileptic seizure prior to HIFU treatment in one patient. Peri-procedural hyperthermia (> 37.5 °C) occurred in two patients. Post-procedural two patients experienced a sciatic nerve irritation up to one year; one patient with very large treated fibroid experienced strong short-lasting post-procedural pain. There were two complication-free pregnancies of HIFU-treated patients. Multidisciplinary management is crucial to optimize safety and outcome of US-guided HIFU for uterine fibroids. Peri-procedural pain and temperature management are critical points where an adequate collaboration between anesthesiologist and interventionalist is mandatory.

Background Epicardial (ECF) and pericardial fat (PCF) are important prognostic markers for various cardiac diseases. However, volumetry of the fat compartments is time-consuming. Purpose To investigate whether total volume of ECF and PCF can be estimated by axial single-slice measurements and in a four-chamber view. Material and Methods A total of 113 individuals (79 patients and 34 healthy) were included in this retrospective magnetic resonance imaging (MRI) study. The total volume of ECF and PCF was determined using a 3D-Dixon sequence. Additionally, the area of ECF and PCF was obtained in single axial layers at five anatomical landmarks (left coronary artery, right coronary artery, right pulmonary artery, mitral valve, coronary sinus) of the Dixon sequence and in a four-chamber view of a standard cine sequence. Pearson's correlation coefficient was calculated between the total volume and each single-slice measurement. Results Axial single-slice measurements of ECF and PCF correlated strongly with the total fat volumes at all landmarks (ECF: r  =  0.85–0.94, P < 0.001; PCF: r  =  0.89–0.94, P < 0.001). The best correlation was found at the level of the left coronary artery for ECF and PCF ( r  =  0.94, P < 0.001). Correlation between single-slice measurement in the four-chamber view and the total ECF and PCF volume was lower ( r  =  0.75 and r  =  0.8, respectively, P < 0.001). Conclusion Single-slice measurements allow an estimation of ECF and PCF volume. This time-efficient analysis allows studies of larger patient cohorts and the opportunistic determination of ECF/PCF from routine examinations.

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Pendahuluan: Tindakan pembedahan sectio caesarea merupakan salah satu bentuk intervensi medis terencana yang dapat menimbulkan kecemasan bagi pasien pre operasi sectio caesarea, salah satu cara untuk menangani kecemasan menjelang operasi dengan teknik relaksasi genggam jari. Tujuan: untuk mengetahui pengaruh pemberian teknik relaksasi genggam jari terhadap tingkat kecemasan pada pasien pre operasi sectio caesarea di Rumah Sakit Umum Daerah Kota Bogor Metode: Desain penelitian menggunakan quasy eksperimental dengan one group pre-test dan post-test without control group, sampel penelitian 15 responden menggunakan teori Diehl (1992). Teknik pengumpulan data menggunakan kuesioner baku dari Hamilton Anxiety Rating Scale (HARS). Uji analisa menggunakan uji Wilcoxon Signed Rank Test. Hasil: Hasil penelitian menunjukkan sebelum pemberian teknik relaksasi genggam jari sebagian besar responden mengalami kecemasan kategori sedang sebanyak 73% dan cemas berat sebanyak 27%. Sesudah dilakukan intervensi didapatkan sebagian besar responden mengalami kecemasan ringan sebanyak 73%, dan berdasarkan Uji Wilcoxon Signed Rank Test, didapatkan p-value sebesar 0,000. Terlihat bahwa p-value 0,000 < (0,05), maka keputusan uji adalah Ho ditolak dan Ha diterima. Kesimpulan: Adanya pengaruh pemberian teknik relaksasi genggam jari terhadap penuruanan tingkat kecemasan pada pasien pre operasi Sectio Caesaria