Key Points TTP in Jehovah’s Witness patients has been managed successfully without PEX. This experience, plus new TTP treatments, may make it possible for patients who are not Jehovah’s Witnesses to avoid PEX in the future.
IntroductionThe authors present the first experience in neonatal magnetic resonance imaging (MRI) examinations using an MR compatible incubator (INC) at the Institute of Mother and Child.Material and methodsForty-nine examinations of 47 newborns (20 girls, 27 boys) were performed using the GE Signa HDxt 1.5T system and INC Nomag IC 1.5. Demographic data, anesthetic methods and MRI findings in the INC in comparison with previously performed imaging were analyzed.ResultsThirty-two neonates were prematurely born (68.1%) at gestational age 23–37 weeks, mean: 29.9 weeks. They were examined at 26 weeks postmenstrual age to 1 month corrected age, mean: 37.5 weeks. Body weight of newborns on the study day was 600–4300 g, mean: 2724 g. Seventeen (34.7%) children were examined in physiological sleep, 32 (65.3%) anesthetized. In none of them did anesthesiological complications or disease worsening occur. In 43 (91.5%) children brain MRI was performed, in 4 (8.5%) MRI of the spinal cord and canal and of the abdomen/pelvis. In children prenatally examined by MRI, the INC provided new diagnostic information in 5 (83.3%) cases, in neonates studied after birth by ultrasound in 32 (82%). Magnetic resonance imaging in the INC did not entail additional knowledge in 9 (18.7%) cases.ConclusionsThe INC enables MRI in preterm newborns and those with low/extremely low body weight. These studies are necessary to assess the extent of changes in the central nervous system and other organs. Incubator coils, designed specifically for neonates, allow more accurate diagnosis than previously used coils for adults. MRI results allow one to determine prognosis, for more accurate planning of diagnostics, helping to make appropriate therapeutic decisions.
Background. The use of a specialized MR-compatible incubator (INC) is very poorly described in the literature and only with regard to brain imaging. Objectives. To present our own experience with brain and body magnetic resonance imaging (MRI) in the INC in a large cohort of neonates. Material and methods. A total of 555 examinations were performed in 530 newborns with the use of a 1.5T system and Nomag IC 1.5 incubator, equipped with head and body coils. Results. More than half of neonates (54%) were prematurely born at 22 + 6-36 + 6 gestational weeks. They were examined from the first to 153 days of life (median: 18.5, mean: 37.7) with body weights 600-5000 g (mean: 3051 g), 23% of less than 2500 g. The proportion of brain MRIs to other body regions was 533:85 = 86%:14%. In 36.6% of cases, MRI showed more abnormalities than ultrasound (USG), in a further 21.8%, MRI diagnosis was completely different, in 4.7%, a pathology described on a USG was ruled out on MRI. The superiority of MRI over USG was 63. 1%. Conclusions. MR-compatible incubator significantly increased the availability of MRI to newborns, especially to premature and unstable newborns. The integration of body coils into the INC increased the spectrum of examinations and made possible the scanning not only of the brain but also the body. Dedicated neonatal coils improved image quality and allowed more accurate diagnosis than the previously used adult coils. Immobilization of the babies in the INC by means of Velcro belts and head fixation inserts is better than in adult coils. The closed space of the INC isolates newborns to a greater extent from the negative influence of noise in the MR environment.
W artykule podjęto tematykę inteligentnych systemów transportowych (ITS), które stanowią jedną z możliwych dróg w poszukiwaniu poprawy życia i innowacyjności w funkcjonowaniu miasta. Transport publiczny jest najbardziej rozległym, a zarazem najczęściej użytkowanym elementem systemu logistycznego miasta, poszukiwane są więc różne sposoby na poprawę zarówno jakości (dostępność, bezpieczeństwo, punktualność itd.) funkcjonowania miasta jako jednostki gospodarującej, jak i przestrzeni do życia dla mieszkańców. Beneficjentami podejmowanych działań są więc pasażerowie transportu (mieszkańcy, dojeżdżający do pracy, turyści itd.), ale także instytucje i urzędy realizujące usługi na rzecz społeczeństwa. Celem opracowania jest identyfikacja i charakterystyka rozwiązań z zakresu ITS w publicznej sieci komunikacyjnej w wybranych miastach wojewódzkich w Polsce (Rzeszów, Bydgoszcz, Wrocław). Artykuł ma charakter przeglądowy. Wykorzystano literaturę przedmiotu, zwłaszcza z zakresu logistyki miasta i telematyki, a także informacje i dane pochodzące z miast wdrażających przedmiotowe rozwiązania.
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