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  • 1
    ISSN: 1573-0956
    Source: Springer Online Journal Archives 1860-2000
    Topics: Geosciences , Physics
    Notes: Abstract This paper reviews the subject of naturalhazards and the use of existing remote sensing systemsin the different phases of disaster management forsome specific natural hazards: forest fires, droughtsand floods. It centers on the applicability of remotesensing for increasing preparedness, providing earlywarnings, monitoring the hazards in real time, andassessing the damage so that relief can be provided. Comparison of the information provided by existingsystems and that needed for operational use of remotesensing in disaster management is also addressed. Thecapability of some of the future sensors to complywith the needs in the field of natural hazards isdiscussed. In this context current pilot projectscarried on at the European Commission Joint ResearchCentre are presented.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2218
    Keywords: Key words: Congenital heart disease — Fetal cardiac intervention — Fetal surgery — Fetoscopy — Heart — Sheep
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Recent efforts to develop procedures for fetoscopic fetal cardiac interventions have been prompted by the development of severe secondary damage to the fetal heart due to semilunar valvar obstructions and the poor outcome of therapy-refractory fetal arrhythmias. The purpose of our manuscript is to analyze and share our experience with the creation of an operative setup for these procedures in sheep. Methods: We studied a total of 48 fetal sheep between 81 and 106 days of gestation (term, 145 days). After entering the amniotic cavity by a percutaneous approach, we performed various fetoscopic fetal cardiac procedures. We analyzed the success of percutaneous fetal access, methods of trocar support, the incidence and management of trocar dislodgement or accidental insertion into the chorioamniotic space, problems related to amniotic insufflation and trocar placement, as well as techniques for fetal posturing and uterine closure. Results: Percutaneous fetal access was achieved in all sheep. The use of resterilizable trocars substantially decreased the costs of our procedures. Utilizing a percutaneous transuterine purse-string suture for trocar support helped to minimize the number of nonabsorbable T-fasteners remaining inside the uterus postoperatively. As complications such as trocar dislodgement, insertion of the trocar into the chorioamniotic space, and problems with intraamniotic insufflation and gas loss were mastered, conversion to an open operative approach was never required. A novel strategy that we devised for percutaneous fetal posturing permitted adequate fetal posturing with ease and minimal trauma to the fetal skin. Conclusion: As operative techniques have become more refined, the feasibility of performing fetoscopic fetal cardiac interventions in human fetuses now depends mainly on technical improvements in imaging and interventional catheters, as well as advances in pacemaker equipment.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1435-1285
    Keywords: Key words Implantable defibrillator – enhanced detection criteria – morphology – stability – sudden onset ; Schlüsselwörter Implantierbarer Defibrillator – Detektionskriterien – Morphologie – Stabilität – Sudden Onset
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Inadäquate Therapien implantierbarer Kardioverter-Defibrillatoren infolge supraventrikulärer Tachykardien stellen weiterhin die häufigste Komplikation der ICD-Therapie dar. Die Einführung des Morphologie (MD)-Kriteriums verspricht eine Verbesserung der Spezifität in der Tachyarrhythmieerkennung bei Erhalt der Sensitivität. Ziel dieser multizentrischen Studie war die systematische Analyse von Sensitivität und Spezifität des MD-Kriteriums in kombinierter Anwendung mit den Kriterien Stabilität und Frequenzsprung (Sudden Onset) bei spontanen Episoden ventrikulärer und supraventrikulärer Tachykardien. Bei 259 Patienten wurden nach ICD-Implantation 787 gespeicherte Episoden bei 74 Patienten mit erhältlichem Speicherelektrogramm während einer Nachbeobachtungszeit von 359±214 Tagen analysiert. Bei nominaler Programmierung des MD-Kriteriums mit ≥60% ergaben sich unter Berücksichtigung aller Episoden eine Sensitivität/Spezifität der Detektion von 82,6%/77,2%. Bei getrennter Analyse von Sinustachykardien, Vorhofflimmern und Vorhofflattern betrug die Spezifität 80,6%, 69,6% und 75%. Bei Patienten mit primär adäquater MD-Detektion waren Sensitivität und Spezifität mit 95,8%/91,7% deutlich verbessert. Bei nominaler Programmierung des Sudden Onset-Kriteriums mit 〈100ms und des Stabilitätskriteriums mit 〈50ms ergaben sich für die Kombination MD- und Sudden-Onset-Kriterium bzw. MD- und Stabilitätskriterium eine Sensitivität/Spezifität von 96,2%/52,2% bzw. 94,4%/63,8%. Die Anwendung des MD-Detektionskriteriums lässt in der kombinierten Anwendung mit den herkömmlichen erweiterten Kriterien wie Sudden Onset- und Stabilitätskriterien eine deutlich verbesserte Spezifität der ICD-Therapie erwarten.
    Notes: Summary The high incidence of inappropriate therapies due to supraventricular tachycardia remains a major unsolved problem of the implantable cardioverter defibrillator. A new morphology discrimination (MD) algorithm has been introduced to improve specificity of ICD therapy without loss of sensitivity. It was the aim of this study to systematically analyze sensitivity and specificity of the MD criterion in combination with the enhanced detection criteria sudden onset and rate stability in the detection of ventricular and supraventricular tachycardia. After ICD implantation in 259 patients, 787 detected episodes in 74 patients with available stored electrograms were documented during a follow-up period of 359±214 days. With a nominal programming of the MD algorithm at ≥60%, sensitivity and specificity for all episodes were 82.6%/77.2%. For sinus tachycardia, atrial fibrillation and atrial flutter the specificities were 80.6%, 69.6% and 75%, respectively. In patients with primarily appropriate MD detection, sensitivity and specificity significantly improved to 95.8%/91.7%. Programming the sudden onset criterion with 〈100ms and the stability criterion with 〈50ms, sensitivity and stability of the combined application of the MD algorithm and sudden onset and MD algorithm and stability were 96.2%/52.2% and 94.4%/63.8%, respectively. The MD criterion in combination with other enhanced detection criteria might significantly improve specificity of tachyarryhthmia detection of ICD therapy.
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