Design Considerations for Interacting and Navigating with 2 Dimensional and 3 Dimensional Medical Images in Virtual, Augmented and Mixed Reality Medical Applications.

The extended realities, including virtual, augmented, and mixed realities (VAMR) have recently experienced significant hardware improvement resulting in an expansion in medical applications. These applications can be classified by the target end user (for instance, classifying applications as patient-centric, physician-centric, or both) or by use case (for instance educational, diagnostic tools, therapeutic tools, or some combination). When developing medical applications in VAMR, careful consideration of both the target end user and use case must heavily influence design considerations, particularly methods and tools for interaction and navigation.

A completely automated pipeline for 3D reconstruction of human heart from 2D cine magnetic resonance slices.

Cardiac magnetic resonance (CMR) imaging is a valuable modality in the diagnosis and characterization of cardiovascular diseases, since it can identify abnormalities in structure and function of the myocardium non-invasively and without the need for ionizing radiation. However, in clinical practice, it is commonly acquired as a collection of separated and independent 2D image planes, which limits its accuracy in 3D analysis. This paper presents a completely automated pipeline for generating patient-specific 3D biventricular heart models from cine magnetic resonance (MR) slices.

Registration Techniques for Clinical Applications of Three-Dimensional Augmented Reality Devices.

Many clinical procedures would benefit from direct and intuitive real-time visualization of anatomy, surgical plans, or other information crucial to the procedure. Three-dimensional augmented reality (3D-AR) is an emerging technology that has the potential to assist physicians with spatial reasoning during clinical interventions. The most intriguing applications of 3D-AR involve visualizations of anatomy or surgical plans that appear directly on the patient.

The Arrhythmic Substrate for Atrial Fibrillation in Patients with Mitral Regurgitation.

Objective: Patients with severe mitral regurgitation commonly develop atrial fibrillation. The precise mechanisms of this relationship remain unknown. The objective of this study was to apply noninvasive electrocardiographic imaging of the atria during sinus rhythm to identify changes in atrial electrophysiology that may contribute to development of atrial fibrillation in patients with severe mitral regurgitation referred for mitral valve surgery.

Noninvasive Mapping of the Electrophysiological Substrate in Cardiac Amyloidosis and Its Relationship to Structural Abnormalities.

Background The relationship between structural pathology and electrophysiological substrate in cardiac amyloidosis is unclear. Differences between light-chain (AL) and transthyretin (ATTR) cardiac amyloidosis may have prognostic implications. Methods and Results ECG imaging and cardiac magnetic resonance studies were conducted in 21 cardiac amyloidosis patients (11 AL and 10 ATTR).

Electrical and Structural Substrate of Arrhythmogenic Right Ventricular Cardiomyopathy Determined Using Noninvasive Electrocardiographic Imaging and Late Gadolinium Magnetic Resonance Imaging.

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a significant cause of sudden cardiac death in the young. Improved noninvasive assessment of ARVC and better understanding of the disease substrate are important for improving patient outcomes.

Methods And Results: We studied 20 genotyped ARVC patients with a broad spectrum of disease using electrocardiographic imaging (a method for noninvasive cardiac electrophysiology mapping) and advanced late gadolinium enhancement cardiac magnetic resonance scar imaging.

Repolarization changes underlying long-term cardiac memory due to right ventricular pacing: noninvasive mapping with electrocardiographic imaging.

Background: Cardiac memory refers to the observation that altered cardiac electrical activation results in repolarization changes that persist after the restoration of a normal activation pattern. Animal studies, however, have yielded disparate conclusions, both regarding the spatial pattern of repolarization changes in cardiac memory and the underlying mechanisms. The present study was undertaken to produce 3-dimensional images of the repolarization changes underlying long-term cardiac memory in humans.

Bullet aspiration and spontaneous expectoration after gunshot wound to trachea.

A young adult male suffered a combat gunshot wound to his anterior trachea, which resulted in bullet migration, via aspiration, to the point of lodgment in the right upper lobe bronchus. He subsequently spontaneously expectorated the intact bullet, a first report of such events. A bronchoscopy was then performed confirming the site of entry, position of previous lodgment, and lack of further pathology.

Therapeutic home adaptations for older adults with disabilities.

Family physicians commonly care for older patients with disabilities. Many of these patients need help maintaining a therapeutic home environment to preserve their comfort and independence. Patients often have little time to decide how to address the limitations of newly-acquired disabilities.

Methadone-induced mortality in the treatment of chronic pain: role of QT prolongation.

Methadone is increasingly prescribed for chronic pain, yet the associated mortality appears to be rising disproportionately relative to other opioid analgesics. We review the available evidence on methadone-associated mortality, and explore potential pharmacokinetic and pharmacodynamic explanations for its greater apparent lethality. While methadone shares properties of central nervous system and respiratory depression with other opioids, methadone is unique as a potent blocker of the delayed rectifier potassium ion channel (IKr).