The safety and efficacy of current ACIP guidelines for the prevention and control of influenza in nursing home populations are uncertain. An outbreak of influenza A/Sichuan (H3N2) in a teaching nursing home during 1988 gave us the opportunity to evaluate the effectiveness of an influenza vaccination and amantadine prophylaxis protocol. Over 13 days, 12 of 60 residents developed influenza. Prior influenza vaccination had been given to 94% of the residents. Protection from infection occurred in those tested who had antibody levels greater than or equal to 1:16 to the A/Leningrad (H3N2) antigen contained in the standard 1987-88 trivalent vaccine. However, five of 17 vaccinated residents who were tested had antibody levels less than or equal to 1:16 at the start of the outbreak. Amantadine (less than or equal to 100 mg/day) was given to all but one resident starting on the third day of the outbreak, and to employees starting on the sixth day of the outbreaks. Seven residents developed illness after the start of amantadine, although amantadine appeared to ameliorate their symptoms. Although amantadine was generally well tolerated by residents, employees receiving amantadine identified a high incidence of side effects and only 44% of employees took at least 70% of the prescribed amantadine. In our opinion, early detection and protocol-directed intervention probably abated a more severe influenza outbreak. Therefore we support existing recommendations that formal nursing home policies be established to ensure that residents and employees receive annual influenza vaccine and that chemoprophylaxis be used when outbreaks of influenza A are suspected.
Graphical visualization systems are a common clinical tool for displaying digital images and three-dimensional volumetric data. These systems provide a broad spectrum of information to support physicians in their clinical routine. For example, the field of radiology enjoys unrestricted options for interaction with the data, since information is pre-recorded and available entirely in digital form. However, some fields, such as microsurgery, do not benefit from this yet. Microscopes, endoscopes, and laparoscopes show the surgical site as it is. To allow free data manipulation and information fusion, 3D digitization of surgical sites is required. We aimed to find the number of cameras needed to add this functionality to surgical microscopes. For this, we performed in silico simulations of the 3D reconstruction of representative models of microsurgical sites with different numbers of cameras in narrow-baseline setups. Our results show that eight independent camera views are preferable, while at least four are necessary for a digital surgical site. In most cases, eight cameras allow the reconstruction of over 99% of the visible part. With four cameras, still over 95% can be achieved. This answers one of the key questions for the development of a prototype microscope. In future, such a system can provide functionality which is unattainable today.
Contemporary surgical microscope systems have excellent optical properties but some desirable features remain unavailable. The number of co-observers is currently restricted, by spatial and optical limitations, to only two. Moreover, ergonomics poses are a problem: Current microscope systems impede free movement and sometimes demand that surgeons take uncomfortable postures over long periods of time. To rectify these issues, some companies developed surgical microscope systems based on a streaming approach. These systems remove some of the limitations. Multi-observer positions, for example, are not independent from each other, for example. In order to overcome the aforementioned limitations, we are currently developing an approach for the next generation of surgical microscope: Namely the fully digital surgical microscope, where the current observation system is replaced with a camera array, allowing real-time 3D reconstruction of surgical scenes and, consequently, the rendering of almost unlimited views for multiple observers. These digital microscopes could make the perspective through the microscope unnecessary allowing the surgeon to move freely and work in more comfortable postures. The requirements on the camera array in such a system have to be determined. For this purpose, we propose of estimation the minimal number of cameras and their positions needed for the 3D reconstruction of microsurgical scenes. The method of estimation is based on the requirements for the 3D reconstruction. Within the MATLAB simulation environment, we have developed a 3D model of a microsurgical scene, used for the determination of the number of required cameras. In a next step a small, compact and costefficient system with few opto-mechanical components could be manufactured.
The article makes a contribution to the ever-important topic of evaluating geometric deviations of tolerated forms related to the datum system using coordinate measuring machines with a touch probe system. The datum system consists of the coordinate system and the coordinates planes. An integral part of the article is the quantification of the true position tolerated form related to the datum system and experimental evaluation of the deviation with calculation of measurement uncertainty, according to STN EN ISO 15530-3.
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