Explore the vast range of titles available.

Ovarian vein thrombosis (OVT) is a rare thromboembolic condition. It involves the right ovarian vein in 70–80% of cases. The risk factors for the development of OVT are pregnancy or puerperium, hormone therapy with estrogen, recent surgery or hospitalization, malignancy, pelvic inflammatory diseases, thrombophilia and idiopathic OVT. We present a rare case of left OVT in a young, non-pregnant woman in her 30 s. A high degree of suspicion is necessitated in patients with the triad of young-middle-aged female, pain abdomen in lower quadrant and hematuria to diagnose OVT. Contrast enhanced computer tomography (CT-venography) is the diagnostic modality of choice. The patient was initially treated with low molecular weight heparin and then switched to direct oral anticoagulants. At 6-monthsfollow-up the patient was free from any symptoms.

The aim of this systematic review was to summarize the currently available literature reporting clinical application of endovenous laser ablation (EVLA) by means of laser systems emitting at wavelengths > 1900 nm, pertaining dosimetry, intraoperative parameters, postoperative outcomes, and efficacy based on occlusion rates, recanalization, and postoperative complications. A literature search was conducted in PubMed, Cochrane Library, Embase, OVID, and Web of Science for publications since the year 2000 until December 2021. Case series, prospective trials, retrospective studies, and randomized controlled trials describing the application of a 1920/1940-nm wavelength laser for EVLA in humans with a minimum of one postoperative follow-up visit were included in the study. Four case series and one randomized controlled trial with a total of 509 EVLA procedures (396 great saphenous veins and 113 small saphenous veins) were identified, meeting the inclusion criteria. The studies were heterogenous in their documentation, EVLA, and duplex ultrasound protocol and result reporting. Overall, the applied average cumulative LEED values ranged from 17.8 to 53 J/cm. Complications observed were pigmentation (0–9.75%), paresthesia (2.5–7.3%), thrombophlebitis (0–5%), EHIT Class 2 (2.26–2.4%), and EHIT Class 1 (1.2–2.4%). Four cases of recanalizations were observed in one study cohort within the first month after treatment. Follow-up at 12 months was available for 3 studies (procedures n = 218) with recanalizations in 8 limbs. Follow-up at 24–36 months was available for 2 studies (procedures n = 126) showing recanalizations in 5 limbs. Recanalizations were asymptomatic and incidental findings on follow-up duplex ultrasound. Pooled occlusion rates were 99.2% at 1 M, 96.3% at 12 M, and 96% at 24 M. Overall, patients undergoing EVLA with long wavelength laser systems > 1900 nm show high occlusion rates, significant improvement in VCSS, low postoperative complication rate, low pain levels, low analgesic requirement, and early convalescence. Apart from persistent paresthesia, all the complications regressed spontaneously within 6 months. EVLA by means of 1920/1940 nm shows promising clinical results with high efficacy and low complication rates. Heterogeneity still exists regarding ideal protocol for duplex ultrasound examination and documentation of anatomical parameters (e.g., vein diameter, ideal stump length and status of accessory veins) and light dosimetry for EVLA.

1.1. Background:The aim of this study was to develop and evaluate an exact, pre-defined, reproducible therapy protocol for endovenous Laser Ablation (EVLA) with 1940nm laser system and radial fibre, to optimize EVLA and minimize adverse thermal complications, whilst maintaining high occlusion rates. This study presents the short-term (1-month) and midterm (12-months) results of EVLA with 1940nm-laser and flush placement of the radial fibre-tip, supported by a 4-Zone, low-energy-application-protocol (LEAP).1.2. Materials and methods:The EVLA procedures were performed with a Thulium-Fibre-Laser-System (Vela XL, Starmedtec GmbH, Starnberg, Germany) with radial fibre (Saturn Side Fibre, 600µm/400 µm Radial Fibre, Light Guide Optics, LGO, Meckenheim, Germany) with intraoperative duplex ultrasound monitoring. The preoperative patient’s data, intraoperative parameters and the postoperative follow-up results were documented on the home-made standardized 4-Zone, LEAP protocol. Great saphenous vein (GSV) and small saphenous vein (SSV) were divided in 4 and 2 zones respectively with corresponding set power levels. Zone-1 (4W) extended from the sapheno femoral junction to the level of the perineum, Zone-2 (4W) perineum to the upper border of patella, Zone-3 (3W) patella to tibial tuberosity for the GSV and the sapheno-popliteal junction to tibial tuberosity for the SSV, Zone-4 (2W) from the tibial tuberosity to ankle joint. Power was increased by 1 W for veins >10 mm and decreased by 1W when intraoperative fibre sticking was encountered. Pullback-velocity was max. 1mm/s.1.3. Results:A total of 152 consecutive patients (185 procedures) were recruited in this prospective non-randomized study between 01st June 2017 and 30th July 2019. Mean follow-up time was 11.9 Months. Follow-up was 100% at 1M and 85.9% (159/185) at 12M. Average Linear Endovenous Energy Density (LEED), median power for GSV were Zone-1: 42J/cm (4W); Zone-2: 33J/cm (3W); Zone-3: 27J/cm (3W); Zone-4: 22J/cm (2W). The corresponding values for SSV were Zone-3: 34J/cm (3W); Zone-4: 27J/cm (2W). Occlusion rates were 98.9% (1-month) and 93.7% (12-months). Complications at 1M were low; laser-induced paraesthesia (LIP 2.2%) and endovenous heat induced thrombosis (EHIT 1.6%). Persistent LIP at 12M was observed in 0.5% of treated limbs.1.4. Conclusion:The proposed 4-Zone, low-energy-application-protocol, an effort to standardize EVLA execution and documentation, supports the operating surgeon to focus on critical elements of EVLA like flush placement of radial fibre and adequate dosimetry, to achieve an effective and durable vein occlusion and to avoid adverse events. This strategy shows good mid-term results with minimal complications. Long-term followup and application in further centres are necessary to prove its reproducibility. Such a guiding tool could improve the ability to analyse, compare and review different EVLA wavelengths and fibre types.

Internet of things (IoT) based systems require power-efficient circuits to raise the battery lifeline. This study presents a single-ended 8T SRAM cell. The core of the proposed 8T SRAM cell is composed of a Schmitt-Trigger circuit which a dynamic body bias technique is applied to a standard CMOS inverter through a feedback mechanism, whereby the threshold voltages of two MOSFETs can be changed, thus changing the switching voltage. Read operation of the proposed cell is conducted using the shared footer per word transistor. The write path is cut-off during the read operation, improving RSNM. A transmission gate placed in the cell core is used to cut the feedback path during write operation. To prove superiority of the proposed cell it is compared with four state-of-the-art SRAM cells under identical conditions on Cadence Virtuoso using 45nm technology at VDD=0.8 V. The proposed circuit shows a 135.74 % improvement in terms of RSNM and a 44.04 % improvement in terms of peak-to-peak power compared to the 6T DTMOS Cell.

Background: Heterogeneity regarding dosimetry and reporting of endovenous laser ablation (EVLA) mandates the development of a standardized protocol. This study presents the mid-term results of EVLA with 1940 nm-laser and radial-fibre, supported by a four-zone dosimetry tool. Materials and methods: Four anatomical dosimetry zones for great saphenous veins (GSV) and two for small saphenous veins (SSV) were defined with set power levels. Zone-1G (4 W) extended from the inguinal ligament to the apex of femoral triangle, Zone-2G (4 W) from the apex of femoral triangle to the upper border of patella. Zone-3G (3 W) from the patella to the tibial tuberosity. Zone-4G (2 W) extended from the tibial tuberosity to the ankle. Zone-1S from the sapheno-popliteal junction to the tibial tuberosity. Zone-2S from the tibial tuberosity to the ankle. Power was increased by 1 W for veins >10 mm and decreased by 1 W when fibre sticking was encountered. Pullback-velocity was max. 1 mm/s. Results: A total of 152 consecutive patients (185 procedures) were recruited. Mean follow-up time was 11.9 months. Mean linear endovenous energy density for GSV was Zone-1G:42 J/cm, Zone-2G:33 J/cm, Zone-3G:27 J/cm, Zone-4G:22 J/cm, Zone-1S:34 J/cm, Zone-2S:27 J/cm. Occlusion rates were 98.9% (1-month) and 93.7% (12-months). Complications at 1 M were low, namely laser-induced paraesthesia (LIP) 2.2% and endovenous heat-induced thrombosis (EHIT) 1.6%. Persistent LIP (12 M) was observed in 0.5%. Conclusion: The proposed four-zone guiding tool is a step towards standardizing dosimetry and documentation for EVLA with 1940 nm. This strategy shows good mid-term results with minimal complications. Long-term follow-up and application in further centres are necessary to prove its reproducibility. Such a guiding tool could improve the ability to analyse, compare and review different EVLA wavelengths and fibre types.