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https://www.readbyqxmd.com/read/29450382/iridex-micropulse-p3-innovative-cyclophotocoagulation
#1
M Monica Gavris, Ioana Olteanu, Erzsebet Kantor, Radu Mateescu, Roxana Belicioiu
Purpose: To present the new IRIDEX MicroPulse P3 (MP3) technology in patients with refractory glaucoma and our preliminary results at 1 week and 1 month postoperatively. Methods: IRIDEX MP3 laser cyclophotocoagulation was performed in 7 eyes of 7 patients under retrobulbar anaesthesia with lidocaine 2% in the operating room. Each eye received two treatments of 80-90s over the superior and inferior hemisphere, avoiding the temporal- and nasal-most clock hours. 810nm IRIDEX MP3 was set to 31,3% duty cycle (0,5ms treatment pulse followed by 1,1 ms of rest)...
April 2017: Romanian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29421068/lean-and-green-hand-surgery
#2
REVIEW
Robert E Van Demark, Vanessa J S Smith, Anthony Fiegen
Health care in the United States is both expensive and wasteful. The cost of health care in the United States continues to increase every year. Health care spending for 2016 is estimated at $3.35 trillion. Per capita spending ($10,345 per person) is more than twice the average of other developed countries. The United States also leads the world in solid waste production (624,700 metric tons of waste in 2011). The health care industry is second only to the food industry in annual waste production. Each year, health care facilities in the United States produce 4 billion pounds of waste (660 tons per day), with as much as 70%, or around 2...
February 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29417586/office-based-esophageal-dilation-in-head-and-neck-cancer-safety-feasibility-and-cost-analysis
#3
Rebecca J Howell, Melissa A Schopper, John Paul Giliberto, Ryan M Collar, Sid M Khosla
OBJECTIVE: To review experience, safety, and cost of office-based esophageal dilation in patients with history of head and neck cancer (HNCA). METHODS: The medical records of patients undergoing esophageal dilation in the office were retrospectively reviewed between August 2015 and May 2017. Patients were given nasal topical anesthesia. Next, a transnasal esophagoscopy (TNE) was performed. If the patient tolerated TNE, we proceeded with esophageal dilation using Seldinger technique with the CRE™ Boston Scientific (Boston Scientific Corp...
February 8, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29413193/editorial-commentary-buckle-up-surgeons-safety-belt-reinforcement-of-knee-anterior-cruciate-ligament-reconstruction-grafts
#4
EDITORIAL
Asheesh Bedi
Safety belt, or cerclage, reinforcement of anterior cruciate ligament (ACL) grafts may protect against various modes of failure including creep and irreversible stretch, traumatic tearing, and slippage of the tendon-bone interface. A time-zero, biomechanical study shows that suture reinforcement may protect small and vulnerable hamstring ACL reconstruction grafts from these various modes of failure. Thus, in vivo comparative outcome analysis is indicated to determine if the benefits of reinforcement translate from the benchtop to the operating room...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29410371/trans-venous-embolization-of-a-basal-ganglia-ruptured-arteriovenous-malformation-with-open-surgical-arterial-control-a-hybrid-technique
#5
Zsolt Kulcsár, Paolo Machi, Karl Schaller, Karl Olof Lovblad, Philippe Bijlenga
Treatment of ruptured deep-seated arteriovenous malformations is challenging and associated with elevated risks. This is due to the proximity or involvement of critical brain structures and the specifically fine and delicate angioarchitecture of these lesions, making both endovascular and surgical access technically complicated. We present the advantages of a true combined, open surgical and endovascular transvenous approach in a hybrid operating room. The technique may overcome in part the difficulties and may improve safety and risk related concerns...
February 1, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29401673/self-test-procedures-for-gas-sensors-embedded-in-microreactor-systems
#6
Andreas Helwig, Angelika Hackner, Gerhard Müller, Dario Zappa, Giorgio Sberveglieri
Metal oxide (MOX) gas sensors sensitively respond to a wide variety of combustible, explosive and poisonous gases. However, due to the lack of a built-in self-test capability, MOX gas sensors have not yet been able to penetrate safety-critical applications. In the present work we report on gas sensing experiments performed on MOX gas sensors embedded in ceramic micro-reaction chambers. With the help of an external micro-pump, such systems can be operated in a periodic manner alternating between flow and no-flow conditions, thus allowing repetitive measurements of the sensor resistances under clean air, R 0 , and under gas exposure, R g a s , to be obtained, even under field conditions...
February 3, 2018: Sensors
https://www.readbyqxmd.com/read/29399903/identifying-the-non-technical-skills-required-of-nurses-in-general-surgical-wards
#7
Dianne Marshall, Mary Finlayson
AIMS AND OBJECTIVES: To identify the non-technical skills (NTS) required of nurses in general surgical wards for safe and effective care. BACKGROUND: As the largest occupational group, nurses are in an ideal position to block the vulnerabilities of patient adverse events in a surgical ward. Previous studies in the surgical environment have identified the NTS required of nurses for safe care in operating rooms however these skills have not been identified for nurses in general surgical wards...
February 5, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29396277/simulation-based-testing-of-pager-interruptions-during-laparoscopic-cholecystectomy
#8
Joseph A Sujka, Karen Safcsak, Indermeet S Bhullar, William S Havron
OBJECTIVE: To determine if pager interruptions affect operative time, safety, or complications and management of pager issues during a simulated laparoscopic cholecystectomy. DESIGN: Twelve surgery resident volunteers were tested on a Simbionix Lap Mentor II simulator. Each resident performed 6 randomized simulated laparoscopic cholecystectomies; 3 with pager interruptions (INT) and 3 without pager interruptions (NO-INT). The pager interruptions were sent in the form of standardized patient vignettes and timed to distract the resident during dissection of the critical view of safety and clipping of the cystic duct...
January 30, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29375283/a-long-term-cohort-study-of-surgery-for-recurrent-prolapse-comparing-mesh-augmented-anterior-repairs-to-anterior-colporrhaphy
#9
Natasha Curtiss, Jonathan Duckett
Background: There are safety concerns regarding the use of mesh in vaginal surgery with a call for long-term follow-up data. This study was designed to evaluate the long-term safety and efficacy of vaginal repairs performed for recurrent cystocele using Perigee (non-absorbable trans-obturator) mesh. Methods: A retrospective consecutive cohort of 48 women who underwent surgery for recurrent prolapse between March 2007 and December 2011 in a single centre was reviewed...
2018: Gynecological Surgery
https://www.readbyqxmd.com/read/29374964/identifying-what-is-known-about-improving-operating-room-to-intensive-care-handovers-a-scoping-review
#10
Karolina Zjadewicz, Kirsten S Deemer, Jennifer Coulthard, Christopher J Doig, Paul J Boiteau
The purpose is to provide a descriptive overview of relevant material exploring improvement of handovers from the operating room (OR) to intensive care unit (ICU). An online search (MEDLINE, Cochrane, EMBASE, CINAHL, and Joanna Briggs), including gray literature and relevant reference lists, was completed. In all, 4574 unique citations were screened and 155 full-text reviews performed; 65 articles were included in the final analysis. The majority of articles discuss an ideal structure for handover (n = 63; 97%); 43 (66%) articles mentioned strategies for implementing such an approach...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29372412/the-effect-of-in-situ-simulation-training-on-the-performance-of-tasks-related-to-patient-safety-during-sedation
#11
Meital Ben-Ari, Gilad Chayen, Ivan P Steiner, Dana Aronson Schinasi, Oren Feldman, Itai Shavit
In many countries, procedural sedation outside of the operating room is performed by pediatricians. We examined if in situ sedation simulation training (SST) of pediatricians improves the performance of tasks related to patient safety during sedation in the Emergency Department (ED). We performed a single-center, quasi-experimental, study evaluating the performance of sedation, before-and-after SST. Sixteen pediatricians were evaluated during sedation as part of their usual practice, using the previously validated Sedation-Performance-Score (SPS)...
January 25, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29369062/simulation-based-assessment-to-reliably-identify-key-resident-performance-attributes
#12
Richard H Blum, Sharon L Muret-Wagstaff, John R Boulet, Jeffrey B Cooper, Emil R Petrusa, Keith H Baker, Galina Davidyuk, Jennifer L Dearden, David M Feinstein, Stephanie B Jones, William R Kimball, John D Mitchell, Robert L Nadelberg, Sarah H Wiser, Meredith A Albrecht, Amanda K Anastasi, Ruma R Bose, Laura Y Chang, Deborah J Culley, Lauren J Fisher, Meera Grover, Suzanne B Klainer, Rikante Kveraga, Jeffrey P Martel, Shannon S McKenna, Rebecca D Minehart, John D Mitchell, Jeremi R Mountjoy, John B Pawlowski, Robert N Pilon, Douglas C Shook, David A Silver, Carol A Warfield, Katherine L Zaleski
BACKGROUND: Obtaining reliable and valid information on resident performance is critical to patient safety and training program improvement. The goals were to characterize important anesthesia resident performance gaps that are not typically evaluated, and to further validate scores from a multiscenario simulation-based assessment. METHODS: Seven high-fidelity scenarios reflecting core anesthesiology skills were administered to 51 first-year residents (CA-1s) and 16 third-year residents (CA-3s) from three residency programs...
January 24, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29365267/decoding-the-three-pronged-mechanism-of-no3%C3%A2-radical-formation-in-hno3-solutions-at-22%C3%A2-c-and-80%C3%A2-c-using-picosecond-pulse-radiolysis
#13
Raluca Musat, Sergey Alexandrovich Denisov, Jean-Louis Marignier, Mehran Mostafavi
With nitric acid (HNO3) being at the core of nuclear technology through actinides separation and extraction processes, achieving a complete characterization of the complex processes involving concentrated HNO3 solutions under ionizing radiation equates bringing efficiency and safety into their operation. In this work, the three mechanisms contributing to the formation of nitrate radicals (NO3•) in the concentrated HNO3 were investigated by measuring the radiolytic yield of NO3• in HNO3 solutions (0.5-23...
January 24, 2018: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/29363608/implementation-of-a-colour-coded-universal-protocol-safety-initiative-in-guatemala
#14
Brad M Taicher, Shannon Tew, Ligia Figueroa, Fausto Hernandez, Sherry S Ross, Henry E Rice
BACKGROUND: Universal protocol implementation can be challenging in low-income or middle-income countries, particularly when providers work together across language barriers. The aim of this quality improvement initiative was to test the implementation of a colour-coded universal protocol in a Guatemalan hospital staffed by US and Guatemalan providers. METHODS: From 2013 to 2016, a US and Guatemalan team implemented a universal protocol at a Guatemalan surgical centre for children undergoing general surgical or urologic procedures...
January 23, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29355033/the-impact-of-operating-room-layout-on-circulating-nurse-s-work-patterns-and-flow-disruptions-a-behavioral-mapping-study
#15
Sara Bayramzadeh, Anjali Joseph, Dee San, Amin Khoshkenar, Kevin Taaffe, Roxana Jafarifiroozabadi, David M Neyens
AIM: To assess how the adjacencies of functionally different areas within operating rooms (ORs) can influence the circulating nurse's (CN) workflow patterns and disruptions. BACKGROUND: The CN plays a significant role in promoting patient safety during surgical procedures by observing, monitoring, and managing potential threats at and around the surgical field. Their work requires constant movement to different parts of the OR to support team members. The layout of the OR and crowded and cluttered environment might impact the CN's workflow and cause disruptions during the surgery...
January 1, 2018: HERD
https://www.readbyqxmd.com/read/29352453/measuring-surgical-safety-during-minimally-invasive-surgical-procedures-a-validation-study
#16
Mathijs D Blikkendaal, Sara R C Driessen, Sharon P Rodrigues, Johann P T Rhemrev, Maddy J G H Smeets, Jenny Dankelman, John J van den Dobbelsteen, Frank Willem Jansen
BACKGROUND: During the implementation of new interventions (i.e., surgical devices and technologies) in the operating room, surgical safety might be compromised. Current safety measures are insufficient in detecting safety hazards during this process. The aim of the study was to observe whether surgical teams are capable of measuring surgical safety, especially with regard to the introduction of new interventions. METHODS: A Surgical Safety Questionnaire was developed that had to be filled out directly postoperative by three surgical team members...
January 19, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29351677/use-of-risk-model-for-assessment-of-residents-perception-of-complexity-of-surgical-steps-example-of-modular-component-steps-of-lumbar-spinal-fusion-surgery
#17
Jeffrey S Raskin, Jesse J Liu, Katherine Holste, Sarah Brown, Fran Hardaway, Priscilla Pang, Ahmed M Raslan
BACKGROUND: Quality improvement projects increasingly emphasize standardization of surgical work flow to optimize operative room efficiency. Removing special cause variability resulting from nonsurgical waste is an obvious target; however, resident surgical education must be maintained, even in the setting of process improvement. OBJECTIVE: To describe the impact of resident-identified "risky" or "uncomfortable" procedural steps on operative time during transforaminal lumbar interbody fusion (TLIF)...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#18
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29335389/checklist-in-colorectal-surgery-proposal-of-experts-of-the-polish-club-of-coloproctology-and-national-consultant-in-general-surgery
#19
Tomasz Banasiewicz, Łukasz Krokowicz, Piotr Richter, Adam Dziki, Piotr Krokowicz, Zbigniew Lorenc, Marek Szczepkowski, Michał Drews, Grzegorz Wallner
A checklist is a collection of information that helps reduce the risk of failure due to limitations in human memory and attention. In surgery, the first Surgical Safety Checklist (SSC), created under the supervision of WHO (World Health Organization), was established in 2007 and covers three stages related to the patient's stay in the operating theater and operation: 1. Prior to initiation (induction) of anesthesia; 2. before cutting the skin; 3. before the patient leaves the operating room Colorectal surgery is particularly at high risk for complications and relatively high mortality...
December 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29330982/assessment-of-safety-levels-in-operation-rooms-at-two-major-tertiary-care-public-hospitals-of-karachi-safe-surgery-saves-life
#20
Muhammad Saeed Minhas, Muhammad Muzzammil, Jahanzeb Effendi
BACKGROUND: The objectives of this study are to determine the knowledge and attitude towards surgical safety among the health care professionals including surgeons, anaesthetist, hospital administrators, and operation room personnel and raise awareness towards the importance of safe surgery. METHODS: A pilot cross- sectional study of 543 healthcare providers working in the operating rooms and the surgical intensive care units was conducted in two tertiary care hospitals, within a study period of one month...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
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