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https://www.readbyqxmd.com/read/28806225/preventing-retained-central-venous-catheter-guidewires-a-randomized-controlled-simulation-study-using-a-human-factors-approach
#1
Maryanne Z A Mariyaselvam, Ken R Catchpole, David K Menon, Arun K Gupta, Peter J Young
BACKGROUND: Retained central venous catheter guidewires are never events. Currently, preventative techniques rely on clinicians remembering to remove the guidewire. However, solutions solely relying upon humans to prevent error inevitably fail. A novel locked procedure pack was designed to contain the equipment required for completing the procedure after the guidewire should have been removed: suture, suture holder, and antimicrobial dressings. The guidewire is used as a key to unlock the pack and to access the contents; thereby, the clinician must remove the guidewire from the patient to complete the procedure...
August 11, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28805464/advancing-preparedness-for-highly-hazardous-contagious-diseases-admitting-10-simulated-patients-with-mers-cov
#2
Angela Vasa, Philip W Smith, Michelle Schwedhelm, Theodore J Cieslak, John Lowe, Christopher J Kratochvil, Elizabeth L Beam, Kate Boulter, Angela Hewlett
The Ebola outbreak of 2014-2016 highlighted the need for the development of a more robust healthcare infrastructure in the United States to provide isolation care for patients infected with a highly hazardous contagious disease. Routine exercises and skills practice are required to effectively and safely prepare care teams to confidently treat this special population of patients. The Nebraska Biocontainment Unit (NBU) at Nebraska Medicine in Omaha has been conducting exercises since 2005 when the unit was opened...
August 14, 2017: Health Security
https://www.readbyqxmd.com/read/28805387/polymyxin-binding-to-the-bacterial-outer-membrane-reveals-cation-displacement-and-increasing-membrane-curvature-in-susceptible-but-not-in-resistant-lps-chemotypes
#3
Denys Ewerton da Silva Santos, Laércio Pol-Fachin, Roberto D Lins, Thereza A Soares
Lipid-A is the causative agent of Gram-negative sepsis and responsible for increasingly high mortality rate among hospitalized patients. Compounds that bind Lipid-A can limit this inflammatory process. The cationic antimicrobial peptide polymyxin B (Pmx-B) is one of the simplest molecules capable of selectively bind to Lipid-A, and may serve as a model for further development of Lipid-A binding agents. Gram-negative bacteria resistance to Pmx-B relies on the upregulation of a number of regulatory systems, which promote chemical modifications of the LPS structure, and leads to major changes in the physical-chemical properties of the outer membrane...
August 14, 2017: Journal of Chemical Information and Modeling
https://www.readbyqxmd.com/read/28805140/a-rat-model-for-the-in-vivo-assessment-of-biological-and-tissue-engineered-valvular-and-vascular-grafts
#4
Yukiharu Sugimura, Anna Kathrin Schmidt, Artur Lichtenberg, Alexander Assmann, Payam Akhyari
The demand for an improvement of the biocompatibility and durability of vascular and valvular implants requires translational animal models to study the in vivo fate of cardiovascular grafts. In the present article, a review on the development and application of a microsurgical rat model of infrarenal implantation of aortic grafts and aortic valved conduits is provided. By refinement of surgical techniques and inclusion of hemodynamic considerations, a functional model has been created, which provides a modular platform for the in vivo assessment of biological and tissue-engineered grafts...
August 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28804730/breast-dose-reduction-with-organ-based-wide-angle-tube-current-modulated-ct
#5
Wanyi Fu, Gregory M Sturgeon, Greeshma Agasthya, William Paul Segars, Anuj J Kapadia, Ehsan Samei
This study aimed to estimate the organ dose reduction potential for organ-dose-based tube current modulated (ODM) thoracic computed tomography (CT) with a wide dose reduction arc. Twenty-one computational anthropomorphic phantoms (XCAT) were used to create a virtual patient population with clinical anatomic variations. The phantoms were created based on patient images with normal anatomy (age range: 27 to 66 years, weight range: 52.0 to 105.8 kg). For each phantom, two breast tissue compositions were simulated: [Formula: see text] and [Formula: see text] (glandular-to-adipose ratio)...
July 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28804729/organ-dose-variability-and-trends-in-tomosynthesis-and-radiography
#6
Jocelyn Hoye, Yakun Zhang, Greeshma Agasthya, Greg Sturgeon, Anuj Kapadia, W Paul Segars, Ehsan Samei
The purpose of this study was to investigate relationships between patient attributes and organ dose for a population of computational phantoms for 20 tomosynthesis and radiography protocols. Organ dose was estimated from 54 adult computational phantoms (age: 18 to 78 years, weight 52 to 117 kg) using a validated Monte-Carlo simulation (PENELOPE) of a system capable of performing tomosynthesis and radiography. The geometry and field of view for each exam were modeled to match clinical protocols. For each protocol, the energy deposited in each organ was estimated by the simulations, converted to dose units, and then normalized by exposure in air...
July 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28803724/implementation-and-outcomes-of-an-evidence-based-precepting-program-for-burn-nurses
#7
Johnnie R Robbins, Krystal K Valdez-Delgado, Nicole W Caldwell, Linda H Yoder, Elizabeth J Hayes, Michaèl G Barba, Hope L Greeley, Colleen Mitchell, Elizabeth A Mann-Salinas
INTRODUCTION: There is significant nationwide interest in transitioning new and new-to-specialty nurses into practice, especially in burn care. Lack of a structured transition program in our Burn Center was recognized as a contributing factor for nursing dissatisfaction and increased turnover compared to other hospital units. Employee evaluations exposed a need for more didactic instruction, hands-on learning, and preceptor support. The goal of this project was to implement an evidence-based transition to practice program specific to the burn specialty...
August 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28803217/accurate-model-based-segmentation-of-gynecologic-brachytherapy-catheter-collections-in-mri-images
#8
Andre Mastmeyer, Guillaume Pernelle, Ruibin Ma, Lauren Barber, Tina Kapur
The gynecological cancer mortality rate, including cervical, ovarian, vaginal and vulvar cancers, is more than 20,000 annually in the US alone. In many countries, including the US, external-beam radiotherapy followed by high dose rate brachytherapy is the standard-of-care. The superior ability of MR to visualize soft tissue has led to an increase in its usage in planning and delivering brachytherapy treatment. A technical challenge associated with the use of MRI imaging for brachytherapy, in contrast to that of CT imaging, is the visualization of catheters that are used to place radiation sources into cancerous tissue...
July 18, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/28802837/development-of-simulation-optimization-methods-for-solving-patient-referral-problems-in-the-hospital-collaboration-environment
#9
Ping-Shun Chen, Ming-Han Lin
This research studied a patient referral problem among multiple cooperative hospitals for sharing imaging services' referrals. The proposed problem consisted of many types of patients and the uncertainty associated with the number of patients of each type, patients' arrival time, and patients' medical operation time, leading to a difficulty in finding solutions due to the uncertain environment. This research used system simulation to construct a model and develop a simulation optimization method, combining the heuristic algorithm (patient referral mechanism) with the particle swarm optimization (PSO) method, to determine a better way to refer patients from one hospital (referring hospital) to another (recipient hospital) to receive certain imaging services...
August 9, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28802802/nodal-stage-migration-and-prognosis-in-anal-cancer-a-systematic-review-meta-regression-and-simulation-study
#10
Hema Sekhar, Marcel Zwahlen, Sven Trelle, Lee Malcomson, Rohit Kochhar, Mark P Saunders, Matthew Sperrin, Marcel van Herk, David Sebag-Montefiore, Matthias Egger, Andrew G Renehan
BACKGROUND: In patients with squamous cell carcinoma of the anus (SCCA), lymph node positivity (LNP) indicates poor prognosis for survival and is central to radiotherapy planning. Over the past three decades, LNP proportion has increased, mainly reflecting enhanced detection with newer imaging modalities; a process known as nodal stage migration. If accompanied by constant T stage distributions, prognosis for both lymph node-positive and lymph node-negative groups may improve without any increase in overall survival for individual patients; a paradox termed the Will Rogers phenomenon...
August 9, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28802790/vascular-air-embolism-a-silent-hazard-to-patient-safety
#11
REVIEW
Sorin J Brull, Richard C Prielipp
PURPOSE: To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). MATERIALS AND METHODS: MEDLINE, SCOPUS, Cochrane Central Register and Google Scholar databases were searched for data published through October 2016. The Manufacturer and User Facility Device Experience (MAUDE) database was queried for "air embolism" reports (years 2011-2016). RESULTS: VAE may be introduced through disruption in the integrity of the venous circulation that occurs during insertion, maintenance, or removal of intravenous or central venous catheters...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28802550/mr-coagulation-a-novel-minimally-invasive-approach-to-aneurysm-repair
#12
Ouri Cohen, Ming Zhao, Erez Nevo, Jerome L Ackerman
PURPOSE: To demonstrate a proof of concept of magnetic resonance (MR) coagulation, in which MR imaging scanner-induced radiofrequency (RF) heating at the end of an intracatheter long wire heats and coagulates a protein solution to effect a vascular repair by embolization. MATERIALS AND METHODS: MR coagulation was simulated by finite-element modeling of electromagnetic fields and specific absorption rate (SAR) in a phantom. A glass phantom consisting of a spherical cavity joined to the side of a tube was incorporated into a flow system to simulate an aneurysm and flowing blood with velocities of 0-1...
August 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28802454/a-novel-low-cost-solution-for-driving-assessment-in-individuals-with-and-without-disabilities
#13
Jakob Rodseth, Edward P Washabaugh, Ali Al Haddad, Paula Kartje, Denise G Tate, Chandramouli Krishnan
Brake reaction time is a key component to studying driving performance and evaluating fitness to drive. Although commercial simulators can measure brake reaction time, their cost remains a major barrier to clinical access. Therefore, we developed open-source software written in C-sharp (C#) for measuring driving related reaction times, which includes a subject-controlled vehicle with straight-line dynamics and several testing scenarios. The software measures both simple and cognitive load based reaction times and can use any human interface device compliant steering wheel and pedals...
November 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28802148/inattentional-blindness-in-anesthesiology-a-simulation-study
#14
Anthony M-H Ho, Joseph Y C Leung, Glenio B Mizubuti, Leeanne H Contardi, Matthew T V Chan, Thomas S F Lo, Alex K T Lee
STUDY OBJECTIVES: Inattentional blindness is the psychological phenomenon of inability to see the unexpected even if it is in plain view. We hypothesized that anesthesiologists may overlook unexpected intraoperative events whereas medical students, lacking in intraoperative monitoring experience and knowledge, may be more likely to notice such events. DESIGN: A simulation study using a video of a simulated septic patient undergoing abdominal surgery. SETTING: A large academic center...
August 9, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28801781/acute-pain-crisis-in-a-patient-with-sickle-cell-disease-undergoing-ovarian-simulation-for-fertility-preservation-prior-to-curative-stem-cell-transplantation-case-report-and-literature-review
#15
Michelle Matthews, Rebecca Pollack
PURPOSE: Hematopoietic stem cell transplantation (HSCT) is a cure for sickle cell disease (SCD) but frequently results in permanent sterility. The complications associated with oocyte cryopreservation and risks of future pregnancy are increased in SCD patients. This case report discusses risk reduction strategies and includes a literature review of pregnancy after HSCT. CASE: A 23-year-old woman underwent ovarian stimulation for fertility preservation resulting in cancelation due to acute pain crisis...
August 11, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/28801767/experimental-validation-of-predicted-application-accuracies-for-computer-assisted-cas-intraoperative-navigation-with-paired-point-registration
#16
Martina Perwög, Zoltan Bardosi, Wolfgang Freysinger
PURPOSE: The target registration error (TRE) is a crucial parameter to estimate the potential usefulness of computer-assisted navigation intraoperatively. Both image-to-patient registration on base of rigid-body registration and TRE prediction methods are available for spatially isotropic and anisotropic data. This study presents a thorough validation of data obtained in an experimental operating room setting with CT images. METHODS: Optical tracking was used to register a plastic skull, an anatomic specimen, and a volunteer to their respective CT images...
August 11, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28801298/-application-of-3d-visualization-technique-in-breast-cancer-surgery-with-immediate-breast-reconstruction-using-laparoscopically-harvested-pedicled-latissimus-dorsi-muscle-flap
#17
Pu-Sheng Zhang, Li-Kun Wang, Yun-Feng Luo, Fu-Jun Shi, Lin-Yun He, Cheng-Bing Zeng, Yu Zhang, Chi-Hua Fang
OBJECTIVE: To study the value of 3D visualization technique in breast-preserving surgery for breast cancer with immediate breast reconstruction using laparoscopically harvested pedicled latissimus dorsi muscle flap. METHODS: From January, 2015 to May, 2016, 30 patients with breast cancer underwent breast-preserving surgery with immediate breast reconstruction using pedicled latissimus dorsi muscle flap. The CT data of the arterial phase and venous phase were collected preoperatively and imported into the self-developed medical image 3D visualization system for image segmentation and 3D reconstruction...
August 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28801203/echocardiographic-prediction-of-cardiac-resynchronization-therapy-response-requires-analysis-of-both-mechanical-dyssynchrony-and-right-ventricular-function-a-combined-analysis-of%C3%A2-patient-data-and-computer-simulations
#18
Wouter M van Everdingen, John Walmsley, Maarten J Cramer, Iris van Hagen, Bart W L De Boeck, Mathias Meine, Tammo Delhaas, Pieter A Doevendans, Frits W Prinzen, Joost Lumens, Geert E Leenders
BACKGROUND: Pronounced echocardiographically measured mechanical dyssynchrony is a positive predictor of response to cardiac resynchronization therapy (CRT), whereas right ventricular (RV) dysfunction is a negative predictor. The aim of this study was to investigate how RV dysfunction influences the association between mechanical dyssynchrony and left ventricular (LV) volumetric remodeling following CRT. METHODS: One hundred twenty-two CRT candidates (mean LV ejection fraction, 19 ± 6%; mean QRS width, 168 ± 21 msec) were prospectively enrolled and underwent echocardiography before and 6 months after CRT...
August 8, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28801150/three-dimensional-wound-maping-software-compared-to-expert-opinion-in-determining-wound-area
#19
E Farrar, O Pujji, S Jeffery
INTRODUCTION: New technologies in the field of burn wound and scar assessment are continually being evaluated. Accurate estimation of total body surface area (TBSA) burn wound is of paramount importance in fluid resuscitation to prevent complications which are associated with morbidity and mortality. Estimating the TBSA is performed by a multitude of different methods, however a gold standard would be ideal. The aim of this study was to compare the estimation of burned TBSA% between 3D photography by Panasonic FZ-M1 Toughpad in conjunction with WoundCare Lite software and expert opinion volunteered by burns doctors...
August 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#20
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
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