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Catherine de Blacam, Sean Tierney, Odhran Shelley
BACKGROUND: Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity...
October 20, 2016: Journal of Plastic Surgery and Hand Surgery
Paula Morgenstern, Maria Li, Rokia Raslan, Paul Ruyssevelt, Andrew Wright
The electricity consumption of 27 departments was measured across 8 medium to large General Acute hospitals in England (largely by the authors, some data was donated and authorised for publication by the respective hospitals). The departments fall into 6 different categories which have been selected due to their prevalence in General Acute Hospitals (wards), their high energy intensities (theatres, laboratories, imaging and radiotherapy) or their distinct operating hours (day clinics). This data article provides floor areas and the time series of departmental power loads, mostly encompassing lighting and small power (but excluding central electricity use for ventilation, pumping and medical gas services)...
June 2016: Data in Brief
Shilpa Ajit Joshi, Shalomith Uppapalli, Pranav More, Madan Deshpande
Brittle cornea syndrome is a rare generalised connective tissue disorder with ocular features like keratoglobus or keratoconus, severe corneal thinning and a high risk of perforation. Various authors in different case reports and case series have brought out the fact that brittle cornea is a disorder with characteristic systemic manifestations such as deafness, joint hypermobility, hyperelasticity of skin, kyphoscoliosis and dental abnormalities alongwith ophthalmic features. We report a case of globe perforation following trivial trauma, in an individual with brittle cornea without any extraocular manifestations, posing a challenge in the diagnosis and dilemma in surgical repair of cornea, restoration of globe integrity and visual rehabilitation...
October 7, 2016: BMJ Case Reports
Rebecca Anna Leslie, Stephen Michael Kinsella, Jeremy Astin, Jennifer Patricia Tuckey
We performed a prospective observational audit to evaluate the application of the Lucas caesarean section urgency classification to assisted vaginal delivery in the operating theatre. We collected data from 400 women having category 1-3 delivery in the operating theatre. Twenty percent of the caesarean sections and 4% of the vaginal deliveries were category 1. The median (IQR) decision-delivery interval was 25 (19.5-37) min for category 1 caesarean section and 19.5 (15-29) min for category 1 vaginal delivery, and 43...
October 18, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Arie S Parnham, Maarten Albersen, Varun Sahdev, Michelle Christodoulidou, Raj Nigam, Peter Malone, Alex Freeman, Asif Muneer
BACKGROUND: Penile cancer is a rare malignancy that is confined to the glans in up to four out of five cases. Although descriptions of glansectomy exist, there are no contemporary video explanations or large published single centre series. OBJECTIVE: To show the efficacy and safety of glansectomy and split-thickness skin graft (STSG) reconstruction. DESIGN, SETTING, AND PARTICIPANTS: Data were collected retrospectively for patients identified from surgical theatre diaries between February 2005 and January 2016...
October 13, 2016: European Urology
Peter Max Halschou-Jensen, Andreas Balslev-Clausen, Peter Søndergaard
Traumatic hip dislocation is uncommon in children. Yet, it represents an orthopaedic emergency, because delayed treatment can lead to avascular necrosis of the femoral head. In this case a four-year-old boy and an eight-year-old girl were treated in an emergency department less than two weeks apart. They both received a posterior hip dislocation after accident during sledging. Their hips were reduced within six hours in the operating theatre, and the patients were discharged few days later. At the follow-up after six and 12 weeks both patients were doing well, and X-rays were normal...
October 10, 2016: Ugeskrift for Laeger
Carsten Engelmann, Gudela Grote, Siegfried Geyer, Dzifa Ametowobla
PURPOSE: Algorithms for surgical operation planning are evidence-based. However, choices sometimes have to be made between medically equal solutions e.g. for staffing of sought-after operations. Such decisions are heavily influenced by micropolitics and power. The article examines the array of highly manipulated processes around operation theatre allocation of convenient time slots or staff, which play out in various ways in all of the world's main regional surgical cultures. METHOD: Essay supported by empiric data from an ethnographic power-analysis targeted to senior executive surgeons...
October 14, 2016: Langenbeck's Archives of Surgery
Davide Ferorelli, Fiorenza Zotti, Silvio Tafuri, Angela Pezzolla, Alessandro Dell'Erba
The study aims to evaluate the use of Patient Safety Walkaround (SWR) execution model in an Italian Hospital, through the adoption of parametric indices, survey tools, and process indicators.In the 1st meeting an interview was conducted to verify the knowledge of concepts of clinical risk management (process indicators). One month after, the questions provided by Frankel (survey tool) were administered.Each month after, an SWR has been carried trying to assist the healthcare professionals and collecting suggestions and solutions...
October 2016: Medicine (Baltimore)
David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Bridget Gray, Andrew Briggs, Ranjit Lall, Tim Js Chesser, Ian Pallister, Sarah E Lamb, Keith Willett
BACKGROUND: Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES: We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN: A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study...
October 2016: Health Technology Assessment: HTA
Daniel A Bossard, Bruno Ledergerber, Patrick O Zingg, Christian Gerber, Annelies S Zinkernagel, Reinhard Zbinden, Yvonne Achermann
Diagnosis of Propionibacterium acnes bone and joint infection is challenging due to long cultivation time of up to 14 days. We retrospectively studied whether reducing cultivation time to 7 days allows accurate diagnosis without losing sensitivity. We identified patients with at least one positive P. acnes sample between 2005 and 2015 and grouped into 'infection' and 'no infection'. An 'infection' was defined when at least two samples from the same case were positive. Clinical and microbiological data including time to positivity for different cultivation methods were recorded...
October 12, 2016: Journal of Clinical Microbiology
Azar Hussain, Robert T Bennett, Mubarak A Chaudhry, Syed S Qadri, Mike Cowen, Alyn H Morice, Mahmoud Loubani
AIM: To determine the optimum resting tension (ORT) for in vitro human pulmonary artery (PA) ring preparations. METHODS: Pulmonary arteries were dissected from disease free sections of the resected lung in the operating theatre and tissue samples were directly sent to the laboratory in Krebs-Henseleit solution (Krebs). The pulmonary arteries were then cut into 2 mm long rings. PA rings were mounted in 25 mL organ baths or 8 mL myograph chambers containing Krebs compound (37 °C, bubbled with 21% O2: 5% CO2) to measure changes in isometric tension...
September 26, 2016: World Journal of Cardiology
Judith Harbertson, Braden R Hale, Nelson L Michael, Paul T Scott
BACKGROUND: Depression and post-traumatic stress disorder (PTSD) are significant risks for suicide and other adverse events among US military personnel, but prevalence data among ship-assigned personnel at the onset of deployment are unknown. AIMS: To determine the prevalence of shipboard personnel who screen positive for PTSD and/or major depressive disorder (MDD) at the onset of deployment, and also those who reported these diagnoses made by a physician or healthcare professional in the year prior to deployment...
September 2016: BJPsych Open
Tanel Laisaar, Eero Jakobson, Bruno Sarana, Silver Sarapuu, Jüri Vahtramäe, Mait Raag
OBJECTIVE: Percutaneous tracheostomy is a common procedure but varies considerably in approach. The aim of our study was to evaluate the need for intraoperative bronchoscopy and to compare various surgical techniques. METHODS: During 1 year all percutaneous tracheostomies in three intensive care units were prospectively documented according to a unified protocol. In one unit, bronchoscopy was used routinely and in others only during the study. RESULTS: A total of 111 subjects (77 males) with median age 64 (range, 18-86) years and body mass index 25...
2016: SAGE Open Medicine
Adam Thomas Cristaudo, Ryo Mizumoto, Rasika Hendahewa
BACKGROUND: Giant cell arteritis (GCA) has the potential to cause irreversible blindness and stroke in affected patients [1-4]. Temporal artery biopsy (TAB) remains the gold standard test for GCA [6-8]. Recent literature suggests that TAB does not change management of patients with suspected GCA and that ultrasound scan (USS) may be sufficient enough alone to confirm the diagnosis [9-11,13]. The aim of this study is to therefore determine the impact of TAB on current surgical practice and emergency theatre services...
November 2016: Annals of Medicine and Surgery
S Singh, S Reddy, Raj Shrivastva
This study compared the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) data for total hip replacements (THRs) and total knee replacements (TKRs) from Hospital A [with laminar airflow (LAF)] and Hospital B (without LAF). These hospitals were originally managed by two different trusts that subsequently merged. Consequently, the theatres in Hospital A have always had LAF and those in Hospital B had only conventional ventilation systems. As this merger happened before the establishment of the NJR, it puts us in a unique position, enabling direct comparison of the revision rates for infected hip and knee replacements between the two hospitals that follow similar infection protocols...
September 29, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Emily K Hartman
No abstract text is available yet for this article.
October 3, 2016: Medical Journal of Australia
Jacqui Agostinello, Camila R Battistuzzo, Peta Skeers, Stephen Bernard, Peter E Batchelor
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aims of this study were to (1) determine the timing of surgery for traumatic TLSCI between 2010 and 2014 and (2) identify major delays in the process of care from accident scene to surgery. SUMMARY OF BACKGROUND DATA: Early spinal surgery may promote neurological recovery and reduce acute complications after thoracolumbar spinal cord injury (TLSCI), however it is difficult to achieve due to logistical issues and the frequent presence of other non-life threatening injuries...
September 23, 2016: Spine
Gregory Tsoucalas, Konstantinos Laios, Marianna Karamanou, Markos Sgantzos, George Androutsos
Daniel Mollière, was a French anatomist and surgeon, born in Lyon, who succeeded in his short life in making his mark in surgery. He was a prolific writer who left a series of medical treatises and a committed surgeon who was responsible for various significant innovative apparatuses in the medical sper. As he lived in an era when the role of microbe had already been recognized, he was among the first to use antisepsis and install extreme measures against microbes, both in the air and on the skin'. Fountains with fresh clean water, carbonic acid, cross ventilation, medical blouses, combined with Valette's apparatus for the dressing of amputations, were some of his precautions to reduce surgical infections and post-operative mortality...
September 1, 2016: Le Infezioni in Medicina
M O Eveleigh, T E Howes, C J Peden, T M Cook
Implementation of a quality improvement bundle for peri-operative management of emergency laparotomy (ELPQuIC) improved mortality in a previous study. We used data from one site that participated in that study to examine whether it was associated with the cost of care. We collected data from 396 patients: 144 before, 144 during and 108 after implementation of the bundle. We estimated costs incurred using previously published methodology based on the time the patient spent in hospital, in the operating theatre and in critical care...
November 2016: Anaesthesia
Paul-Michel Mertes, Erik Florvaag
No abstract text is available yet for this article.
September 2016: La Presse Médicale
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