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Claire E Webster, Jon Clasper, Daniel J Stinner, Joseph Eliahoo, Spyros D Masouros
Background: Throughout history, traumatic amputation of the lower extremity has been a notable feature of all conflicts involving explosive incidents. Even at the close of the recent conflicts in Afghanistan, there were deaths that were deemed "potentially survivable." The purpose of this study is to characterize lower extremity blast injury and to determine if their amputation levels and associated injury characteristics correlate with a higher risk of mortality. Methods: the UK Joint Theatre Trauma Registry (JTTR) was interrogated to identify all lower extremity traumatic amputations sustained in both Iraq and Afghanistan between January 2003 and the end of UK operations in August 2014...
March 14, 2018: Military Medicine
Laurent Mathieu, Michel Levadoux, Emmanuel Soucany de Landevoisin, Tarun J McBride Windsor, Sylvain Rigal
INTRODUCTION: Noncombat-related hand injuries are common in current theatres of operations. Crushing is one of the most frequent mechanisms that may cause traumatic amputations of digits. In the military setting, management of these digital amputations is challenging regarding limitation in microsurgical means in medical treatment facilities and aeromedical evacuation delays out of the combat zone. METHODS: Two cases of digital replantation performed in French forward surgical units are described...
2018: SICOT-J
Rebecca Shirley, Janka Fazekas, Martin McNally, Alex Ramsden
Aim : This study aimed to define the costs of surgical management of chronic osteomyelitis where free tissue transfer was required in addition to debridement of bone, particularly the increased costs incurred by a return to theatre. We hypothesised that there would be a significantly greater cost when patients required re-exploration for vascular compromise. Method : We retrospectively analysed the costs of a consecutive series of sixty patient episodes treated at the Bone Infection Unit in Oxford from 2012 to 2015...
2018: Journal of Bone and Joint Infection
Jennifer Hartley, Muhammad Akhtar, Edmond Edi-Osagie
A 31-year-old nulliparous patient presents with a three-day history of right sided colicky abdominal pain and associated nausea. This patient has previously presented twice with right sided ovarian torsion with the background of polycystic ovaries in the last two consecutive years. Blood tests were normal. Due to previous history, there was a high index of clinical suspicion that this may be a further torsion. Therefore, the patient was taken to theatre for a diagnostic laparoscopy and a further right sided ovarian torsion was noted...
2018: Case Reports in Obstetrics and Gynecology
S-M Lee, K Gordon, R McMillan, F Crystal, P Acher
Introduction Transurethral resection of the prostate has remained the most common operation for bladder outlet obstruction in the UK, but it is associated with potential morbidity and median two-day length of hospital stay. Holmium laser enucleation of the prostate (HoLEP) provides an alternative procedure. Provision of day-case HoLEP would improve patient care through increased efficiency. We assessed the feasibility and safety of day-case HoLEP and examined predictive factors for increased length of hospital stay...
March 15, 2018: Annals of the Royal College of Surgeons of England
H S Thakkar, I Yardley, D Kufeji
Introduction In 2015, the Royal College of Surgeons of England (RCS) commissioned the East Midlands Clinical Network to develop a set of guidelines for the management of paediatric torsion. Two quality measures identified were the provision of surgery locally where possible and 100% of explorations within three hours. We sought to assess the adherence to these quality measures within our referral network. Materials and methods Retrospective data were collected for all paediatric scrotal explorations performed within our centre between January 2014 and July 2016...
March 15, 2018: Annals of the Royal College of Surgeons of England
Benjamin R Poh, Paul A Cashin, Daniel G Croagh
INTRODUCTION: Traditional teaching dictates that it may not be prudent to take the jaundiced patient to theatre for emergency laparoscopic cholecystectomy as they may experience worse outcomes following surgery. METHODS: A prospective cohort of 104 patients undergoing emergency laparoscopic cholecystectomy was stratified into two groups using a serum total bilirubin of above 50 μmol/L (2.9 mg/dL) to define the jaundiced group. Primary outcomes were morbidity and mortality rate...
March 14, 2018: World Journal of Surgery
Anne-Marie Reid, Jeremy M Brown, Julie M Smith, Alexandra C Cope, Susan Jamieson
CONTEXT: For medical education researchers, a key concern may be the practicalities of gaining ethical approval where this is a national or local requirement. However, in qualitative studies, where the dynamics of human interaction pervade, ethical considerations are an ongoing process which continues long after approval has been granted. Responding to ethical dilemmas arising 'in the moment' requires a reflexive approach whereby the researcher questions his/her own motivations, assumptions and interests...
March 13, 2018: Perspectives on Medical Education
Macellina Y Ijadunola, Temitope O Ojo, Florence O Akintan, Ayoade O Adeyemo, Ademola S Afolayan, Olakunle G Akanji
PURPOSE: This study assessed awareness and availability of assistive facilities in a Nigerian public university. METHODS: Study was conducted in Obafemi Awolowo University (OAU), Ile Ife Nigeria using a mixed methods approach. Fifty two students with disability (SWD) were interviewed with a semistructured, self-administered questionnaire. A checklist was used to assess assistive facilities on campus while in-depth interviews (IDI) were conducted with university officials, to assess their perspectives about the availability and use of assistive facilities in the university...
March 12, 2018: Disability and Rehabilitation. Assistive Technology
Randa A Abdallah, Sameh M Ragab, Maher Z Hassanin
OBJECTIVE: To investigate the safety and efficacy of two topical blood stopper modulators; Ankaferd blood stopper (ABS) and feracrylum 1% solution (FS) during adenoid surgery. STUDY DESIGN: Prospective randomized trial. METHODS: Two hundred and twenty five consecutive pediatric adenoid patients aged from 9 months to 2 years old were studied. Patients were randomly allocated into two haemostatic groups; (ABS, FS) and normal saline (control group)...
March 10, 2018: European Archives of Oto-rhino-laryngology
Olivia Sonneborn, Charne Miller, Leon Head, Rachel Cross
BACKGROUND: Operating theatre services can be heavily relied upon during mass casualty disaster events, which require nurses to have adequate training and education of hospital disaster management plans to respond appropriately. The evidence-base of disaster preparedness in the acute setting is limited, particularly with regard to operating theatre nurses. OBJECTIVES: Explore operating theatre nurse's disaster knowledge of their role in a mass casualty event, and identify the preferred mode of disaster education and training to improve disaster preparedness...
February 21, 2018: Nurse Education Today
Declan C Murphy, Mohamed Alfiky, Peter Prinsley
Oncocytomas are rare glandular tumours, typically found in salivary glands and kidneys. A 76-year-old man presented to an ophthalmology department after 3 months of persistent right-sided epiphora. Lacrimal syringing and a fluorescein dye test demonstrated an obstruction at the level of the nasolacrimal duct (NLD). Owing to the patient's history of dacryocystitis, endoscopic dacryocystorhinostomy was organised. When in theatre however, nasendoscopy identified a polypoid mass at the lateral aspect of the inferior turbinate, obstructing the right NLD opening...
March 9, 2018: BMJ Case Reports
Chiara Berlangieri, Giovanna Poggi, Sergio Murgia, Maura Monduzzi, Luigi Dei, Emiliano Carretti
A dynamic, rheological, and structural characterization of aqueous gel-like systems containing hydroxypropyl guar gum (HPG), borax and glycerol is presented in this paper. The role of glycerol, which is introduced as a plasticizer in the formulation, is investigated by means of11 B NMR and1 H NMR PGSTE measurements in order to clarify its contribution to the gel network formation and its interaction with borax, with whom it forms a complex. The effect of gels components on the rheological behaviour and on the activation energy related to the relaxation process of the system was assessed by means of rheology...
February 13, 2018: Colloids and Surfaces. B, Biointerfaces
Thomas Krasemann, Felix Berger, Petru Liuba, John Thomson
A modern catheter laboratory for the treatment of children with CHD should be in close proximity to the paediatric ICU, operating theatres, and imaging facilities. Space requirements and equipment for an up-to-date catheter laboratory are discussed. The document was endorsed by the council of the Association of European Paediatric and Congenital Cardiologists.
March 9, 2018: Cardiology in the Young
Ann Lögde, Gudrun Rudolfsson, Roma Runesson Broberg, Anna Rask-Andersen, Robert Wålinder, Erebouni Arakelian
The lack of specialist nurses in operating theatres is a serious problem. The aim of this study was to describe reasons why specialist nurses in perioperative care chose to leave their workplaces and to describe the process from the thought to the decision. Twenty specialist nurses (i.e. anaesthesia, NA, and operating room nurses) from seven university- and county hospitals in Sweden participated in qualitative individual in-depth interviews. Data were analysed by systematic text condensation. We identified four themes of reasons why specialist nurses quitted their jobs: the head nurses' betrayal and dismissive attitude, and not feeling needed; inhumane working conditions leading to the negative health effects; not being free to decide about one's life and family life being more important than work; and, colleagues' diminishing behaviour...
March 6, 2018: International Journal for Quality in Health Care
Slavisa Ninkovic, Zoe McQuilten, Robert Gotmaker, Andrew E Newcomb, Merrole F Cole-Sinclair
BACKGROUND: Transfusion of platelets is common in cardiac surgery, and while there are guidelines for their use, there are concerns about potential risks. We aimed to assess the impact of platelet transfusion on mortality, thrombosis, and infection in this patient group. STUDY DESIGN AND METHODS: A retrospective cohort study of all patients at St Vincent's Hospital Melbourne who underwent a first cardiac surgery procedure from June 2001 to June 2014 was conducted...
March 7, 2018: Transfusion
Steve Slott
Steve Stott, managing director of Medical Air, discusses the many benefits of ultraclean ventilation systems in the 21st century operating theatre environment, explaining that the development of ever-more advanced and 'flexibly designed' UCV canopies has enabled them to be installed in a wide range of theatres, extending the variety of surgeries that can be undertaken, while helping to minimise the risk of surgical site infection.
June 2017: Health Estate
Leila Amininejad, Benoit Charloteaux, Emilie Theatre, Claire Liefferinckx, Julia Dmitrieva, Pierre Hayard, Vincianne Muls, Jean-Marc Maisin, Michael Schapira, Jean-Michel Ghislain, Pierre Closset, Mehdi Talib, Marc Abramowicz, Yukihide Momozawa, Valerie Deffontaine, François Crins, Myriam Mni, Latifa Karim, Nadine Cambisano, Sandra Ornemese, Alessandro Zucchi, Charlotte Minsart, Jacques Deviere, Jean-Pierre Hugot, Martine De Vos, Edouard Louis, Severine Vermeire, Andre Van Gossum, Wouter Coppieters, Jean-Claude Twizere, Michel Georges, Denis Franchimont
BACKGROUND & AIMS: A few rare monogenic primary immunodeficiencies (PID) are characterized by chronic intestinal inflammation that resembles Crohn's disease (CD). We investigated whether 23 genes associated with 10 of these monogenic disorders contain common, low-frequency or rare variants that increase risk for CD. METHODS: Common and low frequency variants in 1 Mb loci centered on the candidate genes were analyzed using meta-data corresponding to genotypes of approximately 17,000 patients with CD or without CD (controls) in Europe...
February 28, 2018: Gastroenterology
René Fahrner, Falk Rauchfuss, Hubert Scheuerlein, Utz Settmacher
BACKGROUND: There are numerous causes of hepatic gas formation that range from serious pathologies to incidental findings, including mesenteric infarction, liver abscess, inflammatory bowel disease or minimally invasive hepatic interventions. CASE PRESENTATION: We report a case of a 50-year-old man who was admitted to the emergency room after a car accident. The clinical examination and further diagnostics revealed a craniocerebral injury with a fracture of the skull, concomitant soft tissue lesions and subarachnoidal bleeding...
March 2, 2018: BMC Surgery
Robert Bush, Sandra Capra, Selina Box, David McCallum, Stephanie Khalil, Remo Ostini
In the context of stubbornly high childhood obesity rates, health promotion activities in schools provide a potential avenue to improve children's nutritional behaviours. Theatre production has a rich history as a health behaviour promotion strategy but lacks sound, outcome-based evaluation. This study evaluated the effect of an integrated, two-part, place-based theatre performance program with 212 students in five schools in a regional urban and semi-rural area. The program included a theatre performance and a healthy eating competition...
March 2, 2018: Children
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