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Patient safety orthopedic

Elizabeth M White, Jessica G Smith, Rebecca L Trotta, Matthew D McHugh
OBJECTIVES: To investigate whether care in a hospital with more nurses holding at least a Bachelor of Science in Nursing (BSN) degree is associated with lower mortality for individuals with Alzheimer's disease and related dementias (ADRD) undergoing surgery ADRD. DESIGN: Cross-sectional data from 2006-07 Medicare claims were linked with the Multi-State Nursing Care and Patient Safety Survey of nurses in 4 states. SETTING: Adult, nonfederal, acute care hospitals in California, Florida, New Jersey, and Pennsylvania (N=531)...
March 20, 2018: Journal of the American Geriatrics Society
Lindsay L Warner, Paul A Warner, Jason S Eldrige
No abstract text is available yet for this article.
March 9, 2018: International Journal of Medical Education
Ally Ha, Carly Richards, Erik Criman, Jillian Piaggione, Christopher Yheulon, Robert Lim
BACKGROUND: Surgical energy injuries are an underappreciated phenomenon. Improper use of surgical energy or poor attention to patient safety can result in operating room fires, tissue injuries, and interferences with other electronic devices, while rare complications can be devastatingly severe. Despite this, there is no current standard requirement for educating surgeons on the safe use of energy-based devices or evaluation of electrosurgery (ES) education in residency training, credentialing, or practice...
March 1, 2018: Surgical Endoscopy
Nathan Lo, Jorge Antonio Gutierrez, Rajesh V Swaminathan
PURPOSE OF REVIEW: The goal of this review is to describe the benefits and limitations of robotic-assisted percutaneous coronary intervention (PCI), the most important and recent clinical data, and the future applications as robotic technology continues to develop. RECENT FINDINGS: Robotic-assisted PCI can reduce occupational hazards of ionizing radiation exposure and orthopedic injury to the interventional cardiologist while offering increased precision and fine control that may confer benefit to the patient...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
Adam Oesterle, Benjamin Weber, Roderick Tung, Niteesh K Choudhry, Jagmeet P Singh, Gaurav A Upadhyay
BACKGROUND: Although post-operative atrial fibrillation is common after non-cardiac surgery, there is a paucity of data regarding prophylaxis. We sought to determine if pharmacologic prophylaxis reduces the incidence of post-operative atrial fibrillation after non-cardiac surgery. METHODS: We performed an electronic search of Ovid MEDLINE, the Cochrane central register of controlled trials database, and SCOPUS from inception to 9/7/2016 and included prospective randomized studies in which patients in sinus rhythm underwent non-cardiac surgery and examined the incidence of post-operative atrial fibrillation as well as secondary safety outcomes...
February 21, 2018: American Journal of Medicine
C J Donnally, P M Rothenberg, G Metser, D H Massel, A J Butler, D Damodar, S H Shin, T L Zakrison
BACKGROUND: Personal watercrafts (PWC) account for a disproportionate amount of water based injuries. Current literature suggests those with less PWC experience are more at risk for injury. Previous studies have not specifically evaluated the orthopedic implications of PWC usage or how various mechanisms of injury (MOI) contribute to different injury patterns. HYPOTHESIS: PWC injuries will frequently require orthopedic intervention. The presence of an orthopedic injury will result in increased injury severity score (ISS), hospital and intensive care unit (ICU) length-of-stay (LOS)...
February 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Asdrubal Falavigna, Miguel Bertelli Ramos, Alexandre Sadao Iutaka, Cristiano Magalhães Menezes, Juan Emmerich, Nestor Taboada, K Daniel Riew
OBJECTIVE: Spine surgeons are exposed to high amounts of radiation from fluoroscopic procedures during their lifetime. The objective is to evaluate spine surgeons' knowledge and attitude regarding radiation exposure during spine surgery. METHODS: We developed a questionnaire encompassing questions about surgeon's characteristics and surgeon's knowledge and attitude regarding radiation exposure during spine surgery. A survey was performed with the members of AOSpine Latin America...
January 31, 2018: World Neurosurgery
Di Zhang, Xianda Gao, Jiang Jiang, Yong Shen, Wenyuan Ding, Huixian Cui
PURPOSE: This study aims to find a safe and easy-to-perform strategy for lumbar pedicle screw insertion based on anatomical landmarks. METHODS: From March 2011 to January 2012, 74 patients underwent posterior lumbar interbody fusion or transforaminal lumbar interbody fusion using the new-designed screw insertion technique. During the operation, the entry site for screw insertion was on the outer edge of the superior facet joint, 4 mm downward from upper border of processus transversus...
February 2, 2018: International Orthopaedics
Corey S Scher
PURPOSE OF REVIEW: The percentage of people over the age of 65 is growing rapidly and anesthesiologists must develop a medical understanding that is comprehensive to meet the unique medical needs of this population. The changing physiology of an elderly population makes them extremely vulnerable to trauma and the administration of blood products. Although most of these cases involve orthopedic attention, it is not less dangerous as a blunt trauma case. RECENT FINDINGS: This article addresses some of the main concerns for the anesthesiologists of providing a hemostatic resuscitation in the geriatric population...
April 2018: Current Opinion in Anaesthesiology
Masahiro Takeyama, Keiji Nogami, Ryohei Kobayashi, Kenichi Ogiwara, Akira Taniguchi, Yasuaki Nakanishi, Yusuke Inagaki, Yasuhito Tanaka, Midori Shima
Continuous infusions (CI) of factor (F)VIII are preferable to the conventional bolus injections for the maintenance of consistent FVIII levels during surgery in patients with severe hemophilia A. A third generation, B domain-truncated recombinant FVIII (turoctocog alfa, Novo Nordisk, NovoEight®), was approved for clinical use in 2014. The hemostatic efficacy and safety of bolus injections of turoctocog alfa in patients undergoing surgery have been reported, but no reports on CI therapy have been published...
January 30, 2018: International Journal of Hematology
Xinlin Gao, Yi Yang, Hao Liu, Yang Meng, Junfeng Zeng, Tingkui Wu, Ying Hong
The objective of this study is to present the long-term results and to evaluate the safety and effectiveness of the Prestige-LP cervical disc replacement in treatment of patients with symptomatic 2-level cervical degenerative disc disease.Twenty-four patients with 48 Prestige-LP disc were analyzed before surgery and at 1 week, 3 months, 6 months, 12 months, 24 months, and 60 months after surgery. Clinical assessments included 36-Short Form (SF-36), Japanese Orthopedic Assessment (JOA), visual analog scale (VAS), and Neck Disability Index (NDI) scores...
January 2018: Medicine (Baltimore)
Hillary J Mull, Amy K Rosen, William J O'Brien, Nathalie McIntosh, Aaron Legler, Mary T Hawn, Kamal M F Itani, Steven D Pizer
OBJECTIVE: To examine factors associated with 0- to 7-day admission after outpatient surgery in high-volume specialties: general surgery, orthopedics, urology, ear/nose/throat, and podiatry. STUDY DESIGN: We calculated rates and assessed diagnosis codes for 0- to 7-day admission after outpatient surgery for Centers for Medicare and Medicaid Services (CMS) and Veterans Health Administration (VA) dually enrolled patients age 65 and older. We also estimated separate multilevel logistic regression models to compare patient, procedure, and facility characteristics associated with postoperative admission...
January 23, 2018: Health Services Research
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.)
Thais Martins Albanaz da Conceição, Ana Inês Gonzáles, Fernanda Cabral Xavier Sarmento de Figueiredo, Danielle Soares Rocha Vieira, Daiana Cristine Bündchen
Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included...
October 2017: Revista Brasileira de Terapia Intensiva
Xinjie Wu, Mingsheng Tan, Yingna Qi, Ping Yi, Feng Yang, Xiangsheng Tang, Qingying Hao
BACKGROUND: Metastases to the upper cervical spine were rarely reported in the literature. However, metastases to this area may cause spinal instability and cord compression, which in turn can result in respiratory failure and neurological dysfunction. The present study investigated the efficacy and safety of posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for this disease. METHODS: This was a retrospective study that included 10 patients with metastatic involvement of the axis from March 2002 to May 2014...
January 11, 2018: BMC Musculoskeletal Disorders
Kimberly Hamilton, Brandon Rocque, Nathaniel Brooks
BACKGROUND: Deer hunting is popular in much of the United States. In Wisconsin, use of tree stands for hunting is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree stands while hunting. This study's purpose is to systematically characterize and classify those injuries. METHODS: We reviewed the University of Wisconsin Hospital and Clinics' trauma database for tree stand-related injuries from 1999 to 2013...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
Maha A H Ghanem, Tarek A Moustafa, Haidy M Megahed, Naglaa Salama, Sara A Ghitani
BACKGROUND: Lack of awareness and recognition of child maltreatment is the major reason behind underreporting. All victims often interact with the health care system for routine or emergency care. In several research works, non-accidental fractures are the second most common injury in maltreated children and it is represented up to one-third of cases. AIM OF THE STUDY: To determine the incidence of different types of accidental and non-accidental skeletal injuries among children, estimate the severity of injuries according to the modified injury severity score and to determine the degree of fractures either closed or opened (Gustiloe-Anderson open fracture classification)...
December 23, 2017: Journal of Forensic and Legal Medicine
Amitesh Pathak, Neeraj Yadav, Sati Nath Mohanty, Ekta Ratnani, Om Prakash Sanjeev
Introduction: Ropivacaine has been studied previously and holds promise as an agent that offers a safe, efficacious, and better recovery profile than other conventional agents such as bupivacaine. The aim of the present study was to compare the safety and efficacy of equal volume of different concentration of ropivacaine for epidural analgesia in patients undergoing major lower limb orthopedic surgery. Subjects and Methods: One hundred and fifty adult patients were randomized into three groups to receive single dose of equal volume of ropivacaine through epidural route in concentrations of 0...
October 2017: Anesthesia, Essays and Researches
Alexander Khodak, Adam S Budzikowski
BACKGROUND: Barbed suture use in surgical fields such as gynecology and orthopedic surgery has been associated with faster wound closure, improved cosmesis, increased cost-effectiveness and potentially decreased rates of infection. However, the use of barbed suture in electrophysiology device procedures has not been reported. OBJECTIVE: This study aims to (1) investigate the safety and effectiveness of barbed suture in wound closure in patients after EP implantable cardioverter defibrillators and loop recorders (CIED) procedures, (2) to determine whether these sutures have an advantage in device implant procedures by improving incision integrity, (3) and to find out whether these sutures would potentially lead to lower rates of infections compared to non-barbed sutures...
April 2017: Journal of Atrial Fibrillation
Ann Heble, Melanie D Everitt, Jane Gralla, Shelley D Miyamoto, Michael Lahart, Jennifer Eshelman
mTOR inhibitors have been associated with SWC when used in the perioperative period. Limited literature is available to guide providers in managing chronic mTOR inhibitor use in the perioperative period, especially in the pediatric setting. The primary aim of this study was to describe the prevalence of SWC with mTOR inhibitor continuation during the perioperative period for major surgeries. Heart transplant recipients ≤25 years old at the time of primary heart transplant receiving sirolimus maintenance therapy during a surgical procedure and within the study period were included...
February 2018: Pediatric Transplantation
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