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Patient safety orthopedic

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https://www.readbyqxmd.com/read/28416968/safety-and-efficacy-of-resistive-polymer-versus-forced-air-warming-in-total-joint-surgery
#1
Melanie F Sandoval, Paul D Mongan, Michael R Dayton, Craig A Hogan
BACKGROUND: Forced-air warming is used as a mechanism to prevent hypothermia and adverse outcomes associated with hypothermia among patients undergoing surgery. Patient safety in healthcare includes the use of devices and technology that minimize potential adverse events to patients. The present study sought to compare the capabilities of patient warming between two different devices that use different mechanisms of warming: forced-air warming and non-air warming. METHODS: One hundred twenty patients undergoing total hip or total knee arthroplasty received patient warming via a forced warming device or non-air warming fabric conductive material...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#2
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28375957/effects-of-intervention-and-team-culture-on-operating-room-traffic
#3
Ricardo W Pulido, Benjamin Kester, Ran Schwarzkopf
PURPOSE: How changes in the surgical team's culture can potentially reduce operating room (OR) traffic. INTRODUCTION: Excessive OR traffic during surgical procedures can present a risk to the patient's safety and recovery. Data suggest that limiting the number of OR personnel during the intraoperative period can reduce excessive OR traffic. However, it is unclear whether the surgeon's verbal intervention can also successfully reduce intraoperative OR traffic. This study compares traffic rates in hip and knee arthroplasty cases against traffic rates during nonarthroplasty cases to examine the effects of verbal interventions implemented by the surgeon to reduce intraoperative traffic...
April 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28367426/percutaneous-autologous-bone-marrow-derived-mesenchymal-stromal-cell-implantation-is-safe-for-reconstruction-of-human-lower-limb-long-bone-atrophic-nonunion
#4
Mohsen Emadedin, Narges Labibzadeh, Roghayeh Fazeli, Fatemeh Mohseni, Seyedeh Esmat Hosseini, Reza Moghadasali, Soura Mardpour, Vajiheh Azimian, Alireza Goodarzi, Maede Ghorbani Liastani, Ali Mirazimi Bafghi, Mohamadreza Baghaban Eslaminejad, Nasser Aghdami
OBJECTIVE: Nonunion is defined as a minimum of a 9-month period of time since an injury with no visibly progressive signs of healing for 3 months. Recent studies show that application of mesenchymal stromal cells (MSCs) in the laboratory setting is effective for bone regeneration. Animal studies have shown that MSCs can be used to treat nonunions. For the first time in an Iranian population, the present study investigated the safety of MSC implantation to treat human lower limb long bone nonunion...
April 2017: Cell Journal
https://www.readbyqxmd.com/read/28362214/a-systematic-multidisciplinary-initiative-for-reducing-the-risk-of-complications-in-adult-scoliosis-surgery
#5
Rajiv Sethi, Quinlan D Buchlak, Vijay Yanamadala, Melissa L Anderson, Eric A Baldwin, Robert S Mecklenburg, Jean-Christophe Leveque, Alicia M Edwards, Mary Shea, Lisa Ross, Karen J Wernli
OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. METHODS The Group Health Research Institute and Virginia Mason Medical Center implemented a systematic multidisciplinary protocol, the Seattle Spine Team Protocol, in 2010...
March 31, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28358886/-we-can-t-get-along-without-each-other-qualitative-interviews-with-physicians-about-device-industry-representatives-conflict-of-interest-and-patient-safety
#6
Anna R Gagliardi, Pascale Lehoux, Ariel Ducey, Anthony Easty, Sue Ross, Chaim Bell, Patricia Trbovich, David R Urbach
OBJECTIVES: Physician relationships with device industry representatives have not been previously assessed. This study explored interactions with device industry representatives among physicians who use implantable cardiovascular and orthopedic devices to identify whether conflict of interest (COI) is a concern and how it is managed. DESIGN: A descriptive qualitative approach was used. Physicians who implant orthopedic and cardiovascular devices were identified in publicly available directories and web sites, and interviewed about their relationships with device industry representatives...
2017: PloS One
https://www.readbyqxmd.com/read/28332374/comparison-of-dexmedetomidine-and-fentanyl-as-an-adjuvant-to-ropivacaine-for-postoperative-epidural-analgesia-in-pediatric-orthopedic-surgery
#7
Sang Jun Park, Seokyung Shin, Shin Hyung Kim, Hyun Woo Kim, Seung Hyun Kim, Hae Yoon Do, Yong Seon Choi
PURPOSE: Opioids are commonly used as an epidural adjuvant to local anesthetics, but are associated with potentially serious side effects, such as respiratory depression. The aim of this study was to compare the efficacy and safety of dexmedetomidine with that of fentanyl as an adjuvant to epidural ropivacaine in pediatric orthopedic surgery. MATERIALS AND METHODS: This study enrolled 60 children (3-12 years old) scheduled for orthopedic surgery of the lower extremities and lumbar epidural patient-controlled analgesia (PCA)...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28298775/a-comparative-study-of-intravenous-dexmedetomidine-and-intravenous-clonidine-for-postspinal-shivering-in-patients-undergoing-lower-limb-orthopedic-surgeries
#8
Manohar Panneer, Prakash Murugaiyan, Sufala Viswas Rao
BACKGROUND: Dexmedetomidine and clonidine have been used for the prevention and treatment of shivering following spinal blockade. A prospective randomized, double-blinded study was conducted to compare the efficacy and safety of dexmedetomidine and clonidine in controlling postspinal shivering. METHODS: A total of sixty participants of equal sex, aged between 18 and 60 years of American Society of Anesthesiologists (ASA) I/II Class, who underwent orthopedic lower limb surgeries under spinal anesthesia with ≥Grade III shivering were randomly divided into two groups, Group D (n = 30) received injection dexmedetomidine 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298772/effect-of-dexmedetomidine-as-an-adjuvant-to-0-75-ropivacaine-in-interscalene-brachial-plexus-block-using-nerve-stimulator-a-prospective-randomized-double-blind-study
#9
H D Rashmi, H K Komala
BACKGROUND: Ropivacaine, a newer local anesthetic (LA), has been increasingly used nowadays in different concentrations for peripheral nerve blocks. It has lesser cardiac toxicity and higher safety margin when compared to bupivacaine. Dexmedetomidine, a novel α2 agonist, is widely used as adjuvant to LA in peripheral nerve blocks to decrease the time of onset and increase the duration of the block. In this study, we evaluated the effect of dexmedetomidine as an adjuvant with 0.75% ropivacaine for interscalene brachial plexus block using nerve stimulator...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28282305/ce-original-research-identifying-hospitalized-patients-at-risk-for-harm-a-comparison-of-nurse-perceptions-vs-electronic-risk-assessment-tool-scores
#10
COMPARATIVE STUDY
Andrea Stafos, Susan Stark, Kathryn Barbay, Kristen Frost, David Jackel, Lindsey Peters, Elizabeth Riggs, Susan Schedler, Shalan Stroud
: Objective: In many hospitals, nurse-led "safety huddles" are used to relay patient safety information, although whether this effectively identifies patients at risk for harm has not been determined. New electronic risk assessment tools are designed to identify patients at risk for harm during hospitalization, based on specific markers in the electronic health record. This study sought to compare the results of both methods. The findings may help to enhance decision making at the level of care delivery. METHODS: A nonexperimental correlational study was conducted over a three-week period in 2015 in a large metropolitan acute care community hospital...
April 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28271090/intrapelvic-protrusion-of-a-broken-guide-wire-fragment-during-fixation-of-a-femoral-neck-fracture
#11
Ahmadreza Afshar
During fixation of a femoral neck fracture in a 23-year-old male patient with cannulated screws, a broken guide wire fragment inadvertently advanced through the hip joint and protruded into the pelvis. A second surgical approach was needed to remove the broken fragment from the pelvis. Awareness of such a potentially devastating complication will make surgeons more cautious during implementation of orthopedic instruments and increases patient's safety during surgery.
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28261434/survey-of-preferences-in-patients-scheduled-for-carpal-tunnel-release-using-conjoint-analysis
#12
Wan Lim Kim, Jin Sam Kim, Jun Bum Lee, Sun Hwa Kim, Dong-Uk Min, Ho Youn Park
BACKGROUND: This study aimed to investigate the preferences of patients scheduled for carpal tunnel release using conjoint analysis and also introduce an example of how to apply a conjoint analysis to the medical field. The use of conjoint analysis in this study is new to the field of orthopedic surgery. METHODS: A total of 97 patients scheduled for carpal tunnel release completed the survey. The following four attributes were predefined: board certification status, distance from the patient's residency, medical costs, and waiting time for surgery...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28259490/what-do-patients-expect-from-total-knee-arthroplasty-a-delphi-consensus-study-on-patient-treatment-goals
#13
Toni Lange, Jochen Schmitt, Christian Kopkow, Elisabeth Rataj, Klaus-Peter Günther, Jörg Lützner
BACKGROUND: Although total knee arthroplasty (TKA) is among the most frequent orthopedic procedures for end-stage knee osteoarthritis (OA), systematically developed patient treatment goals for this elective intervention are missing. This constitutes a relevant barrier toward patient-centered healthcare. METHODS: A Delphi consensus study was conducted. Patients who were candidates for TKA were recruited through 11 outpatient orthopedic surgeons, 4 physiotherapists, and a patient organization in Germany...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28255955/parecoxib-provides-analgesic-and-opioid-sparing-effects-following-major-orthopedic-surgery-a-subset-analysis-of-a-randomized-placebo-controlled-clinical-trial
#14
Efrain Diaz-Borjon, Armando Torres-Gomez, Margaret Noyes Essex, Patricia Salomon, Chunming Li, Raymond Cheung, Bruce Parsons
INTRODUCTION: Orthopedic surgeries are among the most common and most painful surgeries performed. A multimodal analgesic approach is recommended to reduce opioid consumption, provide effective pain relief, and improve outcomes following surgery. This study examined the efficacy and opioid-sparing effects of parecoxib following major orthopedic surgery. METHODS: This subset analysis of a large, multicenter, randomized, double-blind, placebo-controlled study of parecoxib examined treatment effects on postoperative pain severity, pain interference with function, opioid consumption, occurrence of opioid-related symptoms, safety, and patient satisfaction following major orthopedic surgery...
March 2, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28255511/can-direct-current-electrotherapy-be-used-for-patients-with-orthopedic-implants
#15
Evangeline Thaler, Felippe Toledo, Holger Korte
INTRODUCTION: Although electrotherapy appears to have particularly interesting applications in the field of postoperative orthopedic rehabilitation, relatively little scientifically based research has been conducted in the area of electrotherapy with regard to safety involving patients with orthopedic implants. METHOD: Three electrotherapy forms were tested, such as high-volt stimulation (HVS), transcutaneous electric nerve stimulation (TENS), and galvanic current (GAL), using a model system containing a metal implant plate to evaluate whether heating in excess of 3°C would occur...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28246009/clinical-and-radiographic-features-of-hybrid-surgery-for-the-treatment-of-skip-level-cervical-degenerative-disc-disease-a-minimum-24-month-follow-up
#16
Ting-Kui Wu, Bei-Yu Wang, Ding Cheng, Xin Rong, Ji-Gang Lou, Ying Hong, Hao Liu
We describe the radiographic changes of IS and investigate the safety and feasibility of hybrid surgery (HS) coupling cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) for the treatment of skip-level cervical degenerative disc disease (CDDD). Twenty-seven patients who received HS were retrospectively reviewed. Clinical evaluation based on the Japanese Orthopedic Association (JOA) and Neck Disability Index (NDI) and Visual Analog Scale (VAS) scores. Radiographic parameters included cervical alignment (CA), functional spine unite (FSU) angle of intermediated segment (IS), range of motion (ROM) and intervertebral disc height (IDH)...
February 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28243144/a-double-blind-randomized-comparative-study-of-the-use-of-a-combination-of-uridine-triphosphate-trisodium-cytidine-monophosphate-disodium-and-hydroxocobalamin-versus-isolated-treatment-with-hydroxocobalamin-in-patients-presenting-with-compressive-neuralgias
#17
Henrique Goldberg, Marco Antonio Mibielli, Carlos Pereira Nunes, Stephanie Wrobel Goldberg, Luiz Buchman, Spyros Ge Mezitis, Helio Rzetelna, Lisa Oliveira, Mauro Geller, Fernanda Wajnsztajn
CONTEXT: This paper reports on the results of treatment of compressive neuralgia using a combination of nucleotides (uridine triphosphate trisodium [UTP] and cytidine monophosphate disodium [CMP]) and vitamin B12. OBJECTIVES: To assess the safety and efficacy of the combination of nucleotides (UTP and CMP) and vitamin B12 in patients presenting with neuralgia arising from neural compression associated with degenerative orthopedic alterations and trauma, and to compare these effects with isolated administration of vitamin B12...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28195826/wrong-site-surgery-in-california-2007-2014
#18
Omid Moshtaghi, Yarah M Haidar, Ronald Sahyouni, Afsheen Moshtaghi, Yaser Ghavami, Harrison W Lin, Hamid R Djalilian
Objective The implementation of a universal surgical safety protocol in 2004 was intended to minimize the prevalence of wrong-site surgery (WSS). However, complete elimination of WSS in the operating room continues to be a challenge. The purpose of this study is to evaluate the prevalence and etiology of WSS in the state of California. Study Design A retrospective study of all WSS reports investigated by the California Department of Public Health between 2007 and 2014. Methods Prevalence of overall and specialty-specific WSS, causative factors, and recommendations on further improvement are discussed...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28183145/minimally-invasive-microscopic-posterior-cervical-decompression-simple-safe-and-effective
#19
Pierluigi Vergara
Background and Study Aims Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in the elderly population. Surgery is usually successful in preventing any deterioration, as well as improving functional status and quality of life. This study assesses the safety and efficacy of minimally invasive microscopic posterior cervical decompression for the treatment of CSM. Materials and Methods A retrospective review of patients with myelopathy from cervical stenosis treated with minimally invasive posterior cervical decompression was performed...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28143470/current-use-of-autologous-adipose-tissue-derived-stromal-vascular-fraction-cells-for-orthopedic-applications
#20
REVIEW
Jaewoo Pak, Jung Hun Lee, Kwang Seung Park, Moonhee Park, Lin-Woo Kang, Sang Hee Lee
Autologous adipose stromal vascular fractions (SVFs) containing adipose tissue-derived stem cells (ASCs) are currently being used in clinical settings for various orthopedic applications for human patients. Due to its potential capability of regenerating cartilage, bone, and tendons, autologous adipose SVFs are being tried in treating patients with osteoarthritis (OA), chondromalacia, meniscus tear, osteonecrosis of the femoral head, and tendon injuries. Here, we have reviewed available human clinical studies with regard to patient applications of autologous adipose SVF containing ASCs, specifically assessing effectiveness and safety in the field of orthopedic disorders...
January 31, 2017: Journal of Biomedical Science
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