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Patient safety orthopedic

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https://www.readbyqxmd.com/read/28643113/-safety-culture-in-orthopedics-and-trauma-surgery-course-concept-interpersonal-competence-by-the-german-society-for-orthopaedics-and-trauma-dgou-and-lufthansa-aviation-training
#1
REVIEW
A-K Doepfer, R Seemann, D Merschin, R Stange, M Egerth, M Münzberg, M Mutschler, B Bouillon, R Hoffmann
Patient safety has become a central and measurable key factor in the routine daily medical practice. The human factor plays a decisive role in safety culture and has moved into focus regarding the reduction of treatment errors and undesired critical incidents. Nonetheless, the systematic training in communication and interpersonal competences has so far only played a minor role. The German Society of Orthopaedics and Trauma (DGOU) in cooperation with the Lufthansa Aviation Training initiated a course system for interpersonal competence...
June 22, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28640081/-direct-vision-operation-of-posterior-atlantoaxial-transpedicular-screw-fixation-for-unstable-atlantoaxial-fractures-a-retrospective-study
#2
Liangliang Cao, Erzhu Yang, Jianguang Xu, Xiaofeng Lian, Bin Cai, Xiaokang Liu, Guowang Zhang
BACKGROUND: The posterior screw fixation in atlas via posterior arch and lateral mass, also called C1 "pedicle" screw, combined with C2 pedicle screw fixiation has shown better biomechanical stability in unstable atlantoaxial fractures. However, its popularization has to fulfill the limitation imposed by anatomical characteristics. The aim of this study was to explore the manipulation, effect, and safety of the atlantoaxial transpedicular screw fixation under "direct vision" for the treatment of unstable atlantoaxial fracture...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28605879/a-rct-study-of-rivaroxaban-low-molecular-weight-heparin-and-sequential-medication-regimens-for-the-prevention-of-venous-thrombosis-after-internal-fixation-of-hip-fracture
#3
Yilun Tang, Kunzheng Wang, Zhibin Shi, Pei Yang, Xiaoqian Dang
The guidelines for the prevention of venous thromboembolism in orthopedic surgeries have reached a consensus on the postoperative conventional anticoagulation. However, the choice of anticoagulant drugs is yet controversial. The use of the drug rivaroxaban is expensive. Since the compliance of patients with low-molecular-weight heparin is considerably low, a cost-effective, efficacious and convenient anticoagulant program is essential. The present study investigated the efficacy, safety, patient compliance, and cost-effectiveness of low-molecular-weight heparin with sequential Rivaroxaban anticoagulant therapy in patients with a hip fracture, following internal fixation...
June 8, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28598710/the-use-of-yoga-by-physical-therapists-in-the-united-states
#4
Mary E Wims, Shayla M McIntyre, Ann York, Laura G Covill
How physical therapists (PTs) in the United States currently use yoga in their clinical practices is unknown. The purpose of this study was to determine how PTs in the United States view yoga as a physical therapy (PT) tool and how PTs use yoga therapeutically. The authors conducted a 24-item survey via electronic communications of the Geriatric, Orthopedic, Pediatric, and Women's Health Sections of the American Physical Therapy Association. Participants (n = 333) from 47 states and the District of Columbia replied...
June 9, 2017: International Journal of Yoga Therapy
https://www.readbyqxmd.com/read/28589561/computer-assisted-orthopaedic-surgery
#5
REVIEW
David Hernandez, Roja Garimella, Adam E M Eltorai, Alan H Daniels
Nowadays, operating rooms can be inefficient and overcrowded. Patient data and images are at times not well integrated and displayed in a timely fashion. This lack of coordination may cause further reductions in efficiency, jeopardize patient safety, and increase costs. Fortunately, technology has much to offer the surgical disciplines and the ongoing and recent operating room innovations have advanced preoperative planning and surgical procedures by providing visual, navigational, and mechanical computerized assistance...
June 7, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28585999/treatment-of-a-pediatric-t-type-intercondylar-humerus-fracture-with-hybrid-percutaneous-pinning-and-external-fixation
#6
D Alex Stroh, Brian T Sullivan, Brett A Shannon, Paul D Sponseller
T-type intercondylar fractures of the distal humerus are rare injuries in skeletally immature patients. Few studies are available to guide the treatment of these injuries. Small case series and expert recommendations suggest superiority of the open approach for direct reduction of the articular surface. This approach poses risks of vascular compromise and elbow stiffness. However, success with percutaneous intercondylar screw fixation has been described for simple split patterns. The authors present a case that illustrates a novel percutaneous technique to treat this fracture type...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585992/complex-lumbar-spine-fusion-for-an-elderly-patient-under-spinal-anesthesia
#7
Noah L Lessing, Charles C Edwards, Charles Lin, Charles H Brown
Spinal anesthesia for spine surgery is an emerging technique. Because of their lack of physiologic reserve, elderly patients are an appealing population for this technique. Unfortunately, the safe limits of spine surgery using spinal anesthesia for the geriatric population are not well defined. The authors describe an elderly patient with severe spine degeneration who elected for a 5-level lumbar spine fusion with spinal anesthesia. Adequate anesthesia was maintained throughout the procedure, which lasted 3 hours and 24 minutes...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28583023/safety-of-outpatient-total-ankle-arthroplasty-vs-traditional-inpatient-admission-or-overnight-observation
#8
Ryan P Mulligan, Selene G Parekh
BACKGROUND: Total joint surgeons have successfully performed hip, knee, and shoulder arthroplasty procedures in the outpatient setting without compromising safety, satisfaction, or results. The purpose of this study was to evaluate outpatient total ankle arthroplasty (TAA) as compared with overnight or extended inpatient stay, with regard to 90-day medical and operative complications, reoperations, readmissions or emergency room visits, and pain control. METHODS: The medical records of patients who underwent TAA with 1 fellowship-trained orthopedic foot and ankle surgeon were reviewed...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28579855/thromboprophylaxis-with-apixaban-in-patients-undergoing-major-orthopedic-surgery-meta-analysis-and-trial-sequential-analysis
#9
REVIEW
Daniel Caldeira, Filipe B Rodrigues, Fausto J Pinto, Joaquim J Ferreira, João Costa
BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of orthopedic surgery, and until recently, few antithrombotic compounds were available for postoperative thromboprophylaxis. The introduction of the non-vitamin K antagonists oral anticoagulants (NOAC), including apixaban, has extended the therapeutic armamentarium in this field. Therefore, estimation of NOAC net clinical benefit in comparison with the established treatment is needed to inform clinical decision making...
2017: Clinical Medicine Insights. Blood Disorders
https://www.readbyqxmd.com/read/28535791/clinical-outcomes-in-a-subpopulation-of-adults-with-morquio-a-syndrome-results-from-a-long-term-extension-study-of-elosulfase-alfa
#10
D Hughes, R Giugliani, N Guffon, S A Jones, K E Mengel, R Parini, R Matousek, S M Hawley, A Quartel
BACKGROUND: This post hoc subanalysis examined outcomes in adult patients with Morquio A (mucopolysaccharidosis IVA) who received enzyme replacement therapy (ERT) with elosulfase alfa over a 120-weeks period. Patients ≥18 years of age evaluated in an open-label, long-term extension study of elosulfase alfa (modified per protocol [MPP], n = 32; intent-to-treat [ITT], n = 37; MOR-005; NCT01415427) were compared with the ≥18-year-old untreated population with 2-years follow-up from a Morquio A natural history study (n = 10; MorCAP; NCT00787995)...
May 23, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28507734/adverse-effect-profile-comparison-of-pain-regimens-with-and-without-intravenous-acetaminophen-in-total-hip-and-knee-arthroplasty-patients
#11
Alyssa Gallipani, A Scott Mathis, Hoytin Lee Ghin, Germin Fahim
BACKGROUND: The use of adjunct, non-opioid agents is integral for pain control following total hip and knee arthroplasty. Literature comparing safety profiles of intravenous acetaminophen versus opioids is lacking. OBJECTIVE: To determine whether there is a difference in frequency and type of adverse effects between intravenous acetaminophen-treated and non-intravenous acetaminophen-treated patients. Primary safety endpoints included any adverse effect noted in the electronic medical record post-surgically...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28501353/beta-tricalcium-phosphate-for-orthopedic-reconstructions-as-an-alternative-to-autogenous-bone-graft
#12
P Hernigou, A Dubory, J Pariat, D Potage, F Roubineau, S Jammal, C H Flouzat Lachaniette
Autogenous bone graft (autograft) remains the gold standard in the treatment of many orthopedic problems. However, graft harvest can lead to perioperative morbidity and increased cost. We tested the hypothesis that an osteoconductive matrix, beta-tricalcium phosphate (β-TCP), would be a safe and effective alternative to autograft alone. Beta-tricalcium phosphate (β-TCP) is considered as one of the most promising biomaterials for bone reconstruction. This study analyzes the outcomes of patients who received β-TCP as bone substitutes in orthopedic surgery...
May 10, 2017: Morphologie: Bulletin de L'Association des Anatomistes
https://www.readbyqxmd.com/read/28497931/is-outpatient-continuous-regional-analgesia-more-effective-and-equally-safe-than-single-shot-peripheral-nerve-blocks-after-ambulatory-orthopedic-surgery-a-systematic-review-of-randomized-double-blinded-placebo-controlled-trials
#13
Andrea Saporito, Luciano Anselmi, Evelina Sturini, Alain Borgeat, José A Aguirre
BACKGROUND: Continuous regional analgesia is an established technique for effective postoperative pain treatment, particularly after orthopedic surgical procedures. Even if it has been increasingly applied to the outpatient setting as well, many anesthesiologists are still reluctant to discharge patients with a perineural catheter in place. Aim of this review was to clarify the evidences about safety and effectiveness of outpatient continuous peripheral nerve blocks. METHODS: A systematic review of all prospective, randomized, double-blinded, placebo-controlled trials of the last 20 years on outpatient continuous peripheral nerve blocks after ambulatory orthopedic surgery was performed, using both PubMed and OVID databases were...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28481385/an-assessment-of-the-safety-of-an-orthopedic-specialty-hospital-a-5-year-experience
#14
Eric M Padegimas, Matthew L Ramsey, Matthew Austin, Javad Parvizi, Gerald R Williams, Kelly Doyle, Michael E West, Richard H Rothman, Alexander R Vaccaro, Surena Namdari
One of the goals of orthopedic specialty hospitals is to provide safe and efficient care to medically optimized patients. The authors' orthopedic specialty hospital is a physician-owned, 24-bed facility that accommodates a multispecialty orthopedic practice in the areas of spine, hip and knee arthroplasty, shoulder and elbow, sports, foot and ankle, and hand surgery. The purpose of this study was to examine the first 5 years of an institutional experience with an orthopedic specialty hospital and to determine if any procedures were at increased risk of postoperative transfer...
May 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/28478713/continuous-infusion-ketorolac-for-postoperative-analgesia-following-unilateral-total-knee-arthroplasty
#15
Amy J Schwinghammer, Alex N Isaacs, Rodney W Benner, Heather Freeman, Jacob A O'Sullivan, Sarah A Nisly
BACKGROUND: Previous clinical trials have demonstrated benefit with the addition of continuous infusion (CI) ketorolac to a multimodal pain regimen in surgical patients. Data following major orthopedic surgery are minimal and conflicting. OBJECTIVES: To evaluate CI ketorolac use following unilateral total knee arthroplasty (TKA) through assessment of patient-reported pain scores, opioid consumption, and safety outcomes. METHODS: This was a retrospective, open-label cohort study that included patients undergoing unilateral TKA at a single-center teaching hospital...
June 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28459664/the-development-of-robotic-technology-in-cardiac-and-vascular-interventions
#16
Ali Pourdjabbar, Lawrence Ang, Ryan R Reeves, Mitul P Patel, Ehtisham Mahmud
Robotic technology has been used in cardiovascular medicine for over a decade, and over that period its use has been expanded to interventional cardiology and percutaneous coronary and peripheral vascular interventions. The safety and feasibility of robotically assisted interventions has been demonstrated in multiple studies ranging from simple to complex coronary lesions, and in the treatment of iliofemoral and infrapopliteal disease. These studies have shown a reduction in operator exposure to harmful ionizing radiation, and the use of robotics has the intuitive benefit of alleviating the occupational hazard of operator orthopedic injuries...
April 26, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28446134/assessment-of-perioperative-minute-ventilation-in-obese-versus-non-obese-patients-with-a-non-invasive-respiratory-volume-monitor
#17
Jaideep H Mehta, Davide Cattano, Jordan B Brayanov, Edward E George
BACKGROUND: Monitoring the adequacy of spontaneous breathing is a major patient safety concern in the post-operative setting. Monitoring is particularly important for obese patients, who are at a higher risk for post-surgical respiratory complications and often have increased metabolic demand due to excess weight. Here we used a novel, noninvasive Respiratory Volume Monitor (RVM) to monitor ventilation in both obese and non-obese orthopedic patients throughout their perioperative course, in order to develop better monitoring strategies...
April 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28437546/root-cause-analysis-and-actions-for-the-prevention-of-medical-errors-quality-improvement-and-resident-education
#18
Ryan Charles, Brandon Hood, Joseph M DeRosier, John W Gosbee, James P Bagian, Ying Li, Michelle S Caird, J Sybil Biermann, Mark E Hake
The quality of care delivered by orthopedic surgeons continues to grow in importance. Multiple orthopedic programs, organizations, and committees have been created to measure the quality of surgical care and reduce the incidence of medical adverse events. Structured root cause analysis and actions (RCA2) has become an area of interest. If performed thoroughly, RCA2 has been shown to reduce surgical errors across many subspecialties. The Accreditation Council for Graduate Medical Education has a new mandate for programs to involve residents in quality improvement processes...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28416968/safety-and-efficacy-of-resistive-polymer-versus-forced-air-warming-in-total-joint-surgery
#19
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
#20
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...
July 2017: Journal of Pediatric Orthopedics
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