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Clinical simulation

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https://www.readbyqxmd.com/read/28927207/surgical-approaches-to-the-temporal-horn-an-anatomic-analysis-of-white-matter-tract-interruption
#1
Paulo A S Kadri, Jean G de Oliveira, Niklaus Krayenbühl, Ugur Türe, Evandro P L de Oliveira, Ossama Al-Mefty, Guilherme C Ribas
BACKGROUND: Surgical access to the temporal horn is necessary to treat tumors and vascular lesions, but is used mainly in patients with mediobasal temporal epilepsy. The surgical approaches to this cavity fall into 3 primary categories: lateral, inferior, and transsylvian. The current neurosurgical literature has underestimated the interruption of involved fiber bundles and the correlated clinical manifestations. OBJECTIVE: To delineate the interruption of fiber bundles during the different approaches to the temporal horn...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28926755/neochordoplasty-versus-leaflet-resection-for-ruptured-mitral-chordae-treatment-virtual-mitral-valve-repair
#2
Ahnryul Choi, David D McPherson, Hyunggun Kim
Degenerative mitral valve (MV) disease involving mitral prolapse is one of the most prevalent MV pathologies. Quadrangular leaflet resection and neochordoplasty demonstrate excellent clinical outcomes for the treatment of posterior leaflet prolapse. We evaluated the functional and biomechanical characteristics of a virtual pathologic MV model suffering from chordal rupture, performed virtual neochordoplasty and quadrangular leaflet resection, and compared the two post-repair MV functions. The pre-repair MV demonstrated severe posterior leaflet prolapse due to the ruptured P2 chordae and excessive stress concentration...
September 13, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28926566/guidelines-for-the-management-of-a-brain-death-donor-in-the-rhesus-macaque-a-translational-transplant-model
#3
Tiffany J Zens, Juan S Danobeitia, Peter J Chlebeck, Laura J Zitur, Scott Odorico, Kevin Brunner, Jennifer Coonen, Saverio Capuano, Anthony M D'Alessandro, Kristina Matkowskyj, Weixiong Zhong, Jose Torrealba, Luis Fernandez
INTRODUCTION: The development of a translatable brain death animal model has significant potential to advance not only transplant research, but also the understanding of the pathophysiologic changes that occur in brain death and severe traumatic brain injury. The aim of this paper is to describe a rhesus macaque model of brain death designed to simulate the average time and medical management described in the human literature. METHODS: Following approval by the Institutional Animal Care and Use Committee, a brain death model was developed...
2017: PloS One
https://www.readbyqxmd.com/read/28926204/acceptability-of-clinical-decision-support-interface-prototypes-for-a-nursing-electronic-health-record-to-facilitate-supportive-care-outcomes
#4
Janet Stifter, Vanessa E C Sousa, Alessandro Febretti, Karen Dunn Lopez, Andrew Johnson, Yingwei Yao, Gail M Keenan, Diana J Wilkie
PURPOSE: To determine the acceptability, usefulness, and ease of use for four nursing clinical decision support interface prototypes. METHODS: In a simulated hospital environment, 60 registered nurses (48 female; mean age = 33.7 ± 10.8; mean years of experience = 8.1 ± 9.7) participated in a randomized study with four study groups. Measures included acceptability, usefulness, and ease of use scales. FINDINGS: Mean scores were high for acceptability, usefulness, and the ease of use for all four groups...
September 19, 2017: International Journal of Nursing Knowledge
https://www.readbyqxmd.com/read/28926095/model-based-assessment-using-conventional-bioequivalence-limits-to-ensure-safety-and-efficacy-of-rivaroxaban-in-patients-undergoing-hip-or-knee-replacement
#5
Mario González-Sales, Lanyan Fang, Myong-Jin Kim, Liang Zhao
We evaluated whether the current bioequivalence limit is adequate to ensure safety and efficacy of rivaroxaban in patients under total hip arthroplasty and total knee arthroplasty based on its model informed benefit/risk profile. Clinical data from a total of 7145 patients from 3 phase 2 and 4 phase 3 clinical trials were included in the current model-based exposure-response analysis. The relationships between rivaroxaban exposure measurements (ie, minimum or trough, maximum, average concentration, and area under the concentration-time curve [AUC] at steady state) and clinical outcomes (ie, the probabilities of major bleeding [MB] and venous thromboembolism [VTE]) were modeled using NONMEM 7...
September 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28925760/comparison-of-the-conventional-surgery-and-the-surgery-assisted-by-3d-printing-technology-in-the-treatment-of-calcaneal-fractures
#6
Wenhao Zheng, Zhenyu Tao, Yiting Lou, Zhenhua Feng, Hang Li, Liang Cheng, Hui Zhang, Jianshun Wang, Xiaoshan Guo, Hua Chen
PURPOSE: This study was aimed to compare conventional surgery and surgery assisted by 3D printing technology in the treatment of calcaneal fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients. METHODS: we enrolled 75 patients with calcaneal fracture from April 2014 to August 2016. They were divided randomly into two groups: 35 cases of 3D printing group, 40 cases of conventional group...
September 19, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28925730/impact-of-frequent-interruption-on-nurses-patient-controlled-analgesia-programming-performance
#7
Kristi R Campoe, Karen K Giuliano
OBJECTIVE: The purpose was to add to the body of knowledge regarding the impact of interruption on acute care nurses' cognitive workload, total task completion times, nurse frustration, and medication administration error while programming a patient-controlled analgesia (PCA) pump. BACKGROUND: Data support that the severity of medication administration error increases with the number of interruptions, which is especially critical during the administration of high-risk medications...
September 1, 2017: Human Factors
https://www.readbyqxmd.com/read/28925594/pharyngoesophageal-diverticula-simulating-thyroid-nodules-an-unusual-occurrence-with-unique-features
#8
Karen K Nauschuetz, Lorna L Ogden, Cherry E Starling, Mohammad J Saleh, Allan C Golding, S Thomas Traweek
Pharyngoesophageal diverticula (PED) of the Zenker's and Killian-Jamieson types arise in close proximity to the thyroid gland, and may rarely be confused with a thyroid nodule on ultrasonography. In this brief report, we detail the cytologic, clinical, and radiologic findings of three PED that were thought to be thyroid nodules, and were subjected to fine-needle aspiration (FNA). The patients were females with an age range of 51-64 years. All three patients had multiple thyroid nodules, and two patients reported symptoms attributable to the diverticulum...
September 19, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28925571/human-factors-and-simulation-in-emergency-medicine
#9
Emily M Hayden, Ambrose H Wong, Jeremy Ackerman, Margaret K Sande, Charles Lei, Leo Kobayashi, Michael Cassara, Dylan D Cooper, Kimberly Perry, William E Lewandowski, Mark W Scerbo
This consensus group from the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes" held in Orlando, Florida on May 16, 2017 focused on the use of human factors and simulation in the field of emergency medicine. The human factors discipline is often underutilized within emergency medicine but has significant potential in improving the interface between technologies and individuals in the field. The discussion explored the domain of human factors, its benefits in medicine, how simulation can be a catalyst for human factors work in emergency medicine, and how emergency medicine can collaborate with human factors professionals to affect change...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28925064/improving-realism-in-clinical-trial-simulations-via-real-world-data
#10
EDITORIAL
Holly Kimko, Kwan Lee
Simulation validity depends on how well sampling distributions used reflect real-patient characteristics, such as drug adherence, disease progression, and pharmacologic handling in the body. We challenge the current use of growth charts from nondisease-specific pediatrics in simulations for drug development. Complementary use of data from clinical trials and the real-world is expected to achieve a more realistic representation of clinical outcomes for decisions in drug development, regulatory approval, and health technology assessment...
September 19, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28923549/color-stability-of-lithium-disilicate-ceramics-after-aging-and-immersion-in-common-beverages
#11
Eleni-Sotiria Palla, Eleana Kontonasaki, Nikolaos Kantiranis, Lambrini Papadopoulou, Triantafyllia Zorba, Konstantinos M Paraskevopoulos, Petros Koidis
STATEMENT OF PROBLEM: The color of an esthetic restoration and its color stability are important for long-term success. However, the impact of common beverages on lithium disilicate ceramic is not well known. PURPOSE: The purpose of this in vitro study was to investigate color variations of lithium disilicate ceramics after thermal cycling (TC) and immersion in commonly consumed beverages. MATERIAL AND METHODS: A total of 288 specimens (1×10×10 mm) were fabricated from IPS e-max computer-aided design (CAD) (n=72), IPS e-max CERAM ([CER] n=72), IPS e-max Press with glazing ([PG] n=72), and IPS e-max Press without glazing ([PNG] n=72) according to the manufacturer's instructions...
September 16, 2017: Journal of Prosthetic Dentistry
https://www.readbyqxmd.com/read/28923547/how-oral-environment-simulation-affects-ceramic-failure-behavior
#12
Ediléia Lodi, Kátia R Weber, Paula Benetti, Pedro H Corazza, Álvaro Della Bona, Márcia Borba
STATEMENT OF PROBLEM: Investigating the mechanical behavior of ceramics in a clinically simulated scenario contributes to the development of new and tougher materials, improving the clinical performance of restorations. The optimal in vitro environment for testing is unclear. PURPOSE: The purpose of this in vitro study was to investigate the failure behavior of a leucite-reinforced glass-ceramic under compression loading and fatigue in different simulated oral environment conditions...
September 16, 2017: Journal of Prosthetic Dentistry
https://www.readbyqxmd.com/read/28923421/avoidance-of-food-effect-on-oral-absorption-profile-of-itraconazole-by-self-micellizing-solid-dispersion-approach
#13
Yoshiki Kojo, Kanako Kobayashi, Saori Matsunaga, Hiroki Suzuki, Yoshiki Seto, Hideyuki Sato, Satomi Onoue
The present study was aimed to avoid pharmacokinetic transitions of itraconazole (ITZ) evoked by high-fat meal intake by employing a self-micellizing solid dispersion (SMSD) approach. The dissolution behavior of SMSD/ITZ was assessed in simulated gastric fluid (SGF) and simulated intestinal fluid (SIF). To evaluate the food effect on the oral absorption profile of ITZ, a pharmacokinetic study was conducted on orally-dosed ITZ samples in fasted and high-fat meal-fed rats. Crystalline ITZ showed a 9.0-fold higher dissolution amount of ITZ in fed-state SGF (FeSSGF) than in fasted-state SGF (FaSSGF), whereas there was no significant difference in the dissolution amount of ITZ in SMSD/ITZ between FeSSGF and FaSSGF...
June 15, 2017: Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/28923383/design-synthesis-and-structure-activity-relationship-studies-of-a-focused-library-of-pyrimidine-moiety-with-anti-proliferative-and-anti-metastasis-activities-in-triple-negative-breast-cancer
#14
Dahong Yao, Yuxin Zhou, Lingjuan Zhu, Liang Ouyang, Jin Zhang, Yingnan Jiang, Yuqian Zhao, Dejuan Sun, Shilin Yang, Yang Yu, Jinhui Wang
Triple-negative breast cancer (TNBC) is a clinical conundrum with distinct clinical and pathologic features, which is characterized by high aggression, poor prognosis, and lack of targeted therapies. In this study, based on the structural features of type II kinase inhibitors, we designed and synthesized a focused library of 41 pyrimidine derivatives possessing potent anti-proliferation activity, Y29 showed the most potent activity against MDA-MB-231 cells. Subsequently, we carried out target prediction, homology modeling, molecular docking, dynamics simulation and determination of enzymatic activity...
September 15, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28923311/colorimetric-detection-of-d-dimer-in-a-paper-based-immunodetection-device
#15
Sónia Ruivo, Ana M Azevedo, Duarte M F Prazeres
A microfluidic paper-based analytical device (μPADs) immunoassay for detection of the blood native biomarker D-dimer is reported. The μPAD is created by wax printing on a single piece of chromatographic paper and combined with an anti-D-dimer capture antibody and conjugates of anti-D-dimer antibody with 40 nm gold nanoparticles. The presence of D-dimer in buffer/simulated plasma samples is successfully reported for concentrations as low as 15 ng D-dimer/mL. Linearity between signal intensity and D-dimer concentration is observed up to 100 ng/mL...
September 15, 2017: Analytical Biochemistry
https://www.readbyqxmd.com/read/28923301/clinical-pharmacokinetics-and-pharmacodynamic-target-attainment-of-pazufloxacin-in-prostate-tissue-dosing-considerations-for-prostatitis
#16
Kogenta Nakamura, Kazuro Ikawa, Genya Nishikawa, Ikuo Kobayashi, Masahiro Narushima, Hiroyuki Muramatsu, Shingo Morinaga, Keishi Kajikawa, Yoshiharu Kato, Masahito Watanabe, Kenji Zennami, Kent Kanao, Norifumi Morikawa, Makoto Sumitomo
The present study examined the clinical pharmacokinetics of pazufloxacin in prostate tissue and estimated the probability of target attainment for tissue-specific pharmacodynamic goals related to treating prostatitis using various intravenous dosing regimens. Patients with prostatic hypertrophy received prophylactic infusions of pazufloxacin (500 mg, n = 23; 1000 mg, n = 25) for 0.5 h prior to transurethral prostate resection. Drug concentrations in plasma (0.5-5 h) and prostate tissue (0.5-1.5 h) were measured by high-performance liquid chromatography and used for subsequent noncompartmental and three-compartmental analysis...
September 8, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28922941/taguchi-dynamic-analysis-application-to-computer-tomography-number-mass-density-linear-dependence-optimization
#17
Kuo Hsun-Nan, Yi Juei-En, Chen Chia-Hui, Pan Lung-Fa, Pan Lung-Kwang
The Taguchi dynamic analysis was applied to optimize the linear dependence between computer tomography (CT) number and mass density. The Taguchi unique L18(2(1) × 3(5)) orthogonal array was utilized in the dynamic analysis of a commercial Catphan 600 phantom with CTP 404 module, in order to optimize eighteen combinations of six factors controlling the CT simulator operation, i.e. scan time, kVp, mA, field of view (FOV), slice thickness, and imaging processing algorithm. Each factor being assigned two or three different levels made it possible to organize the required number of combinations (18)...
September 18, 2017: Computer Assisted Surgery (Abingdon, England)
https://www.readbyqxmd.com/read/28922807/tedizolid-is-highly-bactericidal-in-the-treatment-of-pulmonary-mycobacterium-avium-complex-disease
#18
Devyani Deshpande, Shashikant Srivastava, Jotam G Pasipanodya, Pooi S Lee, Tawanda Gumbo
Objectives: To determine if tedizolid is effective for pulmonary Mycobacterium avium complex (MAC) disease, and to use pharmacokinetics/pharmacodynamics to design optimal doses. Methods: We performed an exposure-response experiment in the hollow-fibre system model of intracellular MAC (HFS-MAC). We mimicked the tedizolid concentration-time profiles achieved in the lungs of patients treated once daily for 28 days. The HFS-MAC was sampled at intervals to determine the tedizolid pharmacokinetics and MAC intracellular burden...
September 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28922806/linezolid-as-treatment-for-pulmonary-mycobacterium-avium-disease
#19
Devyani Deshpande, Shashikant Srivastava, Jotam G Pasipanodya, Tawanda Gumbo
Objectives: To identify the pharmacokinetic/pharmacodynamic parameters and exposures of linezolid in the treatment of pulmonary Mycobacterium avium complex (MAC) disease. Methods: Human-derived monocytes infected with MAC were inoculated into hollow-fibre systems for dose-effect and dose-scheduling studies. We mimicked linezolid concentration-time profiles achieved in adult human lungs treated for 28 days. Sampling to confirm that the intended linezolid pharmacokinetics had been achieved, and for enumeration of MAC colony-forming units, was performed based on repetitive sampling from each system over the 28 days...
September 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28922705/from-ancient-to-avant-garde-a-review-of-traditional-and-modern-multimodal-approaches-to-surgical-anatomy-education
#20
REVIEW
Minhao Hu, David Wattchow, Dayan de Fontgalland
The landscape of surgical anatomy education is progressively changing. Traditional methods, such as cadaveric dissection and didacticism are being increasingly phased out in undergraduate courses for multimodal approaches incorporating problem-based learning, radiology and computer-based simulations. Although effective at clinically contextualizing and integrating anatomical information, these approaches may be a poor substitute for fostering a grasp of foundational 'pure' anatomy. Dissection is ideal for this purpose and hence remains the cornerstone of anatomical education...
September 18, 2017: ANZ Journal of Surgery
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