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Operations management

Stan Benjamens, Robert A Pol, Lioe-Fee de Geus-Oei, Aiko P J de Vries, Andor W J M Glaudemans, Stefan P Berger, Riemer H J A Slart
INTRODUCTION: This study focused on the value of quantitatively analyzed and qualitatively graded renal scintigraphy in relation to the expected duration of delayed graft function after kidney transplantation. A more reliable prediction of delayed graft function duration may result in a more tailored and patient-specific treatment regimen post-transplantation. METHODS: From 2000 to 2014, patients with early transplant dysfunction and a Tc-99m MAG3 renal scintigraphy, within 3 days post-transplantation, were included in a dual center retrospective study...
2018: PloS One
Adam Kaiser, Adam Semanoff, Louis Christensen, Rory Sadoff, Jody C DiGiacomo
PURPOSE: To evaluate submental intubation compared with secure airways of patients who have sustained significant maxillofacial trauma. PATIENTS AND METHODS: Patient series of 3 patients who underwent submental intubation prior to open reduction internal fixation of fractures associated with the mid and lower face. All of these patients were initially orally intubated, and then converted to submental intubation prior to the reparative procedure. Detailed description of the procedure is discussed in each patient...
March 20, 2018: Journal of Craniofacial Surgery
Mostafa Mirzaei Aliabadi, Hamed Aghaei, Omid Kalatpour, Ali Reza Soltanian, Asghar Nikravesh
PURPOSE: The present study was aimed to analyze human and organizational factors involved in mining accidents and determine the relationships among these factors. MATERIALS AND METHODS: In this study, Human Factors Analysis and Classification System (HFACS) with Bayesian network (BN) were combined in order to analyze contributing factors in mining accidents. BN was constructed based on a hierarchal structure of HFACS. The required data were collected from a total of 295 cases of Iranian mining accidents and analyzed using HFACS...
March 21, 2018: International Journal of Occupational Safety and Ergonomics: JOSE
Michael Galgano, Jared Fridley, Adetokunbo Oyelese, Albert Telfian, Thomas Kosztowski, David Choi, Ziya L Gokaslan
Metastatic spinal disease is a source of significant morbidity in patients with cancer. Recent advancements in adjuvant oncologic therapy has led to increased survival for many patients who harbor neoplastic disease. As a result of this, the chance of developing metastatic spinal disease over the course of a cancer patient's lifespan has increased. Symptomatic metastatic spinal disease can cause significant morbidity including severe pain, neurologic deficit, and loss of ambulation. Current treatment of these patients typically involves the use of multiple modalities, including surgery, radiation, and chemotherapy...
March 21, 2018: Expert Review of Anticancer Therapy
Tang-Wei Chuang, Shou-Chien Chen, Kow-Tong Chen
AIMS: The aim of this study was to explore the recent advances in diagnosis and treatment of gastroesophageal reflux disease (GERD). METHODS: Previous studies were searched using the terms "gastroesophageal reflux disease" and "diagnosis" or "treatment" in Medline and Pubmed. Articles that were not published in the English language, manuscripts without an abstract, reviews, meta-analysis, and opinion articles were excluded from the review...
July 2017: Acta Gastro-enterologica Belgica
R Dumont, F Puleo, J Collignon, N Meurisse, M Chavez, L Seidel, P Gast, M Polus, C Loly, Ph Delvenne, P Meunier, R Hustinx, A Deroover, O Detry, E Louis, Ph Martinive, D Van Daele
BACKGROUND AND STUDY AIMS: The current standard of care for resectable pancreatic ductal adenocarcinoma (PDAC) is surgery-first followed by adjuvant chemotherapy. We review our single center experience in a PDAC cohort managed by the surgery-first strategy. We then compare our data to those of Belgian and international literature. PATIENTS METHODS: We reviewed a series of 83 consecutive resectable patients with PDAC, treated by the surgery-first approach in a Belgian Academic Hospital between 2007 and 2013...
October 2017: Acta Gastro-enterologica Belgica
Bin Sato, Mitsuro Kanda, Chie Tanaka, Daisuke Kobayashi, Naoki Iwata, Norifumi Hattori, Masaya Suenaga, Masamichi Hayashi, Suguru Yamada, Kenta Murotani, Michitaka Fujiwara, Yasuhiro Kodera
BACKGROUND: Surgical resection is the mainstay of treatment for patients with gastric cancer (GC). Development of a simple, high-performance, integrated scoring system is needed to provide appropriate management. This study aimed to evaluate predictive values of the systemic inflammation score (SIS) for short- and long-term outcomes of patients who underwent surgery for GC. METHODS: A total of 187 patients who underwent gastrectomy for pT2-4 GC without preoperative treatment were analyzed...
March 20, 2018: World Journal of Surgery
Giuseppe Cardellini, Tatiana Valada, Claire Cornillier, Estelle Vial, Marian Dragoi, Venceslas Goudiaby, Volker Mues, Bruno Lasserre, Arkadiusz Gruchala, Per Kristian Rørstad, Mathias Neumann, Miroslav Svoboda, Risto Sirgmets, Olli-Pekka Näsärö, Frits Mohren, Wouter M J Achten, Liesbet Vranken, Bart Muys
Life cycle assessment (LCA) has become a common methodology to analyze environmental impacts of forestry systems. Although LCA has been widely applied to forestry since the 90s, the LCAs are still often based on generic Life Cycle Inventory (LCI). With the purpose of improving LCA practices in the forestry sector, we developed a European Life Cycle Inventory of Forestry Operations (EFO-LCI) and analyzed the available information to check if within the European forestry sector national differences really exist...
March 20, 2018: Environmental Management
Jeffrey A Zuccato, Christopher D Witiw, Julia Keith, Erin Dyer, Arjun Saghal, Leodante da Costa
Introduction: Pre-operative biopsy and diagnosis of chordomas of the mobile spine is indicated as en bloc resections improve outcomes. This review of the management of mobile spine chordomas includes two cases of unexpected mobile spine chordomas where a preoperative tissue diagnosis was decided against and may have altered surgical decision-making. Case presentation: Two lumbar spine chordomas thought to be metastatic and primary bony lesions preoperatively were not biopsied before surgery and eventual pathology revealed chordoma...
2018: Spinal Cord Series and Cases
Kirk R Bingham, Jeffrey B Riley, Gregory J Schears
Anticoagulation during infant-pediatric extracorporeal life support (ECLS) has been a topic of study for many years, but management of anticoagulation is still only partially understood. Adequate anticoagulation during ECLS is imperative for successful outcomes and understanding the individual variables that play part is crucial for properly implementing anticoagulation management strategies. The purpose of our study was to compare the relationships between the variables of activated partial thromboplastin time (aPTT), activated clotting time, international normalized ratio, bleeding, thrombus formation, kaolin + heparinase thromboelastograph alpha angle, kaolin thromboelastograph reaction time (KTEG R-time), heparin dose rates (HDR), antithrombin (AT), anti-Xa, bivalirudin dose rate, argatroban dose rate, interventions, and transfusions...
March 2018: Journal of Extra-corporeal Technology
Alexander Fisher, Leon Fisher, Wichat Srikusalanukul, Paul N Smith
INTRODUCTION: The data on predictive value of the routinely obtained preoperative biochemical parameters in hip fracture (HF) patients are limited. The aims of this study were to examine in older HF patients (1) the relationships between a broad set of routine laboratory parameters at admission and in-hospital mortality, and (2) evaluate the prognostic value the biomarkers and clinical characteristics (alone or in combination) provide to predict a fatal outcome. PATIENTS AND METHODS: In 1820 consecutive patients with low-trauma osteoporotic HF aged >60 years (mean age 82...
March 8, 2018: Injury
D'Andrea K Joseph, Daniel Daman, Rae Lynne Kinler, Karyl Burns, Lenworth Jacobs
The aim of this study was to describe the management of severe blunt renal injuries at a Level I trauma hospital. Data were collected through a record review of patients admitted from January 1, 2000, to December 31, 2011. These data were compiled as part of our hospital's participation in the Nonoperative Management of Grade IV and V Blunt Renal Injuries: A Research Consortium of New England Centers for Trauma Study. Thirty-six patients with severe blunt renal injuries were identified. Twenty-nine (80.6%) underwent nonoperative management (NOM) for their injuries...
March 1, 2018: American Surgeon
Nkem Nweze, Afshin Parsikia, Rakesh Ahuja, Amit R T Joshi
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the apocrine sweat glands. Although the mainstay of surgical treatment is excision, the disease has a high tendency to recur, for reasons that are not well understood. We sought to better characterize the natural history of this disease, focusing on patients who required operative intervention. Two hundred and fourteen patients with axillary HS underwent 293 surgical procedures. We divided the cohort into two groups based on recurrence and then compared them to identify the factors most associated with recurrent axillary HS...
March 1, 2018: American Surgeon
Anya Romanoff, Hank Schmidt, Matthew McMurray, Christina Weltz, Monica Schwartzman, Kathryn Friedman, Laurie Margolies, Elisa Port
The role of MRI in the workup of newly diagnosed breast cancer patients remains controversial. Breast MRI detects additional disease, but this has not translated into improved outcomes. In light of a dramatic rise in MRI use, we investigated patterns of MRI ordering for newly diagnosed breast cancer. All newly diagnosed breast cancer cases presenting for surgical management to a specialized breast center from 2011 to 2013 were reviewed. Patients who had an MRI ordered by their operating surgeon were compared with those who had an MRI completed previously...
March 1, 2018: American Surgeon
Yu Zhou, Zhenyu Zhou, Lifeng Liu, Xuecheng Cao
BACKGROUND: Skeletal and soft tissue damage are often associated with unilateral facet dislocations, which undoubtedly lead to instability of the spine and further increase difficulties in cervical reduction. This type of irreducible facet dislocation is usually accompanied with potential catastrophic consequences including neurological deficit and severe disability. Therefore, a consistent and evidence-based treatment plan is imperative. CASE PRESENTATION: The literature regarding the management of traumatic unilateral locked cervical facet dislocations was reviewed...
March 21, 2018: Journal of Medical Case Reports
Matthew Aizpuru, Christopher Staley, William Reisman, Michael B Gottschalk, Mara L Schenker
OBJECTIVES: To investigate the determinants of length of stay (LOS) for patients surgically treated for femur fractures. DESIGN: Retrospective medical record review. SETTING: Urban Level I Trauma Center. PARTICIPANTS: Three hundred twenty-one patients operatively treated for femur fractures between July 12, 2015 and July 12, 2016. INTERVENTION: Intramedullary nailing, open reduction internal fixation, arthroplasty, or other (percutaneous screw or multiple hardware/technique) definitive fixation of femur fracture...
April 2018: Journal of Orthopaedic Trauma
Eoghan T Hurley, Daren Lim Fat, Shane K Farrington, Hannan Mullett
BACKGROUND: Anterior shoulder instability with significant glenoid bone loss is a challenging condition. The open Latarjet procedure is the established standard treatment method in this setting, but there is an increasing use of the arthroscopic technique. PURPOSE: To systematically review the current evidence in the literature to ascertain if the open or arthroscopic Latarjet procedure resulted in improved patient outcomes. STUDY DESIGN: Systematic review and meta-analysis...
March 1, 2018: American Journal of Sports Medicine
Joseph Christensen, Sean Spence, David Watson, Anjan Shah, Benjamin Maxson, Anthony Infante, Roy Sanders, Hassan R Mir
OBJECTIVE: To review the orthopaedic injuries from watercraft treated surgically at our institution and report the mechanisms, fractures, and complications encountered. DESIGN: Retrospective case series. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: There were 216 fractures from watercraft in 146 patients. Average age was 33 years (range 4-78 years), there were 68% males (99/146), and 16% of the injuries occurred in children...
April 2018: Journal of Orthopaedic Trauma
Jennifer Bido, Roya Ghazinouri, Jamie E Collins, Desirée Diez Portela, Luis Alcantara, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Medical missions to low and middle-income countries are increasingly frequent, with an estimated 6,000 trips sponsored by U.S. organizations accounting for approximately 200,000 surgical cases and $250 million in costs annually. However, these missions have received little critical evaluation. This paper describes the research program Operation Walk (Op-Walk) Boston, and proposes an evaluation model for similar surgical missions. METHODS: We propose an evaluation model, borrowing from the work of Donabedian and enriched by evidence from our research program...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Soad Ali Yehia, Sally Adel Abdel Halim, Mary Yosry Aziz
OBJECTIVE: Formulation of injectable in situ forming implant (ISI) systems of lornoxicam for dental and post operative pain management to decrease dosing frequency and increase patient compliance. METHOD: Polymeric in situ implant solutions were prepared using different concentrations and inherent viscosities of Poly-DL-lactide (PDL) or DL-lactide/glycolide copolymer (PDLG) using 22X4 factorial experimental design. Non polymeric systems were prepared using different concentrations of lipids like cetyl alcohol and stearyl alcohol and also sucrose acetate isobutyrate (SAIB) using 32 factorial experimental design...
March 19, 2018: Current Drug Delivery
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