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https://www.readbyqxmd.com/read/28333831/deployed-skills-training-for-whole-blood-collection-by-a-special-operations-expeditionary-surgical-team
#1
Linda C Benavides, Iain M Smith, Jerome M Benavides, Douglas M Bowley, Heidi A Doughty, Jonathan B Lundy
BACKGROUND: Non-compressible hemorrhage is the leading cause of potentially preventable battlefield death. Combining casualty retrieval from the battlefield and damage control resuscitation (DCR) within the "golden hour" increases survival. However, transfusion requirements may exceed the current blood component stocks held by forward surgical teams. Warm fresh whole blood (WFWB) is an alternative. We report WFWB transfusion training developed by and delivered to a US Golden Hour Offset Surgical Treatment Team (GHOST-T) and the resulting improvement in confidence with WFWB transfusion...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333770/the-diagnostic-yield-of-upper-and-lower-gastrointestinal-endoscopies-in-children-in-a-tertiary-centre
#2
M Thomson, S Sharma
INTRODUCTION: Endoscopy is integral to the diagnosis and management of many gastrointestinal problems in children. Recently the number of endoscopic procedures performed has increased considerably worldwide raising questions about their appropriateness and cost-efficacy. OBJECTIVES: METHODS:: Random selection of cases from a theatre electronic database from a 30 month period covering April 2012 to October 2014. The data was collected for: initial presenting symptoms; age at diagnosis; indications for endoscopy; endoscopic findings; histopathological findings; and any change in management post-endoscopic procedure...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28332061/tutorial-assistance-for-board-certification-in-surgery-frequency-associated-time-and-cost
#3
Robert Mechera, Salome Dell-Kuster, Marco von Strauss Und Torney, Igor Langer, Markus Furrer, Heiner C Bucher, Rachel Rosenthal
BACKGROUND: Tutorial assistance is related to extra time and cost, and the hospitals' financial compensation for this activity is under debate. We therefore aimed at quantifying the extra time and resulting cost required to train one surgical resident in the operating theatre for board certification in Switzerland as an example of a training curriculum involving several surgical subspecialties. Additionally, we intended to quantify the percentage of tutorial assistance. METHODS: We analysed 200,700 operations carried out between 2008 and 2012...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28327433/sonographic-prediction-of-outcome-of-vacuum-deliveries-a-multicenter-prospective-cohort-study
#4
Birgitte H Kahrs, Sana Usman, Tullio Ghi, Aly Youssef, Erik A Torkildsen, Elsa Lindtjørn, Tilde B Østborg, Sigurlaug Benediktsdottir, Lis Brooks, Lotte Harmsen, Pål R Romundstad, Kjell Å Salvesen, Christoph C Lees, Torbjørn M Eggebø
BACKGROUND: Safe management of the second stage of labor is of great importance. Unnecessary interventions should be avoided and correct timing of interventions focused. Ultrasound assessment of fetal position and station has a potential to improve the precision in diagnosing and managing prolonged or arrested labors. The decision to perform vacuum delivery is traditionally based on subjective assessment by digital vaginal examination and clinical expertise and there is currently no method of objectively quantifying the likelihood of successful delivery...
March 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28327419/concomitant-unilateral-post-traumatic-leg-and-foot-compartment-syndrome-in-a-5-years-old-child-case-report
#5
Aissam Elmhiregh, Adel El Feghih, Khaled Faraj
BACKGROUND: Compartment syndrome is one of the most serious orthopedic emergencies [4]. It is usually anticipated and looked at in every single orthopedic case. Early recognition and management of those cases are quite important in order to avoid the devastating consequences of such condition. CASE SUMMARY: This is a case report of a 5 years old child with concomitant unilateral leg and foot compartment syndrome after a roll over trauma. The patient was presented with significant leg and foot swelling, severe pain and absent distal pulses...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28325670/neck-of-femur-fractures-in-the-elderly-does-every-hour-to-surgery-count
#6
Natasha Morrissey, Efthymios Iliopoulos, Ahmad Wais Osmani, Kevin Newman
OBJECTIVES: To determine if early surgery before 12h confers a survival or length of stay benefit for patients with neck of femur (NOF) fractures. DESIGN: Retrospective review of prospectively collected data. SETTING: District general hospital. PATIENTS: 1913 patients aged over 60 admitted with a fractured NOF who underwent surgery between 2011 and 2015. Mean age was 83.9 years. 73.7% were female. INTERVENTION: Patients had surgery for fractured NOF with data collected on demographics, mortality and length of stay...
March 6, 2017: Injury
https://www.readbyqxmd.com/read/28321572/the-extent-of-environmental-and-body-contamination-through-aerosols-by-hydro-surgical-debridement-in-the-lumbar-spine
#7
David Putzer, Ricarda Lechner, Debora Coraca-Huber, Astrid Mayr, Michael Nogler, Martin Thaler
INTRODUCTION: Surgical site infections occur in 1-6% of spinal surgeries. Effective treatment includes early diagnosis, parenteral antibiotics and early surgical debridement of the wound surface. MATERIALS AND METHODS: On a human cadaver, we executed a complete hydro-surgery debridement including a full surgical setup such as draping. The irrigation fluid was artificially contaminated with Staphylococcus aureus (ATCC 6538). Surveillance cultures were used to detect environmental and body contamination of the surgical team...
March 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28318915/computer-assisted-positioning-of-the-proximal-segment-after-sagittal-split-osteotomy-of-the-mandible-preclinical-investigation-of-a-novel-electromagnetic-navigation-system
#8
Igor Nova, Sebastian Kallus, Moritz Berger, Oliver Ristow, Urs Eisenmann, Christian Freudlsperger, Jürgen Hoffmann, Hartmut Dickhaus
INTRODUCTION: Modifications of the temporomandibular joint position after mandible osteotomy are reluctantly accepted in orthognathic surgery. To tackle this problem, we developed a new navigation system using miniaturized electromagnetic sensors. Our imageless navigation approach is therefore optimized to avoid complications of previously proposed optical approaches such as the interference with established surgical procedures and the line of sight problem. MATERIAL AND METHODS: High oblique sagittal split osteotomies were performed on 6 plastic skull mandibles in a laboratory under conditions comparable to the operating theatre...
February 17, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28314498/exploring-social-justice-in-mixed-divided-cities-from-local-to-global-learning
#9
Corey Shdaimah, Jane Lipscomb, Roni Strier, Dassi Postan-Aizik, Susan Leviton, Jody Olsen
BACKGROUND: University of Haifa and the University of Maryland, Baltimore faculty developed a parallel binational, interprofessional American-Israeli course which explores social justice in the context of increasing urban, local, and global inequities. OBJECTIVES: This article describes the course's innovative approach to critically examine how social justice is framed in mixed/divided cities from different professional perspectives (social work, health, law). Participatory methods such as photo-voice, experiential learning, and theatre of the oppressed provide students with a shared language and multiple media to express and problematize their own and others' understanding of social (in)justice and to imagine social change...
November 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28302660/rhabdomyolysis-induced-compartment-syndrome-secondary-to-atorvastatin-and-strenuous-exercise
#10
Louise Dunphy, Rossel Morhij, Sarah Tucker
A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28302635/financial-modelling-of-femtosecond-laser-assisted-cataract-surgery-within-the-national-health-service-using-a-hub-and-spoke-model-for-the-delivery-of-high-volume-cataract-surgery
#11
H W Roberts, M Z Ni, D P S O'Brart
AIMS: To develop financial models which offset additional costs associated with femtosecond laser (FL)-assisted cataract surgery (FLACS) against improvements in productivity and to determine important factors relating to its implementation into the National Health Service (NHS). METHODS: FL platforms are expensive, in initial purchase and running costs. The additional costs associated with FL technology might be offset by an increase in surgical efficiency. Using a 'hub and spoke' model to provide high-volume cataract surgery, we designed a financial model, comparing FLACS against conventional phacoemulsification surgery (CPS)...
March 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28289364/complications-inattendues-de-la-chirurgie-deux-cas-de-br%C3%A3-lure-par-plaque-de-bistouri-%C3%A3-lectrique
#12
B Diop, A Sy, P A Ba, B MBaye, Y Wane, S M Sarre
There is a real risk of electrical accidents in the operating theatre, with the growing number of electrical, electronic and flammable liquids used. Electrocautery remains the most commonly used device for its electrosurgical effect of coagulation or tissue section. When it is defective or misplaced on a small area of the skin, it can cause a typically deep, slow healing skin burn. It adds an unexpected iatrogenic morbidity to the initial condition, with devastating consequences for the patient, the surgeon and sometimes the hospital...
December 31, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28286390/early-postoperative-malignant-subcutaneous-emphysema-report-and-review
#13
N K Sahoo, Shivinder Singh, I D Roy, Amit Bhandari
BACKGROUND: Subcutaneous emphysema is defined as presence of air or gas in subcutaneous tissue layer. It may be localized or generalized due to various aetiological factors. Although SE and pneumomediastinum are self-limiting conditions, life-threatening complications may develop. Escape of air into both pleural cavity causing bilateral pneumothorax and tension pneumothorax can be termed as malignant emphysema. PURPOSE: To report a case of malignant generalized subcutaneous emphysema in early postoperative phase following palatoplasty...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28285480/pediatric-trauma-management-from-an-austere-prospective
#14
Joycelynn Gray, Derek R Linklater, James Johnston, Benjamin Donham
Pediatric trauma represents a notable proportion of casualties encountered by Combat medics, physician assistants, and physicians while in the deployed setting. Most of these resuscitation teams receive limited pediatric- specific training and suffer subsequent emotional stress due the perceived high-stakes nature of caring for gravely wounded children. Even when children survive long enough to arrive at combat support hospitals, there remain high risks for morbidity and mortality for many of them. There are numerous reports of the epidemiological characteristics of these pediatric patients, the common mechanisms of injury, the hospital lengths of stay, and calls for pediatric-specific equipment and specialist presence in-theatre...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28282957/a-multimodality-hybrid-gamma-optical-camera-for-intraoperative-imaging
#15
John E Lees, Sarah L Bugby, Mohammed S Alqahtani, Layal K Jambi, Numan S Dawood, William R McKnight, Aik H Ng, Alan C Perkins
The development of low profile gamma-ray detectors has encouraged the production of small field of view (SFOV) hand-held imaging devices for use at the patient bedside and in operating theatres. Early development of these SFOV cameras was focussed on a single modality-gamma ray imaging. Recently, a hybrid system-gamma plus optical imaging-has been developed. This combination of optical and gamma cameras enables high spatial resolution multi-modal imaging, giving a superimposed scintigraphic and optical image...
March 9, 2017: Sensors
https://www.readbyqxmd.com/read/28281432/the-impact-of-a-modified-world-health-organization-surgical-safety-checklist-on-maternal-outcomes-in-a-south-african-setting-a-stratified-cluster-randomised-controlled-trial
#16
M Naidoo, J Moodley, P Gathiram, B Sartorius
BACKGROUND: In South Africa (SA), the Saving Mothers Reports have shown an alarming increase in deaths during or after caesarean delivery. OBJECTIVE: To improve maternal surgical safety in KwaZulu-Natal Province, SA, by implementing the modified World Health Organization surgical safety checklist for maternity care (MSSCL) in maternity operating theatres. METHODS: The study was a stratified cluster-randomised controlled trial conducted from March to November 2013...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28281430/provision-of-an-emergency-theatre-in-tertiary-hospitals-is-cost-effective-audit-and-cost-of-cancelled-planned-elective-general-surgical-operations-at-pietersburg-hospital-limpopo-province-south-africa
#17
M M Z U Bhuiyan, R Mavhungu, A Machowski
BACKGROUND: Cancellations of planned elective surgical operations increase financial cost to the patient and the hospital. OBJECTIVES: To determine the rate and reasons for cancellations, estimate the cost incurred by such cancellations and recommend possible solutions. METHODS: We did a prospective descriptive study of cancellations of elective general surgical operations over the 1-year period January - December 2014 in the main theatre at Pietersburg (PTB) Hospital, Limpopo Province, South Africa...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28275517/percutaneous-nephrolithotomy-in-complete-supine-flank-free-position-in-comparison-to-prone-position-a-single-centre-experience
#18
Nadeem Sohail, Amjad Albodour, Khalid Mohammed Abdelrahman
OBJECTIVES: To assess the outcomes of performing percutaneous nephrolithotomy (PCNL) in a modified supine position, more feasible for surgeons, anaesthetists, and operating theatre staff, as well as for the patient himself, and evaluating it in comparison to the standard prone position. PATIENT AND METHODS: A retrospective, case-control study was conducted between January 2011 and December 2015. In all, 197 patient's records were reviewed. The initial 101 patients were operated upon in prone position...
March 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/28275016/gastric-volvulus-a-potentially-fatal-cause-of-acute-abdominal-pain
#19
A Sleiwah, G Thomas, I Crawford, A Stanek
A woman aged 67 years attended the emergency department with acute abdominal and back pain of 1-day duration with associated vomiting. The patient had multiorgan failure. Resuscitation was started with intravenous fluids and vasopressors. An abdominal CT scan was completed which confirmed the diagnosis of acute gastric volvulus. The patient was successfully resuscitated from a cardiorespiratory arrest during transfer to the operating theatre. The patient subsequently underwent a total gastrectomy with stapling of the oesophageal and duodenal stumps...
March 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28272851/the-effect-of-emergency-medical-services-response-on-outcome-of-trauma-laparotomy-at-a-level-1-trauma-centre-in-south-africa
#20
S Chowdhury, P H Navsaria, S Edu, A J Nicol
BACKGROUND: Due to resource constrained pre-hospital emergency medical services (EMSs) there is a significant delay in injured patients arriving at Groote Schuur Hospital Trauma Centre (GSHTC). The aim of the study was to examine the effectiveness of EMSs in transferring trauma patients to GSHTC. The effect of any delay to laparotomy from injury was noted. METHOD: A prospective audit of patients presented directly from the scene to GSHTC following abdominal trauma over a four-month period was performed...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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