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https://www.readbyqxmd.com/read/28071950/reporting-individual-surgeon-outcomes-does-not-lead-to-risk-aversion-in-abdominal-aortic-aneurysm-surgery
#1
A Saratzis, A Thatcher, M F Bath, D A Sidloff, M J Bown, J Shakespeare, R D Sayers, C Imray
INTRODUCTION Reporting surgeons' outcomes has recently been introduced in the UK. This has the potential to result in surgeons becoming risk averse. The aim of this study was to investigate whether reporting outcomes for abdominal aortic aneurysm (AAA) surgery impacts on the number and risk profile (level of fitness) of patients offered elective treatment. METHODS Publically available National Vascular Registry data were used to compare the number of AAAs treated in those centres across the UK that reported outcomes for the periods 2008-2012, 2009-2013 and 2010-2014...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28067569/optimizing-postoperative-handover-to-the-intensive-care-unit-at-a-tertiary-centre
#2
Shankar Kumar, Andrew R McKean, Andrew Ramwell, Carolyn Johnston, Susannah Leaver
BACKGROUND: Comprehensive handover of patients transferred from operating theatre to the intensive care unit is crucial in ensuring ongoing quality and safety of care. Handover in this setting poses unique challenges, yet few studies have considered or tested approaches to improve the process. A quality improvement project was undertaken to assess and improve the quality of information transfer during the handover of postoperative patients to the general intensive care unit at a tertiary centre...
January 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28063105/the-moral-of-the-tale-stories-trust-and-public-engagement-with-clinical-ethics-via-radio-and-theatre
#3
Deborah Bowman
Trust is frequently discussed with reference to the professional-patient relationship. However, trust is less explored in relation to the ways in which understanding of, and responses to, questions of ethics are discussed by both the "public" and "experts." Public engagement activity in healthcare ethics may invoke "trust" in analysing a moral question or problem but less frequently conceives of trust as integral to "public engagement" itself. This paper explores the relationship between trust and the ways in which questions of healthcare ethics are identified and negotiated by both "experts" and the public...
January 6, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28053260/comparison-of-the-elution-properties-of-commercially-available-gentamicin-and-bone-cement-containing-vancomycin-with-home-made-preparations
#4
N M Frew, T Cannon, T Nichol, T J Smith, I Stockley
AIMS: Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available, but are significantly more expensive. We investigated whether the elution of antibiotic from 'home-made' cement containing vancomycin was comparable with more expensive commercially available vancomycin impregnated cement. MATERIALS AND METHODS: A total of 18 cement discs containing either proprietary CopalG+V; or 'home-made' CopalR+G with vancomycin added by hand, were made...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28052574/resource-variation-in-colorectal-surgery-a-national-centre-level-analysis
#5
Thomas M Drake, Matthew J Lee, Asha Senapati, Steven R Brown
BACKGROUND: Delivery of quality colorectal surgery requires adequate resources. We set out to assess the relationship between resources and outcomes in English colorectal units. METHODS: Data was extracted from the ACPGBI resource questionnaire to profile resources. This was correlated with Hospital Episode Statistics (HES) outcome data including 90-day mortality and readmissions. Patient satisfaction measures were extracted from the Cancer Experience Patient Survey (CEPS) and compared at unit level...
January 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28052572/an-undergraduate-otolaryngology-curriculum-comparison-in-the-united-kingdom-using-a-curriculum-evaluation-framework
#6
R A Steven, G J Mires, S K W Lloyd, S McAleer
OBJECTIVE: 1.To compare undergraduate Otolaryngology curricula in the United Kingdom. 2.To develop a tool which would allow undergraduate specialty curricula to be compared. DESIGN: Development of a Curriculum Evaluation Framework and survey. SETTING: UK medical schools. PARTICIPANTS: Otolaryngology curricula were requested from all 32 UK medical schools who award a primary medical qualification. 19 curricula were received and examined...
January 4, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28051046/typhoid-perforation-post-operative-intensive-care-unit-care-and-outcome
#7
Mukaila Oyegbade Akinwale, Arinola A Sanusi, Oluwaseun K Adebayo
BACKGROUND: Typhoid perforation ileitis is a serious complication of typhoid fever, a common and unfortunate health problem in a resource-poor country like Nigeria. Following bowel perforation, treatment is usually by simple closure or bowel resection and anastomosis after adequate aggressive fluid resuscitation and electrolyte correction. Postoperatively, some of these patients do require management in Intensive Care Unit (ICU) on account of sepsis or septic shock and to improve survival...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28050462/to-study-the-correlation-of-thompson-scoring-in-predicting-early-neonatal-outcome-in-post-asphyxiated-term-neonates
#8
Dalip Kumar Bhagwani, Manisha Sharma, Stanzin Dolker, Sharada Kothapalli
INTRODUCTION: Throughout the world each year, an estimated 23% of the 4 million neonatal deaths and 8% of all deaths in <5 years of age are associated with signs of asphyxia at birth. AIM: To study the role of cord arterial blood gas analysis at birth and serial Thompson score in predicting the early neonatal outcome in post asphyxiated term neonates. MATERIALS AND METHODS: The study was conducted in Department of Paediatrics, in Neonatal Intensive Care Unit (NICU), Hindu Rao Hospital, New Delhi from May 2014 to February...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28044337/the-role-and-limitations-of-eeg-based-depth-of-anaesthesia-monitoring-in-theatres-and-intensive-care
#9
REVIEW
Z Hajat, N Ahmad, J Andrzejowski
In this article we will look at some of the principles in processed EEG monitoring as applied to bispectral index (BIS). We outline why BIS should be regarded as a 'memory' monitor which in most circumstances reflects the depth of sedation or anaesthesia in particular patients. Its limitation in paralysed and non-paralysed patients must be understood in order for this monitor to be used safely. Finally, its emerging use in critical care will be explored.
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28044334/monitoring-the-anaesthetist-in-the-operating-theatre-professional-competence-and-patient-safety
#10
REVIEW
J Larsson
This article about competence and patient safety in anaesthesia was inspired by a statement in the 2015 AAGBI guidelines on monitoring during anaesthesia: 'the presence of an appropriately trained and experienced anaesthetist is important for patient safety during anaesthesia'. The review starts with a structured description of competence, presenting five dimensions of it; the first two dimensions are identical with the two classical attributes of competence, practical skills and theoretical knowledge. Concerning skills, the value of aiming for a high level of proficiency early in a traning programme is pointed out, and deliberate practice is given as an example of a pedagogical model where aiming for excellence is a core idea...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28043767/bleeding-after-circumcision-is-more-likely-in-children-with-lichen-sclerosus-balanitis-xerotica-obliterans
#11
P Somov, B K Y Chan, C Wilde, H Corbett
INTRODUCTION: Over 27,000 circumcisions were performed in England in 2012-13. The complication rate is generally perceived to be low, although published figures vary widely. Balanitis xerotica obliterans, more correctly termed Lichen Sclerosus et atrophicus (LS), is one of the commonest indications for medical circumcision. To test the hypothesis that children undergoing circumcision for LS have a higher rate of postoperative bleeding than those undergoing the procedure for other reasons, we retrospectively reviewed records for patients undergoing circumcision...
December 9, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28040011/perceptive-and-objective-evaluation-of-calibrated-room-acoustic-simulation-auralizations
#12
Barteld N J Postma, Brian F G Katz
Recently, auralizations have become more prevalent in architectural acoustics and virtual reality. However, there have been few studies examining the perceptual quality achievable by room acoustic simulations and auralizations. Such studies have highlighted potential problems in creating perceptually equivalent simulations when compared to measured auralizations in terms of parameter estimation. In order to accomplish realistic auralizations, calibration of the geometrical acoustics model can be considered a necessary step...
December 2016: Journal of the Acoustical Society of America
https://www.readbyqxmd.com/read/28039999/how-orchestra-members-influence-stage-acoustic-parameters-on-five-different-concert-hall-stages-and-orchestra-pits
#13
R H C Wenmaekers, C C J M Hak, M C J Hornikx
Stage acoustic parameters aim to quantify the amount of sound energy reflected by the stage and hall boundaries and the energy decay over time. In this research, the effect of orchestra presence on parameter values is investigated. The orchestra is simulated by dressed mannequins, which have been compared with humans with respect to acoustic properties. Impulse response measurements were performed in a concert hall, a theatre, a rehearsal room, and in two orchestra pits. Conditions were empty stage floors, stage floors with music stands and chairs only, and floors occupied by the mannequin orchestra...
December 2016: Journal of the Acoustical Society of America
https://www.readbyqxmd.com/read/28039249/intensive-care-utilization-and-outcomes-after-high-risk-surgery-in-scotland-a-population-based-cohort-study
#14
M A Gillies, E M Harrison, R M Pearse, S Garrioch, C Haddow, L Smyth, R Parks, T S Walsh, N I Lone
BACKGROUND: The optimal perioperative use of intensive care unit (ICU) resources is not yet defined. We sought to determine the effect of ICU admission on perioperative (30 day) and long-term mortality. METHODS: This was an observational study of all surgical patients in Scotland during 2005-7 followed up until 2012. Patient, operative, and care process factors were extracted. The primary outcome was perioperative mortality; secondary outcomes were 1 and 4 yr mortality...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28033111/improved-spectrum-analysis-in-eeg-for-measure-of-depth-of-anesthesia-based-on-phase-rectified-signal-averaging
#15
Quan Liu, Yi-Feng Chen, Shou-Zen Fan, Maysam F Abbod, Jiann-Shing Shieh
The definition of the depth of anesthesia (DOA) is still controversial and its measurement is not completely standardized in modern anesthesia. Power spectral analysis is an important method for feature detection in electroencephalogram (EEG) signals. Several spectral parameters derived from EEG have been proposed for measuring DOA in clinical applications. In the present paper, an improved method based on phase-rectified signal averaging (PRSA) is designed to improve the predictive accuracy of relative alpha and beta power, a frequency band power ratio, total power, median frequency (MF), spectral edge frequency 95 (SEF95), and spectral entropy for assessing anesthetic drug effects...
December 29, 2016: Physiological Measurement
https://www.readbyqxmd.com/read/28027789/management-and-cost-of-surgical-site-infection-in-patients-undergoing-surgery-for-spinal-metastasis
#16
R A Atkinson, A Jones, K Ousey, J Stephenson
BACKGROUND: Surgical site infection (SSI) is a serious potential complication of spinal surgery. SSI may impact significantly on inpatient hospitalization and the costs associated with extra care. AIM: To investigate the management of patients experiencing SSI following surgery for spinal metastatic tumours, and to estimate the costs associated with SSI in this context. METHODS: Patients experiencing SSI following spinal tumour surgery at a large spinal surgery centre between January 2009 and December 2012 were identified...
November 30, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28019190/evolution-of-design-considerations-in-complex-craniofacial-reconstruction-using-patient-specific-implants
#17
Sean Peel, Satyajeet Bhatia, Dominic Eggbeer, Daniel S Morris, Caroline Hayhurst
Previously published evidence has established major clinical benefits from using computer-aided design, computer-aided manufacturing, and additive manufacturing to produce patient-specific devices. These include cutting guides, drilling guides, positioning guides, and implants. However, custom devices produced using these methods are still not in routine use, particularly by the UK National Health Service. Oft-cited reasons for this slow uptake include the following: a higher up-front cost than conventionally fabricated devices, material-choice uncertainty, and a lack of long-term follow-up due to their relatively recent introduction...
December 1, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28011071/is-device-assisted-reduction-prior-to-semi-extended-intramedullary-nailing-of-distal-tibial-fractures-necessary
#18
Nisarg Mehta, Veenesh Selvaratnam, Nikolaos Giotakis, Badri Narayan
INTRODUCTION: Traditional methods of nailing distal tibial fractures have an unacceptable risk of mal-alignment due to difficulty in obtaining and maintaining reduction intra-operatively. Methods to obtain and maintain reduction when nailing these fractures, and therefore reducing the risk of Mal-alignment include modified external fixators, distractors and commercial reduction tools. Semi-extended intramedullary nailing of distal tibial fractures via a supra-patellar approach is now being used more commonly...
December 10, 2016: Injury
https://www.readbyqxmd.com/read/28009731/combining-systems-and-teamwork-approaches-to-enhance-the-effectiveness-of-safety-improvement-interventions-in-surgery-the-safer-delivery-of-surgical-services-s3-program
#19
Peter McCulloch, Lauren Morgan, Steve New, Ken Catchpole, Eleanor Roberston, Mohammed Hadi, Sharon Pickering, Gary Collins, Damian Griffin
IMPORTANCE: Patient safety improvement interventions usually address either work systems or team culture. We do not know which is more effective, or whether combining approaches is beneficial. OBJECTIVE: To compare improvement in surgical team performance after interventions addressing teamwork culture, work systems, or both. DESIGN: Suite of 5 identical controlled before-after intervention studies, with preplanned analysis of pooled data for indirect comparisons of strategies...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28008117/1914-18-the-global-veterinary-war
#20
(no author information available yet)
While France was the main theatre of the First World War, it was also fought globally. The Army Veterinary Corps was involved in 13 of these operations. The most important were protecting British interests in the Middle East and defending Britain's African colonies. Bruce Vivash Jones explains that, along with the fighting, the Corps had to deal with a wide range of diseases, unusual species and extremes of climate.
December 24, 2016: Veterinary Record
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