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https://www.readbyqxmd.com/read/29777884/neurosurgical-management-of-self-inflicted-cranial-crossbow-injury
#1
Charles G Kulwin, Andrew DeNardo, Saad Khairi, Troy Payner
BACKGROUND: While gun-related penetrating traumatic brain injuries make up the majority of cranial missile injuries, low-velocity penetrating injuries present significant clinical difficulties that cannot necessarily be identically managed. Bow hunting is an increasingly popular pastime, and a crossbow allows a unique mechanism to cause a self-inflicted cranial injury with a large, low-velocity projectile. Historically, arrow removal is described in an operating room setting, which provides limited knowledge of the location of vascular injury in the setting of post-removal hemorrhage, and may represent an inefficient use of operating room availability...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29777782/financial-analysis-of-pediatric-resident-physician-primary-care-longitudinal-outpatient-experience
#2
Carole H Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Robert Kaplan, Vivian S Lee, Edward B Clark
PURPOSE: To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in outpatient primary care practice with or without residents. METHOD: Patient volume and revenue data (Current Procedural Terminology codes) from an academic primary care general pediatric clinic were evaluated for faculty clinics (faculty only) and resident teaching clinics (Longitudinal Outpatient Experience [LOE]) with 1-4 residents/faculty...
May 16, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#3
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29775606/ecmo-for-acute-respiratory-distress-syndrome-after-thoracoabdominal-aortic-aneurysm-repair
#4
Subhasis Chatterjee, William Mulvoy, Ourania A Preventza, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
Acute respiratory distress syndrome (ARDS) after thoracoabdominal aortic aneurysm (TAAA) repair poses a formidable challenge. Despite conventional maneuvers in the operating room, perioperative ARDS may require extracorporeal membrane oxygenation (ECMO). We present 3 cases of successful ECMO for ARDS after TAAA repair and discuss management of anticoagulation and cerebrospinal fluid drains. Our experience suggests that ECMO is reasonable in selected patients after TAAA repair.
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774820/robotic-sacral-colpopexy
#5
Charles R Powell, Isamu Tachibana, Bridget Eckrich, Jeffrey Rothenberg, Jon Hathaway
INTRODUCTION AND OBJECTIVE: Robot-assisted sacral colpopexy (RASC) is a fast growing approach for surgeons treating patients with advanced stage pelvic organ prolapse (POP). Open abdominal sacral colpopexy has been the gold standard for advanced POP but requires longer hospital stays and a much larger incision. The indications, preoperative preparation, operative positioning, and operative steps are detailed, and an accompanying video shows the approach. METHODS: RASC can be broken down into 11 steps and the reader will be able to reference the article to the corresponding portion of the video...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29774192/efficacy-of-the-all-in-one-therapeutic-strategy-for-severe-traumatic-brain-injury-preliminary-outcome-and-limitation
#6
Young-Soo Park, Yohei Kogeichi, Yoichi Shida, Hiroyuki Nakase
Objective: Despite recent advances in medicine, no significant improvement has been achieved in therapeutic outcomes for severe traumatic brain injury (TBI). In the treatment of severe multiple traumas, accurate judgment and prompt action corresponding to rapid pathophysiological changes are required. Therefore, we developed the "All-in-One" therapeutic strategy for severe TBI. In this report, we present the therapeutic concept and discuss its efficacy and limitations. Methods: From April 2007 to December 2015, 439 patients diagnosed as having traumatic intracranial injuries were treated at our institution...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29773409/correlation-of-objective-assessment-data-with-general-surgery-resident-in-training-evaluation-reports-and-operative-volumes
#7
Jad M Abdelsattar, Yazan N AlJamal, Raaj K Ruparel, Phillip G Rowse, Stephanie F Heller, David R Farley
OBJECTIVE: Faculty evaluations, ABSITE scores, and operative case volumes often tell little about true resident performance. We developed an objective structured clinical examination called the Surgical X-Games (5 rooms, 15 minutes each, 12-15 tests total, different for each postgraduate [PGY] level). We hypothesized that performance in X-Games will prove more useful in identifying areas of strength or weakness among general surgery (GS) residents than faculty evaluations, ABSITE scores, or operative cases volumes...
May 14, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29771811/use-of-emergency-manuals-during-actual-critical-events-in-china-a-multi-institutional-study
#8
Jeffrey Huang, Jiayan Wu, Christina Dai, Xianwei Zhang, Hui Ju, Yiqi Chen, Chunyuan Zhang, Fan Ye, Yi Tan, Yongbo Zong, Telong Liu
INTRODUCTION: Emergency manuals (EMs) can help healthcare providers respond to crises more efficiently. Three anesthesia EMs have been translated into Chinese. These EMs have been made publicly available as a free document downloadable in China. A year after these Chinese versions of EMs were published, we conducted a multi-institutional survey in China to assess the progress of how well EM had been adapted and used in the setting of critical events. METHODS: Our study used a multi-institutional, anonymous electronic survey...
May 16, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29771394/the-effect-of-intraoperative-hypothermia-on-shoulder-arthroplasty
#9
Toufic R Jildeh, Kelechi R Okoroha, Nathan E Marshall, Chad Amato, Hunter Trafton, Stephanie J Muh, Patricia Kolowich
Limited evidence is available regarding the correlation between intraoperative hypothermia and perioperative complications in shoulder arthroplasty. The purpose of this study was to determine the incidence of intraoperative hypothermia in patients treated with shoulder arthroplasty and its effect on perioperative complications. A retrospective chart review was performed on 657 consecutive patients who underwent shoulder arthroplasty at a single institution between August 2013 and June 2016. Demographic data, surgery-specific data, postoperative complications, length of stay, and 30-day read-mission were recorded...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29770884/activated-carbon-fiber-filters-could-reduce-the-risk-of-surgical-smoke-exposure-during-laparoscopic-surgery-application-of-volatile-organic-compounds
#10
Seock Hwan Choi, Dong Hee Choi, Dong Hwa Kang, Yun-Sok Ha, Jun Nyung Lee, Bum Soo Kim, Hyun Tae Kim, Eun Sang Yoo, Tae Gyun Kwon, Sung Kwang Chung, Tae-Hwan Kim
BACKGROUND: Generation of smoke is inevitable during surgical procedures. Some volatile organic compounds (VOCs) in surgical smoke are known to be strong carcinogens. We used a prototype of a multi-layered complex filter in an attempt to eliminate VOCs. METHODS: From June 2015 to July 2015, 20 patients underwent transperitoneal laparoscopic nephrectomy for renal cell carcinoma. Smoke (pre-filter) was collected 20 min after the electrocautery device was first used during the surgery, by the direct collection method, with a 5-L Tedlar® gas-sampling bag...
May 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29770180/factors-impacting-arthroscopic-rotator-cuff-repair-operational-throughput-time-at-an-ambulatory-care-center
#11
Emily J Curry, Catherine Logan, Kaytelin Suslavich, Kaitlyn Whitlock, Eric Berkson, Elizabeth Matzkin
Identifying patient factors influencing operational throughput time is becoming more imperative due to an increasing focus on value and cost savings in healthcare. The primary objective of this study was to determine patient factors influencing throughput time for primary rotator cuff repairs. Demographic information, medical history and operative reports of 318 patients from one ambulatory care center were retrospectively reviewed. Operating room set up, incision to closure and recovery room time were collected from anesthesia records...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29770174/a-simple-technique-to-prolong-molding-time-during-application-of-a-fiberglass-cast-an-in-vitro-study
#12
Mark Ayzenberg, Michael Narvaez, James Raphael
Casting is routinely used for acute and post-operative immobilization and remains a cornerstone in the non-operative management of fractures and deformities. The application of a properly fitted and wellmolded cast, especially for a trainee, can be challenging. We present a simple method of prolonging cure time of fiberglass cast - placing ice in the dip water. Eight-ply, fiveinch fiberglass cast was circumferentially applied to an aluminum-wrapped cardboard cylinder. An electronic, 2-channel temperature sensor (TR-71wf Temp Logger, T&D Corporation, Matsumoto, Japan), accurate to 0...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29768632/lower-extremity-limb-salvage-with-cross-leg-pedicle-flap-cross-leg-free-flap-and-cross-leg-vascular-cable-bridge-flap
#13
Oscar J Manrique, Sarah N Bishop, Pedro Ciudad, Kian Adabi, Jorys Martinez-Jorge, Steven L Moran, Tony Huang, Aparna Vijayasekaran, Shih-Heng Chen, Hung-Chi Chen
BACKGROUND:  Lower extremity salvage following significant soft tissue loss can be complicated by lack of recipient vessel for free tissue transfer. We describe our experience in lower limb salvage for patients with no recipient vessels with the use of pedicle, free and cable bridge flaps. METHODS:  A retrospective review from 1985 to 2017 of patients undergoing lower limb salvage using a contralateral pedicle cross leg (PCL) flaps, free cross leg (FCL) flaps, or free cable bridge (FCB) flaps was conducted...
May 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29768012/asymmetric-two-terminal-graphene-detector-for-broadband-radiofrequency-heterodyne-and-self-mixing
#14
Jiayue Tong, Matthew C Conte, Thomas Goldstein, K Sigfrid Yngvesson, Joseph C Bardin, Jun Yan
Graphene, a single atomic layer of covalently bonded carbon atoms, has been investigated intensively for optoelectronics and represents a promising candidate for high-speed electronics. Here we present a microwave mixer constructed as an asymmetrically-contacted two-terminal graphene device based on the thermoelectric effect. We report a 50 GHz (minimum) mixer bandwidth as well as 130 V/W extrinsic direct-detection responsivity. Anomalous second-harmonic generation due to self-mixing in our graphene detector is also observed...
May 16, 2018: Nano Letters
https://www.readbyqxmd.com/read/29767569/teaching-tip-development-of-veterinary-anesthesia-simulations-for-pre-clinical-training-design-implementation-and-evaluation-based-on-student-perspectives
#15
Jana L Jones, Jim Rinehart, Jacqueline Jordan Spiegel, Ryane E Englar, Brian K Sidaway, Joie Rowles
Anesthesia simulations have been used in pre-clinical medical training for decades to help learners gain confidence and expertise in an operating room environment without danger to a live patient. The authors describe a veterinary anesthesia simulation environment (VASE) with anesthesia scenarios developed to provide a re-creation of a veterinarian's task environment while performing anesthesia. The VASE uses advanced computer technology with simulator inputs provided from standard monitoring equipment in common use during veterinary anesthesia and a commercial canine training mannequin that allows intubation, ventilation, and venous access...
2018: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/29766136/can-necrotizing-soft-tissue-infection-be-reliably-diagnosed-in-the-emergency-department
#16
Sharon M Henry, Kimberly A Davis, Jonathan J Morrison, Thomas M Scalea
Necrotizing soft tissue infections (NSTIs) are associated with a high mortality and require prompt recognition and treatment, consisting of aggressive surgical debridement and critical care support. Diagnosis is a key step, which is generally made in the operating room (OR), but the decision to debride requires guidance. This is frequently made on clinical grounds, but NSTI can be occult in presentation and several other infective processes can mimic NSTI. It is unknown whether the various scoring systems described in the literature can enable clinicians to reliably diagnose NSTI in the emergency department, rather than the OR...
2018: Trauma Surg Acute Care Open
https://www.readbyqxmd.com/read/29766127/grey-s-anatomy-effect-television-portrayal-of-patients-with-trauma-may-cultivate-unrealistic-patient-and-family-expectations-after-injury
#17
Rosemarie O Serrone, Jordan A Weinberg, Pamela W Goslar, Erin P Wilkinson, Terrell M Thompson, Jonathan L Dameworth, Shawna R Dempsey, Scott R Petersen
Background: Expectations of the healthcare experience may be influenced by television dramas set in the hospital workplace. It is our perception that the fictional television portrayal of hospitalization after injury in such dramas is misrepresentative. The purpose of this study was to compare trauma outcomes on television dramas versus reality. Methods: We screened 269 episodes of Grey's Anatomy , a popular medical drama. A television (TV) registry was constructed by collecting data for each fictional trauma portrayed in the television series...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29765650/-in-situ-investigations-of-the-phase-change-behaviour-of-tungsten-oxide-nanostructures
#18
Kunyapat Thummavichai, Nannan Wang, Fang Xu, Graham Rance, Yongda Xia, Yanqiu Zhu
This study uses two in situ techniques to investigate the geometry and phase change behaviour of bundled ultrathin W18 O49 nanowires and WO3 nanoparticles. The in situ X-ray diffraction (XRD) results have shown that the phase transition of WO3 nanoparticles occurs in sequence from monoclinic (room temperature) → orthorhombic (350°C) → tetragonal (800°C), akin to bulk WO3 ; however, W18 O49 nanowires remain stable as the monoclinic phase up to 500°C, after which a complete oxidation to WO3 and transformation to the orthorhombic β-phase at 550°C is observed...
April 2018: Royal Society Open Science
https://www.readbyqxmd.com/read/29764844/second-look-laparostomy-for-perforated-gangrenous-gastric-volvulus-to-prevent-total-gastrectomy
#19
Paul K Okeny, Omar Abbassi, Ali Warsi
A 42-year-old Caucasian woman presented to the emergency department with severe upper abdominal pain and vomiting. Clinically, she was septic, and abdominal examination suggested peritonitis. Following immediate resuscitation, the patient was stabilised and underwent urgent contrast-enhanced CT of the abdomen and pelvis. This revealed a mesenteroaxial gastric volvulus with traction on the mesentery and a small volume of free fluid. She underwent laparotomy revealing gangrenous gastric fundus perforation complicated by persistent intraoperative hypotension...
May 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29764631/introduction-to-surgical-and-perioperative-clinical-pharmacy-for-third-year-pharmacy-students-a-pilot-study-of-an-elective-course
#20
Eric G Johnson, Douglas R Oyler
INTRODUCTION: The objective of this study was to implement and assess an elective course that exposes pharmacy students to clinical pharmacy in the surgical and perioperative setting. METHODS: A blended-design elective that included synchronous and asynchronous learning was developed and offered to third-year pharmacy students. Students' knowledge and perception regarding clinical topics in perioperative pharmacy was assessed using pre- and post-course assessments, online quizzes, a journal club, and course assignments...
March 2018: Currents in Pharmacy Teaching & Learning
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