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https://www.readbyqxmd.com/read/28441687/c-arm-positioning-is-a-significant-source-of-radiation-in-spine-surgery
#1
Elizabeth W Reiser, Rupen Desai, Sarah A Byrd, Harrison Farber, Deborah Chi, Cary S Idler, Robert E Isaacs
STUDY DESIGN: Prospective chart review. OBJECTIVE: It is well-known that radiation exposure during minimally invasive spine procedures can be substantial. Less interest has focused on setup radiation exposure before incision, including preoperative images used for surgical approach. The present study seeks to better quantify the significance of setup radiation in the total radiation exposure of minimally invasive spine surgery. SUMMARY OF BACKGROUND DATA: Radiographic localization is necessary in minimally invasive spine procedures to visualize anatomy, but increased radiation exposure is associated with health risks...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28441281/incarcerated-medial-epicondyle-fractures-with-elbow-dislocation-risk-factors-associated-with-morbidity
#2
Carley Vuillermin, Kyna S Donohue, Patricia Miller, Andrea S Bauer, Dennis E Kramer, Yi-Meng Yen
BACKGROUND: Incarcerated medial epicondyle fractures in association with elbow trauma are rare and an absolute indication for intervention. Because of the infrequent nature, outcomes following this injury are not well documented. We studied a large cohort of these injuries to determine factors associated with functional outcomes. It was hypothesized that a greater duration between initial presentation and time of surgery would lead to poorer outcomes. METHODS: A total of 32 patients aged 18 and under who underwent surgical treatment for an incarcerated medical epicondyle fracture at a level-1 pediatric trauma center from 2003 to 2015 were identified...
April 24, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28441278/the-utility-of-routine-postoperative-radiographs-after-pinning-of-pediatric-supracondylar-humerus-fractures
#3
Vytas P Karalius, Jacob Stanfield, Philip Ashley, Laura W Lewallen, Casey M DeDeugd, Janet Walker, Annalise N Larson, Todd A Milbrandt
BACKGROUND: The purpose of this study was to determine the frequency with which postoperative radiographs resulted in a change in management following closed reduction and percutaneous pinning of displaced pediatric supracondylar humerus fractures. We hypothesize that only the initial postoperative radiograph will lead to changes in management of operative supracondylar humerus fractures. METHODS: A retrospective review was performed at 2 level I pediatric trauma centers...
April 24, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28440073/antiparallel-dynamic-covalent-chemistries
#4
Bartosz Mateusz Matysiak, Piotr Nowak, Ivica Cvrtila, Charalampos Pappas, Bin Liu, David Komaromy, Sijbren Otto
The ability to design reaction networks with high, but addressable complexity is a necessary prerequisite to make advanced functional chemical systems. Dynamic combinatorial chemistry has proven to be a useful tool in achieving complexity, however with some limitations in controlling it. Herein we introduce the concept of antiparallel chemistries, in which the same functional group can be channeled into one of two reversible chemistries depending on a controllable parameter. Such systems allow both for achieving complexity, by combinatorial chemistry, and addressing it, by switching from one chemistry to another by controlling an external parameter...
April 25, 2017: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/28439744/change-in-cost-after-5%C3%A2-years-of-experience-with-robotic-assisted-hysterectomy-for-the-treatment-of-endometrial-cancer
#5
Andrea M Avondstondt, Michelle Wallenstein, Christopher R D'Adamo, Robert M Ehsanipoor
Health care costs are an important consideration in the decision of hysterectomy routes and robotic surgery is often critiqued for its high cost. We sought to compare the cost of robotic-assisted hysterectomies performed after initial acquisition of the robotic surgical system to cases performed after 5 years of experience. The first 20 patients at a community teaching hospital who underwent robotic-assisted hysterectomy for endometrial cancer by a single gynecologic oncology surgeon were designated Group 1 and 20 patients undergoing robotic hysterectomies 5 years later for the same indication were designated Group 2...
April 24, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28438417/comparing-hospital-outcomes-between-open-and-closed-tibia-fractures-treated-with-intramedullary-fixation
#6
Evan J Smith, Xiangyu Kuang, Rajeev Pandarinath
INTRODUCTION: Tibial shaft fractures comprise a large portion of operatively treated long bone fractures, and present with the highest rate of open injuries. Intramedullary fixation has become the standard of care for both open and closed injuries. The rates of short term complications and hospital length of stay for open and closed fractures treated with intramedullary fixation is not fully known. Previous series on tibia fractures were performed at high volume centers, and data were not generalizable, further they did not report on length of stay and the impact of preoperative variables on infections, complications and reoperation...
March 30, 2017: Injury
https://www.readbyqxmd.com/read/28437491/correct-positioning-of-the-medial-patellofemoral-ligament-troubleshooting-in-the-operating-room
#7
M Tyrrell Burrus, Brian C Werner, Jourdan M Cancienne, David R Diduch
Medial patellofemoral ligament (MPFL) reconstruction is often required after failed nonoperative management of lateral patellar instability. It is important to properly re-create the native ligament to avoid altering patellofemoral biomechanics. Such alterations can cause knee stiffness, anterior knee pain, and patellofemoral chondrosis. Incorrect femoral location is the most common mistake that affects MPFL graft biomechanics. Authors have described multiple radiographic and anatomical landmarks that assist in determining the appropriate location, and time should be taken to accurately localize this position...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437441/fluorescence-imaging-topography-scanning-system-for-intraoperative-multimodal-imaging
#8
Tri T Quang, Hye-Yeong Kim, Forrest Sheng Bao, Francis A Papay, W Barry Edwards, Yang Liu
Fluorescence imaging is a powerful technique with diverse applications in intraoperative settings. Visualization of three dimensional (3D) structures and depth assessment of lesions, however, are oftentimes limited in planar fluorescence imaging systems. In this study, a novel Fluorescence Imaging Topography Scanning (FITS) system has been developed, which offers color reflectance imaging, fluorescence imaging and surface topography scanning capabilities. The system is compact and portable, and thus suitable for deployment in the operating room without disturbing the surgical flow...
2017: PloS One
https://www.readbyqxmd.com/read/28437365/a-method-to-account-for-variation-in-congenital-heart-surgery-length-of-stay
#9
Andrew Brennan, Kimberlee Gauvreau, Jean Connor, Melvin Almodovar, James DiNardo, Puja Banka, Meena Nathan, Derek Mathieu, Aditya Kaza, John E Mayer, Lisa Bergersen
OBJECTIVES: We sought to develop a risk-adjustment methodology for length of stay in congenital heart surgery, as none exist. DESIGN: Prospective cohort analysis combined with previously obtained retrospective cohort analysis of a Department of Cardiovascular Surgery clinical database. PATIENTS: Patients discharged from Boston Children's Hospital between October 1, 2006, and May 31, 2014, that underwent a congenital heart surgery procedure(s) linked to one of 103 surgical procedure types...
April 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28437261/training-in-intraoperative-handover-and-display-of-a-checklist-improve-communication-during-transfer-of-care-an-interventional-cohort-study-of-anaesthesia-residents-and-nurse-anaesthetists
#10
Marion Jullia, Anaïs Tronet, Fabiola Fraumar, Vincent Minville, Olivier Fourcade, Xavier Alacoque, Yannick LeManach, Matt M Kurrek
BACKGROUND: Handovers during anaesthesia are common, and failures in communication may lead to morbidity and mortality. OBJECTIVES: We hypothesised that intraoperative handover training and display of a checklist would improve communication during anaesthesia care transition in the operating room. DESIGN: Interventional cohort study. SETTING: Single-centre tertiary care university hospital. PARTICIPANTS: A total of 204 random observations of handovers between anaesthesia providers (residents and nurse anaesthetists) over a 6-month period in 2016...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28436454/gold-nanoparticle-polymer-nanocomposites-synthesized-by-room-temperature-atmospheric-pressure-plasma-and-their-potential-for-fuel-cell-electrocatalytic-application
#11
Ri-Chao Zhang, Dan Sun, Ruirui Zhang, Wen-Feng Lin, Manuel Macias-Montero, Jenish Patel, Sadegh Askari, Calum McDonald, Davide Mariotti, Paul Maguire
Conductive polymers have been increasingly used as fuel cell catalyst support due to their electrical conductivity, large surface areas and stability. The incorporation of metal nanoparticles into a polymer matrix can effectively increase the specific surface area of these materials and hence improve the catalytic efficiency. In this work, a nanoparticle loaded conductive polymer nanocomposite was obtained by a one-step synthesis approach based on room temperature direct current plasma-liquid interaction. Gold nanoparticles were directly synthesized from HAuCl4 precursor in poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS)...
April 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28436232/safety-performance-and-satisfaction-outcomes-in-the-operating-room-a-literature-review
#12
Anjali Joseph, Sara Bayramzadeh, Zahra Zamani, Bill Rostenberg
OBJECTIVE: This review of empirical literature focuses on the design of operating rooms (ORs) by investigating the physical environmental features of ORs associated with patient and staff outcomes. BACKGROUND: Many ORs built more than 30 years ago remain operational today. However, most are inadequately designed to handle the equipment, processes, and people that a contemporary OR needs to accommodate. However, the evidence base for designing ORs has been sorely lacking, and little guidance exists on how OR design can improve safety and performance outcomes...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/28435283/unlocking-the-black-box-of-practice-improvement-strategies-to-implement-surgical-safety-checklists-a-process-evaluation
#13
Brigid M Gillespie, Kyra Hamilton, Dianne Ball, Joanne Lavin, Therese Gardiner, Teresa K Withers, Andrea P Marshall
BACKGROUND: Compliance with surgical safety checklists (SSCs) has been associated with improvements in clinical processes such as antibiotic use, correct site marking, and overall safety processes. Yet, proper execution has been difficult to achieve. OBJECTIVES: The objective of this study was to undertake a process evaluation of four knowledge translation (KT) strategies used to implement the Pass the Baton (PTB) intervention which was designed to improve utilization of the SSC...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28434965/trochlear-schwannoma-presenting-with-isolated-trigeminal-neuralgia
#14
Cody L Nesvick, Avital Perry, Christopher S Graffeo, Aditya Raghunathan, Julie E Hammack, Jamie J Van Gompel
BACKGROUND: Schwannomas arising from the cranial nerves controlling extraocular eye movements are very rare and usually present with some degree of diplopia. CASE DESCRIPTION: We report a 50-year-old woman who presented with isolated left-sided trigeminal neuralgia of six months' duration. Imaging demonstrated a homogeneously enhancing mass in the left ambient cistern, and the patient was taken to the operating room for resection. A retrosigmoid approach was used, and the mass was directly visualized arising from the trochlear nerve and compressing on the dorsal root entry zone of the trigeminal nerve...
April 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434885/early-performance-on-an-eye-surgery-simulator-predicts-subsequent-resident-surgical-performance
#15
Ramak Roohipoor, Mehdi Yaseri, Amir Teymourpour, Carolyn Kloek, John B Miller, John I Loewenstein
OBJECTIVE: To examine early performance on an eye surgery simulator and its relationship to subsequent live surgical performance in a single large residency program. DESIGN: Retrospective study. SETTING: Massachusetts Eye and Ear, Harvard Medical School, Department of Ophthalmology. METHODS: In a retrospective study, we compared performance of 30 first-year ophthalmology residents on an eye surgery simulator to their surgical skills as third-year residents...
April 20, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28434425/augmented-reality-in-neurosurgery-a-review-of-current-concepts-and-emerging-applications
#16
Daipayan Guha, Naif M Alotaibi, Nhu Nguyen, Shaurya Gupta, Christopher McFaul, Victor X D Yang
Augmented reality (AR) superimposes computer-generated virtual objects onto the user's view of the real world. Among medical disciplines, neurosurgery has long been at the forefront of image-guided surgery, and it continues to push the frontiers of AR technology in the operating room. In this systematic review, we explore the history of AR in neurosurgery and examine the literature on current neurosurgical applications of AR. Significant challenges to surgical AR exist, including compounded sources of registration error, impaired depth perception, visual and tactile temporal asynchrony, and operator inattentional blindness...
April 24, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28434223/ultraclean-single-photon-emission-from-a-gan-quantum-dot
#17
Munetaka Arita, Florian Le Roux, Mark J Holmes, Satoshi Kako, Yasuhiko Arakawa
Wide bandgap III-nitride quantum dots (QDs) are promising materials for the realization of solid-state single-photon sources, especially operating at room temperature. However, so far a large degree of inhomogeneous broadening induced by spectral diffusion has compromised their use. Here, we demonstrate the ultraclean emission from single GaN QDs formed at macro-step edges in a GaN/AlGaN quantum well. As a likely consequence of the high growth temperature and hence a reduced defect density, spectral diffusion is heavily suppressed to levels at least one order of magnitude lower than conventional GaN QDs...
April 24, 2017: Nano Letters
https://www.readbyqxmd.com/read/28433951/transesophageal-echocardiography-in-the-evaluation-of-the-trauma-patient-a-trauma-resuscitation-transesophageal-echocardiography-exam
#18
REVIEW
Stefan W Leichtle, Andrew Singleton, Mandeep Singh, Matthew J Griffee, Joshua M Tobin
The point-of-care ultrasound exam has become an essential tool for hemodynamic monitoring and resuscitation in the trauma bay as well as the intensive care unit. Transthoracic ultrasound provides a dynamic assessment of cardiac function, volume status, and fluid responsiveness that offers potential advantage over traditional methods of hemodynamic monitoring. More recently, a focused transthoracic echocardiography exam was described to improve immediate resuscitation of severely injured patients in the trauma bay...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28433927/performing-boundary-work-the-emergence-of-a-new-practice-in-a-hybrid-operating-room
#19
Kajsa Lindberg, Lars Walter, Elena Raviola
This paper addresses the processes of boundary work, in relation to the introduction of new technology, unfolding during the emergence of new medical practices. Inspired by Gieryn's fluid and practical view of boundaries and boundary work, and by Actor-Network Theory's description of scripting processes, we study the processes of negotiating and (re-)constructing boundaries in order to reveal both the interactions between different kinds of boundary work and their situatedness in the context of the emerging practice...
April 13, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28433042/-alarmins-and-surgical-injury
#20
J Máca, M Peteja
Surgical intervention is an inseparable part of the management of serious surgical disease. However, surgery also presents a potential risk related to the so-called surgical injury causing immune response. When dysregulated the immune activation is able to cause local complications (i.e. wound dehiscence, impaired healing). Systemic decompartmentization of the immunologic disturbance can negatively influence long-term outcomes (i.e. hospital length of stay, mortality). Due to aseptic conditions in the operating room, such an immune activation is almost always of sterile nature...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
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