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https://www.readbyqxmd.com/read/28437491/correct-positioning-of-the-medial-patellofemoral-ligament-troubleshooting-in-the-operating-room
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28432612/evaluation-of-the-analgesia-nociception-index-ani-in-healthy-awake-volunteers
#15
Rami Issa, Marco Julien, Elizabeth Décary, Olivier Verdonck, Louis-Philippe Fortier, Pierre Drolet, Philippe Richebé
BACKGROUND: Analgesia might be evaluated with simple changes in vital signs, a non-specific and non-sensitive method. Heart rate variability (HRV) correlates with autonomous nervous system activity and can be used to evaluate painful stimuli. Heart rate variability is then transformed into a numeric scale called the analgesia nociception index (ANI), where higher values represent predominant parasympathetic tone, thus low nociception. Under general anesthesia, the ANI decreases following painful stimuli and increases after administration of analgesia, but significant interindividual variability is present...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28432189/safety-and-efficiency-of-a-new-generic-package-labelling-a-before-and-after-study-in-a-simulated-setting
#16
Beate Hennie Garcia, Renate Elenjord, Camilla Bjornstad, Kjell Hermann Halvorsen, Sigurd Hortemo, Steinar Madsen
BACKGROUND: Medication errors are frequent and may cause harm to patients and increase healthcare expenses. AIM: To explore whether a new labelling influences time and errors when preparing medications in accordance with medication charts in an experimental setting. METHOD: We carried out an uncontrolled before and after study with 3 months inbetween experiments. Phase I used original labelling and phase II used new generic labelling. We set up an experimental medicine room, simulating a real-life setting...
April 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28431851/ultraviolet-c-light-as-a-means-of-disinfecting-anesthesia-workstations
#17
Matthew Nottingham, Gene Peterson, Christopher Doern, Michelle Doll, Nadia Masroor, Kakotan Sanogo, Michael Stevens, Gonzalo Bearman
BACKGROUND: Anesthesia workstations (AWs) are a reservoir for pathogenic organisms potentially associated with surgical site infections. This study examined the effectiveness of the Tru-D SmartUVC device (Tru-D LLC, Nashville, TN) on bioburden reduction (BR) on AWs. METHODS: Strips of tissue inoculated with a known concentration of either Staphylococcus aureus, Enterococcus faecalis, or Acinetobacter sp were placed on 22 high-touch surfaces of an AW. Half of the AW surfaces received direct ultraviolet (UV) light exposure and half received indirect exposure...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431507/antimicrobial-prophylaxis-outside-the-operating-theatre-an-audit-in-a-university-hospital
#18
Jan W T Deelen, Caroline E Visser, Jan M Prins, Reinier M van Hest
BACKGROUND: The prophylactic use of antimicrobial agents to prevent infections in non-surgical situations has hardly been investigated. We investigate the extent, indications and appropriateness of antimicrobial prophylaxis given outside the operating room in a tertiary care hospital. METHODS: Four point-prevalence surveys were conducted in which all inpatients on that day were screened for the use of prophylactic antimicrobials: medical prophylaxis, prophylaxis around non-surgical interventions and surgical prophylaxis given on the ward...
April 21, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#19
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430878/cosmetic-liposuction-preoperative-risk-factors-major-complication-rates-and-safety-of-combined-procedures
#20
Christodoulos Kaoutzanis, Varun Gupta, Julian Winocour, John Layliev, Roberto Ramirez, James C Grotting, Kent Higdon
Background: Liposuction is among the most commonly performed aesthetic procedures, and is being performed increasingly as an adjunct to other procedures. Objectives: To report the incidence and risk factors of significant complications after liposuction, and to determine whether adding liposuction to other cosmetic surgical procedures impacts the complication risk. Methods: A prospective cohort of patients who underwent liposuction between 2008 and 2013 was identified from the CosmetAssure database...
April 20, 2017: Aesthetic Surgery Journal
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