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Operation room

Henry T Peng, Catherine Tenn, Oshin Vartanian, Shawn G Rhind, Jerzy Jarmasz, Homer Tien, Andrew Beckett
Introduction: Tactical Combat Casualty Care (TCCC) training imposes psychophysiological stress on medics. It is unclear whether these stress levels vary with the training modalities selected. It is also unclear how stress levels could have an impact on medical performance and skill uptake. Materials and Methods: We conducted a pilot study to compare the effects of live tissue (LT) with a high-fidelity patient simulator (SIM) on the level of stress elicited, performance, and skill uptake during battlefield trauma training course in an operating room (OR) and in a simulated battlefield scenario (field)...
March 14, 2018: Military Medicine
Steven M Falowski, Ashwini Sharan, James McInerney, Darren Jacobs, Lalit Venkatesan, Filippo Agnesi
BACKGROUND: Spinal cord stimulation (SCS) is a common intervention for managing intractable pain. Generally, leads are implanted in a minimally invasive procedure with verbal feedback regarding the location and nature of generated paresthesias by active stimulation; in this way their optimal location can be confirmed. However, lead placement under general anesthesia can have additional benefits. OBJECTIVE: To investigate the outcomes of awake vs asleep lead placement procedures...
March 14, 2018: Neurosurgery
Barry A Finegan, Daniel Roblin, Fadi Hammal
Quality problem: For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Initial assessment: Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented...
March 14, 2018: International Journal for Quality in Health Care
Hamid Reza Rajabi, Fatemeh Karimi, Hossein Kazemdehdashti, Leila Kavoshi
In this research, a sono-assisted chemical precipitation method was developed for a quick and efficient water-based synthesis of zinc sulfide (ZnS) quantum dots (QDs), in room temperature. ZnS QDs as pure and doped with some transition metal ions (such as Cu2+ , Mn2+ , Ag+ ) were prepared in the presence of l-cysteine, as capping agent. In comparison with the previous conventional methods, applying the ultrasonic irradiation provides a significant decrease in the reaction time. In comparison with previous reported conventional chemical QD synthesis methods, the required time for a complete synthesis in the presence of ultrasonic irradiations was significantly reduced to a period as short as 15 min, in a temperature of 40 °C...
February 22, 2018: Journal of Photochemistry and Photobiology. B, Biology
Takahiko Kojima, Fumiya Ogishima, Takahisa Nishibu, Hiroaki Kotani, Tomoya Ishizuka, Toshihiro Okajima, Shunsuke Nozawa, Yoshihito Shiota, Kazunari Yoshizawa, Hiroyoshi Ohtsu, Masaki Kawano, Takuya Shiga, Hiroki Oshio
An iron(III) complex having a dibenzotetraethyltetraamido macrocyclic ligand (DTTM4- ), (NEt4 )2 [FeIII (DTTM)Cl] (1), was synthesized and characterized by crystallographic, spectroscopic, and electrochemical methods. Complex 1 has a square-pyramidal structure in the S =3 /2 spin state. The complex exhibited two reversible redox waves at +0.36 and +0.68 V (vs SCE) in the cyclic voltammogram measured in CH2 Cl2 at room temperature. The stepwise oxidation of 1 using chemical oxidants allowed us to observe clear and distinct spectral changes with distinct isosbestic points for each step, in which oxidation occurred at the phenylenediamido moiety rather than the iron center...
March 16, 2018: Inorganic Chemistry
P Stefan, M Pfandler, P Wucherer, S Habert, J Fürmetz, S Weidert, E Euler, U Eck, M Lazarovici, M Weigl, N Navab
Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions...
March 15, 2018: Der Unfallchirurg
Fanny Gabrysz-Forget, Mélanie Hébert, André Denault, Louis P Perrault
This case report presents a manual decompression technique used to decompress a postoperative tamponade compressing right chambers. It consists of lateral movements following subxiphoid finger insertion. This is an accessible procedure to rapidly stabilize the haemodynamics of the patient in the intensive care unit to buy time before operating room (OR) revision.
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Justin S Merkow, Erik J Nelson
BACKGROUND Providing anesthesia to immunocompromised patients introduces unique challenges, including difficulty in detecting respiratory infections. Detailed preoperative evaluation and preparation for perioperative complications is crucial. Human metapneumovirus is a common but lesser known respiratory virus that can lead to pneumonia and respiratory compromise and is challenging to detect in the immunocompromised patient. CASE REPORT We present a case of an immunocompromised individual scheduled for umbilical hernia repair who developed severe bronchospasm and intraoperative respiratory failure after induction of general anesthesia...
March 16, 2018: American Journal of Case Reports
Bryan S Lee, David F Chang
PURPOSE: To compare the rotational stability of the 2 most commonly used toric intraocular lenses (TIOLs). DESIGN: Retrospective cohort study in a single private practice. SUBJECTS: The study included all patients receiving an Acrysof (n = 626) or Tecnis TIOL (n = 647) over an 18-month period from April 2015 to September 2016. Patients were only excluded if their surgery could not be performed using a digital marking system. METHODS: All patients had cataract surgery performed in the same surgical center with a similar technique...
March 12, 2018: Ophthalmology
Narjeet S Khurmi, Yu-Hui Chang, D Eric Steidley, Andrew L Singer, Winston R Hewitt, Kunam S Reddy, Adyr A Moss, Amit K Mathur
BACKGROUND: Cardiovascular disease (CVD) is a leading cause of post-liver transplant death, and variable care patterns may affect outcomes. We aimed to describe epidemiology and outcomes of inpatient CVD care across U.S. hospitals. METHODS: Using a merged dataset from the 2002-2011 Nationwide Inpatient Sample and the American Hospital Association Annual Survey, we evaluated liver transplant patients admitted primarily with myocardial infarction (MI), stroke (CVA), congestive heart failure (CHF), dysrhythmias, cardiac arrest (CA), or malignant hypertension...
March 15, 2018: Liver Transplantation
A V Kalinovskiy, D A Rzaev, K Yoshimitsu
INTRODUCTION: Modern neurosurgical practice is impossible without access to various information sources. The use of MRI and MSCT data during surgery is an integral part of the neurosurgeon's daily practice. Devices capable of managing an image viewer system without direct contact with equipment simplify working in the operating room. AIM AND OBJECTIVES: To test operation of a non-contact MRI and MSCT image viewer system in the operating room and to evaluate the system effectiveness...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Massimiliano Rossi, Nenad Kralj, Stefano Zippilli, Riccardo Natali, Antonio Borrielli, Gregory Pandraud, Enrico Serra, Giovanni Di Giuseppe, David Vitali
Normal-mode splitting is the most evident signature of strong coupling between two interacting subsystems. It occurs when two subsystems exchange energy between themselves faster than they dissipate it to the environment. Here we experimentally show that a weakly coupled optomechanical system at room temperature can manifest normal-mode splitting when the pump field fluctuations are antisquashed by a phase-sensitive feedback loop operating close to its instability threshold. Under these conditions the optical cavity exhibits an effectively reduced decay rate, so that the system is effectively promoted to the strong coupling regime...
February 16, 2018: Physical Review Letters
Duong Tung Pham, Joseph Paul Baboo, Jinju Song, Sungjin Kim, Jeonggeun Jo, Vinod Mathew, Muhammad Hilmy Alfaruqi, Balaji Sambandam, Jaekook Kim
Pyrite (FeS2 ) is a promising electrode material for lithium ion batteries (LIBs) because of its high natural availability, low toxicity, cost-effectiveness, high theoretical capacity (894 mA h g-1 ) and high theoretical specific energy density (1270 W h kg-1 , 4e- /FeS2 ). Nevertheless, the use of FeS2 in electrochemical capacitors was restricted due to fast capacity fading as a result of polysulfide (S/Sn 2- ) formation during the initial electrochemical cycling. In order to avoid the formation of polysulfides, we employed the strategy of utilizing an ether based electrolyte (1...
March 15, 2018: Nanoscale
Samin Nobakht, Arash Shirdel, Yasamin Molavi-Taleghani, Mohammad M Doustmohammadi, Hojjat Sheikhbardsiri
INTRODUCTION: Human resource supply is considered as one of the most vital factors in achieving organizational goals, and human resources are the most valuable factor in the production and delivery of services. Labor shortages and surpluses could downgrade the quality of services offered to patients. Considering the seriousness of this issue, this study aimed to investigate the status of human resources in Iran hospitals. METHODS: The narrative review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines...
March 15, 2018: International Journal of Health Planning and Management
Monica R Drylewicz, Kathryn Robinson, Cary Lynn Siegel
Global endometrial ablation is a commonly performed, minimally invasive technique aimed at improving/resolving abnormal uterine bleeding and menorrhagia in women. As non-resectoscopic techniques have come into existence, endometrial ablation performance continues to increase due to accessibility and decreased requirements for operating room time and advanced technical training. The increased utilization of this method translates into increased imaging of patients who have undergone the procedure. An understanding of the expected imaging appearances of endometrial ablation using different modalities is important for the abdominal radiologist...
March 14, 2018: Abdominal Radiology
David T Fernandes Cabral, Georgios A Zenonos, Maximiliano Nuñez, Pinar Celtikci, Carl Snyderman, Eric Wang, Paul A Gardner, Juan C Fernandez-Miranda
BACKGROUND: The endoscopic endonasal approach (EEA) has been proposed as a potential alternative for ventral brainstem lesions. The surgical anatomy, feasibility, and limitations of the EEA for intrinsic brainstem lesions are still poorly understood. OBJECTIVE: To describe the surgical planning, anatomy, and technique of an intrinsic pontine glioma operated via EEA. METHODS: Six-human brainstems were prepared for white matter microdissection...
March 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
Barclay T Stewart, Adam Gyedu, Cameron Gaskill, Godfred Boakye, Robert Quansah, Peter Donkor, Jimmy Volmink, Charles Mock
OBJECTIVE: Capacity assessments serve as surrogates for surgical output in low- and middle-income countries where detailed registers do not exist. The relationship between surgical capacity and output was evaluated in Ghana to determine whether a more critical interpretation of capacity assessment data is needed on which to base health systems strengthening initiatives. METHODS: A standardized surgical capacity assessment was performed at 37 hospitals nationwide using WHO guidelines; availability of 25 essential resources and capabilities was used to create a composite capacity score that ranged from 0 (no availability of essential resources) to 75 (constant availability) for each hospital...
March 13, 2018: World Journal of Surgery
Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
D A Friedlander, W W Ludwig, J R Jayman, A Akhavan
INTRODUCTION: Endoscopic injection of a bulking agent is a common first-line approach to the treatment of vesicoureteral reflux (VUR). While early outcomes are comparable to open ureteroneocystotomy, 5-25% of children will eventually develop recurrent reflux necessitating repeat injections or open ureteral reimplantation. OBJECTIVE: To determine whether prior endoscopic injection of a bulking agent impacts outcomes of subsequent open ureteral reimplantation. STUDY DESIGN: Using a retrospective cohort design, radiographic and clinical outcomes of open ureteral reimplantation were compared between patients with and without prior endoscopic correction of reflux...
March 1, 2018: Journal of Pediatric Urology
Weijia Zheng, Cristian A Morales-Rivera, Johnny W Lee, Peng Liu, Ming-Yu Ngai
The intermolecular C-H trifluoromethoxylation of arenes remains a long-standing and unsolved problem in organic synthesis. Herein, we report the first catalytic protocol employing a novel trifluoromethoxylating reagent and redox-active catalysts for the direct (hetero)aryl C-H trifluoromethoxylation. Our approach is operationally simple, proceeds at room temperature, uses easy-to-handle reagents, requires only 0.03 mol % of redox-active catalysts, does not need specialized reaction apparatus, and tolerates a wide variety of functional groups and complex structures such as sugars and natural product derivatives...
March 13, 2018: Angewandte Chemie
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