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https://www.readbyqxmd.com/read/28533991/multivariable-analysis-of-factors-affecting-length-of-stay-and-hospital-charges-after-atlantoaxial-fusion
#1
Jian Guan, Michael Karsy, Meic Schmidt, Andrew T Dailey, Erica Bisson
BACKGROUND: Atlantoaxial fusion is an effective procedure for treating degenerative, traumatic, and congenital abnormalities that result in upper cervical instability; however, data on which factors affect the length of stay and hospitalization-related charges are limited. The purpose of this study was to evaluate the pre-, intra-, and postoperative variables that affect these healthcare cost factors for patients undergoing posterior atlantoaxial fusion. METHODS: We retrospectively identified from a clinical database 59 patients who underwent isolated posterior atlantoaxial fusion at a single institution from 2010 to 2015...
April 18, 2017: Curēus
https://www.readbyqxmd.com/read/28529399/modeling-high-school-timetabling-with-bitvectors
#2
Emir Demirović, Nysret Musliu
High school timetabling (HSTT) is a well known and wide spread problem. The problem consists of coordinating resources (e.g. teachers, rooms), times, and events (e.g. lectures) with respect to various constraints. Unfortunately, HSTT is hard to solve and just finding a feasible solution for simple variants of HSTT has been proven to be NP-complete. We propose a new modeling approach for HSTT using bitvectors in which constraint costs of the general HSTT can be calculated using bit operations. This model allows efficient computation of constraint costs making it useful when implementing HSTT algorithms...
2017: Annals of Operations Research
https://www.readbyqxmd.com/read/28528356/operating-room-fires-in-periocular-surgery
#3
Michael A Connor, Anne M Menke, Ivan Vrcek, John W Shore
AIM: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. METHODS: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons...
May 20, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28527547/the-optimal-time-and-method-for-surgical-prewarming-a-comprehensive-review-of-the-literature
#4
Lauren Connelly, Emily Cramer, Quinn DeMott, Jennifer Piperno, Bethany Coyne, Clara Winfield, Michael Swanberg
PURPOSE: Inadvertent hypothermia is a common problem in the operating room. This can contribute to many unfavorable outcomes --rising costs, increased complications, and higher morbidity rates. DESIGN: This review determined the optimal method and time to prewarm a surgical patient to prevent perioperative hypothermia. METHODS: CINAHL and PubMed were searched. Fourteen articles were ultimately included in this review. FINDINGS: Based on the literature reviewed, it was suggested that forced-air warming was most effective in preventing perioperative hypothermia...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28526944/ventilator-data-extraction-with-a-video-display-image-capture-and-processing-system
#5
David B Wax, Bryan Hill, Matthew A Levin
Medical hardware and software device interoperability standards are not uniform. The result of this lack of standardization is that information available on clinical devices may not be readily or freely available for import into other systems for research, decision support, or other purposes. We developed a novel system to import discrete data from an anesthesia machine ventilator by capturing images of the graphical display screen and using image processing to extract the data with off-the-shelf hardware and open-source software...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28523393/flavored-anesthetic-masks-for-inhalational-induction-in-children
#6
Aakriti Gupta, Preethy Joseph Mathew, Neerja Bhardwaj
OBJECTIVES: To evaluate the clinical efficacy of masking the odor of inhalational agents using fruit flavors on the anxiety behavior and compliance of children for inhalational induction. METHODS: A prospective randomized double blind, placebo controlled study was conducted on 60 unpremedicated children in the age group of 4-12 y. Thirty children received anesthetic masks smeared with a flavor of child's choice while the other 30 children were induced using masks without flavor...
May 19, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28521381/-time-in-the-or-outcome-and-surgeons-experience-the-use-of-patient-matched-instruments-in-arthroplasty-of-the-knee
#7
Christoph Schulze, Cem Kai Inan, Claudia Hacke, Alexander Kaltenborn, André Gutcke
Background Arthrosis of the knee is a common problem in Germany that is often treated with arthroplasty. To support the orthopaedic surgeon, person-matched instruments (PMI) are available from several providers. In this study we investigated the clinical and radiological outcome of the use of the PMI Visionaire(™) (Smith&Nephew). Furthermore, we investigated the influence of operative experience of the orthopaedic surgeon on the clinical and radiological results. Time in the operating room (OR) was identified as a parameter for cost effectiveness even during training to become an orthopaedic surgeon...
May 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28511894/incorporating-simulation-into-gynecologic-surgical-training
#8
REVIEW
Kyle Wohlrab, J Eric Jelovsek, Deborah Myers
Today's educational environment has made it more difficult to rely on the Halstedian model of 'see one, do one, teach one' in gynecologic surgical training. There is decreased surgical volume, but an increased number of surgical modalities. Fortunately, surgical simulation has evolved to fill the educational void. Whether it is through skill generalization or skill transfer, surgical simulation has shifted the learning curve from the operating room back to the classroom. This article explores the principles of surgical education and ways to introduce simulation as an adjunct to residency training...
May 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28507731/patient-engagement-with-surgical-site-infection-prevention-an-expert-panel-perspective
#9
REVIEW
E Tartari, V Weterings, P Gastmeier, J Rodríguez Baño, A Widmer, J Kluytmans, A Voss
Despite remarkable developments in the use of surgical techniques, ergonomic advancements in the operating room, and implementation of bundles, surgical site infections (SSIs) remain a substantial burden, associated with increased morbidity, mortality and healthcare costs. National and international recommendations to prevent SSIs have been published, including recent guidelines by the World Health Organization, but implementation into clinical practice remains an unresolved issue. SSI improvement programs require an integrative approach with measures taken during the pre-, intra- and postoperative care from the numerous stakeholders involved...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28505289/financial-and-environmental-costs-of-reusable-and-single-use-anaesthetic-equipment
#10
F McGain, D Story, T Lim, S McAlister
Background.: An innovative approach to choosing hospital equipment is to consider the environmental costs in addition to other costs and benefits. Methods.: We used life cycle assessment to model the environmental and financial costs of different scenarios of replacing reusable anaesthetic equipment with single-use variants. The primary environmental costs were CO 2 emissions (in CO 2 equivalents) and water use (in litres). We compared energy source mixes between Australia, the UK/Europe, and the USA...
May 15, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28498922/outpatient-vs-inpatient-anterior-cervical-discectomy-and-fusion-a-population-level-analysis-of-outcomes-and-cost
#11
David A Purger, Arjun V Pendharkar, Allen L Ho, Eric S Sussman, Lingyao Yang, Manisha Desai, Anand Veeravagu, John K Ratliff, Atman Desai
BACKGROUND: Outpatient anterior cervical discectomy and fusion (ACDF) is a promising candidate for US healthcare cost reduction as several studies have demonstrated that overall complications are relatively low and early discharge can preserve high patient satisfaction, low morbidity, and minimal readmission. OBJECTIVE: To compare clinical outcomes and associated costs between inpatient and ambulatory setting ACDF. METHODS: Demographics, comorbidities, emergency department (ED) visits, readmissions, reoperation rates, and 90-d charges were retrospectively analyzed for patients undergoing elective ACDF in California, Florida, and New York from 2009 to 2011 in State Inpatient and Ambulatory Databases...
May 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28497037/timeliness-of-operating-room-case-planning-and-time-utilization-influence-of-first-and-to-follow-cases
#12
Claudius Balzer, David Raackow, Klaus Hahnenkamp, Steffen Flessa, Konrad Meissner
Resource and cost constraints in hospitals demand thorough planning of operating room schedules. Ideally, exact start times and durations are known in advance for each case. However, aside from the first case's start, most factors are hard to predict. While the role of the start of the first case for optimal room utilization has been shown before, data for to-follow cases are lacking. The present study therefore aimed to analyze all elective surgery cases of a university hospital within 1 year in search of visible patterns...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28492612/a-prospective-randomized-clinical-study-comparing-drug-eluting-stent-therapy-and-intranasal-corticoid-steroid-therapy-in-the-treatment-of-patients-with-chronic-rhinosinusitis
#13
R Taulu, A J Bizaki, J Numminen, M Rautiainen
OBJECTIVES: To conduct the first prospective, randomized controlled clinical trial comparing the efficacy of a drug-eluting stent (DES) (the Relieva StratusTM MicroFlow Spacer) and topical intranasal corticosteroid therapy in patients with chronic rhinosinusitis (CRS). METHODS: Sixty-three adult patients with ethmoiditis were randomized into either the DES group (n=34) or nasal spray group (n=29). The main outcome variable was the Sinonasal Outcome Test 22, Visual Analogue Scale, nasal endoscopy, rhinometric measurements were performed at the beginning of the study, after three months and six months of follow-up...
May 10, 2017: Rhinology
https://www.readbyqxmd.com/read/28489241/in-office-vs-operating-room-procedures-for-recurrent-respiratory-papillomatosis
#14
Anya J Miller, Glendon M Gardner
We conducted a study to analyze hospital and patient costs, outcomes, and patient satisfaction among adults undergoing in-office and operating room procedures for the treatment of recurrent respiratory papillomatosis. Our final study population was made up of 17 patients-1 man and 16 women, aged 30 to 86 years (mean: 62). The mean number of in-office laser procedures per patient was 4.2, and the mean interval between procedures was 5.4 months (although 10 patients underwent only 1 office procedure); the mean number of operating room procedures was 13...
April 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28487512/rapid-learning-curve-assessment-in-an-ex-vivo-training-system-for-microincisional-glaucoma-surgery
#15
Yalong Dang, Susannah Waxman, Chao Wang, Hardik A Parikh, Igor I Bussel, Ralitsa T Loewen, Xiaobo Xia, Kira L Lathrop, Richard A Bilonick, Nils A Loewen
Increasing prevalence and cost of glaucoma have increased the demand for surgeons well trained in newer, microincisional surgery. These procedures occur in a highly confined space, making them difficult to learn by observation or assistance alone as is currently done. We hypothesized that our ex vivo outflow model is sensitive enough to allow computing individual learning curves to quantify progress and refine techniques. Seven trainees performed nine trabectome-mediated ab interno trabeculectomies in pig eyes (n = 63)...
May 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28483679/sensitive-and-non-invasive-assessment-of-hepatocellular-iron-using-a-novel-room-temperature-susceptometer
#16
Johannes Mueller, Hanna Raisi, Vanessa Rausch, Teresa Peccerella, David Simons, Christian Ziener, Heinz-Peter Schlemmer, Helmut Karl Seitz, Nina Waldburger, Thomas Longerich, Beate Katharina Straub, Sebastian Mueller
PURPOSE: Liver iron accumulates in various chronic liver diseases where it is an independent factor of survival and cancerogenesis. We here tested a novel room-temperature susceptometer (RTS) to noninvasively assess liver iron concentration (LIC). MATERIALS AND METHODS: 264 patients with or without signs of iron overload or liver disease were prospectively enrolled. 35 patients underwent liver biopsy with semiquantitative iron determination (Prussian Blue staining), atomic absorption spectroscopy (AAS, n=33) or MRI (n=15)...
May 5, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28483242/prevention-of-post-operative-pediatric-tracheotomy-wounds-a-multidisciplinary-team-approach
#17
Timothy P McEvoy, Nolan B Seim, Abdullah Aljasser, Charles A Elmaraghy, Brenda Ruth, Leslie Justice, Sarah Begue, Kris R Jatana
OBJECTIVE: Tracheotomy-related pressure wounds have been reported as high as 29%. All advanced stage (stage 3 or 4) wounds are reported by hospitals, and CMS will no longer reimburse healthcare costs to manage them. We present the results of an intensive, multidisciplinary wound prevention strategy starting in the operating room at the time of tracheotomy placement. METHODS: Prospective analysis of a tracheostomy wound care protocol at an academic, tertiary-care pediatric hospital from September 2012 to February 2016...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28481258/highly-sensitive-sputtered-zno-ga-thin-films-integrated-by-a-simple-stencil-mask-process-on-microsensor-platforms-for-sub-ppm-acetaldehyde-detection
#18
Lionel Presmanes, Yohann Thimont, Audrey Chapelle, Frédéric Blanc, Chabane Talhi, Corine Bonningue, Antoine Barnabé, Philippe Menini, Philippe Tailhades
The integration of a 50-nm-thick layer of an innovative sensitive material on microsensors has been developed based on silicon micro-hotplates. In this study, integration of ZnO:Ga via radio-frequency (RF) sputtering has been successfully combined with a low cost and reliable stencil mask technique to obtain repeatable sensing layers on top of interdigitated electrodes. The variation of the resistance of this n-type Ga-doped ZnO has been measured under sub-ppm traces (500 ppb) of acetaldehyde (C₂H₄O). Thanks to the microheater designed into a thin membrane, the generation of very rapid temperature variations (from room temperature to 550 °C in 25 ms) is possible, and a rapid cycled pulsed-temperature operating mode can be applied to the sensor...
May 6, 2017: Sensors
https://www.readbyqxmd.com/read/28468405/room-temperature-deposited-dielectrics-and-superconductors-for-integrated-photonics
#19
Jeffrey M Shainline, Sonia M Buckley, Nima Nader, Cale M Gentry, Kevin C Cossel, Justin W Cleary, Miloš Popović, Nathan R Newbury, Sae Woo Nam, Richard P Mirin
We present an approach to fabrication and packaging of integrated photonic devices that utilizes waveguide and detector layers deposited at near-ambient temperature. All lithography is performed with a 365 nm i-line stepper, facilitating low cost and high scalability. We have shown low-loss SiN waveguides, high-Q ring resonators, critically coupled ring resonators, 50/50 beam splitters, Mach-Zehnder interferometers (MZIs) and a process-agnostic fiber packaging scheme. We have further explored the utility of this process for applications in nonlinear optics and quantum photonics...
May 1, 2017: Optics Express
https://www.readbyqxmd.com/read/28467526/centers-for-disease-control-and-prevention-guideline-for-the-prevention-of-surgical-site-infection-2017
#20
Sandra I Berríos-Torres, Craig A Umscheid, Dale W Bratzler, Brian Leas, Erin C Stone, Rachel R Kelz, Caroline E Reinke, Sherry Morgan, Joseph S Solomkin, John E Mazuski, E Patchen Dellinger, Kamal M F Itani, Elie F Berbari, John Segreti, Javad Parvizi, Joan Blanchard, George Allen, Jan A J W Kluytmans, Rodney Donlan, William P Schecter
Importance: The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies. Objective: To provide new and updated evidence-based recommendations for the prevention of SSI...
May 3, 2017: JAMA Surgery
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