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https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#1
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29340301/stable-organic-thin-film-transistors
#2
Xiaojia Jia, Canek Fuentes-Hernandez, Cheng-Yin Wang, Youngrak Park, Bernard Kippelen
Organic thin-film transistors (OTFTs) can be fabricated at moderate temperatures and through cost-effective solution-based processes on a wide range of low-cost flexible and deformable substrates. Although the charge mobility of state-of-the-art OTFTs is superior to that of amorphous silicon and approaches that of amorphous oxide thin-film transistors (TFTs), their operational stability generally remains inferior and a point of concern for their commercial deployment. We report on an exhaustive characterization of OTFTs with an ultrathin bilayer gate dielectric comprising the amorphous fluoropolymer CYTOP and an Al2O3:HfO2 nanolaminate...
January 2018: Science Advances
https://www.readbyqxmd.com/read/29336769/processes-of-health-care-delivery-education-and-provider-satisfaction-in-acute-care-surgery-a-systematic-review
#3
DeGirolamo Kristin, Patrick B Murphy, Karan D'Souza, Jacques X Zhang, Neil Parry, Elliott Haut, W Robert Leeper, Ken Leslie, Kelly N Vogt, S Morad Hameed
In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29332055/operating-room-scheduling-and-surgeon-assignment-problem-under-surgery-durations-uncertainty
#4
Hongwei Liu, Tianyi Zhang, Shuai Luo, Dan Xu
BACKGROUND: Scientific management methods are urgently needed to balance the demand and supply of heath care services in Chinese hospitals. Operating theatre is the bottleneck and costliest department. Therefore, the surgery scheduling is crucial to hospital management. OBJECTIVE: To increase the utilization and reduce the cost of operating theatre, and to improve surgeons' satisfaction in the meantime, a practical surgery scheduling which could assign the operating room (OR) and surgeon for the surgery and sequence surgeries in each OR was provided for hospital managers...
December 29, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29331398/critical-differences-between-elective-and-emergency-surgery-identifying-domains-for-quality-improvement-in-emergency-general-surgery
#5
Alexandra B Columbus, Megan A Morris, Elizabeth J Lilley, Alyssa F Harlow, Adil H Haider, Ali Salim, Joaquim M Havens
OBJECTIVE: The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. BACKGROUND: Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed...
January 10, 2018: Surgery
https://www.readbyqxmd.com/read/29323794/skills-transfer-to-sinus-surgery-via-a-low-cost-simulation-based-curriculum
#6
R Alex Harbison, Jennifer Dunlap, Ian M Humphreys, Greg E Davis
BACKGROUND: Surgical skill development outside the operating room aims to improve technique and subsequent patient safety. The purpose of this study was to evaluate the correlation between technical and cognitive skills with cadaveric endoscopic sinus surgery (ESS) performance and change in ESS performance before and after implementation of a dedicated ESS simulation-based and knowledge-based curriculum. METHODS: A before-after study design was implemented among 10 medical students and 10 junior otolaryngology residents...
January 11, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29318340/evaluating-protocols-for-porcine-faecal-microbiome-recollection-storage-and-dna-extraction-from-the-farm-to-the-lab
#7
Anixa Muiños-Bühl, Oscar González-Recio, María Muñoz, Cristina Óvilo, Juan García-Casco, Ana I Fernández
There is a growing interest in understanding the role of the gut microbiome on productive and meat quality-related traits in livestock species in order to develop new useful tools for improving pig production systems and industry. Faecal samples are analysed as a proxy of gut microbiota and here the selection of suitable protocols for faecal sampling and DNA isolation is a critical first step in order to obtain reliable results, even more to compare results obtained from different studies. The aim of the current study was to establish in a cost-effective way, using automated ribosomal intergenic spacer analysis technique, a protocol for porcine faecal sampling and storage at farm and slaughterhouse and to determine the most efficient microbiota DNA isolation kit among those most widely used...
January 9, 2018: Current Microbiology
https://www.readbyqxmd.com/read/29317119/noninvasive-ventilation-during-endoscopic-procedures-rationale-clinical-use-and-devices
#8
REVIEW
Marina Pieri, Giovanni Landoni, Luca Cabrini
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29303921/blood-loss-management-in-spine-surgery
#9
Jesse E Bible, Muhammad Mirza, Mark A Knaub
Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29299520/the-efficacy-of-lavender-aromatherapy-in-reducing-preoperative-anxiety-in-ambulatory-surgery-patients-undergoing-procedures-in-general-otolaryngology
#10
Michael Wotman, Joshua Levinger, Lillian Leung, Aron Kallush, Elizabeth Mauer, Ashutosh Kacker
Background: Preoperative anxiety is a common problem in hospitals and other health care centers. This emotional state has been shown to negatively impact patient satisfaction and outcomes. Aromatherapy, the therapeutic use of essential oils extracted from aromatic plants, may offer a simple, low-risk and cost-effective method of managing preoperative anxiety. The purpose of this study was to evaluate the efficacy of lavender aromatherapy in reducing preoperative anxiety in ambulatory surgery patients undergoing procedures in general otolaryngology...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29299472/does-a-simple-syringe-applicator-enhance-bone-cement-set-up-time-in-knee-arthroplasty
#11
Nipun Sodhi, Sarah E Dalton, Anton Khlopas, Assem A Sultan, Gannon L Curtis, Matthew A Harb, Qais Naziri, Jared M Newman, John W Barrington, Michael A Mont
Background: The time required for polymethylmethacrylate (PMMA) cement curing or hardening can be modified by a number of variables including the mixing technique, and the temperature and pressure at which the process is taking place. Therefore, the purpose of this study was to evaluate two different methods of PMMA application in terms of set up time. Specifically, we (I) compared the PMMA set up time of cement that remained in the mixing bowl to cement that was placed in a syringe and (II) extrapolated the associated annual cost difference on the national and individual surgeon levels...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29289460/risk-management-for-surgical-energy-driven-devices-used-in-the-operating-room
#12
F Borie, M Mathonnet, A Deleuze, B Millat, J-F Gravié, H Johanet, J-P Lesage, J Gugenheim
Complications related to energy sources in the operating room are not well-recognized or published, despite occasionally dramatic consequences for the patient and the responsible surgeon. The goal of this study was to evaluate the risks and consequences related to use of energy sources in the operating room. PATIENTS AND METHODS: Between 2009 and 2015, 876 adverse events related to health care (AERHC) linked to energy sources in the operating room were declared in the French experience feedback data base "REX"...
December 27, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29286458/surgical-training-for-the-implantation-of-neocortical-microelectrode-arrays-using-a-formaldehyde-fixed-human-cadaver-model
#13
Pierre Mégevand, Alain Woodtli, Aude Yulzari, G Rees Cosgrove, Shahan Momjian, Bojan V Stimec, Marco V Corniola, Jean H D Fasel
This protocol describes a procedure to assist surgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain. Recent technological progress has enabled the fabrication of microelectrode arrays that allow recording the activity of multiple individual neurons in the neocortex of the human brain. These arrays have the potential to bring unique insight onto the neuronal correlates of cerebral function in health and disease. Furthermore, the identification and decoding of volitional neuronal activity opens the possibility to establish brain-computer interfaces, and thus might help restore lost neurological functions...
November 19, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29275116/hospital-discharge-within-1-day-after-total-joint-arthroplasty-from-a-veterans-affairs-hospital-does-not-increase-complication-and-readmission-rates
#14
Eric M Kiskaddon, Jessica H Lee, Brett D Meeks, Spencer W Barnhill, Andrew W Froehle, Anil Krishnamurthy
BACKGROUND: Attempts to control costs associated with total joint arthroplasty have included efforts to shorten hospital length of stay (LOS). Concerns related to patient outcomes and safety with decreased LOS persist. The purpose of this study was to investigate whether discharge on postoperative day (POD) 1 after joint replacement is associated with increased rates of 90-day return to the operating room, and 30-day readmissions and emergency department (ED) visits. METHODS: After chart review, 447 patients admitted between January 2, 2013 and September 16, 2016 met inclusion criteria...
December 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29273773/intravitreal-injections-of-anti-vegf-agents-and-antibiotic-prophylaxis-for-endophthalmitis-a-systematic-review-and-meta-analysis
#15
Manuel F Bande, Raquel Mansilla, María P Pata, Maribel Fernández, María José Blanco-Teijeiro, Antonio Piñeiro, Francisco Gómez-Ulla
We performed a systematic review and meta-analysis to determine whether the use of local antibiotics is a beneficial prophylactic treatment for endophthalmitis in patients treated with anti-VEGF agents. We searched the MEDLINE and EMBASE databases, and the Cochrane Library over the period January 2007 to December 2016. The search terms used included "Endophthalmitis", "Antibiotic" and "Intravitreal injection". Studies in which the patients were treated exclusively with intravitreal injections of anti-VEGF were selected...
December 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29246339/straight-to-the-operating-room-an-emergent-surgery-track-for-acute-testicular-torsion-transfers
#16
Michelle K Arevalo, Kunj R Sheth, Vani S Menon, Lauren Ostrov, Halim Hennes, Nirmish Singla, Korgun Koral, Bruce J Schlomer, Linda A Baker
OBJECTIVE: To assess the effect of implementing an emergency surgery track for testicular torsion transfers. We hypothesized that transferring children from other facilities diagnosed with torsion straight to the operating room (STOR) would decrease ischemia time, lower costs, and reduce testicular loss. STUDY DESIGN: Demographics, arrival to incision time, hospital cost in dollars, and testicular outcome (determined by testicular ultrasound) at follow-up were retrospectively compared in all patients transferred to our tertiary care children's hospital with a diagnosis of testicular torsion from 2012 to 2016...
January 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29239227/micro-costing-analysis-demonstrates-comparable-costs-for-lithovue%C3%A2-compared-to-reusable-flexible-fiberoptic-ureteroscopes
#17
Kazumi Taguchi, Manint Usawachintachit, David T Tzou, Benjamin Sherer, Ian Metzler, Dylan Isaacson, Marshall Stoller, Thomas Chi
INTRODUCTION: Reusable ureteroscope durability and need for repair are significant sources of expense and inefficiency for patients and urologists. Utilization of LithoVue™, a disposable flexible digital ureteroscope, may address some of these concerns. To identify its economic impact on clinical care, we performed a micro-cost comparison between flexible reusable fiberoptic ureteroscopes (URF-P6™) and LithoVue™. PATIENTS AND METHODS: For this prospective, single-center micro-costing study, all consecutive ureteroscopies performed during one week each in July and August 2016 utilized either URF-P6™ or LithoVue™ ureteroscopes respectively...
December 14, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29223668/transumbilical-extracorporeal-laparoscopic-assisted-appendectomy
#18
Lindsey Perea, William H Peranteau, Pablo Laje
AIM OF THE STUDY: The perfect balance between safety, cosmesis, and cost effectiveness in a world with ever growing healthcare costs has yet to be found for nonperforated appendicitis. The aim is to present our data regarding safety and cost effectiveness of the transumbilical extracorporeal laparoscopic-assisted appendectomy technique. METHODS: A retrospective review was performed for all laparoscopic appendectomies for acute appendicitis from October 2014 to October 2016...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29223416/cost-variation-across-centers-for-the-norwood-operation
#19
Kimberly E McHugh, Sara K Pasquali, Matthew A Hall, Mark A Scheurer
BACKGROUND: The Norwood operation is associated with high health care utilization, and prior studies reported substantial variability in Norwood costs across centers. However, specific factors driving this cost variation are unclear. We assessed center variability in Norwood costs and underlying mechanisms in a multicenter cohort. METHODS: Clinical data from the Pediatric Heart Network Single Ventricle Reconstruction trial were linked with cost data from the Children's Hospital Association Inpatient Essentials database...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29210785/large-variability-in-the-diversity-of-physiologically-complex-surgical-procedures-exists-nationwide-among-all-hospitals-including-among-large-teaching-hospitals
#20
Franklin Dexter, Richard H Epstein, Kokila Thenuwara, David A Lubarsky
BACKGROUND: Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment...
November 22, 2017: Anesthesia and Analgesia
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