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https://www.readbyqxmd.com/read/28338868/effects-of-field-size-and-depth-on-photoneutron-dose-equivalent-distributions-in-an-18-mv-x-ray-medical-accelerator
#1
Amir Hakimi, Mehdi Sohrabi, Seied Rabie Mahdavi
Photoneutron (PN) dosimetry studies in high-energy X-ray medical accelerators are of high clinical and scientific interest in particular to protect patients undergoing radiotherapy. In this context, fast, epithermal and thermal PN dose equivalent distributions in different field sizes and depths in air and in a multilayer polyethylene phantom were studied. Polycarbonate track dosemeters in contact with a 10B convertor (with or without cadmium cover) when electrochemically etched were applied. PN dose equivalents in air and on the surface of the phantom are linear functions of field size...
March 1, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/28332442/ultrasound-imaging-in-the-diagnosis-of-large-vessel-vasculitis
#2
Michael Czihal, Christian Lottspeich, Ulrich Hoffmann
Nowadays noninvasive vascular imaging has an important role in the diagnostic work-up of the large vessel vasculitides (LVV), most importantly giant cell arteritis (GCA) and Takayasu arteritis. Among the imaging modalities available, ultrasound (US) has several important advantages, including low costs, rapid and repetitive availability without exposure to radiation, and high spatial resolution for assessment of large and medium-sized arteries. Therefore, US can be regarded the first line imaging method in suspected LVV...
March 23, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28331362/anesthesia-for-the-patient-undergoing-total-knee-replacement-current-status-and-future-prospects
#3
REVIEW
Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore
Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28316307/fast-track-pancreaticoduodenectomy-in-the-elderly
#4
Efstratios Zouros, Theodoros Liakakos, Anastasios Machairas, Paulos Patapis, Helen Tzerbinis, Dimitrios K Manatakis, Matthaios Papadimitriou-Olivgeris, Christos Dervenis
It remains uncertain whether enhanced recovery after surgery (ERAS) protocols can be safely implemented for elderly patients, especially after highly complex surgery such as pancreaticoduodenectomy (PD). The present study was designed to assess the feasibility and safety of an ERAS protocol in elderly patients undergoing PD. Starting January 2010 to February 2015, we prospectively collected data from 85 consecutive patients who underwent PD with a fast-track program. Data of patients older and younger than 70 years were compared...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28296715/evaluating-the-use-of-tissue-oximetry-to-decrease-intensive-unit-monitoring-for-free-flap-breast-reconstruction
#5
Joseph A Ricci, Christina R Vargas, Olivia A Ho, Samuel J Lin, Adam M Tobias, Bernard T Lee
BACKGROUND: Postoperative free flap care has historically required intensive monitoring for 24 hours in an intensive care unit. Continuous monitoring with tissue oximetry has allowed earlier detection of vascular compromise, decreasing flap loss and improving salvage. This study aims to identify whether a fast-track postoperative paradigm can be safely used with tissue oximetry to decrease intensive monitoring and costs. MATERIALS AND METHODS: All consecutive microsurgical breast reconstructions performed at a single institution were reviewed (2008-2014) and cases requiring return to the operating room were identified...
March 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28291930/development-and-performance-evaluation-of-a-high-speed-multileaf-collimator
#6
Xiang Zhang, Peiqing Ye, Hui Zhang
Multileaf collimator (MLC) tracking represents a promising technique for motion management in radiotherapy. However, the conflict between limited leaf speed/acceleration and the demand for tracking fast target motion is now a prominent issue. Conventional MLCs typically have a maximum leaf speed of 3-4 cm/s and a maximum leaf acceleration of 50-70 cm/s(2), which are inadequate to track fast target motion. To cope with this problem, we have recently developed a high-speed multileaf collimator (HS-MLC) prototype, which employs linear motors instead of rotary motors to drive leaves...
January 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#7
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28289835/optimization-of-chest-tube-management-to-expedite-rehabilitation-of-lung-cancer-patients-after-video-assisted-thoracic-surgery-a-meta-analysis-and-systematic-review
#8
Bo Deng, Kai Qian, Jing-Hai Zhou, Qun-You Tan, Ru-Wen Wang
BACKGROUND: The aim of this meta-analysis and systematic review of published evidence was to optimize chest tube management for fast-track rehabilitation of lung cancer patients after video-assisted thoracic surgery (VATS). METHODS: The PubMed, Web of Science, and EMBASE databases were searched to identify all studies that addressed the issue of chest tube management after VATS for lung cancer. Finally, 35 articles were included for analysis, i.e., 29 randomized controlled trials and 6 clinical trials...
March 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28289775/-on-the-fast-track-to-diagnosis-recommendations-for-patients-without-a%C3%A2-diagnosis
#9
Christiane Stieber, Martin Mücke, Isabelle C Windheuser, Lorenz Grigull, Frank Klawonn, Sinem Tunc, Alexander Münchau, Thomas Klockgether
BACKGROUND: Patients, who have spent many years without a proper diagnosis present an extraordinary problem to health care providers and to the healthcare system as a whole. A long 'diagnostic journey' increases the risk of disease chronification, as well as the number of therapy attempts, which could lead to iatrogenic impairment. New resources and specialized health care departments are being developed to help and support this patient group. One example of such department is the Interdisciplinary Competence Unit for Patients without a Diagnosis at the center for rare diseases in Bonn (ZSEB), Germany...
March 13, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28277245/surgery-start-time-does-not-impact-outcome-in-elective-cardiac-surgery
#10
Joshua A Heller, Rishi Kothari, Hung-Mo Lin, Matthew A Levin, Menachem Weiner
OBJECTIVE: Determine if surgery start time impacts patient outcomes in elective cardiac surgery. DESIGN: This was a retrospective study. SETTING: This study was based at a single academic institution. PARTICIPANTS: Patients undergoing elective cardiac surgery over a 3-year period were included. INTERVENTIONS: There were no interventions. MEASUREMENTS AND MAIN RESULTS: The authors performed a retrospective study of patients undergoing elective cardiac surgery over a 3-year period...
August 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28265757/one-stop-clinical-assessment-of-risk-for-endometrial-hyperplasia-oscar-endo-a-fast-track-protocol-for-evaluating-endometrial-pathologies
#11
Katrin Hefler-Frischmuth, Elisabeth Hirtl-Goergl, Verena Unterrichter, Judith Lafleur, Gudrun Brunnmayr-Petkin, Farid Moinfar, Lukas Hefler
PURPOSE: To evaluate a one-stop clinical assessment of risk for assessing endometrial pathologies (OSCAR-Endo), consisting of a fast-track protocol with hysteroscopy, dilation and curettage (D&C) with intraoperative frozen section analysis of the removed tissue in cases of hysteroscopic suspicion of malignancy. METHODS: In this prospective clinical trial, a total of 304 consecutive women with sonographically suspected endometrial hyperplasia and/or postmenopausal bleeding, underwent D&C with intraoperative frozen section analysis between May 2013 and September 2015...
March 6, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28259381/fast-track-pediatric-thoracic-surgery-toward-day-case-surgery
#12
Pauline Clermidi, Myriam Bellon, Alia Skhiri, Olivier Jaby, Christine Vitoux, Michel Peuchmaur, Arnaud Bonnard
PURPOSE: Thoracoscopic lung resection for congenital pulmonary airway malformation (CPAM) is a safe technique for children. Our purpose was to evaluate the feasibility of a fast-track protocol in such cases. METHODS: From September 2007 to May 2016, 101 patients underwent a thoracoscopic pulmonary resection of which 83 for CPAM (lobectomy, wedge resection or sequestrectomy). We retrospectively reviewed the characteristics of surgical procedure, postoperative management and complications through three time periods (September 2007-December 2009: n=14, January 2010-March 2013: n=30, April 2013-May 2016: n=39) corresponding to management protocols modifications introducing fast-track pathways...
February 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28255250/clinical-utility-of-metabolic-syndrome-severity-scores-considerations-for-practitioners
#13
REVIEW
Mark D DeBoer, Matthew J Gurka
The metabolic syndrome (MetS) is marked by abnormalities in central obesity, high blood pressure, high triglycerides, low high-density lipoprotein-cholesterol, and high fasting glucose and appears to be produced by underlying processes of inflammation, oxidative stress, and adipocyte dysfunction. MetS has traditionally been classified based on dichotomous criteria that deny that MetS-related risk likely exists as a spectrum. Continuous MetS scores provide a way to track MetS-related risk over time. We generated MetS severity scores that are sex- and race/ethnicity-specific, acknowledging that the way MetS is manifested may be different by sex and racial/ethnic subgroup...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28243442/speeding-up-laboratory-test-reporting-in-medical-emergency-and-cardiac-arrest-calls-a-quality-improvement-project
#14
Mohammed Al-Talib, Isla Leslie
Many hospitals deploy Medical Emergency (MET) and Cardiac Arrest teams to improve the management and treatment of patients who become critically ill. In many cases, blood results are key in allowing the clinicians involved in these teams to make definitive management decisions for these patients. Following anecdotal reports that these results were often delayed, we assessed the process of blood tests being reported in emergency calls, identified the key factors causing delays and sought to make improvements...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28241971/an-interactive-platform-to-guide-catheter-ablation-in-human-persistent-atrial-fibrillation-using-dominant-frequency-organization-and-phase-mapping
#15
Xin Li, João L Salinet, Tiago P Almeida, Frederique J Vanheusden, Gavin S Chu, G André Ng, Fernando S Schlindwein
BACKGROUND AND OBJECTIVE: Optimal targets for persistent atrial fibrillation (persAF) ablation are still debated. Atrial regions hosting high dominant frequency (HDF) are believed to participate in the initiation and maintenance of persAF and hence are potential targets for ablation, while rotor ablation has shown promising initial results. Currently, no commercially available system offers the capability to automatically identify both these phenomena. This paper describes an integrated 3D software platform combining the mapping of both frequency spectrum and phase from atrial electrograms (AEGs) to help guide persAF ablation in clinical cardiac electrophysiological studies...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28235523/fast-track-anesthesia-in-patients-undergoing-outpatient-laparoscopic-cholecystectomy-comparison-of-sevoflurane-with-total-intravenous-anesthesia
#16
Ceyda Özhan Çaparlar, Mehmet Özgür Özhan, Mehmet Anıl Süzer, Dilek Yazicioğlu, Mehmet Burak Eşkin, Serkan Şenkal, Mehmet Ali Çaparlar, Ersin Özkan Imren, Bülent Atik, Nedim Çekmen
BACKGROUND: The use of short-acting anesthetics has introduced a "fast-track anesthesia" concept in outpatient surgery which provides discharge of the patients from operation room directly to the phase II recovery area without entering into postanesthesia care unit. The aim of this prospective and randomized study was to compare general anesthesia using sevoflurane with propofol-remifentanil-based total intravenous anesthesia (TIVA) for fast-track eligibility in patients undergoing outpatient laparoscopic cholecystectomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28229182/outpatient-unicompartmental-knee-arthroplasty-who-is-afraid-of-outpatient-surgery
#17
Alexander Hoorntje, Koen L M Koenraadt, Margreet G Boevé, Rutger C I van Geenen
PURPOSE: In recent years, duration of hospitalisation after knee arthroplasty has decreased and fast track and outpatient surgery protocols have been developed. Studies have shown that outpatient surgery is feasible, safe, and cost effective. However, the psychological well-being of patients undergoing outpatient surgery has never been described before. The purpose of this study was to investigate how patients experience outpatient surgery for unicompartmental knee arthroplasty (UKA), examining levels of anxiety and depression, satisfaction, and pain...
March 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28211285/can-local-infiltration-analgesia-increase-satisfaction-in-postoperative-short-term-pain-control-in-total-knee-arthroplasty
#18
David Barastegui, I Robert, E Palau, S Haddad, M Reverte-Vinaixa, L Lorente, M Cots
BACKGROUND: One of the major challenges to total knee arthroplasty (TKA) is optimal pain control. Effective analgesia is capital in fast-track surgery programs to allow patient's early functional outcomes. OBJECTIVES: Compare length of stay (LOS) short-term pain control, and patients' satisfaction at 1 month between local infiltration analgesia (LIA) combined with femoral nerve block (FNB) and FNB only in patients undergoing TKA. PATIENTS AND METHODS: Two hundred and fifty-four patients were included in a randomized prospective study and distributed in two groups...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28208231/fast-left-ventricle-tracking-using-localized-anatomical-affine-optical-flow
#19
Sandro Queirós, João L Vilaça, Pedro Morais, Jaime C Fonseca, Jan D'hooge, Daniel Barbosa
In daily clinical cardiology practice, left ventricle (LV) global and regional function assessment is crucial for disease diagnosis, therapy selection and patient follow-up. Currently, this is still a time-consuming task, spending valuable human resources. In this work, a novel fast methodology for automatic LV tracking is proposed based on localized anatomically constrained affine optical flow. This novel method can be combined to previously proposed segmentation frameworks or manually delineated surfaces at an initial frame to obtain fully delineated datasets and, thus, assess both global and regional myocardial function...
February 16, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28198198/comparative-evaluation-of-pain-stress-neuropeptide-y-acth-and-cortisol-levels-between-a-conventional-postoperative-care-protocol-and-a-fast-track-recovery-program-in-patients-undergoing-major-abdominal-surgery
#20
Maria Kapritsou, Elizabeth D Papathanassoglou, Evangelos Bozas, Dimitrios P Korkolis, Evangelos A Konstantinou, Ioannis Kaklamanos, Margarita Giannakopoulou
BACKGROUND: Fast-track (FT) postoperative protocol in oncological patients after major abdominal surgery reduces complications and length of postoperative stay compared to the conventional (CON) protocol. However, stress and pain responses have not been compared between the two protocols. OBJECTIVES: To compare stress, pain, and related neuropeptidic responses (adrenocorticotropic hormone [ACTH], cortisol, and neuropeptide Y [NPY]) between FT and CON protocols. METHOD: A clinical trial with repeated measurements was conducted (May 2012 to May 2014) with a sample of 63 hepatectomized or pancreatectomized patients randomized into two groups: FT ( n = 29) or CON ( n = 34)...
March 2017: Biological Research for Nursing
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