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https://www.readbyqxmd.com/read/28097941/telemedicine-support-shortens-length-of-stay-after-fast-track-hip-replacement
#1
Martin Svoldgaard Vesterby, Preben Ulrich Pedersen, Malene Laursen, Søren Mikkelsen, Jens Larsen, Kjeld Søballe, Lene Bastrup Jørgensen
Background and purpose - Telemedicine could allow patients to be discharged more quickly after surgery and contribute to improve fast-track procedures without compromising quality, patient safety, functionality, anxiety, or other patient-perceived parameters. We investigated whether using telemedicine support (TMS) would permit hospital discharge after 1 day without loss of self-assessed quality of life, loss of functionality, increased anxiety, increased rates of re-admission, or increased rates of complications after hip replacement...
February 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28086896/fast-track-surgery-versus-conventional-perioperative-management-of-lung-cancer-associated-pneumonectomy-a-randomized-controlled-clinical-trial
#2
Qing Dong, Kai Zhang, Shouqiang Cao, Jian Cui
BACKGROUND: The aim of this study is to investigate the effects of fast-track surgery (FTS) on postoperative recovery, hospital stay, total medical costs, and the complications of pneumonectomy in patients with non-small cell lung cancer (NSCLC). METHODS: Studies were performed between June 2012 and March 2014 in 17 patients received FTS and 18 patients given conventional management (control) after pneumonectomy in the Department of Thoracic Surgery, the Fourth Affiliated Hospital of Harbin Medical University...
January 13, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28079428/the-first-6-weeks-of-recovery-after-primary-total-hip-arthroplasty-with-fast-track
#3
Lisette C M Klapwijk, Nina M C Mathijssen, Jeroen C Van Egmond, Bianca M Verbeek, Stephan B W Vehmeijer
Background and purpose - Fast-track protocols have been introduced worldwide to improve the recovery after total hip arthroplasty (THA). These protocols have reduced the length of hospital stay (LOS), and THA in an outpatient setting is also feasible. However, less is known regarding the first weeks after THA with fast track. We examined patients' experiences of the first 6 weeks after hospital discharge following inpatient and outpatient THA with fast track. Patients and methods - In a prospective cohort study, 100 consecutive patients who underwent THA surgery in a fast-track setting between February 2015 and October 2015 received a diary for 6 weeks...
January 12, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28078766/lost-in-transformation-reviving-ethics-of-care-in-hospital-cultures-of-evidence-based-healthcare
#4
Annelise Norlyk, Anita Haahr, Pia Dreyer, Bente Martinsen
Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients' individual perspectives in an evidence-based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously...
January 12, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28077058/imaging-investigations-before-referral-to-a-sarcoma-center-delay-the-final-diagnosis-of-musculoskeletal-sarcoma
#5
Heidi Buvarp Dyrop, Peter Vedsted, Mathias Rædkjær, Akmal Safwat, Johnny Keller
Background and purpose - The use of point-of-care or local investigations before referral to specialist sarcoma centers as part of a fast-track diagnostic pathway varies, and may affect the time to diagnosis. We wanted to investigate differences in time intervals and proportion of malignancy in patients who were referred after initial diagnostic investigations were performed locally and in patients who were referred without these investigations. Patients and methods - We included 545 consecutive patients who were referred to Aarhus Sarcoma Center for suspected musculoskeletal sarcoma...
January 12, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28076441/effects-of-an-integrated-fast-track-rehabilitation-service-for-multi-trauma-patients-a-non-randomized-clinical-trial-in-the-netherlands
#6
Ans I E Bouman, Bea Hemmen, Silvia M A A Evers, Henk van de Meent, Ton Ambergen, Pieter E Vos, Peter R G Brink, Henk A M Seelen
OBJECTIVES: The effects on health related outcomes of a newly-developed rehabilitation program, called 'supported Fast Track multi-trauma rehabilitation service' (Fast Track), were evaluated in comparison with conventional trauma rehabilitation service (Care as Usual). METHODS: Prospective, multi-center, non-randomized controlled study. Between 2009 and 2012, 132 adult multi-trauma patients were included: 65 Fast Track and 67 Care as Usual patients with an Injury Severity Score ≥16, complex multiple injuries in several extremities or complex pelvic and/or acetabulum fractures...
2017: PloS One
https://www.readbyqxmd.com/read/28066523/effects-of-the-genium-microprocessor-knee-system-on-knee-moment-symmetry-during-hill-walking
#7
M Jason Highsmith, Tyler D Klenow, Jason T Kahle, Matthew M Wernke, Stephanie L Carey, Rebecca M Miro, Derek J Lura
Use of the Genium microprocessor knee (MPK) system reportedly improves knee kinematics during walking and other functional tasks compared to other MPK systems. This improved kinematic pattern was observed when walking on different hill conditions and at different speeds. Given the improved kinematics associated with hill walking while using the Genium, a similar improvement in the symmetry of knee kinetics is also feasible. The purpose of this study was to determine if Genium MPK use would reduce the degree of asymmetry (DoA) of peak stance knee flexion moment compared to the C-Leg MPK in transfemoral amputation (TFA) patients...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28064388/stem-cell-recipes-of-bone-marrow-and-fish-just-what-the-stroke-doctors-ordered
#8
REVIEW
Eleonora Napoli, Cesar V Borlongan
Stem cell therapy for stroke has advanced from the laboratory to the clinic, but remains as an experimental treatment. Two lines of transplant regimens have emerged, namely the "early bird" peripheral injections in subacute stroke patients and the "late night" direct intracerebral treatments in chronic stroke patients. Autologous bone marrow-derived stem cells, which only required minimal manipulations during graft cell preparation, gained fast-track entry into the clinic, while gene modified stem cells necessitated overcoming more stringent regulatory criteria before they were approved for clinical use...
January 7, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/28052043/particle-tracking-for-the-assessment-of-microcirculatory-perfusion
#9
Michele Sorelli, Can Ince, Leonardo Bocchi
In recent years the development of portable microscopes, which enable the noninvasive bedside evaluation of the sublingual microcirculation in critically ill patients, has expanded the clinical research on this level of the cardiovascular system. Several semi-quantitative scores have been defined in order to provide researchers with a standardized framework for the offline assessment of the microcirculation status. Among those, space-time diagrams (STDs) constitute an established method for obtaining an estimate of the red blood cells (RBCs) flow velocity in capillaries...
January 4, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28050433/primary-liver-abscess-with-anterior-abdominal-wall-extension-caused-by-mycobacteriumtuberculosis-complex
#10
Jayashri Sanjay Pandya, Rahul Vilas Kandekar, Ajeet Ramamani Tiwari, Rahul Kadam, Devbrata Radhikamohan Adhikari
Tubercular liver abscess is generally secondary to some other primary foci in the body, most notably pulmonary and gastrointestinal system. To find primary tubercular liver abscess is rare, with prevalence of 0.34% in patients with hepatic tuberculosis. Abscess tracking into abdominal wall from spinal and para spinal tuberculosis is known, however primary liver tuberculosis rupturing into anterior abdominal wall has been reported only twice in literature. We report a case of 43-year-old female with direct invasion of the anterior abdominal wall from an isolated tubercular parenchymal liver abscess, caused by Mycobacterium tuberculosis complex, diagnosed primarily on smear for Acid Fast Bacilli (AFB), imaging and isolated by culture and BACTEC MGIT 960 KIT...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28048766/su-g-bra-16-target-dose-comparison-for-dynamic-mlc-tracking-and-mid-ventilation-planning-in-lung-radiotherapy-subject-to-intrafractional-baseline-drifts
#11
M J Menten, M F Fast, S Nill, U Oelfke
PURPOSE: Lung tumor motion during radiotherapy can be accounted for by expanded treatment margins, for example using a mid-ventilation planning approach, or by localizing the tumor in real-time and adapting the treatment beam with multileaf collimator (MLC) tracking. This study evaluates the effect of intrafractional changes in the average tumor position (baseline drifts) on these two treatment techniques. METHODS: Lung stereotactic treatment plans (9-beam IMRT, 54Gy/3 fractions, mean treatment time: 9...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048730/su-f-t-148-are-the-approximations-in-analytic-semi-empirical-dose-calculation-algorithms-for-intensity-modulated-proton-therapy-for-complex-heterogeneities-of-head-and-neck-clinically-significant
#12
P Yepes, U Titt, D Mirkovic, A Liu, S Frank, R Mohan
PURPOSE: Evaluate the differences in dose distributions between the proton analytic semi-empirical dose calculation algorithm used in the clinic and Monte Carlo calculations for a sample of 50 head-and-neck (H&N) patients and estimate the potential clinical significance of the differences. METHODS: A cohort of 50 H&N patients, treated at the University of Texas Cancer Center with Intensity Modulated Proton Therapy (IMPT), were selected for evaluation of clinical significance of approximations in computed dose distributions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048554/th-ab-202-03-a-novel-tool-for-computing-deliverable-doses-in-dynamic-mlc-tracking-treatments
#13
M Fast, C Kamerling, S Crijns, M Menten, S Nill, B Raaymakers, U Oelfke
PURPOSE: In tracked dynamic multi-leaf collimator (MLC) treatments, segments are continuously adapted to the target centroid motion in beams-eye-view. On-the-fly segment adaptation, however, potentially induces dosimetric errors due to the finite MLC leaf width and non-rigid target motion. In this study, we outline a novel tool for computing the 4d dose of lung SBRT plans delivered with MLC tracking. METHODS: The following automated workflow was developed: A) centroid tracking, where the initial segments are morphed to each 4dCT phase based on the beams-eye-view GTV shift (followed by a dose calculation on each phase); B) re-optimized tracking, in which all morphed initial plans from (A) are further optimised ("warm-started") in each 4dCT phase using the initial optimisation parameters but phase-specific volume definitions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048471/su-g-jep3-03-effect-of-robot-pose-on-beam-blocking-for-ultrasound-guided-sbrt-of-the-prostate
#14
S Gerlach, I Kuhlemann, F Ernst, C Fuerweger, A Schlaefer
PURPOSE: Ultrasound presents a fast, volumetric image modality for real-time tracking of abdominal organ motion. How-ever, ultrasound transducer placement during radiation therapy is challenging. Recently, approaches using robotic arms for intra-treatment ultrasound imaging have been proposed. Good and reliable imaging requires placing the transducer close to the PTV. We studied the effect of a seven degrees of freedom robot on the fea-sible beam directions. METHODS: For five CyberKnife prostate treatment plans we established viewports for the transducer, i...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048469/th-cd-207a-08-simulated-real-time-image-guidance-for-lung-sbrt-patients-using-scatter-imaging
#15
G Redler, G Cifter, A Templeton, C Lee, D Bernard, Y Liao, H Zhen, J Turian, J Chu
PURPOSE: To develop a comprehensive Monte Carlo-based model for the acquisition of scatter images of patient anatomy in real-time, during lung SBRT treatment. METHODS: During SBRT treatment, images of patient anatomy can be acquired from scattered radiation. To rigorously examine the utility of scatter images for image guidance, a model is developed using MCNP code to simulate scatter images of phantoms and lung cancer patients. The model is validated by comparing experimental and simulated images of phantoms of different complexity...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048129/su-f-i-15-evaluation-of-a-new-mr-compatible-respiratory-motion-device-at-3t
#16
A Soliman, B Chugh, B Keller, A Sahgal, W Song
PURPOSE: Recent advances in MRI-guided radiotherapy has inspired the development of MRI-compatible motion devices that simulate patient periodic motion in the scanner, particularly respiratory motion. Most commercial devices rely on non MR-safe ferromagnetic stepper motors which are not practical for regular QA testing. This work evaluates the motion performance of a new fully MRI compatible respiratory motion device at 3T. METHODS: The QUASAR™ MRI-compatible respiratory motion phantom has been recently developed by Modus QA Inc...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047891/th-ab-202-04-auto-adaptive-margin-generation-for-mlc-tracked-radiotherapy
#17
M Glitzner, M Fast, B Denis de Senneville, S Nill, U Oelfke, J Lagendijk, B Raaymakers, S Crijns
PURPOSE: To develop an auto-adaptive margin generator for MLC tracking. The generator is able to estimate errors arising in image guided radiotherapy, particularly on an MR-Linac, which depend on the latencies of machine and image processing, as well as on patient motion characteristics. From the estimated error distribution, a segment margin is generated, able to compensate errors up to a user-defined confidence. METHOD: In every tracking control cycle (TCC, 40ms), the desired aperture D(t) is compared to the actual aperture A(t), a delayed and imperfect representation of D(t)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047385/mo-e-brc-02-mri-guided-online-adaptive-radiotherapy-the-ucla-approach-to-quality-management
#18
J Lamb
: Online adaptive radiation therapy has the potential to ensure delivery of optimal treatment to the patient by accounting for anatomical and potentially functional changes that occur from one fraction to the next and over the course of treatment. While on-line adaptive RT (ART) has been a topic of many publications, discussions, and research, it has until very recently remained largely a concept and not a practical implementation. However, recent advances in on-table imaging, use of deformable image registration for contour generation and dose tracking, faster and more efficient plan optimization, as well as fast quality assurance method has enabled the implementation of ART in the clinic in the past couple of years...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047210/th-ab-bra-07-penelope-based-gpu-accelerated-dose-calculation-system-applied-to-mri-guided-radiation-therapy
#19
Y Wang, T Mazur, O Green, Y Hu, H Li, V Rodriguez, H Wooten, D Yang, T Zhao, S Mutic, H Li
PURPOSE: The clinical commissioning of IMRT subject to a magnetic field is challenging. The purpose of this work is to develop a GPU-accelerated Monte Carlo dose calculation platform based on PENELOPE and then use the platform to validate a vendor-provided MRIdian head model toward quality assurance of clinical IMRT treatment plans subject to a 0.35 T magnetic field. METHODS: We first translated PENELOPE from FORTRAN to C++ and validated that the translation produced equivalent results...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046886/mo-e-brc-00-online-adaptive-radiotherapy-considerations-for-practical-clinical-implementation
#20
Sasa Mutic
: Online adaptive radiation therapy has the potential to ensure delivery of optimal treatment to the patient by accounting for anatomical and potentially functional changes that occur from one fraction to the next and over the course of treatment. While on-line adaptive RT (ART) has been a topic of many publications, discussions, and research, it has until very recently remained largely a concept and not a practical implementation. However, recent advances in on-table imaging, use of deformable image registration for contour generation and dose tracking, faster and more efficient plan optimization, as well as fast quality assurance method has enabled the implementation of ART in the clinic in the past couple of years...
June 2016: Medical Physics
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