Dissertations / Theses: 'Department of Orthopedic Surgery'

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Chang, Ta-Cheng. "Simulation Assisted Robotic Orthopedic Surgery in Femoroacetabular Impingement." Scholarly Repository, 2011. http://scholarlyrepository.miami.edu/oa_dissertations/618.

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Femoroacetabular impingement (FAI) has been increasingly recognized as a cause of early hip osteoarthritis. FAI is characterized by pathologic contact between the femur and acetabular rim during hip join movement, caused by morphological abnormalities. Arthroscopic technique has become increasingly popular for FAI surgical treatment because of its minimal invasiveness. However, it involves cumbersome procedures and over- or under-resection are likely to occur. To tackle this issue, robot-assisted FAI arthroscopy is a well suited approach because it results in high accuracy and reproducible surgical outcomes. This dissertation provides new approaches and methods for the current challenges in the development of robot-assisted FAI arthroscopy. The study has three objectives: 1) to develop a robust calibration method for the A-mode ultrasound probe used for noninvasive bone registration, 2) to develop a bone registration simulator for verifying the registration accuracy and consistency for any given registration point-pattern, and 3) to develop a hip range of motion simulation system that returns the virtual range of motion and determines the bone resection volume. Carefully designed calibration procedures and simulation experiments have been conducted during the study of this research. From the experimental results, the developed ultrasound calibration method successfully reduces the registration errors and is proved to be robust. The results from the registration simulator indicate that the pattern with widely distributed points lead to better registration accuracy and consistency. The hip range of motion simulation system results in acceptable accuracy and successfully generates the resection volume. With further modifications, the ultrasound probe can be successfully calibrated with the developed method, and will be applied for noninvasive bone registration. The registration simulator can also be served as a useful tool for determining the optimized registration point-pattern, which can lead to reduced surgical trauma and registration time. Finally, the developed range of motion simulation system can allow the surgeon to evaluate the surgical outcome and to determine the resection volume even before the surgery begins. To conclude, this dissertation provides useful approaches, methods, and software for developing robot-assisted FAI arthroscopy.

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Steen, Alexander, and Marcus Widegren. "3D Visualization for Pre-operative Planning of Orthopedic Surgery." Thesis, Linköpings universitet, Medie- och Informationsteknik, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-94556.

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This report presents a master thesis on 3D visualization for pre-operation planning of orthopedic surgery done for Sectra Medical Systems AB. The focus is on visualizing clinically relevant data for planning a Total Hip Replacement (THR). The thesis includes a pre-study and the implementation of a prototype using the Sectra IDS7 workstation.

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Lee, Goonhee. "Selective laser sintering of calcium phosphate materials for orthopedic implants /." Digital version accessible at:, 1997. http://wwwlib.umi.com/cr/utexas/main.

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Yeung, Wai-kwok Kelvin, and 楊偉國. "Development of a novel spinal implant for progressive scoliosis correction." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B30696823.

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揚偉國 and Wai-kwok Kelvin Yeung. "Gradual scoliosis correction by use of a superelastic alloy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31225469.

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Ribbans, W. J. "Aspects of orthopaedic surgical research with emphasis on surgery in haemophilia and immunocompromised patients." Thesis, University of South Wales, 2003. https://pure.southwales.ac.uk/en/studentthesis/aspects-of-orthopaedic-surgical-research-with-emphasis-on-surgery-in-haemophiia-and-immunocompromised-patients(9675c37c-5ce7-46a4-936b-ec5caa3fcc57).html.

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Ninety-three publications have been presented from the last 22 years. This body of work represents an opus of publications from the author's own medical qualification, in 1980, until the present day. They vary from short abstracts representing research presentations at scientific meetings through to major multi-centre international studies and significant contributions to medical texts. They are accompanied by an overview, which details original contributions to medical knowledge and superior methodology, reinforced by calculation of a citations index, which demonstrates the impact of such research on the medical community. The overview has chosen to collate the output into four main clusters of which Haemophilia represents the largest numerically, with forty-seven contributions, and the most significant scientifically. The other three groups represent Infection, including HIV and Hepatitis, Trauma and its sequelae, and General Surgery and Orthopaedics. Contributions on the issues of surgery on HIV positive Haemophilic patients, the more general problems surrounding surgical intervention in Haemophilia, and the natural history of Orthopaedic pathology in these patients has been the area where it is felt the most significant contribution has been made. Papers have been published demonstrating the generally positive clinical and economic outcomes following different forms of joint replacement in Haemophilia. However, the markedly increased infection risks following joint replacement in HIV positive Haemophilic patients has been highlighted in the largest paper published on the subject, combining the results from many different countries. In contrast, by access to historical laboratory specimens, it has been shown that Orthopaedic surgical interventions have not adversely affected the natural history of HIV in terms of immune competence. A number of papers have been published on the subject of the natural history of ankle arthropathy in Haemophilia - an area under investigated in the past. A critical review of accepted scoring systems in Haemophilia has been published with a more scientifically evaluated system suggested in its stead. The Infection section has developed from the initial interests in the problems encountered in Haemophilia. Further work has been undertaken evaluating protective gloves designed to minimise injury to staff during high risk procedures and the more general exposure to HIV and Hepatitis in general Orthopaedic practice. The Trauma section presents a number of varied papers in terms of publication type and subject matter. The randomised prospective paper on intertrochanteric fractures of the hip, demonstrating no advantage in outcome following a more technically difficult surgical procedure, is an important contribution to the iterature. The first paper published on the pathology demonstrated by CT following an initial shoulder dislocation has been a similarly influential publication - as demonstrated by its citation count. The final section on General Surgery and Orthopaedics provides a catholic collection of publications reflecting a number of surgical interests and career appointments. One paper from this group was particularly influential. It evaluated the outcomes of knee arthroscopy as a day case procedure and it was an mportant contribution at its time, as witnessed by its widespread acceptance as normal practice sixteen years later.

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Nysjö, Johan. "Interactive 3D Image Analysis for Cranio-Maxillofacial Surgery Planning and Orthopedic Applications." Doctoral thesis, Uppsala universitet, Avdelningen för visuell information och interaktion, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-301180.

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Modern medical imaging devices are able to generate highly detailed three-dimensional (3D) images of the skeleton. Computerized image processing and analysis methods, combined with real-time volume visualization techniques, can greatly facilitate the interpretation of such images and are increasingly used in surgical planning to aid reconstruction of the skeleton after trauma or disease. Two key challenges are to accurately separate (segment) bone structures or cavities of interest from the rest of the image and to interact with the 3D data in an efficient way. This thesis presents efficient and precise interactive methods for segmenting, visualizing, and analysing 3D computed tomography (CT) images of the skeleton. The methods are validated on real CT datasets and are primarily intended to support planning and evaluation of cranio-maxillofacial (CMF) and orthopedic surgery. Two interactive methods for segmenting the orbit (eye-socket) are introduced. The first method implements a deformable model that is guided and fitted to the orbit via haptic 3D interaction, whereas the second method implements a user-steered volumetric brush that uses distance and gradient information to find exact object boundaries. The thesis also presents a semi-automatic method for measuring 3D angulation changes in wrist fractures. The fractured bone is extracted with interactive mesh segmentation, and the angulation is determined with a technique based on surface registration and RANSAC. Lastly, the thesis presents an interactive and intuitive tool for segmenting individual bones and bone fragments. This type of segmentation is essential for virtual surgery planning, but takes several hours to perform with conventional manual methods. The presented tool combines GPU-accelerated random walks segmentation with direct volume rendering and interactive 3D texture painting to enable quick marking and separation of bone structures. It enables the user to produce an accurate segmentation within a few minutes, thereby removing a major bottleneck in the planning procedure.

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Truhlář, Jindřich. "Evaluation of the Wi-Fi technique for use in a navigated orthopedic surgery." Master's thesis, Vysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií, 2012. http://www.nusl.cz/ntk/nusl-219668.

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Following text focuses on use of wireless technologies in OrthoPilot navigation system developed by B.Braun company. Description of OrthoPilot software is followed by overview of available wireless technologies highlighting their both advantages and disadvantages. Practical part consists of two main parts, mostly dealing with electronic circuits. First part describes development process of camera-wireless printed circuit board which substitutes currently used RS-422 cable connection between PC and stereo camera. Part of this chapter covers programming in C++ in order to make interface compatible with the rest of current OrthoPilot software. Second bigger part deals with remote controller development using prototyping board mikroMedia for XMEGA. Besides electrical circuits design, chapter describes also software part - microcontroller programming in C language. Thesis is concluded by discussing system limitations and ideas for future development.

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D'Urso, Paul Steven. "Stereolithographic biomodelling in surgery /." [St. Lucia, Qld.], 1998. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17881.pdf.

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Pennington, Brandy Paige. "The Impact of Prealbumin on Postoperative Length of Stay in Elderly Orthopedic Patients." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etd/1019.

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The purpose of this research was to evaluate whether serum prealbumin levels would serve as a predictor of hospital length of stay for elderly orthopedic patients who underwent hip replacement surgery. The study consisted of a set of 54 patients admitted to a hospital in Bristol, Tennessee. Patients with depleted prealbumin levels, low to low/normal prealbumin levels, or normal prealbumin levels were analyzed. Data collected from a retrospective chart review included: age, length of stay, serum glucose, sodium, potassium, hematocrit, hemoglobin, BUN, creatinine, WBC, prealbumin, and post operative diet consumption. Data were analyzed using analysis of variance for treatment effects. Because of the limited size of the data set, probabilities approaching p<0.10 were considered and levels of p<0.05 were considered significant. The research failed to show a significant relationship between prealbumin levels at admission and length of patient stay during post-operative recovery.

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Reid, Tracey. "The impact of physician communication skills on continuity of care and emergency department use by regular emergency department users /." Thesis, McGill University, 1998. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=21629.

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Regular use of the emergency department is associated with a patient's inability to identify a regular primary care physician. Continuity of the physician-patient relationship is largely determined by patient satisfaction, which in turn is influenced by the physician's communication and interpersonal skills. The objective of this study was to estimate the relationship between the communication competency of newly licensed family physicians and the ambulatory health care utilization behaviour of their regular emergency department users. It was hypothesized that physicians with higher levels of competency in patient communication would be the providers of a greater proportion of their patients' ambulatory care than physicians with poorer communication abilities. Consequently, these patients would rely on the emergency department for a smaller proportion of their ambulatory care than patients of physicians with lower levels of communication competency.
In total, 474 newly licensed family physicians and 42 113 regular ED user patients were included in the study population. Analysis was conducted at the level of the physician and patients were attributed to the practice populations of the first study physician they saw. (Abstract shortened by UMI.)

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Young, Nancy, and J. G. Wright. "Measuring Pediatric Physical Function." Lippincott, Williams & Wilkins, 1995. https://zone.biblio.laurentian.ca/dspace/handle/10219/111.

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Most pediatric orthopaedic interventions are intended to improve or preserve physical function, yet their outcomes have been assessed using primarily surrogate measures (e.g., radiographic indices) that may not accurately represent patients'function. Physical function may be more appropriately measured with activity-based scales, but these have been infrequently applied in surgical studies. The purpose of this study was to identify existing activity-based physical-function scales appropriate for pediatric orthopaedics, to present criteria useful for scale selection, and to discuss the special problems of measuring physical function in children. Twenty-one scales relevant to pediatric orthopaedics are described according to their target population, purpose, method of administration, content, and quality of standardization. These scales have been further classified according to a new taxonomy. The unique aspects of measuring physical function in children are discussed and include the effect of age and development, method of reporting, and question formats. Standardized measures of physical function based on physical-activity ability exist and should be used more frequently to assess pediatric orthopaedic interventions

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Parker, Trevor Wayne. "Functional outcome and complications after treatment of moderate to severe slipped upper femoral Epiphysis with a modified Dunn procedure." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5447.

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Mahjub, Hossein. "Logistic discrimination, screening and the simulation of a heart surgery department." Thesis, University of Newcastle Upon Tyne, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.308030.

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Kapur, Atul Kumar. "Emergency department treatment of clinically stable paroxysmal atrial fibrillation." Thesis, University of Ottawa (Canada), 2002. http://hdl.handle.net/10393/6228.

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Introduction. Optimal management of paroxysmal atrial fibrillation (PAF), a common presenting complaint in emergency departments (EDs), remains undetermined. Methods. Six month prospective observational study at three EDs. Patients had clinically stable PAF for less than 48 hours. Conservative (rate control) and aggressive (pharmacologic and/or electrical cardioversion) treatment were analyzed. Results. 169 patients were analyzed, 32 treated conservatively and 137 aggressively. 83.9% of aggressively treated patients converted in the ED, 8.0% were admitted, and 52.3% stayed in sinus rhythm for four weeks. The corresponding proportions for conservative treatment were 34.4%, 37.5%, and 30.0%. There were 15 ED complications (2 rate control, 4 pharmacologic, and 9 electrical), two required admission (one pharmacologic and one electrical). No thromboembolism occurred by four-week follow-up. Conclusions. The results of this study---the first prospective study of ED treatment of PAF---will be used to plan a randomized controlled trial which will compare the two treatments.

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Schull, Michael. "Coronary thrombolysis in the emergency department : concordance with clinical guidelines." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ37164.pdf.

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McGarvey, Helen Elizabeth. "The operating department : investigating the role of the nurse." Thesis, University of Ulster, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326331.

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Godwin, Ellen M. "Long-term effect of single event multiple level orthopedic surgery on the functional classification of children with cerebral palsy." NSUWorks, 2005. http://nsuworks.nova.edu/hpd_pt_stuetd/29.

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Bartolozzi, IV Arthur R. "The Forest for the Trees: Using Big Data to Improve Preoperative Assessment and Risk Stratification in Pediatric Orthopedic Surgery." Thesis, Harvard University, 2017. http://nrs.harvard.edu/urn-3:HUL.InstRepos:32676123.

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This thesis uses the Kid’s Inpatient Database to analyze surgical epidemiology, clinical outcomes, LOS, and total costs for two major pediatric surgeries. The goal is to establish clinically meaningful identifiers of risk, complexity, and variation in management both for improving preoperative assessment and understanding demographic determinants of health. Chapter 1 focused on open hip reduction for the treatment of DDH. This has become more expensive despite shorter hospital stay over time. It is also a longer, more costly experience for children who have reached walking age particularly those over 3 years old. Other patient factors including: developmental delay, ethnicity and insurance, hospital factors, and surgical management contribute to increased LOS and total charges. Despite the conclusions above a more detailed cost-analysis at an institutional level is necessary to identify how the above variables interact with each other. Chapter 2 investigated the pediatric neuromuscular population undergoing primary spinal fusions. Analyses of urinary function and anemia in addition to CCC scoring can be conducted preoperatively to determine likelihood of complications and LOS. Complications are strongly associated with both LOS and total charges and were lower at high volume centers. Additional factors including hospital size, patient race, anterior/posterior surgery, and BMP use were associated with higher charges. We presented individual prediction models for grouping patients by risk for long LOS and high cost.

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Vaidya, Jayant Sharad. "A novel approach for local treatment of breast cancer." Thesis, University College London (University of London), 2002. http://discovery.ucl.ac.uk/18745/.

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Early local recurrence of breast cancer most commonly (over 90%) occurs at the site of the primary tumour. This is true whether or not radiotherapy is given and irrespective of the margin status. Whole-organ analysis of mastectomy specimens on the other hand, reveals that 63% of breasts harbour occult cancer foci and 80% of these are situated remote from the index quadrant. Therefore, these occult cancer foci may be clinically irrelevant and it may not be necessary to treat the whole breast with radiotherapy. This 6-wks long course of post-operative radiotherapy after breast conserving therapy is not only inconvenient and costly, but may cause many women from geographically remote areas to choose mastectomy. Targeted Intraoperative radiotherapy (TARGIT) to the peri-tumoural area alone might provide adequate local control. ‘Intrabeam’ (PeC) is a portable electron-beam driven device that can deliver therapeutic radiation (soft x-rays) in 20-30 minutes within a standard operating theatre environment. The pliable breast tissue - the target - is wrapped around a spherical applicator - the source - providing truly conformal radiotherapy. The prescribed dose is 5 & 20Gy at 1cm and 0.2cm respectively, from the tumour bed. The biologically effective dose is 7-53Gy for α/β=10 and 20-120Gy for α/β=1.5. In our pilot study of 26 patients (age 30-80 years, T=0.42-4.0cm), we replaced the routine post-operative tumour bed boost with targeted intra-operative radiotherapy. There have been no major complications and no patient has developed local recurrence, although the median follow-up time is short at 34 months. The cosmetic outcome is satisfying to both the patient and the clinician. Having established the feasibility, acceptability and safety in the pilot study, we started in March 2000, a randomised trial that compares TARGIT with conventional postoperative radiotherapy for infiltrating duct carcinomas, with local recurrence and cosmesis as the main outcome measures. Patient accrual in this trial has been excellent and it has attracted several international collaborative groups. If proven effective, TARGIT could eliminate the need for postoperative radiotherapy potentially saving time, money and breasts.

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Murray, Heather Elizabeth. "Cellulitis in the emergency department: Developing and testing objective outcome measures." Thesis, University of Ottawa (Canada), 2002. http://hdl.handle.net/10393/6277.

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Introduction. The treatment of cellulitis with intravenous antibiotics administered in Emergency Departments is a new phenomenon with significant inter-physician variation. A clinical trial will address many of the questions surrounding this practice. Previous trials have been flawed because of the absence of a validated objective outcome measure. Methods. Eligible patients with cellulitis were prospectively recruited for an observational cohort study and underwent daily measurements of their infection. These measurements were evaluated for their feasibility, inter-rater reliability and criterion validity (compared with the primary outcome of treatment failure versus clinical response; a classification based on physician treatment decisions) Results. Only the infection size and change in size over time performed well, obtaining statistical significance in all domains. Conclusions. The change in size of infection over time is a valid and reliable reflection of clinical decisions for patients with cellulitis, and should be used as the primary outcome for clinical trials of cellulitis therapy.

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Hanson, Holly R. M. D. "Describing Pediatric Acute Kidney Injury in the Emergency Department." University of Cincinnati / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459528673.

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Azevedo, Marcela Padilha Facetto. "Infecções cirúrgicas em ortopedia causadas por micobactérias de crescimento rápido: revisão integrativa da literatura." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-23082012-160610/.

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As micobacterioses são doenças causadas por micobactérias não tuberculosas pertencentes ao gênero Mycobacterium. As infecções por micobactéria de crescimento rápido (MCR) estão fortemente relacionadas às falhas nos processos de limpeza, desinfecção e esterilização de produtos médicos. Objetiva-se, analisar a ocorrência de infecções de sítio cirúrgico, por MCR, em pacientes submetidos a procedimentos ortopédicos, por meio de revisão integrativa; caracterizar as infecções de sítio cirúrgico (ISC) por MCR; verificar a presença de fatores que possam explicar as infecções de sítio cirúrgico por MCR. Como método utilizou-se a revisão integrativa, a qual contém as seguintes etapas: elaboração da questão da pesquisa; estabelecimento de critérios de inclusão e exclusão; definição das informações a serem extraídas do estudo; avaliação dos estudos incluídos; interpretação dos resultados e apresentação da revisão. No resultado foram encontrados 21 artigos, a maioria publicada no idioma inglês, e dois em francês, variando quanto ao continente e país de origem de edição. O tempo entre a cirurgia e o início dos sintomas foi mencionado para os 34 (100%) pacientes, mas a análise foi feita para 33 pacientes, pois se considerou apenas o primeiro episódio de infecção por MCR. O tempo médio para o diagnóstico da ISC foi de 653,6 dias (93 semanas), desvio padrão ±1.343 dias (192 semanas), mediana de 80 dias (11,4 semanas) e moda de 90 dias (três meses). Quanto aos sinais e sintomas relatados pelos pacientes, os mais prevalentes foram: dor (61,8%), secreção (50,0%), edema (41,2%), febre (41,2%), eritema (26,5%), fístula (20,6%), calor (14,7%), tremor (5,9%), abscesso (5,9%) e hematoma (3,0%). Em relação às intervenções cirúrgicas efetuadas nos pacientes, após o diagnóstico de ISC, a mais frequente foi a antibioticoterapia (100%), remoção de prótese total (50,0%), drenagem (41,2%), debridamento cirúrgico (41,2%), irrigação (23,5%), revisão cirúrgica (17,6%) troca da prótese total (8,8%), remoção de componentes da prótese (8,8%) e reimplante da prótese (2,9%). A identificação do(s) agente(s) etiológico(s) da(s) ISCs não seguiu uma metodologia de rotina, o que pode influenciar na confiabilidade do resultado, principalmente quanto à espécie do agente etiológico. Quanto à espécie de MCR isoladas dos sítios de infecção constatamos que M.fortuitum foi a mais prevalente; tendo sido isolados também M.chelonae, M.abscessus, M.goodii, M.smegmatis, M.farcinogenes e M.wolinskyi. Em relação às fontes investigadas, tem-se: provavelmente de origem iatrogênica, hábito do médico residente de ortopedia, presente nas cirurgias, de utilizar a hidromassagem antes de operar; componentes líquidos ou pó do cimento metilmetacrilato ou a prótese metálica; injeções de cortisona por sinovite crônica, durante cinco anos, antes da cirurgia; sistema de ar condicionado ou a solução de imersão para enxágue da prótese; sabão na água, onde foi realizada a imersão do pé (recomendação do podólogo); parafuso bioabsorvível utilizado na cirurgia; injeções intra-articulares de dexametasona; no entanto, nenhuma delas pode ser confirmada. Quando feito o teste de senbilidade observou-se que as cepas apresentavam em torno de 80% de sensibilidade à amicacina, claritromicina e ciprofloxacina.
The mycobacteriosis is a disease caused by nontuberculous mycobacteria belonged to the Mycobacterium genus. Infections due to rapidly growing mycobacteria (RGM) are strongly related to failures in the processes of cleaning, disinfection and sterilization of medical products. The objective is to analyze the occurrence of surgical site infections by RGM in patients undergoing orthopedic procedures through integrative review; to characterize the surgical site infections (SSI) by RGM; and to verify the presence of factors that may explain the surgical site infections by RGM. The method was the integrative review, which includes the following steps: elaboration of the research question; establishment of inclusion and exclusion criteria; definition of information to be extracted from the study; assessment of the included studies; interpretation of results; and presentation of the review. 21 articles were found, mostly published in English and two in French, varying considering the continent and country of the origin of the article. The time between surgery and onset of symptoms was reported by 34 (100%) patients, but the analysis was performed for 33 patients because it was considered only the first episode of infection by RGM. The average time to diagnosis of SSI was 653.6 days (93 weeks), standard deviation ± 1343 days (192 weeks), median of 80 days (11.4 weeks) and mode of 90 days (three months). The most prevalent signs and symptoms reported by patients were: pain (61.8%), secretion (50.0%), edema (41.2%), fever (41.2%), erythema (26.5%), fistula (20.6%), heat (14.7%), tremor (5.9%), abscess (5.9%) and hematoma (3.0%). Regarding surgical interventions performed in patients after diagnosis of SSI, the most frequent was antibiotic therapy (100%), removal of dentures (50.0%), drainage (41.2%), surgical debridement (41.2%), irrigation (23.5%), surgical revision (17.6%), replacement of dentures (8.8%), removal of the prosthetic components (8.8%), and reimplantation of the prosthesis (2.9%). The identification of etiological agent(s) of SSI did not follow a routine methodology, which can influence the reliability of the results, especially regarding the kind of etiologic agent. Related to the kind of isolated RGM of the infection sites, it was found that M.fortuitum was the most prevalent; being also isolated the M.chelonae, M.abscessus, M.goodii, M.smegmatis, M.farcinogenes and M.wolinskyi. Regarding the sources investigated: probably from iatrogenic origin, it is habits of residents in orthopedics during surgeries to use hydromassage before operating; liquid components or cement powder of methylmethacrylate or metal prosthesis; cortisone injections for chronic synovitis during 5 years before surgery; air conditioning system or soaking solution to rinse the denture; soap in the water, where it was accomplished the immersion foot (podiatrist\'s recommendation); bioabsorbable screws used in surgery; intraarticular injections of dexamethasone; however, none of them can be confirmed. When the sensitivity test was done, it was observed that the strains had approximately 80% of sensitivity to amikacin, clarithromycin, ciprofloxacin. Quando feito o teste de senbilidade observou-se que as cepas apresentavam em torno de 80% de sensibilidade à amicacina, claritromicina e ciprofloxacina.

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Wheeler, Anthony J. "Procedural Rates, Economic Costs, and Geographic Variation of Primary and Revision Lumbar Total Disc Replacement." DigitalCommons@USU, 2013. https://digitalcommons.usu.edu/etd/1764.

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Lumbar degenerative disc disease is a remarkably common condition among patients presenting with chronic low back pain and physical disability. When a surgical treatment option is warranted, patients now have the option of undergoing lumbar total disc replacement (TDR), a relatively new procedure that is designed to replace lumbar fusion, the traditional surgical intervention for degenerative disc disease. The lumbar TDR procedure has demonstrated clinical efficacy equivalent to that of lumbar fusion, although concern remains about the longevity, safety, and costs related to the procedure. These issues were addressed in three separate observational studies using administrative claims data. The first study estimated the revision burden and economic revision burden of lumbar TDR. The second study examined the lumbar TDR hybrid procedure, where both a lumbar TDR and lumbar fusion are performed simultaneously. No observational data have been reported on the frequency, cost, and diagnostic indications related to the TDR hybrid procedure. The third study mapped the geographic variation of procedural rates of lumbar TDR. Previous research has found substantial geographic variation in lumbar spine surgery rates and a similar analysis of lumbar TDR variation has yet to be reported. The present series of studies found the revision burden and economic revision burden of lumbar TDR to be similar to data reported for this procedure from the mid-2000s, though the overall occurrence of the procedure appears to have declined. The economic revision burden made this a lower-cost procedure than lumbar fusion, with a tradeoff in terms of revision burden being higher for lumbar TDR. The lumbar TDR hybrid procedure was found to make up approximately 16% of the total number of TDR procedures, involving much higher costs than a single-level TDR procedure. Finally, geographic variation of the procedural rate of lumbar TDR varied dramatically across the U.S., surpassing the variation observed in lumbar fusion surgery. Limitations of the observational data used in these studies are described. Recommendations for future observational research are offered as well. Finally, implications for these studies on practice guidelines and reimbursement policies are provided.

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Lipshaw, Matthew J. M. D. "Antibiotic Use and Outcomes in Children in the Emergency Department with Suspected Pneumonia." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1583154608624437.

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Lazo-Langner, Alejandro. "Comparing strategies for thromboprophylaxis in major orthopedic surgery using an estimation of net risk-benefit through probabilistic simulation A clinical cost-effectiveness study." Thesis, University of Ottawa (Canada), 2007. http://hdl.handle.net/10393/27874.

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Clinical decisions should take into account the clinical risk and benefit of a new intervention compared to the reference treatment. A method was developed to compare multiple competing interventions using a clinical cost-effectiveness approach. A meta-analysis was conducted to estimate the clinical cost (major bleeding) and benefit (averted venous thromboembolism) of thromboprophylaxis with different anticoagulants in orthopedic surgery. The increment in cost and benefit of anticoagulants compared to placebo were calculated using replications of the values obtained through Monte Carlo simulations. Net clinical benefit was calculated for each replication across a range of risk acceptance values (risk-benefit acceptability threshold). Multiple anticoagulants were compared by calculating the probability that each agent had of achieving the highest net clinical benefit. The preferred anticoagulants varied depending on risk acceptance, type of surgery, bleeding and thrombosis definitions, and timing of anticoagulant initiation. This method allowed comparing multiple interventions in the absence of randomized trials.

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Flaming, Susan L. "The effect of implementing a flow coordinator on emergency department throughput." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1586503.

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Emergency department (ED) overcrowding is a widespread and multifaceted problem caused by many factors including overutilization of the ED by non-emergency patients and a decreasing number of available ED beds nationwide. The flow of patients through the ED is known as throughput process, and many interventions to improve the efficiency have been described in the literature including sorting patients by acuity or condition, placing providers in the triage area, using a flow expeditor role and various technology applications.

This retrospective, comparative study assessed the implementation of an experienced registered nurse in the role of flow coordinator, with the focus solely on moving patients efficiently through their ED course. Three throughput metrics were used to measure ED efficiency before and after the role implementation: discharge length of stay (DCLOS), left without being seen (LWBS) and elopements. While no difference was seen in any of the three throughput metrics with regard to the sample as a whole, there were statistically significant differences between each of the throughput metrics when the sample was partitioned by age and gender. Additionally, though not statistically significant at the p < .05 level, patient satisfaction improved after the flow coordinator was implemented. These findings add to what is known about the science of ED throughput processes as they suggest a flow coordinator may improve patient satisfaction and interventions to improve flow should be individualized to patients based on their age and gender.

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Sharan, Viktor. "Hospital Admission and Emergency Department Visit After Bariatric Surgery, a 2- Year Follow Up." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-86761.

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Introduction Previous study investigating Emergency Department (ED) visits rate and admission rates in bariatric patients’ post-surgery shows a 2-year admission rate of 26%. Aim The primary aim of this study was to assess the number of ED visits and admissions as well as examine if there is a correlation with comorbidities, education level, quality of life, and image method used. The secondary aim was to compare the ED and admission rate between the cohort and the general population. Methods This retrospective study included a total of 190 patients. They were followed for 2 years. All the patients were operated on during 2017 in Region Örebro. The cohort and data were obtained from the Scandinavian Obesity Surgery Registry and data concerning ED visit and admittance rate was collected by reviewing medical records. Results The ED visit rate was 116 (61%) and the admittance rate was 76 (40%). Poor mental health, low education level and smoking were correlated to a higher degree of admittance and ED visit rate. There were more imagining used in the group that visited the ED or got admitted. The most common diagnoses were symptoms related to the digestive system and abdomen. The study population had a higher degree of admittance and ED visit rate than the general population. Conclusions Rate of admittance seem to be correlated to factors related to socioeconomic status. More research is needed to investigate what intervention would help this subgroup most, so they don’t have to seek medical care to the same degree.

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Osborne, Michelle. "EXPLORATION OF THE RELATIONSHIP BETWEEN PAIN INTENSITY, COMFORT LEVEL AND PATIENT SATISFACTION AMONG ORTHOPEDIC PATIENTS FOLLOWING KNEE SURGERY ON POSTOPERATIVE DAY ONE." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1430142885.

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Kerrey, Benjamin T. "Rapid sequence intubation for pediatric emergency patients: higher frequency of failed attempts and adverse effects by video review." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1321371035.

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31

Huang, Jing Ye. "Visual Simulation in virtual abdominal surgery." Thesis, University of Macau, 2012. http://umaclib3.umac.mo/record=b2586278.

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32

Page, Jacqueline. "Parent and physician decision making in children with suspected ear infection presenting to a children's hospital emergency department." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0017/MQ48175.pdf.

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Charras, Guillaume Thomas. "Digital Image-Based Finite Element Modeling (DIBFEM) : validation and application to biological structures." Thesis, Georgia Institute of Technology, 1998. http://hdl.handle.net/1853/17765.

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Murtagh, Kurowski Eileen M. D. "Evaluation of Differences Between Pediatric and General Emergency Departments in Rate of Admission and Resource Utilization for Visits by Children and Young Adults with Complex Chronic Conditions." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353950161.

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35

Au, Man-yee, and 區敏儀. "Appropriateness and feasibility of music intervention in reducing anxiety for patients undergoing minor operative procedures in Accidentand Emergency Department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44622740.

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36

Salazar, Garcia Fátima. "Temperatura, Oximetría Cerebral y Disfunción Cognitiva Postoperatoria (DCPO) en pacientes intervenidos de Prótesis Total de Rodilla (PTR) con anestesia intradural. Estudio prospectivo." Doctoral thesis, Universitat de Barcelona, 2015. http://hdl.handle.net/10803/398949.

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Introducción: La Disfunción cognitiva postoperatoria (DCPO) tiene una alta incidencia en pacientes de cirugía ortopédica. Durante la anestesia y la cirugía se produce un descenso progresivo de la temperatura. Esta hipotermia tiene efectos deletéreos pero también puede tener un efecto protector cerebral. Nosotros planteamos la hipótesis que la temperatura perioperatoria puede tener un impacto sobre la aparición de DCPO. Por otro lado, la monitorización de la saturación regional cerebral de oxígeno (SrO2) puede reflejar un desequilibrio de la oxigenación cerebral intraoperatoria y alertar de una disfunción cerebral. Nuestro objetivo fue explorar la potencial utilidad de los valores de la rSO2 como signo de alerta para el desarrollo de diferentes tipos de decline en la función psicológica postoperatoria. Métodos: Hemos incluido 150 pacientes mayores de 65 años de edad programados para intervenirse de prótesis total de rodilla con anestesia intradural, randomizados para recibir cuidado estándar (abrigo con capa de sábanas) o ser calentados activamente. Una evaluación neurocognitiva (11 subtests) fue realizada preoperatoriamente, al cuarto día (3 subtests) y a los 3 meses (10 subtests). Un grupo control de 55 pacientes no quirúrgicos realizaron el mismo test en los tiempos equivalentes. La DCPO fue definida como un descenso de la puntuación individual de más de 2 desviaciones estándar (SDs) por debajo del basal en al menos 2 subtests o 2SDs en la z-score combinada, en ambos casos ajustando por los cambios del grupo control. Para el análisis observacional de la SrO2 bilateral intraoperatorios fueron elegidos como puntos de corte un valor absoluto de rSO2 <50% o una reducción >20% o >25% por debajo del valor basal. Como la valoración era de los dos hemisferios, se reagruparon las pruebas neuropsicológicas para analizar un declive más específico: función memoria y función ejecutiva, usando la misma definición estadística. Aparte se usaron escalas para la valoración de síntomas psicológicos: ansiedad, depresión, quejas subjetivas de pérdida de memoria y concentración. Resultados: La temperatura timpánica descendió por debajo de 35ºC en 88% de los pacientes de cuidado estándar; 25.3% de los pacientes calentados activamente tuvieron una temperatura ≥ 36ºC. Al cuarto día, 3.2% de los pacientes del grupo con cuidado estándar y 19.4% de los pacientes del grupo calentado activamente padecieron DCPO (P= 0.0058). A los 3 meses, no hubo diferencia entre los dos grupos (grupo estándar, 14,3%; grupo calentado, 6,5%) con tres subtests (P= 0.2440) ni con 10 subtests (grupo estándar, 20,6%; grupo calentado, 22,6%). No se observaron diferencias en los valores basales de SrO2; La SrO2 descendió significativamente en todos los pacientes durante la cirugía (P<0.0001). 75 pacientes (60%) no presentaron signos de decline cognitivo o síntomas psicológicos. 21 pacientes (16.8%) tuvieron decline de memoria, 3 pacientes (2.4%) tuvieron decline VM-EF, y 33 pacientes (26.4%) presentaron síntomas psicológicos. Los valores de la SrO2 en los hemisferios derecho e izquierdo fueron en los pacientes que presentaron decline de memoria (media [SD] izda-dcha ratio de 95.03 [8.51] vs 101.29 [6.7] para pacientes sin cambios, P = 0.0012). La diferencia media dcha-izda en los valores de rSO2 fue también significativa en estos pacientes (−2.87% [4.73%], más bajos en el derecho, P = 0.0034). Conclusiones: La hipotermia mantenida en los pacientes del grupo que no fue calentado activamente ha tenido un efecto protector de la DCPO a los 4 días de la IQ. La temperatura >36ºC constituyó un factor de riesgo de DCPO a los 4 días y 3 meses del postoperatorio. La detección de una tendencia a la asimetría en los valores de rSO2 puede alertarnos de un posible decline de memoria en el postoperatorio. La presencia de síntomas psicológicos y decline de memoria fueron comunes tres meses después de la artroplastia total de rodilla en nuestros pacientes > 65 años.
Background: Post-operative cognitive dysfunction (POCD) can affect 30% of orthopedic surgery patients. We hypothesized that perioperative temperature has an impact on POCD. Bilateral regional brain oxygen saturation (rSO2) trends, reflecting intraoperative brain oxygen imbalance, could warn of brain dysfunction such as memory decline, alterations in executive function or subjective complaints. Methods: We included 150 patients over 65 years of age scheduled for total knee replacement under spinal anesthesia. They were randomized to receive standard care (sheet cover) or active warming. Demographic, hemodynamic and bilateral rSO2 intraoperative values were recorded. An absolute rSO2 value of <50% or a reduction of >20% or >25% below baseline were chosen as relevant cutoffs. Neurocognitive assessment (11 subtests) was performed pre-operatively and at day 4 (three subtests) and 3 months (10 subtests). A control group of 55 nonsurgical patients took the same tests at equivalent times. POCD was defined as an individual score decrease of more than 2 standard deviations (SDs) below the baseline on at least two subtests or 2 SDs in the combined z-score, in both cases using control-adjusted changes. Results: Tympanic temperature declined below 35ºC in 88% of standard-care patients; 25.3% of warmed patients had a temperature ≥36ºC. On day 4, 3.2% of standard care patients and 19.4% of warmed patients had POCD (P=0.0058). At 3 months, there were no differences (standard care, 14.3%; warmed, 6.5% (P=0.2440). We observed no differences in baseline rSO2 values; rSO2 decreased significantly in all patients during surgery (P < 0.0001). Seventy-five patients (60%) had no sign of cognitive decline or psychological symptoms. Twenty-one patients (16.8%) had memory decline, 3 (2.4%) had VM-EF decline, and 33 (26.4%) had psychological symptoms. Left and right rSO2 values were asymmetric in patients who had memory decline (mean [SD] left-right ratio of 95.03 [8.51] vs 101.29 [6.7] for patients with no changes, P = 0.0012). The mean right-left difference in rSO2 was also significant in these patients (−2.87% [4.73%], lower on the right, P = 0.0034). Conclusions: Perioperative warming was associated with a higher incidence of cognitive dysfunction at 4 days. A temperature >36ºC constituted a risk factor for POCD at 4 days and at 3 months. Detection of a trend to asymmetry in rSO2 values can warn of possible postoperative onset of memory decline. Psychological symptoms and memory decline were common three months after knee replacement.

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Verdon, Josée. "Seniors in the emergency department : age and gender differences in presenting characteristics and predictors of adverse functional outcome at six months." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33450.

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With the rapid aging of the population, the presence of seniors in the emergency department (ED) is increasing. While the functional outcomes of seniors following an ED visit has been described, their predictors have not been examined by gender and age. This prospective multi-centre study of a cohort of 1659 seniors living in the community described the characteristics of men and women, age 65 to 79 and age 80 and over, presenting to the ED, and defined predictors of adverse functional outcome (functional decline, institutionalisation or death) 6 months after their visit.
There were more gender differences in the presenting characteristics and predictors in seniors age 65 to 79, than in those aged 80 and over. Two factors predicted adverse functional outcome in all seniors: admission to hospital at the ED visit and baseline level of disability. For seniors age 80 and over, these were the main predictors. For seniors age 65 to 79, predictors differed by gender. Among men, death was more frequent and predictors included measures of comorbidity. Among women, functional decline was more frequent and predictors included living alone, visual and cognitive impairment.
These results underline the importance of age and gender when describing functional outcomes of seniors. Knowledge of these predictors should allow emergency department staff to identify seniors at risk and develop appropriate interventions that may help prevent such poor outcome.

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Lee, Jacques Simon. "Acute abdominal pain in the emergency department : physicians' use of opioid analgesics and the incidence of serious outcomes." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0004/MQ44204.pdf.

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39

Brady, Patrick. "Cephalometric analysis of adolescents with severe Class II Division 1 malocclusions treated surgically and non-surgically." Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/3052.

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Introduction: Class II Division 1 malocclusions are characterized by a retrusive mandible and prominent upper incisors. Despite Class II malocclusions being one of the most frequently treated cases in orthodontists' office, there is no uniform consensus in the orthodontic community on the best treatment modality and biomechanical approach to use in treating patients with Class II malocclusions. Purpose: This paper examines the end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical versus non-surgical approaches. Study Design: This is a retrospective study of consecutively treated severe Class II Division I patients at the University of Iowa. Initial and deband lateral cephalometric radiographs were compared between 45 non-surgical and 21 surgical patients. All patients that were debanded between the ages of 13 to 19 years were included. Multivariable regression analyses were used to examine differences in outcomes between treatment groups. Results: Following adjustment for patient level confounders (age, gender, and race), those treated surgically had better end of treatment cephalometric outcomes. Those treated surgically had a more balanced skeletal profile, greater reduction in overjet, and improvement in ANB angle (p Conclusion: Orthodontic treatment in conjunction with orthognathic surgery is a more ideal treatment for patients with severe Class II Division I malocclusion. When treated surgically, a greater amount of overjet can be reduced while keeping lower incisors in a more stable position in bone.

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Sjöling, Mats. "Experiences of abandonment and anonymity among arthroplastic surgery patients in the perioperative period : some issues concerning communication, pain and suffering." Umeå : Kirurgisk och perioperativ vetenskap, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-509.

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Wang, Lejing Verfasser], Nassir [Akademischer Betreuer] [Navab, Russel H. [Akademischer Betreuer] Taylor, and Ekkehard [Akademischer Betreuer] Euler. "Novel techniques for integrating video augmented X-ray imaging into orthopedic and trauma surgery / Lejing Wang. Gutachter: Nassir Navab ; Russel H. Taylor ; Ekkehard Euler. Betreuer: Nassir Navab." München : Universitätsbibliothek der TU München, 2012. http://d-nb.info/1031550534/34.

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Johnson, Laurie. "Factors affecting the timing of systemic corticosteroid administration in acute asthma exacerbations in an urban pediatric emergency department." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1393237034.

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Dean, Preston. "Understanding Video Laryngoscope Screen Visualization Patterns in the Pediatric Emergency Department and the Impact on Procedural Performance." University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1623169774702892.

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Chang, Yen Yin [UNESP]. "Comparação entre o ponto P6 (NEIGUAM), ondansetron e da associação de ambos na prevenção de náuseas e vômitos em cirurgia ortopédica de membros inferiores sob bloqueio subaracnoideo." Universidade Estadual Paulista (UNESP), 2013. http://hdl.handle.net/11449/106000.

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Made available in DSpace on 2014-06-11T19:35:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-04-10Bitstream added on 2014-06-13T18:46:37Z : No. of bitstreams: 1 chang_yy_dr_botfm.pdf: 574285 bytes, checksum: ec51866cadcc3a8299ccb843ebe9f34d (MD5)
O estudo teve por objetivo avaliar náuseas e vômitos no pós-operatório (NVPO) com utilização da acupuntura com eletroestimulação do ponto P6 (Neiguam) comparado ao grupo fármaco Ondansetron e ao grupo da associação da eletroacupuntura com o Ondansetron. Trata-se de um estudo clínico prospectivo randomizado realizado em pacientes ortopédicos submetidos a cirurgias de membros inferiores com bloqueio subaracnóideo com morfina, realizado no período de maio de 2010 a dezembro de 2011 no Hospital Universitário Getúlio Vargas e Fundação Hospital Adriano Jorge, em Manaus – Amazonas. Foram incluídos no estudo 90 pacientes, sendo 30 pacientes no grupo Ondansetron G (O); os pacientes receberam o fármaco Ondansetron 8 mg EV na indução anestésica; 30 pacientes no grupo acupuntura G (A), os pacientes na SRPA receberam, antes do procedimento cirúrgico, eletroestimulação durante 30 minutos de 10 Hz dos pontos P6 (Neiguam) e IG11 (Quchi) – ponto neutro; e 30 pacientes no grupo Ondansetron e acupuntura G (OA), onde receberam ambas técnicas, a farmacológica e a não farmacológica. Foram avaliadas número de ocorrências de NV (náuseas e vômitos) com relatos preenchidos em protocolo próprio por avaliadores independentes em três momentos distintos: no período perioperatório na sala de cirurgia, nas primeiras 2 horas durante o período na SRPA e nas 24 horas durante a permanência na enfermaria. Para as variáveis quantitativas foi realizada a análise de variância no delineamento inteiramente ao acaso e para as variáveis qualitativas foi realizado o teste Exato de Fisher. O nível de significância utilizado foi de 5%. Foram randomizados 96 pacientes ≥ 18 anos ASA I e II, excluídos seis pacientes por violarem o protocolo; dos 90 pacientes incluídos, 19 eram do sexo feminino e 71 do sexo masculino. Os...
The study aims at evaluating the postoperative nauseas and vomiting (PONV) with utilization of acupuncture with electrostimulation of point P-6 (Neiguam) compared to the group of drug Ondansetron and the group of association of electroacupuncture with Ondansetron. It is a randomized, prospective, clinical study carried out in orthopedic patients undergone surgeries of lower limbs with subarachnoid block with morphine, carried out in the period from May, 2010 to December, 2011 in the Hospital Universitário Getúlio Vargas and Fundação Hospital Jorge in Manaus – Amazonas; 90 patients were enrolled in the study, being 30 patients in the Ondansetron group G (O), the patients received the drug Ondansetron 8 mg EV in the anesthesia induction; 30 patients in the acupuncture group G (A), the patients in SRPA received before the surgical procedure, electrostimulation during 30 minutes of 10 Hz of points P6 (Neiguam) and IG11 (Quchi) – neutral point; and 30 patients in the Ondansetron and acupuncture group G (OA) where the patients received both techniques, the pharmacological one and the non-pharmacological one. The number of occurrences of NV (nausea and vomiting) was evaluated with reports completed in suitable protocol by independent evaluators in three distinct moments: in the peri-operative period in the surgery room, in the first 2 hours during the period in SRPA and in the 24 hours during the stay in the nursing ward. For the quantitative variables the analysis of variance in the completely randomized design was carried out and for the qualitative variables the Fisher’s Exact test was carried out. The significance level used was 5%. 96 patients > 18 years old ASA I and II were randomized, and 6 patients were excluded due to protocol violation; of the 90 included patients, 19 were female and 71 were male. The anthropometric... (Complete abstract click electronic access below)

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Joss, Brendan Keith. "Clinical and biomechanical outcomes following unicondylar knee arthroplasty with Preservation fixed and mobile bearing tibial components." University of Western Australia. School of Surgery and Pathology, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0079.

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[Truncated abstract] Unicondylar knee arthroplasty (UKA) has re-emerged as a successful treatment option for isolated single compartment tibio-femoral joint osteoarthritis. However despite its increasing use, controversy still remains over fixed or mobile bearing tibial components, as there is a lack to prospective randomised studies reported in the literature. In addition, the theoretical advantages of the mobile bearing for knee kinematics, kinetics and clinical outcome have not been evaluated in vivo. The aim of this research study was to explore the clinical and biomechanical outcomes of the fixed and mobile bearing UKA. . . . When the results for the both studies were combined, utilising the Preservation and MG fixed bearing prostheses, there was a significant relationship between knee adduction moment, and a poor prognosis predicted from RSA. Those patients with translation or rotation of the tibial component in any direction above 1mm and 1.5 degrees respectively were considered to have a poor prognosis for long term fixation. Of the 28 patients, the 8 patients considered to have a poor prognosis, had increased knee adduction moments post-surgery (mean difference = 1.66Nm.kg-1, p = 0.007). There was no difference between the groups for knee flexion moment (mean difference 0.16Nm.kg-1, p = 0.844). Pre-surgery gait was unable to predict the post-surgery outcome, due to the significant changes in gait from pre- to post-surgery. Care must taken when implanting the Preservation mobile bearing prosthesis, as long term outcome is questionable. The mobile bearing prosthesis also produced the worst clinical outcome, however the theoretical advantages of the mobile bearing does not affect gait. Gait analysis is a useful tool to identify patient who are overloading their prosthesis, leading to potential early failure. Identification of these gait patterns can allow for early intervention to reduce joint load, and possible extend the longevity of the prosthesis.

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46

Chang, Yen Yin. "Comparação entre o ponto P6 (NEIGUAM), ondansetron e da associação de ambos na prevenção de náuseas e vômitos em cirurgia ortopédica de membros inferiores sob bloqueio subaracnoideo/." Botucatu, 2013. http://hdl.handle.net/11449/106000.

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Orientador: Norma Sueli Pinheiro Módolo
Banca: José Reinaldo Cerqueira Braz
Banca: Guilherme Antonio Moreira de Barros
Banca: Eduardo Toshiyuki Moro
Banca: Angélica de Fátima de Assunção Braga
Resumo: O estudo teve por objetivo avaliar náuseas e vômitos no pós-operatório (NVPO) com utilização da acupuntura com eletroestimulação do ponto P6 (Neiguam) comparado ao grupo fármaco Ondansetron e ao grupo da associação da eletroacupuntura com o Ondansetron. Trata-se de um estudo clínico prospectivo randomizado realizado em pacientes ortopédicos submetidos a cirurgias de membros inferiores com bloqueio subaracnóideo com morfina, realizado no período de maio de 2010 a dezembro de 2011 no Hospital Universitário Getúlio Vargas e Fundação Hospital Adriano Jorge, em Manaus - Amazonas. Foram incluídos no estudo 90 pacientes, sendo 30 pacientes no grupo Ondansetron G (O); os pacientes receberam o fármaco Ondansetron 8 mg EV na indução anestésica; 30 pacientes no grupo acupuntura G (A), os pacientes na SRPA receberam, antes do procedimento cirúrgico, eletroestimulação durante 30 minutos de 10 Hz dos pontos P6 (Neiguam) e IG11 (Quchi) - ponto neutro; e 30 pacientes no grupo Ondansetron e acupuntura G (OA), onde receberam ambas técnicas, a farmacológica e a não farmacológica. Foram avaliadas número de ocorrências de NV (náuseas e vômitos) com relatos preenchidos em protocolo próprio por avaliadores independentes em três momentos distintos: no período perioperatório na sala de cirurgia, nas primeiras 2 horas durante o período na SRPA e nas 24 horas durante a permanência na enfermaria. Para as variáveis quantitativas foi realizada a análise de variância no delineamento inteiramente ao acaso e para as variáveis qualitativas foi realizado o teste Exato de Fisher. O nível de significância utilizado foi de 5%. Foram randomizados 96 pacientes ≥ 18 anos ASA I e II, excluídos seis pacientes por violarem o protocolo; dos 90 pacientes incluídos, 19 eram do sexo feminino e 71 do sexo masculino. Os... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The study aims at evaluating the postoperative nauseas and vomiting (PONV) with utilization of acupuncture with electrostimulation of point P-6 (Neiguam) compared to the group of drug Ondansetron and the group of association of electroacupuncture with Ondansetron. It is a randomized, prospective, clinical study carried out in orthopedic patients undergone surgeries of lower limbs with subarachnoid block with morphine, carried out in the period from May, 2010 to December, 2011 in the Hospital Universitário Getúlio Vargas and Fundação Hospital Jorge in Manaus - Amazonas; 90 patients were enrolled in the study, being 30 patients in the Ondansetron group G (O), the patients received the drug Ondansetron 8 mg EV in the anesthesia induction; 30 patients in the acupuncture group G (A), the patients in SRPA received before the surgical procedure, electrostimulation during 30 minutes of 10 Hz of points P6 (Neiguam) and IG11 (Quchi) - neutral point; and 30 patients in the Ondansetron and acupuncture group G (OA) where the patients received both techniques, the pharmacological one and the non-pharmacological one. The number of occurrences of NV (nausea and vomiting) was evaluated with reports completed in suitable protocol by independent evaluators in three distinct moments: in the peri-operative period in the surgery room, in the first 2 hours during the period in SRPA and in the 24 hours during the stay in the nursing ward. For the quantitative variables the analysis of variance in the completely randomized design was carried out and for the qualitative variables the Fisher's Exact test was carried out. The significance level used was 5%. 96 patients > 18 years old ASA I and II were randomized, and 6 patients were excluded due to protocol violation; of the 90 included patients, 19 were female and 71 were male. The anthropometric... (Complete abstract click electronic access below)
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Overmann, Kevin M. M. D. "A Video-based Study of Apneic Oxygenation to Prevent Oxyhemoglobin Desaturation during Rapid Sequence Intubation in a Pediatric Emergency Department." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535464378124989.

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48

Alievi, Marcelo Meller. "Implante ósseo cortical alógeno conservado em mel na reconstrução de falha óssea diafisária em fêmur de cães." Universidade Federal de Santa Maria, 2006. http://repositorio.ufsm.br/handle/1/4070.

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Fourteen adult mongrel dogs were used to evaluate the honey preserved cortical allografts in the repair of diaphyseal femoral defect. The allografts were inserted into a 5cm segmental defect created in the mid-diaphysis of the right femur in each dog. The bones were stabilized with a 3.5mm dynamic compression plate and eight 3.5mm bone screws. Each dog was examined daily to evaluate complications and weight-bearing of the operated limb. Radiographs of the right femur were taken postsurgically and once every 15 days for the next three months. Following this, radiographs were taken once per month until the end of the research. Each two animals were euthanized after 30, 60, 90, 120, 180, 270, and 360 days. The right femur was harvested and prepared for histological evaluation. Nineteen (79.17%) of the twenty-four host-graft interfaces were radiographically healing (union). The mean time to allograft incorporation was 67.10 days (range, 45-90 days). There was no statistical difference in the allograft incorporation time between proximal and distal host-graft interfaces. It was observed Bacillus contamination in three honey samples, however, in allografts it was not verified. Good incorporation of donor graft by bone was observed histologically. Initially, there were osteoclastic activity increases in graft surfaces, and after bone formation. Complications observed were nonunion, allograft fracture, and allograft resorption. We conclude that despite the complications, honey preserved cortical allografts are a viable options to bone reconstruction.
O objetivo do presente estudo foi avaliar a utilização de implante ósseo cortical alógeno conservado em mel na reconstrução de falha óssea segmentar em fêmur de cães. Foi realizada uma falha óssea de 5cm na região diafisária do fêmur direito de 14 cães adultos, sendo utilizado um implante ósseo cortical alógeno conservado em mel para a sua reconstrução. O implante foi estabilizado no leito receptor por meio de uma placa de compressão dinâmica e oito parafusos corticais de 3,5mm. Os animais foram avaliados clinicamente, verificando-se o seu estado geral, o aspecto da ferida cirúrgica e o grau de deambulação. Radiografias do fêmur direito foram realizadas no pós-operatório imediato e quinzenalmente, até o 90 dia de pós-operatório. A partir desse período, as avaliações foram mensais até os 360 dias de pós-operatório. Dois animais foram submetidos à eutanásia aos 30, 60, 90, 120, 180, 270 e 360 dias de pós-operatório, sendo o fêmur direito retirado e encaminhado para exame histológico. A porcentagem de incorporação das interfaces foi de 79,17%, e o tempo médio necessário para a incorporação foi de 67,10 dias, variando entre 45 e 90 dias. Não foi verificada diferença significativa entre o tempo de incorporação das interfaces proximal e distal. Na análise bacteriológica, foi verificado Bacillus spp. em três amostras de mel, porém, não houve crescimento bacteriano nas amostras obtidas dos implantes ósseos. Histologicamente foi verificada adequada união entre as interfaces, com atividade osteoclástica na periferia do implante seguida por osteoblástica e formação de matriz óssea. As principais complicações verificadas foram não-união, fratura e reabsorção intensa do implante. Apesar das complicações, é possível concluir que o implante ósseo cortical alógeno conservado em mel é uma opção viável para a reconstrução óssea.

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49

Mondino, Ludimila Nunes Zini. "Avaliação do risco de hipotensão arterial durante a indução de raquianestesia em pacientes tratados cronicamente com fármacos antihipertensivos." Niterói, 2017. https://app.uff.br/riuff/handle/1/3294.

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A Raquianestesia com bupivacaína isobárica 0,5% (BP) é amplamente utilizada para cirurgia ortopédica de artroplastia primária de quadril (AQ), e a hipotensão Arterial é uma das complicações mais freqüentes desta técnica. O objetivo deste estudo foi quantificar a incidência de hipotensão arterial em pacientes submetidos à AQ e identificar fatores de risco independentes associados ao aumento da incidência de hipotensão após a indução da raquianestesia. Estudo de caso-controle, realizado com a análise de 937 (100%) registros de anestesia de pacientes de ambos os sexos, com uso de BP e idade igual ou superior a 40 anos. De acordo com os critérios pré-definido de "hipotensão arterial" (diminuição da pressão arterial média (PAM) maior que 30% do valor da PAM na pré-indução ou quando a PAM for inferior a 70mmHg), o evento foi detectado em 35,3% (n = 284) dos pacientes incluídos na análise. O risco relativo para hipotensão em pacientes que usam inibidores da ECA ou diuréticos é de 1,66 e 1,63 vezes, respectivamente. Por análise multivariada, idade (OR-1,034), hipertensão arterial (OR-2,44) e / ou diabetes melittus (OR- 17,14) foram independentemente associados com a ocorrência de hipotensão durante a indução da raquianestesia.
Spinal anesthesia with isobaric bupivacaine 0,5% (BP) is widely used for orthopedic surgery of primary hip arthroplasty (AQ), and the hypotension is one of the most frequent complications of this technique. The goal of this study was to quantify the incidence of hypotension in patients undergoing AQ and identify independent risk factors associated with increased incidence of hypotension after induction of anesthesia. Case-Control study was conducted, with the analysis of 937 (100%) anesthesia records of patients of both sexes, use of BP and age equal or greater than 40 years. According to the predefined criteria of "hypotension" (decrease > 30% of Mean arterial blood preassure (MAP) in the pre-induction or when MAP <70 mmHg), the event was detected in 35.3% (n = 284) of the patients included in the analysis. The relative risk for hypotension in patients who use ACE inhibitors or diuretics is 1.66 and 1.63 times respectively. By multivariate analysis, age (OR-1,034), hypertension (OR-2,44) and/or presence of diseases diabetes (OR-17,14) were independently associated with the occurrence of hypotension during induction of anesthesia.

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50

Reed, Jennifer L. M. D. "A qualitative analysis of adolescent and caregiver acceptability of universally offered gonorrhea and chlamydia screening in the pediatric emergency department." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin14907017879557.

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Dissertations / Theses on the topic 'Department of Orthopedic Surgery'

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