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Journal of Radiological Protection :... Jul 2024Surgical procedures involving the use of X-rays in the operating room have increased in recent years, thereby increasing the exposure of operating room staff to ionizing...
Surgical procedures involving the use of X-rays in the operating room have increased in recent years, thereby increasing the exposure of operating room staff to ionizing radiation. An individual dosimeter makes it possible to record the irradiation doses to which these personnel are exposed, but there is a lack of compliance in the wearing of these dosimeters for several practical reasons. This makes the dose results obtained unreliable. To try to improve the rate of dosimeter wearing in the operating room, the Dosibadge project studied the association of the individual dosimeter with the hospital access badge, forming the Dosibadge. Through a study performed at the Tours University Hospital in 8 different operating rooms for two consecutive periods of 3 months. The results show a significant increase in the systematic use of the dosimeter thanks to the Dosibadge, which improves the reliability of the doses obtained on the dosimeters and the monitoring of personnel. The increase is especially marked with clinicians. Following these results and the very positive feedback to this first single-center study, we are then planning a second multicenter study to validate our proof of concept on different sites, with the three brands of individual dosimeters used in France.
PubMed: 38964291
DOI: 10.1088/1361-6498/ad5f37 -
Frontiers in Oncology 2024A novel systemic immune-inflammation index (SII), based on the neutrophils, lymphocytes, and platelet counts, is associated with the prognosis of several cancers,...
OBJECTIVE
A novel systemic immune-inflammation index (SII), based on the neutrophils, lymphocytes, and platelet counts, is associated with the prognosis of several cancers, including non-metastatic renal cell carcinoma (RCC). In the present study, we evaluate the prognostic significance of SII in patients with metastatic RCC (mRCC) treated with systemic therapy.
METHOD
Relevant studies were searched comprehensively from Web of Science, PubMed, Embase and the Cochrane Library up to January 2024. The pooled hazard ratio (HR) and 95% confidence interval (CI) were extracted from each study to evaluate the prognostic value of SII in patients with mRCC treated with tyrosine kinase inhibitor (TKI) or immune checkpoint inhibitor (ICI).
RESULTS
A total of 12 studies including 4,238 patients were included in the final analysis. High SII was significantly correlated to poor overall survival (OS, HR = 1.88; 95% CI 1.60-2.21; < 0.001) and progression-free survival (PFS, HR = 1.66; 95% CI 1.39-1.99; < 0.001). Stratified by therapy, high SII was also related to the poor OS (TKI: HR = 1.63, < 0.001; ICI: HR = 2.27, < 0.001) and PFS (TKI: HR = 1.67, < 0.001; ICI: HR = 1.88, = 0.002).
CONCLUSION
In conclusion, high SII could serve as an unfavorable factor in patients with mRCC treated with systemic therapy. Stratified by therapies, the elevated SII was also associated with worse prognosis. Whereas, more prospective and large-scale studies are warranted to validate our findings.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024522831, identifier CRD42024522831.
PubMed: 38962274
DOI: 10.3389/fonc.2024.1404753 -
Advances in Simulation (London, England) Jul 2024During a critical event in the labor and delivery operating room, it is crucial for team members responding to the situation to be aware of the designated leaders....
BACKGROUND
During a critical event in the labor and delivery operating room, it is crucial for team members responding to the situation to be aware of the designated leaders. Visual and verbal cues have been utilized to designate leadership in various healthcare settings; however, previous research has indicated mixed results using visual cues for role designation.
METHODS
The purpose of this study was to explore the use of the red surgical hat as a visual cue of leadership during obstetric emergency simulation training. We used a mixed-methods design to analyze simulation-based education video and debriefing transcripts.
RESULTS
There was a statistically significant difference in the proportion of participants who declared leadership vs. those who donned the red hat. Participants were more likely to visually declare leadership utilizing a red surgical bouffant hat than to verbally declare leadership. Most participants indicated that observing the red hat to detect leadership in the operating room was more effective than when leaders used a verbal declaration to inform others who was leading.
CONCLUSIONS
Our findings suggest that utilizing a visual cue of leadership with the red surgical bouffant hat improves participant perceptions of communication of the surgical team during an obstetrical critical event in a simulation environment.
PubMed: 38961507
DOI: 10.1186/s41077-024-00295-2 -
Cellular Signalling Jul 2024It has been demonstrated that circular RNAs (circRNAs) are associated with the development of diabetic retinopathy (DR). Nevertheless, the function of circSLC16A10 in...
It has been demonstrated that circular RNAs (circRNAs) are associated with the development of diabetic retinopathy (DR). Nevertheless, the function of circSLC16A10 in the development of DR remains unclear. In order to investigate the role of circSLC16A10, we employed cell and animal models of DR. An analysis of a public database revealed that hsa_circSLC16A10 was expressed at lower levels in DR patients than in diabetic patients without DR or healthy controls. Additionally, the level of hsa_circSLC16A10 was lower in high glucose (HG)-exposed ARPE-19 cells and diabetic mice. hsa_circSLC16A10 was observed to be mainly distributed in the cytoplasm. Moreover, overexpression of hsa_circSLC16A10 alleviated HG-induced endoplasmic reticulum stress and cell apoptosis in vitro. Furthermore, overexpression of hsa_circSLC16A10 ameliorated HG-induced mitochondrial dysfunction, as evidenced by improvements in mitochondrial structure and function. Hsa_circSLC16A10 acted as a hsa-miR-761-5p sponge to increase MFN2 expression. MFN2 knockdown or hsa-miR-761-5p overexpression partially reversed the protective effect of hsa_circSLC16A10 in vitro. The protective effect of mmu_circSLC16A10 against DR was confirmed in an animal model of DR. These findings indicate that circSLC16A10 may regulate DR progression by improving mitochondrial function via the miR-761-5p/MFN2 axis.
PubMed: 38960059
DOI: 10.1016/j.cellsig.2024.111283 -
Ecotoxicology and Environmental Safety Jul 2024With the advancement of medical technology, tools such as electrosurgical equipment, laser knives, and ultrasonic scalpels have made modern medical procedures more...
BACKGROUND
With the advancement of medical technology, tools such as electrosurgical equipment, laser knives, and ultrasonic scalpels have made modern medical procedures more convenient and effective. However, the generation of surgical smoke during these procedures poses significant health risks to medical personnel. Despite this, only a few studies have examined the literature systematically in this area. By analyzing bibliometric data on surgical smoke, we can gain insights into current research hotspots and forecast future trends.
METHODS
This study included literature related to surgical smoke from the Web of Science and China National Knowledge Infrastructure (CNKI) databases, covering the period from 2000 to 2024. We used VOSviewer, CiteSpace, and BioBERT to visualize research trends and hotspots.
RESULTS
In the early stages of research, the focus was mainly on the composition, generation mechanisms, and susceptible populations related to surgical smoke. In recent years, with the development of laparoscopic surgery and the global COVID-19 pandemic, research interests have shifted towards occupational protection of healthcare workers and public health. Currently, the research in this field primarily explores the promoting effects of surgical smoke on conditions such as inflammation and tumors, as well as occupational protection and health education for healthcare workers. Disease research focuses heavily on Smoke Inhalation Injury, Infections, Neoplasms, Postoperative Complications, and Inflammation.
CONCLUSION
We explored future research directions in the field of surgical smoke using VOSviewer, CiteSpace, and BioBERT. Our findings indicate that current research focuses on investigating the promoting effects of surgical smoke on conditions such as inflammation and tumors, as well as on occupational protection and health education for healthcare workers. We summarized existing preventive measures, aiming to facilitate further research advancements and the translation of research outcomes into clinical results. These efforts provide new insights for advancing research in occupational protection of healthcare workers.
PubMed: 38959788
DOI: 10.1016/j.ecoenv.2024.116671 -
Wound Management & Prevention Jun 2024Operating room-acquired pressure injury (PI) is defined as PI that develops within the first 48 to 72 hours after surgery.
BACKGROUND
Operating room-acquired pressure injury (PI) is defined as PI that develops within the first 48 to 72 hours after surgery.
PURPOSE
To determine the incidence and risk factors of operating room-acquired PI.
METHODS
This descriptive cross-sectional study was conducted at a university hospital in Turkey between May 20, 2021, and December 20, 2021, and included 309 patients who met the inclusion criteria. The study was reported based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.
RESULTS
Operating room-acquired PI developed in 5.8% of the patients in this study. Moreover, 54.4% of the patients had medical devices, and medical device-acquired PI occurred in 4.2% of these patients (7/168). Patient age, hemodynamic parameters, and albumin level, as well as duration of surgery, were found to affect the development of operating room-acquired PI.
CONCLUSION
Surgical nurses are responsible for both recognizing situations that may result in perioperative PI and taking necessary precautions. It is recommended that nurses identify existing and potential preoperative, intraoperative, and postoperative risks that impair skin integrity and affect tissue oxygenation to reduce the risk of operating room-acquired PI.
Topics: Humans; Cross-Sectional Studies; Risk Factors; Operating Rooms; Pressure Ulcer; Female; Male; Incidence; Turkey; Middle Aged; Adult; Aged
PubMed: 38959344
DOI: 10.25270/wmp.23037 -
Surgical Infections Jul 2024Posterior fossa craniotomy is commonly performed for various pathologies. However, intra-cranial infection following craniotomy causes morbidity. Pseudomeningocele is...
Posterior fossa craniotomy is commonly performed for various pathologies. However, intra-cranial infection following craniotomy causes morbidity. Pseudomeningocele is one of the main complications following posterior fossa operation. This study aimed to test the hypothesis that the risk of intra-cranial infection is increased in patients who undergo posterior fossa craniotomy with pseudomeningocele compared with those without pseudomeningocele. We retrospectively analyzed the data of patients undergoing posterior fossa craniotomy for the management of neurological pathologies at our institute from 2011 to 2020. A total of 308 craniotomies were included, and the primary outcome of interest was the occurrence of intra-cranial infection. Standard statistical methods were used to explore associations between several parameters, including pseudomeningocele, intra-cranial infection, and wound leak. Of the 308 craniotomies, 41 (13.3%) developed intra-cranial infection and 59 (19.2%) involved pseudomeningocele. Of cases involving pseudomeningocele, 27 (45.8%) developed an intra-cranial infection compared with only 14 of 249 without pseudomeningocele (5.6%; p < 0.001). In the multi-variable analysis, pseudomeningocele was associated with intra-cranial infection (odds ratio [OR] 8.56; 95% confidence interval [CI] 3.145-23.299; p < 0.001) and wound leak (OR 91.339; 95% CI 10.437-799.364; p < 0.001). The findings indicate that patients undergoing posterior fossa craniotomy are at a greater risk of intra-cranial infection if there is pseudomeningocele after the operation.
PubMed: 38959195
DOI: 10.1089/sur.2024.071 -
Clinical and Investigative Medicine.... Jun 2024The COVID-19 pandemic has resulted in a significant diagnostic, screening, and procedure backlog in Ontario. Engagement of key stakeholders in healthcare leadership...
PURPOSE
The COVID-19 pandemic has resulted in a significant diagnostic, screening, and procedure backlog in Ontario. Engagement of key stakeholders in healthcare leadership positions is urgently needed to inform a comprehensive provincial recovery strategy.
METHODS
A list of 20 policy recommendations addressing the diagnostic, screening and procedure backlog in Ontario were transformed into a national online survey. Policy recommendations were rated on a 7-point Likert scale (strongly agree to strongly disagree) and organized into those retained (≥75% strongly agree to somewhat agree), discarded (≥80% somewhat disagree to strongly disagree), and no consensus reached. Survey participants included a diverse sample of healthcare leaders with the potential to impact policy reform.
RESULTS
Of 56 healthcare leaders invited to participate, there were 34 unique responses (61% response rate). Participants were from diverse clinical backgrounds, including surgical subspecialties, medicine, nursing, and healthcare administration and held institutional or provincial leadership positions. A total of 11 of 20 policy recommendations reached the threshold for consensus agreement with the remaining 9 having no consensus reached.
CONCLUSION
Consensus agreement was reached among Canadian healthcare leaders on 11 policy recommendations to address the diagnostic, screening, and procedure backlog in Ontario. Recommendations included strategies to address patient information needs on expected wait times, expand health and human resource capacity, and streamline efficiencies to increase operating room output. No consensus was reached on the optimal funding strategy within the public system in Ontario or the appropriateness of implementing private funding models.
Topics: Humans; COVID-19; Ontario; Surveys and Questionnaires; Pandemics; SARS-CoV-2; Leadership; Mass Screening; Delivery of Health Care; Male; Female; Health Personnel
PubMed: 38958478
DOI: 10.3138/cim-2024-2655 -
Brazilian Journal of Medical and... 2024This study explored the association between loneliness and mental health among nurses in China during the COVID-19 pandemic. This cross-sectional study was conducted...
This study explored the association between loneliness and mental health among nurses in China during the COVID-19 pandemic. This cross-sectional study was conducted from March to April 2022. We enrolled 2,811 nurses from a tertiary hospital in China. Demographic characteristics, lifestyle factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. Loneliness was measured with the three-item short form of the Revised UCLA Loneliness Scale, and the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale were used to measure mental health. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were determined using binary logistic regression. Among participants in this study, 12.0% (337) experienced loneliness, and 7.8% (219) and 6.7% (189) reported depression and anxiety, respectively. The loneliness scores were categorized into three levels (3, 4-6, and 7-9). For depression, compared with the lowest reference, the ORs and 95% CI across the tertile were 1.31 (0.69-1.84) and 2.53 (1.11-5.76) after adjustment, respectively, and the P-value for trend was 0.045. For anxiety, compared with the lowest reference, the ORs and 95%CI across the tertile were 1.84 (1.28-2.63) and 2.52 (1.57-4.10) after adjustment, respectively; the P-value for trend was 0.004. This study showed that loneliness was significantly associated with poor mental health among nurses during the COVID-19 pandemic. These findings suggested that medical establishments should offer interventions for nurses to prevent mental health problems by targeting this modifiable risk factor.
Topics: Humans; Loneliness; Cross-Sectional Studies; Female; China; COVID-19; Adult; Male; Mental Health; Depression; Nurses; Middle Aged; SARS-CoV-2; Anxiety; Surveys and Questionnaires; Risk Factors; Pandemics
PubMed: 38958366
DOI: 10.1590/1414-431X2024e13408 -
MedEdPORTAL : the Journal of Teaching... 2024As surgical technologies grow, so too do demands on surgical trainees to master increasing numbers of skill sets. With the rise of endovascular surgery, trainees have...
INTRODUCTION
As surgical technologies grow, so too do demands on surgical trainees to master increasing numbers of skill sets. With the rise of endovascular surgery, trainees have fewer opportunities to practice open vascular techniques in the operating room. Simulation can bridge this gap. However, existing published open vascular simulation curricula are basic or based on expensive models.
METHODS
We iteratively developed an open vascular skills curriculum for second-year surgery residents comprising six 2-hour sessions. We refined the curriculum based on feedback from learners and faculty. The curriculum required skilled facilitators, vascular instruments, and tissue models. We evaluated the latest iteration with a survey and by assessing participants' technical skills using the Objective Structured Assessment of Technical Skills (OSATS) form.
RESULTS
Over the past 10 years, 101 residents have participated in the curriculum. Nine of 13 residents who participated in the latest curricular iteration completed the survey. All respondents rated the sessions as excellent and strongly agreed that they had improved their abilities to perform anastomoses with tissue and prosthetic. Facilitators completed 18 OSATS forms for residents in the fifth and sixth sessions of the latest iteration. Residents scored well overall, with a median 26.5 (interquartile range: 24-29) out of a possible score of 35, with highest scores on knowledge of instruments.
DISCUSSION
This simulation-based curriculum facilitates open vascular surgical skill acquisition among surgery residents. The curriculum allows residents to acquire critical vascular skills that are challenging to learn in an increasingly demanding operative setting.
Topics: Humans; Curriculum; Internship and Residency; Simulation Training; Clinical Competence; Surveys and Questionnaires; Vascular Surgical Procedures; Anastomosis, Surgical; Dissection; Education, Medical, Graduate; Educational Measurement
PubMed: 38957530
DOI: 10.15766/mep_2374-8265.11406