Presentation at the Western Orthopaedic Association Annual Meeting 2012 - Collagen Stuffed Sutures Enhance Healing of Full-Thickness Rotator Cuff Tears
Rotator cuff tear is a very common orthopedic condition, which causes shoulder pain and stiffness. The slides are on rotator cuff tears and its management by open repair, mini open repair & by arthroscopy
Rotator cuff tear is a very common orthopedic condition, which causes shoulder pain and stiffness. The slides are on rotator cuff tears and its management by open repair, mini open repair & by arthroscopy
Presentation at Canadian Orthopaedic Association Annual Meeting 2012 - PASTA Bridge - A New Technique in PASTA Repairs: A Biomechanical & Clinical Evaluation
Automated Quantitative Measures of Forelimb Function in Rats and MiceInsideScientific
During this webinar Drew Sloan, PhD and Seth Hays, PhD discuss automated forelimb tasks for both rats and mice and applications of the quantitative data collected.
These new procedures are advancing discovery in basic neuroscience and offering deeper understanding of motor control and developing therapies for disease models such as traumatic brain injury, spinal cord injury, and Parkinson’s disease.
Dr. Drew Sloan demonstrates typical training and testing protocols for using the Vulintus MotoTrak behavioral system, including Isometric pull, supination and lever press tasks.
Following, Dr. Seth Hays shares his research which has used MotoTrak to investigate neuroplasticity-enhancing therapies for motor dysfunction, specifically looking at vagus nerve stimulation (VNS) as a method to promote plasticity.
Method for enhancing retention in complete denture bases/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Measuring “Culture of Safety” Tawam’s Experience
Discovery:
Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc).
Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Solution:
Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.
An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.
Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.
Those who spent at least 50% of their time in the identified units were only included to participate in the survey.
Survey was administered during departmental meetings to increase response rate.
Conducted separate sessions of physicians.
Staff dropped the completed surveys in an envelope.
82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.
The three CUSP pilot units were re-surveyed in 2010.
Anonymity, privacy and confidentiality were maintained from the beginning till the end.
Outcome:
The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm.
The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans.
The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi
How to plan and execute contractile measurements in permeabilized muscle fibe...InsideScientific
Join Matt Borkowski and Dr. Tim West for this informative webinar covering the A-to-Z of assessing muscle performance and contractile function in single muscle fibers.
For more information: https://insidescientific.com/webinar/how-plan-execute-contractile-measurements-permeabilized-muscle-fibers-aurora-scientific
Presentation at Canadian Orthopaedic Association Annual Meeting 2012 - PASTA Bridge - A New Technique in PASTA Repairs: A Biomechanical & Clinical Evaluation
Automated Quantitative Measures of Forelimb Function in Rats and MiceInsideScientific
During this webinar Drew Sloan, PhD and Seth Hays, PhD discuss automated forelimb tasks for both rats and mice and applications of the quantitative data collected.
These new procedures are advancing discovery in basic neuroscience and offering deeper understanding of motor control and developing therapies for disease models such as traumatic brain injury, spinal cord injury, and Parkinson’s disease.
Dr. Drew Sloan demonstrates typical training and testing protocols for using the Vulintus MotoTrak behavioral system, including Isometric pull, supination and lever press tasks.
Following, Dr. Seth Hays shares his research which has used MotoTrak to investigate neuroplasticity-enhancing therapies for motor dysfunction, specifically looking at vagus nerve stimulation (VNS) as a method to promote plasticity.
Method for enhancing retention in complete denture bases/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Measuring “Culture of Safety” Tawam’s Experience
Discovery:
Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc).
Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Solution:
Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.
An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.
Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.
Those who spent at least 50% of their time in the identified units were only included to participate in the survey.
Survey was administered during departmental meetings to increase response rate.
Conducted separate sessions of physicians.
Staff dropped the completed surveys in an envelope.
82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.
The three CUSP pilot units were re-surveyed in 2010.
Anonymity, privacy and confidentiality were maintained from the beginning till the end.
Outcome:
The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm.
The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans.
The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi
How to plan and execute contractile measurements in permeabilized muscle fibe...InsideScientific
Join Matt Borkowski and Dr. Tim West for this informative webinar covering the A-to-Z of assessing muscle performance and contractile function in single muscle fibers.
For more information: https://insidescientific.com/webinar/how-plan-execute-contractile-measurements-permeabilized-muscle-fibers-aurora-scientific
Similar to Collagen Stuffed Sutures Enhance Healing of Full-Thickness Rotator Cuff Tears (20)
A presentation on different techniques for shoulder joint preservation in regards to the advances in technology for rotator cuff pathology, from tendonitis to cuff tear arthropathy.
Presentation on the Anterolateral Ligament (ALL) with information on diagnosis with ultrasound and treatment using an ultrasound guided, percutaneous, reconstruction and an internal brace
Update on ACL reconstruction, with information on current direction of demineralized bone matrix (DBM) use in bone tunnels and biocartilage on chondral lesions
E-Poster at the Arthroscopy Association of North America Annual Meeting 2012 - PASTA Bridge - A New Technique in PASTA Repairs: A Biomechanical Evaluation of Construct Strength vs. Suture Anchors
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
CDSCO and Phamacovigilance {Regulatory body in India}
Collagen Stuffed Sutures Enhance Healing of Full-Thickness Rotator Cuff Tears
1. Collagen Stuffed Sutures Enhance
Healing of Full-Thickness Rotator
Cuff Tears
Alan M. Hirahara, M.D., FRCS(C)
Private Practice
Sacramento, CA USA
Medical Director Team Physician Consultant
Sacramento State Athletics Sacramento River Cats Oakland A’s
MiLB - AAA
2. Objective of Study
• To evaluate the clinical effectiveness of a new
collagen stuffed suture on full-thickness
rotator cuff repairs
3. Introduction
• No other study has evaluated the clinical effectiveness
of a collagen stuffed suture on full-thickness rotator cuff
repairs
• Mazzocca et al showed that collagen-coated
polyester/polyethylene suture stimulates adhesion,
proliferation alkaline phosphatase and protein synthesis
more than uncoated sutures
– Therefore, may aid in the tendon to bone incorporation process
critical to rotator cuff repair
Mazzocca et al. JSES 2007; 16(5): S222-30.
4. Scanning Electron Microscopy
Control suture exhibiting Collagen fibers appear
smooth surfaces 1000X Mag
as thread-like structures
for all images
Courtesy of Gus Mazzocca, U Conn
5. Study Design
• Case-control study
• Collection period: 1/10 – 12/11
• Pain scores, ASES scores taken every month for 6
months
– ROM measured pre-op and monthly for 3 months post
– Date of discharge and date of return to work were noted
6. Study Design
• Inclusions:
– All patients requiring a full-thickness RC repair
• Exclusions:
– any post-operative trauma
– non-compliance with physical therapy protocol
• Failure to heal:
– Evaluated any symptoms 4-6 months post-op with repeat MRA
or surgery
8. Surgical Technique: Control Group
• SutureBridge technique
• 5.5 mm biocomposite full
thread Corkscrew anchors
& 3.5 mm biocomposite
PushLock anchors
• SpeedBridge technique
• 4.5 mm vented SwiveLock
anchors with FiberTape
9. Patient Data
Study Group Control Group
• 56 patients • 45 patients
• 31 male / 26 female • 25 male / 20 female
• Age range: 25 – 86 years • Age range: 34 – 78 years
• Age average: 58.83 years • Age average: 56.64 years
10. Results
Pain Scores ASES Scores
p = NS p = 0.02 p = NS p = 0.02
7.0 90.0
80.0
6.0
70.0
5.0
60.0
4.0 50.0
3.0 40.0
30.0
2.0
20.0
1.0
10.0
0.0 0.0
Pre-op Month Month Month Month Month Month Pre-op Month Month Month Month Month Month
1 2 3 4 5 6 1 2 3 4 5 6
Control Group: n = 45
Study Group: n = 56
11. Range of Motion
160.0
140.0
120.0
100.0
Control Flexion
Degrees
80.0 Study Flexion
Control ER
60.0
Study ER
40.0
20.0
0.0
Initial Visit 1 Month 2 Month 3 Month
No Significant Difference Between the 2 Groups
12. Results – Return to Work
p = 0.03
250.0 200.5
200.0
150.0
81.2
Days
100.0
50.0
0.0
Control Group Study Group
13. Results – Days to Discharge
p = 0.0004
176.8
180.0
160.0
140.0
109.0
120.0
100.0
Days
80.0
60.0
40.0
20.0
0.0
Control Group Study Group
14. Results - Failures
6 • Control Failures
6
• 2 - small
5 • 2 - moderate
4
• 1 - large
3
• 1 - massive
3
2
1
• Study Failures
0
• 1 - moderate
• 2 - massive
Control Group Study Group
No Significant Difference Between the 2 Groups
15. Results
• Significant Difference in:
– Pain scores at 6 months
– ASES scores after 5 months
– Time to return to work by 119.3 days
– Time to discharge by 67.8 days
• No significant difference in failure rate
– 13.3% to 5.3%
17. Discussion
• Collagen stuffed suture appears to enhance healing of rotator cuff
repairs
– Significantly improved function & less pain by 5 & 6 months
– Patients were discharged and returned to work faster
– Fewer failures in the study group but not statistically significant
• Those that did fail tended to be larger in size in the study group
• Further study is needed on the best mode of use of collagen with
sutures and anchors
• Will require a randomized controlled trial to confirm the results