Current Issue : October - December Volume : 2011 Issue Number : 1 Articles : 5 Articles
Background: To assess the reliability of the measurements obtained with the PalmScanââ??¢, when compared with another standardized A-mode ultrasound device, and assess the consistency and correlation between the two methods.\nMethods: Transversal, descriptive, and comparative study. We recorded the axial length (AL), anterior chamber depth (ACD) and lens thickness (LT) obtained with two A-mode ultrasounds (PalmScanââ??¢ A2000 and Eye Cubedââ??¢) using an immersion technique. We compared the measurements with a two-sample t-test. Agreement between the two devices was assessed with Bland-Altman plots and 95% limits of agreement.\nResults: 70 eyes of 70 patients were enrolled in this study. The measurements with the Eye Cubedââ??¢ of AL and ACD were shorter than the measurements taken by the PalmScanââ??¢. The differences were not statistically significant regarding AL (p < 0.4) but significant regarding ACD (p < 0.001). The highest agreement between the two devices was obtained during LT measurement. The PalmScanââ??¢ measurements were shorter, but not statistically significantly (p < 0.2).\nConclusions: The values of AL and LT, obtained with both devices are not identical, but within the limits of agreement. The agreement is not affected by the magnitude of the ocular dimensions (but only between range of 20 mm to 27 mm of AL and 3.5 mm to 5.7 mm of LT). A correction of about 0.5 D could be considered if an intraocular lens is being calculated. However due to the large variability of the results, the authors recommend discretion in using this conversion factor, and to adjust the power of the intraocular lenses based upon the personal experience of the surgeon....
Background: Environmental surfaces play an important role in transmission of healthcare-associated pathogens.\r\nThere is a need for new disinfection methods that are effective against Clostridium difficile spores, but also safe, rapid,\r\nand automated.\r\n\r\nMethods: The Tru-Dââ??¢ Rapid Room Disinfection device is a mobile, fully-automated room decontamination technology\r\nthat utilizes ultraviolet-C irradiation to kill pathogens. We examined the efficacy of environmental disinfection using the\r\nTru-D device in the laboratory and in rooms of hospitalized patients. Cultures for C. difficile, methicillin-resistant\r\nStaphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) were collected from commonly touched\r\nsurfaces before and after use of Tru-D.\r\n\r\nResults: On inoculated surfaces, application of Tru-D at a reflected dose of 22,000 Ã?µWs/cm2 for ~45 minutes\r\nconsistently reduced recovery of C. difficile spores and MRSA by >2-3 log10 colony forming units (CFU)/cm2 and of VRE\r\nby >3-4 log10 CFU/cm2. Similar killing of MRSA and VRE was achieved in ~20 minutes at a reflected dose of 12,000 Ã?µWs/\r\ncm2, but killing of C. difficile spores was reduced. Disinfection of hospital rooms with Tru-D reduced the frequency of\r\npositive MRSA and VRE cultures by 93% and of C. difficile cultures by 80%. After routine hospital cleaning of the rooms\r\nof MRSA carriers, 18% of sites under the edges of bedside tables (i.e., a frequently touched site not easily amenable to\r\nmanual application of disinfectant) were contaminated with MRSA, versus 0% after Tru-D (P < 0.001). The system\r\nrequired <5 minutes to set up and did not require continuous monitoring.\r\n\r\nConclusions: The Tru-D Rapid Room Disinfection device is a novel, automated, and efficient environmental\r\ndisinfection technology that significantly reduces C. difficile, VRE and MRSA contamination on commonly touched\r\nhospital surfaces....
Background\nWe hypothesize that implantation of left ventricular assist device through off-pump technique is feasible and has a comparable result to implantation on cardiopulmonary bypass and could improve one-year survival.\nMethods\nThis retrospective, observational, single-center study was conducted on 29 consecutive patients at our institution who underwent off-pump left ventricular assist device implantation by a single surgeon.\nResults\nTwenty-seven procedures were performed successfully using the off-pump technique. The survival rate was 92% at 30 days, 76% at 90 days, and 67% at one year. We compared the one-year survival of different implantation periods, and divided our study into three time intervals (2004-2005, 2006, and 2007). There was a trend in reduction in number of deaths over one year that demonstrated a decrease in death rate from 50% to 17%, as well as improvement in our experience over time. However, this trend is not statistically significant (p = 0.08) due to limited sample size.\nConclusions\nBased upon our findings, off-pump left ventricular assist device implantation is a feasible surgical technique, and combining this technique with improved device technology in the future may provide even greater improvement in patient outcomes....
Cardiogenic shock has a poor prognosis with established treatment strategies. We report a 62 years old man with heart failure exacerbating into refractory cardiogenic shock successfully treated with the combination of a percutaneous left ventricular assist device (LVAD) and subacute cardiac resynchronization therapy (CRT) implantable cardioverter-defibrillator device (CRT-D)....
Remote monitoring (RM) of homebound heart failure (HF) patients has previously been shown to reduce hospital admissions. We conducted a pilot trial of ambulatory, non-homebound patients recently hospitalized for HF to determine whether RM could be successfully implemented in the ambulatory setting. Eligible patients from Massachusetts General Hospital (n =150) were randomized to a control group (n=68) or to a group that was offered RM (n=82). The participants transmitted vital signs data to a nurse who coordinated care with the physician over the course of the 6-month study. Participants in the RM program had a lower all cause per person readmission rate (mean=0.64, SD± 0.87) compared to the usual care group (mean =0.73, SD± 1.51; P-value=0.75) although the difference was not statistically significant. HF-related readmission rate was similarly reduced in participants. This pilot study demonstrates that RM can be successfully implemented in non-homebound HF patients and may reduce readmission rates....
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