600 Technology (Applied Sciences)
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Primary Epiploic Appendagitis☆
J COLOPROCTOL. 2013;33(3):161–166 Journal of Coloproctology www.jcol.org.br Case report Primary epiploic appendagitis☆ Carlos Augusto Real Martineza,*, Rogério Tadeu Palmab, Paulo Pedroso Silveira Júnior c, Daniela Tiemi Satoc, Murilo Rocha Rodriguesc, Hermínio Cabral de Resende Júniorb, René Crepaldi Filhod,e a Graduate Program in Health Sciences of Universidade São Francisco (USF), Bragança Paulista, SP, Brazil b Discipline of Digestive System Surgery of Faculdade de Medicina da Fundação ABC (FUABC), Santo André, SP, Brazil c School of Medicine, USF, Bragança Paulista, SP, Brazil d Discipline of Digestive System Surgery of Faculdade de Medicina da Fundação ABC (FUABC), Santo André, SP, Brazil e Discipline of Digestive System Surgery of Universidade Nove de Julho (UNIVOVE), São Paulo, SP, Brazil article info abstract Article history: Primary epiploic appendagitis (PEA) is a seldom reported disease caused by spontaneous Received 2 February 2013 torsion of one or more epiploic appendices. The aim of this study is to describe two cases Accepted 15 March 2013 of PEA reviewing the main aspects of the diagnosis and treatment of disease. Case report: Case 1) Male patient, 55 years old, obese, with abdominal right iliac fossa (RIF) pain for two Keywords: days. Abdominal examination showed pain on palpation in the RIF with rebound tenderness. Appendicitis Abdominal computed tomography identifi ed lobulated lesion in the cecum, measuring 4.5 Cecal diseases cm in diameter, which was suggestive of PEA or early neoplasm of the colon wall. The lapa- Infl ammation roscopic assessment confi rmed the diagnosis of PEA and the appendix was removed. The pa- Colon tient had a satisfactory outcome, being discharged on the second postoperative day. -
Multimodal Analgesia for Colorectal Surgery: a Retrospective Evaluation of an Enhanced Recovery Protocol
10/10/2020 Multimodal Analgesia for Colorectal Surgery: A Retrospective Evaluation of an Enhanced Recovery Protocol Andrew Candelore, DNP, CRNA Andrea Mazzei, DNP, CRNA Robert Wolfrom, DNP, CRNA 1 Introduction and Background Traditional Colorectal Surgery Laparoscopic Surgery ● Large abdominal incisions • Reduced complications ● High rates of adverse • Significantly shortened LOS outcomes • Decreased readmission rates ○ PONV ○ Increased pain Continued Challenges ○ Decreased mobility • Opioids used as primary ○ Delayed gastric motility analgesic modality ○ Urinary dysfunction • Troublesome side effects: ○ 78% increase in LOS • PONV, respiratory depression, ○ Readmission rates as high sedation, constipation, as 35.4% addiction 2 1 10/10/2020 Significance • The Opioid Epidemic • 99% of adult surgical patients receive an opioid • 6-10% of opioid-naïve patients have continued dependence • 14.4% of colorectal surgical patients report chronic use pattern postoperatively • Anesthetic Pain Management • Aim to limit opioids • Adopt alternative approaches • Provide effective analgesia while promoting optimal patient outcomes 3 Purpose and Objectives • Project Purpose Evaluate the perioperative care improvement initiative implemented at Christiana Care by the Department of Anesthesia which aimed to improve the quality of recovery from colorectal surgery through the utilization of multimodal analgesia. • Determine if multimodal analgesia, as compared to traditional anesthesia care, reduced: • Pain scores • Opioid consumption • PONV • Hospital LOS -
The Impact of Star Physicians on Diffusion
THE IMPACT OF STAR PHYSICIANS ON DIFFUSION OF A MEDICAL TECHNOLOGY A Dissertation Submitted to The Temple University Graduate Board in Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY By Laura Shinn January, 2011 Examining Committee Members: Erwin A. Blackstone, PhD, Advisory Chair, Economics Joseph P. Fuhr, Jr., PhD, Economics Thomas E. Getzen, PhD, Risk, Insurance and Healthcare Management Paul N. Rappoport, PhD, Economics Albert I.Wertheimer, PhD, MBA, External Member, Pharmaco-Economics ii ABSTRACT The Impact of Star Physicians on Diffusion of a Medical Technology Laura Shinn Temple University January, 2011 Professor Erwin A. Blackstone, Chair This dissertation studies the effect of star power among physicians on the diffusion of a medical technology. Studies of the diffusion of medical technologies document institutional and market level factors influencing diffusion rates and patterns. The role of the physician in the diffusion of medical technology in hospitals is not widely studied. This dissertation seeks to fill this gap. Certain ―star‖ physicians and hospitals are recognized as highly attractive to patients. A star physician is defined as a physician who meets any of the following criteria: (i) completed residency training at top 30 ranked hospital, (ii) graduated from a top 30 medical school or (iii) is included in Castle & Connolly’s Top Docs publications. A star hospital is defined as a member of the American Association of Medical Colleges’ Council of Teaching Hospitals. iii Using quarterly data on all bariatric surgeries performed in the state of Pennsylvania from 1995 through 2007, I measure the effect of stars physicians and star hospitals on the diffusion of a surgical innovation in bariatric surgery called laparoscopic gastric bypass surgery. -
Coloduodenal Fistula in Right Colorectal Cancer: Case Report and Review of the Literature
Journal of Medical Research and Health Sciences Received 5 Dec 2020 | Accepted 12 Jan 2021 | Published Online 16 Jan 2021 DOI: https://doi.org/10.15520/jmrhs.v4i1.303 JMRHS 4 (1), 1135−1138 (2020) ISSN (O) 2589-9031 | (P) 2589-9023 CASE REPORTS Coloduodenal Fistula in Right Colorectal Cancer: Case Report and Review of the Literature ∗ Patricia Ciriano Hernández 1 Carlos Martínez Pinedo Rafael Picón Rodríguez Elisa Jiménez Higuera Daniel Sánchez Peláez Ángel Fernández Camuñas Jesús Martín Fernández 1General and Digestive System Abstract Surgery Hospital General In spite of the high incidence of colorectal cancer, cases of right colon Universitario de Ciudad Real Calle Obispo Rafael Torija 13005 cancer presenting with local invasion are not common. This is even Ciudad Real, Castilla la Mancha, more infrequent if we focus on duodenal invasion and presence of Spain duodenal fistula. We present the case of a patient admitted to our hospital due to severe weight loss, malnutrition and bowel obstruction. The patient was diagnosed of advanced right colon cancer with coloduodenal fistula and concomitant liver metastasis. According to diagnosis, palliative surgery was performed. 1 INTRODUCTION mia, diarrhea or feculent vomiting. (1)(5) Diagnosis is based on upper endoscopy and olorectal cancer is one of the most frequent colonoscopy, which can also provide the biopsy for malignancies among developed countries. CLocally advanced cases range from 5 to 25%. histopathological confirmation. The gold standard The specific invasion of the duodenum has been radiology test is the CT scan. reported to account for 0, 4 %. ((1),(2) Management of malignant duodenal fistula poses a This clinical entity has become a rare event in present dilemma to surgeons. -
July/August 2004 Newsletter
Environmental Defense Institute News on Environmental Health and Safety Issues ")··..--~~~~~~~~~-,-~~~~~~--"--~~~ I July/August 2004 Volume 15 Number 3 Idaho Cancer Rates Continue to Rise at Record Levels According to the Cancer Data Registry ofldaho Dr. Thomas Pigford which was commissioned by the US there is a steady increase in Idaho cancer rates from the District Court hearing the Hanford Downwinders suit, beginning of data collection through 2002 (the latest both showed that causation for the high rate of cancer in report issued by the Registry). The 2000 report notes an the Northern Idaho Panhandle and Health District 3 increase of 3 59 cancer cases in recent years. "This was (Lewiston area) can be attributed to Hanford emissions one. of the largest single-year increases in cancer following wind patterns up the Columbia and Snake incidence in the history of the Cancer Data Registry of River drainage canyons. Idaho. Cancer sites with notable increases from 1999 to The Hanford· Downwinder litigation won two 2000 were lung, melanoma (in-situ), oral cavity and significant legal wins; 1.) the US 9th District Court of pharynx cancer counts increased over 1999 levels. The Appeals overruled the 1998 Spokane District Court number ofin-situ melanoma cases is 65% higher than for ruling by Judge McDonald that previously rejected the any previous year. The prostate cancer incidence rate is claims of most of the plaintiffs, and remanded the case the highest it has been since the spike in prostate cancer back to District Court for trial, based on Plaintiffs rates in 1990-1993 due to prostate-specific antigen scientific briefs showing significantly more particulate screening. -
Nuclear Propulsion
16 Nuclear Propulsion Claudio Bruno DIMA, University of Rome (La Sapienza), Roma Italy 1. Introduction Nuclear propulsion (NP) concepts go back to the very end of WW II. Scientists informed about the effects of the US atomic bomb thought of exploiting its energy release for applications like commercial electric power generation, but also rockets and space flight [Shepherd and Cleaver, 1948, 1949; Bussard and DeLauer, 1958]. However, space flight was still considered science fiction, and the military had to deal with more concrete things, like the Cold War. Thus, besides power generation, second stages of ICBM, submarine propulsion, long range and long duration airplanes and missiles became the focus of nuclear energy applications. It was the second-stage and airplane application that drove R&D in nuclear propulsion. With the advent of reliable ICBM (the Atlas missile) and lighter fission and thermonuclear warheads, a nuclear-powered second stage became no longer necessary. Airplane applications were found impractical: the Convair NB-36 required such a heavy lead shield for the crew that testing and operation were much restricted. Nuclear-powered missiles were easier to design, e.g., project PLUTO, but still far more complicated compared to conventional. The Soviets investigated airplanes and rockets powered by nuclear power as well, and discarded them too. The history of NP can be found in [Czysz and Bruno, 2009, Chapter 7; Lawrence, 2008; Lawrence et al, 1995; Gunn and Ehresman, 2003; Dewar, 2004] and will not be reported here. Basic technology is also discussed in the references above, in particular reactor design is in [Lawrence et al, 1995]. -
Fact Sheet on U.S. Nuclear Powered Warship (NPW) Safety
Fact Sheet on U.S. Nuclear Powered Warship (NPW) Safety 1. Commitments of the U.S. Government about the Safety of U.S. NPWs U.S. Nuclear Powered Warships (NPWs) have safely operated for more than 50 years without experiencing any reactor accident or any release of radioactivity that hurt human health or had an adverse effect on marine life. Naval reactors have an outstanding record of over 134 million miles safely steamed on nuclear power, and they have amassed over 5700 reactor-years of safe operation. Currently, the U.S. has 83 nuclear-powered ships: 72 submarines, 10 aircraft carriers and one research vessel. These NPWs make up about forty percent of major U.S. naval combatants, and they visit over 150 ports in over 50 countries, including approximately 70 ports in the U.S. and three in Japan. Regarding the safety of NPWs visiting Japanese ports, the U.S. Government has made firm commitments including those in the Aide-Memoire of 1964; the Statement by the U.S. Government on Operation of Nuclear Powered Warships in Foreign Ports of 1964; the Aide-Memoire of 1967; and the Memorandum of Conversation of 1968. Since 1964 U.S. NPWs have visited Japanese ports (i.e., Yokosuka, Sasebo and White Beach) more than 1200 times. The results of monitoring in these ports conducted by the Government of Japan and the U.S. Government, respectively, demonstrate that the operation of U.S. NPWs does not result in any increase in the general background radioactivity of the environment. The U.S. Government states that every single aspect of these commitments continues to be firmly in place. -
Tariff of Fees for Insured Medical Services Regulations (O.I.C. 81-379)
0 Certified to be a true copy of an Order of his Honour the Governor of Nova Scotia in Council made the EXCUTVE coUNCIL Lieutenant 24th day of March A. D. 1981 N. S. Reuhton NOVA scoriA _3i/_’) 81-379 / The Governor in Council on the report and recommendation of the Minister of Health dated the 13th day of March, A... D., 1981, and pursuant to clause (a) of subection (1) of Section 11 of Chapter 8 of the Statutes of Nova Scotia, 1973, the Health Services and Insurance Act, and subsection (3) of Section 4 of Chapter 15 of the Statutes of Nova Scotia, 1973, the Regulations Act, is pleased to: (a) approve and authorize payments by the Health Services and Insurance Commission in respect of the tariff of fees for insured medical services attached to and forming part of the report and recommendation, and marked Schedule “A”, effective for a period of one year, comrnencing.on the 1st day of April, A. D., 1980, at a rate of 85% of the fee so calculated; and (b) order that the publication of this regulation be dispense4 with due to the length of the Schedule attached to and forming part of the report and recommendation. 1-3. H F. G. STEVEiS, Q..C., CLEKOF THE EXECUTIVE COUNCIL. 5/1 SCHEDULE “A” TABLE OF CONTENTS PREAMBLE 2 UNIT VALUE SYSTEM 21 MISCELLANEOUS FEES 22 FAMILY PRACTICE 24 ANAESTHESIA 26 DERMATOLOGY 29 INTERNAL MEDICINE 31 NEUROLOGY 33 PHYSICAL MEDICINE AND REHABILITATION 35 PABDIATRICS 37 PSYCHIATRY 39 DIAGNOSTIC AND THERAPEUTIC PROCEDURES 41 GENERAL SURGERY 51 NEUROSURGERY 75 OBSTETRICS AND GYNAECOLOGY 82 OPHTHALMOLOGY 87 OTOLARYNGOLOGY 92 ORTHOPAEDIC SURGERY 98 PLASTIC SURGERY 116 UROLOGY 124 RADIATION ONCOLOGY 133 PATHOLOGY CONSULTATIONS 134 INDEX 150 —- — — e • r. -
The Nuclear Non-Proliferation Treaty's Obligation to Transfer Peaceful Nuclear Energy Technology: One Proposal of a Technology
Fordham International Law Journal Volume 19, Issue 5 1995 Article 11 The Nuclear Non-Proliferation Treaty’s Obligation to Transfer Peaceful Nuclear Energy Technology: One Proposal of a Technology Seth Grae∗ ∗ Copyright c 1995 by the authors. Fordham International Law Journal is produced by The Berke- ley Electronic Press (bepress). http://ir.lawnet.fordham.edu/ilj The Nuclear Non-Proliferation Treaty’s Obligation to Transfer Peaceful Nuclear Energy Technology: One Proposal of a Technology Seth Grae Abstract This Essay discusses the technology transfer provisions of the Treaty on the Non-Proliferation of Nuclear Weapons (“NPT”) and describes the Radkowsky Thorium Reactor, which is being developed as a peaceful nuclear energy technology. THE NUCLEAR NON-PROLIFERATION TREATY'S OBLIGATION TO TRANSFER PEACEFUL NUCLEAR ENERGY TECHNOLOGY: ONE PROPOSAL OF A TECHNOLOGY Seth Grae* INTRODUCTION The Treaty on the Non-Proliferaticn of Nuclear Weapons ("NPT")1 is the main document in the international effort to stop the proliferation of nuclear weapons. As stated in the pre- amble of the NPT, "proliferation of nuclear weapons would seri- ously enhance the danger of nuclear war," and devastation "would be visited upon all mankind by a nuclear war."' The NPT calls for a halt to proliferation of nuclear weapons and tech- nology and also calls for the transfer of "peaceful" nuclear en- ergy technology. This Essay discusses the technology transfer provisions of the NPT and describes the Radkowsky Thorium Re- actor, which is being developed as a peaceful nuclear energy technology. I. BACKGROUND TO THE RADKOWSKY THORIUM REACTOR A. The Treaty on the Non-Proliferationof Nuclear Weapons Obligation to Transfer Peaceful Nuclear Energy Technology Article IV(1) of the NPT asserts that parties to the NPT have an "inalienable right" to develop, research, produce, and use nu- clear energy for peaceful purposes. -
Table of Contents
TABLE OF CONTENTS 4 GENERAL INFORMATION ABOUT THE MEETING Communications at the 4 Registration Information SAGES Meeting 6 SCHEDULE AT A GLANCE 8, 10 SAGES Meeting Leaders You will be able to reach the world and the world will be able to reach you while you are in attendance at the 12 Wednesday, March 31, 2004 Program SAGES meeting. 19 Thursday, April 1, 2004 Program Option 1: 31 Friday, April 2, 2004 Program A message can be left for you at either of the following 40 Saturday, April 3, 2004 Program phone numbers. A fax message can be sent using the number below. The phone or fax message will be posted for you on 2004 HANDS-ON COURSES SAGES Message Board outside the Main Session Room. 16 Advanced Laparoscopic Techniques Registration: 303-228-8293 20 Surgeons in the Digital Age SAGES On-Site Office: 303-228-8291 2004 POSTGRADUATE COURSES SAGES On-Site Office Fax: 303-228-8292 14 Complications in Bariatric Surgery and Option 2: How to Manage Them Five email stations will be available at which attendees 22 Top to Bottom: GERD can check and send email. Two stations will be placed in the Exhibit hall, one in the Olympus booth (309) and one 24 Top to Bottom: Colon adjacent to booth 230. An additional two stations will be 26 Minimally Invasive Surgery in HPB Tumors located outside the Main Session room. A final station will be located in the Foundation Donors booth (accessible to 17 Primer on Establishing and Running a MIS/GI Foundation donors only). Fellowship Program 18 Evening Video Session 21 Allied Health Professionals Course Thanks to our 28 RESIDENT & FELLOW SCIENTIFIC SESSION Corporate Supporters! 30 Industry Education Events Platinum Level Donors 31 Industry Breakfast 32 2004 SCIENTIFIC SESSION Auto Suture Ethicon Endo-Surgery, Inc. -
Hospital and Day Surgery 2017 National Institute for Health Development
Hospital and day surgery 2017 National Institute for Health Development Hospital and day surgery 2017 Merike Rätsep Tallinn 2019 The mission of the National Institute for Health Development is to create and share knowledge for influencing the attitudes, behaviour, policies and the environment with evidence-based information with an aim of improving the well-being of the people in Estonia. When using the information presented in this report, refer to the publication. Recommended reference: Rätsep M. Hospital and day surgery 2017. Tallinn: National Institute for Health Development; 2019. Contents Definitions ................................................................................................................................................................................................. 4 Abbreviations .......................................................................................................................................................................................... 4 Summary .................................................................................................................................................................................................... 5 Introduction ............................................................................................................................................................................................. 6 1 Results .................................................................................................................................................................................................. -
NAVY Safety & Occupational Health Manual OPNAV M-5100.23 of 5 Jun
OPNAV M-5100.23 5 Jun 2020 NAVY SAFETY AND OCCUPATIONAL HEALTH MANUAL THIS PAGE INTENTIONALLY LEFT BLANK THIS PAGE INTENTIONALLY LEFT BLANK OPNAV M-5100.23 5 Jun 2020 TABLE OF CONTENTS SECTION A. SAFETY MANAGEMENT SYSTEM Chapter 1. INTRODUCTION A0101. Purpose……………………………………………………………………..... A1-2 A0102. Scope and Applicability……………………………………………………… A1-2 A0103. Definition of Terms………………………………………………………….. A1-4 A0104. Background…………………………………………………………………... A1-4 A0105. Discussion……………………………………………………………………. A1-5 A0106. Introduction to the Navy SMS Framework………………………………….. A1-6 A0107. Responsibilities………………………………………………………………. A1-7 Chapter 2. POLICY AND ORGANIZATIONAL COMMITMENT A0201. Introduction………………………………………………………………….. A2-1 A0202. Methodology………………………………………………………………… A2-1 A0203. Organizational Commitment and Accountability…………………………… A2-3 A0204. Appointment of SMS Personnel……………………………………………… A2-4 Chapter 3. RISK MANAGEMENT A0301. Introduction………………………………………………………………….. A3-1 A0302. Methodology………………………………………………………………… A3-1 A0303. Error Tolerance……………………………………………………………… A3-1 A0304. Principles…………………………………………………………………..... A3-2 A0305. Requirements………………………………………………………………… A3-3 Chapter 4. ASSURANCE A0401. Introduction………………………………………………………………….. A4-1 A0402. Methodology………………………………………………………………… A4-1 A0403. Requirements……………………………………………………..................... A4-1 A0404. Continuous Improvement………………………………………………….… A4-2 A0405. Management Review……………………………………………………….... A4-2 Chapter 5. PROMOTION A0501. Introduction………………………………………………………………….. A5-1