Technology and health care : official journal of the European Society for Engineering and Medicine
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Femoral malrotation is a common complication after internal fixation of a femoral shaft fracture. The only valid, objective monitoring method is computer tomography-assisted torsion measurement between the proximal and distal femur; unfortunately, this can only be carried out postoperatively. A difference of 15° compared to the contralateral femur is seen as an indication for revision. ⋯ These methods also allow for navigation-assisted definition of the optimal incision site, intramedullary access, femoral nail and interlocking. The main problem lies in the extra time of surgery, which is due to performing all the steps of the surgery navigated. The solution for this problem is "hybrid navigation", in which the surgeon can select the steps he needs from the navigation system, depending on his experience or surgical technique.
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Technol Health Care · Jan 2012
Impact of enterococcus on immunocompetent and immunosuppressed patients with perforation of the small or large bowel.
The role of enterococcus in intraabdominal infection remains controversial. A retrospective study of 473 patients with bowel perforation was conducted to assess the impact of enterococci on outcome of patients with perforation of the small and large bowel. ⋯ Enterococci seem to play a minor role in uncomplicated intraabdominal infections. Our results suggest that enterococci play a role in the severity of postoperative complications. In particular, detection of enterococci in patients with anastomotic leakage are suggested to be an indicator of severe illness. We found significantly higher rates of E. faecium than described before, but no significant differences in clinical outcome between E. faecalis and E. faecium. When empirical therapy against enterococci is recommended, E. faecalis and E. faecium should both be covered.
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Technol Health Care · Jan 2012
What do patients know about their low back pain? An analysis of the quality of information available on the Internet.
Previous surveys showed a poor quality of the web sites providing health information about low back pain. However, the rapid and continuous evolution of the Internet content may question the current validity of those investigations. The present study is aimed to quantitatively assess the quality of the Internet information about low back pain retrieved with the most commonly employed search engines. ⋯ News web sites were well designed and easy to use, but lacked in validity. The average quality of the hits retrieved by the most commonly employed search engines could be defined as satisfactory and favorably comparable with previous investigations. Awareness of the user about checking the quality of the information remains of concern.
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Technol Health Care · Jan 2012
ReviewPrevention and diagnosis of retained foreign bodies through the years: past, present, and future technologies.
Post operative retained foreign bodies are a rare but recalcitrant problem. We detail reports of interventions over the last two centuries and review the most current interventions using automated data identity capture and computer aided detection. This was one of earliest areas in which multidisciplinary collaboration was achieved in patient safety. This multidisciplinary collaboration was unique because most other initiatives had been internal: among the disciplines working in the OR i.e. surgeons, nurses and anesthesiologists; this collaboration, to achieve optimal patient safety at that point in time was between surgeons and radiologists to ensure a lack of post operative retained foreign bodies.
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Technol Health Care · Jan 2012
Comparative StudyComparison of helicopter and ground emergency medical service: a retrospective analysis of a German rescue helicopter base.
In consideration of rising cost pressure in the German health care system, the usefulness of helicopter emergency medical service (HEMS) in terms of time- and cost-effectiveness is controversially discussed. The aim of the present study was to investigate whether HEMS is associated with significantly decreased arrival and transportation times compared to ground EMS. ⋯ The results of the present study indicate the time-effectiveness of German air ambulance services with significantly decreased transportation times.