...Do Bioprosthetic Heart Valves Pose a Greater Risk than Mechanical Heart Valves in the Development of Infective Endocarditis? Prosthetic heart valves are, undoubtedly, one of the most profound innovations to be introduced into the medical community. In 1961 the Starr-Edwards ball and cage mitral valve became the first commercially available mechanical heart valve. In 1969, the Bjork-Shiley tilting disk valve emerged, which was then followed by the St. Jude Medical bi-leaflet valve in 1977. In addition to the creation of mechanical valves, bioprosthetic valves were also being developed; and in1968 the Hancock and Carpentier-Edwards porcine mitral valve became a popular alternative to the mechanical valve (Wheatley and Will, 2005, p.1). Over the...
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...A Hybrid Operating Suite at Community Medical Center Russell F Stahl, M.D., Carmen Sciandria, CCP, Cassandra Cuesta, BA The Evolution of Treatment of Cardiovascular Disease Surgery for coronary artery disease (CABG), valve repair and replacement, and the treatment of aortic disease, all have a remarkable history of success and evolution. Just as with computer technology, the trend in surgery has been to become smaller, faster and better. The treatment of cardiovascular disease (CVD) is moving towards less invasive and, in many cases, catheter based technologies. First interventional radiologists, then cardiologists, and now cardiac and vascular surgeons have embraced this trend. Clinicians are encouraged by outcomes that appear to be at least as good, albeit with trade-offs, and a high level of patient acceptance. Hybrid operating rooms - rooms combining operating room sterility and functionality with fixed angiography and echocardiographic imaging- are rapidly growing in prevalence and gaining increased interest from hospital administrators. These rooms are used by cardiac surgeons, vascular surgeons, interventional cardiologists, and neuro-interventionalists, and are suited for both open and closed procedures, as well as collaborative “hybrid” procedures. Given the dynamic nature of this room, these investments require thoughtful preparation operationally and logistically, especially when planning for physician and support staff that will work and cover call in this...
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...Title: Pain, Coping and Sleep in Children and Adolescents with Sickle Cell Disease (Quantitative?) Abstract: Purpose The study examined the relationships among pain, pain coping, and sleep, and assessed factors (age, gender, frequency, and intensity of pain) that affect pain, coping, and sleep in children with sickle cell disease ( SCD). Methods Participants (66) were 39 children ( M = 11.5 years) and 27 adolescents ( M = 15.5 years) with SCD who completed an electronic visual analog scale ( eVAS), Pain Coping Questionnaire, and Pittsburg Sleep Quality Index. Results About two-thirds of the children reported pain the previous month. No significant differences were found between pain and age, gender, pain intensity, or frequency. Most children coped with pain by seeking information, problem solving, seeking social support, and positive self-statements. There were significant negative correlations in males between worse pain severity and behavioral distraction and internalizing or catastrophizing. The majority (91.2%) had mild to severe sleep disturbances, with 18.2% requiring sleeping medication three or more times a week. There were no significant differences between sleep and age, gender, pain intensity, or frequency. Conclusion Children with SCD experience pain that affects sleep patterns and the way they cope with pain. Nurses need to concurrently assess pain, coping, and sleep and promote sleep hygiene and positive coping strategies during pain episodes. Graves, J. K....
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...Heart Valve Replacements: Requirements and Evolution Advanced Structural Aspects of Biomaterials Fall 2013 Sonia Travaglini 1 , Hao Ji 1 , Yangxin Chen 1 , Sofia Cafaggi 2 , Britta Berg-Johansen 2 C215 & 2 BioE C222 Advanced Structural Aspects of Biomaterials University of California, Berkeley 1 ME Table of Contents TABLE OF CONTENTS --------------------------------------------------------------------------------------------------------------- II 1. EXECUTIVE SUMMARY----------------------------------------------------------------------------------------------------------- 1 2. ANALYSIS OF STRUCTURAL FUNCTION & REQUIREMENTS OF THE DEVICE ------------------------------ 2 2.1 HEART VALVE DYNAMICS ------------------------------------------------------------------------------------------------------------- 2 2.2 HEART VALVE HEMODYNAMICS ------------------------------------------------------------------------------------------------------ 2 2.4 MATERIAL PROPERTY REQUIREMENTS ----------------------------------------------------------------------------------------------- 3 2.5 BI-LEAFLET HEART VALVES ----------------------------------------------------------------------------------------------------------- 3 3. DESIGN & MATERIAL EVOLUTION ------------------------------------------------------------------------------------------ 4 3.1 DEVICE DESIGN -------------------------------------------------------------------------------------------------------------------------- 4...
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...Security Analysis Edwards Lifesciences Jesse Blair Security Analysis Edwards Lifesciences Jesse Blair 2014 2014 Industry Analysis Medical Appliances and Equipment For this security analysis project I have chosen to research the medical equipment industry that specializes in artificial heart valves and related health products. This industry helps in the repair of cardiovascular diseases and critical care monitoring. There are two different types of artificial heart valves. There is the Tissue heart valve which is commonly given to older patients and it has a lifespan from 10 to 15 years. It is safer for older adults because it has less chance for post operation bleeding which could be fatal. The second type of heart valve is mechanical heart valve which has a lifespan of a patient’s lifetime. This type of valve has a higher risk of bleeding and requires for a patient to take blood thinner medication for the remainder of their life. Top Competitors When it comes to competitors there are three main groups that are leading the way in artificial heart valves and medical equipment. These companies are Edwards Lifesciences, Medtronic, and St. Jude Medical. You can examine the total revenues of the top three competitors on chart 1. Chart 1 Discussing the Competitors Medtronic Inc. Medtronic is the largest of the three competitors with revenues of over 17 billion last year. They are currently in the process of acquiring Covidien, which has been put on hold due...
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...Running Head: TEAM B COURSE PROJECT Team B Course Project Final Draft April 20, 2013 Professor Aimee James DeVry University Abstract Robotic surgery is a described as when a surgeon uses robotic equipment to assist during a surgical procedure. The surgeon manipulates controls which send information to the robotic equipment, telling it what to do. This surgical technology can be used for a wide range of surgical procedures. There are multiple benefits from choosing this type of surgery, but can also cost more than laparoscopic. Robotic surgery has been discussed for over two decades. Over the last decade, it has increased in popularity and applicability. There are many economic concerns over the use of this technology such as the cost versus the applicable use. There are also concerns about the implications the use of this technology will have on the environment, as well as moral and ethical concerns. By providing background information and history of this technology, information on the use of this technology, economical, sociological, and psychological effects and concerns associated with this technology, and information on environmental implications and moral and ethical concerns of this technology, we hope to provide readers a basis to form an educated opinion on the applicability of remote and robotic surgery. Table of Contents Abstract (Jesse Edwards)…...……………………………………………….…………………….ii Introduction (Jesse Edwards)……………………………………………….……………………..1 Description...
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...Cardiovascular Case Study Mr. Smith is a 56-year-old Caucasian man who is being evaluated in the emergency room with progressively worsening chest pain that began 2 hours ago. The patient describes the pain as pressure in the center of his chest. He rates his pain 7/10. He reports the pain is now radiating down his left arm and through to his back, he is diaphoretic, and complaining of shortness of breath. He denies nausea or vomiting. Mr. Smith reports no previous history of chest pain or pressure. He smoked one pack of cigarettes daily for 13 years but quit smoking last year. He denies a family history of heart disease. Upon initial examination he did not have jugular venous distension, no carotid bruits, normal S1 and S2 with an S3 present. No S4 or murmurs auscultated. Lung sounds clear to auscultation bilaterally, bowel sounds normal, all pulses palpable 2+/4, no edema present. Diagnostic data: BP: 165/98 mmHG HR: 96 bpm RR: 30 breaths/min Temp: 37 C SaO2: 96% with 2L/min O2 per nasal cannula Wt:100 kg A 12-lead ECG was performed in the emergency room showed: Normal Sinus Rhythm (NSR) with frequent premature ventricular contractions. ST segment elevation in Leads 1, aVL, and V2 through V6 (3mm). ST segment depression in Leads III and aVF. Q waves in V2 through V4. The chest X-ray revealed slight cardiomegaly with mild congestive heart failure. An echocardiogram reveals an ejection fraction of 30% and mild mitral valve regurgitation. Mr. Smith’s...
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...SITUATION : Arthur, A registered nurse, witnessed an old woman hit by a motorcycle while crossing a train railway. The old woman fell at the railway. Arthur rushed at the scene. 1. As a registered nurse, Arthur knew that the first thing that he will do at the scene is A. Stay with the person, Encourage her to remain still and Immobilize the leg while While waiting for the ambulance. B. Leave the person for a few moments to call for help. C. Reduce the fracture manually. D. Move the person to a safer place. 2. Arthur suspects a hip fracture when he noticed that the old woman’s leg is A. Lengthened, Abducted and Internally Rotated. B. Shortened, Abducted and Externally Rotated. C. Shortened, Adducted and Internally Rotated. D. Shortened, Adducted and Externally Rotated. 3. The old woman complains of pain. John noticed that the knee is reddened, warm to touch and swollen. John interprets that this signs and symptoms are likely related to A. Infection B. Thrombophlebitis C. Inflammation D. Degenerative disease 4. The old woman told John that she has osteoporosis; Arthur knew that all of the following factors would contribute to osteoporosis except A. Hypothyroidism B. End stage renal disease C. Cushing’s Disease D. Taking Furosemide and Phenytoin. 5. Martha, The old woman was now Immobilized and brought to the emergency room. The X-ray shows a fractured femur and pelvis. The ER Nurse would carefully monitor Martha for which of the following...
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...Robotic Surgery To Stay Or Not Too Stay The use of surgical robots has increased greatly and is continuing to grow. Although these robots are already being used they have advantages as well as disadvantages. Surgical robots are only going to improve the outcomes for the patients, surgeons, and hospitals and will keep improving as time goes on, overcoming the disadvantages that are seen today. Many different types of robots are being used to carry out surgical procedures such as the Endowrist, AESOP, Zeus, PROBOT, ROBODOC, SOCRATES and the da Vinci being the most popular. Also there are many specific types of surgical procedures that are being carried out robotically such as urological, gynecological, cardiac, and general surgeries. “Shorter hospital stays, smaller incisions, less blood loss, quicker recovery, less painful, reduced rates of bacterial infections and blood transfusions, eliminating the surgeons hand tremors, more comfort and decrease in fatigue for the surgeon, 3D view, superior suturing skills, reverse fulcrum” are some of the advantages that affect the patient. Disadvantages involved with robot assisted surgery are “high cost, the large size of the robot, lack of compatible instruments and equipment, lengthy set up times, longer operative times, lack of haptic tactile feedback,” but are believed to disappear with more research and time. Surgical robots could be the most successful and most used technology in surgery in the future. “A surgical robot...
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...An Atlas of Surgical Anatomy An Atlas of Surgical Anatomy Surgical commentary by Alain C Masquelet, MD Illustrations by Léon Dorn © 2005 Taylor & Francis, an imprint of the Taylor & Francis Group First published in the United Kingdom in 2005 by Taylor & Francis, an imprint of the Taylor & Francis Group, 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN Tel.: +44 (0) 1235 828600 Fax.: +44 (0) 1235 829000 E-mail: info@dunitz.co.uk Website: http://www.dunitz.co.uk All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. Although every effort has been made to ensure that drug doses and other information are presented accurately in this publication, the ultimate responsibility rests with the prescribing physician. Neither the publishers nor the authors can be held responsible for errors or for any consequences arising...
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...Robotic Surgery Table of Contents Introduction 3 Historical Development of Robotics 4 Political and Legal Influences 6 Economic Considerations 8 Technology in Today’s Culture 10 Environmental Concerns 12 Moral and Ethical Implications 13 Psychological and Sociological Effects 17 Conclusion 18 References 20 Introduction Robotic surgery, or computer-assisted surgery, is the term used to describe the technology of using robotic systems to aid in surgical procedures. It was developed to help surgeons and medical health professionals overcome the human limitations of minimally-invasive surgery and enhance the abilities of the surgeons performing these procedures. It has many benefits to not only surgeons and medical facilities but for the patients as well. After years of development, training, and global awareness of the technology, medical manufacturers of the robots, surgeons, and medical professionals hope the technologies benefits will outweigh and overcome the environmental, financial, legal and ethical controversies. Dr. James McEwen, Dr. Brian Day and a team of engineering students, developed the very first surgical robot in 1983. It was used on March 12, 1984 for an orthopedic surgical procedure in Vancouver, Canada. Over sixty minimally invasive joint surgeries were performed in the first 12 months after the first successful surgery. After this, several other robotic devices were developed. A surgical scrub nurse was created...
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...1. Congenital rubella: a) Has an incubation period of 7-10 days. b) May be complicated by polyarthralgia. c) Rarely causes deafness. d) Is an indication for termination if it occurs in the first two months of pregnancy. e) May cause prolonged jaundice. 2. Recognised causes of delayed bone age include: a) Hypopiturtarism b) Primary hypothyroidism c) Congenital adrenal hypoplasia d) Prolonged corticosteroid therapy e) Tuberculosis 3. Kwashiorkor: a) Hypothermia is a recognized complication T b) Edema is mainly due to protein losing enteropathy. T c) Measles is a recognized precipitant F d) The incidence is highest in the first two month of life F e) The birth of a second child to the mother may be a contributory factor F 4. At the age of eight months a baby can be expected to: a) Roll over from front to back T b) Sit up with a straight back T c) Pick a small bead between thumb and finger T d) Say up to five word clearly F e) Feed himself with a spoon F 5. if a child in the ward's develops measles, the following action are appropriate a) Close the wards to all admissions for one week F b) Actively immunized all the other patients against measles T c) Give gamma globulin to all patients who have not been immunized or had measles T d) Forbid visiting by the parents until the rash has gone F e) Give prophylactic antibiotics to all contacts at home T 6. Convulsion in the first week of life is characteristic of a) Hypocalcaemia T b) Post maturity...
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...Darren & Jenny’s Nursing Study Guide Darren & Jenny Nursing Study Guide Nursing Formulas and Conversions Drugs and Dosage Formulas and Conversions Volume 60 minims = 1 dram = 5cc = 1tsp 4 drams = 0.5 ounces = 1tbsp 8 drams = 1 ounce 16 ounces = 1pt. 32 ounces = 1qt. Weight 60 grains = 1dram 8 drams = 1 ounce 12 ounces = 1 lb. (apothecaries') Household 1tsp = 1tsp = 3tsp = 1tbsp = Household 1tsp=5cc 3tsp=1tbsp 1tbsp=0.5oz or 15cc 2tbsp=1oz or 30cc 1pt.=16oz or 480cc 1qt=32oz or 960cc 1/60 grain=1mg 15 grains=1g 2.2 lbs.=1kg Apothecary 1 dram 60 gtts (drops) 0.5 ounce 0.5 ounce Metric 5cc=1tsp 15cc=1tbsp 30cc=2tbsp(1oz) 1cc=16minims Apothecary 1fl.dram=4cc 4drams=0.5oz 8drams=2tbsp(1oz) 16minims=1cc 500cc=0.5L or 1pt. 1000cc=1L or 1qt. Temp. Conversion C= F-32/1.8 F= 1.8*C-32 2 Darren & Jenny Nursing Study Guide NOTES CARDIOVASCULAR Arterial Ulcer – Pale, deep base, surrounded by tissue that is cool with trophic changes such as dry, soluble skin and loss of hair. Cause by ischemia from inadequate arterial blood supply of oxygen and nutrients . Venous stasis Ulcer – Dark, red base, surrounded by skin that is brown in color with edema. Caused by the accumulation of waste products of metabolism that are not cleared due to venous congestion. Stage I Ulcer – Reddened area with intact skin surface. Management of DVT – Bed rest, limb elevation , relief of discomfort with warm, moist, heat and analgesics (Tylenol, not narcotics) prn. Ambulation is contraindicated...
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...Darren & Jenny’s Nursing Study Guide Darren & Jenny Nursing Study Guide Nursing Formulas and Conversions Drugs and Dosage Formulas and Conversions Volume 60 minims = 1 dram = 5cc = 1tsp 4 drams = 0.5 ounces = 1tbsp 8 drams = 1 ounce 16 ounces = 1pt. 32 ounces = 1qt. Weight 60 grains = 1dram 8 drams = 1 ounce 12 ounces = 1 lb. (apothecaries') Household 1tsp = 1tsp = 3tsp = 1tbsp = Household 1tsp=5cc 3tsp=1tbsp 1tbsp=0.5oz or 15cc 2tbsp=1oz or 30cc 1pt.=16oz or 480cc 1qt=32oz or 960cc 1/60 grain=1mg 15 grains=1g 2.2 lbs.=1kg Apothecary 1 dram 60 gtts (drops) 0.5 ounce 0.5 ounce Metric 5cc=1tsp 15cc=1tbsp 30cc=2tbsp(1oz) 1cc=16minims Apothecary 1fl.dram=4cc 4drams=0.5oz 8drams=2tbsp(1oz) 16minims=1cc 500cc=0.5L or 1pt. 1000cc=1L or 1qt. Temp. Conversion C= F-32/1.8 F= 1.8*C-32 2 Darren & Jenny Nursing Study Guide NOTES CARDIOVASCULAR Arterial Ulcer – Pale, deep base, surrounded by tissue that is cool with trophic changes such as dry, soluble skin and loss of hair. Cause by ischemia from inadequate arterial blood supply of oxygen and nutrients . Venous stasis Ulcer – Dark, red base, surrounded by skin that is brown in color with edema. Caused by the accumulation of waste products of metabolism that are not cleared due to venous congestion. Stage I Ulcer – Reddened area with intact skin surface. Management of DVT – Bed rest, limb elevation , relief of discomfort with warm, moist, heat and analgesics (Tylenol, not narcotics) prn. Ambulation is contraindicated...
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...scrape it when I am putting my shirt on and off. It bothers my wife more than it does me.” BB denies having any other moles that he is concerned with. BB states that he hasn't had any other skin issues such as itching, pain, tingling or redness. BB does think that his skin is somewhat dry. BB states that he has had no skin problems other than a sunburn once in a while. He doesn't know of any allergies or skin reactions other than the normal skin reactions such as poison ivy. BB states that he doesn't notice any significant hair loss. He has not noticed any changes in his nails or nail beds. BB denies any issues with body odor. Past History: BB states that he has never had neck or head injuries. He has never had surgery on his...
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