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Technical Error (technical + error)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

CRITICAL EVALUATION: PATTERNS OF SURGICAL TECHNICAL ERROR

ANZ JOURNAL OF SURGERY, Issue 8 2008
Thomas B Hugh
No abstract is available for this article. [source]

Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality

PEDIATRIC ANESTHESIA, Issue 5 2007
KEN R. CATCHPOLE PhD
Summary Background:, We aimed to improve the quality and safety of handover of patients from surgery to intensive care using the analogy of a Formula 1 pit stop and expertise from aviation. Methods:, A prospective intervention study measured the change in performance before and after the implementation of a new handover protocol that was developed through detailed discussions with a Formula 1 racing team and aviation training captains. Fifty (23 before and 27 after) postsurgery patient handovers were observed. Technical errors and information omissions were measured using checklists, and teamwork was scored using a Likert scale. Duration of the handover was also measured. Results:, The mean number of technical errors was reduced from 5.42 (95% CI ±1.24) to 3.15 (95% CI ±0.71), the mean number of information handover omissions was reduced from 2.09 (95% CI ±1.14) to 1.07 (95% CI ±0.55), and duration of handover was reduced from 10.8 min (95% CI ±1.6) to 9.4 min (95% CI ±1.29). Nine out of twenty-three (39%) precondition patients had more than one error in both technical and information handover prior to the new protocol, compared with three out of twnety-seven (11.5%) with the new handover. Regression analysis showed that the number of technical errors were significantly reduced with the new handover (t = ,3.63, P < 0.001), and an interaction suggested that teamwork (t = 3.04, P = 0.004) had a different effect with the new handover protocol. Conclusions:, The introduction of the new handover protocol lead to improvements in all aspects of the handover. Expertise from other industries can be extrapolated to improve patient safety, and in particular, areas of medicine involving the handover of patients or information. [source]

Disulfide bonds in merozoite surface protein 1 of the malaria parasite impede efficient antigen processing and affect the in vivo antibody response

EUROPEAN JOURNAL OF IMMUNOLOGY, Issue 3 2004
M. Hensmann
Vol. 34(3) 2004, DOI 10.1002/eji.200324514 Due to a technical error, the wrong affiliations were given for C. Moss and V. Lindo. These are correct as given above. See original article http://dx.doi.org/10.1002/eji.200324514 [source]

Ultrasound-guided core needle biopsy of breast masses: How many cores are necessary to diagnose cancer?

JOURNAL OF CLINICAL ULTRASOUND, Issue 7 2007
Clécio, nio Murta de Lucena MD
Abstract Purpose. To investigate the number of cores required to diagnose breast cancer using ultrasound (US)-guided core needle biopsy. Methods. US-guided core biopsy of 150 masses was performed in 144 patients. For each mass, 6 cores were obtained and analyzed separately. The histopathologic diagnosis was classified as benign, malignant, or normal breast tissue. Each core was analyzed separately. For diagnostic purposes, the cases were grouped as follows: group G1 comprised the first core; group G2 comprised the first and second core; group G3 comprised the first 3 cores; up to group G6, which included all 6 cores. The results were also analyzed by tumor size (,2 cm and >2 cm). Results. The sensitivity in the diagnosis of breast cancer was 90.1% in group G1 and 94.1% in the remaining groups (G2,G6). In tumors ,2 cm, the sensitivity was 88.4% for group G1 and 90.7% for the others, whereas for tumors >2 cm the sensitivity was 91.4% for group G1 and 96.6% when 2 or more cores were obtained. Conclusion. It appears that 2 cores are sufficient to diagnose breast cancer in this study population assuming no technical error occurred in US guidance of the needle through the mass. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007 [source]

Effect of the two-wall-stitch mistake upon patency of rat femoral vein anastomosis: Preliminary observations

MICROSURGERY, Issue 4 2004
Marco Pignatti M.D.
Anastomotic patency is believed to be the most important factor in microvascular surgery. The two-wall stitch is a technical error commonly considered to cause thrombosis of the anastomosis, especially on the venous side. In order to demonstrate the real effect on vein patency of the two-wall stitch, the authors performed a standardized mistake after correct microanastomosis on the femoral vein of 15 rats, with one stitch passing through the whole thickness of the two walls of the vein. Traditional correct anastomoses on the contralateral side were used as controls. Patency was assessed at 5, 20, and 60 min and at 24 h by the milking test, and by direct section of the vessel at 24 h. The results showed no statistically significant difference between the two techniques. Histological examination confirmed the clinical judgment about the vessel's patency, and ultrastructural microscopy evidenced only mild signs of endothelial activation. In conclusion, this study indicates that the occasional two-wall stitch does not necessarily increase the risk of venous occlusion in anastomoses of the rat femoral vein. © 2004 Wiley-Liss, Inc. [source]

Relationship between the propagation characteristics of via and microstrip connecting angle

MICROWAVE AND OPTICAL TECHNOLOGY LETTERS, Issue 3 2003
Wusheng Ji
Abstract The microstrip-via-microstrip is a popular interconnect structure in multilayer circuits at microwave frequency. The microstrip connecting angle is an arbitrary angle due to layout and technical error. The relationship between the propagation characteristics of via and the microstrip connecting angle was analyzed by using the Ansoft simulator. The obtained results have important application value for the design of a similar multilayer circuit. © 2003 Wiley Periodicals, Inc. Microwave Opt Technol Lett 38: 225,228, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.11021 [source]

Comparing indirect methods of digit ratio (2D:4D) measurement

AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2009
Christoph J. Kemper
The ratio of the lengths of the second and fourth finger (2D:4D) has been proposed to index prenatal exposure to androgens. Different methods have been utilized to measure digit ratio, however, their measurement precision and economy have not been systematically compared yet. Using different indirect methods (plastic ruler, caliper, computer software), three independent raters measured finger lengths of 60 participants. Generally, measurement precision (intraclass correlation coefficient, technical error of measurement, and relative technical error of measurement) was acceptable for each method. However, precision estimates were highest for the computer software, indicating excellent measurement precision. Estimates for the caliper method were somewhat lower followed by ruler which had the lowest precision. On the contrary, the software-based measurements took somewhat longer to complete than the other methods. Nonetheless, we would favor the use of these tools in digit ratio research because of their relative superior reliability which could be crucial when associations with other variables are expected to be low to moderate or sample size is limited. Software offers several promising opportunities that may contribute to an accurate identification of the proximal finger crease (e.g., zooming, adjusting contrast, etc.). Am. J. Hum. Biol., 2009. © 2008 Wiley-Liss, Inc. [source]

Metric properties of the root-mean-square deviation of vector sets.

ACTA CRYSTALLOGRAPHICA SECTION A, Issue 5 2002
Erratum
A technical error invalidates the proof that the optimal root-mean-square deviation of vector sets induces a metric given in Kaindl & Steipe [Acta Cryst. (1997), A53, 809]. Nevertheless, the conclusions are correct and a revised proof is given in Steipe [Acta Cryst. (2002), A58, 506]. [source]

Knee-heel length measurements in preterm infants: evaluation of a simple electronically equipped instrument

ACTA PAEDIATRICA, Issue 2 2003
E Engström
Aim: To compare and evaluate a mini-knemometer with a simple and inexpensive electronic caliper with regard to precision, handling error (technical error) and estimation of growth velocity. Methods: Thirty-five prematurely born infants, with a median gestational age of 29 (range 24,33) wk and a median birthweight of 960 (range 480,2480) g, were measured on 409 different occasions with both instruments. On each occasion, five independent readings were made. Results: There was no significant difference in precision between the two instruments, when measuring growth velocity over a 4 wk period (median 0.41, range 0.10,0.59 mm d,1). The handling error in this study, calculated as the mean standard deviation, was 0.36 (SD 0.18, coefficient of variation 0.38%) mm for the simple electronic caliper and 0.59 mm for the mini-knemometer. Short-term growth was detectable within 2 d when growth velocity was normal. Conclusion: Longitudinal measurement of lower leg length is a gentle and useful complementary method for assessing growth in preterm infants. An inexpensive electronic caliper is well suited for routine use in clinical practice, with measurements taken once or twice a week. [source]

Monitoring surgical performance: an application to total hip replacement

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2009
David J. Biau MD
Abstract Rationale, aims and objectives, Inadequate surgical implantation of a hip replacement may result in decreased patient satisfaction and reduced implant survival. The objective was to monitor surgical performance in hip replacement. Method, The study took place at a teaching centre. All primary total hip replacements were prospectively included in the series. For each hip replacement, intraoperative technical errors, cup and stem fixation and position, and postoperative complications were recorded. If all items rated were correct, the procedure was considered as correct. The Cumulative Sums (CUSUM) test was used to monitor the performance of the centre. A 90% proportion of successful procedures was considered as adequate performance and a 75% proportion of successful procedures was deemed as inadequate performance. Meetings were conducted to discuss the results of monitoring. Results, Eighty-three total hip replacements were monitored. Overall, 28 procedures (34%) were considered inadequate. The most potent reasons for inadequate performance were cup positioning and stem fixation. The CUSUM test signalled after the second procedure that performance was inadequate. After the first meeting, despite an improvement was seen, the CUSUM test raised an alarm indicating inadequate performance. The study was stopped after the second meeting because of funding reasons before it could be demonstrated that performance had reached the desired level. Conclusion, This study has demonstrated that implementing a dedicated system to monitor surgical performance in a teaching hospital improves the quality of implantation of total hip replacements. Nonetheless, the target of ninety percent of adequate primary total hip replacement could not be reached and efforts should be continued. [source]

Isolated right hepatic vein obstruction after piggyback liver transplantation

LIVER TRANSPLANTATION, Issue 5 2006
Federico Aucejo
The "piggyback" technique for liver transplantation has gained worldwide acceptance. Still, complications such as outflow obstruction have been observed, usually attributable to technical errors such as small-caliber anastomosis of the suprahepatic vena cava, twisting, or kinking. Iatrogenic Budd-Chiari syndrome after piggyback liver transplantation has been reported as a consequence of obstruction involving the entire anastomosis (usually the 3 hepatic veins). Here we describe technical issues, clinical presentation, diagnosis, and treatment of 3 cases in which outflow obstruction affected only the right hepatic vein. In conclusion, all 3 patients developed recurrent ascites requiring angioplasty and/or stent placement across the right hepatic vein to alleviate the symptoms. Liver Transpl 12:808,812, 2006. © 2006 AASLD. [source]

Assessment of the patency of microvascular anastomoses using microscope-integrated near-infrared angiography: A preliminary study

MICROSURGERY, Issue 7 2009
Charlotte Holm M.D., Ph.D.
Background: Technical problems at the site of the anastomosis compromise an underappreciated proportion of microsurgical free tissue transfers. Intraoperative identification of technical errors may be able to prevent reexploration surgery and early flap failure. We report the first human study on a new microscope-integrated fluorescence angiography technique, which allows for intraoperative imaging of the anastomotic site. Methods: Fifty consecutive patients undergoing reconstructive microsurgical procedures were enrolled in the study. Intraoperative near infrared indocyanine green videoangiography (ICGA) was performed on all microsurgical anastomoses, after they had been assessed by the operating surgeon by conventional clinical patency tests. Anastomoses deemed to be occluded by the ICG-angiography were intraoperatively revised, and the result of revision was compared with angiographic findings. Results: In 11/50 (22%) of patients, where the surgeon had classified the anastomoses as patent, microangiography identified a total luminal occlusion (six) and/or significant alterations in blood flow (five), potentially predisposing toward postoperative flap failure. Intraoperative revision confirmed angiographic findings in 100% of cases, and was always associated with flap survival. The decision not to revise despite anastomotic occlusion by the intraoperative angiogram was always followed by flap loss or early reexploration. A delayed return of venous blood from the flap predisposed toward postoperative flap failure. Conclusions: Hand-sewn anastomoses are subject to technical errors, and conventional patency tests have a low sensitivity for revealing anastomotic failure. Microscope integrated microangiography is an excellent method for identifying significant anastomotic problems, which would have otherwise gone unnoticed. The potential impact on early flap failure and reexploration surgery is considerable. © 2009 Wiley-Liss, Inc. Microsurgery 2009. [source]

Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality

CT01 IMPACT OF COMPLETION ANGIOGRAPHY AFTER SURGICAL CORONARY REVASCULARIZATION

ANZ JOURNAL OF SURGERY, Issue 2007
S. Kumar
Background Coronary revascularization surgery does not traditionally employ angiography to assess procedural success. Early graft failure is reported up to 30% in one year (JAMA Nov 2005) may relate to technical errors or conduit problems. We hypothesize that intra-operative assessment of graft by angiography identifies graft defects and may improve the long term graft survival. Methods We have developed one of the first hybrid operation room in the USA. In one year period 203 consecutive patients (age:63+/,16, M/F:126/39) underwent coronary revascularization with angiography before decannulation. Results Of 436 grafts, 72 angiographic defects were detected in 69 grafts (17% of total grafts). There were 11% conduit defects, 3% anastomotic defects, and 3% target vessel error. Of 72 defects, 25/72 defects required minor revision, 47/72 required either surgical or percutaneous intervention. Intra-operative angiography added an average 20+/,12 minutes to the surgery and 112+/,56 ml contrast. Renal function at 24hours and 48 hours after procedure did not vary significantly between patients who did vs. those did not have revisions. There were no significant differences in cardiopulmonary bypass time, aortic cross clamp time, and length of hospital stay for patients who underwent revision compared to those who did not. Renal function, bleeding complication, transfusion were similar in patients with percutaneous vs. surgical revision. Conclusions Intraoperative graft angiography performed at the time of CABG identifies graft defects, allowing for immediate surgical or percutaneous revision. Long-term study is in progress to assess whether intra-operative completion angiography decreases the rate of early graft failure. [source]

In vivo magnetic resonance spectroscopy of gynaecological tumours at 3.0 Tesla

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2009
SJ Booth
Background, Magnetic resonance spectroscopy (MRS) uses the same hardware as MR imaging and allows us to analyse the biochemistry of tissues in vivo. Published data for gynaecological lesions are limited and are largely based on MRS carried out at the lower magnetic field strength of 1.5 Tesla (T). Objective, The purpose of this study was to determine whether in vivo proton MRS could be performed at the higher magnetic field strength of 3 T to characterise the spectra of a variety of benign and malignant gynaecological lesions. Design, Prospective, non-randomised study. Setting, MRI department within a tertiary referral centre for gynaecological cancers. Sample, All women with a pelvic mass under going 3T MRI. Methods, We carried out MRS on nonrandomised women undergoing routine 3 T MRI within our MRI department during investigation for gynaecological lesions from February 2006 to April 2008. Only those women for whom histopathological data were available were included. Main outcome measures, The presence of choline detected by in vivo 3T MRS. Results, Eighty-seven women underwent MRS, 57 of whom had newly diagnosed neoplasms. MRS data for 39 of these new women (18 were excluded because of technical errors or missing data) were used to detect the presence of choline, an indicator of basement membrane turnover. Overall, choline was present in 13 of the 14 ovarian cancers, 8 of the 11 cervical tumours and all 4 of the uterine cancers. There was no statistical significant difference between choline levels in various lesion types (P= 0.735) or between benign and malignant disease (P= 0.550). Conclusions,In vivo MRS can be performed at 3 T to provide biochemical information on pelvic lesions. The way in which this information can be utilised is less clear but may be incorporated into monitoring tissue response in cancer treatments. [source]