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The article focuses on the environmental impact of orthopaedic surgery and emphasizes the need for sustainable practices in the operating room. Topics discussed include the large carbon footprint of surgical procedures, the primary sources of greenhouse gas emissions in operating rooms, and strategies for reducing energy consumption and waste generation.

Objectives: The objectives are to compare lead blood concentrations in veterinary workers using lead shielding with concentrations in a control population, to measure hand surface lead before and after use of shielding, and to compare hand surface lead with and without the use of disposable gloves worn under hand shielding. Methods: Blood and hand wipe samples were analyzed for lead using inductively coupled plasma mass spectrometry. Results: There was no difference in blood lead between exposed and control groups. After lead glove use, 69% (18/26) of hand surface lead samples from workers not using disposable gloves were greater than 500 μg, 42% (11/26) were greater than 1000 μg, and 12% (3/26) were greater than 2000 μg. Conclusions: If lead shielding use is unavoidable, disposable gloves should be worn, and skin should be decontaminated after use. [ABSTRACT FROM AUTHOR]

The article focuses on minimizing risk of infection when using developmental and psychological assessment tools. Topics discussed include aims to share such measures implemented within a developmental and behavioral pediatrics (DBP) clinic in Singapore; and describes measures taken in the authors' clinic to reduce contamination when performing developmental and psychological assessments.

Background and Objectives: Operating room costs contribute significantly to the overall expenditure for inpatient care. We evaluated a simple way to reduce urology operating room costs by limiting the loss from unused disposable items. Methods: Baseline data were collected on opened and unused disposable items. Surgeons were asked to edit their preference cards and mark optional surgical items that would only be opened if requested. Results: The cost of unused disposable items during the first 4 weeks in 3 operating rooms averaged $410/week. Costs after implementing the intervention declined to an average of $30/week. This yielded $380/week in savings, equating to a 92% reduction in waste, and a potential savings of $19 760 annually in the 2 urology operating rooms alone. Conclusion: Since the urology department represents only 10% of the main operating rooms at our institution, if other operating rooms implemented similar cost saving methods the hospital could potentially accrue significant savings. [ABSTRACT FROM AUTHOR]

Background: Research and history have largely shown the covert billion-dollar global market of single-use medical device (SUD) reprocessing and reuse to be a safe endeavor, but awareness and perceptions of the practice both within and outside of healthcare have received limited attention. Methods: Responses for patients, physicians, and medical practitioners were attained on both online and article-based surveys, in which attitudes and perceptions of SUD reprocessing and reuse were expressed in an assortment of closed-ended questions and partially closed-ended questions. Results: Of the 214 participants, a collective 77% were unaware that the Food and Drug Administration allows SUD reprocessing and reuse. This included 65% of physicians and 84% of patients, which were significantly different proportions (P  = 0.005). A significantly greater proportion of patients than physicians (92 vs. 68%) also felt that hospitals bear the responsibility of informing patients of the practice as part of their care (P  < 0.001). Conclusion: There is a profound lack of awareness of SUD reprocessing and reuse among all relevant stakeholders. In addition, the overwhelming desire for transparency among patients further forces the debate of whether current, covert methods should be altered, in addition to the question of who bears this responsibility. Despite research and history having shown the practice to be safe, apprehension and misconceptions remain. Survey results suggest that education may be able to subdue such patient concerns. What is known about the topic? The efficacy and safety of SUD reprocessing and reuse. The prevalence of SUD reprocessing and reuse. The economic and environmental benefits of SUD reprocessing and reuse. What does this article add? Significant insight into patient perception of SUD reprocessing and reuse, and consequent discussion of the ethics relating to this practice. Insight into the discrepancy of perceptions between healthcare professionals performing the SUD reprocessing and reuse, perceptions of the patients that these products are being used on, and reality. A comprehensive review of current safety record data and prevalence of this practice. [ABSTRACT FROM AUTHOR]

Background: Common standard practice after complex arthroscopic elbow surgery includes hospital admission for 72 h. The authors hypothesized that an expedited care pathway, with 24 h of hospital admission and ambulatory brachial plexus analgesia and continuous passive motion at home, results in equivalent elbow range of motion (ROM) 2 weeks after surgery compared with standard 72-h hospital admission.Methods: A randomized, single-blinded study was conducted after obtaining approval from the research ethics board. Forty patients were randomized in a 1:1 ratio using a computer-generated list of random numbers into an expedited care pathway group (24-h admission) and a control group (72-h admission). They were treated equally aside from the predetermined hospital length of stay.Results: Patients in the control (n = 19) and expedited care pathway (n = 19) groups achieved similar elbow ROM 2 weeks (119 ± 18 degrees and 121 ± 15 degrees, P = 0.627) and 3 months (130 ± 18 vs. 130 ± 11 degrees, P = 0.897) postoperatively. The mean difference in elbow ROM at 2 weeks was 2.6 degrees (95% CI, -8.3 to 13.5). There were no differences in analgesic outcomes, physical function scores, and patient satisfaction up to 3 months postoperatively. Total hospital cost of care was 15% lower in the expedited care pathway group.Conclusion: The results suggest that an expedited care pathway with early hospital discharge followed by ambulatory brachial plexus analgesia and continuous passive motion at home is a cost-effective alternative to 72 h of hospital admission after complex arthroscopic elbow surgery. [ABSTRACT FROM AUTHOR]

The article presents a study on the short and long-term performance of reusing pacemakers. It provides a comparison between study group and control group patients who received resterilized pacemakers and new ones respectively. It mentions that reusing such devices is considered safe and feasible as well as a viable choice for patients suffering from bradyarrhythmias.

Changes reflect replenished stockpiles of approved equipment. [ABSTRACT FROM AUTHOR]

Focuses on the prevalence of the reuse of single-use orthopedic devices in response to environmental and economic pressure in the U.S. Reduction of reimbursement for managed care and Medicare in the country; Size of the market for reprocessing of single-use devices; Cost-effectiveness and efficacy of the devices in orthopedics.

BACKGROUND. Foam sclerotherapy is an increasingly popular modality in the treatment of varicose veins. Worldwide, the most popular agents used are sodium tetradecyl sulfate (STS) and polidocanol (POL). The double-syringe system technique to make foam out of a sclerosing solution and air has received wide attention for its ease and reproducibility. This study examined the possibility that the relative silicone content of various disposable connectors may affect overall foam stability. We also evaluated the differences in the stability of foam between STS and POL. MATERIALS AND METHODS. In the first part of the study, one nondispos able stainless steel connector and five disposable plastic connectors were used to create foam from STS 0.50% and air. The procedure was then repeated to produce foam from POL 0.50% and air from each of the six different connector types. As a measure of foam stability, once foam was created with each type of connector, the time required for half of the original volume of sclerosing solution to settle was recorded. In the second part of the study, foam was created with a nondispo sable stainless steel connector only and various concentrations of STS and POL. Foam stability was then measured for these different concentrations of sclerosants. RESULTS. The time for sclerosing solution to settle to half of its initial volume was found to vary according to the specific sclerosant and concentration used, with no statistically significant variation based on connector type. CONCLUSIONS. The type of connector used in the double- syringe system technique to produce foam for sclerotherapy is not a factor in foam stability. Sclerosing solutions differ in their foaming stability. [ABSTRACT FROM AUTHOR]

The article informs that the reprocessing of single-use instruments have become common and that studies have found a significant rate of physical defects, performance issues and improper decontamination on re-processed single-use devices. It suggests that it is the ethical responsibility if the surgeon is to make a good faith effort to know whether these devices are to be used. The article also comments that physicians should be informed if these devices are used in gynecologic surgery.

The article offers pharmaceutical news briefs in the U.S. as of June 1, 2015. The Food and Drug Administration (FDA) expresses concerns on the risk of infection when multidose diabetes pen devices are used to treat multiple patients. An oral medication known as Palbociclib has been available for postmenopausal women with human epidermal growth factor receptor 2-negative metastatic breast cancer. FDA also approved a drug to treat complicated intraabdominal and urinary tract infections.

The article outlines the evidence for making proper patient bathing practices a priority by nurses. It discusses two basic options for bathing adult patients using soap and water and/or chlorhexidine gluconate (CHG) solution, or premoistened cloths containing a cleaning agent or CHG. It states the advantages of using CHG solutions during bathing of patients.

Background: Supraglottic airway devices commonly are used for securing the airway during general anesthesia. Occasionally, intubation with an endotracheal tube through a supraglottic airway is indicated. Reported success rates for blind intubation range from 15 to 97%. The authors thus investigated as their primary outcome the fraction of patients who could be intubated blindly with an Air-Qsp supraglottic airway device (Mercury Medical, USA). Second, the authors investigated the influence of muscle relaxation on air leakage pressure, predictors for failed blind intubation, and associated complications of using the supraglottic airway device.Methods: The authors enrolled 1,000 adults having elective surgery with endotracheal intubation. After routine induction of general anesthesia, a supraglottic airway device was inserted and patients were ventilated intermittently. Air leak pressure was measured before and after full muscle relaxation. Up to two blind intubation attempts were performed.Results: The supraglottic airway provided adequate ventilation and oxygenation in 99% of cases. Blind intubation succeeded in 78% of all patients (95% CI, 75 to 81%). However, the success rate was inconsistent among the three centers (P < 0.001): 80% (95% CI, 75 to 85%) at the Institute of Anesthesia and Pain Therapy, Kantonsspital Winterthur, Winterthur, Switzerland; 41% (95% CI, 29 to 53%) at the Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland; and 84% (95% CI, 80 to 88%) at the Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland. Leak pressure before relaxation correlated reasonably well with air leak pressure after relaxation.Conclusions: The supraglottic airway device reliably provided a good airway and allowed blind intubation in nearly 80% of patients. It is thus a reasonable initial approach to airway control. Muscle relaxation can be used safely when unparalyzed leak pressure is adequate. [ABSTRACT FROM AUTHOR]

The article discusses the contraindications for nasopharyngeal airway (NPA) insertion. NPA is a short uncuffed tube, inserted nasally along the floor of the nasopharynx past the base of the tongue to maintain a patent airway. The NPA prevents the patient's tongue from occluding the airway. However, there are contraindications to placing an NPA and they include traumatic brain injury (TBI) or central facial fractures, anticoagulant therapy, coagulopathic disorders and transsphenoidal surgery. INSET: Sizing up an NPA.

The article focuses on the report of the National Institute for Occupational Safety and Health (NIOSH) which states that approximately one-third of the disposable hospital isolation gowns it tested failed to meet industry standards. It mentions that seven out the 22 different gowns evaluated for seams, fabrics, and ties did not meet the performance standard for protective apparel set by the American National Standards Institute and the Association for the Advancement of Medical Instrumentation.

The article reports on the debate on whether or not reprocessed single-use devices are safe or not. Congressman Tom Davis has asked the U.S. Food and Drug Administration for a detailed explanation of its regulation on the reprocessing industry and measures to ensure the safety and efficacy of such devices. Reprocessed medical devices have the advantage of substantially reducing costs and medical waste.

Tattooing is a commonly used procedure for camouflage of depigmented lesions, especially in vitiligo. To find a cheap and effective instrument for manual tattooing. A watchmaker's pin-vise has been described for use as an instrument along with sewing needles for tattooing in vitiligo. A watchmaker's pin-vise is a cheap and effective for manual tattooing of vitiligo. A watchmaker's pin-vise loaded with sewing needles is an effective, cheap, and sterilizable instrument for tattooing. Sewing needles can be used as disposable needles. A. SINGAL, MD, G. P. THAMI, MD, AND M. BHALLA, MD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [ABSTRACT FROM AUTHOR]

Provides information on the Frullini method, a technique in producing sclerosing foam (SF) in a disposable syringe. Properties of SF; Difference between liquid solution and foam; Reduction in the possibility of contamination.

The article discusses concerns about the use of reusable surgical instruments by dermatology surgeons in Great Britain. The results of a survey that examined the sharpness, size and grip of reusable surgical instruments are presented. The authors also share their positive experience of using disposable instruments for dermatologic surgery.

The article focuses on medication errors. It discusses mistaken letters and numerals in handwritten drug prescription and the susceptibility of cursive writing to illegibility and misinterpretation. It outlines the reuse of insulin pen by practitioners and the errors practitioners commit when administering vaccines such as the two-component vaccine Menveo.

The article focuses on the statement from nonprofit organization The Joint Commission (TJC) regarding the patients who were harmed by the wrong use of single- and multiple-dose drug vials in both inpatient and outpatient settings

Examines the risk of reusing blood tube holders. Case study of a nurse who was exposed to pathogens due to the practice; Recommendations on the use of blood tube holders.

Discusses the plans of the United States Food and Drug Administration (FDA) to regulate all parties who reprocess medical devices labeled for single use only. List of reused devices and their risk levels; Brief overview of the FDA guidelines.

Presents a patient-care product survey focusing on disposable suction catheters. Features that can affect patient care; Pros and cons of related products. INSETS: THE IDEAL SUCTION CATHETER;TIPS TO HELP YOU IMPROVE YOUR SUCTIONING TECHNIQUE.