scholarly journals Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

2019 ◽  
Vol 29 (5) ◽  
pp. 927-936
Author(s):  
Giovanni Barbanti-Brodano ◽  
Cristiana Griffoni ◽  
Jarkko Halme ◽  
Giuseppe Tedesco ◽  
Silvia Terzi ◽  
...  

Abstract Purpose To investigate whether the World Health Organization Safety Surgical Checklist (SSC) is an effective tool to reduce complications in spinal surgery. Methods We retrospectively evaluated the clinical and radiological charts prospectively collected from patients who underwent a spinal surgery procedure from January 2010 to December 2012. The aim of this study was to compare the incidence of complications between two periods, from January to December 2010 (without checklist) and from January 2011 and December 2012 (with checklist), in order to assess the checklist’s effectiveness. Results The sample size was 917 patients with an average of 30-month follow-up. The mean age was 52.88 years. The majority of procedures were performed for oncological diseases (54.4%) and degenerative diseases (39.8%). In total, 159 complications were detected (17.3%). The overall incidence of complications for trauma, infectious pathology, oncology, and degenerative disease was 22.2%, 19.2%, 18.4%, and 15.3%, respectively. No correlation was observed between the type of pathology and the complication incidence. We observed a reduction in the overall incidence of complications following the introduction of the SSC: In 2010 without checklist, the incidence of complications was 24.2%, while in 2011 and 2012, following the checklist introduction, the incidence of complications was 16.7% and 11.7%, respectively (mean 14.2%). Conclusions The SSC seems to be an effective tool to reduce complications in spinal surgery. We propose to extend the use of checklist system also to the preoperative and postoperative phases in order to further reduce the incidence of complications. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Stéphane Amadéo ◽  
Moerani Rereao ◽  
Aurelia Malogne ◽  
Patrick Favro ◽  
Ngoc Lam Nguyen ◽  
...  

The World Health Organization <em>Suicide trends in at-risk territories</em> study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless – given its importance – the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country.


2012 ◽  
Vol 17 (37) ◽  
Author(s):  
E Kopel ◽  
Z Amitai ◽  
M Savion ◽  
Y Aboudy ◽  
E Mendelson ◽  
...  

A measles outbreak is affecting the Tel Aviv district, Israel, since April 2012. As of 10 September, 99 cases were confirmed, including 63 (64%) migrants of Eritrean and Sudanese origin. All genotyped cases had the African B3 genotype*. The mean age of migrant and non-migrant cases was 6.0±9.6 and 30.2±24.2 years, respectively (p<0.001). The majority of both migrant and non-migrant cases was unvaccinated. This is the second African measles B3 genotype outbreak within the World Health Organization European region in 2012.


2013 ◽  
Vol 11 (2) ◽  
pp. 263-264 ◽  
Author(s):  
Marcelo Vieira

Semen analysis is of paramount importance to study potential male fertility, couple's infertility, the effects of gonadotoxic agents on spermatogenesis and as follow-up test during treatment of male infertility. Since 1987, the World Health Organization proposes the standardization of this test and its reference values based on population-based data. The latest version of the World Health Organization guidelines was published in 2010. It introduced a new methodology that produced new references values, which triggered a discussion that lies inconclusive. We revised the original World Health Organization paper focusing on methodological changes and its results, the new references values and their impact on clinical practice.


2015 ◽  
Vol 7 (2) ◽  
pp. 48-53
Author(s):  
Stéphane Amadéo ◽  
Moerani Rereao ◽  
Aurelia Malogne ◽  
Patrick Favro ◽  
Ngoc Lam Nguyen ◽  
...  

The World Health Organization Suicide trends in at-risk territories study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless – given its importance – the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Aslı Patır Münevveroğlu ◽  
Beyza Ballı Akgöl ◽  
Tuğba Erol

This study assessed the feelings and attitudes of children toward their dentists and their association with oral health. Methods. A questionnaire designed to evaluate the attitudes of children toward dentists and preferences was completed by 200 children and their families. In addition, the children were examined and the World Health Organization (WHO) method was used to obtain dmft and DMFT scores. Results. The mean dmft and DMFT scores were 3.52±2.44 and 1.35±1.29, respectively. Of the children, 92.5% reported that they had visited a dentist before. Of the children who had visited dentists, approximately 71.5% reported that they enjoyed their visits. Of the children, 84% preferred female dentists, 76.5% preferred dentists that wore a colored coat, and 63% preferred a decorated dental clinic over a plain clinic. The mean dmft and DMFT values of children who were afraid of dentists were significantly higher than those of children who were not (P<0.01 and P<0.05, resp.). Conclusion. Children have strong perceptions and preferences regarding the appearance of their dentists and dental clinics. The results of this study might help dentists to improve their delivery of care.


2020 ◽  
Author(s):  
Shadrack Muma ◽  
Stephen Obonyo

Abstract Background: Visual impairment is the partial or complete loss of vision and it is attributed to uncorrected refractive error. In Kenya, little attention has been directed towards children vision and causes of visual impairment. Therefore, this study was designed to investigate the prevalence and causes of visual impairment in the children population of Kenya.Methods: This cross-sectional population-based study included 3400 (1800, 52.9% female) randomly selected children with a mean age of 12 ± 2 years (range 5–16 years). Visual acuity was taken using Snellens chart at 6 meters. Anterior and posterior segment was assessed using slit lamp and indirect ophthalmoscope. The World Health Organization definition formed the baseline for calculating the mean prevalence of visual impairment.Results: Visual acuity measurements were available for 3240 (95.3%) participants. The mean prevalence of visual impairment, based on pin-hole value, using World Health Organization definition, was 1.7 ± 0.3%. The prevalence of visual impairment, based on presenting visual acuity value, was 2.4 ± 0.7%, using the World Health Organization definition. Multivariate analysis demonstrated that the presence of visual impairment on pin-hole, according to World Health Organization definition increased significantly with increasing age (odds ratio 1.230, P=.021) and increased uncorrected refractive error (odds ratio 0.834, P = .032). Cases of uncorrected refractive error remained the main cause for presenting visual impairment. Causes of visual impairment due to presenting visual acuity were nystagmus (14%), amblyopia (24%) and uncorrected refractive error (62%).Conclusion: The prevalence of visual impairment in Kenya is associated with age. Uncorrected refractive error remains the major causes of visual impairment.


2020 ◽  
Author(s):  
Giovanni Barbanti Brodano ◽  
Cristiana Griffoni ◽  
Alessandro Ricci ◽  
Sandra Giannone ◽  
Daniela Francesca Ghisi ◽  
...  

Adverse events in Hospitals are often related to surgery and they represent a relevant problem in healthcare. Different approaches have been introduced during the last decade to address the problem of patient safety, especially in the surgical environment. The teamwork is crucial in all these actions which aim to decrease adverse events and improve clinical outcomes. We analyze in particular the use of adverse events capture systems in spinal surgery and the use of checklist systems, starting from the Surgical Safety Checklist introduced by the World Health Organization (WHO) in 2008.


2006 ◽  
Vol 130 (11) ◽  
pp. 1649-1653
Author(s):  
Walid A. Mourad ◽  
Asma Tulabah ◽  
Adher Al Sayed ◽  
Madras Raja ◽  
Yasser Khafaga ◽  
...  

Abstract Context.—The World Health Organization classification of posttransplant lymphoproliferative disorders divides them into 4 main categories. Objective.—To classify cases of posttransplant lymphoproliferative disorders diagnosed in our institution according to the World Health Organization scheme and correlate the classification and clonality with clinical data. Design.—Cases of posttransplant lymphoproliferative disorders were reviewed. They were classified according to the World Health Organization scheme. Clonality was determined by flow cytometry and/or polymerase chain reaction. Patients' charts were reviewed. Results.—Thirty-one cases were identified. Median age was 33 years. There were 19 cases of kidney, 8 cases of liver, and 4 cases of bone marrow transplant. Immunosuppression consisted of cyclosporin A and prednisone (N = 24) or FK506 and prednisone (N = 7). Twenty cases (63%) were World Health Organization type 3, 7 cases (23%) type 2, 3 cases (6.4%) type 1, and 1 case type 4 posttransplant lymphoproliferative disorder. Ten patients received chemotherapy, 20 patients had reduction of immunosuppression, and 1 had no treatment. Follow-up was available on 25 patients. Seven (43.75%) of 16 with type 3 lesions with available follow-up died of their disease. Five of these patients received reduction of immunosuppression alone. Only 2 of 9 patients with type 3 disease who received chemotherapy died of disease. Two patients with type 2 disease died of unrelated causes. One patient is alive with disease; the remaining patients with types 1 and 2 disease are alive with no disease. Conclusions.—The World Health Organization classification of posttransplant lymphoproliferative disorders is valuable in the identification of subtypes. It helps identify early lesions (1 and 2) requiring reduction of immunosuppression and type 3 disease, which requires chemotherapy from the outset.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shadrack Muma ◽  
Stephen Obonyo

Abstract Background Visual impairment is the partial or complete loss of vision in which the presenting visual acuity lie between 6/18-no perceptions of light. In Kenya, little attention has been directed towards children vision and causes of visual impairment. Therefore, this study was designed to investigate the prevalence and causes of visual impairment in the children population of Kenya. Methods This cross-sectional population-based study included 3400 (1800, 52.9% female) randomly selected children with a mean age of 12 ± 2 years (range 5–16 years). Visual acuity was taken using Snellens chart at 6 m. Anterior and posterior segment was assessed using slit lamp and indirect ophthalmoscope. The World Health Organization definition formed the baseline for calculating the mean prevalence of visual impairment. Results Visual acuity measurements were available for 3240 (95.3%) participants. The mean prevalence of visual impairment based on pin-hole value was 1.7 ± 0.3% using World Health Organization definition. The prevalence of visual impairment based on presenting visual acuity value was 2.4 ± 0.7% using the World Health Organization definition. Multivariate analysis demonstrated that the presence of visual impairment on pin-hole increased significantly with increasing age (odds ratio 1.230, P = .021) and uncorrected refractive error (odds ratio 0.834, P = .032) according to World Health Organization definition. Cases of uncorrected refractive error remained the major cause for presenting visual impairment. Causes of visual impairment due to presenting visual acuity were nystagmus (14%), amblyopia (24%) and uncorrected refractive error (62%). Conclusion The prevalence of visual impairment in Kenya is associated with age. Uncorrected refractive error remains the major causes of visual impairment.


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