Augmentation Of Human Skill In Microsurgery

Surgeons performing highly skilled microsurgery tasks can benefit from information and manual assistance to overcome technological and physiological limitations to make surgery safer, efficient, and more successful. Vitreoretinal surgery is particularly difficult due to inherent micro-scale and fragility of human eye anatomy. Additionally, surgeons are challenged by physiological hand tremor, poor visualization, lack of force sensing, and significant cognitive load while executing high-risk procedures inside the eye, such as epiretinal membrane peeling. This dissertation presents the architecture and the design principles for a surgical augmentation environment which is used to develop innovative functionality to address the fundamental limitations in vitreoretinal surgery. It is an inherently information driven modular system incorporating robotics, sensors, and multimedia components. The integrated nature of the system is leveraged to create intuitive and relevant human-machine interfaces and generate a particular system behavior to provide active physical assistance and present relevant sensory information to the surgeon. These include basic manipulation assistance, audio-visual and haptic feedback, intraoperative imaging and force sensing. The resulting functionality, and the proposed architecture and design methods generalize to other microsurgical procedures. The system's performance is demonstrated and evaluated using phantoms and in vivo experiments

Textbook of Patient Safety and Clinical Risk Management

Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties

Pain Management

Pain Management - Current Issues and Opinions is written by international experts who cover a number of topics about current pain management problems, and gives the reader a glimpse into the future of pain treatment. Several chapters report original research, while others summarize clinical information with specific treatment options. The international mix of authors reflects the "casting of a broad net" to recruit authors on the cutting edge of their area of interest. Pain Management - Current Issues and Opinions is a must read for the up-to-date pain clinician

Clamp-assisted retractor advancement for lower eyelid involutional entropion

Scientific Poster 144PURPOSE: To describe a novel approach to internal repair of lower lid entropion using the Putterman clamp. METHODS: Retrospective, consecutive case series of patients with entropion who underwent retractor advancement using the clamp. RESULTS: Seven eyes of 6 patients (average age: 80; 4 women and 2 men) were analyzed. Complete resolution was achieved in 5 of the 6 patients (83.3%). The 1 patient with recurrence had 2 previous entropion surgeries on each eye over the past 4 years; there was lid laxity, and horizontal tightening was needed. No severe adverse events occurred in the patients. CONCLUSION: Clamp-assisted lower lid retractor advancement offers a safe and effective, minimally invasive approach to involutional entropion. Further study is needed to assess its role in recurrent entropion.postprin

Space Biology and Medicine

Volume IV is devoted to examining the medical and associated organizational measures used to maintain the health of space crews and to support their performance before, during, and after space flight. These measures, collectively known as the medical flight support system, are important contributors to the safety and success of space flight. The contributions of space hardware and the spacecraft environment to flight safety and mission success are covered in previous volumes of the Space Biology and Medicine series. In Volume IV, we address means of improving the reliability of people who are required to function in the unfamiliar environment of space flight as well as the importance of those who support the crew. Please note that the extensive collaboration between Russian and American teams for this volume of work resulted in a timeframe of publication longer than originally anticipated. Therefore, new research or insights may have emerged since the authors composed their chapters and references. This volume includes a list of authors' names and addresses should readers seek specifics on new information. At least three groups of factors act to perturb human physiological homeostasis during space flight. All have significant influence on health, psychological, and emotional status, tolerance, and work capacity. The first and most important of these factors is weightlessness, the most specific and radical change in the ambient environment; it causes a variety of functional and structural changes in human physiology. The second group of factors precludes the constraints associated with living in the sealed, confined environment of spacecraft. Although these factors are not unique to space flight, the limitations they entail in terms of an uncomfortable environment can diminish the well-being and performance of crewmembers in space. The third group of factors includes the occupational and social factors associated with the difficult, critical nature of the crewmembers' work: the risks involved in space flight, changes in circadian rhythms, and intragroup interactions. The physical and emotional stress and fatigue that develop under these conditions also can disturb human health and performance. In addition to these factors, the risk also exists that crewmembers will develop various illnesses during flight. The risk of illness is no less during space flight than on Earth, and may actually be greater for some classes of diseases

New Insight into Cerebrovascular Diseases

“Brain circulation is a true road map that consists of large extended navigation territories and a number of unimagined and undiscovered routes.” Dr. Patricia Bozzetto Ambrosi This book combines an update on the review of cerebrovascular diseases in the form of textbook chapters, which has been carefully reviewed by Dr. Patricia Bozzetto Ambrosi, Drs. Rufai Ahmad and Auwal Abdullahi and Dr. Amit Agrawal, high-performance academic editors with extensive experience in neurodisciplines, including neurology, neurosurgery, neuroscience, and neuroradiology, covering the best standards of neurological practice involving basic and clinical aspects of cerebrovascular diseases. Each topic was carefully revised and prepared using smooth, structured vocabulary, plus superb graphics and scientific illustrations. In emphasizing the most common aspects of cerebrovascular diseases: stroke burden, pathophysiology, hemodynamics, diagnosis, management, repair, and healing, the book is comprehensive but concise and should become the standard reference guide for this neurological approach

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery