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Browsing by Subject "surgery"

Now showing 1 - 5 of 5
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    An Anatomic Analysis Of The Palatal Root Of Maxillary Molars Using Micro-Computed Tomography
    (2018-08) Divine, Katherine
    Introduction: The morphology of the palatal root of maxillary first and second molars was analyzed and compared using micro-computed tomography (mCT) scanning. Methods: Forty-seven maxillary molars were scanned with a mCT device to analyze the palatal radicular dentin dimensions, canal working width, root length, canal curvature, lateral canals, and apical constriction anatomy. Quantitative data were analyzed with mean and standard deviation for first and second molars respectively. Comparison was made between first and second molars using an unpaired t-test. Results/Conclusions: The palatal root of maxillary first molars was found to have statistically significantly thinner dentin than second molars on the palatal aspect of the root 8-11mm from the apex, correlating to the coronal and middle thirds of root. First molar palatal roots also had a statistically significantly wider canal mesio-distally than second molars at 13-15mm from the apex, correlating approximately to the level of the CEJ and pulpal floor. Significant canal curvature was present. These findings suggest need for conservative coronal flaring and instrumentation. The absence of an apical constriction in 76.6% of specimens highlights the importance of creating an apical seat through instrumentation to maintain obturation materials. A minimum master apical file size of 40 is recommended based on pre-operative working widths in the apical 0.5-1.0mm. A root-end resection of 3.5mm would remove a greater majority of lateral canals.
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    Beta Blockers: A Guide for Patients
    (2009-09-18) Sharpe, Emily
    In patients who are at risk for heart disease, beta blockers started during surgery prevented heart attack but increased the risk of stroke and death. The current guidelines that recommend the initiation of beta-blocker therapy in patients having noncardiac surgery should be reevaluated. However, patients who have been treated with beta blockers for a long time should continue their medication throughout the perioperative period.
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    Low dose aspirin should be continued in the perioperative period for patients with cardiac risk factors who are scheduled for non-cardiac surgery
    (2010-11-02) McAdams, Sean
    Low-dose aspirin is strongly recommended for prevention of a heart attack in patients with known cardiac risk factors. These risk factors include previous heart attack, coronary artery disease (CAD), heart failure, poor kidney function, and insulin dependent diabetes mellitus. Patients are commonly instructed to discontinue low-dose aspirin before surgery because of the anti-platelet effect of the drug may increase surgical bleeding and surgical complications. Despite these concerns, there is evidence that patients who take low-dose aspirin prior to surgery have less risk of heart attack, and do not have an increased number of complications from surgical bleeding.
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    Mortality and Cause of Death Following Pediatric Cardiac Surgery for Congenital Heart Defects
    (2021-06) Zmora, Rachel
    Congenital heart defects (CHD) affect almost 1% of births. The primary method for managing these defects is surgery. These analyses used data from the Pediatric Cardiac Care Consortium (PCCC), a large, US-based registry of pediatric interventions for CHDs. The PCCC was previously linked to the National Death Index and was linked to the American Medical Association Physician Masterfile as part of this dissertation. The first two analyses examined the associations between surgeon and center characteristics and post-surgical mortality using multilevel modeling. These analyses examined procedure-specific volume at the surgeon and center levels as well as training center status at the center level and years since graduation from medical school at the surgeon level. In the third analysis, multiple cause of death data were examined to determine the burden of contributing causes of death. Standardized mortality ratios and competing risk Cox regression compared these results with those calculated using underlying cause of death. The first analysis found that after adjusting for known patient-level risk factors, center factors including procedure-specific volume were not associated with early post-discharge mortality. The second analysis of short and medium term mortality demonstrated a consistent center-level association between procedure-specific volume and mortality among several complex repairs. No association was observed among patients with relatively simple ventricular septal defect repairs. Finally, we found that standardized mortality ratios based on underlying cause of death underestimated the burden of death associated with injury as well as perinatal, infectious, endocrine, genitourinary, and circulatory diseases. These differences varied by age and defect severity. Perinatal and endocrine disease were highest among those with severe defects. Differences in mortality due to infection showed a bimodal association with age at the time of death. The combination of multi-level modeling and multiple cause of death methods leveraged in these analyses advances the understanding of the roles of healthcare systems and multiple causes of death.
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    Surgical Action Predicates with Mapping
    (2012-10-31) Wang, Yan; Pakhomov, Serguei; Melton, Genevieve
    The ‘procedure description’ section in operative note contains a significant amount of description of actions performed during an operation. The action predicates (e.g., fill, incision, irrigate, etc.) encode predicative relations between nominal arguments (e.g., chamber, viscoelastic, Murphy hook, L5 root, antibiotic solution). These predicate arguments convey the important details about actions performed during a procedure. This dataset includes frequent action predicates collected from 362,310 operation narratives obtained from University of Minnesota-affiliated Fairview Health Services with the UMLS and SPECIALIST lexicon mapping.