First Aid Treatment of Electric Shock

The mode of death was determined in the 82 electrocutions as being either asphyxial or cardiac in type. Using the information obtained from the electrocutions, the functional response in the 7,724 electrical accidents was determined. From this, the relative success of the first aid treatments was decided.

External cardiac massage with mouth-to-mouth artificial respiration was a failure even when applied to the cases with ventricular fibrillation. Only four cases of recovery from ventricular fibrillation following electric shock are known. Mouth-to-mouth artificial respiration compared very unfavorably with the older manual methods.

It is recommended that the first aid treatment of electric shock be reevaluated. The recommended treatment should consist of two blows on the chest followed by a manual method of artificial respiration. In electric shock, external cardiac massage with mouth-to-mouth artificial respiration should not be recommended for use by first aid personnel.     

Getting to Zero: Evidence‐based healthcare risk management is key

In this article we call for a new approach to patient safety improvement, one based on the emerging field of evidence‐based healthcare risk management (EBHRM). We explore EBHRM in the broader context of the evidence‐based healthcare movement, assess the benefits and challenges that might arise in adopting an evidence‐based approach, and make recommendations for meeting those challenges and realizing the benefits of a more scientific approach.     

Development of an Anthropomorphic Shoulder Phantom Model That Simulates Bony Anatomy for Sonographic Measurement of the Acromiohumeral Distance

The purpose of this project was to create a sonographic phantom model of the shoulder that was accurate in bone configuration. Its main purpose was for operator training to measure the acromiohumeral distance. A computerized 3‐dimensional model of the superior half of the humerus and scapula was rendered and 3‐dimensionally printed. The bone model was embedded in a gelatin compound and set in a shoulder‐shaped mold. The materials used had speeds of sound that were well matched to soft tissue and epiphyseal bone. The model was specifically effective in simulating the acromiohumeral distance because of its accurate bone geometry.     

Ambulatory bio-feedback for stress incontinence exercise regimes: a novel development of the perineometer

Stress incontinence is a debilitating condition affecting a large proportion of the female population. Pelvic floor exercising with the aid of bio-feedback is well established as an effective treatment regime. However, current monitoring devices are restrictive in the way they may be employed in community-based therapy. A prototype unit is described, which is both compact and accurate and suitable for ambulatory monitoring of vaginal pressure. This device is suitable for self-help domiciliary regimes and may also be used as an accurate yardstick to judge individual response to therapy. Conceptual changes in health-care provision are leading to greater emphasis on community-centred care for non-acute conditions such as stress incontinence. Development of more appropriate scientific and technological support is likely to have a fundamental role in the success of such schemes.     

The Effects of the Odstock Drop Foot Stimulator on Perceived Quality of Life for People With Stroke and Multiple Sclerosis

Introduction. Gait speed is often used as a proxy for gait quality. However, some users of FES devices for correction of dropped foot choose to continue to use the device despite no significant change in speed. The Psychosocial Impact of Assistive Devices Scale (PIADS) was used to evaluate the effects of the Odstock Dropped Foot Stimulator (ODFS) on perceived quality of life (QOL) for people with stroke and multiple sclerosis (MS) and was compared with change in walking speed. Method. A total of 21 people with stroke and 20 with MS completed the PIADS questionnaire after 18 weeks of using the ODFS. Walking speed was recorded more than 10 m with and without stimulation. Results. Both groups recorded positive median scores for all three sections of the PIADS questionnaire: Competence (1.25 stroke, 0.91 MS), Adaptability (1.25 stroke, 0.50 MS), and Self‐esteem (0.88 stroke, 0.75 MS). These were significantly greater for the stroke than the MS group for Competence, p= 0.04 and Adaptability, p= 0.006. There was no significant correlation between changes in PIADS and changes in walking speed. Conclusions. FES for correction of dropped foot has a beneficial effect on perceived QOL for people with stroke and MS but this is not correlated with an objective measures of gait.     

Migration of “bioabsorbable” screws in ACL repair. How much do we know? A systematic review

Purpose

Although bioabsorbable screws promise to degrade within months up to several years after implantation, often this does not happen. In fact, other problems such as screw breakage, tunnel enlargement, allergic or foreign body reactions, cyst or abscess formation, and delayed migration of “biodegradable” screws have been reported. This study aims to provide relevant basic science knowledge and recent insights concerning “biomaterials” currently used in fixation devices for anterior cruciate ligament (ACL) repair. A systematic review on the topic of screw “migration” is provided.

Methods

A PubMed search combining all the key terms was done looking for complications related to late migration of “bioabsorbable” screws used in ACL reconstruction without inferior time limitation up to January 2012. Only clinical reports were included. Reference lists of reports were checked to detect others not identified by the original search. A pre-publication search was performed to identify the most recent relevant articles.

Results

A total of ten articles referred to migration of “bioabsorbable” interference screws. Most cases reported on poly-L-lactic acid-based screws. Migration was noticed between 3 and 22 months postoperatively. It was noticed both in the tibia and the femur and with the application of several types of graft.

Conclusion

Migration is a possible complication of “bioabsorbable” interference screws. The information related to all clinical implications of the so-called “biodegradable screws” remains scarce and probably suffers from the phenomenon of publication bias. The complexity of possible reactions occurring in the human body is difficult to reproduce under controlled laboratory conditions.

Level of evidence

Systematic review including case-reports, Level V.     

Biomechanics of Cantilever Fixed Partial Dentures in Shortened Dental Arch Therapy

PURPOSE: The purpose of the present study was to investigate, by means of 3-dimensional finite element analysis, aspects of the biomechanics of cantilever fixed partial dentures replacing the maxillary canine in shortened dental arch therapy. The null hypothesis was that no differences would be identified by finite element analysis in the mechanical behavior of the 2 designs of cantilever fixed partial denture under different scenarios of occlusal loading. MATERIALS AND METHODS: Single- and double-abutted cantilever fixed partial dentures were modeled and analyzed using the finite element packages PATRAN and ABAQUS. Displacement and maximum principal stresses (magnitude and location) within the fixed partial dentures, supporting structures, and the periodontal ligament/bone and abutment/retainer interfaces were examined under 20 different scenarios of axial and lateral occlusal loading. RESULTS: The results indicate that more displacement occurred in the 2 rather than the 3-unit cantilever fixed partial denture, with the greatest displacement having occurred under lateral loading. The maximum principal stresses observed in the periodontal ligament/bone interfaces were greatest buccocervically, with the highest value being observed in the 2-unit fixed partial denture under lateral loading. The highest maximum principal stresses observed in the retainer/abutment interfaces were located cervically in relation to the distal margin of the retainer of the 2-unit fixed partial denture under axial loading. CONCLUSIONS: It was concluded that in adopting a cantilever fixed partial denture approach for the replacement of a missing maxillary canine in shortened dental arch therapy, there may be merits, in terms of mechanical behavior, in selecting a double-rather than a single-abutment design. Furthermore, prostheses' displacement and functional stresses may be minimized by reducing lateral loading and avoiding pontic only loading.     

Dental materials: 1979 literature review Part II

This paper, which is presented in two parts, reviews the work on dental materials published in 1979. Included in Part II are sections on impression materials, model, die and investment materials, waxes, acrylic resins, denture base polymers, soft lining materials and tissue conditioners, cast and wrought dental alloys, ceramics, implants and, finally, corrosion. Part I included sections on dental biomechanics, fissure sealants, cements, amalgam, composite filling materials, endodontic materials and microleakage.     

Monitoring EEG frequency and amplitude during cardiac surgery

Changes in the electroencephalograms of patients undergoing cardiac surgery with cardiopulmonary bypass were studied. An analysis technique with a simple display of amplitude and frequency within the traditional bands was used. During the course of an operation, there can be dramatic changes in frequency contribution with little or no change in overall EEG amplitude. Evaluation of the results shows that this technique clearly draws attention to periods of EEG change, and examples are given.