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Biomedical subjects

Kenneth Wong

Publications and source records attributed to Kenneth Wong.

26 records · Page 2Linked to original sources
PubMed2004

Surgical risk management: the value of a weekly surgical radio-pathological meeting.

BACKGROUND: Clinical risk management in surgery involves organizational practices focused on the prevention of adverse outcomes. The present study evaluates the value of a weekly clinical meeting involving surgeons, radiologists and pathologists as a model of clinical risk management within a general surgical department. METHODS: Data for all meetings conducted over a 6-month period were prospectively collected. Changes to previously reported pathology and radiology results, revisions to patient diagnosis, management and recommendations for subsequent patient care arising from the meetings were recorded. RESULTS: Data were collected for 18 meetings. One hundred and eleven patients were reviewed. Seventy-six patients had previously reported radiological investigations. Sixty-five patients had previously reported pathology specimens. Four per cent of radiology reports and 8% of pathology reports were amended at the meeting. Seven per cent of patients received a revised diagnosis. Twenty-seven per cent of patients had suggestions for changes in management. Changes to patient care arose from pathologist input in seven patients, from radiologist input in nine patients and from clinician input in 14 patients. Four patients were recommended for an alternative surgical procedure. Five patients were recommended for cancellation of a planned procedure. Adjuvant chemo/radiotherapy was considered for four patients. Referral to specialist surgeons was suggested for two patients. CONCLUSIONS: Weekly multidisciplinary clinical meetings allow early revision and refinement of patient diagnosis and management. As such, they are an effective pre-emptive incident monitoring system, facilitating regular audit and quality control as part of an overall strategy for surgical clinical risk management.

Disease Management↗
PubMed2003

Trauma teams in Australia: a national survey.

BACKGROUND: Trauma teams have been associated with improved trauma patient outcomes. The present study seeks to estimate the use of trauma teams in Australian hospitals and describe their medical composition, leadership and criteria for activation. METHODS: Australian public hospitals with more than 100 beds, an emergency department and offering surgical services were identified. A survey assessing the presence, composition and means of activation of a trauma team was mailed to the 'Director, Emergency Department' of all identified hospitals. Three months later, all hospitals were contacted by telephone to complete and verify data collection. RESULTS: Questionnaires were distributed to 130 hospitals. After exclusion of hospitals that did not receive patients with traumatic injuries, and dedicated paediatric tertiary referral centres, 111 hospitals remained for analysis. Of these, 56% had an established trauma team, while 71% of hospitals without a trauma team claimed to have insufficient doctors to form one team. Ninety-five per cent of trauma teams were potentially activated by prehospital paramedic data (field triage). For 92% of trauma teams a combination of anatomical, physiological and mechanistic criteria were required for activation. The most common methods of mobilizing a trauma team were by dispatching a common call onto individual pagers (31%) or by paging trauma team members individually (31%). Fifty-eight per cent of trauma team leaders were emergency medicine specialists/registrars, while 8% of trauma teams were led by surgeons/registrars. Consultant surgeons were members of 23% of trauma teams and 74% of trauma teams consisted of more junior members after hours. Some form of trauma audit was engaged in by 64% of hospitals. CONCLUSIONS: Trauma teams are yet to be utilized by many Australian hospitals that provide trauma care. Australian surgeons presently have limited leadership roles and membership in trauma teams. Trauma audit can be more widely adopted in Australian hospitals.

Australia↗
PubMed2003

Operative experience in the Victorian general surgical training programme.

BACKGROUND: The Royal Australasian College of Surgeons recommends minimum operative and endoscopy training requirements for advanced trainees in general surgery. This study examines the influences of trainee seniority, geographical location of surgical rotation, and surgeons' remuneration arrangements on the operative and endoscopy experiences of general surgical trainees in Victoria. METHODS: Trainee log books covering two 6-month training periods in the year 2001 were analysed for depth and breadth of reported operative and endoscopy experience. RESULTS: A total of 81 trainee log books was reviewed. Senior trainees were significantly more likely to have a higher primary operator experience. Total operative caseload and primary operator experience, in terms of major operative cases, were greater in rural rotations. Endoscopy experience was significantly greater in rural rotations. Operative exposure to gynaecological, laparoscopic, orthopaedic, paediatric and plastic surgical procedures was significantly greater in rural rotations. Surgeons' remuneration arrangements were not significantly related to trainee operative experience. CONCLUSIONS: Rural surgical rotations enhance the depth and breadth of operative experience of Victorian general surgical registrars, allowing greater exposure to subspecialty surgical procedures.

Australia↗
PubMed2002

Activation of erythropoietin receptor through a novel extracellular binding site.

Activation of erythropoietin (EPO) receptor (EPOR) by a small peptide (ERP) was reported previously. ERP binds to a different receptor site than EPO, and binding of ERP does not change the dissociation constant and maximal binding for EPO binding to the receptor. The extracellular binding site for ERP is now characterized. The site is located in the membrane proximal, extracellular part of the receptor. ERP binds to a region on the EPOR that contains the same sequence as ERP. It is speculated that ERP binds to its identical sequence on EPOR, as ERP self-interacts. ERP is specific for EPOR and associates noncovalently with EPOR in a ratio 1:1. Peptide binding to the receptor results in receptor-mediated cellular proliferation, intracellular signaling, and erythroid colony-forming unit formation in bone marrow cells. The activity is comparable to that of EPO. Recognition of such receptor sites represents a new and important concept in receptor function.

Amino Acid Sequence↗
PubMedDate not supplied

Ultrasonographic anatomy of the canine elbow.

To produce detailed ultrasonographic images of the soft tissue structures around the canine elbow joint, a series of greyhound cadaver limbs were scanned both intact and dissected in a water bath. Suitable transducer positions and bone landmarks are described and the ultrasonographic appearance of the lateral collateral ligament, anconeal process, triceps tendon, origin of olecranon ligament, biceps tendon insertion, medial collateral ligament, and medial coronoid process are illustrated. Improved understanding of the anatomy of the canine elbow will support clinical ultrasonography of this region.

Animals↗