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Biomedical subjects

T J Hunt

Publications and source records attributed to T J Hunt.

9 recordsLinked to original sources

Evaluating the potential effectiveness of using computerized information systems to prevent adverse drug events.

In this study a dynamic computer simulation model is used to estimate the effectiveness of various information systems applications designed to detect and prevent medication errors that result in adverse drug events (ADEs). The model simulates the four stages of the drug ordering and delivery system: prescribing, transcribing, dispensing and administering drugs. In this study we simulated interventions that have been demonstrated in prior studies to decrease error rates. The results demonstrated that a computerized information system that detected 26% of medication errors and prevented associated ADEs could save 1,226 days of excess hospitalization and $1.4 million in hospital costs annually. Those results suggest that such systems are potentially a cost-effective means of preventing ADEs in hospitals. The results demonstrated the importance of viewing adverse drug events from a systems perspective. Prevention efforts that focus on a single stage of the process had limited impact on the overall error rate. This study suggests that system-wide changes to the drug-ordering and delivery system are required to significantly reduce adverse drug events in a hospital setting.

Clinical Pharmacy Information Systems↗

Skeletal fixation: a review.

While improvements in surgical techniques and recent trends toward early surgery and patient mobilization have led to skeletal traction being utilized more sparingly, it continues to be a basic skill required by the orthopaedic surgeon. The most commonly used anatomical sites for skeletal fixation--distal femur, proximal tibia, distal tibia, calcaneus, and olecranon--are reviewed and illustrated.

Bone Nails↗

Lipid adsorption onto hydrogel contact lens materials. Advantages of Nile red over oil red O in visualization of lipids.

An artificial tear solution containing the major types of proteins, glycoproteins, and lipids represented in human tears has been developed. The adsorption of lipids onto various hydrogel lens materials (polymacon, lidofilcon A, phemfilcon A, etafilcon A) was examined by exposing the lenses to our artificial tear solution for 18 h. The adsorbed lipids were detected using Nile red stain. The patterns of deposits obtained in vitro were similar to those obtained with human worn lenses. The Nile red stain appeared far more sensitive in detecting lipids adsorbed to hydrogel lenses than the oil red O stain. It was found that lipids adsorb to hydrogel materials quite readily either in a pure state or combined with mucin or other proteins. In view of this work more attention should be given to the role of lipids in the etiology of various contact lens wear complications.

Adsorption↗

Childhood lead poisoning and inadequate child care.

Sixteen caretakers of children hospitalized for their first episode of lead poisoning and 16 caretakers of children with normal lead levels were interviewed in their homes to determine if caretakers of children with lead poisoning provided more inadequate child care than the comparison group of caretakers. Children were matched according to age, race, and sex. Correlations were found between children's lead levels and caretakers' scores on the measures of inadequate child care. Differences were evident in the overall physical and cognitive emotional care provided to these children. No differences were found in the caretakers' ages, number of years of education and family monthly income, number of occupants in the household, and family mobility. Implications of the intertwined roles of inadequate child care, subclinical lead poisoning, and later developmental sequelae are discussed.

Child Care↗

Multiquadrant digital analysis of shoulder capsular thickness.

PURPOSE: Nonablative thermal capsular shrinkage has been developed in an attempt to address the plastic capsule deformation thought to cause increased rates of recurrent instability following arthroscopic stabilization procedures. Although the temperature required to optimize collagen shrinkage is known, a safe depth of thermal penetration, in various locations about the shoulder capsule, has not been defined. The purpose of this study was to measure shoulder capsule thickness by quadrant and circumferentially from the glenoid to the humerus so that thermal energy in shoulder procedures can be more precisely applied to limit possible injury to pericapsular structures. TYPE OF STUDY: This is an anatomic study using a cadaveric shoulder specimens. MATERIALS AND METHODS: Soft tissue was dissected from 8 fresh cadaveric shoulders to isolate intact glenohumeral joint capsules. The humeral insertion was released and the capsule was cut into 6 longitudinal quadrants around the glenoid. The capsule specimens were then flash frozen and stored at -80 degrees C. Quadrant tissue was cut into longitudinal sections 14 to 16 microm wide and stained with hematoxylin and eosin. The specimens were then digitized under a dissecting microscope and measured using computer imaging software at approximately 4-mm intervals. Two-way analysis of variance (ANOVA) was performed on the measurements of the intact capsule specimens 2.5 cm off the glenoid. Humeral insertion data were recorded separately. RESULTS: A total of 248 separate measurements were made throughout the capsule in 8 specimens. Capsular thickness increased from an average of 2.42 mm anteriorly to 2.80 mm in the inferior capsular pouch and again thinned to 2.22 mm posteriorly. Global shoulder capsule thickness ranged from 1.32 to 4.47 mm. When analyzed by position, from glenoid to humerus, a general thinning was noted with a mean thickness of 3. 03 mm at the glenoid to 2.17 mm at the humeral insertion. Two-way ANOVA showed a significant thickness variation along the specimen (P <.05), a nearly significant thickness variation with regard to quadrant (P <.03), and no significant interaction (P >.07) when applied to specimen measurements approximately 2.5 cm off the glenoid. CONCLUSIONS: The thickness of the shoulder capsule ranges from 1.32 to 4.47 mm, with a significant thinning laterally from the glenoid to the humerus. Further, capsule thickness ranges from 2.76 to 3.18 mm in the regions in closest proximity to the axillary nerve. These data may help determine the proper amount of thermal penetration necessary when performing shrinkage procedures and provide safety guidelines to limit the depth of thermal penetration to avoid possible injury to pericapsular structures.

Aged↗