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Counting procedures in the operating room are essential for the risk management. They contribute to patient safety and to the safety of the whole operating team. This year, the "German Coalition for Patient Safety" published recommendations to prevent the unintentional missing of foreign bodies. These informations designed to improve patient safety are provided to each interested person. Source


Brock G.,University of Western Ontario | Montorsi F.,Vita-Salute San Raffaele University | Costa P.,Montpellier University | Shah N.,Addenbrookes Hospital | And 9 more authors.
Urology | Year: 2015

Objective To report penile integrity measures, including stretched penile length (SPL), from a randomized, double-blind, double-dummy, placebo-controlled trial evaluating treatment with tadalafil initiated after nerve-sparing radical prostatectomy (nsRP). Methods Patients aged ≤68 years were randomized after nsRP 1:1:1 to 9-month double-blind treatment (DBT) with tadalafil 5 mg once daily (OaD), 20-mg tadalafil on-demand ("pro-re-nata"; PRN), or placebo, followed by 6-week drug-free washout and 3-month open-label OaD treatment. Secondary outcome measures included the change in SPL from pre-nsRP to the end of DBT (analysis of covariance adjusting for treatment, country, baseline, age, and nerve-sparing score), responses to Sexual Encounter Profile (SEP) questions 1-3 (mixed models for repeated measures adjusting for treatment, country, visit, visit-treatment-interaction, age), and Standardized Morning Erection Question (Cochran-Mantel-Haenszel test adjusted for age and country). Results Four hundred twenty-three patients were randomized to tadalafil OaD (N = 139), tadalafil PRN (N = 143), and placebo (N = 141). Greater retainment of SPL was observed with tadalafil OaD vs placebo at the end of DBT (least-square mean [95% confidence interval] difference OaD vs placebo, 4.1 mm [0.4 to 7.8 mm]; P =.032). No significant effects on SPL were found for tadalafil PRN vs placebo, or for the nerve-sparing score. Penile tumescence (SEP1) and ability for vaginal insertion (SEP2) significantly improved vs placebo at the end of double-blind and open-label treatment for patients randomized to tadalafil OaD only. The ability for successful sexual intercourse (SEP3) significantly improved with tadalafil OaD vs placebo only during DBT. The distribution of Standardized Morning Erection Question responses was different at the end of DBT (P =.045); 34.2% of patients on tadalafil OaD, 50.0% on tadalafil PRN, and 56.5% on placebo reported absence of morning erections. Conclusion These data suggest the early initiation of tadalafil OaD protects from penile length loss and may contribute to protection from structural cavernosal changes after nsRP. © 2015 Elsevier Inc. Source


Grant
Agency: Cordis | Branch: FP7 | Program: CSA-CA | Phase: Fission-2013-5.1.1 | Award Amount: 1.86M | Year: 2013

Medical exposures for radiological examinations represent the highest and fastest growing contribution to manmade radiation exposure in the EU underlying the need for medical physics experts (MPEs), regulators and scientists in industry to bring in new research results and expertise and to deploy resources in addressing this important issue. The EC recognized the urgency and the EU tender European guidelines for the Medical Physics Expert (MPE) (TREN/H4/1672009) was issued to develop and update the role of MPEs in Europe. The final report has been approved by the EC and includes an agreed mission statement and key activities for MPEs. The new qualification framework defines the MPE as an MP who, through planned advanced training and CPD, achieves the highest level possible (i.e., European Qualifications Level 8) in her/his specialty. However, it is recognized that few Member States have the expertise and facilities to provide the necessary training. A preliminary survey among National Organisations of MP and medical device companies showed that a dedicated training scheme has become a necessity. Three end-users were identified: the hospital MPE, the scientist in industry and regulators assessing exposures in Diagnostic and Interventional Radiology. The EUTEMPE-RX consortium will develop, put into practice and evaluate a new pilot EFTS for the MPE in Diagnostic and Interventional Radiology, which includes both face-to-face and on-line teaching. The aim is to ensure that candidates become knowledgeable about all current issues in radiation safety culture in hospitals and to make the MPE a radiation protection advocate for patients. The course will address the themes identified in the MELODI strategic research agenda, DoreMi and EMAN projects. A business plan will be developed for the sustainability of the network, which would provide a template for the development of similar programmes in the other specialties of medical physics.


Brock G.,University of Western Ontario | Montorsi F.,Vita-Salute San Raffaele University | Costa P.,Montpellier University | Shah N.,Addenbrookes Hospital | And 9 more authors.
Urology | Year: 2015

Objective: To report penile integrity measures, including stretched penile length (SPL), from a randomized, double-blind, double-dummy, placebo-controlled trial evaluating treatment with tadalafil initiated after nerve-sparing radical prostatectomy (nsRP). Methods: Patients aged≤68years were randomized after nsRP 1:1:1 to 9-month double-blind treatment (DBT) with tadalafil 5mg once daily (OaD), 20-mg tadalafil on-demand ("pro-re-nata"; PRN), or placebo, followed by 6-week drug-free washout and 3-month open-label OaD treatment. Secondary outcome measures included the change in SPL from pre-nsRP to the end of DBT (analysis of covariance adjusting for treatment, country, baseline, age, and nerve-sparing score), responses to Sexual Encounter Profile (SEP) questions 1-3 (mixed models for repeated measures adjusting for treatment, country, visit, visit-treatment-interaction, age), and Standardized Morning Erection Question (Cochran-Mantel-Haenszel test adjusted for age and country). Results: Four hundred twenty-three patients were randomized to tadalafil OaD (N= 139), tadalafil PRN (N= 143), and placebo (N= 141). Greater retainment of SPL was observed with tadalafil OaD vs placebo at the end of DBT (least-square mean [95% confidence interval] difference OaD vs placebo, 4.1mm [0.4 to 7.8mm]; P= .032). No significant effects on SPL were found for tadalafil PRN vs placebo, or for the nerve-sparing score. Penile tumescence (SEP1) and ability for vaginal insertion (SEP2) significantly improved vs placebo at the end of double-blind and open-label treatment for patients randomized to tadalafil OaD only. The ability for successful sexual intercourse (SEP3) significantly improved with tadalafil OaD vs placebo only during DBT. The distribution of Standardized Morning Erection Question responses was different at the end of DBT (P= .045); 34.2% of patients on tadalafil OaD, 50.0% on tadalafil PRN, and 56.5% on placebo reported absence of morning erections. Conclusion: These data suggest the early initiation of tadalafil OaD protects from penile length loss and may contribute to protection from structural cavernosal changes after nsRP. © 2015 Elsevier Inc. Source


Pfingsten-Wurzburg S.,Stadtisches Gesundheitsamt | Pieper D.H.,Helmholtz Center for Infection Research | Bautsch W.,Stadtisches Klinikum Braunschweig gGmbH | Probst-Kepper M.,Stadtisches Klinikum Braunschweig gGmbH
Journal of Hospital Infection | Year: 2011

Nursing home residents are a population at risk for carrying meticillin-resistant Staphylococcus aureus (MRSA). To better guide infection control and healthcare network initiatives, we investigated the point prevalence and molecular epidemiology of MRSA colonisation among nursing home residents in Brunswick, northern Germany. Among the 32 participating nursing homes of the available 34 in the region, 68% of residents (1827 of 2688) were screened for nasal and/or wound colonisation. A total of 139 residents (7.6%; 95% confidence interval: 6.4-8.8%) were identified as MRSA positive, almost six-fold more than the 24 MRSA carriers (0.9%) expected according to the nursing homes' pre-test information. Although known risk factors including urinary tract catheters, wounds, preceding hospital admission, and high grade resident care were confirmed, none was sensitive enough to be considered as the sole determinant of MRSA carriage. spa typing revealed that more than 70% of isolates belonged to the Barnim strain (ST-22, EMRSA-15, CC22) typical for hospital-acquired MRSA in northern Germany. There was no evidence for the presence of community-acquired or livestock-associated S. aureus strains. These data show that in northern Germany MRSA has spread from the hospital environment to other healthcare institutions, which must now be regarded as important reservoirs for MRSA transmission. © 2011 The Healthcare Infection Society. Source

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