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Software-based simulation for pipeline vantage flow diverter preprocedural assessment: Method and validation study
No full textBackgroundFlow diverters (FDs) have revolutionized intracranial aneurysm (IA) treatment. Proper FD sizing is crucial for aneurysm occlusion and complication prevention. Ankyras (Mentice, Gothenburg, Sweden) is a device-specific sizing software. We evaluated Ankyras\u27 performance in predicting the final deployment of the Pipeline™ Vantage Embolization Device with Shield Technology™ (PVST) (Medtronic Neurovascular, Irvine, California, USA).MethodsWe analyzed with Ankyras software the three-dimensional rotational angiography (3DRA) images of 10 consecutive patients with unruptured IA treated with PVST. Conventional digital subtraction angiography (DSA) measurements were used for FD sizing, FD was implanted, and postprocedure DSA and 3DRA images were obtained. Ankyras software generated an aneurysm model and simulated the FD size used in actual procedures. We compared the simulated length (SL) from Ankyras and the labeled length (LL) provided by the vendor to the real-case postdeployment measured length. We also compared the expansion from Ankyras simulation (SE) with the real case measured expansion (ME).ResultsOur analysis revealed a mean accuracy for SL across all cases of 92.05% (SD: 4.93%; range: 81.60%-99.10%), while the LL accuracy was 78.71% (SD: 12.43%; range: 62.20%-98.38%). A Pearson R² test indicated a strong correlation for SL at 0.9818, compared to 0.8625 for LL. Furthermore, the mean accuracy for expansion prediction was 86.28% (SD: 4.88%; range: 79.34%-92.46%).ConclusionThe Ankyras software shows promise as a viable tool for sizing PVST. Enhancing the accuracy of expansion predictions may further improve the precision of device specific simulation
Alleviating leader burden: A manager relief program for vacancy support
No full textThe results of an organizational leadership survey in 2021 revealed burnout in managers. The impact of manager vacancies results in a leadership vacuum which strains resources, creates turnover, and increases costs. Leaders drive outcomes in safety, quality, patient and employee satisfaction. This resulted in the creation of a budget neutral nurse leadership relief program as a three-tiered approach which creates a development path for the leader, shares best practices throughout the organization, and supports the hospital site. To date, the program has supported 23 different site departments with five being manager vacancies without resulting in covering leader burnout revealing great practical takeaways. There were strong positive ratings on the effectiveness of the relief manager model from department staff and executive leaders. Initiated in 2022 as a result of the leadership needs assessment, the program entered its pilot stage successfully. The compatibility between the interim leader and the host site was evident, leading to the decision for the leader to continue in the role, providing a pathway for development in a permanent capacity. Standard tools included the creation of a playbook, dashboards, surveys for site leaders and teammates, and resources. Additional program deliverables resulted in an enterprise-wide competency onboarding checklist and interim leader toolkit. The demand for relief nursing leaders was so strong that there were not enough leaders to meet the demand. Therefore, a supervisor relief branch was created. This model is a branch of this program which provides relief and succession paths for manager roles with front-line nurses. In 2022, there were 182 manager openings which was reduced to 144 in 2023 resulting in an improvement of 38 manager positions. Of the 23 departments supported, five departments that managers assumed revealed favorable outcomes. 5/5 departments have seen improvements in vacancies, turnover, agency utilization, and positive subjective feedback in access to leadership, staffing concerns, and overall well-being of the department. With a strong focus on stabilization of the workforce, a total of 24 nurses that would have been agency and were hired internally instead. This resulted in a 44.90/hour and 0.9 FTE. Teammate post-surveys showed positive results, with the greatest improvements in access to leadership, staffing, and well-being. Quality, safety, and shared governance were also strengthened. Executive leadership yielded excellent survey results for all areas. The program creates development and succession pipeline for leaders through stretch assignments and networking. The relief leaders build their resume with each assignment to strengthen their leadership skills and outcome portfolio. These skills will support preparation for future roles as well as stabilize, maintain, and enhance the current department. The program helps sustain the site without causing leader burnout, which offered valuable insights. Department staff and executive leaders gave highly positive feedback on the effectiveness of the relief manager model. Post assignment, the relief manager assumes a mentoring role for the newly hired leader.The Relief Manager program alleviates covering leader burnout and revealed great practical takeaways. There were strong positive ratings on the effectiveness of the relief manager model from department staff and executive leaders. Key lessons learned include having dedicated and involved executive leadership, regular department rounds with staff, willingness to find and address opportunities, using systematic tools, resources and outcomes tracking. Essential relief leader traits are driving engagement, empowering teams, achieving results, and transformational leadership. Future directions include a strong interest in expanding to other organizational regions and settings outside of acute care
A systematic review and meta-analysis of randomized trials of therapeutic intraarticular facet joint injections in chronic axial spinal pain
No full textBackground: Chronic axial spinal pain remains a leading cause of disability. Therapeutic interventional modalities for managing axial spinal pain of facet joint origin include intraarticular injections, facet joint nerve blocks, and radiofrequency neurotomy.Based on multiple randomized controlled trials (RCTs), systematic reviews, and clinical guidelines, the evidence supporting intraarticular facet joint injections is rated as Level III, with a weak to moderate recommendation for managing spinal facet joint pain.
Objective: To evaluate intraarticular facet joint injections as a therapeutic option for managing chronic axial spinal pain of facet joint origin.
Study design: A systematic review and meta-analysis of RCTs involving intraarticular facet joint injections, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.
Methods: A comprehensive literature search was conducted across multiple databases from 1966 through February 2025, including manual searches of bibliographies from known review articles. The methodological quality and risk of bias for the included studies were assessed.Evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. The level of evidence was classified using a modified best evidence synthesis, ranging from Level I to Level V.
Outcome measures: The primary outcome measure was the proportion of patients achieving significant pain relief and functional improvement of more than 50% for a minimum of 3 months. Duration of relief was categorized as short-term (\u3c 6 months) and long-term (\u3e 6 months).
Results: This analysis identified 12 high-quality and 2 moderate-quality RCTs based on Cochrane review criteria, and 11 high-quality and 3 moderate-quality RCTs based on Interventional Pain Management Techniques - Quality Appraisal of Reliability and Risk of Bias Assessment (IPM-QRB) criteria. Based on grade assessment, there were no high quality trials.Evidence synthesis using both qualitative and quantitative analyses, along with GRADE assessment, indicated Level IV (limited evidence), with low certainty and a low level of recommendation.
Limitations: The primary limitation is the continued paucity of high-quality literature.
Conclusion: Based on qualitative analysis and GRADE assessment, intraarticular facet joint injections are supported by Level IV evidence, with limited quality, low certainty, and a low strength of recommendation
Cardiovascular toxicity of fruquintinib in patients with colorectal and other cancers: A systematic review and meta-analysis
No full textIllinois Masonic Medical Center House Staff Directory, 2006-2007
No full textIllinois Masonic Medical Center, Chicago, IL: House staff directory with photos of IMMC residents in 2006-2007 for the specialties of anesthesiology, cardiac electrophysiology, cardiology, dentistry, emergency medicine, family practice, internal medicine, obstetrics and gynecology, osteopathic rotating internship, pathology, podiatry, radiology, general surgery, and surgical critical care.https://institutionalrepository.aah.org/alldocuments/2176/thumbnail.jp
Illinois Masonic Medical Center House Staff Directory, 2003-2004
No full textIllinois Masonic Medical Center, Chicago, IL: House staff directory with photos of IMMC residents in 2003-2004 for the specialties of anesthesiology, cardiac electrophysiology, cardiology, dentistry, emergency medicine, family practice, internal medicine, obstetrics and gynecology, osteopathic rotating internship, pathology, podiatry, radiology, general surgery, and surgical critical care.https://institutionalrepository.aah.org/alldocuments/2173/thumbnail.jp
Illinois Masonic Medical Center House Staff, 1997-98
No full textIllinois Masonic Medical Center, Chicago, IL: House staff roster with photos of IMMC residents in 1997-1998 for the specialties of anesthesiology, cardiology, cardiac electrophysiology, dentistry, emergency medicine, family practice, internal medicine, obstetrics and gynecology, osteopathic rotating internship, pathology, podiatry, psychology, radiology, general surgery, and transitional year.https://institutionalrepository.aah.org/alldocuments/2169/thumbnail.jp
Illinois Masonic Medical Center House Staff, 1988-89
No full textIllinois Masonic Medical Center, Chicago, IL: House staff roster with photos of IMMC residents in 1988-1989 for the specialties of anesthesiology, cardiology, dentistry, emergency medicine, internal medicine, obstetrics and gynecology, pathology, pediatrics, radiology, surgery, and transitional year.https://institutionalrepository.aah.org/alldocuments/2161/thumbnail.jp