1,721,407 research outputs found
Robotic surgery for the treatment of early-stage lung cancer
No full texthttp://hdl.handle.net/20.500.11768/9644
Robotic lobectomy and segmentectomy for lung cancer: results and operating technique
No full texthttp://hdl.handle.net/20.500.11768/9656
Clinical leadership and hospital performance: Assessing the evidence base
Full text linkA widespread assumption across health systems suggests that greater clinicians' involvement in governance and management roles would have wider benefits for the efficiency and effectiveness of healthcare organisations. However, despite growing interest around the topic, it is still poorly understood how managers with a clinical background might specifically affect healthcare performance outcomes. The purpose of this review is, therefore, to map out and critically appraise quantitatively-oriented studies investigating this phenomenon within the acute hospital sector. Methods: The review has focused on scientific papers published in English in international journals and conference proceedings. The articles have been extracted through a Boolean search strategy from ISI Web of Science citation and search source. No time constraints were imposed. A manual search by keywords and citation tracking was also conducted concentrating on highly ranked public sector governance and management journals. Nineteen papers were identified as a match for the research criteria and, subsequently, were classified on the basis of six items. Finally, a thematic mapping has been carried out leading to identify three main research sub-streams on the basis of the types of performance outcomes investigated. Results and contribution: The analysis of the extant literature has revealed that research focusing on clinicians' involvement in leadership positions has explored its implications for the management of financial resources, the quality of care offered and the social performance of service providers. In general terms, the findings show a positive impact of clinical leadership on different types of outcome measures, with only a handful of studies highlighting a negative impact on financial and social performance. Therefore, this review lends support to the prevalent move across health systems towards increasing the presence of clinicians in leadership positions in healthcare organisations. Furthermore, we present an explanatory model summarising the reasons offered in the reviewed studies to justify the findings and provide suggestions for future research
Digital versus analog procedures for the prosthetic restoration of single implants: A randomized controlled trial with 1 year of follow-up
Full text linkAim. To compare the outcome of digital versus analog procedures for the restoration of single implants. Methods. Over a two-year period (2014-2016), all patients who had been treated in a dental center with a single implant were randomly assigned to receive either a monolithic zirconia crown, fabricated with digital workflow (test group), or a metal-ceramic crown, fabricated with analog workflow (control group). All patients were followed for 1 year after the delivery of the final crown. The outcomes were success, complications, peri-implant marginal bone loss (PIMBL), patient satisfaction, and time and cost of the treatment. Results. 50 patients (22 males, 28 females; mean age 52.6±13.4 years) were randomly assigned to one of the groups (25 per group). Both workflows showed high success (92%) and low complication rate (8%). No significant differences were found in the mean PIMBL between test (0.39±0.29mm) and control (0.54±0.32mm) groups. Patients preferred digital impressions. Taking the impression took half the time in the test group (20±5min) than in the control (50±7min) group. When calculating active working time, workflow in the test group was more time-efficient than in the control group, for provisional (70±15min versus 340±37min) and final crowns (29±9min versus 260±26min). The digital procedure presented lower costs than the analog (277.3 versus 392.2). Conclusions. No significant clinical or radiographic differences were found between digital and analog procedures; however, the digital workflow was preferred by patients; it reduced active treatment time and costs. The present study is registered in the ISRCTN (http://www.isrctn.com/ISRCTN36259164) with number 36259164
Robotic segmentectomy S7 + S8 with the use of indocyanine green (ICG): technical details
Full text linkIn the last few years, segmentectomy has become a popular alternative procedure with curative intent to standard lobectomy in selected cases, like peripheral ground glass opacities (GGOs) less than 2 cm or patients non suitable for lobectomy. In the setting of a minimally invasive surgery, use of the robotic system Da Vinci has proved to be a safe and feasible approach with better dexterity and lower length of stay compared to video-assisted thoracic surgery (VATS). Moreover, intravenous administration of indocyanine green (ICG) during surgery dramatically improve identification of targeted segment(s) thus sparing a certain amount of healthy lung with better conservation of respiratory function. We hereby show a step-by-step guide to perform a robotic-assisted segmentectomy of right S7 + S8 with the use of ICG for intersegmental plane identification
Oncological clearance of minimally invasive lobectomy for clinical n0 non-small cell lung cancer: The role of robotic surgery
No full textThe health legacy: Promoting and enhancing a socially fair intergenerational transmission of ideal health
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