Considerations for developing a health-system 503B outsourcing strategy.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

[Features, management and prognosis of Chilean patients with non valvular atrial fibrillation: GARFIELD AF registry].

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with high rates of death, ischemic stroke and systemic embolism (SE). There is scarce information about clinical characteristics and use of anti-thrombotic therapies in Chilean patients with non-valvular AF.

Aim: To describe the characteristics and 1-year outcomes of patients with recently diagnosed AF recruited in Chile into the prospective global GARFIELD-AF registry.

Impact of a quality-assessment dashboard on the comprehensive review of pharmacist performance.

Purpose: The impact of a quality-assessment dashboard and individualized pharmacist performance feedback on the adherence of order verification was evaluated.

Methods: A before-and-after study was conducted at a 1,440-bed academic medical center. was defined as orders verified according to institution-derived, medication-related guidelines and policies.

Accuracy assessment for navigated maxillo-facial surgery using an electromagnetic tracking device.

Purpose: To evaluate the accuracy and the usability of an electromagnetic tracking device in maxillo-facial surgery through testing on a phantom skull under operating room (OR) conditions.

Material And Methods: A standard plastic skull phantom was equipped with a custom made model of the maxilla and with target markers and dental brackets. Imaging was performed with a computed tomography (CT) scanner.

Comparative study of application accuracy of two frameless neuronavigation systems: experimental error assessment quantifying registration methods and clinically influencing factors.

This study aimed at comparing the accuracy of two commercial neuronavigation systems. Error assessment and quantification of clinical factors and surface registration, often resulting in decreased accuracy, were intended. Active (Stryker Navigation) and passive (VectorVision Sky, BrainLAB) neuronavigation systems were tested with an anthropomorphic phantom with a deformable layer, simulating skin and soft tissue.

Accuracy of template-based dental implant placement.

Purpose: The accuracy of a system for image-guided dental implant planning and placement based on individually fabricated oral templates was investigated in a phantom study.

Materials And Methods: The study was performed on identical phantoms of a partially edentulous mandible. In one phantom mandible (the master model), pilot boreholes for dental implants were placed.

Clinical use of navigation based on cone-beam computer tomography in maxillofacial surgery.

Image-guidance in maxillofacial surgery is based predominantly on computed tomographic (CT) images. Its main disadvantage is the considerable amount of radiation to which the patient is exposed, and dental metal artefacts. Recently, a new class of devices based on the concept of cone-beam computed tomography (CBCT) has been introduced for maxillofacial imaging, which we have investigated.

Orthodontic archwire in the nasal cavity. A case report.

We present the unusual case of a patient who lost an orthodontic archwire after having, via manipulation, detached it from the brackets. It was only on a routine radiograph at the end of treatment that the archwire was found in the patient's nasal cavity, where it had failed to cause any symptoms! We discuss the treatment following the inhalation and ingestion of foreign bodies in orthodontics, as well as their prevention.

The accuracy of image guided surgery based on cone beam computer tomography image data.

Objective: The objective of this study was to verify if accurate patient-to-image registration for precision navigation in maxillofacial surgery is possible based on cone beam computed tomography (CBCT) image data.

Study Design: A maxillary registration template was placed on a standard plastic skull phantom that was equipped with a custom made model of the maxilla and with target markers. Imaging was performed with a CBCT device (Newtom 9000 Digital Volume Tomograph (DVT), QR s.

System design of a hand-held mobile robot for craniotomy.

This contribution reports the development and initial testing of a Mobile Robot System for Surgical Craniotomy, the Craniostar. A kinematic system based on a unicycle robot is analysed to provide local positioning through two spiked wheels gripping directly onto a patients skull. A control system based on a shared control system between both the Surgeon and Robot is employed in a hand-held design that is tested initially on plastic phantom and swine skulls.

Intraoperative computed tomography and automated registration for image-guided cranial surgery.

Objectives: Two key problems for the use of navigation systems in image-guided surgery are accurate patient-to-image registration and the fact that with ongoing surgery the patient's anatomy is altered while the image data remains unchanged. A system for intraoperative CT imaging and fully automated registration of this image addresses both problems. It had been evaluated successfully in phantom studies.

Geometric accuracy of digital volume tomography and conventional computed tomography.

Digital volume tomography is a recently established imaging method that is based on the principle of cone beam computed tomography (CBCT). One of its main applications is imaging in dental and maxillofacial surgery. The objective of this study was to compare the geometric accuracy of digital volume tomographic imaging with that of conventional CT and to assess the suitability for image-guided operating.

Automated registration of intraoperative CT image data for navigated skull base surgery.

Objectives: With a new intraoperative computed tomography (CT) imaging system, patient-to-image registration without any invasive registration markers is possible. Furthermore, registration can be performed fully automatically. The accuracy of this method for skull base surgery was investigated in this study.

Projector-based augmented reality for intuitive intraoperative guidance in image-guided 3D interstitial brachytherapy.

Purpose: The aim of this study is to implement augmented reality in real-time image-guided interstitial brachytherapy to allow an intuitive real-time intraoperative orientation.

Methods And Materials: The developed system consists of a common video projector, two high-resolution charge coupled device cameras, and an off-the-shelf notebook. The projector was used as a scanning device by projecting coded-light patterns to register the patient and superimpose the operating field with planning data and additional information in arbitrary colors.

Template-based registration for image-guided skull base surgery.

Objectives: To evaluate whether patient-to-image registration with the use of a maxillary template is sufficiently accurate for image guided skull base surgery.

Study Design And Setting: In an experimental phantom study, pair-point registration of a skull phantom to its CT image data was performed with 243 different configurations of a maxillary template with markers. Then artificial skull mounted target markers were located with an infrared tracking device as used in navigation systems.

Effects of implementing a rapid admission policy in the ED.

Objective: The purpose of this study is to determine the impact of a new rapid admission policy (RAP) on emergency department (ED) length of stay (EDLOS) and time spent on ambulance diversion (AD).

Methods: The RAP, instituted in January 2005, allows attending emergency physicians to send stable patients, requiring admission to the general medicine service, directly to available inpatient beds. The RAP thereby eliminates 2 conventional preadmission practices: having admitting physicians evaluate the patient in the ED and requiring all diagnostic testing to be complete before admission.

Inverted papilloma of paranasal sinuses.

Introduction: Inverted papilloma (Schneiderian papilloma) is a primarily benign lesion that occurs in the nasal cavity and paranasal sinuses. Clinical problems include a tendency towards local destruction, recurrence and malignant transformation into squamous cell carcinoma. Hence, complete surgical removal is the therapy of choice and a meticulous follow-up is mandatory.

Age- and tooth-related pulp cavity signal intensity changes in healthy teeth: a comparative magnetic resonance imaging analysis.

Objective: To determine if it is possible to measure age-related pulp cavity signal intensity changes by using magnetic resonance imaging (MRI).

Study Design: Dental pulp cavity signal intensities were assessed in 92 test subjects on the basis of MRI signal intensity measurements at freely defined regions of interest by using T1 gradient echo sequences before and after contrast-agent administration. Relative signal intensity differences were calculated and provided the basis for age- and tooth-related comparisons.

Image-to-patient registration techniques in head surgery.

Frame-based stereotaxy was developed in neurosurgery at the beginning of the last century, evolving from atlas-based stereotaxy to stereotaxy based on the individual patient's image data. This established method is still in use in neurosurgery and radiotherapy. There have since been two main developments based on this concept: frameless stereotaxy and markerless registration.

Piezosurgery--a new safe technique in cranial osteoplasty?

All surgical interventions on the neurocranium bear the risk of injury of the dura mater and development of a cerebrospinal fluid fistula. Therefore, despite careful preparation, damage to the dura mater cannot always be omitted. Especially after surgery and in patients with increased intracranial pressure (craniosynostoses) there is a high risk of perforating the dura.

Augmented reality with fibre optics.

In this paper we present the concept and the first results of the Fibre Optic Pointer - a miniaturized Augmented Reality system for craniofacial surgery. The objective is the integration into surgical instruments.

Template-based registration for image-guided maxillofacial surgery.

Purpose: Fiducial marker registration using bone screws is a proved and tested method for patient-to-image registration for image-guided surgery of the head. The use of intraoral fiducial markers mounted on a template for the maxillary dentition is a less invasive alternative and is in use for intraoral image-guided surgery. The aim of this study was to verify if this method is sufficiently accurate for extraoral use.

Geometric accuracy of magnetic resonance imaging of the mandibular nerve.

Objectives: Magnetic resonance imaging (MRI) is not routinely used for dental implant planning. A prerequisite for dental implant planning is the accurate imaging of risk structures like the mandibular nerve. The geometric accuracy of the imaging of the mandibular nerve was investigated.