Reducing the use of carcinogens: the Massachusetts experience.

Toxics use reduction (TUR) is one part of a comprehensive cancer prevention strategy. TUR emphasizes reducing the use of cancer-causing chemicals by improving manufacturing processes and identifying and adopting safer alternatives. This analysis draws on 20 years of data collected from industries reporting to the Massachusetts Toxics Use Reduction Act (TURA) program to assess trends in the use and release of chemicals associated with cancer.

Hospital patients' reports of medical errors and undesirable events in their health care.

Objective: To investigate hospital patients' reports of undesirable events in their health care.

Design: Cross-sectional mixed methods design.

Participants: A total of 80 medical and surgical patients (mean age 58, 56 male).

How developing nations can protect children from hazardous chemical exposures while sustaining economic growth.

Increasing worldwide use of chemicals, including heavy metals used in industry and pesticides used in agriculture, may produce increases in chronic diseases in children unless steps are taken to manage the production, use, trade, and disposal of chemicals. In 2020 the developing world will account for 33 percent of global chemical demand and 31 percent of production, compared with 23 percent and 21 percent, respectively, in 1995. We describe present and potential costs of environmental exposures and discuss policy options to protect future generations of children in a sustainable development context.

Higher hazard substances under The Massachusetts Toxics Use Reduction Act: lessons from the first four years.

The Massachusetts Toxics Use Reduction Act (TURA) has achieved significant reductions in toxic chemical use in Massachusetts, using a combination of regulatory and voluntary measures. Historically the program has regulated only users of relatively large quantities of toxic chemicals, with services provided to facilities of all sizes on a voluntary basis. Statutory amendments adopted in 2006 created an authority to designate Higher and Lower Hazard Substances (HHS and LHS).

Patients' and health care professionals' attitudes towards the PINK patient safety video.

Rationale, Aims And Objectives: Patients can play an important role in reducing health care harm. Finding strategies to encourage patients to take on an active role in issues related to the quality and safety of their care is therefore essential. The aim of this study was to examine patients' and health care professionals' attitudes towards a video aimed at promoting patient involvement in safety-related behaviours.

Systemic leukofiltration does not attenuate pulmonary injury after cardiopulmonary bypass.

Pulmonary injury mediated by activated leukocytes is a recognized complication of cardiopulmonary bypass. The aim of this paper is to systematically analyze the effects of systemic leukofiltration within the cardiopulmonary bypass circuit on pulmonary injury and related clinical outcomes. We performed a systematic search to identify randomized controlled trials reporting on the effects of systemic leukofiltration on respiratory parameters.

Does systemic leukocyte filtration affect perioperative hemorrhage in cardiac surgery? A systematic review and meta-analysis.

Cardiopulmonary bypass causes a systemic inflammatory reaction. Activation of leukocytes is an important part of this process, and is known to directly contribute to the development of postoperative coagulopathy, and thus hemorrhage. The removal of leukocytes from the cardiopulmonary bypass circulation, using specialized filters, has been proposed as one method for attenuating this inflammatory response.

Skeletonization of radial and gastroepiploic conduits in coronary artery bypass surgery.

The use of a skeletonized internal thoracic artery in coronary artery bypass graft surgery has been shown to confer certain advantages over a traditional pedicled technique, particularly in certain patient groups. Recent reports indicate that radial and gastroepiploic arteries can also be harvested using a skeletonized technique. The aim of this study is to systematically review the available evidence regarding the use of skeletonized radial and gastroepiploic arteries within coronary artery bypass surgery, focusing specifically on it's effect on conduit length and flow, levels of endothelial damage, graft patency and clinical outcome.

The surgical care practitioner: a feasible alternative. Results of a prospective 4-year audit at St Mary's Hospital Trust, London.

Introduction: Surgical care practitioners (SCPs) are an expanding group of professionals, drawn from nursing and the allied health professions. Amongst other functions, SCPs can provide a range of surgical procedures including a 'minor surgical' service. The aim of this study was to audit the volume and outcomes related to the SCP service at St Mary's since its inception.

The effects of various leukocyte filtration strategies in cardiac surgery.

It is known that cardiopulmonary bypass causes an inflammatory reaction with an associated morbidity and mortality. Several anti-inflammatory strategies have been implemented to reduce this response, including leukocyte removal from the circulation using specialised filters. The aim of this study is to systematically review the available evidence on leukocyte filtration in cardiac surgery, focusing on its effect on systemic inflammation and whether this has influenced clinical outcomes.

Surgery for complex coarctation of the aorta.

The application of improved surgical techniques to correct coarctation in the neonate and infant may in the longterm reduce the incidence of recoarctation in the adult. In addition, in many cases, catheter-based intervention offers an alternative to reoperation and the role of catheter-based intervention is likely to be extended with the introduction of improved technology. However, surgery is likely to be required in coarctation and recoarctation in the adult in some cases, particularly those with hypoplasia of the aortic arch, aneurysms of the ascending aorta and those with intracardiac pathology.