Quality Improvement: Arterial Grafting Redux, 2010:2019.

Background: The evidence base favoring utilization of multiple arterial conduits in coronary artery bypass grafting has strengthened in recent years. Nevertheless, utilization of arterial conduits in the US lags behind that of many European peers. We describe a statewide collaborative based approach to improving utilization.

The Role of Regional Collaboratives in Quality Improvement: Time to Organize, and How?

Over the last 12 years, surgeon representatives from the 33 participating hospitals of the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC), along with data specialists, surgical and quality improvement (QI) teams, have met at least 4 times a year to improve health-care quality and outcomes of cardiac and general thoracic surgery patients. The MSTCVS-QC nature of interactive learning has allowed all members to examine current data from each site in an unblinded manner for benchmarking, learn from their findings, institute clinically meaningful changes in survival and health-related quality of life, and carefully follow the effects. These meetings have resulted in agreement on various interventions to improve patient selection, periprocedural strategies, and adherence with evidence-based directed medication regimens, Factors contributing to the quality movement across hospitals include statewide-recognized clinicians who are eager to involve themselves in QI initiatives, dedicated health-care professionals at the hospital level, trusting environments in which failure is only a temporary step on the way toward achieving QI goals, real-time analytics of accurate data, and payers who strongly support QI efforts designed to improve outcomes.

Respiratory health effects associated with restoration work in post-Hurricane Katrina New Orleans.

Background: This study examines prevalence of respiratory conditions in New Orleans-area restoration workers after Hurricane Katrina.

Methods: Between 2007 and 2010, spirometry and respiratory health and occupational questionnaire were administered to 791 New Orleans-area adults who mostly worked in the building construction and maintenance trades or custodial services. The associations between restoration work hours and lung function and prevalence of respiratory symptoms were examined by multiple linear regression, χ², or multiple logistic regression.

Longitudinal respiratory health study of the wood processing industry.

Background: A 5-year longitudinal study examined nonmalignant respiratory effects of wood processing dust exposure.

Methods: Ten study plants, investigator selected from 447 candidate plants, included 1 sawmill-planing-plywood, 1 plywood, 1 milling, 3 cabinet and 4 furniture facilities. Personal dust samples (2363) were divided into three size fractions (extrathoracic, tracheobronchial, and respirable) which were apportioned into wood solids (WS) and residual particulate matter (RPM), and used to compute each individuals TWA exposure for the 6 exposure types.

Can a falling bullet be lethal at terminal velocity? Cardiac injury caused by a celebratory bullet.

This is a case report of rare cardiac and abdominal organ injuries sustained by an innocent bystander from a New Year's Eve celebratory gun shooting. The force and velocity of a projectile fired into the air as it ascends and returns to earth, along with its potential for bodily injury will be reviewed.

Spray-painting and chronic airways obstruction.

Background: The aim was to investigate the respiratory response of HDI-based paint aerosol within the context of the protection afforded by current exposure guidelines.

Methods: A cross-sectional study of 240 painters spraying polyurethane enamels was undertaken at four aircraft maintenance plants. Questionnaire and spirometric data were related to gravimetric measures of cumulative total and respirable paint aerosol (TPA and RPA) and estimated isocyanate in total and respirable aerosols (TIA and RIA).