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Conference Highlights: CHEST 2011

New research presented at CHEST 2011, the 77th annual meeting of the American College of Chest Physicians, from October 22-26 in Honolulu addressed many important topics in pulmonary, critical care, and sleep medicine. The features below highlight just some of the studies that emerged from the meeting. » Pain Common for Pulmonologists Performing Bronchoscopy » Guideline Effects on CRBSI  » An Effective Computer Model for Smoking Cessation  Pain Common for Pulmonologists Performing Bronchoscopy The Particulars: Much attention has been paid to ergonomics and overuse injury in gastroenterology and surgery settings. However, little attention has been paid on other medical specialties, such as bronchoscopy. Data Breakdown: Researchers in New York gave an online questionnaire to 132 pulmonologists to assess pain and injury while performing bronchoscopy. Nearly 40% reported experiencing pain while operating a bronchoscope. Among this group, 22% reported recurring pain, which mostly occurred in the shoulder, back, wrist, neck, and thumb. This pain appeared to be associated with overuse and height less than 5’7″. Only 38% of pulmonologists who felt pain attempted to modify their workspace. Take Home Pearl: Interventions may be needed to prevent musculoskeletal injuries among pulmonologists who perform bronchoscopies. Guideline Effects on CRBSI [back to top] The Particulars: The Institute of Health Improvement Bundle was created in 2006 as a guideline to help hospitals reduce catheter-related bloodstream infection (CRBSI) rates. Whether this goal has been achieved remains uncertain. Data Breakdown: An investigation from researchers in Tampa retrospectively reviewed 895 patient charts for people admitted to two hospitals who required a central venous catheter (CVC) between 2007, when the guidelines were first released, and 2010. The rate of CRBSIs decreased from 4.38 per...

Laparoscopy: Patients Benefit, But Do Surgeons Suffer?

When compared with open surgical techniques, the benefits of minimally invasive surgery have been well documented in medical literature, including increased safety, quicker recovery, shorter hospital stays, and cosmetic advantages. Nonetheless, surgeons who perform a majority of their cases laparoscopically appear to encounter physical stress and mental strain beyond what they experience when performing open surgery. New survey findings suggest that surgeon burden may be greater than previously assumed. “Surgeon injuries appear to be a significant problem that not only affects surgeons but also all stakeholders in the delivery of healthcare, particularly surgical care,” says Adrian E. Park, MD. “Any type of surgery, particularly minimally invasive surgery, takes a physical and mental toll on surgeons. They continuously adapt to ensure the best outcome for patients, often dipping hugely into their own health reserve. We’re not going to serve our patients, the public, or the healthcare system well if we have prematurely shortened careers because of the physical tolls and cognitive ravages of what we do.” Scant literature is available on the extent to which strain during laparoscopy affects surgeons’ bodies when compared with open surgery. In a study in the March 2010 Journal of the American College of Surgeons, Dr. Park and colleagues published a study that sought to confirm the prevalence of minimally invasive surgery-related operator symptoms and discomforts within a broad population of laparoscopic surgeons. Since previous surveys, the adoption rate of minimally invasive procedures has steadily grown, and more surgeons are now performing these surgeries than ever before. According to findings from the study, a fairly astounding number of injuries or symptoms were related to occupation...
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