Begell House Inc.
Journal of Long-Term Effects of Medical Implants
JLT
1050-6934
16
3
2006
Avian Flu Pandemic in the United States. The Sanitec Industry's Solution
205-206
10.1615/JLongTermEffMedImplants.v16.i3.10
Richard
Edlich
Legacy Verified Level I Shock Trauma Center Pediatrics and Adults, Legacy Emanual Hospital; and Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health System, USA
Lise
Borel
Sales and Pharmaceutical Representative, West Chester, Pennsylvania, USA
H. Gordon
Jensen
Life Member of the American Society of Civil Engineers, Life Senior Member of the Institute of Electrical and Electronic Engineers, Oregon City, Oregon, USA
Kathryne L.
Winters
Website Manager and Information Specialist, Trauma Specialists, LLP, Legacy Emanuel Hospital, Portland, OR, USA
William B.
Long III
Trauma Specialists LLP, Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emmanuel Hospital, Portland, OR, USA
K. Dean
Gubler
Surgical Critical Care, Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emanuel Hospital, Portland, OR, USA
Melissa A.
Corson
Information Specialist, Vancouver, WA, USA
Jill Amanda
Greene
Washington State University, Vancouver, WA, USA
Dillon E.
Chang
Chairman, Department of Anesthesiology, Kapiolani Medical Center for Women and Children, Honolulu, Hawaii, USA
Jonathan
Korngold
Pre-Medical Student, New York, New York, USA
W. Randolph
Chitwood, Jr.
Professor of Surgery; Senior Associate Vice Chancellor Health Sciences (Cardiovascular Diseases); Chief, Division of Cardiothoracic and Vascular Surgery, Brody School of Medicine/East Carolina University, Greenville, NC, USA
Kant Y.
Lin
Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA, USA
Larry S.
Nichter
Pacific Center for Plastic Surgery, Huntington Beach, CA, USA
Susan
Berenson
Clinical Nurse Specialist in Integrative Medicine Certified by the American Reflexology Certification Board, Certified for Reiki Level II, Memorial Sloan Kettering Cancer Center, New York, NY, USA
L.D.
Britt
Chairman, Brickhouse Professor of Surgery, Department of General Surgery, Eastern Virginia Medical School, Hofheimer Hall, 825 Fairfax Ave., Norfolk, VA 235001, USA
John A.
Tafel
Physical Medicine and Rehabilitation, Livermore, Colorado, USA
On the basis of the extensive testing of the Sanitec Industries, Inc. waste management system by the North Carolina State University, the authors of this Editorial strongly recommend the immediate implementation of the Sanitec medical waste disinfection system throughout the United States to prevent the potential pandemic of the Avian Flu viral infection.
A Tribute to a Gifted Scholar, Anne Hudson, Who Has Made Revolutionary Advances in Healthcare and Patient Safety in Our Nation
207-222
10.1615/JLongTermEffMedImplants.v16.i3.20
Richard
Edlich
Legacy Verified Level I Shock Trauma Center Pediatrics and Adults, Legacy Emanual Hospital; and Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health System, USA
This article describes how Mary Anne Hudson, RN, BSN, turned a devastating spinal injury from lifting patients into a powerful, national-level campaign for safe patient handling in America. Anne Hudson was a well-respected nurse, caring for acutely ill patients in medical-surgical, telemetry, and intermediate care units of a hospital, until a spinal injury from lifting patients ended her hospital career. She discovered that training in “correct” patient lifting technique and body mechanics was inadequate to protect against injury with lifting adult patients of all sizes. The injury led to 2 years of conservative treatment, followed by a two-level, anterior-posterior, lumbar, interbody fusion, with placement of cadaver bone grafts and titanium hardware.
During nearly 5 years of dealing with the workers' compensation system, Anne Hudson found that workers' compensation does not assist back-disabled nurses to return to their employment, but, typically re-directs such injured nurses away from nursing, into lower-paying, non-nursing work. With permanent lifting restrictions, Anne Hudson counts herself as quite fortunate to have found other employment as a public health nurse with the county health department. She was aware that a cycle of pain, frustration, and depression is common among injured nurses who are terminated when they can no longer lift. Anne Hudson's response was to seek information on back injury to nurses. She discovered that the National Institute for Occupational Safety and Health recommends a safety lifting limit of 51 lbs. for men, 46 lbs. for women; that research has proven there are no safe methods of manual patient lifting; that healthcare workers suffer more work-related musculoskeletal injuries than any other occupation; that a survey of injured nurses revealed that the majority of nurse back injuries are to lumbar spinal discs; and that use of safe, mechanical, patient-lift equipment could prevent most nurse back injury. Anne Hudson learned that manual lifting had been described as deplorable, inefficient, dangerous to nurses, and often painful and brutal to patients. She knew thatpatients could suffer pain, bruising, skin tears, abrasions, tube dislodgement, and sometimes dislocations, fractures, and being dropped by nursing staff during attempts to lift. Anne Hudson learned about “no lifting” patient handling practices in other countries, such as England and Australia, where government regulations and nursing policies have banned manual lifting for many years due to the recognized danger to patients and nurses.
Her devastating spinal injury became the catalyst for Anne Hudson to become a voice for back-injured nurses, to speak out against the irrefutable hazard of manual patient lifting and to endorse modern, more humane, mechanized patient lifting. Anne Hudson was prepared for her advocacy role by excellent training during her Associate of Science in Nursing program at Southwestern Oregon Community College, with the guidance of her highly-esteemed nursing advisor, Dr. Angie Quinn, and by her Bachelor of Science in Nursing program at Oregon Health Sciences University, where she was inspired by her much-admired nursing instructor, Carol Christieb, who portrayed the significance of contributions made by nurses on the community level. With a crucial message to share, Anne Hudson now had a vision of “caring” for the community of nurses.
A fortuitous meeting with William Charney, the remarkable man whose pioneering research with “no lift” policy and “lift team” use of patient-lift equipment proved that most nurse back injury could be prevented, at tremendous financial savings on medical and compensation costs, led to opportunities to speak on behalf of back-injured nurses at healthcare and safety conferences, including the Safe Patient Handling and Movement Conference, Occupational Hazards to Health Care Workers Conference, Association of Occupational Health Professionals in Healthcare National Convention, and Healthcare Ergonomics Conference. Anne Hudson's first international speaking event occurred on November 23, 2005, at the Australian Nursing Federation Victorian Branch “No Lifting Expo” in Melbourne, Victoria. Anne Hudson has put aside her natural inclination to avoid public speaking in order to increase awareness of the epidemic of needless back injury from manual patient lifting; to expose the plight of back-injured nurses, often terminated as worthless when disabled by forced hazardous lifting; and to espouse the need for state and national “safe patient handling−no manual lift” legislation. To further the cause of such legislation, she was the guest on a television news talk show and was interviewed for a television news broadcast. Anne Hudson has, also, met with the officers of multiple labor unions that represent healthcare workers, regarding efforts for state legislation, and, with state and national legislators, with the ultimate goal of a national mandate for “safe patient handling−no manual lift” in America.
When Anne Hudson became back-injured, she could find no organized support for injured nurses. This was surprising since back injury is such a common problem among nurses. She has reached out to help injured nurses by founding Work Injured Nurses' Group USA (WING USA) at www.wingusa.org, which offers information, mutual support, and advocacy for back-injured nurses and other healthcare workers. There are currently about 550 visitors per day from at least six countries. Online contacts have led to many special and lasting friendships, including with Maria Bryson, an English nurse who is an influential and widely-respected Royal College of Nursing Work Injured Nurses Group steward and safety representative, and Elizabeth Langford, Coordinator of the Australian Nursing Federation Victorian Branch Injured Nurses' Support Group, whose landmark report, Buried But Not Dead: A Survey of Occupational Illness and Injury Incurred by Nurses in the Victorian Health Service Industry, sparked the “no lifting” movement in Australia and provided the foundation for the Australian Nursing Federation Victorian Branch No Lifting Policy. Elizabeth Langford's research revealed that the majority of back-injured nurses reported lumbar disc injury, indicating that work injury data listing “sprains and strains” as most common may capture only an initial diagnosis, thereby obscuring the true severity of back injury to nurses, the majority of which appears to be disc injury which may be discovered by diagnostic testing at a later date.
Anne Hudson has become a prolific writer on issues surrounding back injuries to nurses and safe patient handling. She collaborated with William Charney on Back Injury among Healthcare Workers: Causes, Solutions, and Impacts, the most definitive book to date on the epidemic of back injuries caused by manually lifting patients. The first of its kind, the book combines preventive technology with the financial and ethical case for implementing comprehensive, safe patient handling programs that eliminate manual patient lifting. This book presents comprehensive information on the hazards of manual patient lifting and proven solutions, through the use of modern technology, with an international perspective. Intertwined with technical information on injury prevention are the poignant personal stories of back-injured nurses, revealing the lasting, devastating impacts of severe injury caused by physically lifting patients. Contributing author Elizabeth Shogren observed that the healthcare industry has relied upon people to do the work of machines.
Anne Hudson joined the Editor-in-Chief of the Journal of Long-Term Effects of Medical Implants, and a team of gifted scientists, to publish three papers. “Prevention of Disabling Back Injuries in Nurses by the Use of Mechanical Patient Lift Systems” explores the benefits of overhead mechanical lift systems in preventing back injuries among healthcare workers, such as offered by Guldmann, Inc., one of the largest, and indisputably most-experienced, overhead lift installers in the United States. “The Sit & Stand™ Chair. A Revolutionary Advance in Adaptive Seating Systems” explains that a major factor governing independence for the elderly and persons with disabilities is the ability to stand from a chair. The report describes the innovative Sit & Stand™Chair, which allows the elderly and persons with disabilities to achieve a standing position without the assistance of a healthcare worker. Following publication, this lift system became commercially available from Golden Inc., marketed as the Easy Up Chair. After Anne Hudson joined the Editorial Board of the Journal of Long-Term Effects of Medical Implants, she coordinated a comprehensive review on the crisis of devastating back injuries in healthcare workers, which involved 30 distinguished healthcare professionals across our nation. “Devastating Injuries in Healthcare Workers: Description of the Crisis and Legislative Solution to the Epidemic of Back Injury from Patient Lifting” describes the crisis in healthcare of disabling back injuries in U.S. healthcare workers and outlines the proven solution of safe, mechanized, patient lifting. Because the U.S. healthcare industry has not voluntarily implemented mechanical lift devices to reduce back injuries to healthcare workers, Anne Hudson believes the solution must be mandated through state and federal legislation. Additionally, Medicare reimbursement policies must be updated to allow the disabled community to purchase electrically operated overhead ceiling lifts for use in their homes.
Anne Hudson's outstanding article, “Texas Passes First Law for Safe Patient Handling in America: Landmark Legislation Protects Healthcare Workers and Patients from Injury related to Manual Patient Lifting,” heralds the dawn of a new era of safe patient handling in America. With the signing of Texas Senate Bill 1525, by Republican Governor Rick Perry on June 17, 2005, Texas became the first state in the nation to adopt legislation requiring hospitals and nursing homes to implement a safe patient handling and movement program. TX SB 1525, which will take effect January 1, 2006, requires hospitals and nursing homes to adopt a policy to develop strategies to control risk of injury to nurses and patients with lifting and movement. Also included is provision for nurses to refuse to perform patient handling activities which are believed in good faith to expose a patient or nurse to an unacceptable risk of injury. Anne Hudson highly commends Texas Governor Rick Perry for taking this heroic first stand for safe patient handling in America.
Anne was delighted to champion legislation in the state of Washington that represented a further advance in protecting healthcare workers and their patients from serious injury. Washington State HB 1672 was signed by Governor Gregoire on March 22, 2006. This law mandates that hospitals provide lift equipment as part of their policy for safe patient handling, with their choice of three options for implementation (http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf?Bills?House%20Passed%20Legislature/1672-S.PL.pdf).
Turning her unfortunate injury into victory for others, Anne Hudson has become a champion for nurses. Her vision is of the day when nurses no longer need to fear being disabled by dangerous lifting and losing their career to preventable back injury. Anne Hudson holds fast to her ultimate goal of meeting with President George W. Bush at the White House for the signing of national “safe patient handling−no manual lift” legislation in America.
Gait Change After Local Anesthetic of Chronically Arthritic Knee
223-234
10.1615/JLongTermEffMedImplants.v16.i3.30
K.
Zhang
Obesity Research Center, St Luke's-Roosevelt Hospital Center, and Institute of Human Nutrition, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY
A.
Gorjian
University of Southern California School of Dentistry, Los Angeles, CA
D. K.
Lester
University of California San Francisco-Fresno, Fresno, CA
Gait alterations of chronic knee arthritis before and after injection of local anesthesia was measured in the orthopedist's office area. A portable gait analyzer was used to evaluate gait characteristics before and after injection of local anesthesia in the chronically arthritic knee. Gait was analyzed during a 400-meter walk. Overall velocity and cadence increased 3.3% (p = 0.016) and 2.8% (p = 0.005). In-stance phase single and double support time (SLS and DLS) reduced 1.3% (p = 0.003) and 3.8% (p = 0.028). The ratio of SLS/DLS increased confirming a relatively increased duration in SLS as a percentage of the overall gait cycle. In swing phase the pulling power (initial swing), swing power (terminal swing) and ground impact increased 10.3% (p < 0.001), 6.8% (p = 0.003), and 4.2% (p = 0.003). Patients demonstrated fatigability at the end of walking measured as diminished velocity. Fatigability decreased after injection of the arthritic knee. The study demonstrates the specific gait phase changes afforded by injection of local anesthesia into the chronically arthritic knee. This study may serve as a benchmark for the measure of possible improvements afforded by different therapy for the patient suffering from chronic knee arthritis.
Technical Advances in Penile Prostheses
235-248
10.1615/JLongTermEffMedImplants.v16.i3.40
Stephen
Lazarou
Harvard Medical School, Beth Israel Deaconess Medical Center, Division of Urology, Boston, MA
Luis
Reyes-Vallejo
Harvard Medical School, Beth Israel Deaconess Medical Center, Division of Urology, Boston, MA
Abraham
Morgentaler
Harvard Medical School, Beth Israel Deaconess Medical Center, Division of Urology, Boston, MA
Despite the introduction of oral phosphodiesterase inhibitors, penile prostheses continue to be an important form of treatment for erectile dysfunction (ED). Penile prostheses are associated with high satisfaction rates due to their ease of use, reliability, and ability to provide excellent rigidity. Advances over the last decade include steps to reduce mechanical failures and surface coatings to prevent prosthetic infections. These advances make the penile prosthesis an excellent option for the treatment of ED, particularly for men who fail oral therapy.
Bone Grafts and Substitutes
249-260
10.1615/JLongTermEffMedImplants.v16.i3.50
C. Suzanne
Cutter
Research Fellow, Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA, and General Surgery Resident, New York Hospital Queens, Flushing, NY, USA
Babak J.
Mehrara
Assistant Attending Surgeon, Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA, and Assistant Professor of Surgery, Cornell University Medical College
Bone is a complex organ system that provides structural support for the human body while also serving an important protective function for the internal organs. It is estimated that over 500,000 bone-grafting procedures are performed annually in the United States. These procedures have stimulated the pursuit of novel biomaterials with ideal properties. Key goals are to develop a biomaterial to replace bone that is inexpensive, biocompatible, radiolucent, resistant to infection, compressible, and replaced by host bone. The purpose of this review is to present the uses of commercially available bone grafts substitutes including allografts, calcium sulfates, calcium phosphates, and polymer materials. Descriptions of these biomaterials are provided in the context of their applications including craniofacial surgery, neurosurgery, fracture repair, dental and periodontal procedures, as well as pediatric reconstruction.
IN MEMORIAM: A Tribute to Dr. Robert C. Allen, an Inspirational Teacher, Humanitarian, and Friend (Nov. 18, 1950−Mar. 24, 2005)
261-264
10.1615/JLongTermEffMedImplants.v16.i3.60
William B.
Long III
Trauma Specialists LLP, Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emmanuel Hospital, Portland, OR, USA
Richard
Edlich
Legacy Verified Level I Shock Trauma Center Pediatrics and Adults, Legacy Emanual Hospital; and Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health System, USA
Jill Amanda
Greene
Washington State University, Vancouver, WA, USA
Dr. Robert C. Allen was a gifted educator, as well as experienced ophthalmologist, who was a close personal friend of Dr. Edlich at the University of Virginia Health System. While serving on the faculty at the University of Virginia Health System, Dr. Allen proved to be a compassionate physician, who developed close personal relationships with the residents, faculty, and his patients. Dr. Allen was invited by Dr Edlich to be a member of the Editorial Board of the Journal of Long-Term Effects of Medical Implants. When Dr. Allen told Dr. Edlich that he had ocular melanoma in 2000, this news was a wake-up call to Dr. Edlich on the need to prevent skin cancer, as well as ocular melanoma. Empowered by this news, Dr. Edlich was honored to co-author four articles on skin cancer prevention, as well as the latest article focusing on prevention of ocular melanoma. The Ocular Melanoma Foundation (Richmond, VA (USA)) was founded in 2003 by Dr. Robert C. Allen to increase awareness, enhance education, and provide advocacy among both patients and health care professionals regarding this rare, but potentially lethal cancer. It has a website that provides patient information, up-to-date information and enables communication/ discourse between and among patients and practitioners (admin@ocularmelanoma.org). Dr. Allen died on March 24, 2005, at his home surrounded by family and loved ones.
When surgeons are faced with challenging healthcare diseases, Dr. Edlich's mentor, Dr. Owen Wangensteen, advised Dr. Edlich that he should seek the advice and guidance of skilled basic scientists, who are familiar with the problem. Dr. Wangensteen is recognized as the greatest surgical teacher during the 20th century. Consequently, Dr. Edlich enlisted the advice and guidance from the two co-authors of the next article regarding the scientific basis for the selection of sunglasses to prevent the development of cataracts, pterygia, skin cancer, as well as ocular melanoma. Dr. Reichow is a Professor of Optometry at Pacific University College of Optometry (Forest Grove, OR (USA)). Dr. Citek is Associate Professor of Optometry at Pacific University College of Optometry (Forest Grove (USA)).