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284 results on '"Papaconstantinou, Harry"'

54. Impact of a Novel Surgical Wound Protection Device on Observed versus Expected Surgical Site Infection Rates after Colectomy Using the National Surgical Quality Improvement Program Risk Calculator

Author

Papaconstantinou, Harry T., primary, Birnbaum, Elisa H., additional, Ricciardi, Rocco, additional, Margolin, David A., additional, Moesinger, Robert C., additional, Lichliter, Warren E., additional, Thomas, J. Scott, additional, and Bergamaschi, Roberto, additional

Published
2019
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57. The emerging role of microdialysis in diabetic patients undergoing amputation for limb ischemia

Author

Liasis, Lampros Malietzis, George Galyfos, George and Athanasiou, Thanos Papaconstantinou, Harry T. Sigala, Fragiska and Zografos, Georgios Filis, Konstantinos

Abstract

Lower limb ischemia in diabetic patients is a result of macro- and microcirculation dysfunction. Diabetic patients undergoing limb amputation carry high mortality and morbidity rates, and decision making concerning the level of amputation is critical. Aim of this study is to evaluate a novel microdialysis technique to monitor tissue microcirculation preoperatively and predict the success of limb amputation in such patients. Overall, 165 patients with type 2 diabetes mellitus undergoing lower limb amputation were enrolled. A microdialysis catheter was placed preoperatively at the level of the intended flap for the stump reconstruction, and the levels of glucose, glycerol, lactate and pyruvate were measured for 24consecutive hours. Patients were then amputated and monitored for 30 days regarding the outcome of amputation. Failure of amputation was defined as delayed healing or stump ischemia. Patients were divided into two groups based on the success of amputation. There was no difference between the two groups regarding gender, ASA score, body mass index, comorbidities, diagnostic modality used, level of amputation, as well as glucose, glycerol, and pyruvate levels. However, local concentrations of lactate were significantly different between the two groups and lactate/pyruvate (L/P) ratio was independently associated with failed amputation (threshold defined at 25.35). Elevated preoperative tissue L/P ratio is independently associated with worse outcomes in diabetic patients undergoing limb amputation. Therefore, preoperative tissue L/P ratio could be used as a predicting tool for limb amputation's outcome, although more clinical data are needed to provide safer conclusions.

Published
2016

59. Patients' Perspectives of Surgical Safety: Do They Feel Safe?

Author

Dixon, Jennifer L., Tillman, Matthew M., Wehbe-Janek, Hania, Song, Juhee, and Papaconstantinou, Harry T.

Subjects
Original Research
Abstract

Increased focus on reducing patient harm has led to surgical safety initiatives, including time-out, surgical safety checklists, and debriefings. The perception of the lay public of the surgical safety process is largely unknown.A 20-question survey focused on perceptions of surgical safety practice was distributed to a random sample of patients following elective operations requiring hospitalization. Responses were measured by a 7-point Likert scale. Qualitative feedback was obtained through nonphysician-moderated sessions. Participation was voluntary and anonymous.Surveys were distributed to 345 patients of whom 102 (29.5%) responded. Overall, patients felt safe as evidenced by scores for the questions "I felt safe the day of my surgery" (6.53 ± 0.72) and "Mistakes rarely happen during surgery" (5.39 ± 1.51). Patients undergoing their first surgery and patients with higher income levels were associated with a significant decrease in specific safety perceptions. Qualitative feedback sessions identified the physician-patient relationship as the most important factor positively influencing patient safety perceptions.Current surgical safety practice is perceived positively by our patients; however, patients still identify physician-patient interactions, relationships, and trust as the most positive factors influencing their perception of the safety environment.

Published
2015

68. Implementation of a Surgical Safety Checklist: Impact on Surgical Team Perspectives

Author

Papaconstantinou, Harry T., Jo, ChanHee, Reznik, Scott I., Smythe, W. Roy, and Wehbe-Janek, Hania

Subjects
Original Research
Abstract

The World Health Organization (WHO) surgical safety checklist has been shown to decrease mortality and complications and has been adopted worldwide. However, system flaws and human errors persist. Identifying provider perspectives of patient safety initiatives may identify strategies for improvement. The purpose of this study was to determine provider perspectives of surgical safety checklist implementation in an effort to improve initiatives that enhance surgical patients' safety.In September 2010, a WHO-adapted surgical safety checklist was implemented at our institution. Surgical teams were invited to complete a checklist-focused questionnaire 1 month before and 1 year after implementation. Baseline and follow-up results were compared.A total of 437 surgical care providers responded to the survey: 45% of providers responded at baseline and 64% of providers responded at follow-up. Of the total respondents, 153 (35%) were nurses, 104 (24%) were anesthesia providers, and 180 (41%) were surgeons. Overall, we found an improvement in the awareness of patient safety and quality of care, with significant improvements in the perception of the value of and participation in the time-out process, in surgical team communication, and in the establishment and clarity of patient care needs. Some discordance was noted between surgeons and other surgical team members, indicating that barriers in communication still exist. Overall, approximately 65% of respondents perceived that the checklist improved patient safety and patient care; however, we found a strong negative perception of operating room efficiency.Implementation of a surgical safety checklist improves perceptions of surgical safety. Barriers to implementation exist, but staff feedback may be used to enhance the sustainability and success of patient safety initiatives.

Published
2013

75. Re

Author

Liasis, Lampros, primary, Tierris, Ioannis, additional, Fotini, Lazarioti, additional, Clark, Clarence C., additional, and Papaconstantinou, Harry T., additional

Published
2013
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79. The novel BH3 α-helix mimetic JY-1-106 induces apoptosis in a subset of cancer cells (lung cancer, colon cancer and mesothelioma) by disrupting Bcl-xL and Mcl-1 protein–protein interactions with Bak

Author

Cao, Xiaobo, primary, Yap, Jeremy L, additional, Newell-Rogers, M Karen, additional, Peddaboina, Chander, additional, Jiang, Weihua, additional, Papaconstantinou, Harry T, additional, Jupitor, Dan, additional, Rai, Arun, additional, Jung, Kwan-Young, additional, Tubin, Richard P, additional, Yu, Wenbo, additional, Vanommeslaeghe, Kenno, additional, Wilder, Paul T, additional, MacKerell, Alexander D, additional, Fletcher, Steven, additional, and Smythe, Roy W, additional

Published
2013
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81. Traumatic abdominal wall hernia

Author

Liasis, Lampros, primary, Tierris, Ioannis, additional, Lazarioti, Fotini, additional, Clark, Clarence C., additional, and Papaconstantinou, Harry T., additional

Published
2013
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93. Not-so-Minor Injuries: Delayed Diagnosis of a Large Splinter.

Author

Liasis, Lampros, Howells, Lara, and Papaconstantinou, Harry T.

Subjects
WOUNDS & injuries, QUALITY of life, SIGMOIDOSCOPY, MAGNETIC resonance imaging, SURGERY
Abstract

Introduction: In contrast with victims of major trauma, patients who suffer minor injuries receive little specialist input. In most cases, this causes no difficulty, but there are situations where minor trauma results in persistent disability affecting the quality of life. Case Presentation: A young man sustained a perineal puncture wound resulting from a fall onto a bush. Following an initial delay, he sought medical advice for a continual pain in his right leg, and a discharging perineal wound. A computed tomography (CT) scan and flexible sigmoidoscopy failed to identify the cause, and he was subsequently discharged from hospital. One year after his initial presentation, a magnetic resonance imaging (MRI) scan identified a retained foreign body consistent with a fragment of wood. Conclusions: Penetrating trauma from wooden fragments provides a diagnostic challenge. A stubborn discharge from a wound must always raise the suspicion of retained fragment. Early and appropriate surgical exploration is imperative. [ABSTRACT FROM AUTHOR]

Published
2017
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100. House Staff Quality Council: One Institution's Experience to Integrate Resident Involvement in Patient Care Improvement Initiatives.

Author

Dixon, Jennifer L., Papaconstantinou, Harry T., Erwin III, John P., McAllister, Russell Keith, Berry, Tiffany, and Wehbe-Janek, Hania

Subjects
*HOSPITAL personnel, *MEDICAL records, *REIMBURSEMENT, *MEDICAL education, SCOTT & White Memorial Hospital (Temple, Tex.)
Abstract

Background: Residents and fellows perform a large portion of the hands-on patient care in tertiary referral centers. As frontline providers, they are well suited to identify quality and patient safety issues. As payment reform shifts hospitals to a fee-for-value-type system with reimbursement contingent on quality outcomes, preventive health, and patient satisfaction, house staff must be intimately involved in identifying and solving care delivery problems related to quality, outcomes, and patient safety. Many challenges exist in integrating house staff into the quality improvement infrastructure; these challenges may ideally be managed by the development of a house staff quality council (HSQC). Methods: Residents and fellows at Scott & White Memorial Hospital interested in participating in a quality council submitted an application, curriculum vitae, and letter of support from their program director. Twelve residents and fellows were selected based on their prior quality improvement experience and/or their interest in quality and safety initiatives. Results: In only 1 year, our HSQC, an Alliance of Independent Academic Medical Centers National Initiative III project, initiated 3 quality projects and began development of a fourth project. Conclusion: Academic medical centers should consider establishing HSQCs to align institutional quality goals with residency training and medical education. [ABSTRACT FROM AUTHOR]

Published
2013

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