Surgical, Urological and Medical Services of the Massachusetts General Hospital

1964 ◽  
Vol 2 (1) ◽  
pp. 160
Author(s):  
&NA;
Author(s):  
Ronald S. Weinstein ◽  
N. Scott McNutt

The Type I simple cold block device was described by Bullivant and Ames in 1966 and represented the product of the first successful effort to simplify the equipment required to do sophisticated freeze-cleave techniques. Bullivant, Weinstein and Someda described the Type II device which is a modification of the Type I device and was developed as a collaborative effort at the Massachusetts General Hospital and the University of Auckland, New Zealand. The modifications reduced specimen contamination and provided controlled specimen warming for heat-etching of fracture faces. We have now tested the Mass. General Hospital version of the Type II device (called the “Type II-MGH device”) on a wide variety of biological specimens and have established temperature and pressure curves for routine heat-etching with the device.


2019 ◽  
Vol 31 (2) ◽  
pp. 131

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dan B. Ellis ◽  
Aalok Agarwala ◽  
Elena Cavallo ◽  
Pam Linov ◽  
Michael K. Hidrue ◽  
...  

Abstract Background The Massachusetts General Hospital is a large, quaternary care institution with 58 operating rooms, 164 anesthesiologists, 76 certified nurse anesthetists (CRNAs), an anesthesiology residency program that admits 25 residents annually, and 35 surgeons who perform laparoscopic, vaginal, and open hysterectomies. In March of 2018, our institution launched an Enhanced Recovery After Surgery (ERAS) pathway for patients undergoing hysterectomy. To implement the anesthesia bundle of this pathway, an intensive 14-month educational endeavor was created and put into effect. There were no subsequent additional educational interventions. Methods We retrospectively reviewed records of 2570 patients who underwent hysterectomy between October 2016 and March 2020 to determine adherence to the anesthesia bundle of the ERAS Hysterectomy pathway. RESULTS: Increased adherence to the four elements of the anesthesia bundle (p < 0.001) was achieved during the intervention period. Compliance with the pathway was sustained in the post-intervention period despite no additional actions. Conclusions Implementing the anesthesia bundle of an ERAS pathway in a large anesthesia group with diverse providers successfully occurred using implementation science-based approach of intense interventions, and these results were maintained after the intervention ceased.


Author(s):  
Franklin José Espitia De La Hoz

Resumen Introducción El deseo sexual hipoactivo describe el bajo interés hacia la actividad sexual en general, caracterizando la escasa o nula motivación para tener relaciones eróticas, con disminución o ausencia de pensamientos o fantasías sexuales. Objetivo Evaluar la prevalencia y factores asociados, al deseo sexual hipoactivo en hombres del Quindío, así como estimar las demás disfunciones sexuales. Métodos Estudio observacional. La población estuvo constituida por 171 hombres que asistieron a consulta externa en una clínica universitaria de la ciudad de Armenia, Colombia, en el 2019. Se excluyeron los hombres menores de 18 años, residentes fuera del Quindío, situación psicopatológica o social que dificultara la comprensión del instrumento y los que no consintieron participar en el estudio. Se aplicó como instrumento el “Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ)”. Se evaluaron las características socio-demográficas, estilos de vida, salud sexual y reproductiva, antecedentes y comportamiento sexual. Se hizo análisis descriptivo. Resultados La edad promedio fue de 41,79 ± 11,46 años (rango 18–81). La prevalencia de disfunciones sexuales en el grupo estudiado fue de 21,63%. La puntuación del MGH-SFQ fue de 14,61 ± 4,23 puntos (variación: 7,26 - 19,26). Se presentaron dificultades con el interés sexual (15,78%), excitación sexual (6,43%), orgasmo (8,77%), erección (21,63%) y satisfacción sexual global (12,28%). La mediana de disfunciones sexuales por hombre fue de 2, que se hizo presente en el 27,48% %. El análisis multivariado (regresión logística) mostró que los factores asociados al deseo sexual hipoactivo fueron testosterona baja (OR: 5,59; IC95% 1,82–18,37), ansiedad / depresión (OR: 5,53; IC95% 1,72–18,43), convivencia en pareja mayor a 10 años (OR: 5,19; IC95%: 2,71–11,71), ansiedad de desempeño (OR: 4,62; IC95% 1,95–10,56), incremento de la edad (OR: 3,42; IC95%: 1,26–9,36), cansancio / estrés (OR: 2,58; IC95%: 1,08–3,28), trastornos del sueño (OR: 1,89; IC95%: 1,35–2,58), conflictos de pareja (OR: 1,53; IC95%: 1,02–2,37) y antecedente de disfunciones sexuales (OR: 1,47; IC95%: 0,99–2,22); mientras que, el uso de juguetes sexuales (OR: 0,78; IC95%: 0,72–0,96; p = 0,021), consumo de vitamina D (2000 UI / diarias) (OR: 0,64; IC95%: 0,42–0,96) o de Inhibidores de fosfodiesterasa-5 (OR: 0,78; IC95%: 0,63–0,93) constituyeron factores protectores. Conclusiones En el presente estudio, el 21,63% de los hombres presentaron disfunciones sexuales. Los trastornos de la erección (21,63%) y el interés sexual (15,78%), fueron los más afectados. La testosterona baja, ansiedad / depresión y convivencia en pareja mayor a 10 años, encabezan los principales factores asociados al deseo sexual hipoactivo. El hacer actividades juntos (OR: 0,44; IC95%: 0,34–0,68), el respeto a ser personas diferentes (OR: 0,53; IC95%: 0,41–0,71), mantener la armonía en la pareja (OR: 0,61; IC95%: 0,47–0,79) y la expresión de sentimientos a la pareja (OR: 0,68; IC95%: 0,46–0,95) constituyen una línea de protección para mejorar las estrategias de prevención de los trastornos sexuales en esa población.


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