Papers by Charles Chambers
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2015
Best practices should be followed in the catheterization laboratory for Radiation safety, and whe... more Best practices should be followed in the catheterization laboratory for Radiation safety, and when they are, this benefits patients, staff, and operator. Point radiation measurements do not accurately reflect either patient or staff radiation risk. Operators should: (a) know their own dose, (b) utilize all standard dose reduction methods, (c) realize the ethical issues inherent in personal protection at the expense of the patient.
Catheterization and Cardiovascular Interventions, 2015
Catheterization and cardiovascular diagnosis, 1997
The Laboratory Performance Standards Committee of the Society for Cardiac Angiography and Interve... more The Laboratory Performance Standards Committee of the Society for Cardiac Angiography and Interventions has proposed guidelines for establishing an internal peer review program in the cardiac catheterization laboratory. The first step is to establish a committee and a data base. This data base should include quality indicators that reflect: physician qualifications, outcomes of procedures, and processes of care. The outcomes must be risk-adjusted to account for the variable severity of illness. Data should be collected by catheterization laboratory personnel and entered into a laboratory-specific computerized data base. These data must be analyzed and organized into profiles that reflect the quality of care. Based on this information, the Committee would institute the following interventions to improve physician performance: education, clinical practice standardization, feedback and benchmarking, professional interaction, incentives, decision-support systems, and administrative inte...
Journal of vascular and interventional radiology : JVIR, 2015
Chinese medical journal, 2014
Catheterization and Cardiovascular Diagnosis, 1995
Retroperitoneal hemorrhage and associated hematoma is a rare but potentially life threatening com... more Retroperitoneal hemorrhage and associated hematoma is a rare but potentially life threatening complication of cardiac catheterization and coronary artery interventions. This case presents the potential diagnostic utility of a supine film of the abdomen for early identification of a retroperitoneal hematoma in a patient following acute infarction PTCA. o 1995 Wiley-Liss, Inc.
Progress in Biophysics and Molecular Biology, 2001
Several laboratories have now developed methods to make single-molecule mechanical recordings fro... more Several laboratories have now developed methods to make single-molecule mechanical recordings from interacting pairs of biological molecules. The mechanical work done (product of force and distance) by a single biomolecular interaction is usually of the same order as thermal energy. Recordings made from non-processive, intermittently interacting, molecular motors such as acto-myosin therefore contain a large background of thermal noise. We have applied Page's test to analyse mechanical interactions between muscle myosin II's and F-actin recorded using an optical tweezers based single-molecule mechanical transducer. We compare Page's test with other variance-based methods and find it to be a robust method for analysing both simulated and real data sets. We discuss some of the problems associated with automatic detection of transient mechanical events in noisy data signals, and show that if the start and end points of individual events are known accurately then the events may be synchronised and combined to give more detailed information about different mechanical states.
The Journal of Thoracic and Cardiovascular Surgery, 2000
endoscopic instruments have accentuated the effect of the surgeon's tremor, making completion of ... more endoscopic instruments have accentuated the effect of the surgeon's tremor, making completion of an anastomosis both difficult and time consuming. 7 Recent technological developments have addressed the difficulties associated with endoscopic CABG. To overcome the limitations of traditional endoscopic instruments, robotic systems have been developed to enhance surgical dexterity. We have used one of these systems to perform a prospective clinical trial of endoscopic CABG.
Journal of the American College of Cardiology, 2009
Journal of the American College of Cardiology, 2004
Journal of Pharmacological and Toxicological Methods, 2013
This report is based on discussions and submissions from an expert working group consisting of ve... more This report is based on discussions and submissions from an expert working group consisting of veterinarians, animal care staff and scientists with expert knowledge relevant to the field. It aims to facilitate the implementation of the Three Rs (replacement, reduction and refinement) in the use of animal models or procedures involving experimental autoimmune encephalomyelitis (EAE), an experimental model used in multiple sclerosis research. The emphasis is on refinement since this has the greatest potential for immediate implementation. Specific welfare issues are identified and discussed, and practical measures are proposed to reduce animal use and suffering. Some general issues for refinement are summarised to help achieve this, with more detail provided on a range of specific measures to reduce suffering.
Journal of Pharmacological and Toxicological Methods, 2013
This report is based on discussions and submissions from an expert working group consisting of ve... more This report is based on discussions and submissions from an expert working group consisting of veterinarians, animal care staff and scientists with expert knowledge relevant to the field and aims to facilitate the implementation of the Three Rs (replacement, reduction and refinement) in the use of animal models or procedures involving seizures, convulsions and epilepsy. Each of these conditions will be considered, the specific welfare issues discussed, and practical measures to reduce animal use and suffering suggested. The emphasis is on refinement since this has the greatest potential for immediate implementation, and some general issues for refinement are summarised to help achieve this, with more detail provided on a range of specific refinements.
Journal of Cardiothoracic and Vascular Anesthesia, 2001
Journal of Cardiac Surgery, 2010
This prospective study was performed as a Phase 1 Food and Drug Administration clinical trial to ... more This prospective study was performed as a Phase 1 Food and Drug Administration clinical trial to assess the safety and feasibility of robotically assisted coronary artery bypass grafting (CABG). Eighteen patients undergoing elective CABG were enrolled in this study. Full sternotomy was performed in 17 of 18 patients, while cardiopulmonary bypass and cardioplegic arrest was used in all cases. Robotically assisted CABG of the left internal thoracic artery (LITA) to the left anterior descending artery (LAD) was performed through three ports using a robotically assisted microsurgical system. Conventional techniques were used to perform all other grafts. Blood flow in the LITA graft was measured in the operating room, and when necessary, angiography was performed. Six weeks after the operation, all patients underwent selective coronary angiography of the LITA graft. Robotically assisted coronary artery anastomoses were successfully completed in all patients. Blood flow through the LITA graft was adequate in 16 of 18 patients (89%). The two inadequate grafts were revised successfully by hand. Six weeks after the operation, angiography demonstrated a graft patency of 100% (13 of 13). Mean follow-up has been over 190 days. All patients remain New York Heart Association Angina Class I. Robotic assistance represents an enabling technology that may allow the surgeon to perform endoscopic coronary artery anastomoses. Further clinical trials are needed to explore the clinical potential and value of robotically assisted CABG.
Clinical Obstetrics and Gynecology, 1994
Catheterization and …, 1995
This report represents the first guidelines for prevention, diagnosis, and treatment of anaphylac... more This report represents the first guidelines for prevention, diagnosis, and treatment of anaphylactoid reactions to contrast media occurring specifically during cardiac catheterization. The incidence of contrast media complications in the catheterization laboratory is 0.23% with 1 death per 55,000. Anaphylactoid reactions are nonimmune mediated, but histamine release and other mediators produce a clinical presentation indistinguishable from anaphylaxis. In patients with known previous reactions, pretreatment with steroids and diphenhydramine and the use of nonionic contrast media have significantly reduced the potential of recurrent reaction. Minor reactions such as limited urticaria may be watched for progression or treatment with diphenhydramine, whereas more serious reactions such as angioedema or laryngeal edema require airway stability and ephinephrine administration. Shock should be vigorously treated simultaneously with intravenous epinephrine and large volumes of normal saline. If the patient can be stabilized, the study should be completed as histamine, leukotrienes, and other vasoactive products should be relatively depleted.
Catheterization and Cardiovascular Interventions, 2009
Catheterization and Cardiovascular Interventions, 2004
Coronary intervention may be combined with diagnostic cardiac catheterization or performed separa... more Coronary intervention may be combined with diagnostic cardiac catheterization or performed separately. In the early years of angioplasty, performing these procedures separately was standard practice. Gradually, ad hoc intervention (performing diagnostic angiography and coronary intervention within the same session) has become more common, largely because of its convenience for patients and efficiency for physicians. However, the safety and potential cost savings of this approach remain uncertain. Criteria for the appropriate use of ad hoc intervention have not been established. Ad hoc intervention is reasonable for many, but not appropriate for all patients and should not be considered standard therapy. This document updates an earlier review of this topic and provides suggestions for the use of ad hoc intervention as a routine strategy. Catheter
Catheterization and Cardiovascular Interventions, 2011
As described in Part I of this Position Statement [1], programmatic assessment of percutaneous co... more As described in Part I of this Position Statement [1], programmatic assessment of percutaneous coronary intervention (PCI) outcomes is fundamental to the delivery of high quality care. Quality improvement requires documenting clinical outcomes and modifying ...
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Papers by Charles Chambers