Parental Views on the Non-Operative Management of Simple Appendicitis in Children: Results of a Cross-Sectional Survey

2021 ◽  
Author(s):  
N. Ensor ◽  
K. R. Qin ◽  
M. Sivasubramaniam ◽  
B. Roddis ◽  
K. Mayakaduwage ◽  
...  
Keyword(s):  
Operative Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Parental Views ◽  
Non Operative Management

scholarly journals Anaesthetic management of maxillofacial surgeries: A cross-sectional survey to analyze current trend of practices

2021 ◽  
Vol 8 (2) ◽  
pp. 331-334
Author(s):  
Ayya Syama Sundar ◽  
Akhya Kumar Kar ◽  
Emmala Mounika
Keyword(s):  
Head Injury ◽  
Current Trend ◽  
Operative Management ◽  
Anaesthetic Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Operative Care ◽  
Delayed Extubation ◽  
Operative Evaluation ◽  
Special Subset

Anaesthetic management of maxillo-facial surgeries considered as special subset of surgery where the airway management needs proper attention. Most of the time it varies depending on the resources and skill availability. We tried to evaluate the current trend of practices in managing maxilla-facial surgeries among various practicing anaesthesiologists. This is a retrospective questionnaire based survey conducted among practicing anaesthesiologists to determine the trend of practices and institutional protocols followed for maxillo-facial surgeries. A set of questionnaires prepared to ask about the preferred mode of securing airway, frequency of facing complications and plan for extubation and post-operative management. Total of 86 responses were collected which were analyzed. A total of 91% evaluated the airway with history and physical examination. Fiberoptic broncoscope available in 46% of cases, 51% cases video laryngoscope was preferred as gadget. Naso-tracheal is the commonest route for securing the airway which was preferred by 53% respondents. Only 38% respondents were in favor of extubation of the patients inside the operation theatres after surgery for patients without head injury. In patients with head injury 90% responders believed either a delayed extubation in the ICU or elective ventilation for some hours before extubation is a better option. Most of the anaesthesiologists (61%) preferred shifting the patients to the ICU for post-operative care. Theanaestheticmanagement ofmaxillo-facial surgeries need special attention. It necessitates proper pre-operative evaluation, shared decision making with the surgeons, timely decision of extubation and post-operative care are keys to successfully manage the airway.

Sport-Related Structural Brain Injury and Return to Play: Systematic Review and Expert Insight

Neurosurgery ◽  
2021 ◽  
Author(s):  
Scott L Zuckerman ◽  
Aaron M Yengo-Kahn ◽  
Alan R Tang ◽  
Julian E Bailes ◽  
Kathryn Beauchamp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Injury ◽  
Case Reports ◽  
Operative Management ◽  
Return To Play ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Expert Opinions ◽  
Meta Analyses ◽  
Structural Brain

Abstract BACKGROUND Sport-related structural brain injury (SRSBI) is intracranial pathology incurred during sport. Management mirrors that of non-sport-related brain injury. An empirical vacuum exists regarding return to play (RTP) following SRSBI. OBJECTIVE To provide key insight for operative management and RTP following SRSBI using a (1) focused systematic review and (2) survey of expert opinions. METHODS A systematic literature review of SRSBI from 2012 to present in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and a cross-sectional survey of RTP in SRSBI by 31 international neurosurgeons was conducted. RESULTS Of 27 included articles out of 241 systematically reviewed, 9 (33.0%) case reports provided RTP information for 12 athletes. To assess expert opinion, 31 of 32 neurosurgeons (96.9%) provided survey responses. For acute, asymptomatic SRSBI, 12 (38.7%) would not operate. Of the 19 (61.3%) who would operate, midline shift (63.2%) and hemorrhage size > 10 mm (52.6%) were the most common indications. Following SRSBI with resolved hemorrhage, with or without burr holes, the majority of experts (>75%) allowed RTP to high-contact/collision sports at 6 to 12 mo. Approximately 80% of experts did not endorse RTP to high-contact/collision sports for athletes with persistent hemorrhage. Following craniotomy for SRSBI, 40% to 50% of experts considered RTP at 6 to 12 mo. Linear regression revealed that experts allowed earlier RTP at higher levels of play (β = –0.58, 95% CI –0.111, –0.005, P = .033). CONCLUSION RTP decisions following structural brain injury in athletes are markedly heterogeneous. While individualized RTP decisions are critical, aggregated expert opinions from 31 international sports neurosurgeons provide key insight. Level of play was found to be an important consideration in RTP determinations.

scholarly journals Consensus-based classification system for intra-operative management of labral tears during hip arthroscopy—aggregate recommendations from high-volume hip preservation surgeons

2021 ◽  
Author(s):  
Ajay C Lall ◽  
Shawn Annin ◽  
Jeff W Chen ◽  
Samantha Diulus ◽  
Hari K Ankem ◽  
...  
Keyword(s):  
Decision Making ◽  
Classification System ◽  
High Volume ◽  
Operative Management ◽  
Labral Repair ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
System A ◽  
Labral Tears ◽  
Comprehensive Classification

Abstract The purpose of this study was to survey high-volume hip preservation surgeons regarding their perspectives on intra-operative management of labral tears to improve decision-making and produce an effective classification system. A cross-sectional survey of high-volume hip preservation surgeons was conducted in person and anonymously, using a questionnaire that is repeated for indications of labral debridement, repair and reconstruction given the torn labra are stable, unstable, viable or non-viable. Twenty-six high-volume arthroscopic hip surgeons participated in this survey. Provided the labrum was viable (torn tissue that is likely to heal) and stable, labral debridement would be performed by 76.92% of respondents for patients >40 years of age and by >84% of respondents for stable intra-substance labral tears in patients without dysplasia. If the labrum was viable but unstable, labral repair would be performed by >80% of respondents for patients ≤40 years of age and > 80% of respondents if the labral size was >3 mm and located anteriorly. Presence of calcified labra or the Os acetabuli mattered while deciding whether to repair a labrum. In non-viable (torn tissue that is unlikely to heal) and unstable labra, labral reconstruction would be performed by 84.62% of respondents if labral size was <3 mm. The majority of respondents would reconstruct calcified and non-viable, unstable labra that no longer maintained a suction seal. Surgeons performing arthroscopic hip labral treatment may utilize this comprehensive classification system, which takes into consideration patient age, labral characteristics (viability and stability) and bony morphology of the hip joint. When choosing between labral debridement, repair or reconstruction, consensus recommendations from high-volume hip preservation surgeons can enhance decision-making.

scholarly journals Modalities in the management of splenic trauma

2020 ◽  
Vol 7 (9) ◽  
pp. 2940
Author(s):  
Swetha B. M. ◽  
Santosh Raja Erabati ◽  
V. V. Harika Majji
Keyword(s):  
Conservative Management ◽  
Road Traffic ◽  
Operative Management ◽  
Hemodynamic Instability ◽  
Splenic Trauma ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Hemodynamic Status ◽  
Fall From Height ◽  
Non Operative Management

Background: The aim of the study to study the modalities in the management of splenic trauma. Factors affecting non operative management in order to improve the outcome of conservative management, and the factors responsible for conversion to operative management.Methods: 30 patients were admitted in the Department of Surgery, NRI Institute of Medical Sciences, Visakhapatnam, satisfying the inclusion criteria between 01 June 2016 to 31 August 2018.Results: A cross-sectional type of study was performed. Among the 30 patients, 21 were male and 9 were female. It was seen that in 80% of patients the mode of injury was road traffic accident. Human assault, animal attack and fall from height contributed to 6.66% each. The most common reason for conversion to operative management was fragile hemodynamic status of the patient. 20% of the cases were grade I, 40% grade II, 26.66% grade III, 6.66% each of grade IV and grade V, all cases of grade IV and grade V were managed operatively. In this study 60% of the cases could be managed conservatively, 1 case (3.33%) splenorraphy was done. 33.3% (1/3rd) patients required splenectomy, and 1 (3.33%) patient expired who presented late and with hemodynamic instability, belonged to grade V splenic injury.Conclusions: Conservative management has replaced splenectomy as the most common method of splenic trauma management in patients with stable hemodynamic status. Higher grades of splenic injuries have been managed conservatively. As a result, 60% of all blunt splenic injuries can be managed non-operatively with a success rate of 98%. Operative management associated with stringent intensive care unit (ICU), transfusions are restricted to higher grades of splenic injuries.

scholarly journals Proportion of Cases Managed Non-Operatively and Its Predictors for Failure in Splenic Injury – A Cross Sectional Study from VSSIMSAR, Odisha

2021 ◽  
Vol 8 (17) ◽  
pp. 1116-1121
Author(s):  
Harekrishna Majhi ◽  
Abinasha Mohapatra ◽  
Sachin Paul James ◽  
Ashok Kumar Nayak
Keyword(s):  
Blood Pressure ◽  
Splenic Injury ◽  
Operative Management ◽  
Hemodynamic Instability ◽  
Cross Sectional Study ◽  
Primary Objective ◽  
Haemodynamic Instability ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Operative Management

BACKGROUND The primary objective in the management of splenic injury earlier was to achieve early haemostasis which resulted in splenectomy as the treatment of choice. But after recognising the role of spleen in immune and haematopoietic functions, nonoperative management (NOM) was started. In order to practice non-operative management safely a better way to assess the severity of splenic injury was necessary. Eventually it became possible with the advent of computed tomography. Along with clinical assessment, it enabled us in the selection of appropriate patients for non-operative management. Now this modality is considered as the gold standard for patients who are hemodynamically stable or readily stabilisable. It decreases the duration of hospital stay and prevents postoperative morbidity. We wanted to find out the proportion of cases and predictors for failure of non-operative management among splenic injury patients in VIMSAR, Burla. METHODS This cross-sectional study was done among 35 patients with splenic injury who were hemodynamically stable from November 2018 to October 2020. RESULTS Age, sex, systolic blood pressure, diastolic blood pressure, mechanism of injury, Glasgow Coma Score (GCS), associated injury (if hemodynamically stable) were not found to be significant predictors in deciding the failure of non-operative management. CONCLUSIONS Most important predictor for failure of non-operative management was development of haemodynamic instability. Tachycardia, low mean arterial pressure (MAP), drop in haemoglobin (Hb) and haematocrit were significant parameters in our study and all these parameters ultimately point towards hemodynamic instability. KEYWORDS Non-Operative Management (Successful), Non-Operative Management (Failure), Hemodynamically Stable, Blunt Trauma Abdomen

Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 82-88 ◽  
Author(s):  
Bob Lew ◽  
Ksenia Chistopolskaya ◽  
Yanzheng Liu ◽  
Mansor Abu Talib ◽  
Olga Mitina ◽  
...  
Keyword(s):  
Social Support ◽  
Suicidal Behavior ◽  
Online Survey ◽  
Perceived Social Support ◽  
Strain Theory ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychological Strains ◽  
Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conflicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

Fit and Congruency

2019 ◽  
Vol 18 (3) ◽  
pp. 148-156
Author(s):  
Mary Hogue ◽  
Lee Fox-Cardamone ◽  
Deborah Erdos Knapp
Keyword(s):  
Role Theory ◽  
Social Role ◽  
Gender Diversity ◽  
Job Fit ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Working Adults ◽  
Role Congruity ◽  
Self Selection ◽  
Selection Of

Abstract. Applicant job pursuit intentions impact the composition of an organization’s applicant pool, thereby influencing selection outcomes. An example is the self-selection of women and men into gender-congruent jobs. Such self-selection contributes to a lack of gender diversity across a variety of occupations. We use person-job fit and the role congruity perspective of social role theory to explore job pursuit intentions. We present research from two cross-sectional survey studies (520 students, 174 working adults) indicating that at different points in their careers women and men choose to pursue gender-congruent jobs. For students, the choice was mediated by value placed on the job’s associated gender-congruent outcomes, but for working adults it was not. We offer suggestions for practitioners and researchers.

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