scholarly journals Correction to: The Role of HbA1c as a Positive Perioperative Predictor of Surgical Site and Other Postoperative Infections: An Explorative Analysis in Patients Undergoing Minor to Major Surgery

2021 ◽  
Author(s):  
Andrea Kopp Lugli ◽  
Walter R. Marti ◽  
Lilian Salm ◽  
Edin Mujagic ◽  
Marcel Bundi ◽  
...  
Keyword(s):  
Major Surgery ◽  
Postoperative Infections

scholarly journals Decision Making from the Experience of Orthognathic Surgery Patients: A Grounded Theory Approach

2021 ◽  
pp. 238008442110144
Author(s):  
N.R. Paul ◽  
S.R. Baker ◽  
B.J. Gibson
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Treatment Options ◽  
Study Data ◽  
Primary Objective ◽  
Major Surgery ◽  
Future Research ◽  
Decision Making Process ◽  
Theory Approach

Introduction: Patients’ decisions to undergo major surgery such as orthognathic treatment are not just about how the decision is made but what influences the decision. Objectives: The primary objective of the study was to identify the key processes involved in patients’ experience of decision making for orthognathic treatment. Methods: This study reports some of the findings of a larger grounded theory study. Data were collected through face-to-face interviews of patients who were seen for orthognathic treatment at a teaching hospital in the United Kingdom. Twenty-two participants were recruited (age range 18–66 y), of whom 12 (male = 2, female = 10) were 6 to 8 wk postsurgery, 6 (male = 2, female = 4) were in the decision-making stage, and 4 (male = 0, female = 4) were 1 to 2 y postsurgery. Additional data were also collected from online blogs and forums on jaw surgery. The data analysis stages of grounded theory methodology were undertaken, including open and selective coding. Results: The study identified the central role of dental care professionals (DCPs) in several underlying processes associated with decision making, including legitimating, mediating, scheduling, projecting, and supporting patients’ decisions. Six categories were related to key aspects of decision making. These were awareness about their underlying dentofacial problems and treatment options available, the information available about the treatment, the temporality of when surgery would be undertaken, the motivations and expectation of patients, social support, and fear of the surgery, hospitalization, and potentially disliking their new face. Conclusion: The decision-making process for orthognathic treatment is complex, multifactorial, and heavily influenced by the role of DCPs in patient care. Understanding the magnitude of this role will enable DCPs to more clearly participate in improving patients’ decision-making process. The findings of this study can inform future quantitative studies. Knowledge Transfer Statement: The results of this study can be used both for informing clinical practice around enabling decision making for orthognathic treatment and also for designing future research. The findings can better inform clinicians about the importance of their role in the patients’ decision-making process for orthognathic treatment and the means to improve the patient experience. It is suggested that further research could be conducted to measure some of the key constructs identified within our grounded theory and assess how these change during the treatment process.

The Role of Nutritional Access in Malnourished Elderly Undergoing Major Surgery for Acute Abdomen: A Propensity Score-Matched Analysis

2020 ◽  
pp. 000313482097371
Author(s):  
Shekhar Gogna ◽  
David Samson ◽  
James Choi ◽  
Jorge Con ◽  
Kartik Prabhakaran ◽  
...  
Keyword(s):  
Propensity Score ◽  
Abdominal Surgery ◽  
Acute Abdomen ◽  
Anastomotic Dehiscence ◽  
The Elderly ◽  
Major Surgery ◽  
P Value ◽  
Gastrointestinal Complications ◽  
Group I

Background About 50% of the elderly undergoing emergency abdominal surgery are malnourished. The role of timely surgical nutritional access in this group of patients is unknown. Methods We analyzed the National Inpatient Sample database from 2009 through the first three-quarters of 2015 of patients aged ≥65 years who were malnourished and underwent major abdominal surgery for the acute abdomen within the first 2 days of hospital admission. Results Of 3 246 721 patients analyzed, 4311 patients met inclusion criteria. Of these, only 507 (11.8%) patients had surgical nutritional access (gastrostomy or jejunostomy) (group I), while 3804 patients (88.2%) did not (group II). In the propensity score-matched population, there were 482 patients in each group. The patients in group I had lower odds of mortality and postoperative gastrointestinal complications (paralytic ileus, anastomotic dehiscence, and intestinal fistulae) ( P-value <.01, respectively). Discussion Elderly who receive surgical nutritional access have lower rates of gastrointestinal complications and mortality.

scholarly journals Septoplasty with and without additional sinonasal surgery: postoperative sequelae and the use of prophylactic antibiotics

2021 ◽  
Author(s):  
Ida Kotisalmi ◽  
Maija Hytönen ◽  
Antti A. Mäkitie ◽  
Markus Lilja
Keyword(s):  
Infection Rate ◽  
Postoperative Infection ◽  
Patient Characteristics ◽  
Neck Surgery ◽  
Prophylactic Antibiotics ◽  
University Hospital ◽  
Postoperative Infections ◽  
Prophylactic Measure ◽  
Prophylaxis Group

Abstract Purpose One of the most common complications after septoplasty is a postoperative infection. We investigated the number of postoperative infections and unplanned postoperative visits (UPV) in septoplasties with and without additional nasal surgery at our institution and evaluated the role of antibiotic prophylaxis. Methods We collected data of all consecutive 302 septoplasty or septocolumelloplasty patients operated during the year 2018 at the Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital (Helsinki, Finland). Hospital charts were reviewed to record sociodemographic patient characteristics and clinical parameters regarding surgery and follow-up. Results Altogether 239 patients (79.1%) received pre- and/or postoperative prophylactic antibiotics and within this group 3.3% developed a postoperative infection. The infection rate in the non-prophylaxis group of 63 patients was 12.7% (p = 0.007). When all patients who received postoperative antibiotics were excluded, we found that the infection rate in the preoperative prophylaxis group was 3.8%, as opposed to an infection rate of 12.7% in the non-prophylaxis group (p = 0.013). When evaluating septoplasty with additional sinonasal surgery (n = 115) the rate of postoperative infection was 3.3% in the prophylaxis group and 16.7% in the non-prophylaxis group (p = 0.034). These results show a statistically significant stand-alone effect of preoperative prophylactic antibiotics in preventing postoperative infection in septoplasty, especially regarding additional sinonasal surgery. Conclusion The use of preoperative antibiotics as a prophylactic measure diminished statistically significantly the rate of infections and UPVs in septoplasty when all postoperative infections, superficial and mild ones included, were taken into account.

scholarly journals Do anesthesiologists need epidural anesthesia and do surgeons need an anesthesiologist?

2016 ◽  
Vol 10 (3) ◽  
pp. 155-164
Author(s):  
Alexei M. Ovechkin
Keyword(s):  
Epidural Anesthesia ◽  
Critical Analysis ◽  
Risk Groups ◽  
Convincing Evidence ◽  
Major Surgery ◽  
Minimally Invasive Techniques ◽  
Thoracic And Abdominal ◽  
Invasive Techniques ◽  
Infiltration Analgesia

Presented paper reviews up-to-date often contradictive concepts about the role of epidural anesthesia in anesthesiological support of patients undergone major surgery. The author performed critical analysis of the arguments of the opponents of the wide use of epidural analgesia who propose to substitute the epidural anesthesia with minimally invasive techniques in particular infiltration analgesia with local anesthetics. The article includes convincing evidence in favour of continuous epidural anesthesia remains the method of choice for open major thoracic and abdominal surgery especially in patients from high risk groups.

The diagnosis and surgical management of olfactory neuroblastoma: The role of craniofacial resection

1981 ◽  
Vol 95 (8) ◽  
pp. 785-799 ◽  
Author(s):  
P. Chapman ◽  
R. L. Carter ◽  
P. Clifford
Keyword(s):  
Electron Microscopy ◽  
Computerized Tomography ◽  
Surgical Management ◽  
Clinical Management ◽  
Olfactory Neuroblastoma ◽  
Major Surgery ◽  
Craniofacial Resection ◽  
Cytoplasmic Filaments ◽  
Extent Of Disease

SummaryThe diagnosis and clinical management of olfactory neuroblastoma are discussed. Computerized tomography is a valuable means of assessing the pre-operative extent of disease and the efficacy of subsequent major surgery. The tissue diagnosis is facilitated by electron microscopy, demonstrating the presence of dence core vesicles and cytoplasmic filaments. Radiotherapy followed by craniofacial resection is the treatment of choice for olfactory neuroblastomas that are locally extensive at presentation.

scholarly journals Predictive Role of F2-Isoprostanes as Biomarkers for Brain Damage after Neonatal Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
L. J. Stolwijk ◽  
P. M. A. Lemmers ◽  
M. Y. A. van Herwaarden ◽  
D. C. van der Zee ◽  
F. van Bel ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Risk Factors ◽  
Brain Injury ◽  
Multivariable Analysis ◽  
Major Surgery ◽  
Oxidative Stress Biomarkers ◽  
Stress Biomarkers ◽  
Significant Difference ◽  
Predictive Role

Objective. Neonates have a high risk of oxidative stress during anesthetic procedures. The predictive role of oxidative stress biomarkers on the occurrence of brain injury in the perioperative period has not been reported before. Methods. A prospective cohort study of patients requiring major surgery in the neonatal period was conducted. Biomarker levels of nonprotein-bound iron (NPBI) in plasma and F2-isoprostane in plasma and urine before and after surgical intervention were determined. Brain injury was assessed using postoperative MRI. Results. In total, 61 neonates were included, median gestational age at 39 weeks (range 31–42) and weight at 3000 grams (1400–4400). Mild to moderate brain lesions were found in 66%. Logistic regression analysis showed a significant difference between plasma NPBI in patients with nonparenchymal injury versus no brain injury: 1.34 umol/L was identified as correlation threshold for nonparenchymal injury (sensitivity 67%, specificity 91%). In the multivariable analysis, correcting for GA, no other significant relation was found with the oxidative stress biomarkers and risk factors. Conclusion. Oxidative stress seems to occur during anaesthesia in this cohort of neonates. Plasma nonprotein-bound iron showed to be associated with nonparenchymal injury after surgery, with values of 1.34 umol/L or higher. Risk factors should be elucidated in a more homogeneous patient group.

Clotting system activation in patients with cancer undergoing major surgery: The role of heparin prophylaxis

1992 ◽  
Vol 65 ◽  
pp. S112
Author(s):  
A. Falanga ◽  
F. Delaini ◽  
R. Caccia ◽  
S. Marziali ◽  
S. Longatti ◽  
...  
Keyword(s):  
Major Surgery ◽  
Clotting System ◽  
Patients With Cancer ◽  
System Activation ◽  
Heparin Prophylaxis

The Role of Perioperative Hyperglycemia in Postoperative Infections

2009 ◽  
Vol 43 (1) ◽  
pp. 103-109 ◽  
Author(s):  
Selwyn O. Rogers ◽  
Michael J. Zinner
Keyword(s):  
Postoperative Infections

scholarly journals Mediating role of perceived social support on mental health problems in pre-operative patients

2021 ◽  
Vol 25 (1) ◽  
pp. 63-70
Author(s):  
Muhammad Rafiq ◽  
Saba Safdar
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Mental Health Problems ◽  
Perceived Social Support ◽  
Health Problems ◽  
Major Surgery ◽  
Mediating Role ◽  
Self Compassion ◽  
Operative Recovery

Background: Pre-operative patients are not only suffering from physical and physiological symptoms but they might have psychological issues which may lead to mental health issues. However, different psychosocial factors may help in managing the mental health problems in pre-operative patients. Purpose: This study was aimed to investigate the mediating role of perceived social support on mental health problems in pre-operative patients. Methodology: The sample of the study consisted of 180 participants who were going to get their major surgery done in a week including 51% men and 49% women between the ages of 18-35 years. The participants were presented with a questionnaire including a demographics sheet and three Urdu translated scales as Self -Compassion Scale, Multidimensional Scale of Perceived Social Support, and Depression Anxiety and Stress Scale. Results: The results indicated that there was a significant negative correlation between self-compassion/perceived social support and mental health problems in pre-operative patients. The Pearson Product-Moment Correlation indicated a significant relationship among self-compassion, perceived social support, and mental health problems. Conclusion: The current study spotlighted the importance of the pre-operative time in young adults and the dire need for counseling services to be provided to the patients in this crucial time to enhance the chances of post-operative recovery and wellbeing of the patients. Key words: Self-compassion, Perceive Social Support, Mental Health problems, Pre-operative patients, Major Surgery, young adulthood Citation: Safdar S, Rafiq M. Mediating role of perceived social support on mental health problems in pre-operative patients. Anaesth. pain intensive care 2021;25(1):63–70; DOI: 10.35975/apic.v25i1.1442 Received: 2 December 2020, Reviewed: 1 January 2021, Accepted: 2 January 2021

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