Disrupted rhythms and mobile ICT in a surgical department

Aim. To study the influence of deproteinized dialysate from blood of milk-fed calves on the type of exudative discharge and dynamics of inflammatory reaction after hernia repair with plastics of the anterior abdominal wall with hernioendoprosthesis of polypropylene. Materials and Methods. The study involved 59 patients being on stationary treatment in the surgical department of Kursk Regional Clinical Hospital. Patients were hospitalized for the herniation of small or medium dimension. The patients were divided to two groups: the main (n=30) and control (n=29) groups. After endoprosthetics, the patients of the control group were given complex conservative treatment. The patients of the main group, besides standard treatment, were administered deproteinized dialysate from blood of milk-fed calves intravenously in drips 10 ml + 200 ml of 0.9% sodium chloride solution within 7 days. For cytological examination and determination of the type of cytograms, the traumatic discharge was collected and analyzed using the method of M.F. Kamaev and M.A. Palthsev. Results. Cytomorphometric examination was conducted on the third, fifth and seventh day after endoprosthetics with the aim of studying dynamic changes. Determination of cell composition and also of its changes characteristic of each studied period, was necessary for obtaining further information characterizing inflammatory process in the region of placement of the endoprosthesis. After endoprosthetics in patients who were administered hemodialysate, the inflammatory reaction was less pronounced than in patients who did not receive the preparation. This was associated with a more dynamic change of stages of the inflammatory process. In patients of the main group who received deproteinized dialysate, regenerative type of inflammation first appeared on the fifth day and made 6.9%; by the seventh day the share of patients with the regenerative type rose to 17.5%, while in the patients of the control group no regeneration stage was observed in both periods. Conclusion. Analysis of the efficiency of influence of hemodialysate on the inflammatory reaction in plastics of the anterior abdominal wall with polypropylene endoprosthesis evidences faster course of all stages of inflammation and reduction of its intensity by 10%.

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THE PRELIMINARY RESULTS OF OPERATION COLORECTAL ADENOMATOUS POLYPOSIS BY LAPAROSCOPY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.3.9 ◽

2017 ◽

pp. 63-68

Author(s):

Quoc Phong Le ◽

Nhu Hiep Pham

Keyword(s):

Laparoscopic Surgery ◽

Bowel Resection ◽

Right Hemicolectomy ◽

Adenomatous Polyposis ◽

Operative Indication ◽

Surgical Department ◽

Colorectal Polyposis ◽

Segmental Bowel Resection ◽

The Mean ◽

Bloody Stools

Objective: To study the clinical characteristics, paraclinic, the operative indication and treatment outcomes operation of colorectal polyposis by laparoscopic. Marterials: 12 patients with colorectal polyposis, is surgically the subtotal colectomy, and the total colorectomy by laparoscopic from 11/2012 to 4/2015 at Digestive Surgical Department of Hue Central Hospital. Method: Prospective study, all patients were examined clinically, endoscopic colorectal, operative indication, the type of surgery, lengh of post-operative stay, complications, and pathology. Results: From 11/2012 to 4/2015. We had overalled 12 patients: 8 males and 4 females, the mean patient was 36.33 ± 19.5 years of age (15-71). Dyspepsia 66.7%, bloody stools 100%. Laparoscopic segmental bowel resection in four (33,3%) cases: right hemicolectomy in one (8.3%), resection of transverse colon in one (8.3%), left hemicolectomy in two (16.7%), and totally colorectomy in eight (66.7%) by laparoscopic surgery. The mean post-operative hospital stay was 10.1 ± 3.8 days. The early complication: fistula anastomosis in one (8.3%), patients recovered after conservative treatment, no bleeding and no wound infection. The pathology is adematous polyps 91.7% and hyperplasia polyps 8.3%. Conclusion: Laparoscopic surgery is currently the technique of choice. The resection of colorectal polyposis is the method safe, effective, high success, low rate complications. Key words: laparoscopic, polyposis, colo-rectal polyposis, hemicolectomy

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ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.14 ◽

2011 ◽

pp. 114-118

Author(s):

Nhu Hiep Pham ◽

Huu Thien Ho ◽

Anh Vu Pham ◽

Van Nghia Tran

Keyword(s):

Laparoscopic Appendectomy ◽

Single Port ◽

Operation Time ◽

Invasive Procedure ◽

Minimal Invasive ◽

Central Hospital ◽

Surgical Department ◽

A New Technique ◽

Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

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187 Improving Awareness of Managing Post-Operative Haemorrhage in Patients Undergoing Thyroid and Parathyroid Surgery: The SCOOP Protocol

British Journal of Surgery ◽

10.1093/bjs/znab134.382 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

S Bhattacharya ◽

J Jegadeeson ◽

J Ramsingh ◽

P Truran

Keyword(s):

Nursing Staff ◽

Simulation Training ◽

Clinical Signs ◽

Skin Wound ◽

Junior Doctors ◽

Parathyroid Surgery ◽

Surgical Department ◽

Life Threatening ◽

Clinical Questions ◽

Life Threatening Complication

Abstract Introduction Post-operative haemorrhage is a rare but potentially life-threatening complication of thyroid surgery and occurs in 1 in 100 patients. Our aim was to assess current levels of awareness of post-operative haemorrhage in the surgical department and to improve confidence in managing this. Method Questionnaires with a combination of clinical questions were distributed amongst nurses, foundation doctors, senior house officers and registrars in the surgical department. Results There was a clear gap in awareness in all grades. The British Association of Endocrine and Thyroid surgeons (BAETS) have guidance on the management of these patients and in particular the acronym SCOOP (Steristrips removed, Cut subcuticular sutures, Open skin wound, Open strap muscles, Pack wound). 18/24 of participants had not heard of the SCOOP protocol. Most nurses (6/12) all junior doctors (8/8) showed lack of confidence in managing patients with suspected bleeding. Conclusions An informative poster was created for relevant clinical areas as per the BAETS recommendation. These posters outlined the steps in the SCOOP acronymas well as the main clinical signs of haemorrhage. BAETS recommend that all first responders, including nursing staff, junior doctors and the crash team should be aware of the SCOOP protocol. Simulation training sessions are in progress for these members of staff.

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Surgical leadership within rapidly changing working conditions in Germany

Innovative Surgical Sciences ◽

10.1515/iss-2019-0002 ◽

2019 ◽

Vol 4 (2) ◽

pp. 51-57 ◽

Cited By ~ 3

Author(s):

Thomas Schmitz-Rixen ◽

Reinhart T. Grundmann

Keyword(s):

Working Conditions ◽

Corporate Culture ◽

Employee Performance ◽

Working Hours ◽

Physician Assistants ◽

Work Life ◽

Work Life Balance ◽

Life Balance ◽

Surgical Department ◽

Chief Physician

AbstractIntroductionAn overview of the requirements for the head of a surgical department in Germany should be given.Materials and methodsA retrospective literature research on surgical professional policy publications of the last 10 years in Germany was conducted.ResultsSurveys show that commercial influences on medical decisions in German hospitals have today become an everyday, predominantly negative, actuality. Nevertheless, in one survey, 82.9% of surgical chief physicians reported being very satisfied with their profession, compared with 61.5% of senior physicians and only 43.4% of hospital specialists. Here, the chief physician is challenged. Only 70% of those surveyed stated that they could rely on their direct superiors when difficulties arose at work, and only 34.1% regarded feedback on the quality of their work as sufficient. The high distress rate in surgery (58.2% for all respondents) has led to a lack in desirability and is reflected in a shortage of qualified applicants for resident positions. In various position papers, surgical residents (only 35% describe their working conditions as good) demand improved working conditions. Chief physicians are being asked to facilitate a suitable work-life balance with regular working hours and a corporate culture with participative management and collegial cooperation. Appreciation of employee performance must also be expressed. An essential factor contributing to dissatisfaction is that residents fill a large part of their daily working hours with non-physician tasks. In surveys, 70% of respondents stated that they spend up to ≥3 h a day on documentation and secretarial work.DiscussionThe chief physician is expected to relieve his medical staff by employing non-physician assistants to take care of non-physician tasks. Transparent and clearly structured training to achieve specialist status is essential. It has been shown that a balanced work-life balance can be achieved for surgeons. Family and career can be reconciled in appropriately organized departments by making use of part-time and shift models that exclude 24-h shifts and making working hours more flexible.

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Weak ties matter: Social network dynamics of mobile media multiplexity and their impact on the social support and psychological well-being experienced by migrant workers

Mobile Media & Communication ◽

10.1177/20501579211001106 ◽

2021 ◽

pp. 205015792110011

Author(s):

Piper Liping Liu ◽

Tien Ee Dominic Yeo

Keyword(s):

Social Support ◽

Migrant Workers ◽

Well Being ◽

Weak Ties ◽

Mobile Media ◽

Strong Ties ◽

Psychological Well Being ◽

The Social ◽

Media Multiplexity ◽

Mobile Ict

This study investigates the contextual and relational characteristics that underlie people’s information and communication technology (ICT) use and the implications for their well-being. We contextualize this investigation according to migrants, because they are faced with disruptions to their personal networks in the migration process that may attenuate the availability of social support and negatively affect their mental health. Migrants tend to be proficient in using mobile ICT to connect with different social ties to fulfill their needs, which potentially makes a difference to their psychological well-being. Through a survey of 504 internal migrant workers in China, we examined the social network factors that underlie multiple mobile ICT use and the attendant influences on social support and psychological well-being. Redressing the overemphasis on the importance of strong ties in extant literature, this study highlights the salience of mobile media multiplexity (i.e., the use of multiple mobile communication channels for social interactions) in weak tie communication and the greater contribution of weak ties toward social support and psychological well-being than strong ties. Our findings suggest that mobile-mediated communicative relationships with newer and more distanced social connections outside their immediate circles enhance the well-being of migrants. We contend that media multiplexity vis-à-vis weak ties underscores the reconfiguration of migrants’ communicative relationships following the separation from original ties and facilitates rewarding interactions with new ties.

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708 Examining the Management of Acute Lower GI Bleeds in Order to Improve Policies and Reflect Safe and Updated Guidance

British Journal of Surgery ◽

10.1093/bjs/znab134.474 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

L Han ◽

H White ◽

K Bosch ◽

M Nair

Keyword(s):

Gastrointestinal Bleeding ◽

Surgical Intervention ◽

Lower Gastrointestinal Bleeding ◽

University Hospital ◽

British Society ◽

Shock Index ◽

Surgical Department ◽

Upper Gi ◽

Cardiovascular Comorbidities ◽

New Guidelines

Abstract Introduction Acute lower gastrointestinal bleeding (LGIB) tends to occur in elderly patients with complex comorbidities. At North Middlesex University Hospital (NMUH), LGIB patients are primarily managed by the surgical department. We amended local policies by integrating aspects of new guidelines published by the British Society of Gastroenterology (BSG). Method Handover documentation between November 2019 and January 2020 established patients admitted with LGIB (n = 45). Further data regarding the management of these patients was collated from clinical software and compared to standards set from BSG guidelines. Results We found NMUH to be efficient in ruling out upper GI bleeds via 24-hour OGDs and had low surgical intervention rates (0.02%). 40% of patients were transfused with an admission haemoglobin above suggested NICE thresholds, accounting for cardiovascular comorbidities. 56% of patients were discharged without a documented anticoagulation plan. Over 50% of patients did not have BSG recommended inpatient investigations. Conclusions Updated Trust guidelines aim to uphold areas that NMUH were shown to excel in, while reiterating NICE transfusion thresholds and include guidance regarding anticoagulant and antiplatelet medications. The Oakland score and shock index have been integrated into local protocols and will aid clinicians in making safe decisions in the management of LGIB patients.

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Academic relationships between Hungarian professors and the Second Vienna Medical School

Wiener Medizinische Wochenschrift ◽

10.1007/s10354-021-00840-y ◽

2021 ◽

Author(s):

Béla Szende ◽

Attila Zalatnai

Keyword(s):

Medical Education ◽

Medical School ◽

Medical Doctors ◽

Surgical Department ◽

Treatment And Prevention ◽

Obstetrics And Gynaecology ◽

Practice Of Medicine ◽

Vienna Medical School ◽

The University ◽

The Impact

SummaryThis article discusses the impact of the ‘second’ Vienna Medical School, hallmarked by Karl Rokitansky, Joseph Skoda and Ferdinand Hebra, on the study and practice of medicine in Hungary. Six medical doctors’ lives and achievements are outlined, who formed a bridge between Vienna and Budapest through their studies and work. Four of them returned to Hungary and promoted the cause of medicine and medical education there. Lajos Arányi (1812–1877) founded in 1844 the Institute of Pathology at the University of Pest. János Balassa (1814–1868) took the Chair of the Surgical Department. Ignaz Philip Semmelweis (1818–1865), the ‘Saviour of Mothers’, received a position at the Department of Obstetrics and Gynaecology in Vienna in 1846. Gustav Scheuthauer (1832–1894) became Arányi’s successor. Each of them continued to keep contact with their tutors in Vienna, especially with Karl Rokitansky, and followed the clinicopathological conception pioneered by the Vienna Medical School regarding diagnostics, treatment and prevention of diseases. Two physicians remained in Vienna: Mór Kaposi (1837–1902), who became known worldwide posthumously due to the connection between Kaposi’s sarcoma and AIDS, was the director of the Department of Dermatology of the Vienna University in 1878. Salomon Stricker (1837–1898) undertook the leadership of the Department of General and Experimental Pathology in 1872.

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Detailed head localization and incidence of skin cancers

Scientific Reports ◽

10.1038/s41598-021-91942-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Marta Fijałkowska ◽

Mateusz Koziej ◽

Bogusław Antoszewski

Keyword(s):

Skin Cancer ◽

Cell Carcinoma ◽

Vertical Dimension ◽

Surgical Department ◽

Surface Areas ◽

Common Cancer ◽

Skin Cancers ◽

Sex Type ◽

Cancer Subtype ◽

The Face

AbstractSkin cancers are the most common neoplasms; frequently, they localize on the face. The aim of paper is to present the incidence of skin tumors in a single center from 2017 to 2019, describe trends in its frequency and find relations between neoplasms and sex, type of cancer, and its size. An analysis of histopathological files from the surgical department between 2017 and 2019 was calculated. These items were selected: sex, age, type of skin cancer, subtype of basal cell carcinoma (BCC), grading of squamous cell carcinoma (SCC), localization and dimensions of the tumor. The study sample consisted of 387 cases. BCC was the most common cancer and its nodular type was the most frequent. In older patients, the vertical dimension of excised carcinoma was significantly larger. Moreover, this connection was detected only in women compared to men. There were statistically significant differences between dimensions of the skin cancer and sex. In men group, skin cancers had statistically higher vertical dimensions and larger surface areas. On the face and head, BCC more often localizes in the nasal area, while SCC on the auricle. It has been demonstrated that the older the patient, the larger the vertical dimension of the tumor. As such, tumor size is larger in men than in women, as women usually see their physicians sooner than men: cosmetic concerns are more important to them.

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Open Appendicectomy under Spinal Anesthesia—A Valuable Alternative during COVID-19

The Surgery Journal ◽

10.1055/s-0041-1725933 ◽

2021 ◽

Vol 07 (02) ◽

pp. e69-e72

Author(s):

Dinh Van Chi Mai ◽

Alex Sagar ◽

Oliver Claydon ◽

Ji Young Park ◽

Niteen Tapuria ◽

...

Keyword(s):

United Kingdom ◽

Patient Satisfaction ◽

Spinal Anesthesia ◽

Stated Preference ◽

Case Series ◽

District General Hospital ◽

Complication Rates ◽

Open Appendicectomy ◽

Surgical Department ◽

The United Kingdom

Abstract Introduction Concerns relating to coronavirus disease 2019 (COVID-19) and general anesthesia (GA) prompted our department to consider that open appendicectomy under spinal anesthesia (SA) avoids aerosolization from intubation and laparoscopy. While common in developing nations, it is unusual in the United Kingdom. We present the first United Kingdom case series and discuss its potential role during and after this pandemic. Methods We prospectively studied patients with appendicitis at a British district general hospital who were unsuitable for conservative management and consequently underwent open appendicectomy under SA. We also reviewed patient satisfaction after 30 days. This ran for 5 weeks from March 25th, 2020 until the surgical department reverted to the laparoscopic appendicectomy as the standard of care. Main outcomes were 30-day complication rates and patient satisfaction. Results None of the included seven patients were COVID positive. The majority (four-sevenths) had complicated appendicitis. There were no major adverse (Clavien-Dindo grade III to V) postoperative events. Two patients suffered minor postoperative complications. Two experienced intraoperative pain. Mean operative time was 44 minutes. Median length of stay and return to activity was 1 and 14 days, respectively. Although four stated preference in hindsight for GA, the majority (five-sevenths) were satisfied with the operative experience under SA. Discussion Although contraindications, risk of pain, and specific complications may be limiting, our series demonstrates open appendicectomy under SA to be safe and feasible in the United Kingdom. The technique could be a valuable contingency for COVID-suspected cases and patients with high-risk respiratory disease.

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