Local Anesthesia and Conscious Sedation Does Not Affect Patient's Mood and Anxiety Levels during Percutaneous Endoscopic Lumbar Diskectomy: A Prospective Study

2021 ◽  
Author(s):  
H. Yener Erken ◽  
Oguz Karaeminogullari ◽  
Onur Yilmaz ◽  
Kerem Mirel ◽  
R. Ozgur Ozer
Keyword(s):  
Prospective Study ◽  
Operating Room ◽  
Local Anesthesia ◽  
Postoperative Period ◽  
Conscious Sedation ◽  
Early Postoperative Period ◽  
Preoperative Period ◽  
Significant Difference ◽  
Anxiety Levels ◽  
A Prospective Study

Abstract Background and Study Aims Undergoing a surgical procedure can be very stressful for patients and can lead to high anxiety levels during both the preoperative and the postoperative period. Levels of anxiety and fear may depend on multiple factors including the type of anesthesia to be used. The objective of this study is to evaluate whether patient's awareness of the surgical environment in the operating room under local anesthesia and conscious sedation (LACS) affects their mood and anxiety levels. Methods We performed a prospective study for a series of consecutive patients who underwent transforaminal percutaneous endoscopic lumbar diskectomy (PELD) for the treatment of lumbar disk herniation. The patients completed Profile of Mood States (POMS) and State-Trait Anxiety Inventory (STAI) forms in the preoperative period and in the early postoperative period. We divided the patients into two groups according to the type of anesthesia applied during surgery: LACS and general anesthesia (GA) groups. We compared the preoperative and postoperative POMS and STAI scores between groups and the change of these scores between the preoperative and postoperative periods in each group. Results In this study, we included 30 patients who underwent PELD between May and December 2019 and met the inclusion criteria. The GA group consisted of 16 patients and the LACS group consisted of 14 patients. In each group, POMS and STAI scores decreased in the early postoperative period compared with the preoperative period. We found no significant difference in percentage of POMS and STAI TX-1 score changes between the LACS and GA groups. Conclusion The results of our study show that patients' awareness of the surgical environment in the operating room under LACS does not significantly affect their mood and anxiety levels and patients do not seem to endure increased emotional stress during the PELD operation, as compared with PELD operation under GA.

scholarly journals Assessment of the Seric Calcium and Parathormone Levels in Patients Underwent Hemithyroidectomy.

2021 ◽  
Author(s):  
Isabel Fernández Palop ◽  
Cristina Fernández Martínez ◽  
María Jesús Segura Giménez ◽  
María del Carmen Azorín Samper ◽  
Rafael García Fuster
Keyword(s):  
Prospective Study ◽  
Postoperative Period ◽  
Gradient Descent ◽  
Statistical Significance ◽  
Thyroid Cell ◽  
Preoperative Period ◽  
Thyroid Lobectomy ◽  
Ionic Calcium ◽  
Safe Technique ◽  
A Prospective Study

Abstract Background and objective: Hypocalcemia is one of the main complications that patients undergoing thyroid surgery can suffer. We believe that there may be an impact on serum parathormone and calcium values, despite only one thyroid cell is manipulated in thyroid lobectomy. The former explanation is the reason because we carried out a measurement and analised a potential correlation between them. Methods: This is a prospective study of 53 patients underwent thyroid lobectomy. The serum parathormone value was determined in the preoperative period, 15 min after extraction of the surgical piece, 24 hours and 3 weeks after surgery. Ionic calcium was also measured at 6 hours, 24 hours and 3 weeks. Postoperative parathormone values were compared as well as their gradient descent respect to the postoperative calcium value. The appearance of the parathyroid glands was described during surgery. Results: In none of the patients did the ionic calcium drop below 4mg / dl. The decrease in preoperative calcemia compared with the values at 6 and 24 hours had statistical significance, there were no differences compared to 3 weeks experiment. An analogous trend was observed between the percentage values of decrease in parathormone and postoperative calcemia. Conclusions: Although the calcemia decreased after a lobectomy, it always remained above 4 mg / dl. We conclude that hemithyroidectomy is a safe technique regarding the appearance of hypocalcemia in the postoperative period.

scholarly journals The structure and risk factors of the postoperative cerebral dysfunction in oncosurgery

2021 ◽  
Vol 40 (4) ◽  
pp. 43-50
Author(s):  
Nikolay V. Tsygan ◽  
Victoria A. Yakovleva ◽  
Aleksander V. Ryabtsev ◽  
Semen I. Evtukhov ◽  
Sergey Yu. Golokhvastov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Retrospective Study ◽  
Prospective Study ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Malignant Neoplasms ◽  
Perioperative Stroke ◽  
Cerebral Dysfunction ◽  
A Prospective Study

Aim of the research was to study the features of the structure of postoperative cerebral dysfunction, establishing the risk factors for the development of postoperative cerebral dysfunction and for the each of the clinical types during operations for malignant neoplasms of the chest and abdomen. The study was conducted in 2 stages: a retrospective study based on medical records and a prospective study. In a retrospective study by the method of directed selection from 93,129 clinical cases of patients, 47 cases of patients with acute stroke after surgery were selected. In prospective study, 102 patients (69 men, 33 women) aged 38 to 85 years were examined, the median age was 67 years. They were divided into two study groups: thoracic, abdominal. In a retrospective study, the incidence of perioperative stroke was 0.05%. In a prospective study of surgical operations for malignant neoplasms of the chest and abdomen, the incidence of postoperative cerebral dysfunction was 34%, perioperative stroke 2%, symptomatic delirium of the early postoperative period 11%, deferred cognitive impairment 31%. Statistical processing of the prospective study data revealed 10 risk factors for postoperative cerebral dysfunction, 12 risk factors for perioperative stroke, 7 risk factors for symptomatic delirium of the early postoperative period, and 6 risk factors for deferred cognitive impairment. For each of the clinical types of postoperative cerebral dysfunction the Charlson comorbidity index has a significant predictive value, and therefore it seems appropriate to include this parameter in the preoperative examination algorithm (3 tables, bibliography: 8 refs)

scholarly journals The Effect of Aspirin as an Irreversible COX1 Inhibitor in Preventing Non-Valvular Atrial Fibrillation After Coronary Bypass Surgery

2019 ◽  
Vol 22 (2) ◽  
pp. E149-E154
Author(s):  
Bilgehan Erkut ◽  
Azman Ates
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Stay ◽  
Free Group ◽  
Postoperative Period ◽  
Artery Bypass ◽  
Hospital Costs ◽  
Early Postoperative Period ◽  
Preoperative Period ◽  
Medication Group ◽  
Significant Difference

Background: We investigated whether the use of aspirin (irreversible COX1 inhibitor) in the preoperative period may prevent non-valvular atrial fibrillation, which is the most common rhythm problem in the postoperative period. Non-valvular atrial fibrillation after coronary surgery may lead to an increase in hospital costs due to excessive drug use and long-term hospitalization. Methods: More than 1000 coronary artery bypass grafting operations were performed between January 2011 to and Nov 2018. The 572 patients were included in this study. Patients were divided into two groups as medication (n=292) and medication-free group (n=280). In the medication group, while patients received aspirin (300 mg daily) therapy (up to 5 days) before the operation, the other group did not receive any anti-aggregan treatment. The patients were followed up for the occurrence of atrial fibrillation from the early postoperative period up to 3 months. Results: While non-valvular atrial fibrillation was developed in 16 patients (5,5 %) in medication group, this rate was 24,3 % with 68 patients in medication-free group 3 month after operation (P < .05). In addition to the intensive care unit and hospital stay, there was a significant difference between the groups in terms of hospital costs (P < .05). Conclusions: According to the results of our study, we found that the aspirin used in preoperative period may prevent non-valvular atrial fibrillation in the postoperative period. In relation to these results; we found that hospital stay and hospital expenses decreased.

scholarly journals Tumor Tissue MIR92a and Plasma MIRs21 and 29a as Predictive Biomarkers Associated with Clinicopathological Features and Surgical Resection in a Prospective Study on Colorectal Cancer Patients

2020 ◽  
Vol 9 (8) ◽  
pp. 2509
Author(s):  
Masahiro Fukada ◽  
Nobuhisa Matsuhashi ◽  
Takao Takahashi ◽  
Nobuhiko Sugito ◽  
Kazuki Heishima ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prospective Study ◽  
Surgical Resection ◽  
Tumor Tissue ◽  
Lymphatic Invasion ◽  
Clinicopathological Features ◽  
Stage Iii ◽  
Sample Type ◽  
Significant Difference ◽  
A Prospective Study

Cancer-related microRNAs (miRNAs) are emerging as non-invasive biomarkers for colorectal cancer (CRC). This study aimed to analyze the correlation between the levels of tissue and plasma miRNAs and clinicopathological characteristics and surgical resection. This study was a prospective study of CRC patients who underwent surgery. Forty-four sample pairs of tissue and plasma were analyzed. The miRNA levels were evaluated by RT-qPCR. The level of tumor tissue MIR92a showed a significant difference in CRC with lymph node metastasis, stage ≥ III, and high lymphatic invasion. In preoperative plasma, there were significant differences in CRC with stage ≥ III (MIR29a) and perineural invasion (MIR21). In multivariate analysis of lymphatic invasion, the levels of both preoperative plasma MIR29a and tumor tissue MIR92a showed significant differences. Furthermore, in cases with higher plasma miRNA level, the levels of plasma MIRs21 and 29a were significantly decreased after the operation. In this study, there were significant differences in miRNAs levels with respect to the sample type, clinicopathological features, and surgical resection. The levels of tumor tissue MIR92a and preoperative plasma MIR29a may have the potential as a biomarker for prognosis. The plasma MIRs21 and 29a level has the potential to be a predictive biomarker for treatment efficacy.

P–542 Relationship between the single nucleotides polymorphisms in Mitochondrial Nicotinamide Adenine Dinucleotide Hydride dehydrogenase (NADH) Subunit 4 gene (MT-ND4) and male infertility

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Dahadhah ◽  
M. Sale Jaweesh ◽  
M. Sali. A Zoubi ◽  
M Issa. Ab. Alarjah ◽  
M Ei Hammadeh ◽  
...  
Keyword(s):  
Mitochondrial Dna ◽  
Male Infertility ◽  
Prospective Study ◽  
Nicotinamide Adenine Dinucleotide ◽  
Mitochondrial Gene ◽  
Genetic Disorders ◽  
Nicotinamide Adenine ◽  
Significant Difference ◽  
Repair Mechanisms ◽  
A Prospective Study

Abstract Study question Is there any association between male infertility and the polymorphic variants of Mitochondrial Nicotinamide Adenine Dinucleotide Hydride dehydrogenase (NADH) Subunit 4 (MT-ND4)? Summary answer Our findings suggested that male infertility was correlated to rs2853495 and rs869096886 SNPs in MTND4. What is known already The rate of mutations in the mtDNA, the powerhouse of the cell, is high due to the lack of histones and DNA repair mechanisms. Therefore, mutations that occur in the mitochondrial genome, play a major role in some human genetic disorders. 15 - 30% of male infertility are related to genetic predisposition. Sperm containing defective mitochondria cannot effectively produce ATP and more likely to produce reactive oxygen species (ROS) and free radicals, thereby causing a defect in mtDNA, make trouble energy, and deteriorate motility and fertility. Study design, size, duration: A prospective study carried out between 2018 and 2019. 112 semen samples were collected in this study. Participants/materials, setting, methods The present study was carried out at the department of Obstetrics and Gynecology, University of Saarland, Germany. Samples were divided into 68 subfertile and 44 fertile men. Mitochondrial DNA was extracted using a QIAamp DNA Mini Kit, after that the mtDNA was amplified by using REPLI-g Mitochondrial DNA Kit. Polymerase chain reaction (PCR) was used to amplify MT-ND4 gene. Then, samples were purified and sequenced using the Sanger method in the Microsynth Seq lab, Germany. Main results and the role of chance The genotypes frequencies of the study population showed a statistically significant association between rs2853495 G&gt;A (Gly320Gly) and male infertility (P = 0.0351). Similarly, the allele frequency test showed that rs2853495 G&gt;A (Gly320Gly) and rs869096886 A&gt;G (Leu164Leu) were significantly associated with male infertility (adjusted OR = 2.616, 95% CI = 1.374 - 4.983, P = 0.0028; adjusted OR = 2.237, 95% CI = 1.245 - 4.017, P = 0.0073, respectively). On the other hand, no statistically significant difference was observed between the asthenozoospermia, oligozoospermia, teratozoospermia, asthenoteratozoospermia, oligoasthenoteratozoospermia, oligoteratozoospermia subgroups of subfertile males and the fertile ones. Limitations, reasons for caution The size number of the study samples. Wider implications of the findings: A larger prospective study will be required to confirm these associations of mitochondrial gene polymorphisms rs2853495 and rs869096886 in MT-ND4 and male infertility and to clarify the definite effect of the mitochondrial genetic variations on male infertility. Trial registration number Not applicable

scholarly journals Gastroesophageal Reflux and Idiopathic Pulmonary Fibrosis: A Prospective Study

Medicina ◽  
2011 ◽  
Vol 47 (4) ◽  
pp. 28 ◽  
Author(s):  
Ahmed Fahim ◽  
Peter Dettmar ◽  
Alyn Morice ◽  
Simon Hart
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Gastroesophageal Reflux ◽  
Prospective Study ◽  
Antibody Detection ◽  
Extraesophageal Reflux ◽  
Reflux Symptoms ◽  
Significant Difference ◽  
H Pylori ◽  
A Prospective Study

Background and Objective. Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias. There is evidence of the increased prevalence of gastroesophageal reflux disease in patients with IPF. The aim of this prospective study was to evaluate reflux in patients with IPF by analyzing the scores of the reflux cough questionnaire, measurement of pepsin in exhaled breath condensate (EBC) to detect extraesophageal reflux, and Helicobacter pylori serology to evaluate the prevalence of this stomach bacterium in patients with IPF. Material and Methods. The Hull airway reflux questionnaire (HARQ) was completed by 40 patients with IPF and 50 controls in order to evaluate reflux symptoms. EBC was collected from 23 patients (17 patients with IPF and 6 controls) for measurement of pepsin by the lateral flow technique. A prospective study of 57 subjects (34 patients with IPF and 23 controls) for H. pylori antibody detection by ELISA was performed. Results. Significantly higher HARQ scores (maximum score, 70) were recorded in patients with IPF compared with controls (19.6 [SD, 12.4] vs. 3 [SD, 2.9], P<0.001). There was no significant difference in EBC pepsin positivity between patients with IPF and controls (2 of the 17 patients vs. none of the 6 controls, P=0.38). There was no significant difference in H. pylori serology between patients with IPF and controls (17 of the 34 patients vs. 14 of the 23 controls, P=0.42). Conclusion. Patients with IPF had significantly increased scores of airway reflux symptoms. However, no objective evidence of extraesophageal reflux or H. pylori infection in patients with IPF was obtained in this study. The role of gastroesophageal and extraesophageal reflux in pathogenesis of IPF should be evaluated in a larger prospective study.

scholarly journals Screening of epileptic seizures in children and adolescents with hydrocephalus and ventriculoperitoneal shunt

2009 ◽  
Vol 15 (3) ◽  
pp. 106-109 ◽  
Author(s):  
Raimundo Francisco de Amorim Júnior ◽  
Suerda Emiliana Cavalcanti Dantas ◽  
Rodrigo de Holanda Mendonça ◽  
Abdiel de Lira Rolim ◽  
Maria Luiza de Carvalho Jales ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Data Analysis ◽  
Prospective Study ◽  
Children And Adolescents ◽  
Ventriculoperitoneal Shunt ◽  
Epileptic Seizures ◽  
Significant Difference ◽  
A Prospective Study ◽  
Larger Sample ◽  
Diagnosis Age

OBJECTIVES: To assess the occurrence of epileptic seizures (ES) in children and adolescents with hydrocephalus and their relationship with ventriculoperitoneal shunt (VPS) treatment. METHODS: Retrospective study of 45 patients from both genders, aged 0 to 18 years, with hydrocephalus and presenting with ES or not. The following variables were analyzed: gender, hydrocephalus etiology, age at diagnosis, age at initial VPS treatment, age at first ES and types of ES. RESULTS: Data analysis showed the following: 20 (44.4%) presented with ES, 13 (65%) of the girls and seven (35%) of the boys. There was a predominance of ES in the girls, but with no statistically significant difference. In total, 13 (65%) patients used VPS. Of the 13 patients with VPS and ES, it was observed that the onset of ES was after VPS in 10 (76.9%) individuals, whereas it occurred before VPS in two (15.4%). CONCLUSIONS: The results showed no association between VPS treatment and ES (ρ=0.832); however, most of the patients presented with their first ES episode after VPS, suggesting a possible relationship between this treatment and the occurrence of ES. A larger sample and a prospective study might answer this question.

Distribution of bacteria in the operating room environment and its relation to ventricular shunt infections: a prospective study

1991 ◽  
Vol 7 (4) ◽  
Author(s):  
Ann-Christine Duhaime ◽  
Kathleen Bonner ◽  
KarinL. McGowan ◽  
Luis Schut ◽  
LeslieN. Sutton ◽  
...  
Keyword(s):  
Prospective Study ◽  
Operating Room ◽  
A Prospective Study ◽  
Shunt Infections

scholarly journals Bridge-therapy with enoxaparin in the preoperative period of endarterectomy

2010 ◽  
Vol 68 (5) ◽  
pp. 775-777
Author(s):  
Jair Leopoldo Raso ◽  
Rogério Zenóbio Darwich ◽  
Francisco de Lucca Jr ◽  
Romeu Valle Santana ◽  
Marco Túlio Tanure ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Mortality Rate ◽  
Prospective Study ◽  
Low Molecular Weight Heparin ◽  
The Other ◽  
Low Molecular Weight ◽  
Preoperative Period ◽  
Safe Strategy ◽  
A Prospective Study ◽  
Bridge Therapy

Cervical clot is one of the complications of endarterectomy. This risk may be higher in patients using aspirin or clopidogrel. On the other hand, stroke may occur if the medication is interrupted before surgery. We carried out a prospective study of 124 endarterectomies in 119 patients in which aspirin or clopidogrel was stopped and a bridge-therapy with enoxaparin was administered preoperatively. There was no case of stroke during the period of the bridge-therapy. One patient developed cervical clot (0.8%) in the fifth postoperative day. Mortality rate in this series was 0.8%. There was no complication directly related to the use of enoxaparin. Bridge-therapy with low molecular weight heparin is a safe strategy for patients elected for endarterectomy

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