scholarly journals O21 EVALUATION OF THE TREATMENT OF PARASTOMAL HERNIA IN THE NETHERLANDS: A NATIONAL SURVEY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Sarah van Egmond ◽  
Marijn Poelman ◽  
Johannes Wegdam ◽  
Bob Bloemendaal
Keyword(s):  
The Netherlands ◽  
Parastomal Hernia ◽  
Daily Practice ◽  
Prophylactic Mesh ◽  
Level Of Evidence ◽  
Mesh Placement ◽  
Surgical Department ◽  
European Hernia Society ◽  
High Level

Abstract Aim The incidence of a parastomal hernia (PSH) is approximately 40% two years after stoma construction and can even increase to 50% after a longer period. The European Hernia Society (EHS) published a guideline showing that the evidence for treatment of a PSH is of low quality. Due to the lack of evidence, a survey was conducted to provide insight into the Dutch approach. Material and Methods A survey was sent to 104 surgeons in the Netherlands representing their surgical department. The survey was developed by three hernia surgeons and a physiotherapist specialized in abdominal wall pathology. Results The survey was completed by 103 surgeons (99%) from 75 hospitals. 75% of the respondents perform a laparoscopic Sugarbaker for the treatment of PSH after colostomy, ileostomy or Bricker deviation. Most respondents (75%) replied that they never use a prophylactic mesh to prevent for the occurrence of PSH, although more than half of them do wish to introduce this. Conclusions Authors believe that the implementation of minimally invasive surgery and the systematic review performed by Hansson et al. in 2012, shifted the treatment strategy for PSH towards the use of a laparoscopic Sugarbaker. Nevertheless, little is known about the results of this treatment. Although there is a high level of evidence for the use of prophylactic mesh placement in reducing the incidence of PSH development, this has not been implemented in daily practice for colorectal and/or hernia surgeons. Authors aim for registration of PSH repair to evaluate the outcomes in terms of recurrence, pain and quality of life.

scholarly journals Consumer Satisfaction with the Services of Prosthetics and Orthotics Facilities

2009 ◽  
Vol 33 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Joline Bosmans ◽  
Jan Geertzen ◽  
Pieter U. Dijkstra
Keyword(s):  
The Netherlands ◽  
Consumer Satisfaction ◽  
Daily Practice ◽  
Delivery Time ◽  
Satisfactory Quality

Consumer satisfaction with the services provided in a prosthetics and orthotics (P&O) facility has seldom been studied. The aim of this study was to analyze consumer satisfaction regarding the services provided by 15 P&O facilities in The Netherlands. Consumers ( n = 1,364) of these P&O facilities who were fitted with a prosthesis, orthopaedic shoes, an orthosis, or another device, were asked to rate the overall services provided and whether they were satisfied with the device provided and its delivery time. Additionally, they filled in a modified SERVQUAL questionnaire (see Appendix). Consumers gave the service provided by P&O facilities a mean overall rating of 8.1. The highest ratings were given by consumers fitted with a prosthesis (mean overall rating of services: 8.4). In total, 78% of the consumers were satisfied with the device provided and 93% with the delivery time. The results of our study showed that, on the SERVQUAL, 50% of the statements fulfilled the criteria for a satisfactory quality of the services. The overall consumer rating of the service provided by P&O facilities is high and depends on the device provided. The outcomes on the SERVQUAL were moderate. In future, it is important to study consumer satisfaction more extensively in order to improve the quality of P&O services in daily practice. Additionally, specific questionnaires need to be developed to measure all aspects of prosthetic and orthotic care, with the aim to improve the services.

scholarly journals PO 18213 - Evaluation of hallux valgus treatment through percutaneous

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 46S
Author(s):  
Jorge Eduardo De Schoucair Jambeiro ◽  
Antero Tavares Cordeiro Neto ◽  
Fernando Delmonte Moreira ◽  
José Augusto De Oliveira ◽  
Clara Cristiane Miguelino Sousa ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Surgical Trauma ◽  
Complication Rates ◽  
Percutaneous Surgery ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Percutaneous Procedures ◽  
High Level

Introduction: Hallux valgus (HV) is characterized by the lateral deviation of the first finger, associated with pain and medial exostosis of the first metatarsus. The cause is usually multifactorial. The treatment varies with the degree of deformity and can be conservative or surgical. Percutaneous techniques have gained interest, offering less surgical trauma, fewer complications and faster recovery. The present study aims to evaluate the results of the surgical treatment of hallux valgus through percutaneous surgery.  Methods: A search was performed in PubMed / Medline and BVS, from 2013 to 2018, using as descriptors "hallux valgus" and "percutaneous surgery". Original articles in English, Portuguese and Spanish were included. We excluded systematic reviews, descriptions of surgical technique and publications older than 5 years. The quality of the methodology was evaluated with the help of the STROBE tool, with an emphasis on hallux valgus (HVA), intermetatarsal angle (IMA) and the AOFAS score.  Results: We found 185 references. After applying the inclusion and exclusion criteria, and STROBE tool, 5 articles were eligible, comprising a total of 290 percutaneous procedures. The follow-up time ranged from 6 months to 10 years. We found a reduction of IMA between 3.9º and 9.5º and a reduction of HVA between 12.5º and 26.8º. The AOFAS score ranged from 85 to 97.1 points in the evaluated works.  Discussion: In general, we found a good correction of HV deformity with improvement of HVA, IMA, DMAA and clinical improvement by the postoperative AOFAS score, with low complication rates. However, the heterogeneity of the studies, with variation of techniques and samples did not allow us to generalize the findings. Conclusion: It was possible to note that percutaneous surgery for HV treatment produces good outcomes with low complication rates, but few studies had a high level of evidence demonstrating the efficacy of these techniques, despite encouraging preliminary results.

scholarly journals Does High and Intensive Care Reduce Coercion? Association of Hic Model Fidelity to Seclusion Use in the Netherlands

2020 ◽  
Author(s):  
A.L. van Melle ◽  
E.O. Noorthoorn ◽  
G.A.M. Widdershoven ◽  
C.L Mulder ◽  
Y. Voskes
Keyword(s):  
Intensive Care ◽  
The Netherlands ◽  
Rating Scale ◽  
Patient Characteristics ◽  
Team Processes ◽  
Model Fidelity ◽  
Fidelity Scale ◽  
Explained Variance ◽  
High Level

Abstract BackgroundA new inpatient care model has been developed in the Netherlands: High and Intensive Care (HIC). The purpose of HIC is to improve quality of inpatient mental healthcareand to reduce coercion.MethodsIn 2014, audits were held at 32 closed acute admission wards for adult patients throughout the Netherlands. The audits were done by trained auditors, who were professionals of the participating institutes, using the HIC monitor, a model fidelity scale to assess implementation of the HIC model. The HIC model fidelity scale (67 items) encompasses 11 domains including for example team structure, team processes, diagnostics and treatment, and building environment. Data on seclusion and forced medication was collected using the Argus rating scale. The association between HIC monitor scores and the use of seclusion and forced medication was analyzed, corrected for patient characteristics.ResultsResults showed that wards having a relatively high HIC monitor total score, indicating a high level of implementation of the model as compared to wards scoring lower on the monitor, had lower seclusion hours per admission hours (2.58 versus 4.20) and less forced medication events per admission days (0.0162 versus 0.0207).The HIC model fidelity scores explained 27% of the variance in seclusion rates (p< 0.001). Adding patient characteristics to HIC items in the regression model showed an increase of the explained variance to 40%. ConclusionsThis study showed that higher HIC modelfidelity was associated with less seclusion and less forced medication at acute closed psychiatric wards in the Netherlands.

scholarly journals Prophylactic mesh placement of permanent stomas at index operation for colorectal cancer

2012 ◽  
Vol 94 (8) ◽  
pp. 569-573 ◽  
Author(s):  
NT Ventham ◽  
RR Brady ◽  
RG Stewart ◽  
BM Ward ◽  
C Graham ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Abdominal Wall ◽  
Parastomal Hernia ◽  
Abdominal Wall Defect ◽  
Prophylactic Mesh ◽  
Permanent Colostomy ◽  
Wall Defect ◽  
Mesh Placement ◽  
Clinical Endpoints ◽  
Index Operation

INTRODUCTION Parastomal herniation occurs in 30–50% of colostomy formations. The aim of this study was to radiologically evaluate the mechanical defects at stoma sites in patients who had previously undergone a permanent colostomy with or without mesh at the index operation for colorectal cancer. METHODS A study was performed of all colorectal cancer patients (n=41) having an end colostomy between 2002 and 2010, with or without Prolene® mesh plication, with blinded evaluation of the annual follow-up staging computed tomography (CT) for stomal characteristics. The presence of parastomal hernias, volume, dimensions, grade of the parastomal hernia and abdominal wall defect size were measured by two independent radiologists, and compared with demographic and operative variables. RESULTS In those patients with radiological evidence of a parastomal hernia, Prolene® mesh plication significantly reduced the incidence of bowel containing parastomal hernias at one year following the procedure (p<0.05) and also reduced the diameter of the abdominal wall defect (p=0.006). CONCLUSIONS Prophylactic mesh placement at the time of the index procedure reduces the diameter of abdominal wall aperture and the incidence of parastomal hernias containing bowel. Future studies should use both objective radiological as well as clinical endpoints when assessing parastomal hernia development with and without prophylactic mesh.

scholarly journals RELATION BETWEEN IMPACT FACTOR IN ORTHOPEDIC JOURNALS AND LEVEL OF EVIDENCE

2018 ◽  
Vol 26 (4) ◽  
pp. 275-277
Author(s):  
Mauricio Pandini Monteiro de Barros ◽  
Fabio Teruo Matsunaga ◽  
Marcel Jun Sugawara Tamaoki
Keyword(s):  
Impact Factor ◽  
Orthopedic Surgery ◽  
Randomized Clinical Trials ◽  
Point Of View ◽  
Impact Factors ◽  
Level Of Evidence ◽  
High Level ◽  
The Impact ◽  
Source Of Information

ABSTRACT Objective: This study aims to assess the quality of articles published in the leading orthopedic surgery journals, by measuring the relation between the impact factor and the number studies with a high level of evidence. Methods: A literature review was performed of articles published in four previously selected journals. A score of journal evidence (RER - Relation between Randomized clinical trials and Systematic reviews) was calculated, considering the number of RCTs and SR published and the total number of full-text articles. Results: The selected journals were JBJS-Am, ASMJ, BJJ-Br and Arthroscopy, with Impact factors of 5.280, 4.362, 3.309 and 3.206 respectively in 2015. In the study, the RER Scores, in the same order, were 9.408, 6.153, 7.456 and 7.779. Conclusion: The journal JBJS-Am is the best available source of information on orthopedic surgery from this point of view. It has the highest Impact Factor and clearly the highest RER Score. On the other hand, we could conclude that the number of published RCT and good quality SR is very low, with less than 10% of all the articles. Level of evidence III, Analyses based on limited alternatives and costs, and poor estimates.

scholarly journals Quality of information of websites dedicated to obesity: a systematic search to promote high level of information for Internet users and professionals

2021 ◽  
Author(s):  
Alessandra Perra ◽  
Antonio Preti ◽  
Valerio De Lorenzo ◽  
Antonio Egidio Nardi ◽  
Mauro G. Carta
Keyword(s):  
Poor Quality ◽  
Quality Of Information ◽  
Level Of Evidence ◽  
Flesch Reading Ease ◽  
Internet Users ◽  
Treatment Support ◽  
Technological Quality ◽  
Level I ◽  
High Level

Abstract Background The Internet is increasingly used as a source of information. This study investigates with a multidimensional methodology the quality of information of websites dedicated to obesity treatment and weight-loss interventions. We compared websites in English, a language that it is used for the international scientific divulgation, and in Italian, a popular local language. Methods Level of Evidence: Level I, systematic review search on four largely used search engines. Duplicated and unrelated websites were excluded. We checked: popularity with PageRank; technological quality with Nibbler; readability with the Flesch Reading Ease test or the Gulpease readability index; quality of information with the DISCERN scale, the JAMA benchmark criteria, and the adherence to the Health on the Net Code. Results 63 Italian websites and 41 English websites were evaluated. English websites invested more in the technological quality especially for the marketing, experience of the user, and mobile accessibility. Both the Italian and English websites were of poor quality and readability. Conclusions These results can inform guidelines for the improvement of health information and help Internet users to achieve a higher level of information. Users must find benefits of treatment, support to the shared decision-making, the sources used, the medical editor's supervision, and the risk of postponing the treatment.

scholarly journals Effectiveness of nursing interventions in preventing and treating radiotherapy side effects in cancer patients: a systematic review

2021 ◽  
Vol 55 ◽  
Author(s):  
Aline Moraes de Abreu ◽  
Duan Renato da Silva Fraga ◽  
Bruna Bastos Giergowicz ◽  
Rosália Borges Figueiró ◽  
Roberta Waterkemper
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Oral Care ◽  
Nursing Interventions ◽  
Patient Centered ◽  
Level Of Evidence ◽  
Centered Care ◽  
Recommendation Grade ◽  
High Level

ABSTRACT Objective: To synthesize the best available evidence on the effectiveness of nursing interventions in radiotherapy patient care and to summarize the evidence on the experience and acceptability of interventions reported by health professionals involved in the prevention and treatment of side effects. Method: A mixed-method systematic review. Quantitative and qualitative studies are presented. Results: Twelve studies published between 2013 and 2017 were included. Most interventions found focused on skin care, oral care, nausea and vomiting and nursing consultation. In accordance with high level of evidence and recommendation grade of the studies, the use of Calendula officinalis and thyme honey were considered effective for preventing and treating radiodermatitis and mucositis, respectively. Conclusion: The quality of evidence of nursing interventions is weak. Although there are studies with a strong design and a high level of evidence, publication of nursing interventions is not enough and does not present a high quality to support practice to plan an effective patient-centered care.

scholarly journals Modern approaches to the prevention and correction of complications caused by systemic treatment of severe acne forms

2019 ◽  
Vol 95 (2) ◽  
pp. 87-93 ◽  
Author(s):  
M. M. Tlish ◽  
M. E. Shavilova
Keyword(s):  
Systemic Treatment ◽  
Life Quality ◽  
Skin Condition ◽  
Level Of Evidence ◽  
Severe Acne ◽  
Therapy Assessment ◽  
Treatment And Prevention ◽  
Comparison Groups ◽  
High Level

Background. According to European and RF clinical guidelines, only the systemic use of isotretinoin in severe acne has a high level of evidence. However, this therapy is frequently associated with the development of retinoid dermatitis, the prevention and correction of which requires the application of emollients. Aim. To evaluate the efficacy and tolerability of the Perfectoin cream during treatment and prevention of retinoid dermatitis in patients with severe acne receiving systemic treatment with isotretinoin.Materials and methods. Two groups of patients each comprising 38 people with moderate, severe and resistant to standard therapy forms of acne were observed. Each group included 22 patients with retinoic dermatitis manifestations and 16 without such symptoms. The patients in the main and comparison groups were prescribed the Perfectoin cream and the dexpanthenol cream, respectively. Control of the skin condition was performed prior to the study and following 1, 3 and 6 months of therapy. Assessment parameters were the main symptoms of retinoid dermatitis (erythema, lichenification, excoriation, itching, feeling of dryness/tightness of the skin), indicators of the hydration of the horny layer of the epidermis and the transepidermal loss of moisture, as well as the dermatology life quality index.Results. The study has shown that the Perfectoin cream in patients with acne receiving isotretinoin therapy helps to restore skin hydration and leads to a rapid regression of the main dermatological symptoms of retinoid dermatitis, thus improving the overall quality of patients’ life.

scholarly journals Has the Level of Evidence in Orthopaedic Trauma and Nontrauma Publications Improved? A Publication Review of 3 Major Orthopaedic Journals

2020 ◽  
Author(s):  
Kitchai Luksameearunothai ◽  
Yash Paul Chaudhry ◽  
Sorawut Thamyongkit ◽  
Xiaofeng Jia ◽  
Erik A. Hasenboehler
Keyword(s):  
Biomedical Research ◽  
Trauma Studies ◽  
Orthopaedic Trauma ◽  
Level Of Evidence ◽  
Related Research ◽  
Research Level ◽  
Orthopaedic Literature ◽  
Level I ◽  
High Level

Abstract Background In biomedical research, level of evidence (LOE) indicates the quality of a study. Recent studies evaluating orthopaedic trauma literature between 1998-2013 have indicated that LOE in this field has improved. The objective of this study was to determine the validity of one such study by 1) comparing our results and how they relate to more recent years of publications; and 2) assessing how our findings may be used to estimate future changes. Methods A total of 3,449 articles published from 2013 to 2018 in The Journal of Orthopaedic Trauma (JOT); Journal of Bone and Joint Surgery, American Volume (JBJS-Am); and Clinical Orthopaedics and Related Research (CORR) were evaluated for their LOE. Articles published in JBJS-Am or CORR were classified as trauma or nontrauma studies; articles published in JOT were considered trauma studies. Articles were assigned a LOE using guidance published by JBJS-Am in 2015. Results The percentage of total high-level (level I or II) trauma and nontrauma articles published in JOT, JBJS-Am, and CORR decreased from 2013 to 2018 (trauma 23.1% to 19.2%, p = 0.190; nontrauma 28.8% to 24.9%, p = 0.037). JBJS-Am published the highest percentage of level-I trauma studies, and CORR published the lowest percentage of level-IV studies. JBJS-Am and CORR published higher percentages of level-I trauma studies and lower percentages of level-IV nontrauma studies than all trauma studies. Conclusions Based on our results we cannot validate the findings of previous studies as we found the overall LOE of both trauma and nontrauma orthopaedic literature has decreased in recent years. JBJS-Am published a greater percentage of high-level studies than did JOT and CORR. Although the number and percentage of high-level studies published in JOT increased during the study period, it still lagged behind JBJS-Am and CORR.

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