DOZ047.62: Fixed the gap, solved the problem? Children operated on of esophageal atresia: what happen 3 years later

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
F Bevilacqua ◽  
B Ragni ◽  
A Conforti ◽  
F Morini ◽  
A Dotta ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Surgical Care ◽  
Health Care Team ◽  
Eating Problems ◽  
Respiratory Problems ◽  
Feeding Difficulties ◽  
Meal Time ◽  
Set Up

Abstract Background With improvements in surgical care long-term morbidity of patients with esophageal atresia (EA) has been recently taken into account (Lees et al., 2018). Morbidities include gastrointestinal and respiratory complication, problems of nutrition and growth, feeding difficulties, oral aversion or food refusal (Menzies et al., 2016). Aim Purpose of this study is to explore eating problems and its implications at 3 years in infants born with esophageal atresia. Methods A retrospective study including all infants operated for EA at our Institution in the period ranging from January 2012 and January 2016 who attended our follow-up program. A specific interview was set up for the study. The interview was delivered by telephone by a trained psychologist. Results Parents of 51 children (male = 67%) were interviewed. Twenty-two percent of children showed a growth <10th percentile; 30% presented oral aversion for a period of their life; 45% still have episodes of chock during meals and 18% of these had more than one episode a week; 45% suffer of GERD and 41% experienced recurrent respiratory problems; 37% of parents experience anxiety during meals. Fifty-seven percent attended kindergarten (8% with a dedicated educator during meal time), and 92% attended preschool (26% with dedicated educator during meal time). Currently 67% of the families benefit of social facilities. Conclusions Three years after surgical repair of the structural defect, a high percentage of family still experience physical and psychological problems related to eating behavior of their children. Efforts of the health care team as well as research should focus on how to prevent eating problems and improve quality of life both of children and families.

The prevalence and role of coping strategies in the nutritional intake of children born with esophageal atresia: a condition-specific approach

2019 ◽  
Vol 32 (7) ◽  
Author(s):  
M Dellenmark-Blom ◽  
J E Chaplin ◽  
J H Quitmann ◽  
L Jönsson ◽  
V Gatzinsky ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coping Strategies ◽  
Esophageal Atresia ◽  
Nutritional Intake ◽  
Eating Quality ◽  
Life Questionnaire ◽  
Eating Problems ◽  
Specific Approach ◽  
Feeding Difficulties

SUMMARY This study describes results of a condition-specific approach to the assessment of coping strategies in nutritional intake situations used by children with esophageal atresia. One hundred three families of children 2–17 years old with esophageal atresia participated (94% response rate). Following standardized focus groups with 30 families, nine coping items were developed, reflecting nine different coping strategies in nutritional intake situations. The coping items were pilot tested by 73 new families and evaluated for feasibility, validity, and reliability. The families also completed a validated condition-specific quality-of-life questionnaire for children with esophageal atresia, which included the scale Eating-Quality-of-life. Data were analyzed using descriptives, between-group analysis, and Spearman's rho (P < 0.05). Altogether, the coping items were feasible, valid, and reliable. Items reflecting problem-focused strategies revealed that 89% of 2–17 years old ‘recognized their responsibility’ and managed nutritional intake problems on their own, 79% ‘tried to solve their feeding problems’ testing different solutions, 79% took a ‘confronting approach’ to do what peers did in eating situations, and 54% ‘sought other people's support’. Items reflecting emotion-focused strategies showed that 86% of the children ‘accepted’ their feeding difficulties, 68% ‘reappraised feeding difficulties into positive outcomes’ such as to eat only when food tasted good. Moreover, 63% of the children ‘avoided’ nutritional intake situations, 29% ‘expressed worry or fear’ when faced with these situations, while 25% ‘distanced’ themselves from eating problems by hiding or throwing away food. The children's use of coping strategies were mostly related to the existence of digestive symptoms (P < 0.05). Positive and negative coping strategies were identified. Of particular note was a correlation cluster of the so-called disengagement strategies ‘avoidance’, ‘expression of emotional concerns’ and ‘distancing’. These strategies were negatively correlated with Eating-Quality-of-Life. Conversely, taking a ‘confronting approach’ correlated positively with Eating-Quality-of-life (P < 0.05). Hence, most children with esophageal atresia employ various coping strategies in nutritional intake situations. A good Eating-Quality-of-life may be positively affected by treating digestive morbidity and encouraging children to take an active approach to their eating problems rather than using disengagement coping.

Quality of life and long-term results in patients operated on for Esophageal Atresia

2021 ◽  
Author(s):  
Martina CAPITANIO ◽  
Riccardo GUANÁ ◽  
Salvatore GAROFALO ◽  
Federico SCOTTONI ◽  
Maria Grazia CORTESE ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Atresia ◽  
Long Term Results

scholarly journals The impact of Post-COVID-Syndrome on functioning – results from a community survey in patients after mild and moderate SARS-CoV-2-infections in Germany

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Christina Lemhöfer ◽  
Christian Sturm ◽  
Dana Loudovici-Krug ◽  
Norman Best ◽  
Christoph Gutenbrunner
Keyword(s):  
Quality Of Life ◽  
Activity Limitations ◽  
Handling Stress ◽  
Respiratory Problems ◽  
Daily Routines ◽  
Participation Restrictions ◽  
Fear And Anxiety ◽  
The Impact

Abstract Background In COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptoms (now called Post-COVID-Syndrome) may have an impact on functioning and may also hinder to participation in social life in affected people. However, little is known about developing such syndrome a for patients with mild and moderate COVID-19 who did not need hospitalization or intensive care. Methods A cross-sectional study in 1027 patients with mild or moderate COVID-19 was performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life, was used. Descriptive statistics were calculated. Results In all, 97.5% of patients reported one symptom in the infection stage, such as fatigue, respiratory problems, limitations of the senses of taste and smell, fear and anxiety and other symptoms. In this time period, 84.1% of the participants experienced activity limitations and participation restrictions such as carrying out daily routines, handling stress, getting household tasks done, caring for/supporting others, and relaxing and leisure concerns. In all, 61.9% of participants reported persisting symptoms more than 3 months after infection. These were fatigue, sleep disturbances, respiratory problems, pain, fear and anxiety, and restrictions in movement; 49% of the participants reported activity limitations and participation restrictions. Predominately, these were handling stress, carrying out daily routines, looking after one’s health, relaxing and leisure activities and doing house work. The impacts on quality of life and vocational performance were rather low. Conclusion The results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not severe and do not lead to frequent or serious issues with quality of life or work ability.

Fixed the gap, solved the problem? Eating skills in esophageal atresia patients at 3 years

2020 ◽  
Vol 33 (1) ◽  
Author(s):  
Francesca Bevilacqua ◽  
Benedetta Ragni ◽  
Andrea Conforti ◽  
Simonetta Gentile ◽  
Antonio Zaccara ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Esophageal Atresia ◽  
Medical Records ◽  
Preventive Intervention ◽  
Structured Interview ◽  
Eating Problems ◽  
Parental Anxiety ◽  
Weaning Age

Abstract Although eating problems have been described as long-term morbidities of esophageal atresia (EA), there have been few studies exploring eating outcomes in children born with EA as primary aim. Parents of children operated on for EA in our Institution from January 2012 to January 2016, answered a telephone structured interview developed specifically to conduct the present study, assessing eating skills at 3 years of age. Clinical data were collected from children’s medical records. Parents (45 mothers and 6 fathers) of 51 children (male = 34; female = 17) with a median age of 3.5 years form the object of the study. Considering eating problems, parents reported that 23 children (45%) still have episodes of choking during meals at 3 years of age, 9 (45%) of these have more than one episode a week, and 19 parents (39%) reported higher levels of anxiety during mealtimes. Forty-four children (86%) were described by their parents as able to eat alone, 32 (65%) accepted all food textures and 45 (90%) was described as curious about food (3 years). Forty-three (86%) parents let their children eat with other people. Correlations showed that weaning age was significantly associated with number of dilatations (rs = 0.35, P = 0.012), days of mechanical ventilation (rs = 0.40, P &lt; 0.001), and presence of gastrostomy tube at discharge (rs = 0.45, P &lt; 0.001). Chewing age resulted associated with number of dilatations (rs = 0.34, P &lt; 0.01) and days of mechanical ventilation (rs = 0.38, P &lt; 0.01). Presence of choking episodes was associated with curiosity about food (rs = 0.29, P &lt; 0.05), while frequent choking episodes were associated with higher parental anxiety during mealtimes (rs = 0.45, P &lt; 0.05). In order to prevent delay in the achievement of eating developmental milestones in children operated on of EA, we advocate a dedicated preventive intervention from birth to follow-up.

Current Topics and Practical Considerations of Cytology Practice in Lung Cancer: Reflexions from the Lung Symposium at the 42nd European Congress of Cytology, Malmö, 2019

2020 ◽  
Vol 64 (5) ◽  
pp. 463-470
Author(s):  
Sule Canberk ◽  
Verena Tischler ◽  
Marianne Engels
Keyword(s):  
Lung Cancer ◽  
Molecular Profile ◽  
Term Survival ◽  
Lung Cancer Patients ◽  
European Congress ◽  
Dna And Rna ◽  
Site Evaluation ◽  
Set Up

In June 2019, a lung symposium was held at the 42nd European Congress of Cytology in Malmö, Sweden. Due to the current importance of cytological samples in the diagnoses and molecular analysis to set up the utmost management of lung cancer patients, cytologists from different countries shared the experience of their institutions. The place of the cytological samples gains more and more importance on the potential long-term survival gain through personalized medicine and this harbors the improvement of the guidelines both in pathology and cytology field. In this symposium, the new 6-tiered reporting system for pulmonary cytology proposed by the Papanicolaou Society of Cytopathology and detailed cytomorphological approach to lung carcinoma including lookalike lesions and DNA- and RNA-based analysis of cytology material have been discussed. The cytopathologist plays a pivotal role in ensuring success of a correct triage for the cytology material to be sure of the adequacy and quality of the yield from the rapid on-site evaluation till the report which should encompass molecular profile in rational patient management.

Quality and Extent of Locum Tenens Coverage in Pediatric Surgical Practices

2015 ◽  
Vol 81 (4) ◽  
pp. 377-380 ◽  
Author(s):  
Tracy L. Nolan ◽  
Jessica J. Kandel ◽  
Don K. Nakayama
Keyword(s):  
Pediatric Surgery ◽  
Surgical Care ◽  
Full Time ◽  
Short Term ◽  
Community Based ◽  
Surgical Workforce ◽  
Strongly Agree ◽  
Do So

The prevalence and quality of locum tenens coverage in pediatric surgery have not been determined. An Internet-based survey of American Pediatric Surgical Association members was conducted: 1) practice description; 2) use and frequency of locum tenens coverage; 4) whether the surgeon provided such coverage; and 5) Likert scale responses (strongly disagree, disagree, neutral, agree, strongly agree) to statements addressing its acceptability and quality (two x five contingency table and χ2 analyses, significance at P < 0.05). Three hundred sixteen of 1163 members (27.2% response rate) responded. One-fourth (24.1%) used a locum tenens regularly. Reasons were long-term inability to recruit a full-time surgeon (35.2%) and short-term vacancies (32.4%). One-fifth (20.4%) did locum tenens work; one-fourth (27.0%) plan to do so in the future. Two-thirds (64.2%) believe that surgical care in a locum tenens situation does not provide the same level of care as a full-time community-based surgeon. Most support locum tenens for short-term coverage (87.3%) and recruitment problems (72.1%), but not long-term vacancies (38.8%; P < 0.001) or permanent coverage (27.0%; P < 0.001). Locum tenens coverage is an established feature of pediatric surgery. Most view it as a stopgap solution to the surgical workforce shortage.

scholarly journals Evaluation of possum scoring system in patients undergoing laparotomy

2019 ◽  
Vol 6 (2) ◽  
pp. 512
Author(s):  
Manoharan G. V. ◽  
Vijayalakshmi G.
Keyword(s):  
Scoring System ◽  
Elective Surgery ◽  
High Risk Patient ◽  
Surgical Care ◽  
Scoring Systems ◽  
Patient Counseling ◽  
Emergency Group ◽  
Set Up ◽  
Prediction Of Complications

Background: Prediction of complications is an essential part of risk management in surgery. Knowing which patient is at risk of developing complications contributes to the quality of surgical care and cost reduction in surgery. Among the variety of scoring systems used to identify the “high risk” patient POSSUM scoring is the most widely used.Methods: Patients undergoing laparotomy were selected serially and their physiological severity score on admission and operative severity scored at the end of 30days and compared with the POSSUM predicted score.Results: In the elective surgery group, patients with morbidity correlated with high POSSUM scores but due to low overall morbidity conclusions could not be drawn while in the emergency group predicted morbidity correlated well with observed results. The low overall mortality in the study group precluded meaningful analysis.Conclusions: POSSUM scoring system has an undeniable advantage in this set up for better patient counseling, improving the surgical outcomes in both emergency and elective wards and for better management of limited resources and manpower.

scholarly journals Investigation Of Short And Long-Term Complications Of Respiratory System After Esophageal Atresia And/Or Tracheoesophageal Fistular Surgery

2020 ◽  
Author(s):  
Gökçen Kartal Öztürk ◽  
Aykut Ekşi ◽  
Esen Demir ◽  
Figen Gülen
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Pulmonary Function ◽  
Esophageal Atresia ◽  
Respiratory System ◽  
Pulmonary Infections ◽  
Study Results ◽  
Short And Long Term

INTRODUCTION: Esophageal atresia (EA) and/or tracheoesophageal fistula (TEF) is one of the common developmental anomalies of the foregut. Despite advances in surgical techniques and postoperative care, respiratory system complications affect the quality of life of patients. We planned to evaluate our patients in terms of the general features, the risk factors for respiratory morbidity and short- and long-term respiratory complications after surgical treatment. METHODS: Thirty-six patients with EA and/or TEF and followed after surgical treatment between 2002 and 2019 were retrospectively enrolled in the study. RESULTS: The most common symptom was chronic cough (77.7%) and wheezing (41.6%). Recurrent pulmonary infections were present in the majority. The number of pulmonary infections was high in patients who had dilatation due to stricture(N=14) and in patients with recurrent TEF(N=6) and malacia(N=10). Bronchiectasis was present in 8 patients and hospital admission due to infections was high. Aeroallergen sensitivity was detected in four patients and food allergy in five patients. Scoliosis was present in 33.3% of the patients all of whom had recurrent pulmonary infections. Pulmonary function tests were performed in 10 patients. Five patients had impaired pulmonary function. Medical treatment for reflux was given to the majority of patients (N=30), while fundoplication was performed in 10 patients. Most of the patients had a significant decrease in the frequency of pulmonary infections after the procedure. DISCUSSION AND CONCLUSION: The etiology of pulmonary complications is multifactorial and many factors affect each other. Evaluation and management of the patients for each complication will improve the quality of life and comfort of the patients.

Long-Term Outcomes and Health-Related Quality of Life in a Swiss Patient Group with Esophageal Atresia

2021 ◽  
Author(s):  
Anthony di Natale ◽  
Jessica Brestel ◽  
Andrea Alexis Mauracher ◽  
Sasha Job Tharakan ◽  
Martin Meuli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Atresia ◽  
Well Being ◽  
Adult Patients ◽  
World Health ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Introduction Surgical treatment of esophageal atresia (EA) has markedly improved, allowing the focus to shift from short-term complications and mortality to long-term complications and quality of life. Health-related quality of life (HRQoL) is variable and reported to range from reduced to unimpaired in patients with repaired EA. We assessed the HRQoL, determined the prevalence of long-term complications and their possible impact on the HRQoL in patients who had correction of EA in Switzerland. Further, we also investigated in the general well-being of their parents. Materials and Methods Patients with EA repair in Switzerland between 1985 and 2011 were enrolled. Long-term complications were assessed by enquiring disease-related symptoms, standardized clinical examinations, and analysis of radiographs. HRQoL was inquired using different validated questionnaires (KIDSCREEN-27, World Health Organization [WHO]-5, and Gastrointestinal Quality of Life Index [GIQLI]). Patients were grouped according to their age. In underage patients, general well-being of the parents was assessed using the WHO-5 questionnaire. Results Thirty patients were included with a mean age of 11.3 ± 5.7 years. Long-term complications were present in 63% of all patients. HRQoL in underage patients was comparable to the provided reference values and rated as good, while adult patients reported a reduced HRQoL. The presence of gastroesophageal reflux disease symptoms was associated with reduced HRQoL in underage patients. Parents of underage patients stated a good general well-being. Conclusion Long-term complications among patients with repair of EA in Switzerland are common. HRQoL in underage patients is good and general well-being of their parents is unimpaired. Adult patients reported a reduced HRQoL, consistent with other reports. As long-term complications may manifest only later in life, a structured follow-up of patients with an EA repair during childhood and adolescence is needed.

Evaluation of long-term quality of life in children and young adults after neonatal surgery for esophageal atresia

2018 ◽  
Vol 177 (6) ◽  
Author(s):  
Maria Athanasopoulou ◽  
Xenophon Sinopidis ◽  
Efstratios Koletsis ◽  
Dimitrios Dougenis ◽  
Ageliki Karatza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Esophageal Atresia ◽  
Neonatal Surgery ◽  
Children And Young Adults
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