scholarly journals PROVIDING EMERGENCY SURGICAL CARE TO PATIENTS IN A COVID-19 PANDEMIC

2021 ◽  
pp. 5-9
Author(s):  
V. V. Boyko ◽  
V. M. Likhman ◽  
O. Yu. Tkachuk ◽  
A. O. Merkulov ◽  
O. M. Shevchenko ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Surgical Care ◽  
Surgical Pathology ◽  
Surgical Service ◽  
Viral Etiology ◽  
Surgical Interventions ◽  
Absolute Priority ◽  
Surgical Disease ◽  
Increased Risk ◽  
Strict Compliance

Among the features of surgical care for patients with COVID-19 are the need for strict compliance with the epidemiological regime, minimizing the number of staff in the operating room, the possible minimization of surgical interventions and reducing their duration. The most important task in these conditions is the safety of personnel. Materials and methods. The results of surgical treatment of 85 pa-tients with acute surgical pathology are presented, and the presence of the virus was confirmed by the results of laboratory tests in 75.3 %. 24.7 % of patients had a clear picture of pneumonia of viral etiology with a high probability. All operations were performed in compliance with the epidemiological regime by pre-trained and instructed per-sonnel in compliance with the rules of asepsis and antiseptics. Discussion of results. There are no fundamental changes in the tac-tics of management of patients with acute surgical pathology. Howev-er, in the presence of the patient, in addition to acute surgical disease, COVID-19 and viral pneumonia of varying severity, it is necessary to take into account the increased risk of both bacterial and thrombo-embolic complications. Conclusions. Given the limitations caused by the spread of COVID-19, emergency surgical care should be provided to all pa-tients in a timely, highquality and complete manner. Any action of the emergency surgical service must be justified by the specific situa-tion, with the absolute priority of public and patient safety.

Influence of medical and socio-psychological factors on changes in psychological status in patients after simultaneous surgical operations

2017 ◽  
pp. 42-45
Author(s):  
V.L. Dronova ◽  
◽  
A.N. Mokryk ◽  
R.S. Teslyuk ◽  
◽  
...  
Keyword(s):  
Psychological Factors ◽  
Surgical Care ◽  
Study Groups ◽  
Negative Influence ◽  
Surgical Pathology ◽  
Psychological Status ◽  
Psychological State ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Simultaneous Operations

The article presents data on the influence of medical and socio - psychological factors on changes in the psychological status of patients who underwent simultaneous surgical interventions. The objective: to determine the features of the psychological status and quality of life in the postoperative period in women who underwent simultaneous surgical interventions. Patients and methods. To solve the tasks, 110 patients were surgically assisted in the department of operative gynecology of the State Institution «IPAH of the National Academy of Medical Sciences of Ukraine». They were divided into two groups. The first group consisted of patients with isolated gynecological pathology (n=83), the second group consisted of simultaneous pathology (n=27). Patients with isolated surgical pathology (n=26) were included in the study, surgical care was provided in the surgical department of the City Clinical Hospital No. 10 in Kiev. They made up the third group. Results. According to the data received, the majority of patients underwent psychological and psychological influences on their psychological state, but the frequency and level of influence were different. Women (group II) operated on the simultaneous pathology were much more sensitive to the effect of socio - psychological factors, in relation to patients of groups I and III with isolated gynecological and surgical pathology, respectively, in whom the negative influence of medical and socio - psychological factors was revealed. Conclusion. The results of the research prove that the violations of the psychological status (in particular, anxious and depressive conditions) in the patients of the study groups who underwent operative interventions in a large percentage of cases depend not only on medical, but mainly on the socio-psychological factors of influence, which in the future will Is necessarily taken into account when developing measures for psychological correction in this patient population. Key words: simultaneous operations, psychological state, medical and socio-psychological risk factors.

scholarly journals Analysis of the provision of surgical care in Zhytomyr oblast for the period 2008-2017

2018 ◽  
Vol 22 (4) ◽  
pp. 724-729
Author(s):  
N.P. Suslik ◽  
O.O. Zaritskiy ◽  
O.M. Zaritskіy ◽  
I.V. Ogiychuk ◽  
L.A. Vozna ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Correlation Coefficient ◽  
Statistical Methods ◽  
Average Length ◽  
Surgical Care ◽  
The State ◽  
Human Potential ◽  
Surgical Service ◽  
Surgical Interventions ◽  
Average Length Of Stay

Annually more than 20% of patients who undergo treatment in hospitals of Zhytomyr region are operated. The purpose of the study was to trace the state of the organization of the surgical service of Zhytomyr region for the period from 2008 to 2017 (inclusive) to identify problems and ways to solve them. The article analyzes human potential, works of surgical beds and indicators of planned and urgent surgical care for the population of Zhytomyr region for the indicated period using analytical, analytical-synthetic and statistical methods with calculation of correlation coefficient. Positive dynamics was revealed: the average number of days of bed occupation increased, the average length of stay of the patient in the bed decreased, the bed turnover increased, the frequency of surgical interventions increased and postoperative lethality decreased. At the same time there is a problem of staffing; systematic work is needed to improve the indicators associated with late hospitalization of patients.

scholarly journals Surgical Interventions in Patients Hospitalised with COVID-19. A Review of Seven Months of Experience Working in a COVID-19 Dedicated Centre

2021 ◽  
Vol 10 (3) ◽  
pp. 395
Author(s):  
Justyna Rymarowicz ◽  
Michał Pędziwiatr ◽  
Piotr Major ◽  
Bryan Donohue ◽  
Karol Ciszek ◽  
...  
Keyword(s):  
Emergency Surgery ◽  
Surgical Procedure ◽  
Surgical Care ◽  
Major Surgery ◽  
Surgical Specialty ◽  
Surgical Interventions ◽  
Face To Face ◽  
Overall Mortality

The Coronavirus Disease 2019 (COVID-19) pandemic has made changes to the traditional way of performing surgical consultations. The aim of the present study was to assess the need for surgical care performed by various surgical specialties among patients infected with COVID-19 hospitalized in a COVID-19 dedicated hospital. All surgical consultations performed for patients infected with COVID-19 in a COVID dedicated hospital in a seven month period were evaluated. Data on demographics, surgical specialty, consult reason, procedure performed, and whether it was a standard face to face or teleconsultation were gathered. Out of 2359 COVID-19 patients admitted to the hospital in the seven month period, 229 (9.7%) required surgical care. Out of those 108 consultations that did not lead to surgery, 71% were managed by telemedicine. A total of 36 patients were operated on while suffering from COVID-19. Out of them, only three patients admitted primarily for COVID-19 pneumonia underwent emergency surgery. The overall mortality among those operated on was 16.7%. Conclusions: Patients hospitalised with COVID-19 may require surgical care from various surgical specialties, especially during peaks of the pandemic. However, they rarely require a surgical procedure and only occasionally require major surgery. A significant portion of potentially surgical problems could be managed by teleconsultations.

A Targeted Literature Review of the Disease Burden in Patients With Symptomatic Peripheral Artery Disease

Angiology ◽  
2019 ◽  
Vol 71 (4) ◽  
pp. 303-314
Author(s):  
Rupert Bauersachs ◽  
Sebastian Debus ◽  
Mark Nehler ◽  
Maria Huelsebeck ◽  
Janita Balradj ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Disease Burden ◽  
Ankle Brachial Index ◽  
Peripheral Artery ◽  
Economic Burden Of Disease ◽  
Surgical Interventions ◽  
Treatment Practice ◽  
Patient Profile ◽  
Increased Risk ◽  
Artery Disease

Patients with peripheral artery disease (PAD) have an increased risk of cardiovascular (CV) and limb events, but the disease is frequently underdiagnosed and treatment options are limited. This review examines the disease burden of symptomatic PAD as well as key guideline recommendations. Publications were identified using the ProQuest portal to access the Medline, Medline In-Process, and Embase databases. Search terms for symptomatic PAD were combined with terms relevant to epidemiology, burden, treatment practice, and physiopathology. Articles in English published between January 2001 and September 2016 were screened according to the population, interventions, comparator, outcomes, and study design criteria. Relevant publications (n = 200) were identified. The reported incidence and prevalence of PAD varied depending on the definitions used and the study populations. Patients generally had a poor prognosis, with an increased risk of mortality, CV, and limb events and decreased quality of life. Guideline recommendations included ankle–brachial index measurements, exercise testing, and angiography for diagnosis and risk factor modification, antiplatelets, cilostazol, exercise therapy, or surgical interventions for treatment, depending on the patient profile. The clinical, humanistic, and economic burden of disease in patients with symptomatic PAD is substantial and needs to be reduced through improved PAD management.

scholarly journals Complications of Extended Endoscopic Endonasal Surgery in Elderly Patients

2018 ◽  
Vol 79 (S 03) ◽  
pp. S287-S288 ◽  
Author(s):  
Tyler Kenning ◽  
Carlos Pinheiro-Neto
Keyword(s):  
Cerebrospinal Fluid ◽  
Elderly Population ◽  
Operative Time ◽  
The Elderly ◽  
High Flow ◽  
Endoscopic Endonasal ◽  
Surgical Interventions ◽  
Perioperative Morbidity ◽  
Increased Risk ◽  
Cerebrospinal Fluid Leaks

AbstractExtended endoscopic endonasal procedures are not unique among surgical interventions in carrying increased risk in the elderly population. There are, however, components of the procedure, namely high-flow cerebrospinal fluid leaks, that do result in the potential for increased perioperative morbidity for these patients. We present the case of a 77-year-old male with a large invasive pituitary macroadenoma resected through a transplanum-transtuberculum-transsellar endonasal approach. A gross total resection was obtained with resolution of the patient's preoperative ophthalmologic deficits. One month postoperatively, the patient developed progressive lethargy and cranial imaging demonstrated a left convexity subacute subdural hematoma. This was evacuated through a twist drill craniostomy. Despite measures to limit the operative time of the initial endonasal procedure as well as the absence of a postoperative cerebrospinal fluid fistula, the patient still developed this complication. Along with more typical potential causes of postoperative decline following extended endonasal procedures, problems from high-flow intraoperative cerebrospinal fluid leaks alone can result in morbidity in the elderly population. This should be acknowledged preoperatively and a high suspicion should exist for the presence of intracranial hemorrhage in these patients with any postoperative deficits. Additional intraoperative measures can be utilized to minimize such risks.The link to the video can be found at: https://youtu.be/EkLmt2T8_UE.

PREDICTORS OF NEUROLOGICAL COMPLICATIONS AFTER CARDIAC SURGICAL INTERVENTIONS IN OLDERY PATIENTS

2020 ◽  
pp. 319-324
Author(s):  
О. В. Каменская ◽  
А. С. Клинкова ◽  
В. В. Ломиворотов ◽  
В. А. Шмырев ◽  
А. М. Чернявский
Keyword(s):  
Intraoperative Monitoring ◽  
Cerebral Oxygenation ◽  
Artery Bypass ◽  
Neurological Complications ◽  
Myocardial Infarctions ◽  
Bypass Grafting ◽  
Surgical Interventions ◽  
Increased Risk ◽  
History Of ◽  
Left And Right

Для выявления предикторов неврологических осложнений в госпитальный период после коронарного шунтирования (КШ) проанализированы данные 92 больных 70 лет и старше с ИБС. Интраоперационно проведен мониторинг церебральной оксигенации ( rSO , %). На этапе вводной анестезии средний уровень rSO по правому и левому полушариям составлял 64-65% без значительных изменений во время операции. Снижение rSO во время искусственного кровообращения (ИК) связано с увеличением риска развития неврологических осложнений в раннем послеоперационном периоде. При снижении rSO во время ИК на 20% и более относительно исходных значений по левому и правому полушариям риск неблагоприятных неврологических событий возрастает в 7 и 9 раз соответственно. Два и более инфаркта миокарда в анамнезе в 3 раза увеличивают риск неврологических осложнений после КШ. To identify predictors of neurological complications in the hospital period after coronary artery bypass grafting (CABG), 92 patients with coronary heart disease aged 70 years and over were analyzed. Intraoperative monitoring of cerebral oxygenation ( rSO , %) was carried out. At the stage of induction anesthesia, the average level of rSO for left and right hemispheres was 64-65 % without significant changes during the operation. A decrease in rSO during cardiopulmonary bypass (CPB) was associated with increased risk of neurological complications. The risk of neurological complications increase 7-fold and 9-fold with a decrease in rSO by 20 % or more during CPB relative to baseline for left and right hemispheres, respectively. A history of two or more myocardial infarctions increases 3-fold the risk of neurological complications after CABG.

scholarly journals Nonoperative Treatment of Appendicitis during Pregnancy in a Remote Area

2018 ◽  
Vol 08 (01) ◽  
pp. e37-e38 ◽  
Author(s):  
Anne-Kathrine Carstens ◽  
Lise Fensby ◽  
Luit Penninga
Keyword(s):  
Antibiotic Treatment ◽  
Treatment Option ◽  
Fetal Loss ◽  
Surgical Care ◽  
Weather Conditions ◽  
Nonoperative Treatment ◽  
Definitive Treatment ◽  
Bridge To Surgery ◽  
Increased Risk ◽  
Geographical Distances

AbstractAppendicitis is the most common nonobstetric surgical disease during pregnancy. Appendicitis during pregnancy is associated with an increased risk of morbidity and perforation compared with the general population. Furthermore, it may cause preterm birth and fetal loss, and quick surgical intervention is the established treatment option in pregnant women with appendicitis. In Greenland, geographical distances are very large, and weather conditions can be extreme, and surgical care is not always immediately available. Hence, antibiotic treatment is often initiated as a bridge-to-surgery. We report on a pregnant Greenlandic Inuit woman with appendicitis who was treated with intravenous antibiotics. Antibiotic treatment was successful before surgical care became available and the patient was not operated. No complications occurred, and further pregnancy was uneventful. Our case suggests that antibiotic treatment of appendicitis during pregnancy as a bridge-to-surgery may be a sensible treatment option in remote areas, where no surgical care is immediately available. In some cases, antibiotic treatment may turn out to be definitive treatment.

scholarly journals Global neurosurgery, Bangladesh and COVID-19 era

2020 ◽  
pp. 574-576
Author(s):  
Robert Ahmed Khan ◽  
Moshiur Rahman ◽  
Amit Agrawal ◽  
Ezequiel Garcia-Ballestas ◽  
Luis Rafael Moscote-Salazar
Keyword(s):  
Developing Countries ◽  
Healthcare Workers ◽  
Surgical Care ◽  
Medical Procedure ◽  
Surgical Service ◽  
Training Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Significant Obstacle ◽  
To Come

Background. COVID-19 has become an alarming pandemic for our earth. It has created panic not only in China but also in developing countries like Bangladesh. Bangladesh has adequate confinements to constrain the spread of the infection and in this circumstance, overall healthcare workers including neurosurgeons are confronting a ton of difficulties. The purpose of this paper is to depict the proficiency of Global neurosurgery in this COVID-19 time. Method. Global neurosurgery offers the chance of fusing the best proof-based guidelines of care. This paper demonstrated that, in low to middle-income countries, Global medical procedure has been received to address the issues of residents who lack critical surgical care. Results. Inappropriate and insufficient asset allotment has been a significant obstacle for the health system for decently giving security to the patients. The fundamental training process has been genuinely hampered in the current circumstance. Worldwide health activities have set to an alternate centre and Global neurosurgery as an assurance is slowed down. Conclusion. This paper recommended that Global neurosurgical activities need to come forward and increase the workforce to emphasize surgical service.

scholarly journals The Surgical Care Practitioner: A Feasible Alternative. Results of A Prospective 4-Year Audit at St Mary's Hospital Trust, London

2007 ◽  
Vol 89 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Shirley Martin ◽  
Sanjay Purkayastha ◽  
Rachel Massey ◽  
Paraskevas Paraskeva ◽  
Paris Tekkis ◽  
...  
Keyword(s):  
Waiting Times ◽  
Surgical Care ◽  
Wound Dehiscence ◽  
General Anaesthetic ◽  
Surgical Service ◽  
Allied Health Professions ◽  
Short Course ◽  
Patient Questionnaires ◽  
Feasible Alternative ◽  
A Minor

INTRODUCTION Surgical care practitioners (SCPs) are an expanding group of professionals, drawn from nursing and the allied health professions. Amongst other functions, SCPs can provide a range of surgical procedures including a ‘minor surgical’ service. The aim of this study was to audit the volume and outcomes related to the SCP service at St Mary's since its inception. PATIENTS AND METHODS All prospectively collected data regarding SCP-managed patients between 2001 and 2005 were retrospectively audited. Volume, case mix, waiting times, complications and patient satisfaction were recorded and evaluated. RESULTS In this 4-year period, the SCP performed 381 minor operative cases (year 1 to year 4: 32, 74, 114 and 161 cases, respectively). These included excision of lipomas, sebaceous cysts and suspicious naevi under local anaesthesia and 7 similar cases under general anaesthetic. There were 11 minor postoperative complications which included 7 wound infections which were all resolved with a short course of oral antibiotics, 2 seromas of which one needed aspiration under local anaesthetic and one minor wound dehiscence which was re-sutured the same day. Overall, 71% were seen within 1 month of referral, 16% within 1–2 months, 3% within 3 months and 10% within 6 months. In addition, 59% were seen and treated within 20 min of their appointed time, 15% within 30–60 min and 24% within 1–2 h. The 3-month patient perspective audit carried out between May and July 2004 included 59 completed patient questionnaires following surgery; 100% were totally satisfied with the care that they received; 98% were happy to see the SCP and 98% documented that they would recommend the SCP to others. CONCLUSIONS The 4-year period of using an SCP at St Mary's shows that it is feasible and safe for minor operative procedures, that it contributes positively to waiting times and is acceptable to patients.

scholarly journals P.015 Mesial Temporal Sclerosis is a rare occurrence in Intractable Pediatric Temporal Lobe Epilepsies

2018 ◽  
Vol 45 (s2) ◽  
pp. S19-S19
Author(s):  
J Kassiri ◽  
T Rajapakse ◽  
L Schmitt ◽  
M Wheatley ◽  
B Sinclair
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Pediatric Patients ◽  
Focal Cortical Dysplasia ◽  
Surgical Pathology ◽  
Pediatric Epilepsy ◽  
Mesial Temporal Sclerosis ◽  
Surgical Interventions ◽  
Retrospective Cohort Studies ◽  
Magnetic Resonance Imaging Mri

Background: Temporal lobe epilepsy (TLE) accounts for approximately 20% of pediatric epilepsy cases. Of those, many are considered medically intractable and require surgical interventions. In this study, we hypothesized that mesial temporal sclerosis (MTS) was less common in patients who had undergone surgery for intractable pediatric TLE than in adult series. We further hypothesized that there was a radiological and pathological discordance in identifying the cause of pediatric TLE. Methods: We retrospectively reviewed the charts of pediatric patients with TLE who had undergone surgical treatments as part of the University of Alberta’s Comprehensive Epilepsy Program between 1988 and 2018. Along with preoperative magnetic resonance imaging (MRI) reports, post-surgical pathology results and seizure outcomes were studied Results: Of the 83 pediatric patients who had undergone temporal lobe epilepsy surgery, 28% had tumors, 22% had dual pathologies, 18% had MTS, 11% had focal cortical dysplasia, and 22% had other pathologies. In addition, for 36% of these patients, discordance between their pre-surgical MRI reports and post-surgical pathology reports were found. Conclusions: This was one of the largest retrospective cohort studies of pediatric patients who had undergone surgery for intractable TLE. This study showed that tumors, and not MTS, were the most common pathology in surgical pediatric TLE.

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