Medicine and Health Sciences Commons^™

Reducing Delirium In Post-Surgical Patients Through Pre-Operative Risk Assessment Screening: A Policy Option, Skye Porter Berg Msn, Fnp

Doctor of Nursing Practice Final Manuscripts

One of the major complications and reasons for prolonged stay amongst patients who undergo surgery is related to the occurrence of hospital associated delirium. Unfamiliar environment, previous comorbidities, age and anesthesia can alter and affect cognitive status in the general population. While there is substantial evidence previously listing high risk patients through demographics as well as prior medical history, this study collectively gathers information based upon prior evidence-based practice data to determine the benefit of prescreening patients through use of a predictive indicator tool. Based on the literature review and inclusion data gathered from fifty patients undergoing surgery, it was …

Minimally Invasive Tissue Extraction: Continued Growth Through Simulation For Obgyn Residents, Angela Frankel, Md, Mph, Melanie Hotz, Md, Patrick Teefey, Md

Department of Obstetrics and Gynecology Posters

Background

• Minimally invasive surgery often requires tissue morcellation for extraction of large surgical specimens.¹
• Surgeon comfort with tissue morcellation in gynecologic surgery is vital in providing a minimally invasive (MIS) approach.
• However, OBGYN residents often feel underprepared to perform this skill independently.²
• While practicing tissue morcellation in the OR is ideal, simulation has been shown to improve resident technical skill without risking increased operative time or associated morbidity.³
• This intervention seeks to build upon a prior simulation exercise, with the ultimate goal of improving OB-GYN resident self-reported comfort with minimally invasive tissue extraction.

Spontaneous Pneumothorax And Bullous Emphysema In A Young Patient? About A Case, María Manuela Rodriguez-Gutierrez, Hernán Cardona-Gaviria, Luisa María Hincapie-Cano, María Camila Oyuela-Gutiérrez, Tatiana Ximena Quevedo-Cristancho, Daniela Valencia-Riascos, Juliana Gómez-Raigosa, María Carolina Díaz-Rivera

Revista de la Facultad de Medicina Humana

Introduction: Pneumothorax is a pathology prevalent in traumatic accidents in the thorax, but it can also be found spontaneously due to causes attributable to bullous disease, pneumonia, airway obstruction, malignancy, among others. Case report: Young male patient who debuted with spontaneous pneumothorax who required management in the intensive care unit with subsequent appearance of bullae in diagnostic images and pathology. Discussion: Primary spontaneous pneumothorax (PSP) in the young population is influenced by psychosocial factors such as age, gender, habits, environment, and genetic factors. In 80% of patients with PSP, the presence of bullae or apical blebs has been demonstrated, in …

Ercp Extraction Of Stones In Situs Inversus Patients; State-Of-The-Art Techniques, Deniz Gunsahin, Madalina Ilie, Oana Plotogea, Dan Nicolae Paduraru, Alexandra Bolocan, Octavian Andronic, Florentina Musat, Vlad Baleanu, Dragos Davitoiu, Mihai Pahomeanu, Bogdan Dumbrava, Vlad Enciu, Alexandru Constantinescu

Journal of Mind and Medical Sciences

Situs inversus totalis (SIT) is a rare congenital disease that causes mirror transposition of the abdomino-thoracic structures. When such patients develop pathologies related to the bile duct, most commonly choledocholithiasis, the optimal diagnostic process can be hampered by the rarity of such a pathology and the lack of medical information on this topic. Once the diagnosis is established, through endoscopic ultrasound and MRCP, the patient is sent to perform ERCP, which requires tailored approaches for each case. We present the case of a 33-year-old patient who was previously documented with SIT. On admission she presented with abdominal pain and fever …

Systematic Surgical Approach To Juvenile Angiofibroma, Raluca Oana Pulpă, Viorel Zainea, Cătălina Voiosu, Ruxandra Oana Aliuș, Andreea Rusescu, Irina Gabriela Ioniță, Veronica Epure, Dragoș Octavian Palade, Răzvan Hainăroșie

Journal of Mind and Medical Sciences

Introduction. Juvenile nasopharyngeal angiofibroma is a rare type of benign vascular tumour that affects only young males, especially those between the ages of 9 and 19. Therapeutic management depends on the extent of the lesion, being conditioned by the complexity of the anatomy of the skull base and the risk of massive bleeding due to the abundant vascular supply. The purpose of this article is to describe the modern approach to juvenile nasopharyngeal angiofibroma, starting from the general knowledge on this topic and presenting the experience of our clinic. Materials and Methods. A retrospective study was conducted on 10 male …

Medical And Psychological Management Of Patients With A History Of Surgical Treatment For Pancreatic Diseases, Magdalena Țone, Daniel Cochior, Oana Denisa Balalau, Tomescu Dana Rodica, Cristian Balalau, Teodora Mocan, Aurelian Udristoiu, Gabriel Petre Gorecki

Journal of Mind and Medical Sciences

Background. Pancreatic cancer, known for its high mortality rate and late diagnosis, remains a significant health concern. Surgery offers a potential therapeutic remedy, but it is only valid in the early stage of detection. Increasing risk factors and an aging population are expected to raise the incidence of pancreatic cancer, further challenging healthcare systems. Methods. The general objective of this study was to analyze doctors' experiences regarding the health status of patients with benign pancreatic pathology who underwent surgery and were admitted to CF2 Clinical Hospital in Bucharest. The research involved a specialized questionnaire addressing various aspects of patient health, …

Genetic And Serological Markers In Colorectal Cancer Surgery, Adrian Silaghi, Vlad Denis Constantin, Dragos Serban, Dragos Epistatu, Ioana Paunica, Daniela Gabriela Bălan, Laura Florentina Rebegea

Journal of Mind and Medical Sciences

Colon cancer is relatively asymptomatic in the early stages, the manifestations appearing and intensifying with the evolution of the disease, especially when associated with local and/or systemic complications. In such cases, surgical interventions are often emergency and involve more extensive operations (on metabolically and immune-stressed organisms), so that an early diagnosis (endoscopy, tumor markers, etc.) remains not only desirable but even a priority, especially in predisposed patients (genetic factors, lifestyle, etc.). As a consequence, the involvement of tumor markers in colon neoplasms has become more and more investigated in recent times. This review investigates the roles of serological and genetic …

Obstructive Sleep Apnea And Risk Of Postoperative Complications After Non-Cardiac Surgery, Rabail Arif Chaudhry, Lori Zarmer, Kelly West, Frances Chung

Journal Articles

Obstructive sleep apnea (OSA), a common sleep disorder, poses significant challenges in perioperative management due to its complexity and multifactorial nature. With a global prevalence of approximately 22.6%, OSA often remains undiagnosed, and increases the risk of cardiac and respiratory postoperative complications. Preoperative screening has become essential in many institutions to identify patients at increased risk, and experts recommend proceeding with surgery in the absence of severe symptoms, albeit with heightened postoperative monitoring. Anesthetic and sedative agents exacerbate upper airway collapsibility and depress central respiratory activity, complicating intraoperative management, especially with neuromuscular blockade use. Additionally, OSA patients are particularly prone …

The Reduction Of Pain Perception Through Music Therapy In Surgical Patients, David Collier

MSN Capstone Projects

The control of pain perceptions of surgical patients is an ongoing problem in trying to control the pain with enough narcotics while not giving too much to depress their respiratory status. Using narcotics increases the risks of several side effects which can negatively impact the patient’s recovery (Fu et. al., 2019). Perioperative music is a nonpharmacological method used to decrease the need for pain medication (Fu et. al, 2019; Kahloul et. al., 2016). The patient is in an anxiety state that causes a heightened state of arousal of the sympathetic system, which in turn releases catecholamines to act on the …

A Strategic Plan For The Development Of A Model Of Care For Post Operative Bariatric Patients In Rural Utah, Cris R. Chamberlain

Doctoral Dissertations and Projects

The delivery of health care for postoperative bariatric patients remains a challenge in rural settings, often leading to varied patient outcomes and inefficient resource allocation. This study aims to develop and implement a strategic model of care for postoperative bariatric patients at Castleview Hospital in Rural Utah. Grounded in the Iowa Model of Evidence-Based Practice, this initiative focuses on creating a cohesive and comprehensive postoperative care pathway, tailored to the unique patient demographics and facility constraints of a 39-bed hospital serving 35-45 bariatric patients annually. Methodology includes ethical considerations, secured through CITI training and pending IRB approval, robust data collection …

Enhanced Recovery After Surgery (Eras) Protocol For Bariatric Surgery, Krista Bunch

Doctor of Nursing Practice Projects

Bariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). …

Correlation Of Sonographic With Intraoperative Findings In Laparoscopic Managed Ectopic Pregnancies, A 10-Year Synopsis: A Retrospective Observational Study, Steve Mutiso

Obstetrics and Gynaecology, East Africa

Background: Ectopic pregnancies (EP) are a common pregnancy complication that's associated with significant morbidity and rarely mortality if not managed properly. Ultrasound examination forms the cornerstone of diagnosis of EP with some sonographic features occasionally not correlating with intraoperative findings. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the correlation and prediction of sonographic findings to intraoperative findings.

Methods: This study was designed as a Retrospective Observational Study based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis of …

Operative Versus Nonoperative Management For Diverticulitis Complicated By Abscess, Alix Bernholtz, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

You K, Bendl R, Taut C, et al. Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively. Br J Surg. 2018;105(8):971-979. https://doi.org/10.1002/bjs.10868

for a patient with a recurrent diverticulitis complicated by abscess formation.

Safety And Cost Effectiveness Of Immediate Sequential Bilateral Cataracts Surgery, Miles Bowman, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Rush SW, Gerald AE, Smith JC, Rush AJ, Rush RB. Prospective analysis of outcomes and economic factors of same-day bilateral cataract surgery in the United States. Journal of Cataract and Refractive Surgery. 2015;41(4):732-739. https://doi.org/10.1016/j.jcrs.2014.07.034

for a patient with bilateral cataracts.

The Long-Term Economic Implications Of Burn Injury For Burn Survivors, Jacob M. Dougherty Bs, Hannan A. Maqsood Mbbs, Zhaohui Fan Md Mph, Stewart C. Wang Md Phd, Mark R. Hemmila Md, Naveen F. Sangji Md Mph

Medical Student Research Symposium

Introduction: The long-term economic implications of burn injury on patients and payors has not been well described. Burn injury can be costly due to prolonged intensive care, wound care, rehabilitation, psychological care, and reconstructive surgery that may be required well after the initial injury. We investigated index and post-acute payor and out-of-pocket (OOP) costs related to burn injury for in-patient care at 30 days, and up to 36 months post-discharge to understand the long-term economic implications for burn survivors.

Methods: An observational cohort study was conducted using a commercial claims database from IBM Watson Health® Marketscan. Patients age ≤ …

Exploring The Effects Of Amniotic Bladder Therapy On Female Sexual Dysfunction In Interstitial Cystitis/Bladder Pain Syndrome Patients, Jonathan D. Lutchka, Jack Vercnocke Md, David Pearlman Md, Aron Liaw Md, Nivedita Dhar Md

Medical Student Research Symposium

Introduction and Objectives: Female sexual dysfunction (FSD) is commonly associated with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). FSD manifests as abnormalities in sexual desire, arousal, orgasm, pain, distress, and satisfaction. Our primary objective was to assess the impact of micronized amniotic membrane injections (AM) on FSD and lower urinary tract symptoms using comprehensive measures, including the multi-domain Female Sexual Function Index (FSFI), the Pain Visual Analog Scale (VAS), and the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI).

Methods: Study participants included patients diagnosed with IC/BPS and FSD refractory to traditional therapies. Under general anesthesia, these …

Maximizing Value In Total Knee Arthroplasty: Ambulatory Surgical Center Or Hospital Outpatient Department?, Megan Carulla, Meet Patel, Emily Mazier, Alex Lindahl, Trae Hill, Charles S. Day

Medical Student Research Symposium

Introduction:

In the United States, healthcare costs have consistently ranked the highest among developed countries, leading to an urgent push towards decreasing spending. This study compared the cost of robot-assisted total knee arthroplasty (TKA) performed in a hospital outpatient department (HOPD) to an Ambulatory Surgical Center (ASC).

Methods and Materials:

Costs were determined using Time-Driven Activity-Based Costing (TDABC) methodology. All steps of a patient care pathway for robotic TKA performed in ASC and HOPD were organized into one process map. All personnel involved in patient care were included and the average time each allocated to patients was multiplied by their …

Australian Elective Surgery Patients’ Pre-Operative Preparation, Health Literacy, Learning Preferences And Knowledge Resource Needs: A Cross-Sectional Survey, Cory J. Williams, Jed Duff, Chloe Tannagan

Journal of Perioperative Nursing

Aim: To investigate self-reported health literacy levels, learning preferences and knowledge resource needs of Australian elective surgery patients.

Background: Surgery contributes significantly to global health care, but surgical waitlists, cancellations and delay remain major challenges for health care systems. Pre-operative preparation and patient education about the surgical journey are essential to reducing these disruptions. Unfortunately, preparation and education are limited by short timeframes and one-size-fitsall approaches. Limited information exists about Australian surgical patients’ health literacy levels, learning preferences and knowledge resource needs.

Design and methods: This cross-sectional waiting room survey investigated patient health literacy, preferred education mode and learning styles …

High-Grade Avm. Educational Vignette And Clinical Cases, Marcos Devanir Silva Da Costa, Marcelo Augusto Acosta Goiri, Daniela Coelho, Juan Alberto Paz Archila, Talita Helena Martins Sarti, Feres Chaddad-Neto

Archives of Neurosurgery

The arteriovenous malformation (AVM) is a vascular malformation characterized by fistulas between arteries and veins forming a nidus, without interposition of capillary vessels and of which early draining vein is identified at the digital angiography. Potential reports of its existence date from the second century AD. Spetzler and Martin (S-M) proposed a classification considering three features and Lawton then added new predictors. A maximum of 10 score can be achieved by applying the modified S-M grade system. This classification guides decision-making and the possible choice of the multimodal treatment (surgery, radiosurgery and embolization). We discuss historical, pathological, clinical and therapeutic …

Modified Inferior Based Reduction Mammoplasty Versus Matrix Rotational Flap In Upper Inner Quadrant Breast Cancer, Abdelaziz Ragab Abdelaziz Sakr, Alaa Abd Elazeem Elsisi, Tarek Mohey Rageh, Mahmoud Ahmed Shahin

Menoufia Medical Journal

Objectives: to compare between inferior pedicle mammaplasty and matrix rotational advancement flap as techniques for upper inner quadrant breast cancers regarding oncoplastic and aesthetic results. Background: Breast conserving therapy (BCT) is the standard of care in early breast cancer; has a value to provide a treatment as effective as mastectomy with benefits of breast preservation. However, traditional conservative surgery in the upper inner quadrant may not have good cosmetic results. Methods: All 30 patients were candidates for breast conservation and with upper inner breast tumors; patients were randomly categorized into two groups. Group A (16 patients) included patients who underwent …

The Therapeutic Use Of Intraoperative Music To Reduce Postoperative Pain In Patients Receiving General Anesthesia, Caroline Ford

Nurse Residency

Background: The recovery from surgery can be very painful for some patients and require opioid management and longer hospital stays for unmanaged pain. Music has been a non-analgesic way of helping patients with chronic pain and recent studies have shown that music intraoperatively can greatly improve the patients' pain after surgery requiring general anesthesia.

Outcome Of Combined Or Single Flexor Digitorum Superficialis And Flexor Digitorum Profundus Repair In Zone Ii, Mayadah Adel Nossir, Dalia Mofreh Elsakka, Hady Saleh Abou-Ashour, Mohamed Abdallah Elnahas

Menoufia Medical Journal

Objectives: To evaluate the outcomes of the repair of flexor digitorum Profundus (FDP) alone versus its repair combined with flexor digitorum superficialis (FDS) repair in Zone II flexor tendon injury. Background: Flexor tendon injuries in zone II of the hand present a challenging problem for hand surgeons. Injuries involving the FDP and FDS tendons require careful assessment and planning. The primary goals of repair are to achieve optimal tendon healing, maximize range of motion, and restore functional strength. Methods: A total of 24 patients presenting with FDP and FDP injury at zone II were surgically treated from 2020 to 2022. …

Study Of The Different Modalities For Scrotal Skin Reconstruction, Mohamed Ahmed Megahed, Ahmed Tharwat Nassar, Khaled Mohamed Albassam, Qutaibah Alkandari, Ahmed Fergany Saber, Mina Safwat Zaki

Menoufia Medical Journal

Objectives: to study different modalities of reconstruction of defects in the scrotum and to verify indications and efficacy of each technique. Background: Techniques of genital reconstruction continue to evolve. However, mainstays of therapy include split-thickness skin graft, primary closure, and musculocutaneous flap. The best cosmetic and functional outcomes appear to occur in patients being treated for local cutaneous and lymphatic conditions. Methods: A prospective cross-sectional study was conducted on thirty male patients with a defect of scrotal skin with age range between 20 and 70 years old. They attended the plastic surgery and burn department of Menoufia University during the …

What Is The Ideal Free Flap For Microvascular Lower Limb Soft Tissue Reconstruction?, Mohamed Abdallah Elnahas, Abdallah Ahmad Amin, Fouad Mohamed Ghareeb, Hassam Hassan Fawzy

Menoufia Medical Journal

Objectives: is to detail four reliable free flaps including the anterolateral thigh, radial forearm, thoracodorsal and latissimus dorsi for use in lower extremity microvascular reconstruction and to establish factors to consider when developing an algorithm for reconstructing lower extremity injuries. Background: to achieve restoration of normal functions and good aesthetic outcomes ; microvascular free flaps are the preferred method for complex injuries repair in lower limbs. Methods: A total of 30 patients with complex soft tissue lower limb defects and deformities required surgical reconstruction were enrolled in this study. They underwent four types of free flap reconstruction. All patients were …

Treatment Of Post-Burn Hypopigmentation With Non-Cultured Epidermal Grafting, Islam Ibrahim Abd Elmohsen, Ahmed Tharwat Nassar, Tarek Fouad Kishk, Ahmed Fergany Saber, Hossam Hassan Fawzy

Menoufia Medical Journal

Objectives: To evaluate the applicability of cell therapy using non-cultured epidermal transplantation regarding the aesthetic outcome, , and possible complications in the treatment of post-burn hypopigmentation. Background: new non-cultured autologous epidermal techniques have been developed with similar results to the cultured melanocytes techniques, but are simpler, less expensive, and less time-consuming. Methods: This prospective study was conducted on 35 post-burn hypopigmentation patients presented at the Plastic and Reconstructive Surgery Department in Menoufia University Hospitals between April 2020 to April 2023. Results: We found that the repigmentation ranged between 20-95%, and the color matching ranged between 30-80%. Most cases had good …

Patients’ Expectations Before Coronary Artery Bypass Graft Surgery: A Cross- Sectional Study, Mohammad Abdallah, Shymaa Mamdouh Mohamed Abdu Sh.M, Abdel-Hady El-Gilany Ah.G, Wael Abdel-Aziz, Noha Eladawy, Olfat Farag

Menoufia Medical Journal

Background

Exploring patient’ s expectations before coronary artery bypass graft (CABG) surgery provides clinicians with important insights into their service population.

Objectives

The objective of this study is to describe the expectations of patients before CABG surgery and its associated factors.

Patients and methods

A cross-sectional study was conducted in the Outpatient Clinic of an Egyptian Cardiac Surgery Unit during the period from May 2017 to April 2018. A total of 446 patients who underwent CABG surgery were included. The socio-demographic and clinical data were collected from patients and their medical records. The Cardiac Surgery Patient Expectations questionnaire was used …

Treatment Of Acute Lower Extremity Deep Venous Thrombosis With Rivaroxiban Versus Warfarin, Mahmoud S. Eldesouky, Walid Salah-Eldin Gaber Elsayed, Abdelmoniem Farid Mohammed

Menoufia Medical Journal

Objectives: to assess extent of thrombus resolution and rate of complications in patients with lower extremity acute Deep Venous Thrombosis (DVT) treated with rivaroxaban compared to warfarin therapy. Background: For years, the standard treatment for acute lower extremity DVT has been the use of warfarin with bridge therapy by enoxaparin. New oral anticoagulant drugs such as rivaroxaban have been developed and used as an alternative to warfarin in the treatment of acute lower extremity DVT. Methods: This is a prospective study that was conducted on 130 patients to assess extent of thrombus resolution and rate of complications in patients with …

Laparoscopic Sleeve Gastrectomy Versus Endoscopic Intra-Gastric Balloon Placement: Early Outcomes In Morbidly Obese Patients, Mohammed Abd El-Glil Elbalshy, Mohamed Marzouk Azab Elgeldawy, Ahmed Samy Mashaal, Mahmoud Abd-Ellatif Bahram, Adel Saed Zedan

Menoufia Medical Journal

Objectives: to compare outcomes of laparoscopic sleeve gastrectomy (LSG) and endoscopic intra-gastric balloon (IGB) in patients with morbid obesity regarding the degree of weight loss in the first year, complications, and improvement of comorbidities.

Background: LSG and IGB placement are widely used treatment modalities for weight loss in patients with morbid obesity.

Methods: A prospective study involved 60 patients who underwent LSG or IGB insertion. Patients were divided into two groups: LSG group, comprising 30 patients who underwent LSG, and IGB group, including 30 patients who underwent IGB insertion. A Follow-up was conducted for all patients over a period of …

Clinical Results Of Single-Vessel Versus Multiple-Vessel Infrapopliteal Intervention In Critical Limb Ischemia, Yahia M. Elkhateep, Ahmed Hossni, Fawzi Bakr, Mostafa Kamel Abdelrahman, Mahmoud S. Eldesouky

Menoufia Medical Journal

Objectives: to compare the clinical outcomes of single-vessel versus multiple-vessel infrapopliteal interventions in patients diagnosed with critical limb ischemia (CLI) undergoing infrapopliteal revascularization. Background: Critical limb ischemia is a severe condition requiring revascularization procedures to restore blood flow. The choice between single-vessel and multiple-vessel interventions remains debatable. Understanding the clinical outcomes associated with each approach can guide treatment decisions and optimize patient care. Methods: A prospective study was conducted on 60 adult patients diagnosed with CLI who underwent infrapopliteal revascularization between January 2021 and January 2023. Single-vessel interventions were performed on 30 patients, while multiple-vessel interventions were performed on the …

Comparative Analysis Of Md And Do Candidates To A Surgical Residency Program, Duyen Quach, Rachel Wright, Vishal Patel, Scott Zimmerle, Brendan Rosamond, Jonathan Lall, Said Maldonado, Zuhair Ali, Rajeev Raghavan, Mike Liang

Gulf Coast Division GME Research Symposium 2024

No abstract provided.