Medicine and Health Sciences Commons^™

Prevalence Of Pre-Operative Anxiety Among Adult Patients Undergoing Elective Surgery: A Prospective Observational Single-Centre Study, Salihah Asiri, Jed Duff, Jane Currie, Michelle Guilhermino

Journal of Perioperative Nursing

Objective: This study aimed to investigate the prevalence of pre-operative anxiety in elective surgical patients at a major metropolitan hospital in Australia.

Background: Globally, 310 million people are admitted for surgery every year. It is estimated that up to 80 per cent of these patients experience clinically relevant anxiety in the pre-operative period. Pre-operative anxiety can result in post-operative complications such as pain, delayed wound healing, surgical site infection, prolonged recovery and extended hospital stays. While preoperative anxiety has many negative consequences, this anxiety has often been overlooked in clinical practice.

Methods: A prospective study was conducted between November 2021 …

Results Of A Prospective Trial To Evaluate Novel Lung Function Imaging For Lung Cancer Surgery, Lydia J. Wilson, Phd, Richard Castillo, Phd, Edward Castillo, Phd, Bernard Jones, Phd, Moyed Miften, Phd, Lindsey Olsen, Phd, Vikas Aragam, Phd, Robert A. Meguid, Md, Mph, Crystal J. Erickson, Md, Amanda Young, Msn, Matthew Blum, Md, Tyler Grenda, Md, Julie Barta, Md, Benjamin Leiby, Phd, Timothy Waxweiler, Md, Brian Kavanagh, Md, Mph, John D. Mitchell, Md, Yevgeniy Vinogradskiy, Phd

Department of Radiation Oncology Posters

Background

• Surgery is the primary form of definitive treatment for early-stage lung cancer.
• Poor lung function before surgery places patients at high risk of pulmonary complications after resection.
• Surgeons evaluate patient fitness for surgery using pulmonary function tests (PFTs) to calculate the predicted postoperative PFT (ppoPFT).
• Conventional ppoPFT calculations assume homogeneous lung function, which can be inaccurate.
• 4DCT-ventilation is a novel lung function imaging modality developed in radiation oncology that uses 4DCT data to calculate high-resolution ventilation maps.

Quantitative Assessment Of Preoperative And Postoperative Brachycephalic Airway Obstruction Syndrome Surgery Using Clinical Grading Questionnaires And 6-Minute Walk Test In French Bulldogs, Tamolwan Anyamaneecharoen, Krishaporn Kradangnga, Saikaew Sutayatram, Pasakorn Brikshavana, Sumit Durongphongtorn

The Thai Journal of Veterinary Medicine

Brachycephalic airway obstructive syndrome (BAOS) is an anatomical abnormality of the upper airway commonly found in brachycephalic breeds, leading to clinical signs and physical capacity impairment. The degree of stenotic nares was reported to be related to BAOS severity in French bulldogs. This study aimed to compare clinical signs and physical capacity in French bulldogs before and after BAOS surgery using modified Roedler questionnaires and a 6-minute walk test (6-MWT). Twenty-seven French bulldogs were enrolled in this study (non-BAOS control (n=7), non-severe stenotic nares BAOS dogs (n=8), and severe stenotic nares BAOS dogs (n=12). BAOS surgery included staphylectomy using bipolar …

Can Anorectal Stenosis Be Managed With Dilations Alone? A Pcplc Review., Zoe M. Saenz, Kelly Austin, Jeffrey R. Avansino, Andrea Badillo, Casey M. Calkins, Megan M. Durham, Megan K. Fuller, Ankur Rana, Ron W. Reeder, Rebecca M. Rentea, Michael D. Rollins, K Elizabeth Speck, Richard J. Wood, Jamie C. Harris, Jamie Anderson, Maheen Hassan, Payam Saadai, Pediatric Colorectal And Pelvic Learning Consortium (Pcplc)

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Congenital anorectal stenosis is managed by dilations or operative repair. Recent studies now propose use of dilations as the primary treatment modality to potentially defer or eliminate the need for surgical repair. We aim to characterize the management and outcomes of these patients via a multi-institutional review using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) registry.

METHODS: A retrospective database review was performed using the PCPLC registry. The patients were evaluated for demographics, co-morbidities, diagnostic work-up, surgical intervention, current bowel management, and complications.

RESULTS: 64 patients with anal or rectal stenosis were identified (57 anal, 7 rectal) from …

Smoke Evacuation In The Operating Room, Meghan Holley, Mckenzie Moon

Nurse Residency

In perioperative staff, does mandating the use of smoke evacuation in the surgical setting compared to no smoke evacuation decrease the amount of exposure to toxic byproducts found in surgical plume for each surgical case?

National Estimates For The Percentage Of All Readmissions With Demographic Features, Morbidity, Overall And Gender-Specific Mortality Of Transcutaneous Versus Open Surgical Tricuspid Valve Replacement/Repair, Muhammad Shayan Khan, Abdul Baqi, Ayesha Tahir, Ghulam Mujtaba Ghumman, Waqas Ullah, Jay Shah, Yasar Sattar, Tanveer Mir, Zain Sheikh, Fnu Salman, Moaaz Baghal, Kritika Luthra, Vinod Khatri, Zainulabedin Waqar, Malik Waleed Zeb Khan, Mohammed Taleb, Syed Sohail Ali

Abington Jefferson Health Papers

BACKGROUND: The aim of the study was to determine national estimates for the percentage of all readmissions with demographic features, length of stay (LOS), cost analysis, comorbidities, complications, overall and gender-specific mortality and complications of transcutaneous tricuspid valve replacement/repair (TTVR) vs. open surgical tricuspid valve replacement/repair (open TVR).

METHODS: Data were extrapolated from the Nationwide Readmissions Database (NRD) 2015-19. Of the 75,266,750 (unweighted) cases recorded in the 2015 - 2019 dataset, 429 had one or more of the percutaneous approach codes as per the ICD-10 dataset, and 10,077 had one or more of the open approach codes.

RESULTS: Overall, the …

Emerging Biomedical And Clinical Applications Of 3d-Printed Poly(Lactic Acid)-Based Devices And Delivery Systems., Allan John R Barcena, Prashanth Ravi, Suprateek Kundu, Karthik Tappa

Student and Faculty Publications

Poly(lactic acid) (PLA) is widely used in the field of medicine due to its biocompatibility, versatility, and cost-effectiveness. Three-dimensional (3D) printing or the systematic deposition of PLA in layers has enabled the fabrication of customized scaffolds for various biomedical and clinical applications. In tissue engineering and regenerative medicine, 3D-printed PLA has been mostly used to generate bone tissue scaffolds, typically in combination with different polymers and ceramics. PLA's versatility has also allowed the development of drug-eluting constructs for the controlled release of various agents, such as antibiotics, antivirals, anti-hypertensives, chemotherapeutics, hormones, and vitamins. Additionally, 3D-printed PLA has recently been used …

Multiple Extraarticular Giant Cell Tumors., Faraz Yousefian, Marianne Cortes, Benjamin Kahn, Marcus Goodman, Nicole Kounalakis

PCOM Scholarly Works

No abstract available

The Comparison Between Chlorhexidine And Providone-Iodine Antiseptics In The Operating Rom To Prevent Surgical Site Infections, Eleanor Decarolis

Nurse Residency

Background: Surgical site infections (SSI's) are one of the most common and costly complications from surgery. Chlorhexidine gluconate (CHG) and Povidione-Iodine (PVI) are the most common antiseptics used in surgery. The efficacy and uses of these surgical preps have been studied to determine the most effective in preventing surgical site infections.

The Association Between Injury Characteristics And In-Patient Outcomes In A Cohort Of Adult Patients Admitted To A State Spinal Unit Following Spinal Injuries: A Retrospective Observational Study., Anna O’Hanlon, Michelle Trevenen, Farhaan Altaf, Leon Flicker, Mayura Iddagoda

Advanced Spine Journal

Background Data: Spinal injuries are common and are associated with complications either directly related to the spinal injury itself, including autonomic or cord related events, or indirectly related medical complications. These complications are a frequent cause of morbidity and mortality and lead to an increase in the rates of hospitalisation, higher care costs, and decreased quality of life.

Purpose: Our primary outcomes were the impact of management on in-patient outcomes of medical complications, length of hospital stay, physical function on day three and discharge destination. Our secondary aim was to assess the impact of injury characteristics, ASIA score and level …

Modificaciones Realizadas En Cirugías Y En Cuidados De Pacientes En Ecuador, Addison Wolfe

NEXUS: The Liberty Journal of Interdisciplinary Studies

No abstract provided.

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

Faculty and Staff Publications

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 …

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 …

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). …

Randomized Controlled Trial Of The Cmr Immersive Virtual Reality (Ivr) Headset Training Compared To E-Learning For Operating Room Configuration Of The Cmr Versius Robot, Catherine L Eley, Varun Palaniappan, Abbie Carter, Opeyemi Sogaolu, James Horwood, Michael Davies, Jared Torkington, James Ansell

Student and Faculty Publications

Robotic surgery offers potential advantages over laparoscopic procedures, but the training for configuring robotic systems in the operating room remains underexplored. This study seeks to validate immersive virtual reality (IVR) headset training for setting up the CMR Versius in the operating room. This single-blinded randomized control trial randomised medical students with no prior robotic experience using an online randomiser. The intervention group received IVR headset training, and the control group, e-learning modules. Assessors were blinded to participant group. Primary endpoint was overall score (OS): Likert-scale 1-5: 1 reflecting independent performance, with increasing verbal prompts to a maximum score of 5, …

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 …