International journal of surgery
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Delirium is highly prevalent, occurring in 20% of acute hospital inpatients and up to 62% of surgical patients. It is a significant predictor of poor outcomes including mortality and institutionalisation, however it is often viewed as simply a marker of underlying illness and is frequently overlooked in older adults. Although delirium is commonly comorbid with dementia, it represents a more urgent diagnosis, requiring prompt intervention. ⋯ Appropriate treatment of delirium requires thorough investigation, management of the underlying illness, avoidance of complications and simplification of the care environment. Studies suggest a role for pharmacological prophylaxis, particularly in relation to anaesthetic and sedative agents used intra- and post-operatively. Furthermore, gathering evidence suggests that judicious use of antipsychotic medications may be helpful in delirium prevention and treatment.
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The aim of this meta-analysis is to assess the association between obesity and risk of surgical site infections (SSI) risk in orthopedics. ⋯ Our meta-analysis indicates that obesity had about twofold increased risk of surgical site infections risk in orthopedics. However, this conclusion should be verified by further well designed prospective cohort studies.
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Laparoscopic correction of perforated peptic ulcer (PPU) has become an accepted way of management. Patch omentoplasty stayed for decades the main method of repair. The goal of the present study was to evaluate whether laparoscopic simple repair of PPU is as safe as patch omentoplasty. ⋯ Laparoscopic simple repair of PPU is a safe procedure compared with the traditional patch omentoplasty in presence of certain selection criteria.
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Bedside ultrasound is increasingly commonly used by surgeons in their everyday practice. Little is known on the practical implications of bedside ultrasound, its efficacy and safety. ⋯ Evidence exists for the routine use of certain types of bedside ultrasound in surgical practice, especially in hepatobiliary and head and neck scanning. Further study is needed to determine its utility in vascular, hernia and breast ultrasound.
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Patients with suspected appendicitis comprise a large proportion of general surgical workload. The resulting healthcare burden is significant when one considers that investigations, observation and surgical procedures are often needed. As no previous study has examined the cost of managing patients with suspected appendicitis, we performed a cost analysis study of management of cases of right iliac fossa (RIF) pain in University Hospital Limerick. ⋯ Strategies to reduce cost include reducing unnecessary admissions and unnecessary operations. Reducing LOS may be another potentially valuable cost saving method. It is imperative that resources are channelled into the provision of accurate costing structures.