Articles: surgery.
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Infected animal bites and localised infections are traditionally managed by inpatient admission, intravenous antibiotics, and localised washout +/- debridement. Our hand trauma protocol was modified to accommodate the challenges faced in delivering this pathway during the COVID-19 pandemic. ⋯ III.
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The peri-operative period may create a biological environment conducive to cancer cell survival and dissemination. Microscopic residual tumours (micrometastases) can be dislodged even with excellent surgical technique. At the same time, the stress response from surgery can temporarily impair immune function and activate inflammatory processes, increasing the risk of tumour proliferation. ⋯ There is a complex interplay between anaesthetic and analgesic techniques and cancer outcomes. Despite promising data from laboratory experimental models, the balance of available clinical trials indicates an equivalent influence of all evaluated anaesthetic techniques on long-term oncologic outcomes, except, possibly, for peritumoral or intraperitoneal local anaesthetic infiltration.
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In recent years, there has been an outpouring of scoring systems that were built to predict outcomes after various surgical procedures; however, research validating these studies in spinal surgery is quite limited. In this study, we evaluated the predictability of the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator (ACS NSQIP SRC) for various postoperative outcomes after spinal deformity surgery. ⋯ The ACS NSQIP SRC is a poor predictor of outcomes after spinal deformity surgery.
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About one in five adolescents undergoing major surgery develops chronic post-surgical pain (CPSP). Various risk and resilience factors for recovery and CPSP have been identified, including parental processes. However, research commonly relies on nomothetic data, while the psychometric properties of diaries assessing pediatric post-surgical recovery in everyday life are understudied. Therefore, this study aimed to evaluate the preliminary reliability, validity, and variability of diary data in adolescents, and their parents, after spinal fusion surgery. ⋯ The results provide the first evidence for the psychometric properties, with regard to reliability, validity and variability, for diary measures to monitor processes of post-surgical recovery in everyday life in adolescents undergoing spinal fusion surgery. However, replication is suggested, for refinement and further validation, with particular attention to variability and evaluation of sensitivity to change.