Articles: surgery.
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Anesthesia and analgesia · Jan 2025
Preoperative Psychological Factors, Postoperative Pain Scores, and Development of Posttraumatic Stress Disorder Symptoms After Pediatric Anterior Cruciate Ligament Reconstruction.
Acute orthopedic injuries and subsequent surgical repair can be challenging for children and adolescents and result in posttraumatic stress reactions that can be problematic after the acute perioperative period. In a cohort of patients undergoing anterior cruciate ligament reconstruction (ACLR), we investigated the incidence and explored risk factors associated with the development of posttraumatic stress disorder (PTSD) symptoms after surgery. ⋯ A portion of patients undergoing ACLR are at risk for the development of symptoms consistent with PTSD. Risk factors include preoperative anxiety or depression and high postoperative pain scores. Interventions designed to address preoperative risk factors and optimization of postoperative pain may represent opportunities to improve outcomes in this patient population.
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To assess the research productivity, career advancement, grant funding, and scholarly impact of international medical graduates (IMGs) in academic cardiothoracic surgery. ⋯ IMGs represent a more junior cohort of surgeons but contribute significantly to the cardiothoracic surgery workforce, with comparable academic success. Policy efforts to streamline IMGs' path toward US practice could help alleviate surgical shortages, while enhancing diversity and strengthening academia.
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Lumbar disc herniation, canal stenosis, and cervicarthrosis are degenerative spinal pathologies frequently observed in the aging population of patients with Parkinson disease (PD). Spinal surgery in PD patients remains risky with uncertain functional results. The main issue is to determine whether a surgical procedure should be performed on PD patients with common degenerative spinal pathologies. ⋯ Noninstrumented or simple fusion level spinal surgery for patients with PD is fraught with numerous complications and produces very poor functional results. Nevertheless, a multidisciplinary perioperative approach for patients, with less invasive surgery whenever possible, provides the necessary conditions to ensure surgical success and avoid aggravating their fragile general condition.