Articles: surgery.
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Anesthesia and analgesia · Dec 2023
ReviewExploring the Pathophysiology of Delirium: An Overview of Biomarker Studies, Animal Models, and Tissue-Engineered Models.
Delirium is an acute brain disorder associated with disorganized thinking, difficulty focusing, and confusion that commonly follows major surgery, severe infection, and illness. Older patients are at high risk for developing delirium during hospitalization, which may contribute to increased morbidity, longer hospitalization, and increased risk of institutionalization following discharge. ⋯ This review delves into the findings from biomarker studies and animal models, and highlights the potential for tissue-engineered models of the brain in studying this condition. The aim is to bring together the existing knowledge in the field and provide insight into the future direction of delirium research.
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Arch Orthop Trauma Surg · Dec 2023
ReviewSurgical smoke and the orthopedic surgeon: a non-systematic review of the hazards and strategies for mitigating risk.
Surgical smoke generated through the use of electrical surgical devices poses a risk to the surgeon, medical personnel in the operating room, and the patient by exposing them to environmentally hazardous particulate matter. Previous investigation has shown that surgical smoke leads to an increased risk of pulmonary conditions, circulatory disorders, and irritation of the eyes, nose, and throat. Transmission of infectious disease can occur through inhalation of viral particles, and the presence of carcinogens are also of major concern. The deleterious effects of surgical smoke are well documented in several subspecialties, namely dermatology and general surgery, but there has been little discussion on the topic amongst orthopedic surgeons. ⋯ Surgical smoke is an under-recognized occupational hazard within the orthopedic surgery literature. There are several strategies which can be employed to reduce risk. Further investigation is needed to understand the long-term impact of these risks, as well as what can be done to improve the practicality and compliance with protective measures.
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Gastric conduit is most widely used method for esophageal reconstruction. Despite its popularity, certain complications, such as anastomotic leakage and strictures, remain to be resolved. In the present study, we reviewed the outcomes of narrow gastric conduit compared to wide gastric conduit reconstruction. ⋯ The narrow gastric conduit is not inferior to the wide gastric conduit and can be considered an alternative option for gastric conduit preparation.
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Randomized Controlled Trial
The implementation and effect evaluation of AIDET standard communication health education mode under the King theory of goal attainment: A randomized control study.
This research addresses inadequate understanding of interventional prenatal diagnosis, preoperative anxiety psychological problems in pregnant women undergoing interventional prenatal diagnosis, proposing a health education mode combined AIDET standard communication and King's theory of goal attainment approach to potentially improve health education outcomes, anxiety psychological problems, and patient satisfaction. ⋯ Using the AIDET standard communication health education model under the King theory of goal attainment in nurse-patient communication is conducive to the rapid establishment of a harmonious and trusting nurse-patient relationship between pregnant women and nurses, helping pregnant women and nurses jointly promote the establishment and implementation of health education goals, helping to improve pregnant women's acceptance of information related to interventional prenatal diagnosis, health education and the procedure of walking on the day of surgery. It helps enhance the effectiveness of health education and satisfaction, reducing pregnant women's uncertainty about the disease, their unfamiliarity with the surgery environment and surgery procedure, and their preoperative anxiety.
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Rater-based assessment and objective assessment play an important role in evaluating residents' clinical competencies. We hypothesize that a cumulative sum (CUSUM) chart of operative time is a complement to the assessment of chief general surgery residents' competencies with ACGME Milestones, aiding residency programs' determination of graduating residents' practice readiness. ⋯ CUSUM charts of operative time complement the ACGME Milestones evaluations. The use of both may enable residency programs to holistically determine graduating residents' practice readiness and provide recommendations for their upcoming career/practice transition.