No abstract

The topic of patient satisfaction has gained increasing importance over the past decade. Due to the impact of patient satisfaction on health care quality, understanding factors that predict satisfaction is vital. The purpose of this review is to examine the literature and identify factors related to patient perioperative satisfaction as well as predictive variables that, if modified, can enhance satisfaction scores of patients undergoing surgery. Our review reports that patient satisfaction scores are affected by modifiable factors such as clinician-patient communication, information provision to patients, and operational function of a hospital. Non-modifiable factors affecting patient satisfaction scores include patient demographics such as gender, age, and education. In order to enhance patient perioperative satisfaction, we suggest that anesthesiologists and surgeons focus their efforts on enhancing their communication skills and providing information that is appropriately tailored to the understanding of their patients.

There is significant variation in treatment parameters when treating the infraorbital region. Thorough knowledge of these pertinent factors, choice of the optimal filling material, and proper understanding of the anatomy of this unforgiving region will contribute to a safe, effective, and natural result. We aim to conduct a systematic review of published literature related to soft tissue fillers of the tear trough and infraorbital region. A search of published literature was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included PubMed, Embase, and Science Direct databases. The Medical Subject Headings (MeSH) terms used were “tear trough” OR “infraorbital” AND “dermal filler” OR “hyaluronic acid” OR “poly-L-lactic acid” OR “calcium hydroxyapatite” OR “Restylane” OR “Radiesse” OR “Perlane” OR “Juvéderm” OR “Belotero.” Different combinations of these key terms were used. The initial search identified 526 articles. Six additional articles were identified through references. Two-hundred twenty-five duplicates were removed. A total of 307 studies were screened by title and abstract and 258 studies were eliminated based on inclusion and exclusion criteria. Forty-nine articles underwent full-text review. The final analysis included 23 articles. Patient satisfaction was high, and duration of effect ranged from 8 to 12 months. Restylane was most commonly used. Injection technique varied, but generally involved placing filler pre-periosteally, deep to orbicularis oculi muscle, anterior to the inferior orbital rim via serial puncture or retrograde linear threading with a 30-gauge needle. Topical anesthetic was most commonly used. Side effects were generally mild and included bruising, edema, blue–gray dyschromia, and contour irregularities. Nonsurgical correction of the tear trough deformity with soft tissue filler is a minimally invasive procedure with excellent patient satisfaction with long-lasting effects. It is essential to have a fundamental understanding of the relevant anatomy and ideal injection technique to provide excellent patient outcomes and prevent serious complications.

Background: An athlete’s preexisting psychological factors may influence the incidence and/or severity of sports-related concussions (SRCs). Purpose: To determine if emotional states, personality traits, temperament, life stressors, and explanatory styles (optimism vs pessimism) influence the incidence and severity of SRCs in athletes. Study Design: Systematic review. Methods: A systematic literature search of multiple major medical reference databases was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included that evaluated the effect of preexisting psychological factors on the incidence and severity of SRCs in male and female athletes participating in all sports. Results: The initial search identified 1195 articles. Ten studies met our inclusion criteria and were included in our analysis. Factors such as meanness, aggression, and psychoticism were associated with an increased incidence of SRCs. Baseline traits of irritability, sadness, nervousness, and depressive symptoms were associated with worse symptomatology after SRCs. In young athletes, preexisting psychiatric illnesses, family history of psychiatric illness, and significant life stressors were associated with an increased risk of developing postconcussion syndrome after SRCs. Conclusion: This systematic review demonstrated a potential relationship between an athlete’s preexisting psychological factors and the incidence and severity of SRCs. These associations are not entirely clear owing to the heterogeneity across included studies and the low-to-moderate certainty of evidence. Future studies should attempt to evaluate men and women independently, use well-validated psychological questionnaires, and limit the usage of self-reported SRCs, when possible. Furthermore, the potential efficacy of baseline psychological factor and/or symptom reports on the prevention and management of SRCs should be explored.

Background: It is critical to understand factors that may contribute to an increased risk of SPTC in order to develop surveillance protocols in high-risk individuals. This systematic review and meta-analysis will assess the association between primary malignancy and SPTC. Methods: A search of PubMed and Embase databases was completed in April 2020. Inclusion criteria included studies that reported the incidence or standardized incidence ratio of any primary malignancy and SPTC, published between 1980–2020. The PRISMA guidelines were followed and the Newcastle–Ottawa Scale was used to assess quality of studies. Results: 40 studies were included, which were comprised of 1,613,945 patients and 15 distinct types of primary cancers. In addition, 4196 (0.26%) patients developed SPTC following a mean duration of 8.07 ± 4.39 years. Greater risk of developing SPTC was found following primary breast (56.6%, 95%CI, 44.3–68.9, p < 0.001), renal cell (12.2%, 95%CI, 7.68–16.8, p < 0.001), basal cell (7.79%, 95%CI, 1.79–13.7, p = 0.011), and ovarian cancer (11.4%, 95%CI, 3.4–19.5, p = 0.005). SPTC patients were more likely to be females (RR = 1.58, 95%CI, 1.2–2.01, p < 0.001) and Caucasians (p < 0.001). Conclusions: Surveillance protocols should be considered for patients at a higher risk of SPTC, including those with primary breast, renal cell, basal cell and ovarian cancers who are female and/or Caucasian.

Injectable fillers represent one of the most requested minimally invasive treatments to rejuvenate the aging face, and its popularity is steadily rising. A vast majority of filler treatments are with hyaluronic acid (HA). The aim of this systematic review is to evaluate patient outcomes, safety profile, and administration techniques of various HA fillers for malar augmentation. A systematic review of the published literature was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included PubMed, Embase, and Science Direct databases. Medical Subject Headings (MeSH) terms used were “cheek” OR “midface” OR “malar” and “filler” OR “hyaluronic acid” OR “Juvederm” OR “Restylane” OR “Perlane” OR “Belotero.” The initial search identified 699 articles; 256 duplicates were removed. Additional 12 studies were identified from reference lists. A total of 455 were screened by title and abstract and 387 studies were eliminated based on criteria. Also, 68 articles underwent full-text review, and 18 articles were included in the final review and involved seven different HA formulations. Men and women from many age groups were highly satisfied with their results following HA treatment for midface augmentation up to 24 months. The most common adverse events included bruising, swelling, and tenderness, and typically lasted no more than 2 weeks. Upper cheek filler injections near the zygoma should be placed in the submuscular plane while lower cheek injections should be placed in the subcutaneous tissue. HA is an attractive choice for midface augmentation due to its high patient satisfaction, long-lasting effects, and low side-effect profile. Due to the variability in technique, level of expertise, and subjective measurements across studies, one optimal regimen could not be concluded. However, midface augmentation treatment should be personalized to each patient. Additional clinical trials are required to more conclusively determine the most appropriate approach for this procedure.

Facial cosmetic surgery trends are evolving in the current climate of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to evaluate public interest in elective facial plastic surgery during the COVID-19 pandemic including the period of the COVID-19 vaccine distribution using Google Trends. A Google Trends analysis was completed using popular terms related to facial cosmetic surgery and procedures from March 2017 to August 2021. Three stages were identified (baseline, pre-COVID-19 vaccine distribution, and post-COVID-19 vaccine distribution). Descriptive statistics were calculated and two-tailed t-tests were performed between the pre-vaccine and the post-vaccine phases. Linear regression analysis was also performed to determine percent deflection of search terms. There was significantly greater interest in facial aesthetic procedure search terms, except for tear trough filler, during the post-COVID-19 vaccine phase compared with the pre-COVID-19 vaccine phase. There was greater interest in lower facial procedure interest during this phase compared with upper facial procedures (p-value = 0.0011). The search terms with the greatest deflection percentage during the post-vaccine phase were lip filler, brow lift, and lip flip. There continues to be high demands of facial plastic surgery and procedures despite COVID-19 pandemic.

Previously, the medical community held the view that the only 'real' patient-related outcomes are those that have direct impact on morbidity and mortality. This view has changed significantly over the last decade, and currently, issues such as patient satisfaction and quality of life are often considered as important as clinical morbidity. 1 This shift is echoed in recent studies in the anesthesia literature that suggest that patient satisfaction should serve as an important endpoint and indicator of overall quality of anesthesia care. 2,3 Previous research on patient experience in medical and surgical settings has primarily focused on adult patients, whereas little data exist on satisfaction among children and their parents. 4 Previously, our center reported that the themes of modifiable and non-modifiable factors for adult surgical patients include satisfaction from clinician communication skills, information provision to patients, organization aspects of the unit, and demographic and health status predictors. 3 This follow-up special interest article focuses on modifiable and non-modifiable factors in children undergoing surgical procedures and their parents. A summary of articles included in this review is shown in Tables 1-3. | ME A SURING PEDIATRIC PERI OPER ATIVE PATIENT SATIS FAC TI ONIt is important to appreciate that developmental factors such as age and verbal and cognitive ability impact assessment of patient satisfaction in pediatric populations. Research suggests that children as young as four years old can express their opinion on their hospital