We assessed patients after their return home following gynaecological surgery, using a daily electronic diary. Thirty-two females aged 27-77 years took part. After a hospital stay of 1-6 days (mean 2.3), they were given a pen-based electronic diary and asked to record symptoms and other data over one month. They also completed a questionnaire at the end of the study. Substantial effects on quality and duration of sleep, pain during both the night and day, interference with daily activities, energy, and ability to concentrate were recorded, mostly during the first week of treatment. Symptoms reported in the final questionnaire correlated significantly with diary data. Most patients found the electronic diary easy to use, and none found it difficult. Daily electronic diaries are an acceptable method of obtaining better information on the extent and duration of symptoms and other difficulties after discharge following surgery. The costs of healthcare provision increase the pressure for efficient use of resources. Reducing the length of hospital stay after surgery is one approach to cost reduction. To properly assess cost effectiveness, information is needed on the degree to which patients are affected by postsurgical problems on their return home, and their speed of recovery.Most of the work in this area has investigated day case surgery, which now accounts for a large proportion of surgical procedures. In Scotland, for example, about 60% of elective surgery is carried out on a day basis [1]. Some studies have investigated the immediate postoperative recovery period using functional measures (ability to drink, void urine, or walk), symptom measures (pain, nausea) or cognitive testing [2][3][4][5]. Others have used questionnaires to assess symptoms and their impact, as well as overall satisfaction, after return home. Studies considering several time-points after discharge show that a substantial proportion of patients have at least moderate pain sufficient to interfere with daily activities, after their return home [4,6,7]. As well as pain, the after effects of surgery may include cognitive impairments. Thus Tzabar et al.[8] used the Cognitive Failures Scale over a 3-day period after day case surgery, and found more failures in patients who had received a general anaesthetic compared to those given only a local anaesthetic. 1101Work on patients undergoing surgery as in-patients has mostly focused on the recovery period before discharge [9][10][11]. Myles et al.[4] administered a Quality of Recovery Scale to patients daily for 6 days then weekly for up to 6 weeks after minor or major surgery. The scale assessed wellbeing, specific functions, symptoms, and need for support. Questionnaires were administered by telephone after discharge, but it is not clear from the report how long these patients stayed in hospital. Substantially greater effects were recorded after major surgery, as expected, with scores returning to baseline after about one week. Other studies have used questionnaires to assess patient satisfa...
Topical application of nifedipine for management of chronic anal fissure was more effective and had fewer side effects than topical glyceryl trinitrate. Recurrence was frequent with both drugs.
The integrity of the Lap-Band system is essential to achieve the objective of the operation: weight loss. Complications related to the access-port were relatively frequent, but preventable.
Objective To determine the impact of sleeve gastrectomy in patients suffering from depression compared with those who are not in a depressive state. Introduction Obesity is considered a global epidemic. Often patients with obesity suffer from depressive state. Depressive disorders may be both a cause and a consequence of obesity. Material and methods The study includes 300 consecutives patients that underwent laparoscopic sleeve gastrectomy. Out of the 300 patients, 253 (84.33%) of them completed the follow up for three years. Results Out of the 300-patients, with the average age of 41.65±11.05 years old, the ratio of males to females was 1:2. The average baseline BMI was 42.02 kg/m2. A total of 105 (35.33%) of the patients suffer from depression, which was more common in male (43%) than in female (31.5%), with statistically significant difference (p = .05). Comparing the weight loss after surgery in both groups, the mean weight loss in the depression-group was 12.0 ΔBMI and in the non-depression group was 13.03 ΔBMI, (p< .001). After three years, 94 (88.68%) patients of the depression group responded as they were optimistic and satisfied with the results of the operation, with positive changes in their lives, 8 (7.55%) did not experience change and 4 (3.77%) expressed to have worsened their depressive state. Conclusion Laparoscopic sleeve gastrectomy is successful and leads to weight loss even in subjects who are affected by depression syndrome.
Blast injuries are rare, and although blast-induced perforations of the bowel have been described in the past, the entity of a delayed perforation caused by an evolving injury has not been reported. We report three men injured by the explosion of a terrorist bombing in open air. They suffered primary blast injuries, which resulted in isolated perforations of the terminal ileum. They were operated at different times after the blast event. The resected specimens were examined under light microscopy. One patient was operated immediately, and had three perforations in the terminal ileum. In the other two patients, abdominal complaints appeared only 24 and 48 hours later. These two patients were found to have hematomas in the wall of the terminal ileum, and small perforations therein, with almost no contamination of the peritoneal cavity. On histological examination, there were small perforations with disruption of all intestinal layers. In the vicinity of the perforations, the mucosa was necrotic and disorganized. The submucosa showed edema and vascular thrombi, and at several points mucus was shown dissecting through the muscularis propria, thus creating minute microperforations. Because of the findings in these patients, we suggest a mechanism of evolving damage to the bowel wall and delayed perforation rather than delayed diagnosis, after blast injuries. We suggest that patients exposed to a significant blast should be watched carefully for at least 48 hours.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.