ObjectiveThe aim of this study was to evaluate the value and role of patient’s education videos in the informed consent process for patients undergoing preoperative assessment of cataracts.DesignThe study is a single-center prospective randomized controlled trial.Subjects, participants, and/or controlsParticipants enrolled in this study were specifically those undergoing first-time phacoemulsification cataract surgery with the placement of a monofocal lens implant.Participants and methodsSubjects were randomized to either face-to-face surgeon-informed consent with a preceding education video or face-to-face surgeon-informed consent alone.Main outcome measuresThe main outcome measures assessed were time to complete the informed consent process, patient’s satisfaction, and patient’s comprehension.ResultsThe video and control groups were similar in satisfaction (4.67±0.104 video vs. 4.53±0.133 control; P=0.43) and comprehension (79.4%±2.82% video vs. 79.3%±3.39% control; P=0.99). Counseling time was statistically significantly different (117.5±10.9 seconds video versus 241.6±13.0 seconds control; P<0.0001).ConclusionUse of a patient’s education video for cataract surgery was associated with reduced physician counseling time yet similar comprehension and patient-reported satisfaction when compared with traditional counseling methods.
Our initial findings showed that when treated with bevacizumab and ranibizumab, both AMD cybrids and age-matched normal cybrids had a significant decrease in bead-uptake. A similar decrease in bead-uptake was found in normal cybrids treated with aflibercept and while the AMD values trended lower, they were not significant. This data suggests that anti-VEGF drugs can cause loss of phagocytic function.
Transoral incisionless fundoplication is a new treatment for patients with gastroesophageal reflux disease. We present our initial experience with 10 patients undergoing this procedure with varying past surgical histories. All procedures were performed under general nasotracheal anesthesia. RAND-36 and Visual Analog Scale symptom scores were collected at pre and postoperative appointments for a mean of 9.2 months. The mean procedure time was 68 minutes. There were no intraoperative or postoperative complications. Patients with prior pancreaticoduodenectomy had observed reduced working space due to prior distal gastrectomy and required additional insufflation due to no pyloric resistance to insufflation of the small bowel. The patient with prior fundoplication required additional time and force for fastener penetration of the resultant scar from the partially disrupted fundoplication. All patients were discharged within 23 hours of the procedure. Throughout the follow-up period, patients reported gradual changes in medication requirements and symptom scores. There were no late complications. Transoral incisionless fundoplication is technically safe in well-selected patients including those with prior esophageal and gastric surgery.
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