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The Surgical Patient and Nursing Care in a Low-Income Setting: Challenges and Way Forward 低收入环境下的外科病人和护理:挑战和前进的道路
4区 医学 Q2 SURGERY Pub Date : 2023-04-30 DOI: 10.33425/2689-1093.1054
Rex Friday Ogoronte Alderton Ijah, Linda U Iroegbu-Emeruem, Mary Obidiya Okuku, Nwizor Monday Nkadam, Victoria Amagboruju
Background: The newly developed Nigerian addition to the universal health coverage has surgery, obstetrics, anesthesia, and nursing as components of the plan. This study evaluated the challenges in the nursing care of the surgical patient in two public Teaching Hospitals in Port Harcourt, Nigeria. Materials and Methods: A cross sectional descriptive study was conducted among total population of consenting Nurses and Medical Doctors at the Surgery Departments two public Teaching Hospitals, using semi-structured selfadministered questionnaire. Data obtained was entered into Microsoft Excel Spreadsheet / Statistical Package for the Social Sciences, and formed into tables. Results: There were 67(26.1%) male and 190 (73.9%) female respondents. The mean age of respondents was 37.63 ± 10.22 years. The mean years in practice was 11.05 ± 9.26 years. One hundred and forty-nine (58.0%) of the respondents were nurses. Most challenging nursing issues were giving intravenous fluids according to schedule (75 = 29.2%), wound dressing (73 = 28.4%), inadequate equipment and manpower (51 = 19.8%), administration and charting of intravenous fluids (26 = 10.1%), and drug administration (26 = 10.1%). The most challenging surgeon / doctor-related issues was poor staff interpersonal relationship (103 = 40.1%) followed by poor supervision of the surgical team (97 = 37.7%). Conclusion: The challenges of nursing the surgical patient in our setting are of multiple origin. Administrative issues of inadequate employment of manpower and its multiplier effects are reported along with patient-related and health professional issues.
背景:尼日利亚新制定的全民健康保险补充计划将外科、产科、麻醉和护理作为该计划的组成部分。本研究评估了尼日利亚哈科特港两所公立教学医院外科病人护理方面的挑战。材料与方法:采用半结构化的自填问卷,对两所公立教学医院的外科护士和医生进行了横断面描述性研究。将得到的数据输入到Microsoft Excel Spreadsheet / Statistical Package for Social Sciences中,并形成表格。结果:男性67例(26.1%),女性190例(73.9%)。受访者平均年龄37.63±10.22岁。平均执业年数为11.05±9.26年。149人(58.0%)为护士。最具挑战性的护理问题是按计划给予静脉输液(75 = 29.2%),伤口敷料(73 = 28.4%),设备和人力不足(51 = 19.8%),静脉输液的给药和图表(26 = 10.1%)和药物给药(26 = 10.1%)。与外科医生/医生相关的最具挑战性的问题是员工人际关系差(103 = 40.1%),其次是对手术团队的监管差(97 = 37.7%)。结论:本院外科病人护理面临的挑战是多方面的。报告了人力就业不足的行政问题及其乘数效应,以及与病人有关的问题和保健专业问题。
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引用次数: 0
Preliminary Pages 初步的页面
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-03-23 DOI: 10.1159/000529176

Eur Surg Res 2023;64:1–4
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引用次数: 0
Subject Index Vol. 64, No. 1, 2023 主题索引第64卷,第1期,2023年
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-03-01 DOI: 10.1159/000529175
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引用次数: 0
Front & Back Matter 正面和背面事项
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-03-01 DOI: 10.1159/000530321
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引用次数: 0
Author Index Vol. 64, No. 1, 2023 作者索引第64卷,第1期,2023
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-03-01 DOI: 10.1159/000529174
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引用次数: 0
Evaluation of Laboratory Parameters in Stroke Patients Based on Decompressive Craniectomy Timing 基于颅骨减压手术时机的脑卒中患者实验室参数评估
4区 医学 Q2 SURGERY Pub Date : 2023-02-28 DOI: 10.33425/2689-1093.1051
Ibrahim Acir, Haci Ali Erdogan, Mert Gobel, Vildan Yayla
Background: Decompressive craniectomy reduces mortality and morbidity in ischemic stroke patients with malignant cerebral edema. Prognostic markers such as red cell distribution width, neutrophil lymphocyte ratio, and platelet count are needed to predict the timing of decompressive surgery in ischemic stroke patients. Sodium, a parameter that changes before and after decompression surgery, may also be a factor to consider when assessing the patient's prognosis and deciding whether to proceed with surgery. In this study, we aimed to examine the changes in laboratory parameters in stroke patients according to the time of decompression surgery. Material and Method: At our stroke center, 52 patients were diagnosed with stroke and underwent decompressive craniectomy. The patients were divided into four groups based on their decompression time (the first 24 hours, 24-48 hours, 48-72 hours, and after 72 hours). The width of the red cell distribution, platelet count, neutrophillymphocyte ratios, and sodium levels were calculated and compared between groups and National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores are all listed. Results: The patients had a mean age of 62 ± 11 years, with 31 males and 21 females. The patients' admission, 24th hour, and post-operative sodium levels were not significantly different. The patients' admission, 24th hour, and post-op RDW did not differ statistically significantly. The 24th hour NLR levels of the groups differed significantly (p=0.049). Conclusion: There is a need for laboratory measurements that can estimate the time required for decompression surgery. Nevertheless, no significant difference between groups was observed in our study, which investigated at RDW, NLR, platelet count, and sodium levels.
背景:颅脑减压术可降低缺血性脑卒中合并恶性脑水肿患者的死亡率和发病率。预后指标如红细胞分布宽度、中性淋巴细胞比例、血小板计数等是预测缺血性卒中患者减压手术时机的必要指标。钠,一个在减压手术前后变化的参数,也可能是评估患者预后和决定是否进行手术时考虑的因素。在本研究中,我们旨在研究脑卒中患者的实验室参数随减压手术时间的变化。材料和方法:在我们的脑卒中中心,52例患者被诊断为脑卒中并行颅骨减压术。根据患者减压时间分为4组(前24小时、24-48小时、48-72小时、72小时后)。计算并比较各组红细胞分布宽度、血小板计数、中性淋巴细胞比率和钠水平,并列出美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(mRS)评分。结果:患者平均年龄62±11岁,男31例,女21例。患者入院、24小时及术后钠水平无显著差异。患者入院、24小时及术后RDW无统计学差异。各组24小时NLR水平差异有统计学意义(p=0.049)。结论:有必要通过实验室测量来估计减压手术所需的时间。然而,在我们调查RDW、NLR、血小板计数和钠水平的研究中,没有观察到两组之间的显著差异。
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引用次数: 0
Percutaneous Nephrolithotomy: A Mini Invasive Approach for Renal and Pelvic Stones. Initial Experience from a Resource-Limited Setting in Douala Cameroon 经皮肾镜取石术:一种治疗肾结石和盆腔结石的微创方法。喀麦隆杜阿拉资源有限环境的初步经验
4区 医学 Q2 SURGERY Pub Date : 2023-02-28 DOI: 10.33425/2689-1093.1049
Cyril Kamadjou, Divine Enoru Eyongeta, Annie Kameni, Jerry Kuitche, Lamine Niang, Khaled Atallah, Mohammed Lezrek, Herve Moby Mpah
Background and Aim: We present in this paper the technique and results of percutaneous nephrolithotomy as a minimally invasive treatment for large renal and pyeloureteric junction stones at the Centre medico-chirugical d’urologie in Douala, Cameroon. Methods: This was a retrospective study carried out from January 2019 to July 2022. We included 25 patients with calculi in the renal pelvis and pyeloureteric junction treated through percutaneous nephrolithotomy. Results: We included a total of 25 patients (18 men and 7 women) with a median age of 44 [36-48] years. Of the 25 patients, 23(88%) had a single calculus and 3(22%) presented with a Staghorn calculus. The median size of the calculi was 23.5 [20.25–27.75] mm and in 60% of cases; the stone was on the right side of the body. In all cases, the definitive diagnosis was made using abdominal CT scans and in 20 (80%) patients, the diagnosis was made incidentally during a CT scan for other reasons. All patients were treated through percutaneous nephrolithotomy, performed in the prone position in 21(84%) patients. Three patients who had a positive urine culture prior to the procedure benefited from a preoperative double J stent placement and all patients had post-surgery percutaneous drain placement which was left in place for 24 hours. The median surgery duration was 135 [120–165] minutes. Seventeen patients (68%) were stone free after the procedure. Conclusion: Percutaneous nephrolithotomy is an effective mini-invasive technique in the treatment of voluminous kidney and pyeloureteric junction stones. It is reliable, reproducible and has fewer complications and, therefore, proves to be an excellent choice in Sub-Saharan Africa.
背景和目的:我们在喀麦隆杜阿拉的泌尿外科医学中心介绍了经皮肾镜取石术作为一种微创治疗大肾和肾盂输尿管交界处结石的技术和结果。方法:回顾性研究于2019年1月至2022年7月进行。我们纳入了25例经皮肾镜取石术治疗肾盂和肾盂输尿管交界处结石的患者。结果:我们共纳入25例患者(男性18例,女性7例),中位年龄44岁[36-48]。在25例患者中,23例(88%)为单一结石,3例(22%)为鹿角结石。结石的中位大小为23.5 [20.25-27.75]mm, 60%的病例;石头在身体的右边。在所有病例中,最终诊断都是通过腹部CT扫描做出的,在20例(80%)患者中,诊断是由于其他原因在CT扫描期间偶然做出的。所有患者均行经皮肾镜取石术,其中21例(84%)采用俯卧位取石。术前尿培养阳性的3例患者得益于术前双J型支架置入,所有患者术后经皮引流放置24小时。中位手术时间为135[120-165]分钟。17例患者(68%)术后无结石。结论:经皮肾镜取石术是治疗大体积肾盂输尿管交界处结石的有效微创技术。它可靠,可重复,并发症少,因此在撒哈拉以南非洲被证明是一个很好的选择。
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引用次数: 0
Inflammatory Pseudotumor-Like Follicular/Fibroblastic Dendritic Cell Sarcoma: Focus on Surgical Treatment Approach 炎性假肿瘤样滤泡/成纤维树突状细胞肉瘤:手术治疗方法的重点
4区 医学 Q2 SURGERY Pub Date : 2023-02-28 DOI: 10.33425/2689-1093.1050
Zarrin Hossein-zadeh, Katherine Rivero-Soto, Roberto Rivero-Soto
Inflammatory pseudotumor-like follicular/fibroblastic dendritic cell sarcoma (IPT-like FDC sarcomas, also known as FDC/FRC sarcoma) is a subgroup of follicular dendritic cell sarcoma (FDC), a rare neoplasm that often occurs in the spleen [1]. FDC/FRC sarcomas can affect other organs including the liver, colon, and the peripancreatic region [2-4]. The tumor has a predilection for young to middle-aged adults and may present with subset of symptoms including fever, abdominal pain, sweats, fatigue, and commonly a splenic solitary mass formation [5]. FDC/FRC sarcoma comprises of neoplastic spindle cells, typically with a follicular dendritic cell differentiation and over 90% of the cases are associated with EBV infection [6]. Here we present the a case of a IPT-like FDC sarcoma in a 49- year old female treated with splenectomy and a review of the literature.
炎性假肿瘤样滤泡/成纤维树突状细胞肉瘤(IPT-like FDC sarcoma,又称FDC/FRC sarcoma)是滤泡树突状细胞肉瘤(follicular dendritic cell sarcoma, FDC)的一个亚群,是一种常见于脾脏的罕见肿瘤[1]。FDC/FRC肉瘤可累及肝脏、结肠和胰周等其他器官[2-4]。该肿瘤易发于青年至中年人,可出现发热、腹痛、出汗、疲劳等症状,通常为脾脏孤立性肿块形成[5]。FDC/FRC肉瘤由肿瘤梭形细胞组成,通常伴有滤泡树突状细胞分化,90%以上的病例与EBV感染有关[6]。在此,我们报告一位49岁女性,以脾切除术治疗ipt样FDC肉瘤,并回顾相关文献。
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引用次数: 0
Contents Vol. 63, 2022 目录第63卷,2022年
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-01-18 DOI: 10.1159/000528891

Eur Surg Res 2022;63:I–VI
eurosurg Res 2022;63:I - VI
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引用次数: 0
The Dot-Probe Attention Bias Task as a Method to Assess Psychological Well-Being after Anesthesia: A Study with Adult Female Long-Tailed Macaques (Macaca fascicularis). 点探针注意偏向任务作为麻醉后心理健康评估的一种方法:以成年雌性长尾猕猴为研究对象。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2023-01-01 DOI: 10.1159/000521440
Lauren C Cassidy, Emily J Bethell, Ralf R Brockhausen, Susann Boretius, Stefan Treue, Dana Pfefferle

Understanding the impact routine research and laboratory procedures have on animals is crucial to improving their well-being and to the success and reproducibility of the research they are involved in. Cognitive measures of welfare offer insight into animals' internal psychological state, but require validation. Attention bias - the tendency to attend to one type of information over another - is a cognitive phenomenon documented in humans and animals that is known to be modulated by affective state (i.e., emotions). Hence, changes in attention bias may offer researchers a deeper perspective of their animals' psychological well-being. The dot-probe task is an established method for quantifying attention bias in humans (by measuring reaction time to a dot-probe replacing pairs of stimuli), but has yet to be validated in animals. We developed a dot-probe task for long-tailed macaques (Macaca fascicularis) to determine if the task can detect changes in attention bias following anesthesia, a context known to modulate attention and trigger physiological arousal in macaques. Our task included the following features: stimulus pairs of threatening and neutral facial expressions of conspecifics and their scrambled counterparts, two stimuli durations (100 and 1,000 ms), and counterbalancing of the dot-probe's position on the touchscreen (left and right) and location relative to the threatening stimulus. We tested 8 group-housed adult females on different days relative to being anesthetized (baseline and 1-, 3-, 7-, and 14-days after). At baseline, monkeys were vigilant to threatening content when stimulus pairs were presented for 100 ms, but not 1,000 ms. On the day immediately following anesthesia, we found evidence that attention bias changed to an avoidance of threatening content. Attention bias returned to threat vigilance by the third day postanesthesia and remained so up to the last day of testing (14-days after anesthesia). We also found that attention bias was independent of the type of stimuli pair (i.e., whole face vs. scrambled counterparts), suggesting that the scrambled stimuli retained aspects of the original stimuli. Nevertheless, whole faces were more salient to the monkeys as responses to these trials were generally slower than to scrambled stimulus pairs. Overall, our study suggests it is feasible to detect changes in attention bias following anesthesia using the dot-probe task in nonhuman primates. Our results also reveal important aspects of stimulus preparation and experimental design.

了解常规研究和实验室程序对动物的影响,对于改善动物的健康,以及它们所参与的研究的成功和可重复性至关重要。福利的认知测量提供了对动物内部心理状态的洞察,但需要验证。注意偏差——倾向于关注一种类型的信息而不是另一种类型的信息——是人类和动物的一种认知现象,已知是由情感状态(即情绪)调节的。因此,注意偏差的变化可能会让研究人员对动物的心理健康有更深入的了解。点探针任务是一种量化人类注意偏差的既定方法(通过测量对点探针替代成对刺激的反应时间),但尚未在动物身上得到验证。我们为长尾猕猴(Macaca fascularis)开发了一个点探测任务,以确定该任务是否可以检测麻醉后注意偏差的变化,麻醉是一种已知的调节猕猴注意力和触发生理唤醒的环境。我们的任务包括以下特征:刺激对的威胁和中性的面部表情和他们的混乱对应,两个刺激持续时间(100和1000毫秒),以及点探针在触摸屏上的位置(左和右)和相对于威胁刺激的位置的平衡。我们在不同的麻醉天数(基线和麻醉后1、3、7和14天)对8只集体饲养的成年雌性进行了测试。在基线上,当刺激对出现100毫秒而不是1000毫秒时,猴子对威胁性内容保持警惕。在麻醉后的第二天,我们发现有证据表明,注意力偏差转变为对威胁内容的回避。注意偏倚在麻醉后第三天恢复到威胁警戒状态,并一直保持到测试的最后一天(麻醉后14天)。我们还发现,注意偏差与刺激对的类型无关(即,整张脸与打乱的对偶),这表明打乱的刺激保留了原始刺激的某些方面。尽管如此,猴子对整张脸的反应更明显,因为对这些试验的反应通常比对杂乱的刺激对的反应慢。总的来说,我们的研究表明,在非人类灵长类动物中,使用点探测任务来检测麻醉后注意偏倚的变化是可行的。我们的结果也揭示了刺激准备和实验设计的重要方面。
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引用次数: 6
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European Surgical Research
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