Scottish Medical Journal最新文献

Background and aimThis study aimed to determine the effect of the use of "virtual reality (VR) glasses, distraction cards (DCs), and breath exercises (BEs)" on anxiety, pain, and satisfaction levels of women undergoing Pap smear tests, which is a painful and stressful procedure for women.MethodsThe study was conducted as a randomized controlled trial study in a public health center with 140 women (four groups; each group was n = 35) undergoing Pap smear tests. The data were collected using the descriptive information form, state anxiety inventory, the visual analog scale for fatigue, the Newcastle-Satisfaction-Nursing-Care Scale, and the VR glasses application form.ResultsAfter the Pap smear test, anxiety scores decreased significantly within all groups except for the control. The satisfaction scores indicated significant differences between the intervention and the control groups. In terms of the pain scores, the control group had higher pain scores during speculum insertion and the Pap smear test than the other group.ConclusionThe use of VR glasses, DCs, and BEs during a Pap smear test effectively reduces anxiety and pain while increasing satisfaction. These methods are recommended to incorporate into the Pap smear tests.

BackgroundRobot-assisted surgery (RAS) is an extension of minimally invasive surgery rapidly gaining acceptance in many conditions. The study aims to assess and share lessons impact of RAS on the radical nephrectomy (RN) service during the implementation phase.MethodsTwo separate analyses were carried out: to compare the outcome of all RN - before and after the implementation of RAS regardless of surgical mode, and a direct comparison between two minimal invasive approaches: Robotic-assisted radical nephrectomies (RARNs) and Laparoscopic radical nephrectomies (LRNs).ResultsThe study included 55 pre- and 45 robotic era RNs: 45 RARNs, 48 LRNs and 7 open radical nephrectomies (ORNs). Following RAS implementation, all RNs transitioned to RARNs. The broader comparison of all RNs in the robotic versus pre-robotic periods revealed significant reductions in estimated blood loss and the length of hospital stay, though operative times were notably longer. In the direct comparison between LRNs and RARNs, no major differences in perioperative outcomes were noted, except for a significantly longer duration of surgery in the RARN group.ConclusionThe introduction of the robotic platform resulted in a paradigm shift in RN service, eliminating ORN and LRN. Despite increasing operative duration, RARNs improved certain perioperative outcomes (specifically length of stay and blood loss) and were favoured over other modalities.

BackgroundEmergency appendicectomy (EA) is a common procedure, yet few studies have focused on gender differences in these patients. This study aims to evaluate the demographics, preoperative investigations, intraoperative findings, and clinical outcomes between males and females undergoing EA.MethodsA multicenter retrospective observational study was conducted across four hospitals involving patients who underwent EA between August 2018 and November 2025. Patients were identified through pathology records, and data were collected on demographics, preoperative blood tests, imaging, operative details, and clinical outcomes and results compared.Results1128 patients were included, with 57.5% being male. Males were younger (median age: 34 vs 40 years, P < .001). There was no significant difference in preoperative white cell or neutrophil counts, although males had lower C-reactive protein levels (median 72 vs 97, P < .001). Females were more likely to undergo pre-operative imaging, including ultrasound (20.7% vs 1.5%, P < .001) and CT scans (61.8% vs 54.9%, P = .020). Open surgery was more common in males (14% vs 6.5%, P < .001). No differences were observed in the severity of appendicitis, negative EA rates, hospital stay duration, postoperative complications, or 30-day readmission rates.ConclusionsAlthough differences exist between genders in terms of age, imaging usage, and surgical approach, clinical outcomes are comparable.

Background and AimsRoutine group and save (G&S) is commonly performed before appendicectomy despite limited evidence. This study aims to evaluate the necessity of preoperative G&S by determining perioperative blood transfusion rates.MethodsA multicentre retrospective observational study of adult patients who had emergency appendicectomy across four hospitals between August 2018 and November 2020. Data analysed included demographics, operative details, G&S, crossmatching and perioperative blood transfusion.Results1105 patients were identified, 635 (57.4%) were male. Median age was 37 years (IQR 26-52). 1012 (91.6%) were ASA 1 or 2. Surgical approach: 890 (80.5%) laparoscopic, 79 (7.1%) converted to open, 119 (10.8%) open and 17 (1.5%) laparotomy. Severity of appendicitis: 804 (72.8%) inflamed, 56 (5.1%) gangrenous, 235 (21.3%) perforated and 10 (0.9%) normal. 921 (83.3%) patients had preoperative G&S. 42 (3.8%) patients also had crossmatch. No patients required blood transfusion in 30 days post appendicectomy. The cost of G&S is estimated to be £40,164 in this cohort.ConclusionsThe need for perioperative blood transfusion is rare in patients undergoing appendicectomy. It has a significant cost impact and can cause unnecessary delays. Our study suggests that a routine G&S policy is not necessary, and we suggest a more 'selective' G&S policy.