Background Liver transplant patients have increased risk of developing cardiovascular disease and the outcome of these patients following cardiac surgery has been reported in small series of patients. The aim of this review was to examine and report safety outcomes of liver transplant patients undergoing cardiac surgery. Methods Literature review was conducted using three databases from inception to June 2023. Multiple search terms were used and limited to English language. Nine relevant articles were included. Outcomes of interest were short-term mortality, long-term survival, liver graft failure, major morbidity and infection in liver transplant recipients undergoing cardiac surgery. Results Cardiac risk factors (diabetes mellitus, hypertension, hyperlipidemia) were prevalent in liver transplant patients. 30-days mortality ranged across the studies from zero to 23.8%. 1-year survival ranged from 74-91% and 5-years survival ranged from 33-69%. Commonest causes of death were cardiac and sepsis. Predictors of mortality were preoperative encephalopathy, pulmonary hypertension, blood transfusion and postoperative increase in creatinine and bilirubin levels. Liver allograft rejection ranged from zero to 4.7% with no predictors reported. Liver dysfunction was seen in 33-46% of patients, and all were transient with recovery at the time of hospital discharge. Major morbidities were commonly reported and included respiratory and renal failure. Infection rates ranged from zero to 38% and the most common reported sites were pneumonia, sepsis, and surgical site infections. Conclusion Cardiac surgery can be performed in liver transplant patients with good short- and long-term results and acceptable morbidities.
{"title":"Is Cardiac Surgery Safe in Patients with Previous Liver Transplantation? A Narrative Review","authors":"","doi":"10.33140/jsc.03.01.03","DOIUrl":"https://doi.org/10.33140/jsc.03.01.03","url":null,"abstract":"Background Liver transplant patients have increased risk of developing cardiovascular disease and the outcome of these patients following cardiac surgery has been reported in small series of patients. The aim of this review was to examine and report safety outcomes of liver transplant patients undergoing cardiac surgery. Methods Literature review was conducted using three databases from inception to June 2023. Multiple search terms were used and limited to English language. Nine relevant articles were included. Outcomes of interest were short-term mortality, long-term survival, liver graft failure, major morbidity and infection in liver transplant recipients undergoing cardiac surgery. Results Cardiac risk factors (diabetes mellitus, hypertension, hyperlipidemia) were prevalent in liver transplant patients. 30-days mortality ranged across the studies from zero to 23.8%. 1-year survival ranged from 74-91% and 5-years survival ranged from 33-69%. Commonest causes of death were cardiac and sepsis. Predictors of mortality were preoperative encephalopathy, pulmonary hypertension, blood transfusion and postoperative increase in creatinine and bilirubin levels. Liver allograft rejection ranged from zero to 4.7% with no predictors reported. Liver dysfunction was seen in 33-46% of patients, and all were transient with recovery at the time of hospital discharge. Major morbidities were commonly reported and included respiratory and renal failure. Infection rates ranged from zero to 38% and the most common reported sites were pneumonia, sepsis, and surgical site infections. Conclusion Cardiac surgery can be performed in liver transplant patients with good short- and long-term results and acceptable morbidities.","PeriodicalId":93786,"journal":{"name":"Journal of surgery care","volume":"175 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140461536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Multidrug-resistant (MDR) infections are a threat in patients undergoing surgery. This study was undertaken to determine the prevalence and possible predictors of MDR infections over a two-year period in patients with surgical site infection (SSI) at a tertiary care hospital in Riyadh, Saudi Arabia. Methods: We conducted a cross-sectional study from April 2016 to April 2018 by reviewing hospital records of patients with a diagnosis of SSI based on a physician report and laboratory findings. The isolation of MDR organisms (MDRO) from SSI was the primary outcome variable as well as other risk factors. Results: SSI was diagnosed in 55 out of 77 patients under study, with MDRO prevalence rate of 44%. Previous antibiotic use and hospitalization in the last 90 days were strongly associated with developing MDRO infection often due to ESBL producing Gram-negative bacterial pathogens. Superficial and deep incisional SSI were more frequent in patients compared to organ/space SSI. History of diabetes mellitus, duration of surgery and bacterial colonization at other body site also increased the likelihood of MDRO. Factors such as trauma, obesity, general anesthesia, and wound types were not found to increase the risk for MDRO. Conclusions: Our study identified recent antibiotic use and hospitalization as major risk factors for MDRO surgical site infections. Other predisposing factors include diabetes mellitus, duration of surgery and bacterial colonization. MDRO isolated include E. coli and Pseudomonas aeruginosa. Bacterial pathogens harboring multiple resistant mechanisms can complicate SSI adversely affecting clinical outcomes following routine surgical procedures.
{"title":"The Prevalence of Multidrug-Resistant Organisms in Patients with Surgical Site Infections in Riyadh, Saudi Arabia: A Cross-sectional Study at a Tertiary Care Hospital","authors":"","doi":"10.33140/jsc.02.01.08","DOIUrl":"https://doi.org/10.33140/jsc.02.01.08","url":null,"abstract":"Background: Multidrug-resistant (MDR) infections are a threat in patients undergoing surgery. This study was undertaken to determine the prevalence and possible predictors of MDR infections over a two-year period in patients with surgical site infection (SSI) at a tertiary care hospital in Riyadh, Saudi Arabia. Methods: We conducted a cross-sectional study from April 2016 to April 2018 by reviewing hospital records of patients with a diagnosis of SSI based on a physician report and laboratory findings. The isolation of MDR organisms (MDRO) from SSI was the primary outcome variable as well as other risk factors. Results: SSI was diagnosed in 55 out of 77 patients under study, with MDRO prevalence rate of 44%. Previous antibiotic use and hospitalization in the last 90 days were strongly associated with developing MDRO infection often due to ESBL producing Gram-negative bacterial pathogens. Superficial and deep incisional SSI were more frequent in patients compared to organ/space SSI. History of diabetes mellitus, duration of surgery and bacterial colonization at other body site also increased the likelihood of MDRO. Factors such as trauma, obesity, general anesthesia, and wound types were not found to increase the risk for MDRO. Conclusions: Our study identified recent antibiotic use and hospitalization as major risk factors for MDRO surgical site infections. Other predisposing factors include diabetes mellitus, duration of surgery and bacterial colonization. MDRO isolated include E. coli and Pseudomonas aeruginosa. Bacterial pathogens harboring multiple resistant mechanisms can complicate SSI adversely affecting clinical outcomes following routine surgical procedures.","PeriodicalId":93786,"journal":{"name":"Journal of surgery care","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139315844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bouveret syndrome is an extremely rare disease. We report the case of a 54-year-old man who presented to our department with acute vomiting. An upper digestive endoscopy was first done, revealing an enclaved gallstone in the second duodenum. Crosssectional imaging was then performed to confirm the correct diagnosis of Bouveret's syndrome. Through a medline incision, cholecystectomy and extraction of the gallstone were done and the patient was discharged seven days after the operation with a good clinical outcome.
{"title":"Bouveret Syndrome : The Rare Challenging Case of the Day","authors":"Case Report, Sabrine Soua¹, Mohamed Ghanem¹, Mohamed Morched Abdesselem², Mohamed Riadh Bouali¹, Sabrine Soua","doi":"10.33140/jsc.02.01.06","DOIUrl":"https://doi.org/10.33140/jsc.02.01.06","url":null,"abstract":"Bouveret syndrome is an extremely rare disease. We report the case of a 54-year-old man who presented to our department with acute vomiting. An upper digestive endoscopy was first done, revealing an enclaved gallstone in the second duodenum. Crosssectional imaging was then performed to confirm the correct diagnosis of Bouveret's syndrome. Through a medline incision, cholecystectomy and extraction of the gallstone were done and the patient was discharged seven days after the operation with a good clinical outcome.","PeriodicalId":93786,"journal":{"name":"Journal of surgery care","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139355219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The mental health of medical students is notoriously poor, and with the additional challenges posed by the COVID-19 pandemic, there has never been greater concern for the wellbeing of the current cohort. This cross-sectional study investigates the impact of lockdown coping strategies used by Australian medical students during the COVID-19 pandemic on their mental health improvement, including connecting with family and friends, exercise, using social media, and various other interests. Methods An anonymous questionnaire was shared in 2021 with medical students from all years via Facebook and General Practice Student Network’s communications during the COVID-19 pandemic. The impact of a variety of lockdown coping strategies utilized by participants was assessed using SPSS. Results There were 283 participants in this study, 69.6% of whom were females, 54.9% in their pre-clinical years, and 70.5% between the ages of 18-24. The results showed that nearly 80% of participants credited their mental health improvement to peri-lockdown strategies. The logistic regression analysis demonstrated that reading (non-medical books) and spending more time with family were the most notable peri-lockdown strategies associated with mental health improvement. Interestingly, some participants reported that some coping strategies decreased productivity, including TV shows and movies. Conclusions Our study found that lockdown coping strategies played an essential role in the improvement and maintenance of medical students’ mental health during the COVID-19 pandemic. In particular, strategies that allowed students to socialize and engage in non-academic activities allowed them to cope with mental stressors more effectively
{"title":"A Cross-Sectional Study Investigating the Tools and Resources Australian Medical Students Used to Support Their Mental Health During Covid-19","authors":"","doi":"10.33140/jsc.02.01.03","DOIUrl":"https://doi.org/10.33140/jsc.02.01.03","url":null,"abstract":"Background The mental health of medical students is notoriously poor, and with the additional challenges posed by the COVID-19 pandemic, there has never been greater concern for the wellbeing of the current cohort. This cross-sectional study investigates the impact of lockdown coping strategies used by Australian medical students during the COVID-19 pandemic on their mental health improvement, including connecting with family and friends, exercise, using social media, and various other interests. Methods An anonymous questionnaire was shared in 2021 with medical students from all years via Facebook and General Practice Student Network’s communications during the COVID-19 pandemic. The impact of a variety of lockdown coping strategies utilized by participants was assessed using SPSS. Results There were 283 participants in this study, 69.6% of whom were females, 54.9% in their pre-clinical years, and 70.5% between the ages of 18-24. The results showed that nearly 80% of participants credited their mental health improvement to peri-lockdown strategies. The logistic regression analysis demonstrated that reading (non-medical books) and spending more time with family were the most notable peri-lockdown strategies associated with mental health improvement. Interestingly, some participants reported that some coping strategies decreased productivity, including TV shows and movies. Conclusions Our study found that lockdown coping strategies played an essential role in the improvement and maintenance of medical students’ mental health during the COVID-19 pandemic. In particular, strategies that allowed students to socialize and engage in non-academic activities allowed them to cope with mental stressors more effectively","PeriodicalId":93786,"journal":{"name":"Journal of surgery care","volume":"137 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139370858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Surgical site infections are the most common kinds of hospital-acquired infections. It's a common complication that can cause serious morbidity and mortality after surgery. It is also the major cause of extended hospital stays, accounting for up to 20% of hospital expenses. Methods and materials: A random sample of 144 surgical patients was analyzed utilizing a hospital-based retrospective cross-sectional study technique from January 1 to December 31, 2019. The information was acquired using a World Health Organization-developed modified standardized checklist for surgery safety and the national surveillance network for nosocomial infections. A rigorous random sampling strategy was used to choose study participants. Descriptive statistics such as frequency and percentage were used to describe the data. Result: A total of 13 of the 144 patients who were operated on had surgical site infections (9.02 percent). Elective surgical cases made up 102 (71%) of the total, while emergency surgical cases comprised 42 (29%). Preventive antibiotics were administered to the remaining 99 (69%) research participants, with 73 (73%) receiving ceftriaxone, 3% receiving ampicillin, and 23 (24%) receiving a combination of ceftriaxone and metronidazole. There were 13 cases of surgical site infections in all (9.02 percent). Six (46%) were superficial surgical site infections, four (31%) were deep surgical site infections, and three (23%) were organ space surgical site infections. 11 (84%) patients were treated with IV antibiotics and wound treatment, 1 (8%) cases with wound debridement, and the remaining 1 (8%) cases with laparotomy, antibiotics, and wound management. Conclusion: In this study area, surgical site infection is infrequent. The bulk of the population is made up of women. The use of prophylactic antibiotics and the age of the patients were both variables in the development of surgical site infections
{"title":"Prevalence of Surgical Site infections among Surgical operated patients in Zewditu Memorial Hospital. Addis Ababa Ethiopia December 2020.","authors":"","doi":"10.33140/jsc.01.01.01","DOIUrl":"https://doi.org/10.33140/jsc.01.01.01","url":null,"abstract":"Background: Surgical site infections are the most common kinds of hospital-acquired infections. It's a common complication that can cause serious morbidity and mortality after surgery. It is also the major cause of extended hospital stays, accounting for up to 20% of hospital expenses. Methods and materials: A random sample of 144 surgical patients was analyzed utilizing a hospital-based retrospective cross-sectional study technique from January 1 to December 31, 2019. The information was acquired using a World Health Organization-developed modified standardized checklist for surgery safety and the national surveillance network for nosocomial infections. A rigorous random sampling strategy was used to choose study participants. Descriptive statistics such as frequency and percentage were used to describe the data. Result: A total of 13 of the 144 patients who were operated on had surgical site infections (9.02 percent). Elective surgical cases made up 102 (71%) of the total, while emergency surgical cases comprised 42 (29%). Preventive antibiotics were administered to the remaining 99 (69%) research participants, with 73 (73%) receiving ceftriaxone, 3% receiving ampicillin, and 23 (24%) receiving a combination of ceftriaxone and metronidazole. There were 13 cases of surgical site infections in all (9.02 percent). Six (46%) were superficial surgical site infections, four (31%) were deep surgical site infections, and three (23%) were organ space surgical site infections. 11 (84%) patients were treated with IV antibiotics and wound treatment, 1 (8%) cases with wound debridement, and the remaining 1 (8%) cases with laparotomy, antibiotics, and wound management. Conclusion: In this study area, surgical site infection is infrequent. The bulk of the population is made up of women. The use of prophylactic antibiotics and the age of the patients were both variables in the development of surgical site infections","PeriodicalId":93786,"journal":{"name":"Journal of surgery care","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74902628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Researc H Article, Amirhossein Emamian, H. Ramezanpour, H. Yousefi, J. S. Care
Background Subtractive manufacturing have been popular in dental implant production. In order to increase the survival rate of the dental implants, a comprehensive risk analysis has been performed in the technical documentation of the products. Purpose In this paper the most common risk factors categorized as implant-related, surgeon-related, patient-related, and maintenance-related risks in the manufacturing process, application, the long term usage and the so-called survival rate of dental implants are studied. Methods The importance of any of the potential risk factors which is directly or indirectly related to the product quality is assessed. In the evaluation stage, the factors are sorted based on their severity and probability of occurrence, brought to the risk criterion table. Proper measurement called as mitigations were used to standardize the risks to the acceptable criteria. The standardization could be through reducing the severity of the risk or through reducing the probability of its occurrence, or even both of them. Advancing from the hazardous situations was an expected aim for any of the risk factors. Results The equivalent risk assessment factors are compared in pre-mitigation and post-mitigation stages. The main aim was to see whether the risk level of the factors reduces to the acceptable or conditionally acceptable region. Falling in to the conditionally acceptable region makes the application of the product to be under sufficient warnings, which orders to take enough pre-cautions for the user or operator. For most of the risk factors, there was a concern that the measurements are able to only improve them in the frequency of occurrence, however, the results show that there are solutions to improve the severity as well. Conclusion Through this comprehensive study, the risk analysis file is completed however it can be even more complete, in the future, at this industry. In the further studies, discretizing the steps of severity or probability to finer steps, and ultimately converting them to a continuous form would be aimed.
{"title":"Characterizing and Controlling the Risk Factors in Manufacturing Dental Implants","authors":"Researc H Article, Amirhossein Emamian, H. Ramezanpour, H. Yousefi, J. S. Care","doi":"10.33140/jsc.01.01.05","DOIUrl":"https://doi.org/10.33140/jsc.01.01.05","url":null,"abstract":"Background Subtractive manufacturing have been popular in dental implant production. In order to increase the survival rate of the dental implants, a comprehensive risk analysis has been performed in the technical documentation of the products. Purpose In this paper the most common risk factors categorized as implant-related, surgeon-related, patient-related, and maintenance-related risks in the manufacturing process, application, the long term usage and the so-called survival rate of dental implants are studied. Methods The importance of any of the potential risk factors which is directly or indirectly related to the product quality is assessed. In the evaluation stage, the factors are sorted based on their severity and probability of occurrence, brought to the risk criterion table. Proper measurement called as mitigations were used to standardize the risks to the acceptable criteria. The standardization could be through reducing the severity of the risk or through reducing the probability of its occurrence, or even both of them. Advancing from the hazardous situations was an expected aim for any of the risk factors. Results The equivalent risk assessment factors are compared in pre-mitigation and post-mitigation stages. The main aim was to see whether the risk level of the factors reduces to the acceptable or conditionally acceptable region. Falling in to the conditionally acceptable region makes the application of the product to be under sufficient warnings, which orders to take enough pre-cautions for the user or operator. For most of the risk factors, there was a concern that the measurements are able to only improve them in the frequency of occurrence, however, the results show that there are solutions to improve the severity as well. Conclusion Through this comprehensive study, the risk analysis file is completed however it can be even more complete, in the future, at this industry. In the further studies, discretizing the steps of severity or probability to finer steps, and ultimately converting them to a continuous form would be aimed.","PeriodicalId":93786,"journal":{"name":"Journal of surgery care","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79347828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew C Findlay, Sawyer Z Bauer, Diwas Gautam, Brandon Lucke-Wold
Rehabilitation following neurotrauma is an important component of recovery. The best outcomes involve multidisciplinary management. This involves medical therapies, functional therapies, and physical therapies. Speech therapy, physical therapy, and occupational therapy are crucial components. Emerging evidence has implicated the need for vision therapies and a focus on mental health. A seamless integration from inpatient to outpatient is validated. This can be at outpatient facilities or home care. The importance is a key point person for the patient.
{"title":"Rehabilitation After Neurotrauma: A Commentary.","authors":"Matthew C Findlay, Sawyer Z Bauer, Diwas Gautam, Brandon Lucke-Wold","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rehabilitation following neurotrauma is an important component of recovery. The best outcomes involve multidisciplinary management. This involves medical therapies, functional therapies, and physical therapies. Speech therapy, physical therapy, and occupational therapy are crucial components. Emerging evidence has implicated the need for vision therapies and a focus on mental health. A seamless integration from inpatient to outpatient is validated. This can be at outpatient facilities or home care. The importance is a key point person for the patient.</p>","PeriodicalId":93786,"journal":{"name":"Journal of surgery care","volume":"1 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40439635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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