bluuebunny/crossref_metadata_2025 huggingface dataset:
Processes of change in quality of life, weight self-stigma, body mass index and emotional eating after an acceptance-, mindfulness- and compassion-based group intervention (Kg-Free) for women with overweight and obesity
Authors: Palmeira Lara , Cunha Marina , Pinto-Gouveia José
Published: January 2017

This study examined the effectiveness of Kg-Free: an acceptance-, mindfulness- and compassion-based group intervention for women with overweight and obesity at post-treatment and 3-month follow-up and explored the psychological processes that underlie changes in quality of life, weight self-stigma, body mass index and emotional eating at post-treatment. Overall, 53 women completed Kg-Free. At post-treatment and 3-month follow-up, participants reported increased quality of life, mindfulness and self-compassion abilities and decreased weight self-stigma, emotional eating, shame, weight-related experiential avoidance, self-criticism and body mass index. Shame and self-criticism reductions were important mediators of changes in health-related outcomes, whereas weight-related experiential avoidance, mindfulness and self-compassion mediated changes in weight and eating-related outcomes.
The reliability and validity of the Spanish version of the Fear of Pain Questionnaire
Authors: Solé Ester , Castarlenas Elena , Sánchez-Rodríguez Elisabet , Galán Santiago , de la Vega Rocío , Jensen Mark P , Miró Jordi
Published: January 2017

The purpose of this study was to evaluate the psychometric properties of the Spanish version of the Fear of Pain Questionnaire-III. The original three-factor structure of the Fear of Pain Questionnaire-III was confirmed and indicated a good to excellent level of internal consistency. Criterion validity was supported by positive significant correlations between the Fear of Pain Questionnaire-III scores and measures of pain catastrophizing and anxiety sensitivity; discriminant validity was supported by non-significant correlations between the Fear of Pain Questionnaire-III scores and measures of pain intensity and depressive symptomatology. The findings support the reliability and validity of the scores obtained by the Spanish version of the Fear of Pain Questionnaire-III.
Sound attenuation and audibility of fire alarm signal in Korean residential apartment buildings: A case study
Authors: Lee Min-Joo , Kim Myung-Jun
Published: January 2017

With a view to preventing casualties due to fire outbreaks in residential buildings, we investigated the sound attenuation of audible fire-alarm signals in Korean residential apartment buildings and determine an acoustic condition for enhancing the audibility of such signals. Two sets of field measurements were performed, along with theoretical predictions using sound analysis software. In the first set of measurements, in 17 dwelling units, the standardized alarm sound level requirement of 75 dBA could not be achieved in bedrooms with existing alarm devices. In the second set of measurements, with an additional five dwelling units, both the sound attenuation according to the distance between sound sources and bedrooms and the sound insulation performance of bedroom doors were examined. The sound attenuation levels were increased by 0.72 ( R2 = 0.7982) and 0.48 ( R2 = 0.3001) dB m−1 under open- and closed-door conditions, respectively. Further, the bedroom-door sound insulation performance was in the 18- to 23-dB range. Consequently, we have demonstrated that the sound power of a general residential fire alarm must be 98–107.9 dB, depending on the dwelling-unit size and floor-plan type, in order to achieve a bedroom audibility level of 75 dBA.
Prospective Evaluation of Symptom Responses to Successful Operation for Mild-Moderate Primary Hyperparathyroidism
Authors: Järhult J.
Published: January 2017

Background:

Parathyroidectomy is claimed to strongly improve the hypercalcemic symptoms in patients with primary hyperparathyroidism (HPT). The object of this study was to register the patients own experience of symptom changes in response to successful parathyroid surgery.

Methods:

Material one. 44 HPT patients filled in a questionnaire consisting of 8 visual analogue scales referring to “typical” hypercalcemic symptoms before as well as 2 and 12 months after neck surgery. Their results were compared with those obtained from an age — And sex-matched group of patients undergoing surgery for non-toxic thyroid disease. Material two. 25 elderly women with mild-moderate HPT were followed more closely up to 3 years after neck surgery with the same type of questionnaire.

Results:

HPT patients expressed significantly more of fatigue, muscular weakness, impaired memory, thirst and polyuria than patients with non-toxic thyroid disorders. These differences were eliminated 2 months after surgery. The pattern of response to parathyroidectomy was similar for most symptoms: an impressive improvement after 2 months and then a gradual return towards the preoperative value. However, the response was still significant for fatigue, weakness, thirst, polyuria and inactivity after 1 year. The effect of normalization of serum calcium on symptom scoring varied considerably between different individuals and also between different symptoms in the same individual. The elderly women responded in a similar biphasic way but their improvements were less pronounced.

Conclusions:

HPT patients experience significant improvements of most “hypercalcemic” symtoms after successful parathyroidectomy, but the effects are transient and vary considerably between different individuals.
Impact of Endovascular Treatment on Clinical Status and Health-Related Quality of Life
Authors: Virkkunen J. , Venermo M. , Saarinen J. , Keski-Nisula L. , Apuli P. , Kankainen A.-L. , Salenius J.
Published: January 2017

Background and Aims:

Investigating the impact of percutaneous transluminal angioplasty (PTA) on clinical status and health related quality of life in patients with claudication and critical limb ischaemia (CLI).

Material and Methods:

61 patients and 64 limbs underwent a primary PTA (30 claudication and 34 CLI cases). Clinical status was graded according to Ahn and Rutherford and ankle/brachial index (ABI). Quality of life was assessed using the Nottingham Health Profile (NHP) preoperatively, one month and one year after the procedure. Triplex scan evaluation of the treated arterial segment was carried out postoperatively and one year after the procedure.

Results:

Claudication: 24/27 patients underwent one-year follow up, after which 20/24 had no claudication. In triplex evaluation 17 (63.0%) treated segments were open with 0–50% restenosis, 9 (33.3%) with 51–99% restenosis and one (3.7%) was occluded. CLI: 13/34 (38.2%) patients underwent one-year follow-up after which eight patients (61.5%) were asymptomatic and five (38.1%) had claudication. In triplex evaluation there was 0–50% restenosis in 6 (46.2%) segments treated with PTA and 51–99% restenosis in 7 (53.8%) segments. 21 (61.8%) patients did not conclude the one year follow up: 7 had died, 5 had undergone bypass surgery and 6 an amputation and 3 did not attend the follow-up up for unknown reasons. Quality of life: For CLI patients, improvement was observed in the domain of pain, which continued throughout the follow-up period. Among the claudicants, the domain of physical mobility was improved at one month's follow-up, but this effect disappeared during the following year and could not be seen at one the one- year follow-up.

Conclusions:

Technical success and one-year results in claudication are good, and the rate of complications is low. However, although PTA resulted in an immediate improvement in the quality of life, this effect was not seen in the long term. In critical limb ischemia there was a group of patients in whom PTA led to a significant benefit in terms of limb salvage and quality of life.
Minimally Invasive Repair for Treating Pectus Excavatum — Early Results
Authors: Hurme T. , Savola J. , Vilkki V.
Published: January 2017

Minimally invasive repair of pectus excavatum (MIRPE) is the preferred technique for repair of funnel chest deformity. The aim of this study is to evaluate our initial postoperative results, to identify factors related to postoperative complications and to examine the acceptability of MIRPE by the patients.

Patients, Materials and Methods:

25 MIRPE patients (20 male and 5 female) were operated on between November 2002 and February 2007 at the Department of Pediatric Surgery, Turku University Central Hospital. The median age of the patients was 14 years (range from 5 to 23 years). One patient had undergone previously open Sulamaa reconstruction and one had a history of intrathoracic lymphoma. The remaining 23 patients had primary pectus excavatum. A right thoracoscopy was performed to every patient.

Results:

Operative mortality was zero and there were no clinically significant bleeding complications. Epidural analgesia was necessary for adequate pain control. Small symptomless residual pneumothoraxes and pleural effusions were common after the operation but neither required intervention. One patient had a hemothorax 7 months postoperatively, which was cured with a single puncture. Bar displacement took place in 2 patients but required correction in only one of these patients. There were 2 wound infections, one superficial and one which led to removal of the bar was 6 months after the operation. This may have been unnecessary. Two patients had pneumonia, one probably unrelated to the operation. One patient required psychiatric ward treatment, and 3 patients had mild psychological symptoms not requiring specific therapy. The preliminary cosmetic results were good or excellent in 90% of the cases, but a longer follow-up is needed for information on the final outcome.

Conclusions:

MIRPE is a safe operation and gives a cosmetically good result. Thoracoscopy is needed during the operation. The early postoperative period in hospital is painful and there the patients need intensive care. We found the high epidural analgesia beneficial and safe during early period of pain treatment. The bar is removed not earlier than 3 years after the operation as a day care surgical procedure.
Quality of Life after Emergency Vs. Elective Esophagectomy with Cervical Reconstruction
Authors: Schneider L. , Hartwig W. , Aulmann S. , Lenzen Ch , Strobel O. , Fritz S. , Hackert T. , Keller M. , Buchler M. W. , Werner J.
Published: January 2017

Introduction:

Esophagectomy with reconstruction by collar anastomosis has an impact on the patients' quality of life (QOL). The aim of this study was to explore a potential difference in QOL between elective and emergency esophagectomy with collar reconstruction.

Patients and Methods:

Quality of life questionnaires were evaluated in 17 patients prior to esophagectomy, shortly after surgery, hospital discharge, and at least > 9 months after surgery using the EORTC QLQ C30 and EORTC OES 18 forms. In all patients reconstruction was performed by high collar anastomosis. Patients in group A received elective esophageal resection. In group B emergency esophagectomy was performed because of esophageal perforation for various reasons apart from cancer. In this group, delayed reconstruction was performed in a second operation 3–6 months after esophagectomy.

Results:

There was a temporary decrease of postoperative QOL in both groups, which returned to preoperative values in the follow-up except for physical functioning, which remained decreased in group A (p < 0,05). There were no persisting differences in QOL after elective and emergency esophagectomy in the follow-up.

Discussion:

Patients with elective and emergency esophagectomy and reconstruction by high collar anastomosis gained a good long-term QOL in our cohort of patients. This gives evidence that the observed QOL after elective resection of esophageal cancer is not only caused by a relief of cancer burden, but also due to a surgical procedure which is able to provide a good long-term QOL.
Influence of Splenectomy on Morbidity of Esophageal Cancer Surgery
Authors: Aminian A. , Mirsharifi R. , Karimian F. , Khorgami Zh , Nasiri Sh , Yazdankhah-Konari A. , Alibakhshi A.
Published: January 2017

Background and Aim:

During esophagectomy, splenic injury may occur due to unintentional operative trauma, caused by excessive traction on the splenic ligaments or mis-placement of retractors. The role of spleen in immune system is well recognized and the addition of splenectomy to esophagectomy may increase the rate of complications. The goal of this study was to determine the influence of splenectomy on postoperative morbidity and mortality after esophageal resection for esophageal cancer.

Materials and Methods:

Between January 2001 and April 2006, 420 cases with esophageal cancer underwent esophagectomy in a referral cancer institute. In 14 patients (3.3%) splenectomy was added because of unwanted splenic injury during operation. In-hospital morbidities and mortality and hospital stay were compared between patients with and without concomitant splenectomy.

Results:

Although the overall complication rate in splenectomized patients was higher than other patients (43% vs. 30%), this figure was not statistically significant (P value: 0.3). Cervical anastomotic leakage occurred in 35.7% of splenectomized patients in comparison to 12.2% of control group (P value: 0.01, Odds Ratio: 3.93, CI95%: 1.27–12.2). There were no significant differences in cardiac and pulmonary complications, and in-hospital mortality rate between patients with and without splenectomy (P value > 0.05). Splenectomy did significantly affect post operative hospital stay (19 ± 13 vs. 13 ± 7 days, P value: 0.004).

Conclusions:

During esophagectomy, unplanned splenectomy may increase the incidence of anastomotic leakage and hospital stay. Therefore, whenever possible preservation of the spleen should be considered. An unexpected relationship between splenectomy and anastomotic leaks needs further investigation.
Infiltration of Wounds and Extraperitoneal Space with Local Anesthetic in Patients Undergoing Laparoscopic Totally Extraperitoneal Repair of Unilateral Inguinal Hernias: A Randomized Double-Blind Placebo-Controlled Trial
Authors: Abbas M. H. , Hamade A. , Choudhry M.N. , Hamza N. , Nadeem R. , Ammori B. J.
Published: January 2017

Background:

The potential analgesic benefit of infiltration of the wounds and extraperitoneal space with local anesthetic in patients undergoing laparoscopic totally extraperitoneal (TEP) repair of inguinal hernias remains unclear.

Methods:

Consenting adults scheduled to undergo laparoscopic TEP repair of unilateral inguinal hernias were recruited to this randomized double-blind placebo-controlled clinical trial of 0.25% bupivacaine (group I) versus saline (group II) infiltration of abdominal wounds and the extraperitoneal space. Pain scores were assessed at 4 and 24 hours postoperatively using the short-form MCGill pain questionnaire (SF-MPQ), the Present Pain Index (PPI) score and the visual analogue scale (VAS). The intravenous and oral analgesic requirements were recorded. Each patient completed questionnaire to assess their satisfaction with the postoperative analgesia.

Results:

40 patients were randomized (group I, n = 20; group II, n = 20). The two groups were comparable for age, gender, body mass index, and operating time. Minor complications occurred in one patient in each group. There were no significant differences in the postoperative SF-MPQ scores, PPI and VAS at 4 hours (p = 0.413, p = 0.631, p = 0.615 respectively) and 24 hours (p = 0.116, p = 0.310, p = 0.100 respectively) post-operatively. The parenteral and oral analgesics consumed post-surgery were comparable (p = 0.605, p = 0.235). No difference was observed in the patient satisfaction scores.

Conclusions:

Infiltration of abdominal wounds and extraperitoneal space with bupivacaine in patients undergoing laparoscopic TEP repair of unilateral inguinal hernias does not appear to offer analgesic benefits.
Alendronate Reduces Periprosthetic Bone Loss after Uncemented Primary Total Hip Arthroplasty — A 5-Year Follow-up of 16 Patients
Authors: Tapaninen T. S. , Venesmaa P. K. , Jurvelin J. S. , Miettinen H. J. A. , Kröger H.P.J.
Published: January 2017

Background and Aims:

Periprosthetic bone loss, especially in the proximal part of the femur, is common after cemented and uncemented total hip arthroplasty (THA). Short-term studies suggest that bisphosponates can minimize this bone loss related to stress-shielding phenomenon. The aim of the present randomized study was to investigate whether the positive effect of a 6 months alendronate treatment postoperatively still exists at five-year follow up.

Materials and Methods:

Sixteen uncemented primary THA patients were randomized to receive either 10mg alendronate + 500 mg calcium (n = 7) or 500 mg calcium only (n = 9) daily for 6 months postoperatively. Periprosthetic bone mineral density (BMD) was measured with the dual X-ray absorptiometry (DXA) postoperatively and at 6, 12, 24, 36 and 60 months follow-up.

Results:

At the 5-year follow up, the calcium group showed mean BMD decreases of 23.1% (SD 14.6) in the proximal part of the femur (prROI) and 9.6% (SD 14.9) in total femoral regions of interest (totROI). In the alendronate group the corresponding BMD decreases were 13.6% (SD 19.0) and 3.9% (SD 7.6) respectively. The positive effect of alendronate was already demonstrated during the first six months postoperatively. Subsequently the bone loss was equal in both groups, and the 5-year BMD changes were not significantly different between the groups.

Conclusions:

Alendronate seems to decrease early periprosthetic bone loss after arthroplasty but this pilot study could not provide enough evidence that the positive effect noted in the early postoperative period is still maintained 5 years after the operation.
Pediatric Tibial Eminence Fractures: Arthroscopic Treatment Using K-Wire
Authors: Furlan D. , Pogorelić Z. , Biočić M. , Jurić I. , Meštrović J.
Published: January 2017

Background:

Fractures of the tibial intercondylar eminence are observed mostly in children and adolescents, often after minimal trauma. The purpose of this paper is to evaluate the use of K-wire fixation for the arthroscopic treatment of tibial eminence fractures in children.

Patients and Methods:

From January 2002 through January 2009 ten patients were treated arthroscopically because of the intercondylar eminence fracture in a Department of pediatric surgery, University Hospital Split. Arthroscopically controlled reposition was done, and using mobile X-ray two crossed K-wires were introduced percutaneously from the proximal part of the tibia to the fractured intercondylar eminence. Subjective outcome was obtained using IKDC subjective questionnaire.

Results:

Average hospitalization time was 11 days. Average duration of treatment was 12.5 weeks. Average follow-up was 42 months. Follow-up radiographs showed union in all cases. The mean IKDC subjective score was 96/100. Clinically, all patients exhibited a solid endpoint on the Lachman test. The global IKDC objective score was normal in eight knees and nearly normal in two knees.

Conclusion:

Arthroscopic reduction and fixation by Kirschner wires or a small fragment screw is the best way for treatment intercondylar tibial eminence fractures, in the pediatric population, because is not crossing the epiphyseal plate.
Early Complications after Nipple-Sparing Mastectomy and Immediate Breast Reconstruction with Silicone Prosthesis: Results of 214 Procedures
Authors: Radovanovic Z. , Radovanovic D. , Golubovic A. , Ivkovic-Kapicl T. , Bokorov B. , Mandic A.
Published: January 2017

Background and Aims:

Breast reconstruction with silicone prosthesis following nipple-sparing mastectomy has become widely accepted as a reconstruction option in women requiring mastectomy for cancer. The purpose of this study was to evaluate the incidence and some factors influencing early local complications in patients undergoing NSM with immediate implant reconstruction.

Material and Methods:

Prospective study was performed on a consecutive series of 214 breast reconstructions in 205 patients. All complications during the six weeks after surgery were recorded. 42 prostheses were implanted after neoadjuvant chemotherapy, 27 patients previously had radiotherapy due to breast conserving surgery and in all other cases surgery was the primary treatment for cancer.

Results:

The overall six-week complication rate was 16% (35) and included: major skin flap necrosis (4%, 9 procedures), minor skin necrosis (3%, 7), major infection (2%, 5), minor infection (3%, 7), prolonged seroma formation (3%, 6), haematoma (1%, 2) and epidermolysis (1%, 2). In 6% (12) reconstruction procedures explantation of prosthesis was done. Neoadjuvant chemotherapy and radiotherapy were not associated with higher rate of complications.

Conclusion:

Nipple-sparing mastectomy with immediate implant reconstruction has acceptable morbidity rate in the hand of experienced oncoplastic surgeon and therefore should be considered as treatment option to women requiring mastectomy.
Tension-Free by Mesh-Plug Technique for Inguinal Hernia Repair in Elderly Patients
Authors: Pavlidis T. E. , Symeonidis N. G. , Rafailidis S. F. , Psarras K. , Ballas K. D. , Baltatzis M. E. , Pavlidis E. T. , Marakis G. N. , Sakantamis A. K.
Published: January 2017

Background:

Elderly patients are steadily becoming a growing part of the population. The aim of this study is to evaluate the outcome of open inguinal hernia repair in patients aged over 65 years.

Methods:

From January 1999 to December 2008, a total of 719 patients underwent open tension-free inguinal hernia repair with mesh-plug; 301 among them were ≥ 65 years old.

Results:

Elderly patients had a mean age of 72.4 years (women 3.3%), while the mean age of younger patients was 48.7 years (women 5.7%). According to the ASA score, patients aged ≥ 65 years were at significantly higher risk than the younger patients. Spinal anesthesia was used most frequently in both groups. No significant differences were found in postoperative pain, mortality and recurrence. Morbidity and hospital stay were significantly higher in patients aged ≥ 65 years.

Conclusions:

Open hernia repair in the elderly is safe and well tolerated, but it is associated with higher morbidity and longer hospitalization.
Non-Absorbable Interrupted versus Absorbable Continuous Skin Closure in Pediatric Appendectomies
Authors: Pauniaho S.-L. , Lahdes-Vasama T. , Helminen M. T. , Iber T. , Mäkelä E. , Pajulo O.
Published: January 2017

Background and Aims:

Appendectomy wounds are still commonly closed with non-absorbable sutures. Stitch removal has financial costs and causes anxiety in children. Our aim was to compare interrupted non-absorbable (NA) and continuous intradermal absorbable (A) sutures in appendectomy wounds to evaluate whether absorbable suturing increases the risk of complications.

Material and Methods:

198 children (age 4–18 years) including perforated cases were prospectively randomized into two groups (NA and A skin closure). The wounds and inflammatory markers were evaluated on the first two postoperative days. The appearance of the wound was evaluated one week postoperatively by a district nurse. Follow-up data were obtained from 166 patients (87 in NA group and 79 in A group).

Results:

In NA group 86 % and in A group 81 % had appendicitis (8 % and 15.6 % perforated and 9.3 % and 25 % gangrenous cases in NA and A groups, respectively). The total wound infection rate was low, 1.8 % (2.3 % in NA Group and 1.3% in A Group). No differences in the inflammatory markers or the appearance of the wound were noted between the groups, but nine children in NA Group (10.3 %) had a partial wound dehiscence after stitch removal.

Conclusion:

Appendectomy wounds in children can be closed with continuous, absorbable sutures, even in complicated cases.
Immunonutrition in Patients Undergoing Major Upper Gastrointestinal Surgery: A Prospective Double-Blind Randomised Controlled Study
Authors: Sodergren M. H. , Jethwa P. , Kumar S. , Duncan H. D. , Johns T. , Pearce C. B.
Published: January 2017

Introduction:

Current studies suggest immunonutrition decreases the inflammatory process, infection rates and reduces length of hospital stay in surgical patients, however studies are often conducted on heterogeneous groups of patients with varying composition of the immunonutrition. We aim to investigate the effect of immunonutrition on patients undergoing major upper gastrointestinal surgery by assessment of (i) the inflammatory and immune response and (ii) changes in clinical outcome when compared to a randomised control receiving conventional feeding.

Method:

A prospective double-blind randomised controlled study was undertaken to compare a feed supplemented with glutamine, arginine, ω-3 fatty acids and tributyrin, vitamin C, E and B-carotene and micronutrients (zinc, selenium and chromium) to an isonitrogenous, isocaloric control feed in patients undergoing major upper GI surgery. The primary end-points were defined as C-reactive protein (CRP), prealbumin and retinol binding protein (RBP) levels. Secondary end-points included performance scoring systems, length of hospital stay, adverse events and protein and nutrient assays. Variables were measured pre-operatively and routinely up to the 4th post-operative day.

Results:

There was no statistically significant change in primary end-points between the immunonutrition group and the control group. There was no difference in length of hospital stay between the groups. The vitamin C level in the study group was significantly higher at the end of the study period. Both groups tolerated the feeds well with adequate target feeding rate. There were no other significant changes in clinical outcomes between the two groups.

Conclusion:

This study has not shown a benefit of immunonutrition through changes in inflammatory or nutritional markers, a decrease in length of hospital stay, or other morbidity. This may be because of inadequate numbers recruited to the study. Further, multi-centre, randomised trials on homogeneous patient groups are necessary to investigate the role of immunonutrition in major upper GI surgery.
Quality of Life in Patients Operated for Pelvic Fractures Caused by Suicide Attempt by Jumping
Authors: Borg T. , Holstad M. , Larsson S.
Published: January 2017

Background and Aims:

Jumping from great height is an aggressive method of suicide attempt where the frequent combination of psychiatric disorder and somatic injuries makes treatment difficult. Our aim was to evaluate survival rate and get patient-reported outcome in patients operated for a pelvic or acetabular fracture sustained when jumping from a height as a suicide attempt.

Patients and Methods:

During the period 2003–2004, 12 patients (11 women) of whom eight were below 30 years of age, were prospectively included. At two years HRQoL (Health-Related Quality of Life) questionnaires (SF-36 and LiSat-11) were used to describe outcome, and at four years a structured psychiatric interview SCID-I (Structured Clinical Interview for DSM-IV Axis I Disorders) was done.

Results:

At four years all patients were alive. One patient had made a new suicide attempt. Eight patients gave adequate reply on SF-36 and LiSat-11 at two years. In all domains patients scored lower than a norm group with the relatively lowest values in physical domains. Younger patients assessed life as better when compared with middle aged patients.

Conclusions:

This study showed a very low recurrence rate into suicidal behaviour in a group of jumpers and all patients were alive at four years after a suicidal attempt by jumping. The high proportion of psychiatric disorder in these patients highlights the need for a combined treatment effort between orthopaedic and psychiatric expertise.
Cold Intolerance after Flexor Tendon Injury. Disposing Factors and Long Term Prognosis
Authors: Lied L. , Lydersen S. , Finsen V.
Published: January 2017

Background and Aims:

Cold intolerance after hand injuries is often debilitating. We wished to determine what factors make it more likely to occur and whether it improves or worsens with time.

Patients and Methods:

We retrospectively studied 103 patients who had sustained a simple cut leading to a flexor tendon injury in the finger between 3 months and 20 years earlier. A total of 48 had also injured a digital nerve. At review patients indicated on a VAS scale their discomfort during the first winter after injury and the last winter before review and also gave a VAS evaluation of pain in the hand after keeping it in a bath of water at 1–4 degrees centigrade for 60 seconds.

Results:

Cold sensitivity during the first winter after injury was reported by 66% patients. Its development was unrelated to the age at injury. The proportions of smokers, injury of more than one finger, and re-operation or with postoperative complications were significantly higher among patients with cold sensitivity. At review 49% indicated that they had improved, 41% that cold sensitivity was unchanged and 10% that they were worse.

Conclusions:

Standardized immersion in cold water showed that on average cold sensitivity was slightly worse with time.
Impact of Perceptual Ability and Mental Imagery Training on Simulated Laparoscopic Knot-Tying in Surgical Novices Using a Nissen Fundoplication Model
Authors: Jungmann F. , Gockel I. , Hecht H. , Kuhr K. , Räsänen J. , Sihvo E. , Lang H.
Published: January 2017

Background:

Performing minimally invasive surgery requires training and visual-spatial intelligence. The aim of our study was to examine the impact of visual-spatial perception and additional mental training on the simulated laparoscopic knot-tying task performed by surgical novices.

Methods:

A total of 40 medical students randomly assigned to two groups underwent two sessions of laparoscopic basic training on a VR simulator (SimSurgery®, Oslo, Norway). The variables time and tip trajectory (total path length of the instrument tip trajectory) were used to assess the performance of the intracorporeal knot-tying task using a laparoscopic Nissen fundoplication model. The experimental group completed additional mental practice during the interval between the two training sessions. All performed a cube subtest of a standard intelligence test (I-S-T 2000 R) to evaluate visual-spatial ability.

Results:

All participants achieved an improvement in time ( t = 9.861; p < 0.001) and tip trajectory ( t = 6.833; p < 0.001) in the second training session. High scores on the visual-spatial test correlated with a faster performance ( r = −0.557; p < 0.001) and more precise movements ( r = −0.377; p = 0.016). Comparison of the two groups did not show any statistical significant differences in the parameters time and tip trajectory.

Conclusions:

Visual-spatial intelligence tested by a cube test correlated with simulated laparoscopic knot-tying skills in surgical novices. Additional mental practice did not improve the overall knot-tying performance. Further studies are therefore required to determine whether mental practice might be beneficial for experienced laparoscopic surgeons or for more complex tasks.
Learning Curve of Laparoscopy-Assisted Gastrectomy Using a Standardized Surgical Technique and an Established Educational System
Authors: Tokunaga M. , Hiki N. , Fukunaga T. , Miki A. , Ohyama S. , Miyata S. , Yamaguchi T.
Published: January 2017

Background and Aims:

The learning curve of a trainee for laparoscopy-assisted gastrectomy in a high volume center, in which an educational system and a standardized laparoscopic procedure are already established, remains unclear.

Material and Methods:

The early surgical outcomes of the patients of two trainees were investigated. Both trainees followed a training program where they performed at least 20 cases being the camera assistant, 20 cases being the first assistant, before performing the surgery as an operator.

Results:

The average operation time, intraoperative bleeding, the number of retrieved lymph nodes, and morbidity rate were 240.2 min, 45.7 ml, 35.4, and 13.0%, respectively. There was no learning curve effect observed except with the operation time of one trainee.

Conclusions:

In a high volume center with an established educational system, trainees could perform laparoscopy-assisted gastrectomy safely, although there might be a learning curve effect in operation time and the surgeries took longer operation time in trainee's initial cases.
Endoscopic Snare Resection Followed by Laser Ablation in the Treatment of Large, Sessile Rectal Adenomas
Authors: Nesbakken A. , Kristinsson J. , Svindland A. , Lunde O. C.
Published: January 2017

Background and Aims:

Large sessile rectal adenomas can be difficult to eradicate, and different treatment modalities are available. The aim of this study was to evaluate outcome after endoscopic snare resection followed by Nd: YAG laser ablation.

Material and Methods:

Over a 10-year period 92 of 99 (93%) patients were registered prospectively and attended follow-up examinations with endoscopy and biopsies.

Results:

Fifty-four (59%) men and 38 (41%) women were included; 67 patients (73%) had high grade (severe) intraepithelial dysplasia or intramucosal neoplasia. The adenomas ranged from 2–9 cm (median 4 cm) in diameter, and were located 2–15 cm (median 5 cm) from the anal verge. A median of two (range 1–6) piecemeal snare resection sessions and a median of one (range 1–7) laser treatments were performed for each patient. Complete eradication was achieved in 86 patients (93%). Over a median follow-up period of 26 months, 20/86 (23%) suffered local recurrence, eight of whom were given a second laser treatment without developing further recurrence. In five of eight frail patients considered unsuitable for more radical treatment, repeated laser treatment was effective in keeping the adenoma small and symptoms at a minimum. As a whole the treatment was successful in 74/92 (80%) and partially successful in 5/92 (5%) of the patients.

Conclusions:

Snare resection followed by laser ablation is safe and still has a place in the treatment of old, frail patients with large rectal adenomas. However, there is a risk of missing an infiltrating carcinoma, and other treatment options are preferable in fit patients.
Impact of Coronary Artery Bypass Surgery on Ischemic Mitral Regurgitation
Authors: Mustonen J. , Suurmunne H. , Kouri J. , Pitkänen O. , Hakala T.
Published: January 2017

Introduction:

To determine the course of ischemic mitral regurgitation (IMR) after coronary artery bypass grafting (CABG), and evaluate preoperative factors which predict the development of the severity of IMR after CABG.

Methods:

Between 1992–2005, 1995 patients underwent CABG and 170 of them had IMR. Data of 131 patients were retrospectively analyzed and living patients (n = 112) had a clinical follow-up visit. The mean follow-up time was 6.5 years.

Results:

At the time of CABG, 66% of the 131 cases analyzed had mild, 31% had moderate, and 3% had severe IMR. At the time of follow-up, 52% of patients had either no IMR or mild IMR, 27% had moderate IMR, 6% had severe IMR and 15% suffered from cardiac related death. During follow-up IMR grade reduced in 25% of study patients. None of the patient had re-operation due to the mitral regurgitation. Multivariate analysis showed that left ventricular ejection fraction (LVEF) was an independent predictor of good prognosis (O.R. 1.4, 95% C.I. 1.15–1.83/10% increase of LVEF, p = 0.02).

Conclusion:

Half of the patients, who have IMR at the time of CABG, have no IMR or only mild IMR postoperatively. Good LVEF adds to the probability that CABG only can reduce IMR.
Fascial Incision and Adhesiolysis Combined with Radiofrequency Microtenotomy in Treatment of Chronic Midportion Achilles Tendinopathy
Authors: Sarimo J. , Orava S.
Published: January 2017

Background and Aims:

Achilles tendinopathy is a common problem that can cause disturbing symptoms in activities of daily living as well as prevent sports activities. The purpose of this study was to evaluate the effects of fascial incision and adhesiolysis combined with radiofrequency microtenotomy in treatment of chronic midportion Achilles tendinopathy.

Material and Methods:

Twenty-four patients were included in this study. The cases were studied retrospectively. The mean age of the patients was 54 years (range, 39 to 72) and there were 12 women and 12 men. A final evaluation was done at an average of 30 months (range, 18 to 45) after surgery, including radiofrequency microtenotomy.

Results:

In all cases the Nirschl Pain Phase Scale of Athletic Overuse Injuries score improved and the difference was statistically significant (p < 0.0001). The patients themselves rated the result excellent in 14 cases and good in 10 cases.

Conclusion:

Fascial incision and adhesiolysis combined with radiofrequency microtenotomy seems to be a useful alternative in treatment of chronic midportion Achilles tendinopathy in cases of unsuccessful non-operative treatment.
From Home to Operation (FHTO) — A New Surgical Admission Centre: Does the Comprehensive Initialisation of a New Process Harm Surgery Outcome?
Authors: Keränen J. , Keränen U.
Published: January 2017

Background and Aims:

FHTO — From Home To Operation is a same day admission model developed at Finland Hyvinkää Hospital from as early as year 2000. In September 2006, a new FHTO centre was opened, through which surgical patients walk into the operation room. This article describes how an extensive FHTO process transition effects patients operation outcome.

Methods:

The data was collected of all elective surgical patients between March and May in 2006 and in 2007, six months before and after the new FHTO centre was opened. Patient demographics and surgery outcome measurements were reported and analysed between the two study periods. One month postoperative follow-up was recorded.

Results:

Overall 1206 patients were included, 592 in 2006 and 614 in 2007. Before the extensive process change in 2006 54% of patients were admitted through old limited FHTO unit, and 46% through surgical ward. Six months after FHTO centre opening in 2007 same figures were 90,5% and 9,5% respectively. The baseline statistics differed statistically in kidney failure, that increased in 2007. Two deaths were recorded during postoperative follow-up each year.

Conclusions:

FHTO process transition included different surgical specialities and did not have negative impact on surgery outcome. Preoperative process should be debated thoroughly in every public hospital. The preoperative process transition from preoperative hospital stay to same day admission through new centre can be accomplished without harming surgery outcome.
Chest drains – An overview
Authors: Senanayake EL , Smith GD , Rooney SJ , Graham TR , Greaves I
Published: January 2017

Chest drains are used in a number of circumstances for the treatment of specific conditions and also for symptomatic relief, and hence insertion of a chest drain can be a life-saving intervention. Therefore, it is imperative that every hospital doctor is familiar with the indications and the principles of safe chest drain insertion. The knowledge of chest drain management following insertion is equally essential. Appropriate chest drain insertion and management underpins the management of chest trauma. Appropriate chest drain management will allow for resolution and management of the underlying clinical condition. This review article outlines the indications, contraindications, and principles of chest drain insertion. Furthermore, it provides an overview of chest drain management and associated complications. Although this review refers to a surgically placed chest drain, the same principles can be applied to a chest drain that is inserted percutaneously.
Blunt abdominal trauma with uterine rupture and fetal demise
Authors: Lien Christina , Ali Aamna , Culhane John
Published: January 2017

Traumatic uterine rupture is rare, occurring in 0.6% of blunt trauma cases, and usually results from very violent accidents in which patients usually also sustain other major injuries. Following severe blunt abdominal trauma, fetal loss can result from maternal hypotension or hypoxemia, placental abruption, maternal death, and uterine rupture. Although less common, fetal loss can also occur in minor injuries. We report a patient who sustained an isolated anterior uterine rupture with fetal demise without any associated abdominal or pelvic injuries. This case report highlights the importance of proper seat belt usage and placement because both can reduce maternal and fetal morbidity and mortality in motor vehicle accidents.
Traumatic colonic injuries in Westmead Hospital – A paradigm shift in management over 10 years
Authors: Lorenzo Aldenb , Pham Helen , Zahid Assad , Nguyen Ba , Pathmanathan Nimalan , Ctercteko Graeme , Hsu Jeremy M
Published: January 2017

Over the years, there has been a shift towards more conservative treatment, with primary repair of colonic injuries being preferred over faecal diversion. We present a cohort study of the management of penetrating colon injury over the past 10 years from a major trauma hospital in western Sydney. We aim to evaluate the trend of operative management of penetrating colonic injuries.

Methods

Patients were identified via the prospectively collected trauma registry at Westmead Hospital from 2003 to 2013. Fifty-seven patients initially identified with a proven diagnosis of penetrating colonic injury had their medical records reviewed. Excluded in the study are patients who had rectal injuries or serosal tears of the colon. Patient characteristics, mechanisms of injury, treatment course and complications were analysed. Extent of colonic injury was graded of using American Association for the Surgery of Trauma scalings.

Results

A total of 55 patients were then included in the study. Primary repair of colon injuries was the most common method used (63.6%, n = 35) followed by resection and primary anastomosis (21.8% n = 12), diverting colostomy (14.3%, n = 5) and non-operative management (5.5%, n = 3). There was a higher rate of diversion in the earlier time period (2003–2007) when compared to the later time period (2008–2013), p = 0.03. Over the 10-year period, there was no significant difference with regards to complications among groups, particularly intra-abdominal complications.

Conclusion

From 2003 to 2013, there is a shift of management of penetrating colonic injuries from diversion to resection and primary anastomosis to that of primary repair. Primary repair of colonic injuries is a safe option and is associated with low morbidity. It should be considered as a valid tool in the armamentarium of today’s surgeon.
European research on children’s internet use: Assessing the past and anticipating the future
Authors: Livingstone Sonia , Mascheroni Giovanna , Staksrud Elisabeth
Published: January 2017

In this article, we reflect critically on the research agenda on children’s Internet use, framing our analysis using Wellman’s three ages of Internet studies and taking as our case study the three phases of research by the EU Kids Online network from 2006 to 2014. Following the heyday of moral panics, risk discourses and censorious policy-making that led to the European Commission’s first Internet Action Plan 1999–2002, EU Kids Online focused on conceptual clarification, evidence review and debunking of myths, thereby illustrating the value of systematic documentation and mapping, and grounding academic, public and policy-makers’ understanding of ‘the Internet’ in children’s lives. Consonant with Wellman’s third age, which emphasizes analysis and contextualization, the EU Kids Online model of children’s online risks and opportunities helps shift the agenda from how children engage with the Internet as a medium to how they engage with the world mediated by the Internet.
Translation and localization of children’s rights in youth-produced digital media in the Global South: A hermeneutic exploration
Authors: Asthana Sanjay
Published: January 2017

Through the study of two UNICEF-supported youth media initiatives from Palestine, this article theorizes and generates new empirical knowledge about the encounter between constructions of youth in rights-based discourses of UNICEF and young people’s digital media narratives. The research encountered instances where the universal discourse of children’s rights did not connect with the local realities of youth (constraints) but found that young people translate children’s rights to construct new meanings to suit their local contexts and experiences (possibilities).
Digital technology and rights in the lives of children with disabilities
Authors: Alper Meryl , Goggin Gerard
Published: January 2017

Children with disabilities, especially those from the Global North, often figure into public discourse as beneficiaries of the “digital revolution.” However, if children’s voices and experiences are generally under-considered in digital policy and rights debates, this is even more likely when it comes to disability. Against this background, this article looks at the global rights of children with disabilities in the digital age. We consider the state of digital inclusion and exclusion, as well as the intersection between children’s rights and disability rights. Moving forward, we suggest ways to reconceptualize digital and related rights inclusive of all children.
When will a Darwinian approach be useful for the study of society?
Authors: Bagg Samuel
Published: January 2017

In recent years, some have claimed that a Darwinian perspective will revolutionize the study of human society and culture. This project is viewed with disdain and suspicion, on the other hand, by many practicing social scientists. This article seeks to clear the air in this heated debate by dissociating two claims that are too often assumed to be inseparable. The first is the ‘ontological’ claim that Darwinian principles apply, at some level of abstraction, to human society and culture. The second is the more ‘pragmatic’ claim that this observation necessitates substantial changes in the practices of social scientists. Even if some version of the first claim is true, I argue – which I believe is quite likely – the second does not follow. This observation ought to chasten the most overzealous advocates of Darwinian social science, as well as softening the instinctive resistance of many social scientists and historians to the genuine insights enabled by a Darwinian approach. The conclusion discusses these insights, the most important of which is a methodological prescription for normative theory.
Changing practice: The possibilities and limits for reshaping social work practice
Authors: Laird Siobhan E , Morris Kate , Archard Philip , Clawson Rachael
Published: January 2017

Since 2010, the United Kingdom has witnessed a number of initiatives that shift away from reliance on performance management to improve social work with children and families, towards a renewed interest in practice models. This study reports on the evaluation of a local government programme in England to introduce and embed systemic family practice through the roll out of intensive training to social workers and frontline managers. It was anticipated through the programme that child protection social workers would undertake more direct work with families and build more positive relationships, resulting in a fall in the number of child protection plans and children experiencing repeat periods of care. The evaluation adopted a mixed-method approach encompassing an online survey of social workers, interviews with team managers and family members, a case audit and statistical analysis of local level metrics. It found limited employment of systemic family practice or improvement due to the programme. Adopting the 7 S framework, this study examines the barriers to and facilitators of successful change and identifies generic considerations for change programmes in child protection social work.