High Level Of Patient Satisfaction Research Articles

Construction and application of a stratified nursing intervention program for postoperative delirium after Stanford type A aortic dissection: a quasi-experimental trial

BackgroundPostoperative delirium is a common and significant consequence in patients with type A aortic dissection following surgery; however, there is currently no effective postoperative care plan.ObjectiveThe purpose of this study is to develop and evaluate the practical implementation of a stratified nursing intervention program for postoperative delirium in patients undergoing surgery for Stanford type A aortic dissection.MethodsA stratified nursing intervention program for postoperative delirium was created using a literature review, group discussions, and the Delphi method via expert mail inquiry. A quasi-experimental design was used, with patients admitted to the general ward of a tertiary hospital in Wenzhou, China, functioning as subjects. From September to December 2022, 43 patients were included in the control group and given standard treatment. From January to June 2023, 37 patients were recruited in the intervention group, receiving both routine care and the intervention plan. The intervention’s effects were compared in the two groups.ResultsThe intervention group had considerably shorter delirium and hospital stays than the control group (P < 0.05), as well as higher patient satisfaction levels. There were no inadvertent extubations in the intervention group. When the incidence and beginning time of delirium in the general ward were compared, there were no significant differences between the two groups (P > 0.05).ConclusionImplementing this nurse intervention in the ward context can shorten postoperative delirium and hospital stays, increase patient satisfaction with care, and improve patient prognosis and quality of life. This intervention will also serve as a great resource for future clinical management of postoperative delirium.Trial registrationThe National Health Security Information Platform’s Medical Research Registration Information System has registered this study under the registration number MR-33–22-022978.

Rectal Eversion as an Anus-sparing Technique in Laparoscopic Low Anterior Resection With Double Stapling Anastomosis: Long-term Functional Results.

Rectal eversion (RE) is a natural orifice specimen extraction (NOSE) method that allows anus-sparing resection in very low rectal tumors. This study aims to share the long-term results of RE in laparoscopic rectal resection performed with double stapling anastomosis. A single-center retrospective cohort study was conducted for patients who underwent laparoscopic low anterior resection with RE. Age, sex, body mass index, American Society of Anesthesiologists (ASA) classification, type of surgery, distance of the tumor to the dentate line, specimen extraction site, cancer stage, preoperative chemoradiotherapy, postoperative complications, and postoperative clinical follow-up findings were recorded. Incontinence was assessed using the Wexner score (WS). Low anterior resection syndrome (LARS) is determined by the LARS score. A 7-point Likert scale was used to evaluate the satisfaction of the patients. A total of 17 patients underwent resection by RE for rectal tumors. Of the 11 patients included in the study, 4 were female and 7 were male. The mean age was 66.09±15.04 years. The mean follow-up was 64.18±16.83 months. The mean tumor diameter was 3.1cm (range: 0.9 to 7.2cm). The mean distance of the tumor from the dentate line was 2.7cm (range: 1.2 to 5.6cm). No anastomotic leak was observed in any patient. One patient had an anastomotic stenosis and was treated with balloon dilatation. The median LARS score was 16 (range 0 to 32) and 64% of the patients had no LARS. Two patients had minor LARS and 2 patients had major LARS. The median Wexner score was 3.5 (range 0 to 14). The median Likert scale was 7 (range 5 to 7). It was found that 55% of the patients were extremely satisfied, 18% were satisfied, and 27% were slightly satisfied with their surgery. There were no dissatisfied patients. RE is a safe NOSE technique in laparoscopic double stapling anastomosis for rectal resection. There is a high level of long-term patient satisfaction with anus-sparing procedures via RE, even in the presence of various symptoms.

ASSESSMENT ON THE LEVEL OF SATISFACTION OF ADULT SURGICAL PATIENTS WITH ANAESTHESIA CARE AT 68 NIGERIAN ARMY REFERENCE HOSPITALS

This research assessed the level of satisfaction of anaesthesia care among adult’s surgical patients at 68 Nigeria army reference hospital Lagos. The study employed descriptive cross-sectional design and a target population of 384 adult’s surgical patients. The instrument used for this study was a self-structured questionnaire with a reliability 0.7. Descriptive statistics was used to summarize the demographic data of respondents using frequency, proportion, mean, standard deviation and range at a significant level of 0.05. In which the findings showed a mean age of the participants to be 33.97 ± 12.28 years. Among them, the largest age group was 20-29, comprising 166 individuals. Gender distribution showed 168 males and 197 females. And 38.4% participants held tertiary qualifications. Among the respondents, 40.0% were satisfied with anesthesia care, 46.3% reported receiving adequate information that positively influenced their satisfaction, 38.1% were moderately satisfied with the quality of care, and 39.7% perceived effective communication by healthcare providers as satisfactory. Additionally, 46.3% found clear explanations of anesthesia procedures to enhance their quality of care. Three hypothesis were tested and the results showed that; there is no significant relationship between patients’ satisfaction with anaesthesia care provided (p= 0.01), there is no significant relationship between competence of anaesthesia providers and satisfaction (p= 0.01). Also, there is no significant relationship between satisfaction, perceived impact of effective communication and Competence of Anaesthesia Providers on quality of anaesthesia care (p= 0.01). In conclusion, the study highlights a high level of patient satisfaction with anesthesia care, high quality of care provided, and a significant positive impact of effective communication by healthcare providers on patient satisfaction. Therefore, the study recommended that; Hospitals should create enabling environment for implementing further strategies that enhance collaboration, improve training and pain management protocols to ensure patient satisfaction with anaesthesia care.

P0823 Access to an integrated Inflammatory Bowel Disease diet clinic improves patient-reported outcomes and dietary self-confidence in a tertiary service previously without dietetic services

Abstract Background Disability and impaired food-related quality of life (FRQoL) is prevalent in people with inflammatory bowel disease (IBD). The aim of this study was to examine whether access to specialised IBD diet care influenced patient-reported outcomes. Methods This was a prospective study of an IBD Diet Clinic (IBDDC) piloted at The Queen Elizabeth Hospital, South Australia between February 2021- September 2022. During routine IBD care, adults with diet-related issues were referred to a specialised IBD dietitian and invited to complete questionnaires evaluating before- and after dietary intervention. The primary outcome was change in FRQoL (defined as 0 (poor) and 149 (exceptionally high). Secondary outcomes included change in IBD-disability index (IBD-DI), domains of diet self-management including knowledge and self-confidence and satisfaction with IBD diet care. Appropriate statistical tests were applied to descriptive, categorical, and paired data. Results Of 91 who attended first consult in IBDDC, 55 completed before- and after-dietetic intervention questionnaires. FRQoL scores were 64.6 (SD 16.8) at baseline and improved by 13.9 points (95% CI 8.27, 19.6; p&amp;lt;0.001) following dietetic intervention. Similarly, IBD-DI scores improved by 3 points (95% CI 1.78, 4.22; p&amp;lt;0.001), knowledge of what to eat improved by 37% (p&amp;lt;0.001) and confidence in self-managing diet improved by 21% (p=0.003). Satisfaction with dietary advice was high; 46/55 (83%) were satisfied or extremely satisfied and 49/55 (89%) placed high or extremely high value on continuation of an integrated IBDDC within The Queen Elizabeth Hospital IBD service. Conclusion In an IBD service previously without a dedicated diet clinic, access to integrated, specialised and personalised IBD dietary care led to a significant improvement in all patient-reported outcomes and a high level of patient satisfaction. Poor baseline FRQoL was identified in IBD patients without access to specialised dietetic care and through attendance to an IBDDC, FRQoL, disability indices and dietary self-confidence improved.

Immediate Patient Satisfaction with Dental Esthetics After Endodontic and Prosthodontic Treatment of Dental Dyschromia.

Objectives: This study aimed to evaluate patients' satisfaction with the esthetic outcomes of combined endodontic and prosthetic treatments for devitalized or dyschromic teeth, a condition influenced by various intrinsic and extrinsic factors that present a growing concern in modern dentistry. Methods: A total of 104 patients, including 43 men and 61 women, underwent treatment using lithium disilicate restorations for esthetic zones and zirconium oxide restorations for regions with higher occlusal demands. Patient satisfaction was evaluated through a post-treatment questionnaire, classifying responses as either "satisfied" or "dissatisfied". Dissatisfied participants were further asked to specify their concerns. Results: The study revealed a high satisfaction rate of 93%. Dissatisfaction was slightly more prevalent among women than men, but this difference was statistically insignificant. The primary reasons for dissatisfaction included darker restoration color, chipping, and gingival recessions. Conclusions: Combined endodontic and prosthetic treatments, utilizing lithium disilicate and zirconium oxide restorations, achieved high levels of patient satisfaction. Nevertheless, addressing specific issues, such as color matching and gingival health, could enhance outcomes further.

"MINIMIZING THIGHPLASTY COMPLICATIONS: A COMBINED APPROACH OF J MEDIAL PATTERN AND HELIUM-PLASMA ASSISTED LIPOSCULPTURE".

Thighplasty is a widely performed body contouring procedure, utilizing various surgical techniques for thigh lifting, including medial scar positioning, vertical and horizontal procedures, and liposuction. Despite its popularity, thighplasty is associated with high complication rates and suboptimal postoperative outcomes.This article presents a novel technique: the J medial thighplasty combined with helium plasma radiofrequency technology (HPRF) to address moderate skin and soft-tissue laxity and ptosis in the inner thighs. Between 2020 and 2023, 21 patients underwent this combined procedure. The surgical approach involved selective liposuction in targeted areas, skin resection, and preservation of deep tissue layers, coupled with the application of HPRF in the lower third of the medial thigh.Results demonstrated significant reductions in thigh laxity, correction of skin overhang, and fat reduction, yielding improved functional and aesthetic outcomes in the lower thigh region. By strategically avoiding lymphatic vessels in superficial areas, the risk of secondary lymphedema was minimized. Patient satisfaction was notably high, with both patients and surgeons reporting favorable results.In conclusion, the J medial thighplasty combined with HPRF offers an effective and straightforward method for enhancing the lower thigh area with minimal complications. This innovative technique provides a promising solution for patients seeking improved thigh contouring while ensuring high levels of patient satisfaction.

Current concepts of fourth-generation minimally invasive and open hallux valgus surgery.

Hallux valgus (HV) presents as a common forefoot deformity that causes problems with pain, mobility, footwear, and quality of life. The most common open correction used in the UK is the Scarf and Akin osteotomy, which has good clinical and radiological outcomes and high levels of patient satisfaction when used to treat a varying degrees of deformity. However, there are concerns regarding recurrence rates and long-term outcomes. Minimally invasive or percutaneous surgery (MIS) has gained popularity, offering the potential for similar clinical and radiological outcomes with reduced postoperative pain and smaller scars. Despite this, MIS techniques vary widely, hindering comparison and standardization. This review evaluates the evidence for both open Scarf and Akin osteotomy and newer-generation MIS techniques. Fourth-generation MIS emphasizes multiplanar rotational deformity correction through stable fixation. While MIS techniques show promise, their evidence mainly comprises single-surgeon case series. Comparative studies between open and MIS techniques suggest similar clinical and radiological outcomes, although MIS may offer advantages in scar length and less early postoperative pain. MIS may afford superior correction in severe deformity and lower recurrence rates due to correcting the bony deformity rather than soft-tissue correction. Recurrence remains a challenge in HV surgery, necessitating long-term follow-up and standardized outcome measures for assessment. Any comparison between the techniques requires comparative studies. Surgeons must weigh the advantages and risks of both open and MIS approaches in collaboration with patients to determine the most suitable treatment.

Tendon Transfer Procedures for Correction of Foot Drop Due to Injury to the Peripheral Nerves or Muscles.

Background Foot drop is a challenging condition that significantly impacts the affected patient's mobility and quality of life. Tendon transfer has emerged as a viable treatment option. We hereby present data of the tendon transfer procedures in patients with foot drop in our department. Besides a detailed description of our surgical technique, we also compare our results with those reported in the literature. Methods Data from 17 patients (11 males and 6 females) suffering from foot drop due to peripheral nerve or muscle lesions were retrospectively analyzed. All the patients underwent tendon transfer procedures between 2017 and 2022. Assessed outcomes encompassed parameters such as strength of foot dorsiflexion, the necessity for postoperative orthotic devices, and patient satisfaction. Demographic data, the time elapsed from injury/illness to surgery, and the underlying causes of foot drop were collected. Results Postsurgery, 14 patients regained robust dorsiflexion strength (M4), while 2 exhibited slightly lower strength (M3) and 1 attained equal strength as on the unaffected side (M5). Corrective procedures were undertaken in five patients to address problems with tendon tension. After an average follow-up period of 11.9 months (± 9.13), 82.4% of patients reported a high level of satisfaction, although three patients experienced persistent foot inversion. Most patients (94.1%) no longer required orthotic devices following the operative procedure. Conclusion A tendon transfer procedure for correction of foot drop has proven to be a safe and effective treatment option, resulting in a high level of patient satisfaction and restoration of quality of life.

Clinical and radiological outcomes of arthroscopic bony Bankart repair using the 'door-locking' technique: excellent bone healing with a low complication rate.

Arthroscopic repair is recommended for patients with bony Bankart lesions to restore anterior shoulder stability and avoid recurrent glenohumeral instability. The aim of this study was to investigate the clinical and radiological outcomes of patients following arthroscopic bony Bankart repair using a single suture anchor fixation technique named the "door-locking" technique. From January 2017 to February 2024, a consecutive series of 22 patients with acute bony Bankart lesions underwent shoulder arthroscopy. The size of the fragment was measured using computed tomography (CT). The range of motion (ROM) and functional scores including the American Shoulder and Elbow Surgeons (ASES) score, the University of California, Los Angeles (UCLA) score, and Rowe score were assessed preoperatively, immediately after the surgery, and at the final follow-up. The adequacy of reduction and union of the bony fragment were evaluated by CT postoperatively. Intra- and postoperative complications and patient satisfaction were evaluated. Four women and 18 men were included in the study, with an average age of 39.4 years (range, 21-68 years). The mean time from the initial injury to surgery was 16.5 days (range, 3-45 days). The average glenoid bone defect was 21.1% (range, 9%-45%). The operation time ranged from 45-150 minutes, with an average of 80.4 minutes. The mean duration of follow-up was 28.0 months (range, 4-54 months). The mean ASES score, UCLA score, and Rowe score improved from 42.1, 11.6, and 56.0 preoperatively to 91.8, 31.1, and 93.2 at the last follow-up, respectively (all P < 0.05). At the final follow-up, the ROM in terms of forward elevation, external rotation, and internal rotation was significantly improved compared with that before surgery. There was no recurrence of instability. No serious complications (e.g., infection, thrombosis, and re-dislocation) occurred. The postoperative CT scan showed adequate reduction and complete union of the bony fragment in 20 cases. However, the bony fragments were not anatomically reduced in two patients due to a large fragment size. All patients were satisfied or very satisfied with the outcome. The arthroscopic "door-locking" technique is a valid method for treating acute bony Bankart lesions with an intact capsular-labrum-ligament complex. This method has a low complication rate and is associated with high levels of patient satisfaction.

Minimally invasive glass-ceramic restorations: Clinical and patient-reported outcomes in full-mouth rehabilitations.

To evaluate clinical outcomes (restoration survival, technical and biological complications), and patient-reported outcome measures (PROMs) of full mouth rehabilitation with minimally invasive glass-ceramic restorations after up to 12 years of clinical service. Twenty individuals (12 females, 8 males) received full-mouth rehabilitation with minimally invasive tooth-supported glass-ceramic restorations during the years 2009 - 2017 and agreed to participate in a follow-up visit. Full dental and periodontal examinations were completed, and the restorations were evaluated according to United States Public Health Service (USPHS) criteria. Kaplan-Meier was used for analysis of the survival time. The patients received 439 minimally invasive restorations made from lithium disilicate reinforced glass-ceramic (79.7%), feldspathic porcelain (17.5%) and leucite reinforced glass-ceramic (2.7%). Restoration design included occlusal and buccal surface partial coverage restorations (35.3%), full-contour restorations (31.2%), veneers (27.8%), onlays (4.6%) and inlays (1.1%). The mean follow-up time from restoration insertion was 4.5 years (1.5-12.4 years). Five patients lost altogether 13 restorations during the follow-up time. The estimated cumulative Kaplan-Meier 5-year survival rates were 96.6% on the restoration level and 86.4% on the patient level. Major technical complications amounted to 3% (n = 13) of the restorations, including larger chippings (n = 5) and loss of retention (n = 7). Biological complications were observed at a rate of 4.3%. Patients were very satisfied with esthetics (VAS 9.5) and function (VAS 9.3) of the restorations. Minimally invasive full-mouth rehabilitation with glass-ceramic restorations resulted in high survival rates, few complications and a high level of patient satisfaction over a mid-term time-period. There is an increasing trend toward minimally invasive restorations, as previous studies indicate that these designs preserve healthy tooth structure, leading to fewer biological complications. The present study demonstrates that minimally invasive restorations can be reliably used in full-mouth rehabilitations.

Assessment of Patient Satisfaction in the Out Patient Department of a Healthcare Centre in Rural Area of Bihar, India: A Cross Sectional Study

Background: Patient satisfaction is a crucial indicator of the quality of healthcare services and plays a significant role in patient loyalty, treatment adherence, and overall healthcare outcomes. This study aims to assess patient satisfaction in the outpatient department of a healthcare centre in rural Bihar. Methodology: The study utilized a cross-sectional design, collecting data from a sample of 200 patients visiting the outpatient department of a healthcare centre in a rural town in Bihar, India. A semi-structured questionnaire was developed, consisting of validated scales and items to measure various dimensions of patient satisfaction. The survey was administered to patients during their visit, and data were collected through direct interviews. Results: Overall, the majority of patients expressed satisfaction with the care they received, with a high percentage indicating positive experiences across various dimensions. A significant portion of patients were satisfied (88; 44%) or highly satisfied (56; 28%). Communication with healthcare providers emerged as a significant driver of patient satisfaction, highlighting the importance of clear and empathetic communication in fostering positive patient experiences. Staff behavior and professionalism were identified as areas requiring attention, emphasizing the importance of staff training and the need for a patient-centered approach in healthcare delivery. Conclusion: Age, gender, and educational level have varying effects on satisfaction levels, suggesting the importance of tailoring services to meet the specific needs of different patient groups. Furthermore, the study examined the impact of patient expectations on satisfaction and found that aligning patient expectations with the services provided is crucial in achieving high levels of patient satisfaction.

EVALUATION OF QUESTIONNAIRE RESULTS ON THE QUALITY OF FIXED DENTAL PROSTHESES

Introduction: Fixed prosthetics play a crucial role in restoring both functional and aesthetic characteristics of the oral cavity, enhancing patients' quality of life. Patient satisfaction assessment is a key aspect in improving treatment methods and preventing complications. Objective of the Study: This study aims to assess patient satisfaction with fixed dental prostheses among residents of Poltava and the Poltava region through a structured questionnaire. Materials and Methods: The study included 44 patients (29.55% male, 70.45% female) with an average age of 55 years. Participants were divided into three groups: those receiving prostheses for the first time, those using prostheses for less than five years, and those with prostheses for over five years. The survey utilized a proprietary questionnaire comprising two sections: overall satisfaction (60 points), and convenience and comfort (75 points). Data analysis was performed using JASP software with ANCOVA and the Wilcoxon test to identify differences based on prosthesis duration. Results: Questionnaire results revealed a trend of decreasing satisfaction with extended use of fixed prostheses. Average satisfaction scores dropped from 56.69 in the first group to 52.93 in the second group and to 48.18 in the third, indicating an overall decline of 6.26% and 14.18%, respectively, between groups. The second section of the questionnaire indicated an increase in maintenance difficulties and discomfort, with scores rising from 35.15 to 46.71 points, reflecting a 15.42% increase in this trend. These findings suggest that prolonged use of fixed prostheses results in reduced comfort and greater maintenance challenges, adversely affecting quality of life. ANCOVA analysis indicated that gingival health around the prosthesis had the greatest impact on satisfaction in the first section (F = 10.091, p &lt; 0.001), while ease of use had a lesser impact (F = 2.298, p = 0.113). In the second section, tooth decay under the prosthesis emerged as a significant issue (F = 7.716, p = 0.001), whereas satisfaction with tooth color had the least impact (F = 0.465, p = 0.632). Conclusions: The structured division of the questionnaire into two sections proved effective, enabling the collection of detailed information on various aspects of prosthesis satisfaction among residents of Poltava and the Poltava region. The survey highlighted an overall trend of declining satisfaction with prolonged prosthesis use, underscoring the necessity for careful monitoring and timely replacement to improve treatment quality and maintain high levels of patient satisfaction.

Optimization of surgical methods for the treatment of gynecomastia

Background. Gynecomastia has a negative impact on the psychological state of men. Optimisation of surgical treatment for gynecomastia, aimed at minimising unsatisfactory cosmetic consequences of operation, should significantly improve the quality of life of patients. The purpose of the study: to improve the surgical technique of treatment for gynecomastia by optimising the area of transdermal intervention with an emphasis on minimising postoperative complications and scars. Materials and methods. A total of 132 patients (mean age 31.5 ± 2.8 years, body mass index 25.2 ± 3.4, I–II ASA) were operated for gynecomastia. Gynecomastectomy (GME) was performed in patients who were randomly divided into two groups: control (C) and main (M). Patients in group C (n = 80) underwent standard GME with 10–15-mm crescentic incisions along the nipple. Patients of group M (n = 52) were operated with vertical incisions on the nipple-areolar complex at the conditional 12th and 6th hours with a length of 5–7 mm. Statistical analysis of the study results was performed according to the criteria of Pearson, Fisher and Kruskal-Wallis (Stata 12.1 package). After 3 months, the patients were questioned. The following method was used to assess surgical outcomes: 1 point — dissatisfied, 2 points — relatively satisfied, 3 points — satisfied. Results. Patients in group M had significantly fewer complications and a shorter hospital stay by 2 days (p &lt; 0.001). 94.2 % of patients in group M at follow-up survey reported satisfaction with the results of GME in contrast to group C, where 38 % of respondents expressed dissatisfaction with the consequences of GME. The vertical incision technique showed a better cosmetic effect — a significant decrease by 13.4 times (p &lt; 0.001) in the scar area (174.0 ± 12.0 mm2 vs. 13.0 ± 2.0 mm2). Conclusions. The use of the proposed GME demonstrated better cosmetic efficacy, namely a 13.4-fold (p &lt; 0.001) reduction in scar area to 13.0 ± 2.0 mm2 compared with the standard GME (174.0 ± 12.0 mm2). In addition, GME patients with vertical incisions had a reduction in the length of hospital stay by 2 days (p &lt; 0.001). The method of optimised GME demonstrated a 1.8-fold higher level of patient satisfaction with the results of the operation according to a survey conducted 3 months after GME. The use of compression garments after surgery was mandatory, which contributed to better recovery.

Autologous Cell-Free Fat Extract: A Novel Approach for Infraorbital Rejuvenation-A Pilot Study.

CEFFE (Cell-free fat extract) treatment for periocular fine lines requires thorough clinical evaluation to determine its efficacy and safety in enhancing skin quality. The research enrolled 10 healthy female participants aged 31-58, focusing on skin texture, elasticity, and barrier function. CEFFE treatment demonstrated significant benefits, with notable improvements observed as early as 3 months posttreatment, which continued throughout the 12-month follow-up period. Objective assessments revealed reductions in SEr% and SEw%, indicative of reduced skin roughness and wrinkles, particularly pronounced after the third month of treatment. Enhanced skin elasticity, as indicated by improvements in R2%, R5%, and R7%, was observed, with the most significant enhancements noted at the 6-month follow-up. Furthermore, TEWL decreased consistently, highlighting CEFFE's potential in maintaining the skin's barrier function and moisture retention. High patient satisfaction levels, with 70% expressing satisfaction ranging from satisfied to very satisfied, underscored CEFFE's clinical significance. CEFFE demonstrates potential as an effective and safe intervention for addressing periocular fine lines, providing a solution for fine lines while ensuring skin health (ChiCTR1900024329).

Safety and Effectiveness of G-Mesh® Gynecological Meshes Intended for Surgical Treatment of Pelvic Organ Prolapse-A Retrospective Analysis.

Background: The prevalence of POP in women ranges from 30-40%, with 10-20% requiring surgical intervention. Annually, over 225,000 surgical procedures for POP are performed in the United States. The severity of prolapse is assessed using the four-stage POP-Q system, which facilitates clinical research by providing a standardized measure of defect severity. Surgical intervention is indicated for more severe cases, with various techniques available through vaginal or abdominal access. Synthetic meshes, primarily made of polypropylene (PP), are commonly used in POP surgeries due to their biocompatibility and mechanical support. This research aims to evaluate the effectiveness and safety of a non-resorbable, light polypropylene gynecological mesh (G-Mesh®, Tricomed S.A., Łódź, Poland) in the surgical treatment of pelvic floor prolapse in women. Methods: The meshes were implanted via laparoscopy (Dubuisson method) and laparotomy or transvaginally. A multicenter, retrospective study was conducted involving 81 patients aged 28-83. Results: The results collected at three follow-up visits indicated a high level of patient satisfaction, minimal discomfort, and no significant pain. Many patients emphasized significant improvement in quality of life and the lack of any adverse events associated with the presence of the implant. Conclusions: The G-Mesh® gynecological mesh has emerged as an effective and safe intervention for treating pelvic floor dysfunction in women, addressing conditions such as cystocele, rectocele, uterine prolapse, and ureterocele.

Incidence of dysphotopsia following uneventful cataract surgery [phacoemulsification] in patients implanted with different types of monofocal intraocular lenses

Background and objectives: Pseudophakic dysphotopsia is one of the major causes of patient dissatisfaction after cataract surgery. Our aim was to assess the incidence of dysphotopsia after phacoemulsification with implantation of three types of monofocal intraocular lenses. Methods: This prospective clinical study which contained 200 eyes from 195 patients was done at Dr. Aso eye hospital in Sulaimania city between June 2022 to June 2023. Those 200 eyes (participants) were divided into three different groups according to their IOL types were followed-up for 6 months to estimate the incidence and symptoms of dysphotopsia. Results: overall incidence of dysphotopsia was (22%). 34 cases (17%) reported their symptoms in the first three weeks of follow-up. This figure decreased to (4% and 1%) after 3 and 6 months, respectively. The most common phenomenon noted was temporal shadow/darkness; declared by 34.09% of patients who reported dysphotopsia. Optical phenomena occurred more frequently in patients with Acryfold lens group. The great majority of the patients (94.5%) were satisfied with their post-operative visual function. Both, overall incidence of dysphotopsia and its higher rate in the 1st group (Acryfold) were statistically significant values (p= 0.0399 and 0.0418), respectively. Conversely, there was no statistically significant difference between Rayner and Acrysof lenses in terms of dysphotopsia occurrence (p-value= 0.053). Conclusion: Although monofocal intraocular lenses showed significant rates of dysphotopsia, they were still associated with high patient satisfaction level because majority of the symptoms were mild and went away with time.

Anterior Cruciate Ligament Reconstruction in Patients Older Than 50 Years: A Descriptive Study With Minimum 10-Year Follow-up

Background: Anterior cruciate ligament (ACL) reconstruction is increasingly being performed in patients &gt;50 years old; however, the long-term outcomes are unclear. Purpose: To analyze the functional results, osteoarthritic progression, reoperation rate, and failure rate at minimum 10-year follow-up in patients &gt;50 years old who have undergone primary ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: Included in this study were patients &gt;50 years old who underwent primary ACL reconstruction and had at least 10 years of follow-up data. All patients had instability with limitation of their activities, indicating the necessity of surgical intervention. Patients with revision surgeries, ACL repairs, and nonoperative treatment were excluded. Failure was defined as the presence of revision, high-grade Lachman, positive pivot shift (2+), or subjective instability. The Knee injury and Osteoarthritis Outcome Score (KOOS), subjective and objective functional scores, and osteoarthritic progression were analyzed at final follow-up. Results: A total of 38 patients were identified. The mean age at surgery was 56.8 ± 5.7 years (range, 50.6-70 years). The mean clinical follow-up was 16.2 ± 4.3 years (range, 10.9-23.3 years). The failure rate was 10.5% (4/38): 1 of the 4 patients had a recurrence of instability at 13 years postoperatively and underwent revision with a modified Lemaire extra-articular tenodesis, 1 patient had a positive pivot shift (2+) without subjective instability, and 2 patients underwent total knee arthroplasty. The overall KOOS was 74.2 ± 22.2, and 91.4% of patients were satisfied or very satisfied with the results of the procedure. Radiographic osteoarthritis was identified in 88.5% of patients at final follow-up; however, there was no statistical significance on clinical outcomes ( P &gt; .05). Concomitant partial medial meniscectomy ( P &lt; .01) and meniscal repair ( P &lt; .01) were associated with the presence of Ahlbäck grade 3 or 4 osteoarthritic manifestations. Conclusion: In patients over the age of 50 years who underwent primary ACL reconstruction, there was a low long-term failure rate and a high level of patient satisfaction, despite osteoarthritic progression in 88.5% of cases. Concomitant meniscal procedures were associated with more severe osteoarthritic progression.

Streamlining outpatient prepectoral breast reconstruction: The role of polyurethane oxygen-enriched bra cups from pandemic innovation to standardized cost analysis

Background: The COVID-19 pandemic necessitated a reassessment of healthcare delivery, emphasizing on strategies to reduce hospital visits without compromising patient care. In response, plastic surgery units explored innovative approaches to ensure high-quality care and enhanced protection for vulnerable groups, such as oncologic patients undergoing mastectomy and breast reconstruction. This study evaluates the implementation of a polyurethane-polyester bra cup enriched with oxygen to diminish the need for postoperative outpatient visits. Methods: Patients who underwent mastectomy and prepectoral breast reconstruction between February 2020 and March 2021 were selected. A novel postoperative management protocol with a polyurethane-polyester bra cup was adopted, and a cost-benefit analysis evaluated the economic impact of integrating this medical device into postoperative care. Results: The polyurethane-polyester bra cup wound dressing significantly reduced the frequency of outpatient visits, enhancing patient autonomy in postoperative care. Patients reported high satisfaction levels, particularly appreciating the ability to manage the device independently, which contributed to the substantial reduction of hospital accesses. Economic analysis revealed that the devices’ utilized resulted in a notable reduction of 333.5 working hours, translating to a financial saving, ranging between €9990 and €40,020 for nursing and medical staff, respectively. The device cost was established at €20 per unit, demonstrating an effective cost-saving strategy in postoperative care. Conclusions: The adoption of polyurethane-polyester bra cup in postsurgical care for mastectomy patients undergoing implant-based prepectoral breast reconstruction proved to be a strategic measure in reducing hospital visits and maintaining high levels of patient satisfaction.

Chiari Malformation Type I and Syringomyelia: Outcomes of Arachnoid-Preserving Surgical Technique.

BACKGROUND Chiari malformation type 1 occurs when the cerebellar tonsils are pushed into the spinal canal, which can result in syringomyelia. This retrospective study from a single center evaluated outcomes in 89 patients with Chiari malformation type-I (CM-I) and syringomyelia treated with an arachnoid-preserving technique between 2016 and 2023. MATERIAL AND METHODS A retrospective analysis was conducted at a tertiary referral center, involving 88 adult patients and 1 adolescent patient aged 14 to 61 years, with diagnosis by MRI and treated for CM-I with syringomyelia between 2016 and 2023, using the arachnoid-preserving technique. Patients' demographics, clinical presentations, radiological findings, surgical details, and postoperative outcomes were analyzed. Primary outcomes were postoperative complications, while secondary outcomes included neurological improvement (measured by the visual analog scale) and patient satisfaction. RESULTS The study included 89 patients, with 69 female (77.5%) and 20 male (22.5%) patients. A significant reduction in syrinx size was observed in 83.3% of patients, with complete resolution in 16.7%. Mean surgery duration was 90 min, and average hospitalization duration was 2.75 days. All patients experienced significant improvements in neurological symptoms, such as headache, neck pain, numbness, and weakness. High levels of patient satisfaction were reported, with 100% of patients satisfied with their surgical outcomes. The incidence of complications, such as cerebrospinal fluid leakage and arachnoiditis, was notably lower than those by traditional methods. CONCLUSIONS The linear, arachnoid-preserving suboccipital decompression technique offers a safe, effective, and rapid alternative for managing CM-I with syringomyelia, demonstrating a notable reduction in postoperative complications and significant improvements in neurological outcomes.

Lactation Support for Breastfeeding and Chestfeeding People with HIV: A Call for Research to Examine Telelactation Experience, HIV Knowledge, and Lactation Consultants' Attitudes Related to Infant Feeding with HIV.

Clinical guidelines for infant feeding among people with HIV in the U.S. were updated in 2023 to encourage providers to utilize a shared decision-making approach that includes breastfeeding/chestfeeding (B/CF) when appropriate. Despite this historic shift in policy to support B/CF as an infant feeding choice for people living with HIV, birthing people living with HIV who desire B/CF face many barriers, and there is currently a gap in research identifying best practices for facilitating safe and satisfying B/CF in this population. Lactation support specialists have been identified as a positive factor in successful B/CF and a key resource for supporting B/CF for people with HIV. Recent research has shown that telelactation, the provision of care from a qualified lactation consultant or counselor using telehealth, can increase access to quality lactation support in underserved areas and can effectively improve outcomes, such as increased rates of exclusive breastfeeding and decreased early breastfeeding cessation while maintaining high levels of patient satisfaction. Telelactation is an innovative approach to improving access to B/CF among birthing people living with HIV, but little is currently known about what kind of support lactation support specialists and other perinatal HIV care providers may need to meet the clinical and psychosocial needs of B/CF people living with HIV and their infants. More research is needed to identify possible gaps in knowledge and other needs within the lactation support community so that infant feeding specialists are adequately equipped with evidence-based strategies to support the unique needs of parents living with HIV.