Underwent Surgical Treatment Research Articles

A Mixed Study on the Health Education Needs of Caregivers for People Living with Epilepsy Undergoing Surgical Treatment and the Effects of a Health Education Program.

This study aims to understand and address the health education needs of family caregivers of people living with epilepsy, irrespective of the patient's age. It seeks to construct and implement a targeted health education program informed by empowerment education theory and evaluate its effectiveness. Through semi-structured interviews, we explored the diverse health education needs of family caregivers of people with epilepsy, identifying key themes and constructing a responsive health education plan. The program's effectiveness was assessed through a quasi-experimental study. The control group received routine health education, while the intervention group participated in an empowerment-based education program in addition to the standard protocol. We evaluated changes in caregivers' disease management capabilities, knowledge about epilepsy, and quality of life at baseline, one month, and three months post-intervention using appropriate statistical analyses to confirm significance. Sixty-five family caregivers participated, with 32 in the intervention group and 33 in the control group. Guided by phenomenological research, four main themes were identified. Significant improvements in disease management, epilepsy knowledge, and quality of life were observed in the intervention group, exceeding those in the control group at both follow-up intervals (p<0.05). An empowerment-based health education program significantly enhances caregivers' competencies across age groups in managing epilepsy, underscoring its effectiveness as an intervention model.

Risk Factors for Postoperative Contralateral Hemorrhage in Patients With Traumatic Brain Injury who Underwent Surgical Treatment: A Multicenter Study.

Patients with a contralateral intracranial hemorrhage after decompressive craniectomy have a worse prognosis than those whose recovery is uneventful. Therefore, the objective of this study was to identify risk factors for postoperative contralateral hemorrhage (PCH) in patients who underwent unilateral craniectomy or craniotomy due to a traumatic brain injury (TBI). Data were obtained from the Korean Neuro-Trauma Data Bank System and retrospectively reviewed. Patients who had a unilateral craniectomy or craniotomy for acute TBI were included in this study. Clinical outcomes of a PCH group and an uneventful group were compared and the risk factors for PCH were identified using regression analysis. A total of 326 patients were included in this study. PCH was observed in 25 (7.7%) patients. The Glasgow coma scale (GCS) and Glasgow outcome scale extended (GOSE) scores at discharge were significantly lower in the PCH group than those in the uneventful group (GCS: 3.6 vs. 6.2, p=0.043; GOSE: 2.1 vs. 3.2, p=0.032). In the multivariable regression analysis, when the time from injury to surgery was shorter than 150 minutes, the risk of PCH was increased by 4.481 times (p=0.005). When the intraoperative transfusion volume was more than 1.5 L, the risk of PCH was increased by 4.843 times (p=0.003). The risk of PCH is increased when the time from injury to surgery is shorter than 150 minutes and when the intraoperative transfusion volume is greater than 1.5 L. Neurosurgeons must predict and be prepared for the development of PCH in high-risk patients.

Aid Methods of Treatment in the Recovery Period of Patients Underwent Surgical Treatment of Cervical Hip Fractures (Literature Review)

The literature review summarizes the scientific information devoted to the study of auxiliary methods used in restorative treatment after surgery for fractures of the femoral neck. The restoration of motor functions in patients with cervical hip fractures is a priority task of the comprehensive restorative treatment program. Despite the achievements in the field of osteosynthesis and endoprosthetics, many patients receive an unfavorable outcome of surgery and a group of disabilities. As a result of an improperly selected program of complex rehabilitation treatment or neglect of auxiliary methods, in most cases, patients gradually develop secondary complications from the damaged segment: the formation of articular contractures, muscle hypo- and atrophy, violation of the walking stereotype, ineffective consolidation, fracture and migration of metal structures with excessive load on the limb, etc., as well as the general somatic condition of the patient worsens: secondary hypostatic complications join and chronic diseases a exacerbated. The purpose of the literature review is to systematize data on the use of auxiliary treatment methods in the recovery period of patients who have undergone surgical treatment of hip fractures and their effectiveness. The article discusses the general characteristics of the applied auxiliary methods of restorative treatment, the timing and scope of their implementation, and also presents the results of individual randomized controlled trials on their effectiveness.

Craniometric Measurements and Surgical Outcomes in Trigonocephaly Patients Who Underwent Surgical Treatment.

ObjectiveThe aim of this study was to discuss the results of craniometric measurements and surgical treatments in patients operated for isolated trigonocephaly (TC) in light of the current literature.MethodsA total of 18 cases who underwent surgery for isolated TC were included in the study. Age, gender, family history, follow-up time, complications, duration of surgery, surgical blood loss, and amount of blood replacement in these patients were recorded. Craniometric measurements such as metopic angle (MA), cephalic index (CI), interparietal distance (IPD), intercoronal distance (ICD), and their ratio to each other were evaluated according to pre-and postoperative parameters. Photographs of the patients were taken before and after the operation. The Whitaker classification and Kampf "aesthetic outcome staging" were used in the evaluations.ResultsThe mean MA values after the operation increased to reach above 147 degrees in all cases. The average CI did not change. ICD measurement averages increased significantly. The average IPD/ICD ratio decreased due to the increase in ICD and the enlargement of the anterior fossa after the operation. According to the Whitaker classification and Kampf “aesthetic outcome staging” scale, 17 of our cases were at stage I, rated as perfect, and one was at stage II, rated as good.ConclusionSurgery performed at the appropriate time for TC yields cosmetically satisfactory results. Since potential neurological and cognitive morbidities occur mostly in school-age patients, long-term follow-up of the cases is required. Performing craniometric measurements enables patients to be evaluated with objective and measurable numerical data.

The Presence of HPV DNA in Neck Lymph Node Metastasis Correlates with Improved Overall Survival of Patients with Oropharyngeal Cancer Undergoing Surgical Treatment

Background: Few studies have addressed how human papilloma virus (HPV) infection in oropharyngeal squamous cell carcinoma (OPSCC) affects the outcome of surgical therapy; furthermore, the relationship between the presence of HPV DNA and neck lymph node (LN) metastasis has not been well established. Methods: A total of 65 patients who underwent surgery as a first-line therapy for OPSCC were enrolled in this study. In HPV-positive patients, the presence of HPV DNA in metastatic neck LN lesions was evaluated. Results: The HPV-positive patients had significantly better overall survival than the HPV-negative patients (log-rank test, p = 0.04), whereas HPV infection status did not significantly affect disease-free survival (log-rank test, p = 0.65). In all of the HPV-positive OPSCC patients who developed cervical LN metastasis, the same HPV DNA type was found in both the primary tumour and the metastases. Conclusions: The present results suggest that HPV infection is a determining factor for good prognosis in patients undergoing first-line surgical therapy for OPSCC.

Prevalence of common comorbidities among urogynaecological patients.

Due to prolonged life expectancy, regardless of the fact that elderly women are more likely to suffer from comorbidities, urogynaecologists worldwide should expect a growing demand for counseling and effective treatment for patients with pelvic floor defects. The aim of the study was to investigate the incidence of popular comorbidities among urogynaecological patients. The retrospective analysis included clinical data of 4,065 consecutive female patients who under-went surgical treatment in the 2nd Department of Gynaecology at the Medical University of Lublin due to urogynaecological disorders between January 2005 and December 2014. Patients were divided into two groups (< 65 years and ≥ 65 years). The vast majority of patients affected by stress urinary incontinence were treated with mid-urethral slings. Most of patients affected by pelvic organ prolapse underwent reconstructive vaginal surgery with reinforcement using anterior and/or pos-terior meshes. Statistical analysis was performed using STATISTICA 10.0 PL (unpaired Student t-test, U Mann Whitney, χ2 test). In both study groups, overweight and obesity were the most common disorders affecting urogynaecological patients (72.6% overall). Furthermore, the elderly patients suffered more often from the most common comorbidities, such as hypertension (p < 0.01), coronary artery disease (p < 0.001) and diabetes mellitus (p < 0.005). Common comorbidities such as overweight and obesity, followed by hypertension and coronary heart diseases, are usual among urogynaecological patients. Changes in lifestyle leading to a decrease in obesity should be considered as an important line treatment when counselling urogynaecological patients.

Pleomorphic larynx adenoma: a case report and literature review

Pleomorphic adenomas are tumors mostly originating from salivary glands. Almost in 90% of cases, it is localized in the parotid salivary gland. These lesions in the larynx are very rare. Currently the literature describes 27 cases. In the article, the authors describe a case of pleomorphic adenoma of the larynx in men 76 years. Underwent surgical treatment. Currently the patient has no recurrence of the disease within 5 years.

Population-Based Estimates of the Prevalence of Uterine Sarcoma Among Patients With Leiomyomata Undergoing Surgical Treatment

Uterine leiomyoma (ULM) is common among women in the United States and is associated with abnormal uterine bleeding as well as pelvic pressure and pain. The annual diagnosis rate for ULM ranges from 2.0 to 12.8 per 1000 reproductive-age women. Standard surgical management for symptomatic patients includes open and laparoscopic hysterectomy, uterine artery embolization, myolysis, and magnetic resonance–guided focused ultrasound. Electric morcellation has been used by surgeons during laparoscopic and robotic-assisted hysterectomies and myomectomies as a less invasive alternative to open surgery. Concern that morcellation may spread occult sarcoma tissue led the US Food and Drug Administration (FDA) in April 2014 to issue a statement discouraging the use of this technique. Based on a literature search, the FDA reported that 1 in 352 women undergoing surgery for presumed benign ULM have occult uterine sarcoma. A study published in July 2014 reported similar results: 1 in 368 women undergoing morcellation had uterine cancer. The estimates in this study, however, were limited by the lack of pathologic confirmation and by the selective participation of hospitals. Moreover, the literature estimates used by the FDA may overestimate risk because of referral and reporting bias. The aim of this study was to determine the population-based estimates of the prevalence of uterine sarcoma and the risks of major complications after open surgery. Surveillance, Epidemiology, and End Results data were used to identify uterine sarcoma cases recorded between 2008 and 2011 from all California registries. Population denominators were obtained by selecting patients from the California State Inpatient Database and the State Ambulatory Surgery Database who underwent hysterectomy or myomectomy between 2008 and 2011. Two estimates were calculated to provide a reasonable range for prevalence of uterine sarcoma. The first was obtained by including patients as the population denominator who received a diagnosis of ULM and who underwent hysterectomy or myomectomy; this overestimates the prevalence of uterine sarcoma. The second included in the denominator all patients who underwent hysterectomy or myomectomy (any diagnosis); this may underestimate prevalence of uterine sarcoma. Data were stratified by race and age. Prevalence estimates for sarcoma were highly dependent on age; the lowest prevalence was found among women younger than 50 years (0.08%–0.13%) and the highest among women older than 60 years (0.36%–1.53%). Using conservative prevalence estimates (0.13%–1.53%), 1 in 769 women younger than 50 years had sarcomas, whereas 1 in 65 women older than 60 years had sarcomas. There was a higher prevalence among white and black women than among women of other races. Stratified by 3 age groups (>50, 50–59, and >59 years), open surgery was associated with in-hospital mortality rates of 0.01%, 0.02%, and 0.33%, and the risks of acute myocardial infarction were 0.32%, 0.26%, and 0.92%, respectively. In summary, stratified analyses show a 10-fold higher prevalence of uterine sarcoma among women older than 60 years than those women younger than 50 years. The risk of uterine cancer with morcellation should be weighed against the possible increased risk of death and major complications following open surgery without morcellation.

Mo1623 A Retrospective Study of 45 Patients Who Underwent Surgical Treatment for Local Recurrence of Rectal Cancer

Mo1623 A Retrospective Study of 45 Patients Who Underwent Surgical Treatment for Local Recurrence of Rectal Cancer

(408) - Results of Jehovah’s Witnesses Undergoing Surgical Treatment of Advanced CHF

(408) - Results of Jehovah’s Witnesses Undergoing Surgical Treatment of Advanced CHF

Population-Based Estimates of the Prevalence of Uterine Sarcoma Among Patients With Leiomyomata Undergoing Surgical Treatment

Population-Based Estimates of the Prevalence of Uterine Sarcoma Among Patients With Leiomyomata Undergoing Surgical Treatment

Study of Biomolecular and Clinical Prognostic Factors in Patients With Cancer of the Vulva Undergoing Surgical Treatment

Cancers of the vulva account for 3% to 5% of all cancers of the female genital. This study was conducted to evaluate clinical, pathological, and molecular prognostic factors in patients with cancer of the vulva. Patients with squamous cell carcinoma of the vulva who had undergone surgical treatment at the Department of Pelvic Surgery and Gynecology Service, Aristides Maltez Hospital, between June 1993 and June 2011 were selected. Clinical, epidemiological, pathological, and molecular characteristics related to the prognosis of these patients were evaluated in relation to the prognosis. In the molecular evaluation, we studied the expression of p53 and matrix metalloproteinase 2 by immunohistochemistry. Seventy-five patients were eligible for the study. In multivariable analysis, factors related to survival were as follows: tumor size larger than 4 cm (P = 0.014), an invasion depth greater than 2 mm (P = 0.023) and matrix metalloproteinase 2 expression in more than 50% of the tumor cells (P = 0.046). With the use of the relative risks of the factors identified in the multivariable analysis, a point count was developed for a prognostic classification (the score classifies patients into 3 categories). A tumor size larger than 4 cm, an invasion depth greater than 2 mm, and metalloproteinase 2 expression in more than 50% of the tumor cells seem to be related to lower overall survival rate in patients with cancer of the vulva undergoing surgical treatment. A classification of the patient's prognosis can be performed using a point count based on these relative risks.

Correction: Retrospective Analysis of Prognostic Factors in 205 Patients with Laryngeal Squamous Cell Carcinoma Who Underwent Surgical Treatment

Correction: Retrospective Analysis of Prognostic Factors in 205 Patients with Laryngeal Squamous Cell Carcinoma Who Underwent Surgical Treatment

Retrospective Analysis of Prognostic Factors in 205 Patients with Laryngeal Squamous Cell Carcinoma Who Underwent Surgical Treatment

ObjectivesTo investigate the most important factors affecting the prognosis of the patients with squamous cell carcinoma (SCC) of the larynx.MethodsBased on the clinical and follow-up data, 205 patients with SCC of the larynx receiving total laryngectomy, partial laryngectomy, or CO2 laser surgery in GuangDong General Hospital were retrospectively analyzed. A survival analysis was performed by the Kaplan-Meier method and a multivariable analysis of prognostic factors was carried out using the Cox proportional hazard model.ResultsSubtypes of carcinoma included 69.8% glottic and 30.2% supraglottic. Most patients were in N0 stage (77.6%), and 22.4% patients were in N1∼N3 stage. Over half of the patients were in T1∼T2 stage (55.1%), 20.0% in T3, and 24.9% in T4. Mean follow-up duration was 49.2 months. The survival rates 1, 2, and 3 years after the surgery were 99.0%, 91.7%, and 81.5%, respectively. The survival rate for those patients with clinical stage IV was significantly lower than for those with clinical stage I and II (p<0.001 and p = 0.013, respectively). The disease-free progression rates 1, 2, and 3 years after the surgery were 83.9%, 74.6%, and 71.2%, respectively. Futhermore, those patients with a Charlson score of 1 to 2 and ≥3 had higher risk of mortality than those with a Charlson score of 0 (hazard ratios of 1.8 and 2.41 p = 0.042 and p = 0.008). Multivariable analysis revealed that clinical stage, surgical margin, and comorbidity were significantly associated with both mortality and disease-free progression.ConclusionThe surgical resection margin, clinical stage, and comorbidity were independent factors affecting the laryngeal cancer prognosis. The survival rates were lower for patients with advanced laryngeal cancer, positive surgical margins, or severe comorbidity, suggesting the importance of early diagnosis, early treatment, negative surgical margins, and conditions of comorbidity.

Chronic, Recurrent, Progressive Osteomyelitis of the Maxilla Caused by Methicillin-Resistant Staphylococcus Epidermidis: A Therapeutic Dilemma

A 28-year-old man was hospitalized more than 15 timesfrom 2005 to 2008 at the Department of Otolaryngology atour institutions because of chronic, recurrent osteomyelitisof the maxilla on the right side. His medical history began in1994 (when he was a healthy 16-year-old boy without anyallergies or medication intake). At that time, a simple dentalprocedure of excision of an epulis located between theupper molar teeth on the right side was performed. Theprocedure was complicated by opening of the maxillarysinus from the oral cavity, which was surgically closed atthat time. Since then, recurrent right-side sinusitis had de-veloped multiple times with several puncture proceduresand empiric antibiotic therapies. In 1995, a Caldwell-Lucprocedure was performed on the right side with bilateralinferior turbinate submucous resection. Histopathologic ex-amination showed a nonspecific chronic inflammation. Af-ter surgery, the patient felt worse and noted an ongoingsensation of pressure around the tooth, swelling of thecheek, purulent discharge from the nose, and recurrentfever. He was hospitalized at the Department of Otolaryn-gologyoftheMedicalUniversityofGdan´sk,Gdan´sk,Poland,from May to August 2001. He was admitted for facial edemaand subfebrile body temperature; the symptoms appeared afew weeks before hospitalization. Computed tomography(CT) scan showed mucous membrane edema in both max-illarysinusesandedemaoftherightcheekandlowereyelid.Bacteriologic investigations of the nose swabs were nega-tive (Table 1). The results of the other laboratory tests wereas follows: white blood cell count, 8,600 L; erythrocytesedimentation rate, 6 mm; and C-reactive protein level, 3.0mg/L. The patient was treated with intravenous empiricantibiotics (600 mg of clindamycin 3 times daily for 14 days,2.0 g of ciprofloxacin 2 times daily for 3 weeks, and 500 mgof metronidazole 3 times daily for 14 days); at the begin-ning, the symptoms ceased, but within the next 2 weeks,the symptoms returned. Bone scintigraphy showed a highmarker concentration in the right maxilla. Next, a CT scanshowed a hypodense, encapsulated lesion inside tissue ofthe thickened cheek and edema of the mucous membraneof the right maxillary sinus (in its lateral-upper recess).Blood tests for perinuclear antineutrophil cytoplasmic anti-bodies (p/ANCA) and cytoplasmic antineutrophil cytoplas-mic antibodies (c/ANCA) were negative. The patient under-went surgical treatment. On the basis of clinical andpathologic findings (inflammatory infiltration), the diagno-sis of zygomatic osteitis was established. The patient re-ceived 20 expositions of hyperbaric oxygen therapy (HBO)(with protocol of a 70-minute time of exposition, 100%oxygen concentration, and 2.5 atmospheric pressure) withgood local outcome. After that treatment, he was healthyfor 4 years with occasional fullness and tenderness in the

A Study Of Patients With Low Back Pain Who Underwent Surgical Treatment

Back pain is known as an important cause of debilitation of the working adult population in all countries, especially industrialized nations. Cigarette smoking and strenuous physical activity are recognized factors involved in the etiology of the back pain syndrome. Identification of risk factors of back pain can assist the physicians in taking preventive measures and rehabilitating patients. This 7-year study deals with some of the risk factors of back pain. This is a seven-year study of 450 patients with back pain who ultimately underwent surgical treatment. Demographic factors such as age, gender, occupation and type of physical activity (including jobs which require strenuous activity, clerical jobs and those which involve long standing hours) were classified and studied. The established diagnoses of patients which had been confirmed by surgical and pathological findings were extracted from their medical records. Data were analyzed using SPSS software. 450 patients were studied. 58.2 of patients were men and 41.8% were women (1.3:1). 40% of patients were aged between 21 and 40 and 36% were aged between 41 and 60 years. Only 24% of patients were over 60 and below 20 years of age. 29.4% of patients were laborers or porters, 8.2% had jobs with long working hours and 25.5% had clerical jobs. In this study the cause of patient referral was intervertebral disc hernia in 53.3% of cases, spinal stenosis in 12.6% of cases, trauma in 11.1% of cases and spinal column in 10% of cases. 76% of patients in this study were aged between 20 and 60 years, most of whom were men, at the height of their physical activity. Given the similarity of findings of this study and those of other studies, it is recommended that the risk of back pain be more precisely identified and that suitable jobs be chosen for different individuals accordingly, in an effort to reduce the incidence of the debilitating complications of back pain.