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Baig Mirza A, Vastani A, Syrris C, Boardman T, Ghani I, Murphy C, Gebreyohanes A, Vergani F, Mirallave-Pescador A, Lavrador JP, Kailaya Vasan A, Grahovac G. Intraoperative Neurophysiological Monitoring for Intradural Extramedullary Spinal Tumours. Global Spine J 2024; 14:1304-1315. [PMID: 36411068 PMCID: PMC11289564 DOI: 10.1177/21925682221139822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES Intraoperative neurophysiological monitoring (IONM) is widely used in spinal neurosurgery, particularly for intramedullary tumours. However, its validity in intradural extramedullary (IDEM) spinal tumours is less clearly defined, this being the focus of this study. METHODS We compared outcomes for patients that underwent resection of IDEM tumours with and without IONM between 2010 and 2020. Primary outcomes were postoperative American Spinal Injury Association (ASIA) scores. Other factors assessed were use of intraoperative ultrasound, drain placement, postoperative complications, postoperative Eastern Cooperative Oncology Group (ECOG) score, extent of resection, length of hospital stay, discharge location and recurrence. RESULTS 163 patients were included, 71 patients in the IONM group and 92 in the non-IONM group. No significant differences were noted in baseline demographics. For preoperative ASIA D patients, 44.0% remained ASIA D and 49.9% improved to ASIA E in the IONM group, compared to 39.7% and 30.2% respectively in the non-IONM group. For preoperative ASIA E patients, 50.3% remained ASIA E and 44.0% deteriorated to ASIA D in the IONM group, compared to 30.2% and 39.7% respectively in the non-IONM group (all other patients deteriorated further). Length of inpatient stay was significantly shorter in the IONM group (P = .043). There were no significant differences in extent of resection, postoperative complications, discharge location or tumour recurrence. CONCLUSIONS Research focusing on the use of IONM in IDEM tumour surgery remains scarce. Our study supports the use of IONM during surgical excision of IDEM tumours.
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Affiliation(s)
- Asfand Baig Mirza
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Amisha Vastani
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Christoforos Syrris
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Timothy Boardman
- GKT School of Medical Education, King’s College London, London, UK
| | - Imran Ghani
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Christopher Murphy
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Axumawi Gebreyohanes
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK
- Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Francesco Vergani
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Ana Mirallave-Pescador
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
- Department of Clinical Neurophysiology, King’s College Hospital NHS Foundation Trust, London, UK
| | - Jose P. Lavrador
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Ahilan Kailaya Vasan
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Gordan Grahovac
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
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Palmer PK, Wehrmeyer K, Florian MP, Raison C, Idler E, Mascaro JS. The prevalence, grouping, and distribution of stressors and their association with anxiety among hospitalized patients. PLoS One 2021; 16:e0260921. [PMID: 34871325 PMCID: PMC8648119 DOI: 10.1371/journal.pone.0260921] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/22/2021] [Indexed: 11/18/2022] Open
Abstract
Anxiety is prevalent among hospital inpatients and it has harmful effects on patient well-being and clinical outcomes. We aimed to characterize the sources of hospital distress and their relationship to anxiety. We conducted a cross-sectional study of inpatients (n = 271) throughout two Southeastern U.S. metropolitan hospitals. Participants completed a survey to identify which of 38 stressors they were experiencing. They also completed the State Trait Anxiety Inventory six-item scale. We evaluated the prevalence of stressors, their distribution, and crude association with anxiety. We then used multivariate logistic regression to estimate the association between stressors and clinically relevant anxiety, with and without adjusting for demographic variables. We used factor analysis to describe the interrelationships among stressors and to examine whether groups of stressors tend to be endorsed together. The following stressors were highly endorsed across all unit types: pain, being unable to sleep, feelings of frustration, being overwhelmed, and fear of the unknown. Stressors relating to isolation/meaninglessness and fear/frustration tend to be endorsed together. Stressors were more frequently endorsed by younger, female, and uninsured or Medicaid-insured patients and being female and uninsured was associated with anxiety in bivariate analysis. After controlling for the sources of distress in multivariate linear analysis, gender and insurance status no longer predicted anxiety. Feelings of isolation, lack of meaning, frustration, fear, or a loss of control were predictive. Study results suggest that multiple stressors are prevalent among hospital inpatients and relatively consistent across hospital unit and disease type. Interventions for anxiety or emotional/spiritual burden may be best targeted to stressors that are frequently endorsed or associated with anxiety, especially among young and female patients.
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Affiliation(s)
- Patricia K. Palmer
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, Georgia, United States of America
- * E-mail:
| | - Kathryn Wehrmeyer
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Marianne P. Florian
- Graduate Division of Religion, Emory University, Atlanta, Georgia, United States of America
| | - Charles Raison
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, Georgia, United States of America
- School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Ellen Idler
- Department of Sociology and Rollins School of Public Health, Emory University; Atlanta, Georgia, United States of America
| | - Jennifer S. Mascaro
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, Georgia, United States of America
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
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Pliakos I, Papavramidis TS. Do surgeons really know how to perform neuromonitoring in thyroid surgery? An awareness study. Gland Surg 2021; 10:201-206. [PMID: 33633976 DOI: 10.21037/gs-20-579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The aim of this questionnaire-based observational study is to examine the awareness of endocrine surgeons regarding the use of intraoperative neuromonitoring (IONM) techniques in thyroid surgeries. Methods A survey project based on a structured questionnaire was conducted during the 14th Spring Meeting of the Greek Society of Endocrine Surgeons (GSES). The questionnaire consisted of 14 items and was handed to all participants-by the key speaker-during the neuromonitoring session. Results In the 14th spring meeting of GSES there were 205 delegates present. Among them there were 35 residents and 6 medical students. The surgeons being potential responders were 119. In the session of IONM, there were 83 eligible surgeons present and the questionnaire was answered voluntarily by 59 of them (71.08%). The responders' group consisted of 26 members of the GSES and 33 non-members. Conclusions Most of the participants believed that there are many benefits in the use of IONM such as anatomically identifying the branches of the laryngeal nerve, monitoring their functionality or offering to patients' greater confidence to the surgery. Attention should be paid not to abandon the conventional techniques for identifying the laryngeal nerve, as IONM may not always be available. Evidence is needed to establish the proper indications for its application.
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Affiliation(s)
- Ioannis Pliakos
- 1 Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodosios S Papavramidis
- 1 Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Zhang Y, Cui C, Wang Y, Wang L. Effects of stigma, hope and social support on quality of life among Chinese patients diagnosed with oral cancer: a cross-sectional study. Health Qual Life Outcomes 2020; 18:112. [PMID: 32345317 PMCID: PMC7189579 DOI: 10.1186/s12955-020-01353-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 04/07/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Improving quality of life (QoL) has been one of the goals of health care for people living with oral cancer. This study aimed to assess QoL and investigate the effects of stigma, hope, and social support on QoL among Chinese oral cancer patients. METHODS A cross-sectional study was conducted at the Department of Stomatology, Shengjing Hospital of China Medical University and Stomatology Hospital of China Medical University in Liaoning Province, China, between May 2016 and October 2017. A total of 230 oral cancer patients were recruited to complete a questionnaire including the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N), the Social Impact Scale (SIS), the Herth Hope Index (HHI) and the Multidimensional Scale of Perceived Social Support (MSPSS). Univariate one-way ANOVA/t-test, Person's r and hierarchical linear regression analysis were conducted to explore the factors influencing QoL and the relationships between stigma, hope, perceived social support and QoL. RESULTS The mean QoL score was 90.85 ± 20.15 among the patients with oral cancer. Stigma was negatively related to QoL, explaining 39.3% of the variance. In addition, hope and perceived social support were positively associated with QoL, explaining 8.1% of the variance. CONCLUSION Overall, Chinese patients with oral cancer suffer from low QoL. Stigma was significantly and negatively associated with QoL, while hope and perceived social support were positively associated with QoL. Oral cancer patients' psychological states should be addressed, and adequate intervention based on positive psychological resources should be provided to improve the QoL of patients with oral cancer.
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Affiliation(s)
- Ying Zhang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, People's Republic of China
| | - Chunying Cui
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, People's Republic of China
| | - Yu Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, People's Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, People's Republic of China.
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Qian K, Feng YG, Zhou JH, Wang RW, Tan QY, Deng B. Anxiety after Sympathectomy in patients with primary palmar hyperhidrosis may prolong the duration of compensatory hyperhidrosis. J Cardiothorac Surg 2018; 13:54. [PMID: 29859106 PMCID: PMC5984730 DOI: 10.1186/s13019-018-0736-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/10/2018] [Indexed: 11/24/2022] Open
Abstract
Background Compensatory hyperhidrosis (CH) is a frequent side effect after sympathectomy for the treatment of primary palmar hyperhidrosis. We determined the effects of demographic and clinical factors which may increase the duration of CH (DCH). Methods One hundred twenty-two patients who had undergone sympathectomies from 2014 to 2016 were retrospectively reviewed. Anxiety was evaluated using the State and Trait Anxiety Inventory score. Follow-up evaluations continued until CH remitted. A Cox proportional hazards model was used to determine the association between DCH and variables. Results DCH ranged from 5 to 27 weeks (median, 11.47 weeks). Severe CH (HR = 0.318, 95% CI, 0.136–0.741) and exacerbated anxiety 1 month post-operatively (HR = 0.816, 95% CI, 0.746–0.893) may prolong CH. A positive correlation between post-operative anxiety and DCH was common in patients with moderate or severe CH, and in cases with forearm CH. Conclusions Pre- and post-operative anxiety should be evaluated, and anti-anxiety treatment is offered to patients with moderate-to-severe CH to shorten the DCH. Electronic supplementary material The online version of this article (10.1186/s13019-018-0736-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kai Qian
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China
| | - Yong-Geng Feng
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China
| | - Jing-Hai Zhou
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China
| | - Ru-Wen Wang
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China
| | - Qun-You Tan
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China.
| | - Bo Deng
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China.
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