Hypnosis Influence on the Perfusion in Perforator Flaps in Early Postoperative Period: A Series of 18 Cases

Introduction: In practice worldwide, there are experiences affecting different body functions via central control mechanisms with the help of psychotherapy methods. In plastic and reconstructive surgery, there is the experience of applying hypnosis, with the main goal of eliminating pain. The aim of this research is to study the impact of hypnosis on the perfusion level in perforator flaps in the early postoperative period, which could enhance flap survival. Patients and Methods: For studying the impact of hypnosis on blood circulation in perforator flaps, the analysis of a 18 cases has been conducted. All patients had hypnosis sessions on the second day after the reconstruction, and some had additional sessions on the third and fifth days. In the state of trance, the patient was given specially organized instructions aimed at improvement of perforator flap perfusion. Monitoring of microcirculation in the flap during hypnosis sessions was carried out using a Moor VMS-LDF1 Laser Doppler Perfusion and Temperature Monitor. Results: When applying hypnosis, the vast majority of patients had significant increases in perfusion as well as flap surface temperature rise. Most of the patients had significant increases in perfusion during the second part of the hypnosis session in synchrony with hypnosis instruction translation aimed at increasing perfusion. Conclusions: The results of our research cannot be distributed widely in medical practice, but, despite that, they illustrate the central nervous system influence on perforator flap perfusion. Including hypnosis in a medical protocol can contribute to increasing the effectiveness of flap surgery. (Plast Reconstr Surg Glob Open 2019;7:e2491; doi: 10.1097/GOX.0000000000002491; Published online 25 November 2019.

Assessment of appropriateness of hospitalisations in Ukraine: analytical framework, method and fndings

The proposed method is robust in assessing the appropriateness of hospitalisations and duration of inpatient stays. The quantifed levels of unnecessary hospital care indicate the need for improving effciency and quality of care and optimising the excessive hospital capacities in Ukraine

Gastric cancer epidemiology from 2009 to 2019 in Dnipro Region, Ukraine

Background: Gastric cancer (GC) is in top-five the most frequent cancers in Ukrainian males and is the third cause of death among patients with cancer. GC keeps its leading position in cancer ranks despite the decline in incidence and mortality over the last 50 years. Local epidemiological information will help in better targeting medical and public health interventions. Patients and methods: The data about 8438 patients with newly diagnosed GC between 2009 and 2019 was obtained from Dnipro Cancer Registry. Results: Incidence decreased from 24.5 to 22.6, mortality decreased from 21.4 to 15.7 (per 100000), death rate increased from 0.64 to 1.04 between 2009 and 2019. Over 11 years of observation incidence was 23.4, mortality was 19.4, death rate was 0.721. Standardised incidence ratio was 1.42, standardised mortality rate was 1.67; agestandardised incidence was 25.5, age-standardised mortality was 21.2 (European standard). Median (95% confidence interval (95% CI)) survival of the patients was 172 (165− 178) days. One-year survival rate fluctuated between 27% and 34%. Male sex and older age were associated with higher risk of death (hazard ratio (95% CI) – 1.08 (1.03–1.13) vs females and 1.15 (1.12–1.17) per 10-years increase of age, respectively). Conclusions: The study describes the trends in epidemiology of gastric cancer in Dnipro region, Ukraine, between 2009 and 2019. The need for the national prevention strategy of GC in Ukraine was identified

Hypnosis Influence on the Perfusion in Perforator Flaps in Early Postoperative Period: A Seriesof 18 Cases

When applying hypnosis, the vast majority of patients had signifcant increases in perfusion as well as flap surface temperature rise. Most of the patients had signifcant increases in perfusion during the second part of the hypnosis session in synchrony with hypnosis instruction translation aimed at increasing perfusion