Bronchogenic cyst excision using a robotic laparoscopic transdiaphragmatic approach

AbstractWe describe one case of a bronchopulmonary foregut malformations (BPFM) excision using robotic technology in a pediatric patient. Traditionally, surgical resection is performed using a thoracotomy or video-assisted thoracic surgery. A 12-year-old girl with a previous medical history of cough was diagnosed with a left cystic paracardiac mass. Her operation employed a transdiaphragmatic approach to remove the mass. The postoperative course was uneventful, and she was discharged after four days. The subsequent pathology concluded that the mass was a bronchogenic cyst. To the best of our knowledge, this is the first report of transdiaphragmatic laparoscopic approach and first use of robotics-platform for BPFM excision by children. We elected to use this type of procedure to decrease the postoperative morbidity associated with the thoracic approach. The robotic technology permitted surgical resection with a similar efficiency as standard thoracic or laparoscopic procedures. We hypothesized that this technology would simplify some of the technical points, decreasing any postoperative complications

Functional evaluation of mandibular reconstruction with bone free flap. A GETTEC study

peer reviewedObjectives: To assess the functional results of oromandibular reconstruction by free bone flap, in terms of swallowing, speech and esthetics. Materials and methods: A transverse multicenter study included 134 patients reconstructed by free bone flap between 1998 and 2016, with more than 6 months’ follow-up, in 9 centers. A standardized questionnaire collected data on patients and treatment. Study endpoints comprised: weight loss, mouth opening, gastrostomy dependence, type of feeding, and DHI score. The impact of patient baseline characteristics on these functional criteria was explored by uni/multivariate analysis. Results: Ninety of the 134 patients had cancer. Fibula flap was mainly used (80%). 94% of reconstructions were primary successes. 71% of patients had pre- or post-operative radiation therapy. 88% had less than 50% lingual resection. 97% recovered oral feeding. 89% had intelligible speech. 86% judged their esthetic appearance as good/average. 9% had dental prosthetic rehabilitation. Radiation therapy and extensive lingual resection significantly impacted swallowing function (P = 0.04 and P = 0.03, respectively). Radiation therapy and oropharyngeal extension significantly increased gastrostomy dependence (P = 0.04 and P = 0.02, respectively). Conclusion: Oromandibular reconstruction by free bone flap enabled return to oral feeding in most cases. More than 80% of patients were satisfied with their result in terms of speech and esthetics. However, the rate of dental rehabilitation was low and the rate of complications was high. © 202

Job burnout: The contribution of emotional stability and emotional self-efficacy beliefs

status: publishe

Job burnout : The contribution of emotional stability and emotional self-efficacy beliefs

Consistent with insights from both trait and social cognitive theories, this study presents a theoretical model positing emotional self-efficacy beliefs in managing negative emotions at work as a key mechanism that contributes to mediate the negative relationship between emotional stability – a trait highly associated with positive affect and mental health – and job burnout. To test this assertion, a two-wave study using a representative sample of 416 new military cadets of an Italian military academy was designed. Military cadets were involved in the study 2 months after their entrance into the academy and then again, a year later. Results from structural equation modelling supported the hypothesized model. As predicted, self-efficacy beliefs in managing negative emotions at work significantly mediated the longitudinal relation between emotional stability and job burnout, even after controlling for the effect of the other Big Five traits, education, previous experience in military contexts, gender, and age. Practical implications and directions for future research are discussed. In conclusion, our study demonstrates that self-efficacy in managing negative emotions at work represents an important mechanism linking emotional stability level to burnout symptoms. Practitioner points: Self-efficacy in managing negative emotions at work proved to be an important resource for workers in managing job-related stress: practitioners interested in reducing burnout symptoms in stressful working environments should take into account this variable. Self-efficacy beliefs in managing negative emotions at work are cognitive structures malleable to change. Literature on social cognitive theory offers several suggestions on how to promote individuals’ positive beliefs on managing negative emotions and dysphoric affect. Hence, findings and literature reported in this study may be useful for practitioners aiming at strengthen workers’ self-efficacy in managing negative emotions at work, through the development and application of coaching and training programmes

Functional evaluation of mandibular reconstruction with bone free flap. A GETTEC study [Évaluation fonctionnelle des reconstructions mandibulaires par lambeaux libres osseux. Une étude GETTEC]

International audienc

Functional evaluation of mandibular reconstruction with bone free flap. A GETTEC study

International audienceObjectives: To assess the functional results of oromandibular reconstruction by free bone flap, in terms of swallowing, speech and esthetics.Materials and methods: A transverse multicenter study included 134 patients reconstructed by free bone flap between 1998 and 2016, with more than 6 months' follow-up, in 9 centers. A standardized questionnaire collected data on patients and treatment. Study endpoints comprised: weight loss, mouth opening, gastrostomy dependence, type of feeding, and DHI score. The impact of patient baseline characteristics on these functional criteria was explored by uni/multivariate analysis.Results: Ninety of the 134 patients had cancer. Fibula flap was mainly used (80%). 94% of reconstructions were primary successes. 71% of patients had pre- or post-operative radiation therapy. 88% had less than 50% lingual resection. 97% recovered oral feeding. 89% had intelligible speech. 86% judged their esthetic appearance as good/average. 9% had dental prosthetic rehabilitation. Radiation therapy and extensive lingual resection significantly impacted swallowing function (P=0.04 and P=0.03, respectively). Radiation therapy and oropharyngeal extension significantly increased gastrostomy dependence (P=0.04 and P=0.02, respectively).Conclusion: Oromandibular reconstruction by free bone flap enabled return to oral feeding in most cases. More than 80% of patients were satisfied with their result in terms of speech and esthetics. However, the rate of dental rehabilitation was low and the rate of complications was high

Évaluation fonctionnelle des reconstructions mandibulaires par lambeaux libres osseux. Une étude GETTEC

peer reviewed[No abstract available