Size Does Matter: The Role of Patient's Body Surface Predicting Surgical Difficulty in Total Knee Replacement.

Introduction: Total knee replacement (TKR) is a frequently performed surgery with reported very positive outcomes. However, the difficulty of TKR surgery can vary greatly between patients. Many factors have been related to higher surgical difficulty in TKR, but the role of patient anthropometry is still unclear. Although patient Body Mass Index (BMI) is known to affect the postoperative outcome after TKR, it has not proved to be a reliable predictor of surgical difficulty. The aim of this work was to state whether if the patient's overall size, measured with the patient's body surface, had a direct impact on surgical difficulty. Material and methods: We retrospectively reviewed 250 patients who underwent TKR surgery in our center from January 2014 to October2014. The following data were collected from the pre-anesthesia evaluation sheet: age (in years), weight (in kilograms), height (in centimeters),BMI (using the formula weight/height2), body surface (using Dubois' formula [20], x = 0.007184 x weight (kg)0.425 x height (cm)0.725) expressed in m2, and surgical times. Statistical analyses were performed. Results: After the analyses we found there wasn't association between high BMI and higher surgical times. However, there was a direct relation between surgical times and patient body surface values. These findings were statistically significant. Conclusion: In our experience, the patient's body surface is a reliable predictor of surgical difficult

Lapsuuden kiintymyssuhteiden vaikutukset myöhemmin elämässä : Kirjallisuuskatsaus

Tämä on kirjallisuuskatsaus, jossa selvitettiin lapsuuden kiintymyssuhteiden merkityksiä myöhemmin elämässä. Kiintymyssuhde lähtee muodostumaan lapsen ja hoivaajan välille heti syntymästä alkaen vuorovaikutuksen pohjalta. Turvallisessa kiintymyssuhteessa lapsen tarpeisiin ja hätään vastataan johdonmukaisesti ja turvallisesti. Turvattomassa kiintymyssuhteessa ja sen eri muodoissa lapselle ei kyetä luomaan turvallisuuden tunnetta ja hoivaajan vastaaminen lapsen tunteisiin on ristiriitaista. Lapsuuden kiintymyssuhteiden merkitykset myöhemmin elämässä toimi kirjallisuuskatsauksen tutkimuskysymyksenä. Kirjallisuuskatsaukseen valikoitui 16 artikkelia, jotka vastasivat tutkimuskysymykseen ja läpäisivät sisäänottokriteerit. Tutkimuksista luokiteltiin tulokset fyysisiin, psyykkisiin ja sosiaalisiin vaikutuksiin ja turvalliseen ja turvattomaan kiintymyssuhteeseen. Fyysisiä vaikutuksia oli paljon. Useissa tutkimuksissa kävi ilmi turvattoman kiintymyssuhteen vaikutus altistavana tekijänä lapsuusiän lihavuuteen ja fyysisiin sairauksiin. Uniongelmien ja kiintymyssuhteiden välillä yhteyttä ei havaittu. Hermostollisesti eroavia vaikutuksia turvallisessa ja turvattomassa kiintymyssuhteessa ilmeni aikuisuudessa asti. Turvattomassa kiintymyssuhteessa ilmeni enemmän fyysisiä oireita migreenissä sekä lisääntyneitä masennusoireita ja itsemurha-ajatuksia. Sosiaalisista vaikutuksista ainoaksi alaluokaksi valikoituivat sosiaaliset taidot. Turvaton kiintymyssuhde oli selvä riski huonompiin sosiaalisiin taitoihin myöhemmin elämässä. Jatkotutkimusehdotuksena on tarkempi tutkimus kiintymyssuhteiden ja mielenterveyden, lihavuuden tai syömishäiriön välisestä yhteydestä.The thesis was a literature review on the effects of childhood attachment relationships on later life. Attachment between a child and a caretaker begins to form right after the birth. In a secure attachment relationship, the needs of a child are met consistently and in a safe manner. In an insecure attachment relationship, and in its various forms, the needs are responded to in a conflicting fashion, thus generating a feeling of insecurity. With the help of a research question the effects of childhood attachments on later life were examined. A total of sixteen research articles on childhood attachment met the se-lection criteria for the thesis. The themes of the articles were categorized into physical, mental and social effects. Physical effects were abundant. Many studies revealed that insecure attachment led to childhood and adolescence obesity, physical illnesses and other disorders. However, no connection between insecure attachment and sleeping disorders was recognized. The security and insecurity of the attachment were found to be associated with differ-ences in the nervous system in adulthood. Moreover, there was a connection between childhood insecurity and physical symptoms in migraines. Depression and suicide-ideas were the most important mental effects linked with an insecure attachment. Social skills were the only social effect that was reviewed. Insecure attachment appeared to be a risk for poorer social skills. Suggestion for further research could be a study on the connection between attachment and mental health, obesity or eating disorders

Evaluating the impact of filming on the number of errors committed by nursing students to determine the efficacy of simulated clinical situations

Clinic simulation as a training and knowledge method allows people experiment a real event representation with the aim of acquiring knowledge, abilities and aptitudes. The filming of the staging represents a useful tool to review the decisions taken and the actions they did, with the purpose to highlight the strengths, weaknesses and the areas for improvement. The article describes a study carried out by a group of students in second course of nursing, and it tries to evaluate if there is any influence if somebody is filming you during the clinic simulation, does it make you do more errors or not?Peer Reviewe

Functional Discharge Criteria In Total Hip Arthroplasty. What Makes The Difference For Overnight Hospital Stay In Our Center?

Overnight total hip arthroplasty is becoming common in our center. Despite all the patients are under the same protocol, which includes a funcional discharge criteria, not all the patients leave the hospital the day after the surgical procedure. We conducted a study evaluating a group of patients who stayed one night, compared to a matched pair regarding age, body mass index and sex. Group 1 mean age was 61.4 years-old (SD 9.3), Group 2 was 60.8 years-old (SD 9.6); 10 women and 20 men each group, BMI was 28.1 (SD 3.7) and 27.8 (SD 3.6) for Groups 1 and 2 respectively. Patients who stayed only 1 night after THA were found to have higher levels of preoperative hemoglobin, had uncommonly 2 or more major comorbidities, and the operation was predominantly performed by anterior approach

Effect of filming errors committed by nursing students to evaluate simulated clinical situations

Clinic simulation as a training and knowledge method allows people experiment a real event representation with the aim of acquiring knowledge, abilities and aptitudes. The filming of the staging represents a useful tool to review the decisions taken and the actions they did, with the purpose to highlight the strengths, weaknesses and the areas for improvement. The article describes a study carried out by a group of students in second course of nursing, and it tries to evaluate if there is any influence if somebody is filming you during the clinic simulation, does it make you do more errors or not

Excavacions arqueològiques al monestir de Sant Pere de Rodes: primers resultats

Sobre els primers resultats de les excavacions arqueològiques al monestir de Sant Pere de Rode