Analysis of the Role of Physicians in the Cessation of Cigarette Smoking Based on Medical Specialization

OBJECTIVE: Physicians do not adequately use their unique professional privilege to prevent patients from smoking. The aim of this study was to investigate the type and extent of advice given to patients by physicians of different medical specialties regarding smoking cessation. METHODS: In total, 317 volunteer physicians were included in this study. The participants rated their attitudes toward the smoking habits of their patients by completing a questionnaire. The approaches used to address the smoking habits of patients significantly differed among physicians working at polyclinics, clinics and emergency service departments (

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Comparison of Pediatric and Adult Tonsillectomies Performed by Thermal Welding System

Objective. To compare pediatric and adult age groups in terms of postoperative bleeding and pain following tonsillectomy performed by thermal welding system (TWS). Method. The study consisted of 213 patients, of whom 178 were children and 35 were adults. The mean age of the pediatric patients (81 girls and 97 females) was 6.7±2.4 years (range 3–13 years) and the mean age of the adults (20 males and 15 females) was 21.8±7.07 years (range 15–41 years). All of the patients were evaluated in terms of postoperative bleeding and pain following tonsillectomy performed by TWS. Results. Bleeding was detected in the late postoperative period in 11 pediatric and 7 adult patients and of them 2 pediatric and 3 adult patients controlled under general. Postoperative bleeding was significantly less prevalent in the pediatric age group compared to the adult age group (P=0.04). Likewise, postoperative pain was significantly less prevalent in the pediatric age group as compared to the adult age group (P<0.001). Conclusion. Both postoperative bleeding and pain following tonsillectomy performed by TWS were more prevalent in the adult age group compared to the pediatric age group

Permanent bilateral sudden sensorineural hearing loss after acute abdominal surgery under general anesthesia

Sudden sensorineural hearing loss can occur after both otolaryngological and non otolaryngological procedures. Sudden sensorineural hearing loss (SNHL) is a well-recognized phenomenon that is attributed to a variety of etiologies. After cardiopulmonary bypass surgery has been well reported. But this report adds to the literature additional case of sudden permanent bilateral SNHL after acute non-otology, non-cardiopulmonary, non-spine surgery. Possible etiologic factors and the management of sensorineural hearing loss following anesthesia are discussed

Concha bullosa surgery and the distribution of human olfactory neuroepithelium

WOS: 000315443000023PubMed ID: 22941439In bullous middle turbinate surgery, controversy exists over which side of the bullous middle turbinate should be removed, as the distribution of human olfactory neuroepithelium is unclear. This study evaluated whether the middle turbinate tissue of patients undergoing endoscopic concha bullosa surgery contains functional olfactory epithelium. This prospective clinical study was conducted in tertiary referable center. It detected 70 conchae bullosa in 48 patients with sinonasal symptoms, who underwent paranasal computed tomography (CT) that showed pneumatization of the middle concha. All samples were obtained under general anesthesia. Three samples were obtained from each bullous middle turbinate: one each from the anterior, medial, and lateral portions. The mucosa from each sample was stained with olfactory marker protein (OMP). In total, 210 middle turbinate samples were taken from 48 patients during endoscopic surgery for conchae bullosa. The patients were 22 females and 26 males. Of the 70 conchae bullosa, OMP-stained nerve tissue was found in the lateral, anterior and medial aspects of 57 (81.4 %), 42 (60.0 %) and 23 (32.8 %) of the bullous middle turbinates, respectively. OMP-stained nerve tissue was found in 122 (58.1 %) of the 210 bullous middle turbinate tissue samples. OMP-stained nerve tissue was found on the lateral surface of the bullous middle turbinate more often than the medial surface. Therefore, during the concha bullosa surgery, OMP-stained nerve tissue found at least in the medial part of concha, suggested that the opening of the medial part of middle concha

Examen de adenovirus con métodos moleculares y patológicos en casos de pneumonía ovina

Objective. Reveal adenoviruses (AdV) that cause pneumonia in sheep and examine pathologic changes in the pulmonary and mediastinal lymph nodes of naturally infected adenovirus-positive specimens. Material and method. For this purpose, 1459 lungs of sheep slaughtered in a slaughterhouse were macroscopically examined, and pneumonia lesions were detected in 88 (6.03%) of these. The paraffinized tissue sections of these specimens with pneumonia were examined with the immunohistochemical (IHC) and indirect immunofluorescence (IF) methods, whereas their tissue homogenates were examined using the Antigen ELISA and PCR methods for adenovirus positivity. Results. Accordingly, the prevalence of adenoviruses was determined as 19.3% for IHC, 22.7% for IF, 20.5% for ELISA and 13.6% for PCR. Hematoxylin-eosin (HE) staining was performed to examine histopathological changes in the specimens that were naturally infected with adenoviruses. The histopathological examinations of the naturally infected lung specimens revealed mainly interstitial pneumonia, as well as catarrhal and verminous pneumonia findings. Consequently, it was determined that the most effective methods in the detection of adenoviruses in sheep pneumonias were found respectively as IF, ELISA, IHC and PCR. The finding that adenoviruses were observed only in the mediastinal lymph nodes of some specimens in the immunopathological methods suggested that the latency. Conclusions. The presence of adenoviruses in sheep pneumonia cases was determined with the indirect immunofluorescence, antigen ELISA and PCR methods for the first time. The possibility of the latent nature of adenovirus infection in these species was also discussed for the first time.Objetivo. Revelar adenovirus (AdV) que causan pneumonía en ovejas y examinar cambios patológicos en los ganglios linfáticos pulmonares y mediastínicos de muestras positivas para adenovirus infectadas de forma natural. Material y métodos. Se examinaron macroscópicamente 1459 pulmones de ovejas y se detectaron lesiones de pneumonía en 88 (6.03%) de estas. Las secciones de tejido parafinadas de estos especímenes con pneumonía se examinaron con los métodos inmunohistoquímicos (IHC) e inmunofluorescencia indirecta (IF), mientras que tejidos homogeneizados se examinaron usando los métodos ELISA de antígeno y PCR para determinar la positividad de adenovirus. Resultados. La prevalencia de adenovirus se determinó como 19.3% para IHC, 22.7% para IF, 20.5% para ELISA y 13.6% para PCR. La tinción con hematoxilina-eosina (HE) se realizó para examinar los cambios histopatológicos en las muestras que estaban infectadas naturalmente con adenovirus. Los exámenes histopatológicos de las muestras de pulmón infectadas de forma natural revelaron mayormente pneumonía intersticial, junto con hallazgos de pneumonía catarral y verminosa. Se determinó que los métodos más eficaces en la detección de adenovirus en pneumonías ovinas fueron encontrado respectivamente como IF, ELISA, IHC y PCR. El hallazgo de que los adenovirus solo se vio en los ganglios linfáticos mediastínicos de algunas muestras en los métodos inmunopatológicos sugirió latencia. Conclusiones. La presencia de adenovirus en casos de pneumonía ovina se determinó por primera vez con los métodos de inmunofluorescencia indirecta, ELISA de antígenos y PCR. La posibilidad de la naturaleza latente de la infección por adenovirus en estas especies también se discutió por primera vez

The prevelance of psichiatric symptoms in preschool children with adenotonsillar hypertrophy

WOS: 000321535300008PubMed ID: 23643332Objectives: The aim of this study was to determine the prevalence of psychiatric disorders and. symptoms in preschool-age children who are indicated for operation due to adenotonsillar hypertrophy. Materials and methods: Forty-eight patients between the ages of three and five years with indication for adenotonsillectomy were included in the study, as well as 40 control patients. Cases underwent routine ear nose throat (ENT) examination, flexible nasopharyngoscopy and tympanometry. The Early Childhood Inventory-4 (ECI-4) parent form and Strengths and Difficulties Questionnaire (SDQ) parent form were completed by the parent caring for the child. The SPSS for Windows 16.0 program was used for statistical analysis. Results: Groups were compared according to they received at least one psychiatric diagnosis measured by ECI-4, the group of adenotonsillar hypertrophy was diagnosed more than the control group. Attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and sleep disorders were detected at a higher rate in patients with adenotonsillar hypertrophy. It also was established that in the comparison of the severity of psychiatric symptoms determined by ECI-4, symptom severity of ADHD, ODD, anxiety disorders, and sleep disorders was higher in the adenotonsillar hypertrophy group than in the control group. In the evaluation of the SDQ parent form, it was determined that attention deficit, hyperactivity, behavioral, and peer relations problems occurred more frequently in the adenotonsillar hypertrophy group. Conclusions: In addition to oral respiration, snoring, and disordered breathing during sleep, adenotonsillar hypertrophy may also associated with psychiatric disorders and symptoms