Guidelines for emergency laparoscopy

Acute abdominal pain is a leading symptom in many surgical emergency patients. Laparoscopy allows for accurate diagnosis and immediate therapy of many intraabdominal pathologies. The guidelines of the EAES (European Association for Endoscopic Surgery) provides scientifically founded recommendations about the role of laparoscopy in the different situations. Generally, laparoscopy is well suited for the therapy of the majority of diseases that cause acute abdominal pain

Adaptive coping strategies in patients with chronic pain conditions and their interpretation of disease

<p>Abstract</p> <p>Background</p> <p>We examined which adaptive coping strategies, referring to the concept of 'locus of disease control', were of relevance for patients with chronic pain conditions, and how they were interconnected with patients' life satisfaction and interpretation of disease.</p> <p>Methods</p> <p>In a multicenter cross-sectional anonymous survey with the AKU questionnaire, we enrolled 579 patients (mean age 54 ± 14 years) with various chronic pain conditions.</p> <p>Results</p> <p>Disease as an adverse interruption of life was the prevalent interpretation of chronic pain conditions. As a consequence, patients relied on external powerful sources to control their disease (i.e., <it>Trust in Medical Help</it>; <it>Search for Information and Alternative Help</it>), but also on internal powers and virtues (i.e., <it>Conscious Way of Living</it>; <it>Positive Attitudes</it>). In contrast, <it>Trust in Divine Help </it>as an external transcendent source and <it>Reappraisal: Illness as Chance </it>as an internal (cognitive) strategy were valued moderately. Regression analyses indicated that <it>Positive Attitudes </it>and higher age were significant predictors of patients' life satisfaction, but none of the other adaptive coping strategies. While the adaptive coping strategies were not associated with negative interpretations of disease, the cognitive reappraisal attitude was of significant relevance for positive interpretations such as value and challenge.</p> <p>Conclusions</p> <p>The experience of illness may enhance intensity and depth of life, and thus one may explain the association between internal adaptive coping strategies (particularly <it>Reappraisal</it>) and positive interpretations of disease. To restore a sense of self-control over pain (and thus congruence with the situation), and the conviction that one is not necessarily disabled by disease, is a major task in patient care. In the context of health services research, apart from effective pain management, a comprehensive approach is needed which enhances the psycho-spiritual well-being of patients.</p

A systematic review on the effectiveness of implementation strategies to postpone elective caesarean sections to ≥ 39 + (0-6) weeks of gestation

BACKGROUND Caesarean sections often have no urgent indication and are electively planned. Research showed that elective caesarean section should not be performed until 39 + (0-6) weeks of gestation to ensure best neonatal and maternal health if there are no contraindications. This was recommended by various guidelines published in the last two decades. With this systematic review, we are looking for implementation strategies trying to implement these recommendations to reduce elective caesarean section before 39 + (0-6) weeks of gestation. METHODS We performed a systematic literature search in MEDLINE, EMBASE, CENTRAL, and CINAHL on 3rd of March 2021. We included studies that assessed implementation strategies aiming to postpone elective caesarean section to ≥ 39 + (0-6) weeks of gestation. There were no restrictions regarding the type of implementation strategy or reasons for elective caesarean section. Our primary outcome was the rate of elective caesarean sections before 39 + (0-6) weeks of gestation. We used the ROBINS-I Tool for the assessment of risk of bias. We did a narrative analysis of the results. RESULTS We included 10 studies, of which were 2 interrupted time series and 8 before-after studies, covering 205,954 elective caesarean births. All studies included various types of implementation strategies. All implementation strategies showed success in decreasing the rate of elective caesarean sections performed < 39 + (0-6) weeks of gestation. Risk difference differed from - 7 (95% CI - 8; - 7) to - 45 (95% CI - 51; - 31). Three studies reported the rate of neonatal intensive care unit admission and showed little reduction. CONCLUSION This systematic review shows that all presented implementation strategies to reduce elective caesarean section before 39 + (0-6) weeks of gestation are effective. Reduction rates differ widely and it remains unclear which strategy is most successful. Strategies used locally in one hospital seem a little more effective. Included studies are either before-after studies (8) or interrupted time series (2) and the overall quality of the evidence is rather low. However, most of the studies identified specific barriers in the implementation process. For planning an implementation strategy to reduce elective caesarean section before 39 + (0-6) weeks of gestation, it is necessary to consider specific barriers and facilitators and take all obstetric personal into account. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017078231

Механизм осаждения частиц загрязнений в капиллярных каналах

Несмотря на экономическое значение научные вопросы применения в регенерации отработанных моторных масел процесса фильтрации практически не рассматривались [8]. Существующие модели фильтрации основаны на моделировании фильтрующей среды как массива сферических "коллекторов". Взвешенные в фильтрующей среде частицы перемещаются в пространстве между " коллекторами". В нашем исследовании предполагается, что частицы, взвешенные в фильтрующейся среде, перемещаются через многочисленные капилляры, пронизывающие насквозь фильтрующий материал. Рассмотрены силы, действующих на частицу в капилляре, увлекаемую потоком жидкости. Получены уравнения, описывающие траекторию движения частицы. Определены условия осаждения частицы в капилляре. Получены формулы, определяющие эффективность осаждения частиц в капилляре

Relationship between volume and outcome for congenital diaphragmatic hernia: a systematic review protocol

Background: Congenital diaphragmatic hernia is a rare and life-threatening anomaly that occurs during fetal development and results in an incomplete or incorrect formation of the diaphragm. Surgical therapy of the diaphragm should be performed after clinical stabilization of the neonate. Higher hospital or surgeon volume has previously been found to be associated with better clinical outcomes for different especially high-risk, low-volume procedures. Therefore, we aim to examine the relationship between hospital or surgeon volume and outcomes for congenital diaphragmatic hernia. Methods: This systematic review protocol has been designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. We will perform a systematic literature search in MEDLINE, Embase, CINAHL and Biosis Previews without applying any limitations. In addition, we will search for relevant conference abstracts. We will screen titles and abstracts of retrieved studies, obtain potentially relevant full texts, and assess the eligibility of those full texts against our inclusion criteria. We will include comparative studies analyzing the relationship between hospital or surgeon volume and clinical outcomes. We will systematically assess risk of bias of included studies and extract data on the study design, patient characteristics, case-mix adjustments, statistical methods, hospital and surgeon volume, and outcomes into standardized tables. Title and abstract screening, full-text screening, critical appraisal, and data extraction of results will be conducted by two reviewers independently. Other data will be extracted by one reviewer and checked for accuracy by a second one. Any disagreements will be resolved by discussion. We will not perform a meta-analysis as we expect included studies to be clinically and methodologically very diverse. We will synthesize findings from primary studies in a structured narrative way and using GRADE. Discussion: Given the lack of a comprehensive summary of findings on the relationship between hospital or surgeon volume and outcomes for congenital diaphragmatic hernia, this systematic review will put things right. Results can be used to inform decision makers or clinicians and to adapt medical care. Systematic review registration: PROSPERO (CRD42018090231

Interpreting Quality of Life after Brain Injury (QOLIBRI) scores: Cross-walk with the Short Form-36

The Quality of Life after Brain Injury (QOLIBRI) instruments are traumatic brain injury-specific assessments of health-related quality of life (HRQoL), with established validity and reliability. The purpose of the study is to help improve the interpretability of the two QOLIBRI summary scores (the QOLIBRI Total score and the QOLBRI Overall Scale score). An analysis was conducted of 761 patients with traumatic brain injury (TBI) that took part in the QOLIBRI validation studies. A cross-walk between QOLIBRI scores and the SF-36 Mental Component Summary norm-based scoring system was performed using geometric mean regression analysis. The exercise supports a previous suggestion that QOLIBRI Total scores &lt; 60 indicate low or impaired HRQoL, and indicate that the corresponding score on the QOLIBRI-OS is &lt;52. The percentage of cases in the sample that fell into the &lsquo;impaired HRQoL&rsquo; category were 36% for the Mental Component Summary, 38% for the QOLIBRI Total, and 39% for the QOLIBRI-OS. Relationships between the QOLIBRI scales and the Glasgow Outcome Scale &ndash; Extended (GOSE), as a measure of global function, are presented in the form of means and standard deviations that allow comparison with other studies, and data on age and gender are presented for the QOLIBRI-OS. While bearing in mind the potential imprecision of the comparison, the findings provide a framework for evaluating QOLIBRI summary scores in relation to generic HRQoL that improves their interpretability

Correction: Management of bleeding following major trauma: a European guideline

SCOPUS: er.jinfo:eu-repo/semantics/publishe