Does Premedıcatıon wıth Mıdazolam Reduce Preoperatıve Anxıety Through Menstrular Cycle Phases?

Aim: In this study, it was aimed to investigate and compare the effects of menstrual cycle phases on preoperative anxiety and postoperative pain scores in patients given midazolam for premedication before anesthesia. Methods: Septorhinoplasty, goiter surgery and laparoscopic cholecystectomy 126 female patients, aged 21-45, with American Society of Anesthesiologists (ASA) score I-II and with regular menstrual cycles, were included. Of the cases; The phase of the menstrual cycle was recorded according to the last menstrual period (SAT) and accordingly the patients were divided into 3 groups as Follicular phase, the Ovulatory phase, and the Luteal phase. Anxiety assessment was performed using the State-Trait Anxiety Inventory (STAI FORM TX-1) test. Anxiety scores were evaluated by performing a preoperative test 3 minutes before and 1 hour after intravenous (IV) administration of 0.02 mg/kg midazolam. Visual analog scale (VAS) was used for postoperative pain assessment. Results: Midazolam was found to decrease STAI FORM TX-1 scores the most during the ovulatory phase of the menstrual cycle, but there was no significant difference between the groups in terms of VAS scores. Conclusion: It has been observed that premedication with midazolam reduces preoperative anxiety in all phases of the menstrual cycle in women of reproductive age, but is most effective in the ovulatory phase. The effect of premedication with midazolam on postoperative pain does not change according to the phases of the menstrual cycle.

Taste Dysfunction after Tonsillectomy: A Meta-analysis

Objectives: We aimed to provide information on the effects of tonsillectomy, in particular, its effects on taste dysfunction; also known as dysgeusia, and provide direction for future research in this area. Methods: We independently searched five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database) for related studies published as recently as December 2019. From the included studies, we reviewed the findings on tonsillectomy and taste disturbance through the use of a questionnaire, chemogustometry, and electrogustometry. We analyzed other conditions that were measured in these studies that included; postoperative pain intensity and other morbidities (eg, postoperative bleeding, hemostasis, tongue numbness and zinc, copper, and iron hemoglobin levels measured). Results: Postoperative taste disturbance based on questionnaire (VAS) scores at 14 days (SMD = −0.31 [−0.50, −0.12], P value = .0012) tended to decrease significantly in the post-tonsillectomy group compared to the pre-tonsillectomy group. Patients showed significantly decreased taste sensation after tonsillectomy than in the preoperative test. Postoperative electrogusmetry at 7 days (SMD = 0.60 [0.27, 0.94], P = .0004) tended to increase significantly in the post-tonsillectomy group compared to the pre-tonsillectomy group. Conclusion: Tonsillectomy is a commonly performed surgery, and taste disturbance occurs frequently as a post operative effect. Taste dysfunction is important to patients with regard to their quality of life and the overall effects of taste on their day-to-day life. This study can be a useful meta-analysis of dysgeusia in tonsillectomy.

Protocol for assessing the determinants of preoperative test-ordering behaviour for low-risk surgical procedures using a theoretically driven, qualitative design

IntroductionCurrent evidence suggests that preoperative tests such as chest X-rays, electrocardiograms and baseline laboratory studies may not be useful for healthy patients undergoing low-risk surgical procedures. Routine preoperative testing for healthy patients having low-risk surgery is not a scientifically sound practice. In this study, we will interview healthcare providers working at medical facilities where low-risk surgical procedures are carried out. This will allow us to gain insight into the determinants of preoperative testing behaviours for healthy patients undergoing low-risk surgeries and their barriers and enablers to guideline adherence.Methods and analysisWe will use semistructured interviews with anaesthesiologists, surgeons and preadmission clinic nurses to assess the determinants of preoperative testing behaviours. The interview guide was designed around the Theoretical Domains Framework (TDF), developed specifically to determine the barriers and enablers to implementing evidence-based guidelines. Interviews will be audio-recorded, transcribed verbatim and coded according to the TDF. Key themes will be generated for each of the identified domains.Ethics and disseminationWe have received ethics approval from the Health Research Ethics Board in Newfoundland and Labrador (HREB #2018.190) for this study. The results of this work will be disseminated through a peer-reviewed publication, presentation at a healthcare forum and plain-language infographic summaries. Additionally, deidentified data collected and analysed for this study will be available for review from the corresponding author on reasonable request.

The Role of Ancillary Techniques in Salivary Gland Cytopathology Specimens

Salivary gland tumor aspiration cytology is a useful preoperative test to guide the most appropriate clinical and surgical management for these patients. Although salivary gland cytology is often useful to distinguish between non-neoplastic lesions, benign neoplasms and malignant neoplasms, there remain many challenges in this area. Specifically, these tumors are uncommon and may have considerable morphologic overlap, especially in the setting of a malignant tumor. This article reviews some of the immunohistochemical and molecular characteristics of more common salivary gland neoplasms that pathologists and cytotechnologists may encounter. When used in combination with morphologic features, such ancillary testing can be useful to further refine the differential diagnosis, more strongly favor a particular entity, or in some instances confidently provide a specific diagnosis.

GLOBAL BALANCE IN ADULT SPINAL DEFORMITIES. A STUDY OF 60 CASES

ABSTRACT Objectives: Determine the most prevalent type of curve in our population, to quantify the radiographic parameters such as PT, IP, SS and compare the physical function according to ODI and SRS-22r. Methods: Retrospective, observational, longitudinal, single-center study, carried out from January 2010 to May 2015 at the Centro Médico ISSEMYM Ecatepec, Spine Surgery Service. Results: A total of 60 patients were obtained, 60% female, with curvatures according to SRS-Schwab, type T (28%), TL (46.6%), D (15%), N (10%), with a mean preoperative VAS of 7 for all curves and post-surgical 2 after 6 months. The SRS-22r preoperative test was 2.1 and postoperatively was 3.75, with p<0.001. Conclusions: Deformities of the adult spine are a growing disease in our country. The surgical management of deformities requires proper clinical and radiographic planning. Patients undergoing surgical treatment in our study showed curvature type TL and demonstrated significant improvement in ODI and SRS-22r.