Search

Introduction: Surgical fear is common and has a negative impact on surgery and its outcome. Recent research has identified individual religiousness as an important factor among patients with associations to mental health, particularly anxiety. Objective: This study aimed to examine associations between religiousness and surgical fear in a representative sample of adult surgical patients in Croatia. Design: Cross-sectional study among elective surgery patients at different departments of a single hospital. Setting: University Hospital Sveti Duh, a tertiary health care facility in Croatia. Measurements: Religiousness and surgical fear were the variables of interest and assessed through self-report instruments. The Croatian version of the Duke Religiosity Index questionnaire (DUREL) assessed organizational religious activity (ORA), non-organizational religious activity (NORA), and intrinsic religiousness (IR). The Croatian version of the Surgical Fear Questionnaire (SFQ) measured surgical fear and its subscales the fear of the short-term and long-term consequences of surgery. Additionally, sociodemographic characteristics and medical history were assessed. Analyses were carried out using descriptive and linear regression analyses. Results: 178 subjects were included for data analysis. Univariate linear regression found two dimensions of religiousness (non-organizational religious activity, intrinsic religiousness) to be weak, but significant predictors of greater surgical fear (adj. R2 = 0.02 and 0.03 respectively). In the multiple linear regression model together with age, gender, education and type of surgery, all three dimensions of religiousness were found to be significant independent predictors of greater surgical fear. Limitations: The study was single-center and cross-sectional and did not assess patients' specific religious identity. Conclusions: This study demonstrated significant positive associations between dimensions of religiousness and surgical fear, potentially suggesting that surgical patients experience increased religiousness to cope with heightened anxiety. Assessment and intervention to address patient religiousness is warranted in the context of surgical fear among religious patients, and the importance of religiousness in the context of surgical fear needs to be further addressed in research. [ABSTRACT FROM AUTHOR]

Copyright of Lijecnicki Vjesnik is the property of Croatian Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Collegium Antropologicum is the property of Croatian Anthropological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Surgical site infections (SSI) are defined as infections that occur 30 days after surgery. They are among the most common healthcare-associated infections. The aim of our study was to evaluate antimicrobial efficiency of Triclosan coated Polyglactin 910 suture in our patients with colorectal cancer. In our prospective study participants were patients of our surgical departement which underwent colon resection for diagnosed colorectal cancer. For abdominal closure in half of patients Polyglactil 910 coated with triclosan was used and in the other half Polyglactil 910 without triclosan. The occurrence of SSI among groups were observed. Aswell, duration of hospitalization, early postoperative leukocyte and CRP levels were observed. The mean hospitalization period was 11,7±1.2 day in the Triclosan group and 16.4±2.2 in the Non - triclosan group. In both groups lekocyte and CRP levels were similary elevated on 2nd and 5th postoperative day. Higher average leukocyte and CRP levels were found in first group on 7th and 10th postopetaive day. Significantly less SSIs were seen in Triclosan group compared with the Non - triclosan group (10,81% vs 22,2%). SSIs areassociated with longer postoperative hospital stays, may necessitate additional surgical procedures, may require intensive care, and result in higher attributable morbidity and mortality Our study confirmed that patients in which abdominal wall was closed with triclosan coated suture had much better results, less incidence of SSI, shorter hospitalization time and better cost effectiveness. [ABSTRACT FROM AUTHOR]

Colorectal cancer is the most common malignant tumor of the digestive system with an incidence of about 40/100 000. Large bowel resections are extensive and are followed by numerous potential postoperative complications such as SSI (surgical site infection), dehiscence of anastomosis or paralytic ileus. Numerous studies have shown that the patients' nutritional status correlates with the incidence of complications. By introducing the ERAS protocol (enhanced recovery after surgery), the nutritional status of the patient is improved and the risks of complications are reduced. The aim of our study is to examine the importance of using ERAS protocol in patients with colorectal cancer. In a period of 6 months, we included 51 patients from our clinic who went under elective colon resection with ERAS protocol (ERAS group). Incidence of complications and recovery rate were observed. As a control group, we included 57 patients from our clinic that were admitted for elective colon cancer surgery a year prior, but didn't have perioperative nutritional support (non-ERAS group). The ERAS protocol patient group had significantly lower incidence of postoperative complications including SSI (11.75% versus 19.29%), dehiscence of anastomosis (1.9% vs 5.2%) and dehiscence of the abdominal wall (0 vs 3.5%), compared to the patients in the non-ERAS protocol group. They also had shorter hospitalization time (11.7 vs 14.2days). Perioperative nutritional support reduces the risk of complications in patients undergoing colon resection, accelerates recovery and returns the patient to his daily activities sooner, resulting in reduced treatment expenses. [ABSTRACT FROM AUTHOR]

During the hospital stay, patients are exposed to risk factors for nosocomial infections. These risks are particularly increased in patients placed in the ICU, because of their exposure to numerous invasive diagnostic and therapeutic procedures. Some of the most significant risk factors arise from invasive central venous catheters, mechanical ventilators causing pneumonias and urinary catheters causing urinary tract infections. The aim of this study is to determine the frequency of infections related to invasive therapeutic methods and to discover their most frequent causes. Data were obtained retrospectively from the Surgical Department ICU in the Clinical Hospital “Sveti Duh“ from January 1, 2014 until December 31, 2016 using the electronic medical record system. Two thousand and fifty one patient were admitted. These patients were hospitalized for a total of 8,782 days, with an average stay of 3.62 days. Incidence of catheter-associated urinary tract infection was 26. The number of patients who were on mechanical ventilation was 533, while 16 of them developed VAP. The total mortality was calculated to be 7.06%. Hospital infections are good indicators of healthcare and they represent an increasing problem in modern healthcare; they prolong treatment duration and duration of hospital stay. Risk of acquiring nosocomial infections is increased by the number of therapeutic procedures and the duration of their implementation. The most common infection associated with invasive therapeutic procedures was caused by the urinary catheter and the most common isolated bacterium was Acinetobacter baumamnnii. [ABSTRACT FROM AUTHOR]

Endoscopic retrograde cholangiopancreatography (ERCP) is an important technique for treating biliary obstruction. A case report of a 75-year-old male with diagnosed choledocholithiasis and cholangitis was presented. He had a history of hepatic surgery 45 years ago, and during the ERCP, an unusual clinical scenario was encountered. Retained extraction basket during ERCP is a rare but known complication and there are no standard recommendations to manage it. To our knowledge, this is the first case report described in the literature with retention of an extraction basket in surgical sutures at ERCP and the longest period from surgery to stone formation in the biliary system. This case report aims to emphasize that in patients with a history of hepatobiliary surgery, postoperative material can cause complications during ERCP., Competing Interests: The authors declare no conflict of interest., (Copyright 2024, Bogut et al.)

Unlike in children, intussusception is very rare in adults and accounts for only 1% of ileus in that population. While intussusception in children is most often idiopathic, in adults the cause of intussusception in most cases is tumor and most often metastatic adenocarcinoma. It is an extremely rare phenomenon for intestinal melanoma metastasis to be the cause of intussusception and has been described in the literature so far only in a limited number of case reports. 41-year-old female patient was admitted to the emergency department with a clinical picture of ileus. The patient had a melanoma excision on her back five years ago, for which chemotherapy and radiotherapy were carried out. An MSCT of the abdomen was performed, which indicated an obstructive ileus of the small intestine with a typical sign of intussusception (target sign). Upon explorative laparotomy enteroenteric intussusception was found with an invaginated segment of the ileum in a length of about 20 cm. When the intussuscepted segment was reduced, a black tumor the size of a plum was verified as a leading point. Histological analysis indicated metastatic cutaneous melanoma with foci of melanocytes underneath normal intestinal epithelium.

Sacral neuromodulation (SNM) is a safe, efficacious, and minimally invasive advanced therapy that involves electrical stimulation to sacral nerve root to modulate neural pathway. Indications for SNM include symptoms of overactive bladder (OAB), urinary incontinence, urinary retention, urgency and frequency and, regarding bowel dysfunction, fecal incontinence . In Europe and Canada, indication is also established for chronic constipation. The mechanism of action is still not fully elucidated and complete understanding is yet to be determined. It is proposed that SNM modulates neural circuits in both central and peripheral pathways, thus having an impact on the brain, as well as on the bladder-targeting neuronal activity. Another possible significant effect on irregular bladder activity is through inhibition of the bladder afferent pathways by stimulation of the pudendal nerve. Over the past two decades, with more than 300 000 treated patients, SNM has confirmed its efficacy to relieve refractory OAB symptoms, as well as urinary retention or fecal incontinence. First SNM applications in Croatia were uneventful and we are glad to offer our patients this novel therapy in the future., (Sestre Milosrdnice University Hospital.)

The Surgical Fear Questionnaire (SFQ) is an instrument for self-assessment of surgical fear and consists of two subscales, one assessing the fear of short-term consequences (SFQ-s) and another one of long-term consequences (SFQ-l) of surgery. The aim of this study was to test the Croatian version of the SFQ with regard to its psychometric properties. This prospective cohort study included patients who presented to the Department of Surgery for elective surgery in the inpatient setting at a tertiary health care facility in Croatia between April 1 and May 31, 2019. Data on 144 patients were suitable for data analysis. Data collection was performed in the afternoon before surgery using the Personal Information Form, Numerical Rating Scale self-report instruments (NRS), SFQ and Hospital Anxiety and Depression Scale (HADS) assessing sociodemographic factors, surgical fear via NRS and SFQ, expected pain and emotional state. The Cronbach alpha value as a statistical measure for reliability of psychometric tests for the SFQ-s subscale was 0.79, for SFQ-L subscale 0.84, and for total SFQ 0.81. The exploratory factor analysis (EFA) showed a two-factor structure. Significant correlations of the SFQ with the NRS and HADS-anxiety subscale were demonstrated. Our study demonstrated the Croatian version of the SFQ to have a high level of reliability and hence can be used as a self-report instrument for surgical fear with two subscales. Convergent validity of the SFQ with other self-report instruments is shown., (Sestre Milosrdnice University Hospital.)

Introduction: Solitary bone metastasis of colorectal carcinoma (CRC) without other metastasis sites is extremely rare and can be found in less than 1% of patients with CRC., Aim: In the present study, we report the first case of a solitary tibia metastasis and its pathologic fracture as the first presenting feature of a colorectal adenocarcinoma., Material and Methods: A 78-year-old female patient presented to our emergency department due to atraumatic pretibial swelling. Plain radiography did not detect any pathology. The swelling was incised and serous-bloody collection was evacuated, and the patient was discharged. On the 17 th postoperative day, during a regular walk, the patient fell down and broke her leg, which transpired to be a pathologic fracture of the proximal tibial diaphysis, confirmed by X-ray. A biopsy of the altered bone tissue from the fracture site revealed metastatic colorectal adenocarcinoma. On colonoscopy, a circular mass in the upper rectum was found., Conclusions: Solitary bone metastases are most commonly found in bones that are related to venous drainage via the paravertebral plexus of Batson - the pelvis, vertebrae, and sacrum. Long bones are extremely rare localizations of solitary CRC metastases, with only few cases published so far in medical literature. In our case, the patient`s first symptom was related to the osseous tibial metastasis - leg swelling. No tumour was suspected until the pathologic fracture occurred. It is important to consider osseous metastasis in every patient with unexplained swelling, haematoma, or pain of the extremities and make a bone scan to recognize the metastasis early., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Termedia.)