Search

Simple Summary: This study emphasizes the crucial role of effective communication to improve patients' understanding and satisfaction during biopsy procedures. It highlights the importance of managing patient anxiety and fear, which can directly impact pain experiences. The study also identifies areas where real-time pain management can be enhanced and underscores the need for clear and accurate patient education to address concerns after the procedure. Background/Objectives: This study evaluates the effectiveness of communication strategies and pain management protocols to enhance patients' experiences during sarcoma core biopsies. Recognizing the complexity and anxiety associated with sarcoma diagnoses, this research aims to assess the utility of the Invasive Procedure Assessment (IPA) tool, focusing on its ability to identify areas for improvement through Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs). Methods: Conducted at two Integrated Practice Units (IPUs) within the Swiss Sarcoma Network, this study involved 282 consecutive patients who underwent core biopsies. One week post-procedure, patients completed the IPA questionnaire, which included PROMs and PREMs. Statistical analyses explored correlations between physician communication, patient understanding, anxiety, pain, and overall satisfaction. Results: The IPA tool effectively captured patient perspectives on sarcoma core biopsies. A significant positive correlation (rho = 0.619, p < 0.0001) was found between effective physician communication and patient understanding, which was associated with reduced anxiety and pain. Higher anxiety levels strongly correlated with increased pain perception (rho = 0.653, p < 0.0001), emphasizing the need for anxiety management. Patients with malignant tumors reported lower overall satisfaction compared to those with benign tumors (p = 0.0003), highlighting the need for tailored communication and pain management strategies. The data also suggested that clear communication might mitigate overly negative subjective impressions, such as concerns about wound complications. Conclusions: Effective communication and anxiety management are essential for improving patient satisfaction during sarcoma core biopsies. The study emphasizes the need for personalized care strategies tailored to tumor characteristics and patient demographics. Future research should validate these findings in diverse healthcare settings and explore the broader application of the IPA tool across different cultural and demographic contexts. [ABSTRACT FROM AUTHOR]

Background: In recent years, Raoultella spp. have attracted clinical attention as a new type of pathogen. The most common of human infection with Raoultella are bacteremia, urinary tract infections, abdominal infections, etc. Abdominal infection is a serious and complex infection problem. However, there have been no systematic reports of abdominal infections caused by Raoultella. The objective of this study was to explore the clinical characteristics of Raoultella abdominal infections and provide a reference for clinical practice. Methods: A review of publications on abdominal infections caused by the genus Raoultella between 2009 and 2024 is carried out. This review studied seven parameters: infection type, number of cases, gender, age, comorbidities, treatment, and outcome, and descriptive statistical methods were used to analyze the results. Results: A total of 40 cases (16 Raoultella ornithinolytica and 24 Raoultella planticola) were analyzed: 20 cases of biliary tract infection, 5 cases of liver infection, and 4 cases of peritonitis. Fever and abdominal pain were the main symptoms, and some patients present with multiple skin flushes, systemic erythema. Of the 40 cases, 92.5% of patients had underlying diseases. Among them, malignant disease, immunodeficiency, and invasive operations increase the risk of infection. On the basis of the drug susceptibility results, the preferred antibiotics are quinolone, third generations of cephalosporins, carbapenems, and aminoglycoside. Last, patients with abdominal infections caused by Raoultella spp. mostly have a good prognosis after early use of sensitive antibiotics. Conclusions: According to existing literature reports, the main type of abdominal infection caused by Raoultella is biliary tract infection, and most patients have other underlying diseases. Malignancy, immune deficiency, and invasive procedures are risk factors for bacterial infections. This review also emphasizes that Raoultella spp. is a rarely found opportunistic pathogen, which can cause a high incidence of healthcare-associated infections after invasive procedures. [ABSTRACT FROM AUTHOR]

Objective: To determine the individual learning curves for cordocentesis in a low‐cost simulator for maternal‐fetal medicine (MFM) fellows. Methods: This observational, descriptive, educational, and prospective study was performed from July through November 2022. After an introductory course based on a standardized technique for cordocentesis, each second‐year MFM fellow who accepted to participate in the study performed this procedure using a low‐cost simulation model, and experienced operators supervised the cordocenteses. Learning curves were then created using cumulative sum analysis (CUSUM). Results: Seven second‐year MFM fellows with no previous experience in cordocentesis accepted to participate in the study. A total of 2676 procedures were assessed. On average, residents performed 382 ± 70 procedures. The mean number of procedures to achieve proficiency was 369 ± 70, the overall success rate was 84.16%, and the corresponding failure rate was 15.84%. At the end of the study, all fellows were considered competent in cordocentesis. One fellow required 466 attempts to achieve competency, performing a total of 478 procedures, but the resident with the fewest attempts to reach competency required 219 procedures, completing 232 procedures. Some of the most frequent reasons for failed attempts included not reaching the indicated point for vascular access (20.99%) and being unable to retrieve the sample (69.10%). Conclusion: CUSUM analysis to assess learning curves, in addition to using low‐cost simulation models, helped to appraise individualized learning, allowing an objective demonstration of competency for cordocentesis among MFM fellows. Synopsis: Using a low‐cost simulation model, cumulative sum analysis was used to determine individual learning curves for cordocentesis among maternal‐fetal medicine fellows. [ABSTRACT FROM AUTHOR]

Gusgus Ghraha Ramdhanie,1,&ast; Altia Nurrohmah,2,&ast; Adelse Prima Mulya,3,&ast; Henny Suzana Mediani,1,&ast; Nina Sumarni,3,&ast; Aep Maulid Mulyana,4,&ast; Mega Hasanul Huda5,&ast; 1Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 2Undergraduate Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 3Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 4Internship Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 5Department of Pediatric Nursing, Faculty of Nursing Science, Universitas Indonesia, Depok, West Java, 16424, Indonesia&ast;These authors contributed equally to this workCorrespondence: Gusgus Ghraha Ramdhanie, Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia, Tel +62 813-2397-3679, Email gusgus.ghraha.ramdhanie@unpad.ac.idBackground: Invasive procedures in children can lead to painful and uncooperative procedures. It is essential to determine the appropriate method to create a comfortable environment for children during invasive procedures. However, audiovisuals are one of the distraction techniques used in pain management.Purpose: This study aims to identify and categorize related audiovisual distraction techniques in reducing pain due to invasive procedures among children.Methods: This study uses a systematic scoping review. A literature review was conducted using PubMed, EBSCO, Science Direct, Scopus and grey literature through Google Scholar. The study was eligible for inclusion if it included articles published from 2012 to 2022, full-text and open accessed articles, and in Indonesian and English language. Studies were excluded if they were review studies and the adult population. The keywords in English were ”Children” OR ‘Child’ OR ”Kids” OR ‘Youth’ OR ‘Adolescents’ OR ‘Teenager’ OR ‘Teens’ OR ‘Young People’ OR ‘Pediatric’ OR ‘Paediatric’ OR ‘Childhood’ AND ”Audiovisual” OR ‘Movie’ OR ‘Video’ OR ‘Animation’ AND ”Pain” AND ”Invasive procedures” and keyword in Indonesia were ”Anak” OR ‘Remaja’ OR ‘Bayi’ OR ‘Balita’ AND ”Audiovisual” OR ‘Film’ OR ”Video” OR ‘Animasi’ OR “Nyeri” AND ‘Prosedur invasif’.Results: We found 15 articles showing audiovisual distraction techniques in managing pain among children undergoing invasive procedures. Three types of audiovisual interventions were used, including virtual reality (VR), video music, and animated cartoons. In addition, types of invasive procedures that benefited from the analyzed interventions were infusion, surgery, injection, blood draw, dressing change, circumcision, endoscopy, and phlebotomy.Conclusion: Our findings highlight that virtual reality, video music, and animated cartoons have clinical implications in helping to distract from pain in children undergoing invasive procedures. Our study indicates that the potential of audiovisual intervention can be used as an intervention strategy in the pediatric nursing area.Keywords: audiovisual, child, invasive procedures, pain

Aims and Objectives: (I) To identify the opinion and practices of nursing professionals regarding the presence of family members during invasive procedures in hospitalised children; (II) to determine the knowledge of nursing professionals about the patient‐and family‐centred care model. Background: Family presence in invasive procedures benefits the patient and their relatives, but varied attitudes exist among healthcare personnel, with some being favourable and others unfavourable toward family presence. Design: Observational, descriptive, cross‐sectional study. Methods: Study population: Nurses from paediatric critical care services, emergency services, hospital wards, day hospitals and outpatient clinics at a Catalan tertiary hospital who participated voluntarily between September 2021 and July 2022. Data collection instrument: A questionnaire prepared by the researchers, based on the literature and reviewed by experts. REDCap link with access to the questionnaire was sent out to potential respondents through the institutional email. Bivariate analysis was performed with the R 4.2 program. The study was approved by the hospital's Clinical Research Committee and participants gave informed consent before responding to the questionnaire. Results: A total of 172 nurses participated, and 155 valid responses were obtained. All respondents consider the family as a key element in paediatric care and report inviting family members to participate in the care given to their child. However, 12.0% of nurses do not invite the family to be present in invasive procedures. Almost all respondents note the need for training to acquire communication skills and improve the management of emotions. Conclusions: The results show a favourable opinion towards the presence of family members and highlight the need to train nurses to develop communication skills. Relevance to clinical practice: The data provided can favour the design of measures to improve and promote the presence of parents during invasive procedures, reinforcing the patient‐and family‐centred care model and improving the quality of care provided. One example is the creation of family care protocols where the inclusion of parents and the roles of each individual involved in the care process appears. [ABSTRACT FROM AUTHOR]

Copyright of Notfall & Rettungsmedizin is the property of Springer Nature 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.)

Summary: Introduction: This study investigates the impact of invasive procedures on healthcare-associated infections (HAI) at Policlinico Universitario Tor Vergata in Rome, Italy, aiming to understand their role in device-associated HAI and to inform prevention strategies. Methods: A retrospective cohort analysis was conducted, examining mandatory discharge records and microbiology data from 2018 across all departments. The study focused on adult patients, analysing the correlation between invasive procedures and HAI through univariate and multivariate logistic regression. Results: Of the 12,066 patients reviewed, 1,214 (10.1%) experienced HAI. Univariate analysis indicated an association between invasive procedures and HAI (OR = 1.81, P < 0.001), which was not observed in multivariable analysis. Specific procedures significantly raised HAI risks: temporary tracheostomy (AOR = 22.69, P

Background: Sepsis contributes significantly to newborn deaths in Nigeria. A significant proportion of severe infections in the newborn may be health care-related. Objective: To determine the prevalence, types and risk factors for nosocomial infections in the Special Care Baby Unit of a Nigerian Tertiary Hospital. Method: A cross-sectional survey of consecutively admitted infants aged 0 to 28 days with signs of infections or who developed signs of infection following admission. Infants with or without nosocomial infections were compared for the clinical and laboratory details. Results: Out of 356 infants, 32 (8.9%) had between 1 and 3 nosocomial infections while 48 (13.5%) had community-acquired infections. Half of babies with nosocomial infections were preterm and weighed less than 2kg. A significantly higher proportion of babies with nosocomial infections were inborn (p < 0.000) and stayed longer than 7 days on admission (p = 0.034). Bacteraemia was significantly more frequent among babies with nosocomial infections (p = 0.014) while superficial skin and mucosal infections occurred to similar extents in both groups. Klebsiella and Proteus species were the leading isolates among babies with osocomial infections. Nasogastric intubation was significantly more frequently performed among babies with nosocomial infections (p = 0.045). Conclusion: The present study revealed that hospital acquired infection is an important cause of morbidity in the newborn unit.

This study examines the limits of professional practice in the field of comprehensive esthetics and related areas in Ecuador. A mixed methodological approach was used, including document analysis, practitioner surveys and expert interviews. The central objective was to identify and examine discrepancies between existing regulation and actual practice, along with their implications for patient health and safety. The findings revealed confusion in terminology, diversity in professional training, and lack of regulatory awareness. In addition, it was observed that non-medical professionals perform invasive procedures, despite being prohibited by Ecuadorian law. In conclusion, it is necessary to review and strengthen regulation, as well as improve professional training, to ensure safe and ethical practice in the field of comprehensive esthetics in Ecuador. The health of patients should be the main priority, and this will only be achieved through strict compliance with regulations and the promotion of quality education. [ABSTRACT FROM AUTHOR]

The application of augmented reality in training health science students is increasingly widespread. The aim of this work was to assess the usability and user expectations of an augmented reality application for smart glasses (Microsoft HoloLens) that can be used to train on four invasive procedures (i.e. intramuscular injection, nasogastric tube insertion, endotracheal intubation and suctioning via tracheostomy tube). A descriptive study was conducted with nursing students from three Spanish universities. Participants answered a questionnaire to assess the use of the ARSim2care application. This application offers the possibility of visualizing the internal anatomical structures during the training of the clinical technical skills for the performance of the mentioned invasive techniques. The questionnaire included demographic data, the System Usability Scale and questions about the user expectations in relation to learning with the use of augmented reality. In total, 61 participants responded to the questionnaire after using the ARSim2care application. The mean score of the System Usability Scale was 73.15 (standard deviation: 15.04) and 62.4% (n = 38) of the participants considered their experience with the application as excellent or good. In relation to user expectations, more than 90% of students indicated that the use of the application could improve their motivation and stimulation in learning, their content retention and their anatomical understanding. The developed ARSim2care application for Microsoft HoloLens showed a high level of usability and acceptance as a learning tool for training certain clinical procedures by visualizing the internal structures of the body. [ABSTRACT FROM AUTHOR]

Prophylactic treatment with emicizumab has become an important and effective bleeding prevention for people with hemophilia A (PwHA). Perioperative management of PwHA using emicizumab prophylaxis is still challenging due to a lack of experience. Medical records of perioperative management and outcomes were reviewed, and data were collected for adult PwHA receiving emicizumab and undergoing surgical procedures between August 2019 and July 2022 at the University Medical Center Ljubljana. Twelve surgical procedures were performed in eight PwHA (one with FVIII inhibitors) while on emicizumab prophylaxis. Three minor procedures included cataract surgery, cystoscopic lithotripsy, and percutaneous coronary intervention. Nine major surgeries included four osteosyntheses, necrectomy of chronic osteomyelitis with new ankle arthrodesis, two below-knee amputations, total knee replacement, and placement of ventriculostomy after a spontaneous intraventricular hemorrhage. No major bleeds, thrombotic events or deaths, or new inhibitors appeared. Our real-world experience demonstrates that minor and major surgeries can be performed safely in PwHA on emicizumab prophylaxis. Additional data are needed to optimize dosing/duration of additional hemostatic agents in diverse invasive procedures and complex clinical situations.

The global population has been gradually aging over the past few decades, with a growing proportion of people aged 65 years or older. Simultaneously, the medical profession has shifted towards promoting the concept of “positive” gerontology, emphasizing healthy aging. In this context, we investigated the trends in pathological specimen submissions from patients aged 85 or older over ten years at a single center. We observed a nearly two-fold increase in submissions during 2015–2019 compared to 2010–2014, out of proportion to the change in the fraction of older adults in the population, suggesting a changing attitude towards medical care in these older patients. Dermatologic samples were the main driver of growth, followed by gastrointestinal and urinary tract samples. However, other samples, like breast and lung, did not significantly increase. Although further research is needed to understand the implications of increasing invasive procedures in the oldest old, a noteworthy trend has emerged towards increased and more active healthcare for this population. Healthcare providers and administrators should be prepared for a continued rise in invasive interventions in this age group.

Prophylactic treatment with emicizumab has become an important and effective bleeding prevention for people with hemophilia A (PwHA). Perioperative management of PwHA using emicizumab prophylaxis is still challenging due to a lack of experience. Medical records of perioperative management and outcomes were reviewed, and data were collected for adult PwHA receiving emicizumab and undergoing surgical procedures between August 2019 and July 2022 at the University Medical Center Ljubljana. Twelve surgical procedures were performed in eight PwHA (one with FVIII inhibitors) while on emicizumab prophylaxis. Three minor procedures included cataract surgery, cystoscopic lithotripsy, and percutaneous coronary intervention. Nine major surgeries included four osteosyntheses, necrectomy of chronic osteomyelitis with new ankle arthrodesis, two below-knee amputations, total knee replacement, and placement of ventriculostomy after a spontaneous intraventricular hemorrhage. No major bleeds, thrombotic events or deaths, or new inhibitors appeared. Our real-world experience demonstrates that minor and major surgeries can be performed safely in PwHA on emicizumab prophylaxis. Additional data are needed to optimize dosing/duration of additional hemostatic agents in diverse invasive procedures and complex clinical situations. [ABSTRACT FROM AUTHOR]

Invasive procedures are associated with adverse events that are both hazardous to patients and expensive to treat. A trainee is expected to perform complex sterile invasive procedures in a dynamic environment under time pressure while maintaining patient safety at the highest standard of care. For mastery in performing an invasive procedure, the automatism of the technical aspects is required, as well as the ability to adapt to patient conditions, anatomic variability, and environmental stressors. Virtual reality (VR) simulation training is an immersive technology with immense potential for medical training, potentially enhancing clinical proficiency and improving patient safety. Virtual reality can project near-realistic environments onto a head-mounted display, allowing users to simulate and interact with various scenarios. Virtual reality has been used extensively for task training in various healthcare-related disciplines and other fields, such as the military. These scenarios often incorporate haptic feedback for the simulation of physical touch and audio and visual stimuli. In this manuscript, the authors have presented a historical review, the current status, and the potential application of VR simulation training for invasive procedures. They specifically explore a VR training module for central venous access as a prototype for invasive procedure training to describe the advantages and limitations of this evolving technology. [ABSTRACT FROM AUTHOR]

The global population has been gradually aging over the past few decades, with a growing proportion of people aged 65 years or older. Simultaneously, the medical profession has shifted towards promoting the concept of "positive" gerontology, emphasizing healthy aging. In this context, we investigated the trends in pathological specimen submissions from patients aged 85 or older over ten years at a single center. We observed a nearly two-fold increase in submissions during 2015–2019 compared to 2010–2014, out of proportion to the change in the fraction of older adults in the population, suggesting a changing attitude towards medical care in these older patients. Dermatologic samples were the main driver of growth, followed by gastrointestinal and urinary tract samples. However, other samples, like breast and lung, did not significantly increase. Although further research is needed to understand the implications of increasing invasive procedures in the oldest old, a noteworthy trend has emerged towards increased and more active healthcare for this population. Healthcare providers and administrators should be prepared for a continued rise in invasive interventions in this age group. [ABSTRACT FROM AUTHOR]

Abstract Background Family Presence During Invasive Procedures (FPDI) generates controversy among healthcare professionals. Twibell and her team designed an instrument that measured nurses’ Risk-Benefit and Self-Confidence perceptions regarding family presence during resuscitation and was used in numerous studies. Objectives Evaluate the new tool for Family Presence Risk-Benefit and Family Presence Self-Confidence during invasive procedures and find out the opinions of the medical and nursing staff on FPDIP. Method Cross-sectional methodological pilot study. Online and paper questionnaires modified from a previous translation. A factor analysis was performed for the validity of the indices and bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards. Results One hundred twenty healthcare professionals (22.18%) answered the survey. Cronbach’s α on the Family Presence Risk-Benefit scale was 0.877. Cronbach’s α on the Family Presence Self-Confidence scale was 0.937. The correlation between the Risk-Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship. A lower predisposition to Family Presence During Invasive Procedures is observed. Physicians are more reluctant than nurses. Conclusions The FPDI generates controversy as it alters health professionals’ routines when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly physicians, do not favor FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favor of FPDI. The psychometric properties and internal consistency of the questionnaire indicate the validity and reliability of this tool.

Simple Summary: Current acute pain assessment protocols in domestic animals require the use of a suite of methods to evaluate the multidimensional components of pain. Thermal imaging is a method that assesses the physiological response, via heat production, to a noxious stimulus. This may correlate with the affective experience of acute pain. Since the use of the method as a pain assessment tool is still in its relative infancy and has yet to be fully evaluated empirically, the present review brings together current knowledge on the use of infrared thermography to evaluate acute pain in animals. We also propose future directions in this area of research. Pain assessment in domestic animals has gained importance in recent years due to the recognition of the physiological, behavioral, and endocrine consequences of acute pain on animal production, welfare, and animal model validity. Current approaches to identifying acute pain mainly rely on behavioral-based scales, quantifying pain-related biomarkers, and the use of devices monitoring sympathetic activity. Infrared thermography is an alternative that could be used to correlate the changes in the superficial temperature with other tools and thus be an additional or alternate acute pain assessment marker. Moreover, its non-invasiveness and the objective nature of its readout make it potentially very valuable. However, at the current time, it is not in widespread use as an assessment strategy. The present review discusses scientific evidence for infrared thermography as a tool to evaluate pain, limiting its use to monitor acute pain in pathological processes and invasive procedures, as well as its use for perioperative monitoring in domestic animals. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura 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 Notfall & Rettungsmedizin is the property of Springer Nature 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.)

Background: COVID-19 has changed medical practice nowadays. One of the biggest concerns has been establishing when invasive procedures such as surgery, GI endoscopy or bone marrow transplant are safe; and if it is necessary to consider screening for asymptomatic patients.Methods: We identified asymptomatic patients that were scheduled for invasive procedures from May 2020 to April 2021 at Clínica de Marly. Patients were asked to fill a questionnaire about GI and upper respiratory symptoms and contact with possible/confirmed cases of COVID- 19 in the last 15 days. Patients taken to emer-gency procedures, who had symptoms or contact with probable/confirmed cases in the last 15 days were excluded. rt-PCR was performed to screen COVID-19.Results: A total of 1837 patients were included. 104 rt-PCRs tested positive for SARS-CoV-2, leading to a 5.66% of identified asymptomatic patients. Patients were followed-up on the 30th day after the procedure. 1733 negative patients responded to our follow-up, in which only 1 death and 2 complications were detected. 102 positive patients were followed-up and no complications or deaths were reported.Conclusions: We found the presence of 5.66% of asymptomatic patients with positive rt-PCR for COVID-19. Safe screening will decide if these invasive interventions can be postponed, or, if the benefit outweighs the risks.

It is unknown whether invasive procedures are associated with brain abscess. Nationwide, population-based, matched case–control study of patients with culture verified brain abscess in Denmark from 1989 to 2016. Exposure was invasive procedures 0–6 months before study inclusion. We identified 435 patients and 3909 controls. The level of comorbidity was higher among patients with brain abscess than among controls. A total of 48 cases (11%) had one or more invasive procedures 0–6 months before study inclusion (adjusted odds ratios (aOR) of 3.6 (95% confidence interval (CI): 2.5–5.1), a population attributable fractions of 8% (95% CI: 7–9)). In primary care, ear, nose and throat (ENT) procedures were associated with brain abscess (aOR of 4.0 (95% CI: 2.0–8.0)), but gastrointestinal endoscopies were not (aOR of 1.0 (95% CI: 0.3–3.2)). No bronchoscopies were performed in primary care. In the hospital-based setting, ENT procedures, bronchoscopies and gastrointestinal endoscopies were associated with an increased risk of brain abscess (aOR of 14.5 (95% CI: 4.8–43.8), 20.3 (95% CI: 3.8–110.1) and 3.4 (95% CI: 2.0–5.6), respectively). The association between invasive procedures and brain abscess was more pronounced in the hospital-based setting than in primary care. [ABSTRACT FROM AUTHOR]

Introduction: Nuclear examination of the heart plays a crucial role in the diagnosis of ischemic coronary artery disease, serves to predict the prognosis, assess the viability of the myocardium and the eff ectiveness of pharmacotherapy. The sensitivity of this test is constantly improving due to advances in health technology, new software, and radiopharmaceuticals. The purpose of this article is to demonstrate that nuclear cardiac studies are appropriate and valuable in determining myocardial ischemia and viability. Material and methods: A cohort of 207 patients was studied. Of these, 56 were women and the majority (151) were men. The age range was very wide from 28 to 92 years. All patients underwent examinations and tests in a cardiology practice. A total of 117 patients were sent for nuclear cardiac imaging and were free of ischemia. The results of the study show that cardiac nuclear imaging is appropriate and valuable in determining myocardial ischemia and viability. Conclusion: It is recommended that cardiologists be guided by the physiological manifestation and not by the anatomical substrate of the disease. [ABSTRACT FROM AUTHOR]

Background: Family Presence During Invasive Procedures (FPDI) generates controversy among healthcare professionals. Twibell and her team designed an instrument that measured nurses’ Risk-Benefit and Self-Confidence perceptions regarding family presence during resuscitation and was used in numerous studies. Objectives: Evaluate the new tool for Family Presence Risk-Benefit and Family Presence Self-Confidence during invasive procedures and find out the opinions of the medical and nursing staff on FPDIP. Method: Cross-sectional methodological pilot study. Online and paper questionnaires modified from a previous translation. A factor analysis was performed for the validity of the indices and bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards. Results: One hundred twenty healthcare professionals (22.18%) answered the survey. Cronbach’s α on the Family Presence Risk-Benefit scale was 0.877. Cronbach’s α on the Family Presence Self-Confidence scale was 0.937. The correlation between the Risk-Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship. A lower predisposition to Family Presence During Invasive Procedures is observed. Physicians are more reluctant than nurses. Conclusions: The FPDI generates controversy as it alters health professionals’ routines when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly physicians, do not favor FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favor of FPDI. The psychometric properties and internal consistency of the questionnaire indicate the validity and reliability of this tool. [ABSTRACT FROM AUTHOR]

Background: Despite numerous promising innovations, the chance of survival from sudden cardiac arrest has remained virtually unchanged for decades. Recently, technological advances have been made, user-friendly portable devices have been developed, and advanced invasive procedures have been described that could improve this unsatisfactory situation. Methods: A selective literature search in the core databases with a focus on randomized controlled trials and guidelines. Results: Technical aids, such as feedback systems or automated mechanical cardiopulmonary resuscitation (CPR) devices, can improve chest compression quality. The latter, as well as extracorporeal CPR, might serve as a bridge to treatment (with extracorporeal CPR even as a bridge to recovery). Sonography may be used to improve thoracic compressions on the one hand and to rule out potentially reversible causes of cardiac arrest on the other. Resuscitative endovascular balloon occlusion of the aorta might enhance myocardial and cerebral perfusion. Minithoracostomy, pericardiocentesis, or clamshell thoracotomy might resolve reversible causes of cardiac arrest. Conclusions: It is crucial to identify those patients who may benefit from an advanced or invasive procedure and make the decision to implement the intervention in a timely manner. As with all infrequently performed procedures, sound education and regular training are paramount. [ABSTRACT FROM AUTHOR]

Predicting factors of diagnostic yield in electromagnetic navigation bronchoscopy (ENB) have been explored in a number of previous studies based on data from experienced operators. However, little is known about predicting factors when the procedure is carried out by operators in the beginning of their learning curve. We here aim to identify the role of operators' experience as well as lesion– and procedure characteristics on diagnostic yield of ENB procedures in the hands of novice ENB operators. Four operators from three centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or non-diagnostic and predicting factors of diagnostic yield were assessed. A total of 215 procedures were assessed. A total of 122 (57%) of the ENB procedures resulted in diagnostic biopsies. Diagnostic ENB procedures were associated with a minor yet significant difference in tumor size compared to non-diagnostic/inconclusive ENB procedures (28 mm vs. 24 mm; p = 0.03). Diagnostic ENB procedures were associated with visible lesions at either fluoroscopy (p = 0.003) or radial endobronchial ultrasound (rEBUS), (p = 0.001). In the logistic regression model, lesion visibility on fluoroscopy, but none of operator experience, the presence of a bronchus sign, lesion size, or location nor visibility on rEBUS significantly impacted the diagnostic yield. In novice ENB operators, lesion visibility on fluoroscopy was the only factor found to increase the chance of obtaining a diagnostic sample. [ABSTRACT FROM AUTHOR]

Play is an indispensable part of growing up and by using play to distract children while undergoing invasive procedures can have a positive impact. Play can help children to cope with painful procedures and long-term treatment. The aim of the review was to evaluate the evidence concerning the effect of play on anxiety among children undergoing invasive procedures. This is a systematic review and meta-analysis. Data sources: PubMed, The MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Clinical Key, Cochrane Library, and Google Scholar were searched between 2012 and 2020. Review methods: randomized controlled trials (RCTs) that evaluated the effectiveness of play on anxiety among children undergoing invasive procedures were included. Meta-analysis was done using Revman v5.3 software. A total of 451 participants from 5 trials were involved in the systemic review and meta-analysis. Self-reported anxiety, parents reported anxiety, and self-reported pain were found significant in intervention [χ2 = 7.57, df = 2 at P < 0.02]. When compared with control group, the review result revealed that experimental group reduced the anxiety and pain (P < 0.05). [ABSTRACT FROM AUTHOR]

Copyright of Notfall & Rettungsmedizin is the property of Springer Nature 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.)

Background: Hemophilia A is caused by coagulation factor VIII (FVIII) deficiency and increases bleeding risk during invasive procedures., Objectives: To investigate FVIII concentrate use and bleeding outcomes for invasive procedures after valoctocogene roxaparvovec gene transfer., Design: This manuscript presents post hoc analysis of the phase III GENEr8-1 trial., Methods: A post hoc analysis was performed for GENEr8-1, a global, single-arm, open-label, phase III trial that enrolled 134 adults with severe hemophilia A. FVIII activity and bleeding were evaluated after 2 years of follow-up. Invasive procedures were reviewed and categorized as major or minor. FVIII activity was measured with a chromogenic assay. Bleeding was self-reported by participants. Principal investigators completed questionnaires about perioperative management., Results: In total, 111 invasive procedures were performed in 65 participants during GENEr8-1 as of the data cut. Procedures performed with FVIII treatment included 33 minor and 11 major procedures. The remaining 67 invasive procedures were minor and performed without FVIII treatment. When considering these 67 minor procedures, 43/46 investigators completing the questionnaires reported that the gene-therapy-derived FVIII activity was sufficient for the type of procedure. Minor procedures performed without FVIII treatment were associated with participants' higher mean endogenous FVIII activity (50.5 IU/dL) compared with major procedures (14.2 IU/dL) or minor procedures (16.4 IU/dL) performed with concomitant FVIII. Fourteen participants experienced 18 procedure-related bleeds (13 co-occurring with FVIII use). Participants who received FVIII treatment for procedure-related bleeds had numerically lower mean endogenous FVIII activity than those who did not receive FVIII treatment., Conclusion: Invasive procedures were safely performed in participants following treatment with valoctocogene roxaparvovec. The questionnaire responses from investigators generally suggest they used endogenous FVIII activity derived from valoctocogene roxaparvovec to inform clinical decisions in a manner comparable to exogenously administered FVIII, and more commonly prescribed supplementary FVIII concentrate in the peri-procedural period for participants with lower FVIII activity levels., Competing Interests: D.V.Q. has received payments from Bayer, BioMarin Pharmaceutical Inc., Novo Nordisk, Octapharma, Roche/Genentech, and Sanofi; served as a principal investigator for BioMarin Pharmaceutical Inc., Bioverativ/Sanofi, Roche/Genentech, Shire/Takeda, and uniQure; and received honoraria from BioMarin Pharmaceutical Inc., CSL Behring, Novo Nordisk, Roche/Genentech, Sanofi, and Takeda. D.P. has received fees from BioMarin Pharmaceutical Inc. and Sanofi. Y.S.P. has received research support from or participated as a principal investigator for BioMarin Pharmaceutical Inc., Chugai, CSL Behring, Novo Nordisk, Pfizer, Sanofi, and Takeda. G.K. has received grants and payments from Alnylam, Bayer, BioMarin Pharmaceutical Inc., Bio Products Laboratory, CSL, Novo Nordisk, OPKO Biologics, Pfizer, Roche, Sanofi, Takeda, and uniQure. J.M. has received payment and funding from BioMarin Pharmaceutical Inc., Catalyst Biosciences, Chugai, CSL Behring, Novo Nordisk, LFB, Roche, Shire, Spark, and Sobi. J.W. has served as a principal investigator for BioMarin Pharmaceutical Inc., Chugai, Novo Nordisk, Pfizer, and Sanofi; and received honoraria from Bayer, Chugai, Novo Nordisk, Pfizer, Sanofi, and Takeda. M.W. has received honoraria from BioMarin Pharmaceutical Inc., Bioverativ/Sanofi, CSL Behring, Genentech/Roche, HEMA Biologics, Novo Nordisk, and Takeda. S.W.P. has received payment from ApcinteX, ASC Therapeutics, Bayer, BioMarin Pharmaceutical Inc., CSL Behring, Freeline, HEMA Biologics, LFB, Novo Nordisk, Pfizer, Roche/Genentech, Sanofi, Spark Therapeutics, Takeda, and uniQure; and served as a clinical trial investigator for BioMarin Pharmaceutical Inc., Freeline, Genentech/Roche, Sanofi, and uniQure. T.K. has received honoraria from Roche/Genentech, Novo Nordisk, Sanofi, and BioMarin Pharmaceutical Inc. T.M.R. is a former employee and potential shareholder of BioMarin Pharmaceutical Inc. K.C. is an employee and shareholder of BioMarin Pharmaceutical Inc., (© The Author(s), 2024.)

Objective To compare the clinical efficacy between robot‐assisted minimally invasive transforaminal lumbar interbody fusion (robot‐assisted MIS‐TLIF) and traditional open TLIF surgery in the treatment of lumbar spondylolisthesis. Methods According to the inclusion and exclusion criteria, 48 cases with lumbar spondylolisthesis who received surgical treatment from June 2016 to December 2017 in the spinal surgery department of Beijing Jishuitan Hospital were analyzed in this study, including 23 patients who received robot‐assisted MIS‐TLIF and 25 patients who received traditional open TLIF surgery. The two groups were compared in terms of pedicle screw accuracy evaluated by Gertzbein‐Robbins classification on postoperative computed tomography (CT), operation time, blood loss, postoperative drainage, hospitalization, time to independent ambulation, low back pain evaluated by visual analog scale (VAS), lumbar function evaluated by Oswestry Disability Index (ODI), paraspinal muscles atrophy on magnetic resonance imaging (MRI), and complications. Results Postoperative CT showed that the rate of Grade A screws in the robot‐assisted MIS‐TLIF group was significantly more than that in the open surgery group (χ2 = 4.698, P = 0.025). Compared with the open surgery group, the robot‐assisted MIS‐TLIF group had significantly less intraoperative blood loss, less postoperative drainage, shorter hospitalization, shorter time to independent ambulation, and lower VAS at 3 days post‐operation (P

Pain assessment in domestic animals has gained importance in recent years due to the recognition of the physiological, behavioral, and endocrine consequences of acute pain on animal production, welfare, and animal model validity. Current approaches to identifying acute pain mainly rely on behavioral-based scales, quantifying pain-related biomarkers, and the use of devices monitoring sympathetic activity. Infrared thermography is an alternative that could be used to correlate the changes in the superficial temperature with other tools and thus be an additional or alternate acute pain assessment marker. Moreover, its non-invasiveness and the objective nature of its readout make it potentially very valuable. However, at the current time, it is not in widespread use as an assessment strategy. The present review discusses scientific evidence for infrared thermography as a tool to evaluate pain, limiting its use to monitor acute pain in pathological processes and invasive procedures, as well as its use for perioperative monitoring in domestic animals.

New treatment possibilities and modalities are now available globally for patients with haemophilia requiring surgery or invasive procedures. The first is the appropriate application of low‐dose protocols of clotting factor concentrates (CFC) achieving adequate perioperative haemostasis in resources constraint environments. The increasing availability of CFC through humanitarian aid programs allows more invasive surgeries to be performed for which efficacy and safety data should be more widely collected and reported. Second, extended half‐life CFC that are increasingly available in many countries represent valuable alternatives to standard half‐life products in surgical patients allowing reduced number of infusions and lower consumption, in particular for extended half‐life factor IX. Third, in the era of recently introduced nonfactor prophylaxis, some minor surgical procedures can now be performed without additional haemostatic treatment, others with few low‐dose administrations of CFC or bypassing agents. Additional factor VIII/IX or recombinant activated factor VII has proven to be safe and effective in association with emicizumab for major surgeries and it was effectively given at low doses in association with fitusiran (including activated prothrombin complex concentrate). No thrombotic complications have been reported in the surgical setting so far. A multidisciplinary team/facility remains crucial to manage major surgery in patients on prophylaxis with these new agents. [ABSTRACT FROM AUTHOR]

Objectives An epidemiological investigation was conducted into a hepatitis C virus (HCV) outbreak at an outpatients clinic in Seoul (2011–2012). The aim of the study was to analyze the scale of infection, identify the source of infection, and route of transmission to prevent hepatitis C transmission in the future. Methods A retrospective study of the outpatients and health care workers (n = 7,285) in the target outpatient clinic during 2011–2012 was conducted. The history of the study population infection with hepatitis C, electronic medical records, field visits, and health care worker interviews were examined for the period between March 1st, 2006 and March 25th, 2016. The blood samples were collected and tested for anti-HCV antibodies, HCV RNA and HCV gene in 2016. Results The rate of anti-HCV positive results was 4.4% in the study population. The risk factors associated with an anti-HCV positive result were ≥ 10 clinic visits, and receiving an invasive procedure including a nerve block and a block of the peripheral branch of the spinal nerve (p < 0.05). There were 112 HCV RNA positive cases out of 320 anti-HCV positive test result cases, amongst which 100 cases had the dominant HCV genotype 2a which formed either 1 cluster (n = 56) or 2 clusters (n = 25). This result indicated exposure to a high-association infection source. Conclusion Anti-HCV antibodies and genotypic analysis showed an epidemiological association between the outbreak of HCV and invasive procedures performed (2011–2012) at an outpatients clinic in Seoul.

Samuel H Sigal,1 Zachary Sherman,2 Arun Jesudian2 1Department of Medicine, Montefiore Medical Center, Bronx, NY, USA; 2Department of Medicine, Weill Cornell Medical Center, New York, NY, USACorrespondence: Samuel H SigalMontefiore Medical Center, Bronx, NY 10467 Tel +1 718 920-6240Fax +1917 398-8466Email ssigal@montefiore.orgAbstract: Thrombocytopenia is a frequent complication in patients with cirrhosis. As many as 84% of patients with cirrhosis have thrombocytopenia, and it is an independent variable indicative of advanced disease and poor prognosis. Although there is great concern that it may aggravate bleeding during surgical procedures, there is limited evidence to inform decisions regarding the treatment of cirrhotic patients with thrombocytopenia undergoing invasive procedures. Finally, there is evidence that platelets play a significant role in liver regeneration. In this report, the clinical implications of thrombocytopenia in cirrhotic patients are reviewed. The utility of platelet counts in the prognosis of cirrhosis and relationship to complications of advanced liver disease, including portal hypertension, esophageal varices, and hepatocellular carcinoma. The impact of low platelet counts on bleeding complications during invasive procedures is outlined. Finally, the role of platelets and potential adverse impact in liver regeneration is reviewed.Keywords: thrombocytopenia, prognosis, invasive procedures, liver regeneration

Background: Excessive noise in intensive care units poses a significant challenge, impacting both patients and staff by elevating stress, disrupting recovery, and impeding effective communication among healthcare professionals. Despite the World Health Organization recommending noise levels below 35 dB, alarms in these units often surpass these limits, contributing to consistently high noise levels., Objectives: The aim of this study is to explore intensive care unit patients' experiences with music therapy sessions during invasive procedures., Methods: This study was conducted using a qualitative hermeneutic phenomenological methodology grounded in Heideggerian philosophy. Interventions were conducted with a music therapist, and 14 in-depth interviews were collected. Reflexive inductive thematic analysis was performed., Results/findings: From the thematic analysis extracted from the 14 personal interviews, three themes were described that represent the bulk of the experiences and emotions of the study participants following the completion of the music therapy sessions. The most noteworthy results are described in the following, organised according to each theme: (i) music therapy against noise, sounds, and light; (ii) music therapy in the face of invasive tests and techniques; and (iii) music therapy as a strategy and tool., Conclusions: Music therapy has significant potential to enhance the quality of life for patients in the intensive care unit. Music therapy can promote relaxation, reduce stress and anxiety, alleviate pain and discomfort, and improve emotional and physical wellbeing during patients' stay and invasive procedures., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Introduction: This study investigates the impact of invasive procedures on healthcare-associated infections (HAI) at Policlinico Universitario Tor Vergata in Rome, Italy, aiming to understand their role in device-associated HAI and to inform prevention strategies., Methods: A retrospective cohort analysis was conducted, examining mandatory discharge records and microbiology data from 2018 across all departments. The study focused on adult patients, analysing the correlation between invasive procedures and HAI through univariate and multivariate logistic regression., Results: Of the 12,066 patients reviewed, 1,214 (10.1%) experienced HAI. Univariate analysis indicated an association between invasive procedures and HAI (OR = 1.81, P < 0.001), which was not observed in multivariable analysis. Specific procedures significantly raised HAI risks: temporary tracheostomy (AOR = 22.69, P <0.001), central venous pressure monitoring (AOR = 6.74, P <0.001) prolonged invasive mechanical ventilation (AOR = 4.44, P <0.001), and venous catheterisation (AOR = 1.58, P <0.05). Aggregated high-risk procedures had an increased likelihood of HAI in multivariable analysis (OR = 2.51, P < 0.001). High-risk departments were also notably associated with HAI (OR = 6.13, P < 0.001)., Conclusions: This study suggests that specific invasive procedures, such as temporary tracheostomy, significantly increase HAI risks. The results highlighting the need for targeted infection prevention and control procedures and supports the need for innovative methods such as record-linkage in policymaking to address HAI. These findings inform clinical practice and healthcare policy to improve patient safety and care quality., (© 2024 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.)

Background: The impact of palliative care consultation on the management and outcomes of patients hospitalized with out-of-hospital cardiac arrest (OHCA) remains poorly understood. This study examined associations between palliative care consultation and in-hospital outcomes of patients hospitalized with OHCA, stratified by survival status., Method: This cross-sectional study used data from the National Inpatient Sample (2016-2021). Adult patients hospitalized with OHCA who received cardiopulmonary resuscitation were included. Multivariable analyses assessed associations between palliative care consultation and outcomes in non-terminal and terminal OHCA hospitalizations, adjusting for demographics, hospital characteristics, and comorbidities., Results: Among 488,700 OHCA hospitalizations, palliative care consultation was associated with lower odds of invasive procedures in non-terminal hospitalizations, including percutaneous coronary intervention (PCI) (aOR 0.30, 95 % CI 0.25-0.36), mechanical circulatory support (aOR 0.54, 95 % CI 0.44-0.68), permanent pacemaker (aOR 0.27, 95 % CI 0.20-0.37), implantable cardioverter defibrillator insertion (aOR 0.22, 95 % CI 0.16-0.31), and cardioversion (aOR 0.62, 95 % CI 0.55-0.70). In terminal hospitalizations, palliative care was associated with lower odds of PCI (aOR 0.78, 95 % CI 0.70-0.87) and cardioversion (aOR 0.91, 95 % CI 0.85-0.97), but higher odds of therapeutic hypothermia (aOR 3.12, 95 % CI 2.72-3.59), gastrostomy (aOR 1.22, 95 % CI 1.05-1.41), and renal replacement therapy (aOR 1.19, 95 % CI 1.12-1.26). Palliative care was associated with higher DNR utilization in both subgroups and lower hospital costs in non-terminal hospitalizations but higher costs in terminal hospitalizations., Conclusion: Palliative care consultation in OHCA is associated with differences in invasive procedures, DNR utilization, and hospital costs, varying by survival status., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Breakthrough technologies in the neonatal intensive care unit (NICU) revolutionized neonates’ quality of care. Mother scented simulated hand (MSSH) is an ergonomically designed supportive hand that uses the power of touch to simulate the feeling of being held and cuddled. This study aimed to determine the effect of MSSH on promoting comfort among mechanically ventilated preterm neonates during invasive procedures. Methods: A quasi-experimental, pre-posttest two groups study was carried out in NICU in Smouha, Alexandria. A sample of 62 mechanically ventilated neonates was randomly assigned to two equal groups; the study group wrapped with a warm MSSH during the invasive procedures while the control group received standard care of NICU. Two observers independently rated the neonates’ level of comfort, distress, and pain during endotracheal suctioning (ETS) and heel prick using COMFORTneo scale. Results: It is revealed that the mechanically ventilated neonates had a significantly higher comfort level with MSSH than the standard care during and after both ETS and heal break (p < 0.001 for each). The neonates had significantly lower distress and pain scores when encircled by MSSH during invasive procedures than standard care (p < 0.001 for NRS distress and p < 0.001 for NRS distress). Conclusion: Wrapping the preterm neonates with a warm MSSH promotes comfort and reduces their pain and distress during invasive procedures, especially when their mothers are not physically available.

Predicting factors of diagnostic yield in electromagnetic navigation bronchoscopy (ENB) have been explored in a number of previous studies based on data from experienced operators. However, little is known about predicting factors when the procedure is carried out by operators in the beginning of their learning curve. We here aim to identify the role of operators’ experience as well as lesion– and procedure characteristics on diagnostic yield of ENB procedures in the hands of novice ENB operators. Four operators from three centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or non-diagnostic and predicting factors of diagnostic yield were assessed. A total of 215 procedures were assessed. A total of 122 (57%) of the ENB procedures resulted in diagnostic biopsies. Diagnostic ENB procedures were associated with a minor yet significant difference in tumor size compared to non-diagnostic/inconclusive ENB procedures (28 mm vs. 24 mm; p = 0.03). Diagnostic ENB procedures were associated with visible lesions at either fluoroscopy (p = 0.003) or radial endobronchial ultrasound (rEBUS), (p = 0.001). In the logistic regression model, lesion visibility on fluoroscopy, but none of operator experience, the presence of a bronchus sign, lesion size, or location nor visibility on rEBUS significantly impacted the diagnostic yield. In novice ENB operators, lesion visibility on fluoroscopy was the only factor found to increase the chance of obtaining a diagnostic sample.

Objective: To compare the clinical efficacy between robot‐assisted minimally invasive transforaminal lumbar interbody fusion (robot‐assisted MIS‐TLIF) and traditional open TLIF surgery in the treatment of lumbar spondylolisthesis. Methods: According to the inclusion and exclusion criteria, 48 cases with lumbar spondylolisthesis who received surgical treatment from June 2016 to December 2017 in the spinal surgery department of Beijing Jishuitan Hospital were analyzed in this study, including 23 patients who received robot‐assisted MIS‐TLIF and 25 patients who received traditional open TLIF surgery. The two groups were compared in terms of pedicle screw accuracy evaluated by Gertzbein‐Robbins classification on postoperative computed tomography (CT), operation time, blood loss, postoperative drainage, hospitalization, time to independent ambulation, low back pain evaluated by visual analog scale (VAS), lumbar function evaluated by Oswestry Disability Index (ODI), paraspinal muscles atrophy on magnetic resonance imaging (MRI), and complications. Results: Postoperative CT showed that the rate of Grade A screws in the robot‐assisted MIS‐TLIF group was significantly more than that in the open surgery group (χ2 = 4.698, P = 0.025). Compared with the open surgery group, the robot‐assisted MIS‐TLIF group had significantly less intraoperative blood loss, less postoperative drainage, shorter hospitalization, shorter time to independent ambulation, and lower VAS at 3 days post‐operation (P < 0.05). However, the duration of surgery was longer. The VAS of the robot‐assisted MIS‐TLIF group decreased from 6.9 ± 1.8 at pre‐operation to 2.1 ± 0.8 at post‐operation, 1.8 ± 0.7 at 6‐month follow‐up and 1.6 ± 0.5 at 2‐year follow‐up. The VAS of the open surgery group decreased from 6.5 ± 1.7 at pre‐operation to 3.7 ± 2.1 at post‐operation, 2.1 ± 0.6 at 6‐month follow‐up and 1.9 ± 0.5 at 2‐year follow‐up. The ODI of the robot‐assisted MIS‐TLIF group decreased from 57.8% ± 8.9% at pre‐operation to 18.6% ± 4.7% at post‐operation, 15.7% ± 3.9% at 6‐month follow‐up and 14.6% ± 3.7% at 2‐year follow‐up. The ODI of the open surgery group decreased from 56.9% ± 8.8% at pre‐operation to 20.8% ± 5.1% at post‐operation, 17.3% ± 4.2% at 6‐month follow‐up and 16.5% ± 3.8% at 2‐year follow‐up. Paraspinal muscle cross‐sectional area in 2‐year follow‐up in patients of the open surgery group decreased significantly compared to patients of robotic‐assisted MIS‐TLIF group (P = 0.016). Conclusion: In the treatment of lumbar spondylolisthesis, robot‐assisted MIS‐TLIF may lead to more precise pedicle screw placement, less intraoperative blood loss, less postoperative drainage, less postoperative pain, quicker recovery, and less paraspinal muscle atrophy than traditional open surgery. [ABSTRACT FROM AUTHOR]

Introduction: Breakthrough technologies in the neonatal intensive care unit (NICU) revolutionized neonates' quality of care. Mother scented simulated hand (MSSH) is an ergonomically designed supportive hand that uses the power of touch to simulate the feeling of being held and cuddled. This study aimed to determine the effect of MSSH on promoting comfort among mechanically ventilated preterm neonates during invasive procedures. Methods: A quasi-experimental, pre-posttest two groups study was carried out in NICU in Smouha, Alexandria. A sample of 62 mechanically ventilated neonates was randomly assigned to two equal groups; the study group wrapped with a warm MSSH during the invasive procedures while the control group received standard care of NICU. Two observers independently rated the neonates' level of comfort, distress, and pain during endotracheal suctioning (ETS) and heel prick using COMFORTneo scale. Results: It is revealed that the mechanically ventilated neonates had a significantly higher comfort level with MSSH than the standard care during and after both ETS and heal break (p < 0.001 for each). The neonates had significantly lower distress and pain scores when encircled by MSSH during invasive procedures than standard care (p < 0.001 for NRS distress and p < 0.001 for NRS distress). Conclusion: Wrapping the preterm neonates with a warm MSSH promotes comfort and reduces their pain and distress during invasive procedures, especially when their mothers are not physically available. [ABSTRACT FROM AUTHOR]