Objectives: To assess the efficacy of laparoscopic Nissen fundoplication for esophageal reflux in a community hospital.
Methods: One hundred nineteen patients (76%) of 157 patients having laparoscopic fundoplication for symptomatic reflux disease completed a questionnaire. All patients were evaluated with esophagoscopy, esophageal motility, and pH studies.
Results: Mean follow-up was 49 months. Ninety-three patients (78%) no longer had heartburn. Seven patients still had daily heart-burn (5.9%). One hundred three patients (86.6%) had no sour regurgitation. Seventy-five patients (63%) had no dysphagia after surgery. Forty-two patients had some dysphagia after surgery (36.8%). Six patients (5.0%) had significant dysphagia. Only 4 patients stated that dysphagia interfered with their quality of life. Twenty-six patients (22.8%) thought that belching and bloating were worse, whereas 42 patients (36.8%) thought that belching and bloating were better after surgery. Antacids, histamine-2 antagonist, and proton pump inhibitors were still being used by 12.6%, 14.3%, and 21.8% of patients, respectively.
Conclusions: Eighty-seven patients were completely satisfied (73.1%), 26 patients somewhat satisfied (22.8%), and 6 patients unsatisfied (5.3%) with surgery. Overall satisfaction with the surgery was 94.7%. One hundred five patients (88.2%) would recommend the surgery to others. Laparoscopic Nissen fundoplication can be effectively done in a community hospital setting.
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http://dx.doi.org/10.1097/01.SMJ.0000146585.51335.76 | DOI Listing |
SAGE Open Med Case Rep
January 2025
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Atopic dermatitis is a chronic inflammatory skin disease associated with immune dysregulation, particularly overexpression of T helper 2 cytokines. Cytotoxic T lymphocyte-associated antigen 4 deficiency, a primary immune disorder, can exacerbate atopic dermatitis. Dupilumab, an IL-4 and IL-13 receptor antagonist, has demonstrated efficacy in controlling severe, recalcitrant atopic dermatitis by mitigating T helper 2-driven inflammation.
View Article and Find Full Text PDFFront Surg
December 2024
Department of Operating Room Technology, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
The use of the gastrocnemius muscle flap has become an excellent choice for coverage of Knee Defects. However, the surgical management of gastrocnemius muscle flap in the injuries of the popliteal artery remains a challenging therapeutic problem. The purpose of this manuscript is to present a case of a successful knee gastrocnemius flap in a patient with popliteal artery injuries.
View Article and Find Full Text PDFGlob Ment Health (Camb)
December 2024
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Background: There is a high prevalence of depression among refugee youth in low- and middle-income countries, yet depression trajectories are understudied. This study examined depression trajectories, and factors associated with trajectories, among urban refugee youth in Kampala, Uganda.
Methods: We conducted a longitudinal cohort study with refugee youth aged 16-24 in Kampala, Uganda.
Glob Ment Health (Camb)
December 2024
Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Despite significant advancements in the development of psychotropic medications, increasing adherence rates remain a challenge in the treatment and management of psychiatric disorders. The purpose of this study is to qualitatively explore the challenges underlying medication adherence and strategies to improve it among adolescents with psychiatric disorders in Malaysia. This qualitative research design presents results from 17 semi-structured interviews with adolescent psychiatric patients, aged 11 to 19 years old, from public hospitals across Peninsular Malaysia.
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