Changing perspectives of medical staff after Human Milk Bank opening. A single-center retrospective study of a tertiary neonatal unit.

BACKGROUND: Breast milk is an exceptional source of nutrients for neonates, delivering a unique composition of bioactive ingredients such as immunoglobulins, hormones and oligosaccharides. Our research aimed to understand the attitude of medical staff towards milk donation and its use in the NICU (Neonatal Intensive Care Unit) and to determine the influence the milk bank has had on the feeding practices of our patients after the introduction of local Human Milk Bank (HMB). METHODS: Twelve closed-question questionnaires were distributed among employees from the Department of Neonatology and Obstetrics before and after (identical set of questions) the implementation of the HMB. The attitudes of staff towards different aspect of milk banking were recorded. RESULTS: We obtained 67 fully answered questionnaires in 2019 and 48 questionnaires in 2021. After comparing the responses, the analysis of how staff's attitudes have changed was performed. As a second step, four hundred sixty-eight neonates born consecutively in December 2018 (N.=171) and then in December 2019 (N.=297), before and after the HMB introduction, respectively, participated in the study at the Medical University of Gdansk, Poland. Patients' medical charts were retrospectively analyzed. Since the assemblage of the HMB, there has been a significant improvement in the staff's attitude towards the use of donor milk (DM) (68.7% before, 93.8% after HMB) and its safety (65.7% before, 97.9% after HMB). There was also a significant increment in feeding newborns using breast milk compared to formula milk. CONCLUSIONS: HMB allows for the collection of donor milk, matching mother's-own-milk by gestational age and stage of lactation, ensuring adequate composition for the targeted nutritional requirements of premature infants. These findings support the relevance of our study, highlighting the importance and benefits of expanding HMB worldwide and increasing education for mothers and medical staff regarding donor milk.

Improvement in Nasal Obstruction and Quality of Life after Nasal Septoplasty with Turbinoplasty: A Pre- and Post-study

Abstract Introduction Septoplasty and turbinoplasty are common surgical interventions used to relieve nasal obstructive symptoms. Since it is difficult to measure the degree of nasal blockage, current literature wonders about the frequent performance of these procedures. Objective To evaluate the perceived change in the nasal obstruction and the quality of life (QoL) of patients that underwent a septoplasty along with a turbinoplasty by applying subjective scales, to describe the correlation between those scales, and to study the impact of clinical factors in the postoperative outcomes. Methods Prospective observational study. The Nasal Obstruction Symptom Evaluation (NOSE), the Visual Analog Scale (VAS), and the Glasgow Benefit Inventory (GBI) were assessed. The paired sample Wilcoxon test was used to evaluate the difference between the pre- and postoperative surveys. The correlation coefficient between the subjective scales was calculated. A quantile regression was performed to evaluate the effect of surgery on the results adjusted for clinical and demographic variables. Results A total of 115 patients were interviewed. Postoperative NOSE scores were 45 points lower (95% confidence interval [CI]: - 53.53-- 35.46; p < 0.001) in comparison with the NOSE preoperative scores. Obesity was the only statistically significant factor associated with worse outcomes. Additionally, we found a high correlation between the NOSE and VAS scores and a negative correlation between the GBI and postoperative VAS scores. Conclusion Nasal septoplasty, when paired with a turbinoplasty, decreases nasal obstruction and improves QoL. Obesity was associated with worse results. There was a strong correlation between the NOSE and the VAS results and between the GBI and postoperative VAS results.

Improvement in Nasal Obstruction and Quality of Life after Nasal Septoplasty with Turbinoplasty: A Pre- and Post-study.

Introduction Septoplasty and turbinoplasty are common surgical interventions used to relieve nasal obstructive symptoms. Since it is difficult to measure the degree of nasal blockage, current literature wonders about the frequent performance of these procedures. Objective To evaluate the perceived change in the nasal obstruction and the quality of life (QoL) of patients that underwent a septoplasty along with a turbinoplasty by applying subjective scales, to describe the correlation between those scales, and to study the impact of clinical factors in the postoperative outcomes. Methods Prospective observational study. The Nasal Obstruction Symptom Evaluation (NOSE), the Visual Analog Scale (VAS), and the Glasgow Benefit Inventory (GBI) were assessed. The paired sample Wilcoxon test was used to evaluate the difference between the pre- and postoperative surveys. The correlation coefficient between the subjective scales was calculated. A quantile regression was performed to evaluate the effect of surgery on the results adjusted for clinical and demographic variables. Results A total of 115 patients were interviewed. Postoperative NOSE scores were 45 points lower (95% confidence interval [CI]: - 53.53-- 35.46; p < 0.001) in comparison with the NOSE preoperative scores. Obesity was the only statistically significant factor associated with worse outcomes. Additionally, we found a high correlation between the NOSE and VAS scores and a negative correlation between the GBI and postoperative VAS scores. Conclusion Nasal septoplasty, when paired with a turbinoplasty, decreases nasal obstruction and improves QoL. Obesity was associated with worse results. There was a strong correlation between the NOSE and the VAS results and between the GBI and postoperative VAS results.

Nasal Obstruction and Quality of Life Assessment After Septoplasty With Turbinoplasty: Correlation Between Subjective Scales.

BACKGROUND: Assessment of nasal obstruction is imprecise due to a low correlation between findings on the physical examination and objective measures with the severity of symptoms reported by the patient even after septoplasty with turbinoplasty is performed. The aim of this study is to evaluate the use of subjective scales, and the correlation between them for the evaluation of nasal obstruction after surgery. OBJECTIVE: To assess the impact of undergoing septoplasty with turbinoplasty to relieve nasal obstructive symptoms and the quality of life in a mid-term period by using the Visual Analogue Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), and Glasgow Benefit Inventory (GBI). METHODS: A retrospective study was conducted of patients who underwent a septoplasty with turbinoplasty due to nasal septodeviation and secondary nasal obstructive symptoms at the Hospital Universitario Fundación Santa Fe de Bogotá. Three scales were used to measure the outcomes one year after surgery: VAS (0-10), NOSE (0-100), and GBI (-100 to 100). RESULTS: Data from 56 patients (21 females, mean age 37.5 years of age, SD 12.13) was collected. The results showed that 75% of the patients had a post-surgical NOSE score below 50 and a VAS score below 6. Regarding the GBI scale, 75% of the patients improved in their quality of life. An inverse proportional correlation was found between the NOSE and GBI scales (rho = -0.3682) (95% CI -0.579 to -0.111), and there was a directly proportional correlation between the NOSE and VAS scales (rho = 0.7440) (95% CI 0.595 to 0.844). CONCLUSION: Subjective measures suggest there was an improvement in nasal obstructive symptoms and quality of life after surgery. Non-anatomical causes such as rhinitis can be confounding factors to consider in subsequent studies. VAS stands out as a possible interchangeable scale with NOSE to measure nasal obstruction in these patients.

Retrospective Analysis of Pediatric Dermatologic Hospital Admissions.

Statistical data on the frequency of skin conditions in the Pomeranian region of Poland are limited in the field of pediatric dermatology, requiring a multidisciplinary approach to each patient. Dermatitis and skin allergies are the 10 most common pediatric conditions, with a prevalence of 20% among such chronic illnesses in developed countries. This analysis is limited to the recurrence of dermatologic diseases in the hospitalized pediatric population within the Pomeranian region for the purpose of future targeted education. Retrospective analysis included 282 participants over a 3-year period between 2013 and 2015, with admissions to the Department of Dermatology, Venereology, and Allergology at the Medical University of Gdansk. Diagnoses were obtained from the ward admission book and CliniNet database.

El papel de la cirugía endoscópica endonasal en el manejo de tumores malignos de senos paranasales y base del cráneo: Indicaciones, ventajas y limitaciones / The role of endoscopic endonasal surgery in the management of malign sinonasal and skull base tumors: Indications, advantages and limitations

Los recientes avances en el campo de cirugía endoscópica endonasal (CEE) han permitido disminuir la morbilidad de los abordajes abiertos tradicionales, mejorando o al menos igualando los resultados oncológicos y funcionales que hemos visto en estos procedimientos en el manejo de tumores malignos de senos paranasales y base del cráneo. El manejo oncológico de estas patologías complejas se beneficia de un abordaje multidisciplinario, en donde la decisión quirúrgica se basa en el estadio del tumor, localización, histología y relación con estructuras vecinas. La adecuada y cuidadosa selección de pacientes para este tipo de técnicas es esencial para lograr resultados exitosos. Este artículo pretende hacer una revisión narrativa y, exponer las indicaciones que utilizamos en nuestra institución para elegir cada uno de estos abordajes.

Recent advances in the field of endoscopic endonasal surgery (EES) have allowed us to reduce morbidity and to improve the oncological and functional outcomes observed when the traditional open approaches for management of malign sinonasal and skull base tumors are carried out. Oncologic care of these complex pathologies benefits from the inclusion of a multidisciplinary approach where the surgical decision is based on the tumor stage, location, relation with neighboring structures and histology. A careful and adequate patient selection constitutes the key to obtain successful outcomes. The objective of this paper is to perform an narrative review of the current literature and to present the benefits, limitations and the indications of endoscopic approach in our institute.