Spinal Deformity, Surgery at the Cervicothoracic Junction, and American Society of Anesthesiologists Class Increase the Risk of Post-surgical Intensive Care Unit Treatment after Dorsal Spine Surgery: A Single-Center Multivariate Analysis of 962 Patients.

STUDY DESIGN: This was a retrospective multivariate analysis of preoperative risk factors leading to intensive care unit (ICU) admissions in patients undergoing elective or acute dorsal spine surgery. PURPOSE: Numerous studies have predicted a substantial increase in spine surgeries within the next decades, potentially overwhelming hospitals' resources, including ICU occupancy. Accurate estimates of whether patients need postsurgical ICU treatment are pivotal for both resource allocation and patient safety. OVERVIEW OF LITERATURE: Risk factors leading to ICU admissions after dorsal spine surgery have been extensively examined for lumbar elective surgery. Studies including other anatomical segments of the spine and nonelective surgery regarding postsurgical ICU treatment probability are lacking. METHODS: This study was designed to be a single-center multivariate analysis of data retrospectively collected from a tertiary care university hospital. Patients undergoing dorsal spine surgery from 2009 to 2019 were included in this study. The patients' demographic data were analyzed to determine potential preoperative risk factors for ICU admission after surgery using multiple logistic regression. RESULTS: In our cohort, 962 patients with a mean age of 71.1±0.55 years were included. Surgeries involved 3.24±0.08 spinal levels on average. The incidence of ICU treatment after surgery was 30.4% (n=292). Multivariate logistic regression showed a markedly increased odds ratio (OR) for patients undergoing surgery of the cervicothoracic junction (OR, 8.86) and those undergoing surgery for spinal deformity treatment (OR, 7.7). Additionally, cervical procedures (OR, 3.29), American Society of Anesthesiologists (ASA) class 3-4 (OR, 2.74), spondylodiscitis (OR, 2.47), fusion of ≥3 levels (OR, 1.94), and age >75 years (OR, 1.33) were associated with an increased risk of postsurgical ICU admission. CONCLUSIONS: The findings highlight the relevance of anatomical location, preoperative diagnosis, ASA class, and length of surgery regarding the predictability of postoperative ICU admission. Our data allowed for more sophisticated estimates regarding the need for ICU treatment after dorsal spine surgery, guiding the surgeon through patient selection, communication, and ICU admission predictability.

The attitudes of mental health professionals towards patients with mental illness in an inpatient setting in Palestine.

Culture plays a vital role in shaping public and professional attitudes towards mental illness. In Arab cultures negative attitudes toward patients experiencing mental illnesses are common. There is a lack of studies that investigate the attitudes of professionals towards patients in inpatient mental health settings. This study aimed to assess the attitudes of professionals towards patients with mental illnesses in the only psychiatric hospital in Palestine. A survey was undertaken using the Attitudes Toward Acute Mental Health Scale (ATAMHS 33). The scale was distributed to a variety of professionals at the only psychiatric hospital in Bethlehem. Data was managed and analysed by using SPSS 15 (a statistical package for social sciences). The participants (mostly nurses) expressed both negative and positive attitudes toward patients, however, results revealed more negative than positive attitudes, particularly in relation to alcohol misuse, medication, patients' ability to control their emotions, and genetic predisposition to mental illness. This paper provides baseline data about the attitude of mental health professionals towards patients experiencing mental illnesses. Education and direct contact with patients with mental illness may not be enough to foster positive attitudes towards them. This may indicate the need to revise educational curriculum at the Palestinian universities and offer more training for mental health professionals in order to change their attitudes.

Tooth autotransplantation in orthodontic patients.

AIM: The aims of this report are to present three cases of autotransplantation along with a review of the indications, selection criteria for patient donor and recipient sites, and the major steps in the surgical procedure. BACKGROUND: Autogenous tooth transplantation, or autotransplantation, is the surgical movement of a tooth from one location in the mouth to another in the same individual. It can be a good treatment option in many cases if the dentist knows the implications, indications, and contraindications. CASE DESCRIPTIONS: Three cases with different treatment indications and plans are presented. All showed autotransplantation of teeth as part of orthodontic treatment. It emphasized the benefits of this treatment modality such as new bone formation and lower costs. One case, a rare example of multiple congenitally missing teeth treated by autotransplantation, also was presented. SUMMARY: As shown in these case reports, there are instances where the autotransplantation of teeth is appropriate and may possibly simplify future planned orthodontic or prosthodontic treatment. CLINICAL SIGNIFICANCE: Tooth autotransplantation is an easy and good treatment option, applicable in a lot of cases, substituting different types of prostheses, including dental implants.