المؤلفون: Esther A. Kim, Pedro Ciudad, Valeria P. Bustos, Howard N. Langstein, Oscar J. Manrique, Andres Mascaro, Samyd S. Bustos, Antonio J. Forte, Gabriel Del Corral

المصدر: Plastic and Reconstructive Surgery, Global Open, Vol 9, Iss 3, p e3478 (2021)
Plastic and reconstructive surgery. Global open, vol 9, iss 3
Plastic and Reconstructive Surgery Global Open

مصطلحات موضوعية: Gender dysphoria, RD1-811, Process (engineering), Gender affirmation, education, MEDLINE, 8.1 Organisation and delivery of services, 030230 surgery, Space (commercial competition), 03 medical and health sciences, 0302 clinical medicine, Patient satisfaction, Multidisciplinary approach, Clinical Research, Transgender, medicine, Medical education, business.industry, Reconstructive, Health Services, medicine.disease, Good Health and Well Being, 030220 oncology & carcinogenesis, Original Article, Surgery, business, Health and social care services research

الوصف: Background:. Every day, we see more patients present to hospitals and clinics seeking gender-affirmation care to ameliorate the symptoms of gender dysphoria. However, to provide a multidisciplinary approach, it is important to offer an integrated clinical program that provides mental health assessment, endocrine therapy, physical therapy, research, and the full spectrum of surgical services devoted to transgender patients. This article describes our experience on building a specialized, multidisciplinary, academic state-of-the-art gender-affirmation program. Methods:. Herein, we describe the main and critical components on how to build a multidisciplinary academic gender-affirmation program. We share our lessons learned from this experience and describe how to overcome some of the obstacles during the process. Results:. Building a multidisciplinary academic gender-affirmation program requires an invested team, as each and every member is essential for feedback, referrals, and to improve patient’s experience. Institutional support is essential and by far the most important component to overcome some of the obstacles during the process. Having all team members working under the same institution provides all the critical components needed to improve outcomes and patient satisfaction. In addition, the collection of prospective data with a well-structured research team will provide information needed to improve clinical services and standardize clinical protocols, while leaving space for innovation. Conclusions:. This article describes the steps and experience needed to build a multidisciplinary holistic academic gender-affirmation program. We provide our lessons learned during the process that will help guide those who intend to start an academic gender-affirmation program.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7db06e5322630706566b2d3df952ccb7Test
http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003478Test

المؤلفون: Jairo Fernando Gomez, Sammy Nicolás Farah, Sofía Elizabeth Muñoz Medina, Edwarth Soler, Ernesto Martinez Lema, Valeria P. Bustos, Carlos Álvarez Moreno

المصدر: Journal of Orthopaedic Surgery and Research
Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-8 (2021)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Adolescent, Physical examination, 030230 surgery, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, lcsh:Orthopedic surgery, Surveys and Questionnaires, Preoperative Care, Epidemiology, medicine, Humans, Orthopedics and Sports Medicine, Aged, Retrospective Studies, Aged, 80 and over, 030222 orthopedics, medicine.diagnostic_test, business.industry, General surgery, Outpatient surgical procedures, COVID-19, Orthopedic procedures, Retrospective cohort study, Emergency department, Middle Aged, Coronavirus, lcsh:RD701-811, Elective Surgical Procedures, Orthopedic surgery, Female, Surgery, lcsh:RC925-935, Elective Surgical Procedure, Orthopedic Procedures, business, Research Article, Cohort study

الوصف: Background The coronavirus disease 2019 (COVID-19) pandemic is the largest global event in recent times, with millions of infected people and hundreds of thousands of deaths worldwide. Colombia has also been affected by the pandemic, including by the cancellation of medically necessary surgical procedures that were categorized as nonessential. The objective of this study was to show the results of the program implemented in two institutions in Bogotá, Colombia, in April 2020 to support the performance of elective essential and nonessential low- and medium-complexity orthopedic surgeries during the mitigation phase of the COVID-19 pandemic, which involved a presurgical clinical protocol without serological or molecular testing. Methods This was a multicenter, observational, retrospective, descriptive study of a cohort of patients who underwent elective orthopedic surgery at two institutions in the city of Bogota, Colombia, in April 2020. We implemented a preoperative clinical protocol that did not involve serological or molecular tests; the protocol consisted of a physical examination, a survey of symptoms and contact with confirmed or suspected cases, and presurgical isolation. We recorded the types of surgeries, the patients’ scores on the medically necessary, time-sensitive (MeNTs) scale, the presence of signs, symptoms, and mortality associated with COVID-19 developed after the operation. Results A total of 179 patients underwent orthopedic surgery. The average age was 47 years (Shapiro-Wilk, P = 0.021), and the range was between 18 and 81 years. There was a female predominance (61.5%). With regard to the types of surgeries, 86 (48%) were knee operations, 42 (23.5%) were hand surgeries, 34 (19%) were shoulder surgeries, and 17 (9.5%) were foot and ankle surgeries. The average MeNTs score was 44.6 points. During the 2 weeks after surgery, four patients were suspected of having COVID-19 because they developed at least two symptoms associated with the disease. The incidence of COVID-19 in the postoperative period was 2.3%. Two (1.1%) of these four patients visited an emergency department where RT-PCR tests were performed, and they tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No patients died or were hospitalized for symptoms of COVID-19. Conclusion Through the implementation of a presurgical clinical protocol consisting of a physical examination; a clinical survey inquiring about signs, symptoms, and epidemiological contact with suspected or confirmed cases; and presurgical isolation but not involving the performance of molecular or serological diagnostic tests, positive results were obtained with regard to the performance of low- and medium-complexity elective orthopedic surgeries in an early stage of the COVID-19 pandemic. Level of evidence IV.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::572f41d7b4da445ec59ac21455b0a63eTest
https://doi.org/10.1186/s13018-021-02217-8Test

المؤلفون: Howard N. Langstein, Gabriel Del Corral, Valeria P. Bustos, Antonio J. Forte, Oscar J. Manrique, Esther A. Kim, Andres Mascaro, Samyd S. Bustos, Pedro Ciudad

المصدر: Plastic and Reconstructive Surgery, Global Open, Vol 9, Iss 3, p e3477 (2021)
Plastic and Reconstructive Surgery Global Open

مصطلحات موضوعية: education.field_of_study, RD1-811, business.industry, Gender affirmation, Population, MEDLINE, Regret, Reconstructive, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Meta-analysis, Transgender, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Medicine, Original Article, Surgery, education, business, Sensitivity analyses, Demography

الوصف: Supplemental Digital Content is available in the text.
Background: There is an unknown percentage of transgender and gender non-confirming individuals who undergo gender-affirmation surgeries (GAS) that experiences regret. Regret could lead to physical and mental morbidity and questions the appropriateness of these procedures in selected patients. The aim of this study was to evaluate the prevalence of regret in transgender individuals who underwent GAS and evaluate associated factors. Methods: A systematic review of several databases was conducted. Random-effects meta-analysis, meta-regression, and subgroup and sensitivity analyses were performed. Results: A total of 27 studies, pooling 7928 transgender patients who underwent any type of GAS, were included. The pooled prevalence of regret after GAS was 1% (95% CI

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a8a2678203c3748647c46c2801f0e348Test
https://pubmed.ncbi.nlm.nih.gov/35506024Test