Introduction: Postoperative hypocalcemia is a narrow but significant problem for patients undergoing thyroid and parathyroid surgery. It is the most common complication after thyroidectomy. It is associated with transient or permanent hypoparathyroidism. It could potentially be life-threatening for patients and increases the costs of hospitalization. The aim of the study was to evaluate the results of studies that routinely administrated calcium and/or vitamin D during the postoperative period. Materials and Methods: In this article, a literature review – 15 studies that used routine perioperative calcium (7 studies), vitamin D (2 studies) and calcium with vitamin D (11 studies) supplementation was performed. Supplementation effectiveness in prevention of postoperative hypocalcemia was compared to no prophylaxis in 10 studies. Five studies compared the effect of combined administration (calcium and vitamin D) to calcium alone. The number of papers dealing with this problem is not particularly high. Results: Supplementation significantly decreased the rate of laboratory and symptomatic hypocalcemia. It was also effective in reducing the severity of symptoms. The combination of calcium with vitamin D was the most effective strategy. No hypercalcemia or parathyroid hormone inhibition was observed in the supplemented groups. Routine supplementation was less expensive than performing laboratory tests in the course of treatment of hypocalcemia. Conclusions: The results of analyzed studies showed the clinical and economic advantage of routine perioperative prophylactic supplementation of vitamin D and/or calcium as compared to no prophylaxis. However, the majority of studies showed a significant range of variability in patients’ characteristics. Numerous studies did not evaluate the preoperative 25-hydroxycholecalciferol level – a risk factor for postoperative hypocalcemia. Discussion: The use of routine prophylactic supplementation of calcium and vitamin D in the perioperative period can be useful in everyday clinical practice. Further research is needed to draw clear guidelines regarding prophylactic calcium and vitamin D therapy for patients after thyroidectomy.
Introduction: Contemporary psychology of health pays a lot of attention to issues of personal and social resources, perceiving them as factors which favour the individual’s health and quality of life. Scientific studies confirm a positive sense of the possibility to express emotions during hospitalization, operative treatment and convalescence. Studies on the Courtauld Emotional Control Scale (CECS) in women during the perioperative period, treated for gynaecological ailments, may enable identification of patients exhibiting deficits in this respect, who should be covered by a special psychopreventive care. Methods: The studies involved 232 women treated surgically for various gynaecological ailments and were carried out in two stages: on the day preceding the surgery and on the third day after the surgery. The studies were carried out using the Courtauld Emotional Control Scale. The obtained results were analysed statistically. Results: The level of negative emotions control was higher in patients aged over 40, as compared to that in younger women. The category of operative procedure did not condition the level of emotional control, whether in the Total scale or in subscales of Anger, Depression and Anxiety in the preoperative period. On the other hand, in the postoperative period a higher suppression of emotions within the Anxiety subscale wasfound in women after operation with a major injury of tissues, as compared to the patients after operation with a minor injury of tissues. Conclusions: The values of the total level of the Courtauld Emotional Control Scale (total CECS) obtained in our studies, as well as in the subscales of Anger, Depression and Anxiety point to women’s tendency to suppress negative emotions in the perioperative period.
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Wstęp: Współczesna psychologia zdrowia poświęca wiele uwagi problematyce zasobów osobistych i społecznych, upatrując w nich czynniki sprzyjające zdrowiu i jakości życia jednostki. Badania naukowe potwierdzają pozytywne znaczenie możliwości wyrażania emocji w okresie hospitalizacji, leczenia chirurgicznego i rekonwalescencji. Badania poziomu kontroli emocji (CECS) u kobiet w okresie okołooperacyjnym, leczonych z powodów ginekologicznych, mogą umożliwić identyfikowanie pacjentek przejawiających deficyt w tym zakresie, które powinny być objęte szczególną opieką psychoprofilaktyczną. Metody: Badaniami objęto 232 kobiety leczone operacyjnie z różnych powodów ginekologicznych. Badania przeprowadzono w dwóch etapach: w dniu poprzedzającym operację oraz w trzeciej dobie po operacji. Badania przeprowadzono przy użyciu Skali Kontroli Emocji. Uzyskane wyniki badań poddano analizie statystycznej. Wyniki: Poziom kontroli emocji negatywnych był wyższy u pacjentek w wieku powyżej 40 lat aniżeli u kobiet młodszych. Kategoria zabiegu operacyjnego nie warunkowała poziomu kontroli emocji, zarówno w skali Ogólnej, jak i w podskalach Gniew, Depresja i Lęk w okresie przedoperacyjnym. Natomiast w okresie pooperacyjnym stwierdzono większe tłumienie emocji w zakresie podskali Lęku u kobiet po operacji ze znacznym urazem tkanek aniżeli u badanych po operacji z miernym urazem tkanek. Wnioski: Stwierdzone w badaniach własnych wartości ogólnego wskaźnika kontroli emocji (CECS ogólny), jak również w podskalach Gniew, Depresja i Lęk wskazują na tendencję do tłumienia przez kobiety emocji negatywnych w okresie okołooperacyjnym.
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