title: The relationship between patient stress and the blood levels of acute phase proteins in rhinoplasty: the report of a prospective study.
abstract: OBJECTIVE
  This study aims to interrogate the relationship between patient stress and the levels of acute phase proteins (APP) in rhinoplasty.
  
  
  METHODS
  Twenty-six primary rhinoplasty patients were asked about the most stressful step of the rhinoplasty process, which were (1) deciding on the operation, (2) waiting in the preoperative room, (3) the first few postoperative hours, and (4) withdrawing the nasal pack, in order beginning from the most stressful one, preoperatively, and then postoperatively. C-reactive protein (CRP), alfa-1-acide glycoprotein (AAG), ceruloplasmin (CER), haptoglobulin (HPT), and alfa-1-antitrypsin (AT) have been studied in blood to detect a relation between the patient stress and the levels of APP.
  
  
  RESULTS
  Preoperatively, the "imagined" most stressful step was Step 4 (61.53%). Postoperatively, the "declared" most stressful step was Step 3 (50%). The blood levels of APP matched with the imagined rather than the declared stress.
  
  
  CONCLUSIONS
  Patient stress could be a preoperative issue, which should be eliminated preoperatively. Detailed description of the surgery and some pharmaceutics can inhibit the negative effects of the stressors and have a contribution to patient comfort.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Mersin University School of Medicine, Zeytinlibahce Cad., Mersin 33079, Turkey. arslane@mersin.edu.tr
authors.forename: Emrah
authors.initials: E
authors.lastname: Arslan
authors.forename: Ferit
authors.initials: F
authors.lastname: Demirkan
authors.forename: Sakir
authors.initials: S
authors.lastname: Unal
authors.forename: Alper
authors.initials: A
authors.lastname: Aksoy
authors.forename: Gurbuz
authors.initials: G
authors.lastname: Polat
authors.forename: Arzu
authors.initials: A
authors.lastname: Kanik
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D002570:Ceruloplasmin / Q000378:metabolism; D005260:Female; D006242:Haptoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D009961:Orosomucoid / Q000378:metabolism; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D012225:Rhinoplasty / Q000523:psychology*; D013315:Stress, Psychological / Q000097:blood* / Q000209:etiology*; D011795:Surveys and Questionnaires; D000515:alpha 1-Antitrypsin / Q000378:metabolism
chemical_list: D000209:Acute-Phase Proteins; D006242:Haptoglobins; D009961:Orosomucoid; D000515:alpha 1-Antitrypsin; D002097:C-Reactive Protein; D002570:Ceruloplasmin