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Enhanced recovery programme

Sarah A Moore, Ruth Da Silva, Madelaine Balaam, Lianne Brkic, Dan Jackson, Dan Jamieson, Thomas Ploetz, Helen Rodgers, Lisa Shaw, Frederike van Wijck, Christopher Price
BACKGROUND: Loss of upper limb function affects up to 85 % of acute stroke patients. Recovery of upper limb function requires regular intensive practise of specific upper limb tasks. To enhance intensity of practice interventions are being developed to encourage patients to undertake self-directed exercise practice. Most interventions do not translate well into everyday activities and stroke patients continue to find it difficult remembering integration of upper limb movements into daily activities...
October 21, 2016: Trials
Katherine L Pearson, Nigel J Hall
PURPOSE: Enhanced recovery after surgery (ERAS) pathways are standard practice in adult specialties resulting in improved outcomes. It is unclear whether ERAS principles are applicable to Paediatric Surgery. We performed a scoping review to identify the extent to which ERAS has been used in Paediatric Surgery, the nature of interventions, and outcomes. METHODS: Pubmed, Cochrane library, Google Scholar, and Embase were searched using the terms enhanced recovery, post-operative protocol/pathway, fast track surgery, and paediatric surgery...
September 27, 2016: Pediatric Surgery International
Catherina Brady, Hilary Moss, Brendan D Kelly
Art therapy has a long history in mental healthcare, but requires an enhanced evidence base in order to better identify its precise role in contemporary services. This paper describes an evaluation of an art therapy programme in an acute adult psychiatry admission unit in Ireland. A mixed method research design was used. Quantitative data were collected through a survey of 35 staff members and 11 service users. Qualitative data included free text comments collected in the survey and individual feedback from service users...
September 26, 2016: Medical Humanities
David E Messenger, Nathan J Curtis, Adam Jones, Emma L Jones, Neil J Smart, Nader K Francis
OBJECTIVE: To perform a systematic review of published literature for the factors reported to predict outcomes of enhanced recovery after surgery (ERAS) programmes following laparoscopic colorectal surgery. BACKGROUND: ERAS programmes and the use of laparoscopy have been widely adopted in colorectal surgery bringing short-term patient benefit. However, there is a minority of patients that do not benefit from these strategies and their identification is not well characterised...
September 8, 2016: Surgical Endoscopy
Adam Tucker, Darren McCusker, Nidhi Gupta, Jonathon Bunn, Mark Murnaghan
INTRODUCTION: Arthroplasty is commonplace in orthopaedic practice, and post operative pain has been shown to substantially hinder recovery and discharge from hospital. OBJECTIVES: The current study assessed a multidisciplinary, multimodal Orthopaedic ERP in terms of its effect on patient perceived post operative pain in hip and knee arthroplasty. Secondary outcome was in the form of a cost analysis. METHODS: A prospective study was performed on consecutive arthroplasty patients across a 6 week period in a district orthopaedic unit...
May 2016: Ulster Medical Journal
Phillippa Burnell, Rachael Coates, Steven Dixon, Lucy Grant, Matthew Grey, Ben Griffiths, Mike Jones, Anantha Madhavan, Iain McCallum, Ross McClean, Karen Naru, Lydia Newton, Paul O'Loughlin, Fadlo Shaban, Anisha Sukha, Sameer Somnath, Syed Shumon, Deena Harji
INTRODUCTION: Laparoscopic surgery combined with enhanced recovery programmes has become the gold standard in the elective management of colorectal disease. However, there is no consensus with regard to the optimal perioperative analgesic regime in this cohort of patients, with a number of options available, including thoracic epidural spinal analgesia, patient-controlled analgesia, subcutaneous and/or intraperitoneal local anaesthetics, local anaesthetic wound infiltration catheters and transversus abdominis plane blocks...
September 6, 2016: BMJ Open
D A McDonald, A H Deakin, B M Ellis, Y Robb, T E Howe, A W G Kinninmonth, N B Scott
AIMS: This non-blinded randomised controlled trial compared the effect of patient-controlled epidural analgesia (PCEA) versus local infiltration analgesia (LIA) within an established enhanced recovery programme on the attainment of discharge criteria and recovery one year after total knee arthroplasty (TKA). The hypothesis was that LIA would increase the proportion of patients discharged from rehabilitation by the fourth post-operative day but would not affect outcomes at one year. PATIENTS AND METHODS: A total of 242 patients were randomised; 20 were excluded due to failure of spinal anaesthesia leaving 109 patients in the PCEA group and 113 in the LIA group...
September 2016: Bone & Joint Journal
Carmina Wanden-Berghe, Javier Sanz-Valero, Antonio Arroyo-Sebastián, Kamila Cheikh-Moussa, Pedro Moya-Forcen
UNLABELLED: Introducción: Preoperative nutritional status (NS) has consequences on postoperative (POSTOP) recovery. Our aim was to systematically review the nutritional interventions (NI) in Fast-Track protocols for colorectal cancer surgery and assess morbidity-mortality and patient´s recovery. METHOD: Systematic review of scientific literature after consulting bibliographic databases: Medline, The Cochrane Library, Scopus, Embase, Web of Science, Institute for Scientific Information, Latin American and Caribbean Health Sciences Literature, The Cumulative Index to Nursing and Allied Health Literature...
2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Suzanne Hoi Shan Lo, Anne Marie Chang, Janita Pak Chun Chau
BACKGROUND: Recovery after stroke is long-term and demanding. Optimising community-residing stroke survivors' capability to self-manage their health is integral. Recent systematic reviews have shown that stroke self-management programmes were associated with significant improvement in stroke survivors' health-related quality of life and self-efficacy. However some programmes were not designed with an underpinning theoretical framework. The aim of this study is to compare the effectiveness of a nurse-led stroke self-management programme with usual care on recovery of community-residing stroke survivors...
2016: BMC Health Services Research
Toby O Smith, Paul Jepson, Andrew Beswick, Gina Sands, Avril Drummond, Edward T Davis, Catherine M Sackley
BACKGROUND: Total hip arthroplasty (THA) is one of the most common orthopaedic operations performed worldwide. Painful osteoarthritis of the hip is the primary indication for THA. Following THA, people have conventionally been provided with equipment, such as raised toilet seats and chairs, and educated to avoid activities that could cause the hip joint to be in a position of flexion over 90 degrees, or adduction or rotation past the midline. These aspects of occupational therapy have been advocated to reduce the risks of prosthesis dislocation...
2016: Cochrane Database of Systematic Reviews
Gustavo Saposnik, Leonardo G Cohen, Muhammad Mamdani, Sepideth Pooyania, Michelle Ploughman, Donna Cheung, Jennifer Shaw, Judith Hall, Peter Nord, Sean Dukelow, Yongchai Nilanont, Felipe De Los Rios, Lisandro Olmos, Mindy Levin, Robert Teasell, Ashley Cohen, Kevin Thorpe, Andreas Laupacis, Mark Bayley
BACKGROUND: Non-immersive virtual reality is an emerging strategy to enhance motor performance for stroke rehabilitation. There has been rapid adoption of non-immersive virtual reality as a rehabilitation strategy despite the limited evidence about its safety and effectiveness. Our aim was to compare the safety and efficacy of virtual reality with recreational therapy on motor recovery in patients after an acute ischaemic stroke. METHODS: In this randomised, controlled, single-blind, parallel-group trial we enrolled adults (aged 18-85 years) who had a first-ever ischaemic stroke and a motor deficit of the upper extremity score of 3 or more (measured with the Chedoke-McMaster scale) within 3 months of randomisation from 14 in-patient stroke rehabilitation units from four countries (Canada [11], Argentina [1], Peru [1], and Thailand [1])...
September 2016: Lancet Neurology
Josef Dib, Cynthia Mongongu, Corinne Buisson, Adeline Molina, Wilhelm Schänzer, Uwe Thuss, Mario Thevis
The development of new therapeutics potentially exhibiting performance-enhancing properties implicates the risk of their misuse by athletes in amateur and elite sports. Such drugs necessitate preventive anti-doping research for consideration in sports drug testing programmes. Hypoxia-inducible factor (HIF) stabilizers represent an emerging class of therapeutics that allows for increasing erythropoiesis in patients. BAY 85-3934 is a novel HIF stabilizer, which is currently undergoing phase-2 clinical trials...
June 27, 2016: Drug Testing and Analysis
James F Doyle, Marlies Ostermann, Lui G Forni
The use of goal-directed therapy as part of an enhanced recovery programme is well established in terms of management of the modern high-risk surgical patient in order to reduce both morbidity and mortality. The mechanisms behind this improvement are debated, but a reduction in the development of post-operative complications including acute kidney injury may be relevant. A recent study examining this relationship has been reported and is discussed here.
2016: Critical Care: the Official Journal of the Critical Care Forum
Aditya J Nanavati, Sanjay Nagral
There has been a lot of enthusiasm about minimally invasive surgery (MIS) in the surgical community in recent times. Some of the main reasons for this are an unmatched appeal to patients, doctors and healthcare systems alike. Push from the industry also serves as an important reason for its popularity. 'Enhanced recovery after surgery' (ERAS) is a programme of implementing multimodal interventions in the perioperative period to promote faster recovery. Even though MIS is an important component of ERAS protocols, the latter has not seen the reception the former has received...
July 2016: Journal of Minimal Access Surgery
H M Forsmo, F Pfeffer, A Rasdal, G Østgaard, A C Mohn, H Körner, C Erichsen
AIM: The aim of this randomized clinical trial was to compare patients treated using a multimodal approach [enhanced recovery after surgery (ERAS)], with a special focus on counselling, to patients treated in a standard conventional care pathway, who underwent elective colorectal resection. METHOD: In a single-centre trial, adult patients eligible for open or laparoscopic colorectal resection were randomized to an ERAS programme or standard care. The primary end-point was postoperative total hospital stay...
June 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Aditya J Nanavati, Sanjay Nagral
There has been a lot of enthusiasm about minimally invasive surgery (MIS) in the surgical community in recent times. Some of the main reasons for this are an unmatched appeal to patients, doctors and healthcare systems alike. Push from the industry also serves as an important reason for its popularity. 'Enhanced recovery after surgery' (ERAS) is a programme of implementing multimodal interventions in the perioperative period to promote faster recovery. Even though MIS is an important component of ERAS protocols, the latter has not seen the reception the former has received...
April 28, 2016: Journal of Minimal Access Surgery
R Lambertz, H Drinhaus, D Schedler, M Bludau, W Schröder, T Annecke
Locally advanced carcinomas of the oesophagus require multimodal treatment. The core element of curative therapy is transthoracic en bloc oesophagectomy, which is the standard procedure carried out in most specialized centres. Reconstruction of intestinal continuity is usually achieved with a gastric sleeve, which is anastomosed either intrathoracically or cervically to the remaining oesophagus. This thoraco-abdominal operation is associated with significant postoperative morbidity, not least because of a vast array of pre-existing illnesses in the surgical patient...
June 2016: Der Anaesthesist
Justin W Collins, Hiten Patel, Christofer Adding, Magnus Annerstedt, Prokar Dasgupta, Shamim M Khan, Walter Artibani, Richard Gaston, Thierry Piechaud, James W Catto, Anthony Koupparis, Edward Rowe, Matthew Perry, Rami Issa, John McGrath, John Kelly, Martin Schumacher, Carl Wijburg, Abdullah E Canda, Meviana D Balbay, Karel Decaestecker, Christian Schwentner, Arnulf Stenzl, Sebastian Edeling, Sasa Pokupić, Michael Stockle, Stefan Siemer, Rafael Sanchez-Salas, Xavier Cathelineau, Robin Weston, Mark Johnson, Fredrik D'Hondt, Alexander Mottrie, Abolfazl Hosseini, Peter N Wiklund
CONTEXT: Radical cystectomy (RC) is associated with frequent morbidity and prolonged length of stay (LOS) irrespective of surgical approach. Increasing evidence from colorectal surgery indicates that minimally invasive surgery and enhanced recovery programmes (ERPs) can reduce surgical morbidity and LOS. ERPs are now recognised as an important component of surgical management for RC. However, there is comparatively little evidence for ERPs after robot-assisted radical cystectomy (RARC)...
May 24, 2016: European Urology
Ellie Taylor, Dana Perlman, Lorna Moxham, Shane Pegg, Christopher Patterson, Renee Brighton, Susan Sumskis, Tim Heffernan
Mental health consumers are often socially isolated and may lack the basic leisure competencies which serve as a critical building block for community (re)integration. Therapeutic recreation (TR), as a treatment modality for people with mental illness, is yet to be fully embraced in the Australian health-care setting, despite having a strong historical foundation in North America. A team of academics created a TR experience, termed Recovery Camp, which was designed to collectively engage consumers and future health professionals drawn from a range of discipline areas...
May 27, 2016: International Journal of Mental Health Nursing
Bronwen Connolly, Brenda O'Neill, Lisa Salisbury, Bronagh Blackwood
BACKGROUND: Physical rehabilitation interventions aim to ameliorate the effects of critical illness-associated muscle dysfunction in survivors. We conducted an overview of systematic reviews (SR) evaluating the effect of these interventions across the continuum of recovery. METHODS: Six electronic databases (Cochrane Library, CENTRAL, DARE, Medline, Embase, and Cinahl) were searched. Two review authors independently screened articles for eligibility and conducted data extraction and quality appraisal...
October 2016: Thorax
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