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https://www.readbyqxmd.com/read/28534323/-era-of-enhanced-recovery-after-surgery-and-robotic-gastric-cancer-surgery
#1
Yanbing Zhou
Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28523987/six-month-effects-of-early-or-delayed-provision-of-an-ankle-foot-orthosis-in-patients-with-sub-acute-stroke-a-randomized-controlled-trial
#2
Corien Dm Nikamp, Jaap H Buurke, Job van der Palen, Hermie J Hermens, Johan S Rietman
OBJECTIVE: To study the six-month clinical effects of providing ankle-foot orthoses at different moments (early or delayed) in (sub)acute stroke; this is a follow-up to a published trial. DESIGN: Randomized controlled trial. SETTING: Rehabilitation centre. SUBJECTS: Unilateral hemiparetic stroke subjects maximal six weeks post-stroke with indication for ankle-foot orthosis use. INTERVENTIONS: Subjects were randomly assigned to early (at inclusion; week 1) or delayed provision (eight weeks later; week 9)...
May 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28507630/relationship-between-gait-parameters-and-postural-stability-in-early-and-late-parkinson-s-disease-and-visual-feedback-based-balance-training-effects
#3
Mohieldin M Ahmed, Douaa M Mosalem, Aziz K Alfeeli, Ayyoub B Baqer, Doaa Youssry Soliman
BACKGROUND: Gait disorders or postural instability has been done before. However, lack of reviews has addressed the relation between gait and postural stability in Parkinson's disease (PD). AIM: The aim was to evaluate the relation between gait parameters and postural stability in early and late stages of PD. MATERIALS AND METHODS: The forty-one idiopathic PD patients were divided into two groups into a group (A) considered as early PD and group (B) considered as late ambulant PD...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28505995/prediction-of-post-stroke-functional-mobility%C3%A2-from-the-initial-assessment-of%C3%A2-cognitive-function
#4
Se Hee Jung, Shi-Uk Lee, Jihong Park
BACKGROUND: Cognitive impairment is frequently seen in patients with stroke. The possible correlation between cognitive function and functional mobility has been proposed; however, the prognostic importance of early cognitive function in recovery of mobility has not been investigated in patients with stroke. OBJECTIVE: The objective of this study is to investigate whether the cognitive function in the acute phase can independently predict the recovery of mobility after stroke, and to determine the cut-off value of each cognitive evaluation test for community ambulation at six months...
May 11, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28501815/can-the-prehospital-national-early-warning-score-identify-patients-most-at-risk-from-subsequent-deterioration
#5
Joanna Shaw, Rachael T Fothergill, Sophie Clark, Fionna Moore
INTRODUCTION: The National Early Warning Score (NEWS) aids the early recognition of those at risk of becoming critically ill. NEWS has been recommended for use by ambulance services, but very little work has been undertaken to date to determine its suitability. This paper examines whether a prehospital NEWS derived from ambulance service clinical observations is associated with the hospital ED disposition. METHODS: Prehospital NEWS was retrospectively calculated from the ambulance service clinical records of 287 patients who were treated by the ambulance service and transported to hospital...
May 13, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28499454/risk-for-intracranial-pressure-increase-related-to-enclosed-air-in-post-craniotomy-patients-during-air-ambulance-transport-a-retrospective-cohort-study-with-simulation
#6
Helge Brändström, Anna Sundelin, Daniela Hoseason, Nina Sundström, Richard Birgander, Göran Johansson, Ola Winsö, Lars-Owe Koskinen, Michael Haney
BACKGROUND: Post-craniotomy intracranial air can be present in patients scheduled for air ambulance transport to their home hospital. We aimed to assess risk for in-flight intracranial pressure (ICP) increases related to observed intracranial air volumes, hypothetical sea level pre-transport ICP, and different potential flight levels and cabin pressures. METHODS: A cohort of consecutive subdural hematoma evacuation patients from one University Medical Centre was assessed with post-operative intracranial air volume measurements by computed tomography...
May 12, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28481841/a-system-wide-enhanced-recovery-program-focusing-on-two-key-process-steps-reduces-complications-and-readmissions-in-patients-undergoing-bowel-surgery
#7
Terrence J Loftus, Susan Stelton, Brett W Efaw, Joshua Bloomstone
Enhanced recovery programs (ERPs) can improve outcomes following bowel surgery, but implementing an ERP across a large healthcare system remains challenging. In this study, a simplified ERP that focused on two process steps, early and frequent ambulation and early alimentation, was evaluated to determine its impact on outcomes. Data were collected on 5,000 adult patients undergoing elective small and large bowel operations over a 3-year period. Complication, readmission, and mortality rates were evaluated before and after ERP implementation...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28480623/differences-in-emergency-ambulance-demand-between-older-adults-living-in-residential-aged-care-facilities-and-those-living-in-the-community-in-melbourne-australia
#8
Kate Cantwell, Amee Morgans, Karen Smith, Michael Livingston, Paul Dietze
OBJECTIVE: To describe the clinical presentation and temporal variation in ambulance service cases involving patients aged 65 years or older (older adults) from residential aged care facilities and those who are community dwelling (CD). METHODS: This study used four years of electronic case records from Ambulance Victoria in Melbourne, Australia. Trigonometric regression was used to analyse demand patterns. RESULTS: Residential aged care facility cases included proportionally more falls and infection-related problems and fewer circulatory-related incidents than CD cases...
May 7, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28470994/patient-preference-for-radial-versus-femoral-vascular-access-for-elective-coronary-procedures-the-prevas-study
#9
Marlies M Kok, Marieke G M Weernink, Clemens von Birgelen, Anneloes Fens, Liefke C van der Heijden, Janine A van Til
OBJECTIVES: To explore patient preference for vascular access site in percutaneous coronary procedures, the perceived importance of benefits and risks of transradial access (TRA) and transfemoral access (TFA) were assessed. In addition, direct preference for vascular access and preference for shared decision making (SDM) were evaluated. BACKGROUND: TRA has gained significant ground on TFA during the last decades. Surveys on patient preference have mostly been performed in dedicated TRA trials...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28467581/can-we-make-an-early-do-not-resuscitate-decision-in-severe-burn-patients
#10
Yücel Yüce, Hakan Ahmet Acar, Kutlu Hakan Erkal, Erhan Tuncay
BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28465220/the-six-minute-walk-6mwt-as-a-measure-walking-capacity-wc-in-ambulatory-individual-with-amyotrophic-lateral-sclerosis-ambals
#11
Mohammed Sanjak, Velma Langford, Scott Holsten, Nigel Rozario, Charity G Moore Patterson, Elena Bravver, William L Bockenek, Benjamin R Brooks
OBJECTIVE: To determine the validity of the 6MWT as an outcome measure to evaluate WC in ambALS. DESIGN: Observational study. Participants performed 6MWT, 25FWT, TUG, lower extremity maximum voluntary isometric contraction (MVIC), ALSFRS-R, and forced vital capacity (FVC). SETTING: Multidisciplinary ALS clinic at an academic medical center. PARTICIPANTS: AmbALS (N=186) who ambulate without (stage I) or with (stage II) assistive device...
April 29, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28459301/role-of-guideline-adherence-in-improving-field-triage
#12
Craig D Newgard, Rongwei Fu, E Brooke Lerner, Mohamud Daya, Jonathan Jui, Lynn Wittwer, Terri A Schmidt, Dana Zive, Eileen M Bulger, Ritu Sahni, Craig Warden, Nathan Kuppermann
OBJECTIVE: To compare the sensitivity of current field triage practices for identifying high-risk trauma patients to strict guideline adherence, including changes in triage specificity, ambulance transport patterns, and trauma center volumes. METHODS: This was a pre-planned secondary analysis of an out-of-hospital prospective cohort of injured children and adults transported by 44 EMS agencies to 28 trauma and non-trauma hospitals in 7 Northwest U.S. counties from January 1, 2011 through December 31, 2011...
May 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28458530/frailty-syndrome-in-ambulatory-patients-with-copd
#13
Panita Limpawattana, Siraphong Putraveephong, Pratchaya Inthasuwan, Watchara Boonsawat, Daris Theerakulpisut, Jarin Chindaprasirt
Frailty is a state of increased risk of unfavorable outcomes when exposed to stressors, and COPD is one of the several chronic illnesses associated with the condition. However, few studies have been conducted regarding the prevalence of COPD and its related factors in Southeast Asia. The objectives of this study were to determine the prevalence of frailty in COPD patients and to identify the associated factors in these populations. A cross-sectional study of COPD patients who attended a COPD clinic was conducted from May 2015 to December 2016...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28455884/two-hour-evaluation-and-referral-model-for-shorter-turnaround-times-in-the-emergency-department
#14
John A Burke, Jaimi Greenslade, Jadwiga Chabrowska, Katherine Greenslade, Sally Jones, Jacqueline Montana, Anthony Bell, Alan O'Çonnor
OBJECTIVE: The objective of this study was to assess the implementation of a novel ED model of care, which combines clinical streaming, team-based assessment and early senior consultation to reduce length of stay. METHODS: A pre-post-intervention study was used to compare ED performance following an extensive clinical redesign programme. Clinical teams and work sequences were reconfigured to promote the role of the staff specialist, with a focus on earlier decisions regarding disposition...
April 28, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28448398/intrathecal-morphine-versus-extended-release-epidural-morphine-for-postoperative-pain-control-in-pediatric-patients-undergoing-posterior-spinal-fusion
#15
Mindy Cohen, Jeannie Zuk, Nancy McKay, Mark Erickson, Zhaoxing Pan, Jeffrey Galinkin
BACKGROUND: Posterior spinal fusion for scoliosis is one of the most painful elective pediatric surgeries. Good postoperative pain control allows early ambulation and return of ability to tolerate oral intake. Options for analgesia in this patient population are suboptimal. We hypothesized that extended-release epidural morphine (EREM) would provide better pain control and less adverse effects compared to intrathecal (IT) morphine. METHODS: The primary outcome was total IV morphine consumption during 0-48 hours postoperatively...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28446219/the-burden-epidemiology-costs-and-treatment-for-duchenne-muscular-dystrophy-an-evidence-review
#16
REVIEW
S Ryder, R M Leadley, N Armstrong, M Westwood, S de Kock, T Butt, M Jain, J Kleijnen
BACKGROUND: Duchenne Muscular Dystrophy (DMD) is a rapidly progressive, lethal neuromuscular disorder, present from birth, which occurs almost exclusively in males. We have reviewed contemporary evidence of burden, epidemiology, illness costs and treatment patterns of DMD. This systematic review adhered to published methods with information also sought from the web and contacting registries. Searches were carried out from 2005 to June 2015. The population of interest was individuals with clearly defined DMD or their carers...
April 26, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28446119/neurobionics-and-the-brain-computer-interface-current-applications-and-future-horizons
#17
REVIEW
Jeffrey V Rosenfeld, Yan Tat Wong
The brain-computer interface (BCI) is an exciting advance in neuroscience and engineering. In a motor BCI, electrical recordings from the motor cortex of paralysed humans are decoded by a computer and used to drive robotic arms or to restore movement in a paralysed hand by stimulating the muscles in the forearm. Simultaneously integrating a BCI with the sensory cortex will further enhance dexterity and fine control. BCIs are also being developed to: provide ambulation for paraplegic patients through controlling robotic exoskeletons; restore vision in people with acquired blindness; detect and control epileptic seizures; and improve control of movement disorders and memory enhancement...
May 1, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28445305/a-case-report-of-painless-type-a-aortic-dissection-with-intermittent-convulsive-syncope-as-initial-presentation
#18
Chun-Hsien Chen, Kuan-Ting Liu
RATIONALE: The initial presenting symptoms and signs of acute aortic dissection are so diverse that it makes early and accurate diagnosis arduous. Painless and convulsive syncope due to cardiac arrhythmia were not typical presentations of acute aortic dissection. PATIENT CONCERNS: A 61-year-old male presenting with transient consciousness loss and suspected seizure attack was sent to emergency room (ER) by ambulance. Consciousness loss accompanying with upward gaze and limb convulsion was noted in ER, and electrocardiogram monitor recorded a transient cardiac asystole then spontaneous recovery of sinus rhythm...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28443167/elderly-patients-achieving-clinical-and-radiological-outcomes-comparable-with-those-of-younger-patients-following-minimally-invasive-transforaminal-lumbar-interbody-fusion
#19
Joshi Nikhil N, Joel Wei-An Lim, William Yeo, Wai-Mun Yue
STUDY DESIGN: Retrospective analysis of prospective database. PURPOSE: To compare 2-year clinical and radiological outcomes after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) among "middle-age" (50-64.99 years), "young-old" (65-74.99 years), and "old-old" (>75 years) patients. OVERVIEW OF LITERATURE: Owing to higher perioperative morbidity and mortality rates, elderly patients with degenerative lumbar conditions are occasionally denied surgical care, even after conservative treatment failure...
April 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28435582/transient-osteoporosis-of-the-hip-a-case-report
#20
K Pande, T T Aung, J F Leong, I Bickle
Transient osteoporosis of the hip (TOH) is a benign, selflimiting condition characterised by acute onset groin pain in adults. Early diagnosis is important to differentiate it from progressive conditions such as osteonecrosis. We report on a middle-aged male who presented with right groin pain without any prior trauma. The diagnosis of transient osteoporosis of hip was confirmed by Magnetic Resonance Imaging (MRI) and he was successfully treated with a course of Alendronate sodium, anti-inflammatory analgesics and a period of non-weight bearing ambulation...
March 2017: Malaysian Orthopaedic Journal
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