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Leca BM, Lagojda L, Kite C, Karteris E, Kassi E, Randeva HS, Kyrou I. Maternal obesity and metabolic (dysfunction) associated fatty liver disease in pregnancy: a comprehensive narrative review. Expert Rev Endocrinol Metab 2024; 19:335-348. [PMID: 38860684 DOI: 10.1080/17446651.2024.2365791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Obesity and metabolic-associated fatty liver disease (MAFLD) during pregnancy constitute significant problems for routine antenatal care, with increasing prevalence globally. Similar to obesity, MAFLD is associated with a higher risk for maternal complications (e.g. pre-eclampsia and gestational diabetes) and long-term adverse health outcomes for the offspring. However, MAFLD during pregnancy is often under-recognized, with limited management/treatment options. AREAS COVERED PubMed/MEDLINE, EMBASE, and Scopus were searched based on a search strategy for obesity and/or MAFLD in pregnancy to identify relevant papers up to 2024. This review summarizes the pertinent evidence on the relationship between maternal obesity and MAFLD during pregnancy. Key mechanisms implicated in the underlying pathophysiology linking obesity and MAFLD during pregnancy (e.g. insulin resistance and dysregulated adipokine secretion) are highlighted. Moreover, a diagnostic approach for MAFLD diagnosis during pregnancy and its complications are presented. Finally, promising relevant areas for future research are covered. EXPERT OPINION Research progress regarding maternal obesity, MAFLD, and their impact on maternal and fetal/offspring health is expected to improve the relevant diagnostic methods and lead to novel treatments. Thus, routine practice could apply more personalized management strategies, incorporating individualized algorithms with genetic and/or multi-biomarker profiling to guide prevention, early diagnosis, and treatment.
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Affiliation(s)
- Bianca M Leca
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Lukasz Lagojda
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Clinical Evidence-Based Information Service (CEBIS), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Chris Kite
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- School of Health and Society, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
- Chester Medical School, University of Chester, Shrewsbury, UK
| | - Emmanouil Karteris
- College of Health, Medicine and Life Sciences, Division of Biosciences, Brunel University London, Uxbridge, UK
| | - Eva Kassi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Endocrine Unit, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Harpal S Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
- Institute of Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
- Institute of Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, UK
- College of Health, Psychology and Social Care, University of Derby, Derby, UK
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece
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Li J, Hu Z, Luo M, Wu Z, Dou X, Wang Z, Yu S, Xiao L, Qiu J, Yu S, Chen M, Lu S, Su B, Cheng L, Fan Y, Qin HY. Safety and effectiveness of tunneled peripherally inserted central catheters versus conventional PICC in adult cancer patients. Eur Radiol 2024:10.1007/s00330-024-10852-y. [PMID: 38940828 DOI: 10.1007/s00330-024-10852-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/05/2024] [Accepted: 06/05/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES This study aimed to compare the safety and effectiveness of tunneled peripherally inserted central catheters (T-PICC) vs. conventional PICCs (C-PICC) in adult cancer patients. METHODS A multicentre randomized controlled trial was conducted between April 2021 and January 2022 in seven hospitals in China. 564 participants were randomly assigned to T-PICC or C-PICC. These data were collected and compared: the baseline characteristics and catheterization-related characteristics, periprocedural complications, and long-term complications. RESULTS Five-hundred fifty-three participants (aged, 52.6 ± 12.3 years; female, 39.1%) were ultimately analyzed. No significant differences in periprocedural complications were found between the T-PICC and C-PICC groups (all p > 0.05). Compared with C-PICC, T-PICC significantly reduced the incidence of long-term complications (26.4% vs. 39.9%, p < 0.001). Specifically, reduced complications were found in central line-associated bloodstream infection (1.8% vs. 5.1%, p = 0.04), thrombosis (1.1% vs. 4.0%, p = 0.03), catheter dislodgement (4.7% vs. 10.1%, p = 0.01), non-infectious oozing (17.3% vs. 28.6%, p = 0.002), local infection (3.6% vs. 7.6%, p = 0.04), skin irritation (6.1% vs. 10.9%, p = 0.046), and reduced unplanned catheter removal (2.2% vs. 7.2%, p = 0.005). No significant differences were found between T-PICC and C-PICC regarding catheter occlusion (6.5% vs. 5.8%, p = 0.73) or skin damage (2.2% vs. 2.9%, p = 0.58). CONCLUSION T-PICC is safe and effectively reduces long-term complications. CLINICAL RELEVANCE STATEMENT The tunneled technique is effective in reducing PICC-related long-term complications. Thus, it is recommended for cancer patients at high risk of PICC-related complications. TRIAL REGISTRATION The registration number on https://www.chictr.org.cn/ is ChiCTR2100044632. The name of the trial registry is "A multicenter randomized controlled study of clinical use of tunneled vs. non-tunneled PICC". KEY POINTS Cather-related complications are associated with the technique of catheterization. Compared with conventional PICC, tunneled PICC reduced catheter-related long-term complications. Tunneled PICC placement provides an alternative catheterization method for cancer patients.
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Affiliation(s)
- Jia Li
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Zeyin Hu
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Mengna Luo
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Zhenming Wu
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Xinman Dou
- Lanzhou University Second Hospital, Lanzhou, 730030, China
| | - Zhiying Wang
- Hainan Cancer Prevention and Treatment Center, Hankou, 570100, China
| | - Shuang Yu
- Hainan Cancer Prevention and Treatment Center, Hankou, 570100, China
| | - Liping Xiao
- Longyan First Hospital, Longyan, 364000, China
| | - Jinhua Qiu
- Longyan First Hospital, Longyan, 364000, China
| | - Shuxian Yu
- Cancer Hospital of Shantou University Medical College, Shantou, 515000, China
| | - Mengyun Chen
- Jieyang People's Hospital, Jieyang, 522000, China
| | - Suxiang Lu
- Jieyang People's Hospital, Jieyang, 522000, China
| | - Binglian Su
- Gaozhou People's Hospital, Gaozhou, 525200, China
| | - Li Cheng
- Gaozhou People's Hospital, Gaozhou, 525200, China
| | - Yuying Fan
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
| | - Hui-Ying Qin
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
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Sauro KM, Smith C, Ibadin S, Thomas A, Ganshorn H, Bakunda L, Bajgain B, Bisch SP, Nelson G. Enhanced Recovery After Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality: A Meta-Analysis of Randomized Clinical Trials. JAMA Netw Open 2024; 7:e2417310. [PMID: 38888922 PMCID: PMC11195621 DOI: 10.1001/jamanetworkopen.2024.17310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/17/2024] [Indexed: 06/20/2024] Open
Abstract
Importance A comprehensive review of the evidence exploring the outcomes of enhanced recovery after surgery (ERAS) guidelines has not been completed. Objective To evaluate if ERAS guidelines are associated with improved hospital length of stay, hospital readmission, complications, and mortality compared with usual surgical care, and to understand differences in estimates based on study and patient factors. Data Sources MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Central were searched from inception until June 2021. Study Selection Titles, abstracts, and full-text articles were screened by 2 independent reviewers. Eligible studies were randomized clinical trials that examined ERAS-guided surgery compared with a control group and reported on at least 1 of the outcomes. Data Extraction and Synthesis Data were abstracted in duplicate using a standardized data abstraction form. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Risk of bias was assessed in duplicate using the Cochrane Risk of Bias tool. Random-effects meta-analysis was used to pool estimates for each outcome, and meta-regression identified sources of heterogeneity within each outcome. Main Outcome and Measures The primary outcomes were hospital length of stay, hospital readmission within 30 days of index discharge, 30-day postoperative complications, and 30-day postoperative mortality. Results Of the 12 047 references identified, 1493 full texts were screened for eligibility, 495 were included in the systematic review, and 74 RCTs with 9076 participants were included in the meta-analysis. Included studies presented data from 21 countries and 9 ERAS-guided surgical procedures with 15 (20.3%) having a low risk of bias. The mean (SD) Reporting on ERAS Compliance, Outcomes, and Elements Research checklist score was 13.5 (2.3). Hospital length of stay decreased by 1.88 days (95% CI, 0.95-2.81 days; I2 = 86.5%; P < .001) and the risk of complications decreased (risk ratio, 0.71; 95% CI, 0.59-0.87; I2 = 78.6%; P < .001) in the ERAS group. Risk of readmission and mortality were not significant. Conclusions and Relevance In this meta-analysis, ERAS guidelines were associated with decreased hospital length of stay and complications. Future studies should aim to improve implementation of ERAS and increase the reach of the guidelines.
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Affiliation(s)
- Khara M. Sauro
- Department of Community Health Sciences and O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology and Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christine Smith
- Department of Community Health Sciences and O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Seremi Ibadin
- Department of Community Health Sciences and O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Abigail Thomas
- Department of Community Health Sciences and O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Heather Ganshorn
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Linda Bakunda
- Department of Community Health Sciences and O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bishnu Bajgain
- Department of Community Health Sciences and O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Steven P. Bisch
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Ariadne Labs, Brigham and Women’s Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Naser IH, Zaid M, Ali E, Jabar HI, Mustafa AN, Alubiady MHS, Ramadan MF, Muzammil K, Khalaf RM, Jalal SS, Alawadi AH, Alsalamy A. Unveiling innovative therapeutic strategies and future trajectories on stimuli-responsive drug delivery systems for targeted treatment of breast carcinoma. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:3747-3770. [PMID: 38095649 DOI: 10.1007/s00210-023-02885-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/02/2023] [Indexed: 05/23/2024]
Abstract
This comprehensive review delineates the latest advancements in stimuli-responsive drug delivery systems engineered for the targeted treatment of breast carcinoma. The manuscript commences by introducing mammary carcinoma and the current therapeutic methodologies, underscoring the urgency for innovative therapeutic strategies. Subsequently, it elucidates the logic behind the employment of stimuli-responsive drug delivery systems, which promise targeted drug administration and the minimization of adverse reactions. The review proffers an in-depth analysis of diverse types of stimuli-responsive systems, including thermoresponsive, pH-responsive, and enzyme-responsive nanocarriers. The paramount importance of material choice, biocompatibility, and drug loading strategies in the design of these systems is accentuated. The review explores characterization methodologies for stimuli-responsive nanocarriers and probes preclinical evaluations of their efficacy, toxicity, pharmacokinetics, and biodistribution in mammary carcinoma models. Clinical applications of stimuli-responsive systems, ongoing clinical trials, the potential of combination therapies, and the utility of multifunctional nanocarriers for the co-delivery of assorted drugs and therapies are also discussed. The manuscript addresses the persistent challenge of drug resistance in mammary carcinoma and the potential of stimuli-responsive systems in surmounting it. Regulatory and safety considerations, including FDA guidelines and biocompatibility assessments, are outlined. The review concludes by spotlighting future trajectories and emergent technologies in stimuli-responsive drug delivery, focusing on pioneering approaches, advancements in nanotechnology, and personalized medicine considerations. This review aims to serve as a valuable compendium for researchers and clinicians interested in the development of efficacious and safe stimuli-responsive drug delivery systems for the treatment of breast carcinoma.
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Affiliation(s)
- Israa Habeeb Naser
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, Iraq
| | - Muhaned Zaid
- Department of Pharmacy, Al-Manara College for Medical Sciences, Maysan, Amarah, Iraq
| | - Eyhab Ali
- Al-Zahraa University for Women, Karbala, Iraq
| | - Hayder Imad Jabar
- Department of Pharmaceutics, College of Pharmacy, University of Al-Ameed, Karbala, Iraq
| | | | | | | | - Khursheed Muzammil
- Department of Public Health, College of Applied Medical Sciences, Khamis Mushait Campus, King Khalid University, Abha, Saudi Arabia
| | | | - Sarah Salah Jalal
- College of Pharmacy, National University of Science and Technology, Dhi Qar, Iraq
| | - Ahmed Hussien Alawadi
- College of Technical Engineering, the Islamic University, Najaf, Iraq
- College of Technical Engineering, the Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
- College of Technical Engineering, the Islamic University of Babylon, Babylon, Iraq
| | - Ali Alsalamy
- College of Technical Engineering, Imam Ja'afar Al-Sadiq University, Al-Muthanna, Iraq.
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Latos M, Kosson D, Zawadka M. Poland's first vascular access team 3-year analysis: Insights and learnings. J Vasc Access 2024:11297298241251502. [PMID: 38708844 DOI: 10.1177/11297298241251502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, Poland saw a surge in interest in midline catheters (MCs) and Long Peripheral Catheters (LPCs) for intravenous therapy. Before this, MCs were not extensively utilised in the country, and there was no formally established Polish vascular access team. MCs, which have been used for years in many countries, are now becoming increasingly common in Poland. This study aimed to analyse the use of MCs in a 3-year perspective of their introduction in daily clinical practice based on a nurse-led Vascular Access Team (VAT). METHODS The records of adult patients who received intravenous therapy with 727 MCs and 293 LPCs from January 2021 to December 2023 at the University Clinical Centre of the Medical University of Warsaw were analysed. RESULTS The main indication for cannulation was expected intravenous therapy over 5 days (81.66%, n = 833), of which 71.37% (n = 728) of patients in this group had concomitant difficult intravenous access (DIVA). Over 6 years, centrally inserted central catheters (CICCs) inserted due to DIVA were reduced from n = 108 in 2017 to n = 18 in 2023. The end of intravenous therapy was the reason for the removal of 64.6% of catheters (n = 659), including death and switch to CICCs as well. Complications leading to premature removal accounted for 31.2%, such as: occlusion (14.6%), patient self-removal (7.1%) and thrombosis (3.43%). CONCLUSIONS The introduction of MCs as a possible option for peripheral venous access reduces the use of CVCs. Developing MCs programmes should be based on investing in staff competencies, which increases success rates. The nurses and physicians should be trained in infusion care to achieve better results in the use of MCs and LPCs. Increasing the competence of nurses in Poland is necessary for the implementation of full-service and top-level functioning of VAT.
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Affiliation(s)
- Maciej Latos
- Department of Anaesthesiology and Intensive Care Division of Teaching, Medical University of Warsaw, Warsaw, Poland
| | - Dariusz Kosson
- Department of Anaesthesiology and Intensive Care Division of Teaching, Medical University of Warsaw, Warsaw, Poland
| | - Mateusz Zawadka
- 2nd Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland
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Tang K, Sutherland JM, Liu G, Crump T, Bazzarelli A, Dingee C, Pao JS, Warburton R, McKevitt E. Preoperative depression and anxiety associated with younger age and receipt of immediate breast reconstruction. Am J Surg 2024; 231:106-112. [PMID: 38350745 DOI: 10.1016/j.amjsurg.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/24/2024] [Accepted: 02/07/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND As survivorship for breast cancer continues to improve, emphasis of care falls upon improving patients' quality of life. Understanding physical and mental health in the preoperative period is needed to aid surgical decision making and improve patient experience. METHODS Consecutive patients awaiting total mastectomy (TM), TM with immediate breast reconstruction (IBR) and breast conserving surgery (BCS) were prospectively recruited. Scores for PHQ-9, GAD-7, Breast-Q, EQ5D(5L), PEG were collected preoperatively. Association was measured with multivariate analyses. RESULTS 477 participants (374 BSC, 46 TM, 84 IBR) were included. Younger patients and those choosing IBR reported worse depression and anxiety symptoms. Clinical tumor features did not affect patient reported outcomes. Higher Breast-Q scores were seen with BCS and lower scores with TM. CONCLUSIONS Patients scheduled for IBR and younger patients reported worse symptoms of depression and anxiety, regardless of clinical features. This will help with surgical decision making and identify patients in need for additional perioperative supports.
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Affiliation(s)
- Katelynn Tang
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Guiping Liu
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Trafford Crump
- Department of Surgery, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
| | - Amy Bazzarelli
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
| | - Carol Dingee
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
| | - Jin-Si Pao
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
| | - Rebecca Warburton
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
| | - Elaine McKevitt
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
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Xiao X, Zuo YD, Kuang SY, Liu CY, Kun-Shao, Wang H, Yan SY, Yu F, Xu Y, Zhou L, Jiang CL. Effectiveness of WeChat-assisted preoperative education to reduce perioperative anxiety in breast cancer patients: a prospective randomized controlled study protocol. Trials 2024; 25:231. [PMID: 38570855 PMCID: PMC10993457 DOI: 10.1186/s13063-024-08071-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Breast cancer is the most prevalent cancer among women globally, and surgical procedures continue to be the primary treatment. However, over 50% of patients experience preoperative anxiety due to the unknown and fear associated with surgery. Although drug therapy is commonly used to address this anxiety, its side effects have led to a heated debate regarding its effectiveness. Consequently, non-pharmacological therapies, such as preoperative education, have emerged as an alternative approach to alleviate anxiety. WeChat, a widely popular social media platform, offers a public platform that can potentially be utilized for effective preoperative education. This study aims to evaluate the use of WeChat public platform as a tool for preoperative education in patients undergoing breast surgery. METHODS This is a prospective, randomized, and controlled trial will involve 392 adult women scheduled for breast cancer resection. Participants will be randomly assigned to either the WeChat education group or the regular group. In addition to regular preoperative visits, the WeChat education group will also watch science videos through the WeChat public platform. The regular group will only receive education from ward nurses during preoperative visits. The primary outcome measure will be the incidence of preoperative anxiety, defined by scores of the State Anxiety Inventory (SAI) exceeding 40 points. Secondary outcome measures include the incidence of severe anxiety (SAI > 44) on the day before surgery, incidence of anxiety 72 h after surgery, incidence of severe anxiety 72 h after surgery, NRS scores for pain at rest and during activity 24, 48, and 72 h after surgery, incidence of nausea and vomiting within 24 h after surgery, subjective sleep score at 1 week postoperatively, quality of life QoR-15 scores at 1 and 3 months postoperatively, incidence of chronic pain at 3 months postoperatively, bowel function recovery, length of hospital stay, and hospitalization expenses. DISCUSSION This is the first clinical trial to investigate the use of WeChat public platform for delivering preoperative education on perioperative anxiety in breast cancer patients. By utilizing the renowned WeChat public platform, our study aims to improve patient outcomes by providing video education that explains the disease, surgery, and anesthesia in a more accessible manner, thereby reducing the incidence of perioperative anxiety. If our hypothesis is confirmed, this non-pharmacological approach can be universally acknowledged as a cost-effective and practical method in clinical care. Its application can also be extended to other medical fields beyond breast cancer. TRIAL REGISTRATION ClinicalTrials.gov, NCT05291494. Registered on 29 December 2021.
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Affiliation(s)
- Xiao Xiao
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Yi-Ding Zuo
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
- West China Xiamen Hospital of Sichuan University, 361000, Xiamen, China
| | - Shu-Yu Kuang
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Chun-Yuan Liu
- Chongqing Liangping District People's Hospital, Chongqing, 400700, China
| | - Kun-Shao
- Xinxiang Central Hospital, Xinxiang, 453000, China
| | - Heng Wang
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Si-Yu Yan
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Feng Yu
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Yan Xu
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Li Zhou
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Chun-Ling Jiang
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China.
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Hanalis-Miller T, Ricon-Becker I, Sakis N, Trachtenberg E, Ohayon F, Wadhawker S, Birnboim Y, Magen A, Sharon E, Tarrasch R, Goldzweig G, Cole SW, Jacoby R, Ben-Eliyahu S. Peri-operative individually tailored psychological intervention in breast cancer patients improves psychological indices and molecular biomarkers of metastasis in excised tumors. Brain Behav Immun 2024; 117:529-540. [PMID: 38346596 DOI: 10.1016/j.bbi.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
Perioperative stress and inflammatory signaling can invigorate pro-metastatic molecular processes in patients' tumors, potentially worsening long-term survival. Yet, it is unknown whether pre-operative psychotherapeutic interventions can attenuate such effects. Herein, three weeks before surgery, forty women diagnosed with stage I-III invasive ductal/lobular breast carcinoma were randomized to a 6-week one-on-one psychological intervention (6 meetings with a medical psychologist and bi-weekly phone calls) versus standard nursing-staff-attention. The intervention protocol was individually tailored based on evaluation of patients' emotional, cognitive, physiological, and behavioral stress response-patterns, and also included psychoeducation regarding medical treatments and recruitment of social support. Resected primary tumors were subjected to whole-genome RNA sequencing and bioinformatic analyses, assessing a priori hypothesized cancer-relevant molecular signatures. Self-report questionnaires (BSI-18, Hope-18, MSPSS, and a stress-scale) were collected three (T1) and one (T2) week before surgery, a day before (T3) and after (T4) surgery, and three weeks (T5) and 3-months (T6) following surgery. The intervention reduced distress (GSI), depression, and somatization scores (BSI-18: p < 0.01, p < 0.05, p < 0.05; T5 vs. T1). Additionally, tumors from treated patients (vs. controls) showed: (i) decreased activity of transcription control pathways involved in adrenergic and glucocorticoid signaling (CREB, GR) (p < 0.001), pro-inflammatory signaling (NFkB) (p < 0.01), and pro-malignant signaling (ETS1, STAT and GATA families) (p < 0.001, p < 0.01, p < 0.005); (ii) increased M1 macrophage polarization (p < 0.05), and CD4+ T cell activity (p < 0.01); and an unexpected increase in epithelial-to-mesenchymal-transition (EMT) signature (p < 0.005). This is the first randomized controlled trial to show beneficial effects of a psychological perioperative intervention on tumor pro-metastatic molecular biomarkers.
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Affiliation(s)
- Tsipi Hanalis-Miller
- Psychoneuroimmunology Laboratory, School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel; Stress, Hope and Cope Laboratory, School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Itay Ricon-Becker
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Nahida Sakis
- Psychoneuroimmunology Laboratory, School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | | | - Frida Ohayon
- Department of Surgery, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Sonya Wadhawker
- Department of Surgery, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Yehudit Birnboim
- Department of Surgery, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Ada Magen
- Department of Surgery, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Eran Sharon
- Department of Surgery, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | | | - Gil Goldzweig
- Stress, Hope and Cope Laboratory, School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Steve W Cole
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Rebecca Jacoby
- Stress, Hope and Cope Laboratory, School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Shamgar Ben-Eliyahu
- Psychoneuroimmunology Laboratory, School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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9
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Giustivi D, Donadoni M, Elli SM, Casella F, Quici M, Cogliati C, Cavalli S, Rizzi G, La Cava L, Bartoli A, Martini E, Taino A, Perego M, Foschi A, Castelli R, Calloni M, Gidaro A. Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis. NURSING REPORTS 2024; 14:455-467. [PMID: 38391080 PMCID: PMC10885060 DOI: 10.3390/nursrep14010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/31/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis aimed to compare the effectiveness of tunneled Peripherally Inserted Central Catheters (tPICCs) to conventional Peripherally Inserted Central Catheters (cPICCs) in terms of bleeding, overall success, procedural time, and late complications. METHODS Randomized controlled trials without language restrictions were searched using PUBMED®, EMBASE®, EBSCO®, CINAHL®, and the Cochrane Controlled Clinical Trials Register from August 2022 to August 2023. Five relevant papers (1238 patients) were included. RESULTS There were no significant differences in overall success and nerve or artery injuries between the two groups (p = 0.62 and p = 0.62, respectively), although cPICCs caused slightly less bleeding (0.23 mL) and had shorter procedural times (2.95 min). On the other hand, tPICCs had a significantly reduced risk of overall complications (p < 0.001; RR0.41 [0.31-0.54] CI 95%), catheter-related thrombosis (p < 0.001; RR0.35 [0.20-0.59] IC 95%), infection-triggering catheter removal (p < 0.001; RR0.33 [0.18-0.61] IC 95%), wound oozing (p < 0.001; RR0.49 [0.37-0.64] IC 95%), and dislodgement (p < 0.001; RR0.4 [0.31-0.54] CI 95%). CONCLUSIONS The tunneling technique for brachial access appears to be safe concerning intra-procedural bleeding, overall success, and procedural time, and it is effective in reducing the risk of late complications associated with catheterization.
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Affiliation(s)
| | - Mattia Donadoni
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Stefano Maria Elli
- Healthcare Profession Department-PICC Team, University of Milan Bicocca, IRCCS San Gerardo dei Tintori Foundation Hospital, 20126 Monza, Italy
| | - Francesco Casella
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Massimiliano Quici
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Chiara Cogliati
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Silvia Cavalli
- Healthcare Profession Department-PICC Team, University of Milan Bicocca, IRCCS San Gerardo dei Tintori Foundation Hospital, 20126 Monza, Italy
| | - Giulia Rizzi
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Leyla La Cava
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Arianna Bartoli
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Elena Martini
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Alba Taino
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Martina Perego
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Antonella Foschi
- Department of Infectious Diseases, Luigi Sacco Hospital, 20157 Milan, Italy
| | - Roberto Castelli
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro N° 8, 07100 Sassari, Italy
| | - Maria Calloni
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Antonio Gidaro
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
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10
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Zeng HJ, Liu JJ, Yang YC. Clinical observation of gastrointestinal function recovery in patients after hepatobiliary surgery. World J Gastrointest Surg 2024; 16:76-84. [PMID: 38328324 PMCID: PMC10845271 DOI: 10.4240/wjgs.v16.i1.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/21/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The liver is an important metabolic and digestive organ in the human body, capable of producing bile, clotting factors, and vitamins. AIM To investigate the recovery of gastrointestinal function in patients after hepatobiliary surgery and identify effective rehabilitation measures. METHODS A total of 200 patients who underwent hepatobiliary surgery in our hospital in 2022 were selected as the study subjects. They were divided into a control group and a study group based on the extent of the surgery, with 100 patients in each group. The control group received routine treatment, while the study group received targeted interventions, including early enteral nutrition support, drinking water before gas discharge, and large bowel enema, to promote postoperative gastrointestinal function recovery. The recovery of gastrointestinal function was compared between the two groups. RESULTS Compared with the control group, patients in the study group had better recovery of bowel sounds and less accumulation of fluids in the liver bed and gallbladder fossa (P < 0.05). They also had shorter time to gas discharge and first meal (P < 0.05), higher overall effective rate of gastrointestinal function recovery (P < 0.05), and lower incidence of postoperative complications (P < 0.05). CONCLUSION Targeted nursing interventions (early nutritional support, drinking water before gas discharge, and enema) can effectively promote gastrointestinal function recovery in patients undergoing hepatobiliary surgery and reduce the incidence of complications, which is worthy of promotion.
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Affiliation(s)
- Hua-Jun Zeng
- Department of General Practice, Nanyang First People's Hospital, Nanyang 473000, Henan Province, China
| | - Jing-Jing Liu
- Department of Anesthesiology, Chinese People’s Armed Police Force Hospital of Beijing, Beijing 100027, China
| | - Ying-Chun Yang
- Department of Anesthesiology, Beijing Fengtai Hospital, Beijing 100071, China
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11
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Greyling CF, Ganguly A, Sardesai AU, Churcher NKM, Lin KC, Muthukumar S, Prasad S. Passive sweat wearable: A new paradigm in the wearable landscape toward enabling "detect to treat" opportunities. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2024; 16:e1912. [PMID: 37356818 DOI: 10.1002/wnan.1912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 04/11/2023] [Accepted: 05/27/2023] [Indexed: 06/27/2023]
Abstract
Growing interest over recent years in personalized health monitoring coupled with the skyrocketing popularity of wearable smart devices has led to the increased relevance of wearable sweat-based sensors for biomarker detection. From optimizing workouts to risk management of cardiovascular diseases and monitoring prediabetes, the ability of sweat sensors to continuously and noninvasively measure biomarkers in real-time has a wide range of applications. Conventional sweat sensors utilize external stimulation of sweat glands to obtain samples, however; this stimulation influences the expression profile of the biomarkers and reduces the accuracy of the detection method. To address this limitation, our laboratory pioneered the development of the passive sweat sensor subfield, which allowed for our progress in developing a sweat chemistry panel. Passive sweat sensors utilize nanoporous structures to confine and detect biomarkers in ultra-low sweat volumes. The ability of passive sweat sensors to use smaller samples than conventional sensors enable users with sedentary lifestyles who perspire less to benefit from sweat sensor technology not previously afforded to them. Herein, the mechanisms and strategies of current sweat sensors are summarized with an emphasis on the emerging subfield of passive sweat-based diagnostics. Prospects for this technology include discovering new biomarkers expressed in sweat and expanding the list of relevant detectable biomarkers. Moreover, the accuracy of biomarker detection can be enhanced with machine learning using prediction algorithms trained on clinical data. Applying this machine learning in conjunction with multiplex biomarker detection will allow for a more holistic approach to trend predictions. This article is categorized under: Diagnostic Tools > Diagnostic Nanodevices Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Diagnostic Tools > Biosensing.
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Affiliation(s)
| | - Antra Ganguly
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, USA
| | - Abha Umesh Sardesai
- Department of Computer Engineering, The University of Texas at Dallas, Richardson, Texas, USA
| | | | - Kai-Chun Lin
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, USA
| | | | - Shalini Prasad
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, USA
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12
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Minciullo A, Filomeno L. Nurse-Administered Propofol Sedation Training Curricula and Propofol Administration in Digestive Endoscopy Procedures: A Scoping Review of the Literature. Gastroenterol Nurs 2024; 47:33-40. [PMID: 37937982 DOI: 10.1097/sga.0000000000000780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 07/21/2023] [Indexed: 11/09/2023] Open
Abstract
Although efficacy and safety of nonanesthesiologist administration of propofol and nurse-administered propofol sedation practices have been amply demonstrated in patients at low American Society of Anesthesiologists physical status risk, they are still severely limited. To date, it is quite difficult to find a protocol or a shared training program. The aim of the study was to verify requirements, types of training, and operating methods described in the literature for the administration of propofol by a nurse. A scoping review of the literature was conducted in accordance with the PRISMA-ScR guidelines and in line with Arksey and O'Malley's framework, within four main databases of biomedical interest: MEDLINE, CINAHL, Scopus, and Web of Science. We selected studies published during the last 20 years, including only nurses not trained in anesthesia. Seventeen articles were eligible. Despite the differences between the training and administration methods, efficacy and safety of deep sedation managed by trained nurses were comparable, just like when sedation was administered by certified registered nurse anesthetists. Training programs have been investigated in detail by only a small number of studies, although its efficacy and safety have been widely demonstrated. It is important, then, to collect evidence that allows developing of unified international guidelines for training methods to offer safe and cost-effective quality sedation.
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Affiliation(s)
- Andrea Minciullo
- Andrea Minciullo, MSN, RN, is Head Nurse, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Lucia Filomeno, MSN, RN, is Research Fellow, Sapienza University of Rome, Rome, Italy
| | - Lucia Filomeno
- Andrea Minciullo, MSN, RN, is Head Nurse, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Lucia Filomeno, MSN, RN, is Research Fellow, Sapienza University of Rome, Rome, Italy
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13
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Kapritsou M, Bozas E, Stavrianos S, Salatas K, Plastiras A, Pistolas K, Fyrfiris N, Kotrotsiou M, Konstantinou EA. The Total Intra Venous Anesthesia Effect Versus Volatile Anesthesia, on Stress and Pain Levels, in Patients Undergoing Breast Reconstruction in Ambulatory Surgery Center Total Intra Venous Anesthesia Protocol and Stress Response. Biol Res Nurs 2024; 26:91-100. [PMID: 37559349 DOI: 10.1177/10998004231194571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
AIM To compare pain and stress response through cortisol and DHEA levels, implementing. Total intra venous anesthesia (TIVA) versus general anesthesia with volatile anesthetics (VOL). DESIGN This is a prospective randomized correlation study with consecutive measurements. METHODS In an ambulatory surgical center from October of 2019 to August of 2020, patients who underwent breast reconstruction with autologous fat grafting were randomized into 2 groups. Patients in the TIVA group (n = 23) received intravenous anesthesia and those in the VOL group (n = 23) received volatile anesthesia (desflurane). Demographic, anthropometric and clinical data were recorded. Arterial systolic (SP) and diastolic (DP) blood pressure, heart rate and oxygen saturation were recorded. Pain and stress levels were evaluated through salivary cortisol and DHEA levels at 4 different time points: T0) 1 hour before induction, T1) during the induction, T2) during anesthesia maintenance, and T3) in recovery phase. Statistical analysis was performed with SPSS 25.0 at significant level α = .05. FINDINGS There were no statistically significant differences between the 2 groups regarding demographic features. Interestingly that there was a statistically significant difference in the vital sign monitoring where patients in the TIVA group reported with higher levels of SP(T2) and DP (T2), whilst DHEA (T1) levels was correlated positively with patient's age and cortisol (T1) levels and negatively with DP (T3). CONCLUSIONS This study supports the use of TIVA as a safe and effective option for anesthesia in patients undergoing breast reconstruction with autologous fat grafting.
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Affiliation(s)
- Maria Kapritsou
- Hellenic Perianaesthesia Nursing Organization, Chief Nurse of Surgery Sector, Hellenic Anticancer Institute ''Saint Savvas'' Hospital, Athens, Greece
| | - Evangelos Bozas
- Department of Nursing, Pediatric Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Aris Plastiras
- Department of Surgical Oncology, St Savvas Oncological Centre of Athens, Athens, Greece
| | | | - Nikolaos Fyrfiris
- Consultant Anesthesiologist, "Saint Savvas" Hospital, Athens, Greece
| | - Maria Kotrotsiou
- Plastic and Reconstructive Clinic, Evaggelismos Hospital, Athens, Greece
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14
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Sheng Y, Yang LH, Wu Y, Gao W, Dongye SY. Implementation of Tunneled Peripherally Inserted Central Catheters Placement in Cancer Patients: A Randomized Multicenter Study. Clin Nurs Res 2024; 33:19-26. [PMID: 37596863 DOI: 10.1177/10547738231194099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
This study sought to evaluate the impact of the subcutaneous tunneling technique on peripherally inserted central catheter (PICC) placement. We randomized 694 patients who needed PICC placement to either the tunneled PICCs (experimental group) or the non-tunneled PICCs (control group) from August to December 2021. The cumulative frequency of complications was assessed as the primary outcome. Secondary outcomes comprised of the amount of bleeding, catheter insertion time, self-reported pain score, and one-puncture success rate. After 6 months of follow-up, the tunneled PICCs group showed a significant decrease in the frequency of total complications, especially in infection (3.0% vs. 7.1%, p = .021) and catheter-related thrombosis (3.3% vs. 8.3%, p = .008), although approximately 0.5 ml bleeding and 3.5 min time were increased. This randomized multicenter study supports the efficacy of subcutaneous tunneling technology in reducing PICC-related complications, enhancing patient comfort, and encouraging using subcutaneous tunneling technology for PICC placement.
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Affiliation(s)
- Yuan Sheng
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
- Medical School, Liaocheng University, China
| | - Li-Hong Yang
- Department of Hematology, Liaocheng People's Hospital, China
| | - Yan Wu
- Medical Oncology Center, Shandong University of Qilu Hospital, Jinan, China
| | - Wei Gao
- Department of PICCs Clinic, Shandong University of Qilu Hospital, Jinan, China
| | - Sheng-Yi Dongye
- Department of Pathology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, China
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15
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Shang MY, Tian LX, Tian CX, Chen WJ, Yu CY, Wang Z, Wang J, Lian DB, Xu GZ, Du DX, Li TX, Amin B, Zhang NW, Wang L. Giant lipoma in the Retzius space resected under laparoscopy: A case report. Exp Ther Med 2024; 27:3. [PMID: 38223329 PMCID: PMC10785029 DOI: 10.3892/etm.2023.12290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/21/2023] [Indexed: 01/16/2024] Open
Abstract
Lipoma is a common type of benign soft tissue tumor that can occur in the shoulders, neck and back, in addition to other body parts. The Retzius space is a small anatomical space between the pubic symphysis and the bladder located extraperitoneally and filled with loose fatty connective tissue. Giant lipomas are rare in the Retzius space. A 61-year-old Chinese male arrived at Beijing Yanhua Hospital (Beijing, China) due to frequent urination, and CT scan images of the lower abdomen observed a large pelvic mass and left inguinal hernia. Preoperative clinical manifestations and auxiliary examination suggested that the tumor originated from the urinary bladder wall. The maximum tumor diameter was ~25 cm and abdominal pressure was increased. Therefore, laparoscopic pelvic tumor resection combined with inguinal hernia repair was attempted. Intraoperatively, the tumor was found to originate from the Retzius space and the postoperative pathological diagnosis was lipoma. The present case report may serve as a reference for minimally invasive treatment of this type of rare disease in future.
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Affiliation(s)
- Ming-Yue Shang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Li-Xin Tian
- Department of Urology, Beijing Yanhua Hospital, Beijing 102500, P.R. China
| | - Chen-Xu Tian
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Wei-Jian Chen
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Cheng-Yuan Yu
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Zheng Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Jing Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Dong-Bo Lian
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Guang-Zhong Xu
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - De-Xiao Du
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Tian-Xiong Li
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Buhe Amin
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Neng-Wei Zhang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Liang Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
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16
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Servin F, Collins JA, Heiselman JS, Frederick-Dyer KC, Planz VB, Geevarghese SK, Brown DB, Jarnagin WR, Miga MI. Simulation of Image-Guided Microwave Ablation Therapy Using a Digital Twin Computational Model. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2023; 5:107-124. [PMID: 38445239 PMCID: PMC10914207 DOI: 10.1109/ojemb.2023.3345733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/14/2023] [Accepted: 12/04/2023] [Indexed: 03/07/2024] Open
Abstract
Emerging computational tools such as healthcare digital twin modeling are enabling the creation of patient-specific surgical planning, including microwave ablation to treat primary and secondary liver cancers. Healthcare digital twins (DTs) are anatomically one-to-one biophysical models constructed from structural, functional, and biomarker-based imaging data to simulate patient-specific therapies and guide clinical decision-making. In microwave ablation (MWA), tissue-specific factors including tissue perfusion, hepatic steatosis, and fibrosis affect therapeutic extent, but current thermal dosing guidelines do not account for these parameters. This study establishes an MR imaging framework to construct three-dimensional biophysical digital twins to predict ablation delivery in livers with 5 levels of fat content in the presence of a tumor. Four microwave antenna placement strategies were considered, and simulated microwave ablations were then performed using 915 MHz and 2450 MHz antennae in Tumor Naïve DTs (control), and Tumor Informed DTs at five grades of steatosis. Across the range of fatty liver steatosis grades, fat content was found to significantly increase ablation volumes by approximately 29-l42% in the Tumor Naïve and 55-60% in the Tumor Informed DTs in 915 MHz and 2450 MHz antenna simulations. The presence of tumor did not significantly affect ablation volumes within the same steatosis grade in 915 MHz simulations, but did significantly increase ablation volumes within mild-, moderate-, and high-fat steatosis grades in 2450 MHz simulations. An analysis of signed distance to agreement for placement strategies suggests that accounting for patient-specific tumor tissue properties significantly impacts ablation forecasting for the preoperative evaluation of ablation zone coverage.
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Affiliation(s)
- Frankangel Servin
- Department of Biomedical EngineeringVanderbilt UniversityNashvilleTN37235USA
- Vanderbilt Institute for Surgery and EngineeringVanderbilt UniversityNashvilleTN37235USA
| | - Jarrod A. Collins
- Department of Biomedical EngineeringVanderbilt UniversityNashvilleTN37235USA
| | - Jon S. Heiselman
- Department of Biomedical EngineeringVanderbilt UniversityNashvilleTN37235USA
- Vanderbilt Institute for Surgery and EngineeringVanderbilt UniversityNashvilleTN37235USA
- Department of Surgery, Hepatopancreatobiliary ServiceMemorial Sloan Kettering Cancer CenterNew YorkNY10065USA
| | | | - Virginia B. Planz
- Department of RadiologyVanderbilt University Medical CenterNashvilleTN37235USA
| | | | - Daniel B. Brown
- Department of RadiologyVanderbilt University Medical CenterNashvilleTN37235USA
| | - William R. Jarnagin
- Department of Surgery, Hepatopancreatobiliary ServiceMemorial Sloan Kettering Cancer CenterNew YorkNY10065USA
| | - Michael I. Miga
- Department of Biomedical EngineeringVanderbilt UniversityNashvilleTN37235USA
- Vanderbilt Institute for Surgery and EngineeringVanderbilt UniversityNashvilleTN37235USA
- Department of RadiologyVanderbilt University Medical CenterNashvilleTN37235USA
- Department of Neurological SurgeryVanderbilt University Medical CenterNashvilleTN37235USA
- Department of OtolaryngologyVanderbilt University Medical CenterNashvilleTN37235USA
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17
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Cano PA, Mora LC, Enríquez I, Reis MS, Martínez E, Barturen F. One-lung ventilation with a bronchial blocker in thoracic patients. BMC Anesthesiol 2023; 23:398. [PMID: 38057754 PMCID: PMC10698967 DOI: 10.1186/s12871-023-02362-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Lung isolation is a technique used in a multitude of surgeries to ensure single-lung ventilation with collapse of the contralateral lung, as to achieve improved access and visualization of relevant anatomical structures. Despite being accepted and having favorable outcomes, bronchial blockers (BBs) are not to this day the main device of choice among anaesthesiologists. METHODS In this retrospective and descriptive study, we analyzed the safety and efficacy of a BB in all types of thoracic surgeries in our centre between 2015 and 2022, excluding patients with massive hemoptysis or empyema, or who had undergone a prior pneumonectomy. RESULTS One hundred and thirty-four patients were intervened due to lung cancer (67.9%), respiratory disease (23.9%), and non-respiratory disease (8.2%) undergoing lung surgeries (65.7%), pleural and mediastinal surgeries (29.9%), chest wall surgeries (3.0%) and other surgeries (1.5%). In most cases, lung collapse was considered excellent (63.9%) or good (33.1%) with only 4 cases (3.0%) of poor lung collapse. More than 90% of patients did not present intraoperative or immediate postoperative complications. No statistically significant differences were found between lung collapse and the demographic, clinical or BB-related variables (p > 0.05). However, we found a significatively higher proportion of excellent lung collapses in VATS surgeries and lateral decubitus positioning, as well as a significatively less proportion of poor lung collapses (p < 0.05). Moreover, there was a significantly higher proportion of excellent lung collapses when the BB was placed in the left bronchus (p < 0.05). CONCLUSIONS With these results, in our experience BBs constitute an effective alternative, capable of achieving pulmonary collapse in all kinds of thoracic procedures with satisfactory safety rates due to their minimal complications.
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Affiliation(s)
- Paulo Andrés Cano
- Department of Anaesthesiology and Resuscitation, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, Palma de Mallorca, Islas Baleares, 07120, Spain.
| | - Luis Carlos Mora
- Department of Anaesthesiology and Resuscitation, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, Palma de Mallorca, Islas Baleares, 07120, Spain
| | - Irene Enríquez
- Department of Anaesthesiology and Resuscitation, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, Palma de Mallorca, Islas Baleares, 07120, Spain
| | - Matías Santiago Reis
- Department of Anaesthesiology and Resuscitation, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, Palma de Mallorca, Islas Baleares, 07120, Spain
| | - Eva Martínez
- Department of Anaesthesiology and Resuscitation, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, Palma de Mallorca, Islas Baleares, 07120, Spain
| | - Fernando Barturen
- Department of Anaesthesiology and Resuscitation, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, Palma de Mallorca, Islas Baleares, 07120, Spain
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Sun Y, Yu C, Wang X, Yang R, Ding Z, Zhou Y. Establishment and Validation of the LI-RADS Morphologic Type II Hepatocellular Carcinoma Early Recurrence Risk Scoring System. J Gastrointest Surg 2023; 27:2787-2796. [PMID: 37932596 DOI: 10.1007/s11605-023-05873-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/14/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Tumor morphology links to early recurrence of hepatocellular carcinoma. Controversy exists regarding the recurrence risk of Liver Imaging Reporting and Data System morphologic Type II hepatocellular carcinoma. This study aims to explore risk factors for early recurrence of Type II hepatocellular carcinoma. METHODS Retrospective analysis of hepatocellular carcinoma patients who underwent curative resection and preoperative contrast-enhanced MRI from June 2016 to June 2020. Our patients formed the development set, and hepatocellular carcinoma patients from the TCIA database served as validation. Univariable and multivariable Cox regression identified independent risk factors for early recurrence. A risk scoring system was established for risk stratification, and an early recurrence prediction model was developed and validated. RESULTS 95 Type II hepatocellular carcinoma patients were in the development set, and 29 cases were in the validation set. Early recurrence rates were 33.7% and 37.9%, respectively. Multivariate analysis revealed age, histological grade, AFP, and intratumoral hemorrhage as independent risk factors for early recurrence. The model's diagnostic performance for early recurrence was AUC = 0.817 in the development set. A scoring system classified patients into low-risk (scores ≤ 3) and high-risk (scores > 3) groups. The high-risk group had significantly lower recurrence-free survival (40.0% vs 73.2%, P = 0.001), consistent with the validation set (25.0% vs 73.3%, P = 0.028). CONCLUSIONS The risk scoring system demonstrated excellent discrimination and predictive ability, aiding clinicians in assessing early recurrence risk and identifying high-risk individuals effectively.
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Affiliation(s)
- Yajuan Sun
- Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, Heilongjiang Province, 150040, People's Republic of China
| | - Can Yu
- Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, Heilongjiang Province, 150040, People's Republic of China
| | - Xinxin Wang
- Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, Heilongjiang Province, 150040, People's Republic of China
| | - Rui Yang
- Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, Heilongjiang Province, 150040, People's Republic of China
| | - ZhiPeng Ding
- Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, Heilongjiang Province, 150040, People's Republic of China
| | - Yang Zhou
- Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, Heilongjiang Province, 150040, People's Republic of China.
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Brescia F, Annetta MG, Pinelli F, Pittiruti M. A GAVeCeLT bundle for PICC-port insertion: The SIP-Port protocol. J Vasc Access 2023:11297298231209521. [PMID: 37953715 DOI: 10.1177/11297298231209521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
In the last decade, a new type of brachial port has been introduced in clinical practice, the so-called "PICC-port." This is a brachial port, but inserted according to the methodologies and technologies currently adopted for the insertion of peripherally inserted central catheters (PICCs). Several studies have shown that PICC-port insertion is safe, not associated with any relevant immediate or early complication, and that the expected incidence of late complications is significantly lower if compared to "traditional" brachial ports (i.e. inserted without ultrasound guidance). Furthermore, PICC-ports yield excellent esthetic results and are associated with optimal patient compliance. This paper describes an insertion bundle-developed by GAVeCeLT, the Italian Group of Long Term Venous Access Devices, and nicknamed "SIP-Port" (Safe Insertion of PICC-Ports)-which consists of few evidence-based strategies aiming to further minimize all immediate, early, or late complications potentially associated with PICC-port insertion. Also, this insertion bundle has been developed for the purpose of defining more closely the differences between a traditional brachial port and a PICC-port. The SIP-Port bundle is currently adopted by all training courses on PICC-port insertion held by GAVeCeLT. It includes eight steps: (1) preprocedural ultrasound assessment utilizing the RaPeVA (Rapid Peripheral Venous Assessment) protocol; (2) appropriate skin antiseptic technique and maximal barrier precautions; (3) choice of appropriate vein, in terms of caliber and site; (4) clear identification of the median nerve and of the brachial artery during the venipuncture; (5) ultrasound-guided puncture and cannulation of the vein; (6) ultrasound-guided tip navigation; (7) intra-procedural assessment of tip location by intracavitary ECG or by trans-thoracic echocardiography; (8) appropriate creation and closure of the subcutaneous pocket.
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Affiliation(s)
- Fabrizio Brescia
- Unit of Anesthesia and Intensive Care Medicine, Vascular Access Team, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Maria Giuseppina Annetta
- Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Rome, Italy
| | - Fulvio Pinelli
- Department of Anesthesia and Intensive Care, Careggi University Hospital, Firenze, Italy
| | - Mauro Pittiruti
- Department of Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Rome, Italy
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Kinsey D, Febrey S, Briscoe S, Kneale D, Thompson Coon J, Carrieri D, Lovegrove C, McGrath J, Hemsley A, Melendez-Torres GJ, Shaw L, Nunns M. Impact of interventions to improve recovery of older adults following planned hospital admission on quality-of-life following discharge: linked-evidence synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023; 11:1-164. [PMID: 38140881 DOI: 10.3310/ghty5117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Objectives To understand the impact of multicomponent interventions to improve recovery of older adults following planned hospital treatment, we conducted two systematic reviews, one of quantitative and one of qualitative evidence, and an overarching synthesis. These aimed to: • understand the effect of multicomponent interventions which aim to enhance recovery and/or reduce length of stay on patient-reported outcomes and health and social care utilisation • understand the experiences of patients, carers and staff involved in the delivery of interventions • understand how different aspects of the content and delivery of interventions may influence patient outcomes. Review methods We searched bibliographic databases including MEDLINE ALL, Embase and the Health Management Information Consortium, CENTRAL, and Cumulative Index to Nursing and Allied Health Literature and Allied and Complementary Medicine Database, conducted forward and backward citation searching and examined reference lists of topically similar qualitative reviews. Bibliographic database searches were completed in May/June 2021 and updated in April 2022. We sought primary research from high-income countries regarding hospital inpatients with a mean/median age of minimum 60 years, undergoing planned surgery. Patients experienced any multicomponent hospital-based intervention to reduce length of stay or improve recovery. Quantitative outcomes included length of stay and any patient-reported outcome or experience or service utilisation measure. Qualitative research focused on the experiences of patients, carers/family and staff of interventions received. Quality appraisal was undertaken using the Effective Public Health Practice Project Quality Assessment Tool or an adapted version of the Wallace checklist. We used random-effects meta-analysis to synthesise quantitative data where appropriate, meta-ethnography for qualitative studies and qualitative comparative analysis for the overarching synthesis. Results Quantitative review: Included 125 papers. Forty-nine studies met criteria for further synthesis. Enhanced recovery protocols resulted in improvements to length of stay, without detriment to other outcomes, with minimal improvement in patient-reported outcome measures for patients admitted for lower-limb or colorectal surgery. Qualitative review: Included 43 papers, 35 of which were prioritised for synthesis. We identified six themes: 'Home as preferred environment for recovery', 'Feeling safe', 'Individualisation of structured programme', 'Taking responsibility', 'Essential care at home' and 'Outcomes'. Overarching synthesis: Intervention components which trigger successful interventions represent individualised approaches that allow patients to understand their treatment, ask questions and build supportive relationships and strategies to help patients monitor their progress and challenge themselves through early mobilisation. Discussion Interventions to reduce hospital length of stay for older adults following planned surgery are effective, without detriment to other patient outcomes. Findings highlight the need to reconsider how to evaluate patient recovery from the perspective of the patient. Trials did not routinely evaluate patient mid- to long-term outcomes. Furthermore, when they did evaluate patient outcomes, reporting is often incomplete or conducted using a narrow range of patient-reported outcome measures or limited through asking the wrong people the wrong questions, with lack of longer-term evaluation. Findings from the qualitative and overarching synthesis will inform policy-making regarding commissioning and delivering services to support patients, carers and families before, during and after planned admission to hospital. Study registration This trial is registered as PROSPERO registration number CRD42021230620. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 130576) and is published in full in Health and Social Care Delivery Research; Vol. 11, No. 23. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Debbie Kinsey
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Samantha Febrey
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Simon Briscoe
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Dylan Kneale
- EPPI-Centre, UCL Social Research Institute, University College London, London, UK
| | - Jo Thompson Coon
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Daniele Carrieri
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Christopher Lovegrove
- School of Health Professions, Faculty of Health and Human Sciences, University of Plymouth, Plymouth, UK
| | - John McGrath
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Anthony Hemsley
- Department of Healthcare for Older People, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | | | - Liz Shaw
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Michael Nunns
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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Fan Z, Jin M, Zhang L, Wang N, Li M, Wang C, Wei F, Zhang P, Du X, Sun X, Qiu W, Wang M, Wang H, Shi X, Ye J, Jiang C, Zhou J, Chai W, Qi J, Li T, Zhang R, Liu X, Huang B, Chai K, Cao Y, Mu W, Huang Y, Yang T, Zhang H, Qu L, Liu Y, Wang G, Lv G. From clinical variables to multiomics analysis: a margin morphology-based gross classification system for hepatocellular carcinoma stratification. Gut 2023; 72:2149-2163. [PMID: 37549980 PMCID: PMC10579519 DOI: 10.1136/gutjnl-2023-330461] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/20/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE Selecting interventions for patients with solitary hepatocellular carcinoma (HCC) remains a challenge. Despite gross classification being proposed as a potential prognostic predictor, its widespread use has been restricted due to inadequate studies with sufficient patient numbers and the lack of established mechanisms. We sought to investigate the prognostic impacts on patients with HCC of different gross subtypes and assess their corresponding molecular landscapes. DESIGN A prospective cohort of 400 patients who underwent hepatic resection for solitary HCC was reviewed and analysed and gross classification was assessed. Multiomics analyses were performed on tumours and non-tumour tissues from 49 patients to investigate the mechanisms underlying gross classification. Inverse probability of treatment weight (IPTW) was used to control for confounding factors. RESULTS Overall 3-year survival rates varied significantly among the four gross subtypes (type I: 91%, type II: 80%, type III: 74.6%, type IV: 38.8%). Type IV was found to be independently associated with poor prognosis in both the entire cohort and the IPTW cohort. The four gross subtypes exhibited three distinct transcriptional modules. Particularly, type IV tumours exhibited increased angiogenesis and immune score as well as decreased metabolic pathways, together with highest frequency of TP53 mutations. Patients with type IV HCC may benefit from adjuvant intra-arterial therapy other than the other three subtypes. Accordingly, a modified trichotomous margin morphological gross classification was established. CONCLUSION Different gross types of HCC showed significantly different prognosis and molecular characteristics. Gross classification may aid in development of precise individualised diagnosis and treatment strategies for HCC.
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Affiliation(s)
- Zhongqi Fan
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Meishan Jin
- Department of Pathology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lei Zhang
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Nanya Wang
- Phase I Clinical Trials Unit, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Mingyue Li
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Chuanlei Wang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Feng Wei
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ping Zhang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiaohong Du
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiaodong Sun
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Qiu
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Meng Wang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hongbin Wang
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Xiaoju Shi
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Junfeng Ye
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Chao Jiang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Jianpeng Zhou
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Wengang Chai
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Jun Qi
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ting Li
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ruoyan Zhang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xingkai Liu
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Bo Huang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Kaiyuan Chai
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yannan Cao
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Wentao Mu
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yu Huang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Tian Yang
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China
| | - Huimao Zhang
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Limei Qu
- Department of Pathology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yahui Liu
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Guangyi Wang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Guoyue Lv
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
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El-Kefraoui C, Do U, Miller A, Kouyoumdjian A, Cui D, Khorasani E, Landry T, Amar-Zifkin A, Lee L, Feldman LS, Fiore JF. Impact of enhanced recovery pathways on patient-reported outcomes after abdominal surgery: a systematic review. Surg Endosc 2023; 37:8043-8056. [PMID: 37474828 DOI: 10.1007/s00464-023-10289-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Evidence supports that enhanced recovery pathways (ERPs) reduce length of stay and complications; however, these measures may not reflect the perspective of patients who are the main stakeholders in the recovery process. This systematic review aimed to appraise the evidence regarding the impact of ERPs on patient-reported outcomes (PROs) after abdominal surgery. METHODS Five databases (Medline, Embase, Biosis, Cochrane, and Web of Science) were searched for randomized controlled trials (RCTs) addressing the impact of ERPs on PROs after abdominal surgery. We focused on distinct periods of recovery: early (within 7 days postoperatively) and late (beyond 7 days). Risk of bias was assessed using Cochrane's RoB 2.0. Results were appraised descriptively as heterogeneity hindered meta-analysis. Certainty of evidence was evaluated using GRADE. RESULTS Fifty-six RCTs were identified [colorectal (n = 18), hepatopancreaticobiliary (HPB) (n = 11), upper gastrointestinal (UGI) (n = 10), gynecological (n = 7), urological (n = 7), general surgery (n = 3)]. Most trials had 'some concerns' (n = 30) or 'high' (n = 25) risk of bias. In the early postoperative period, ERPs improved patient-reported general health (colorectal, HPB, UGI, urological; very low to low certainty), physical health (colorectal, gynecological; very low to low certainty), mental health (colorectal, gynecological; very low certainty), pain (all specialties; very low to moderate certainty), and fatigue (colorectal; low certainty). In the late postoperative period, ERPs improved general health (HPB, UGI, urological; very low certainty), physical health (UGI, gynecological, urological; very low to low certainty), mental health (UGI, gynecological, urological; very low certainty), social health (gynecological; very low certainty), pain (gynecological, urological; very low certainty), and fatigue (gynecological; very low certainty). CONCLUSION This review supports that ERPs may have a positive impact on patient-reported postoperative health status (i.e., general, physical, mental, and social health) and symptom experience (i.e., pain and fatigue) after abdominal surgery; however, data were largely derived from low-quality trials. Although these findings contribute important knowledge to inform evidence-based ERP implementation, there remains a great need to improve PRO assessment in studies focused on postoperative recovery.
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Affiliation(s)
- Charbel El-Kefraoui
- Division of Experimental Surgery, McGill University, Montreal, QC, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Uyen Do
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Andrew Miller
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Araz Kouyoumdjian
- Division of Experimental Surgery, McGill University, Montreal, QC, Canada
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - David Cui
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
| | - Elahe Khorasani
- Division of Experimental Surgery, McGill University, Montreal, QC, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Tara Landry
- Bibliothèque de la Santé, Université de Montréal, Montreal, QC, Canada
- Medical Libraries, McGill University Health Centre, Montreal, QC, Canada
| | | | - Lawrence Lee
- Division of Experimental Surgery, McGill University, Montreal, QC, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Liane S Feldman
- Division of Experimental Surgery, McGill University, Montreal, QC, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Julio F Fiore
- Division of Experimental Surgery, McGill University, Montreal, QC, Canada.
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Department of Surgery, McGill University, Montreal, QC, Canada.
- Montreal General Hospital, 1650 Cedar Ave, R2-104, Montreal, QC, H3G 1A4, Canada.
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Zhang C, Yang R, Wang X, Tao Y, Tang S, Tian Z, Zhou Y. LI-RADS Morphological Type Predicts Prognosis of Patients with Hepatocellular Carcinoma After Radical Resection. Ann Surg Oncol 2023; 30:4876-4885. [PMID: 37133569 DOI: 10.1245/s10434-023-13494-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/27/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE This study aimed to explore the association of preoperative magnetic resonance imaging (MRI) tumor morphological classification with early recurrence (ER) and overall survival (OS) after radical surgery of hepatocellular carcinoma (HCC). PATIENTS AND METHODS A retrospective analysis of 296 patients with HCC who underwent radical resection was performed. On the basis of LI-RADS, tumor imaging morphology was classified into three types. The clinical imaging features, ER, and survival rates of three types were compared. Univariate and multivariate Cox regression analyses were conducted to identify prognostic factors associated with OS and ER after hepatectomy for HCC. RESULTS There were 167 tumors of type 1, 95 of type 2, and 34 of type 3. In patients with type 3 HCC, postoperative mortality and ER were significantly higher than in patients with type 1 and type 2 (55.9% versus 32.6% versus 27.5% and 52.9% versus 33.7% versus 28.7%). In multivariate analysis, the LI-RADS morphological type was a stronger risk factor for predicting poor OS [hazard ratio (HR) 2.77, 95% confidence interval (CI) 1.59-4.85, P < 0.001] and ER (HR 2.14, 95% CI 1.24-3.70, P = 0.007). A subgroup analysis revealed that type 3 was associated with poor OS and ER in > 5 cm cases but not in < 5 cm cases. CONCLUSIONS ER and OS of patients with HCC undergoing radical surgery can be predicted using the preoperative tumor LI-RADS morphological type, which could help to select personalized treatment plans for patients with HCC in the future.
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Affiliation(s)
- Chunhui Zhang
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Rui Yang
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Xinxin Wang
- Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Yuqing Tao
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Shuli Tang
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Zhennan Tian
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Yang Zhou
- Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.
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Li YT, Chiu HC, Hsiao YC, Hsu HH, Chen JS, Cheng YJ. Efficacy of rigid-angle bronchial blockers for uniportal video-assisted thoracoscopic tumor resection. Ann Card Anaesth 2023; 26:303-308. [PMID: 37470529 PMCID: PMC10451124 DOI: 10.4103/aca.aca_132_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 07/21/2023] Open
Abstract
Background For uniportal video-assisted thoracoscopic surgery (VATS), which is greatly dependent on satisfactory lung collapse without lung compression from another port, few reports have elucidated the intraoperative efficacy of bronchial blockers (BBs). We hypothesized that operation time would be prolonged if BBs required more intraoperative repositioning during surgical manipulation. We compared the operation times of different surgical procedures performed using BBs with double-lumen tubes (DLTs) in uniportal VATS. Materials and Methods Patients who underwent intubated uniportal VATS were enrolled retrospectively from March to May 2019. Data on the patient, anesthetic, and surgical factors were collected. Regression analyses were performed to determine the effect of various factors on operation time. Results 317 patients who underwent uniportal VATS were included. Wedge resection constituted 70.7%, and anatomic resection constituted 29.3% of procedures. BBs were applied for left- and right-side wedge resection (85.6% and 78.7%, respectively) and left- and right-side anatomic resection (74.1% and 56.4%, respectively). The surgical factors significantly affecting operation time were operation procedures (P < .01), number of lymph nodes sampled (P < .001), and size of tumors (P < .01). Conclusions The efficacy of BBs was comparable to that of DLTs for uniportal VATS wedge resection. With significantly less preference for right-side anatomic resection, the efficacy of DLTs was comparable with that of BBs, which were applied in more than half of right-side uniportal anatomic VATS. We conclude that even in uniportal VATSs, rigid-angled BBs demonstrate comparable efficacy with feasible alternatives.
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Affiliation(s)
- Ying-Tzu Li
- Department of Anesthesiology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Hsin-Chan Chiu
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yueh-Chen Hsiao
- Department of Anesthesiology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Hsao-Hsun Hsu
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Jin-Shing Chen
- Department of Surgery, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Cancer Center, Taipei, Taiwan
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Shen H, Masingboon K, Samartkit N. Factors related to preoperative uncertainty among patients with breast cancer in Wenzhou, China: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:236-243. [PMID: 37492757 PMCID: PMC10363974 DOI: 10.33546/bnj.2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/30/2023] [Accepted: 06/02/2023] [Indexed: 07/27/2023] Open
Abstract
Background One of the most prevalent psychological signs of breast cancer is uncertainty, which is more prevalent in Chinese patients during the preoperative period. Despite the numerous factors contributing to preoperative uncertainty, there is limited relevant research conducted in China. Objective This study aimed to describe the current state of preoperative uncertainty and to investigate the relationship between anxiety, illness perception, social support, and preoperative uncertainty in patients with breast cancer in Wenzhou, China. Methods This cross-sectional research used a simple random sampling technique to select 122 participants from a university hospital in Wenzhou, China, from July 2022 to December 2022, employing validated instruments. Descriptive statistics and Pearson's correlation coefficient were utilized to analyze the data. Results The average preoperative uncertainty scores of the patients fell within a moderate range (M = 61.92, SD = 7.51). Significant correlations were found between anxiety (r = 0.638, p <0.01), illness perception (r = 0.704, p <0.01), social support (r = -0.481, p <0.01), and preoperative uncertainty. Conclusions The results can assist healthcare professionals, especially nurses, in recognizing the factors contributing to uncertainty before surgery in patients with breast cancer. This knowledge enables them to promptly address and minimize this issue, leading to improved outcomes.
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Affiliation(s)
- Huaiyu Shen
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
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Sheng Y, Carpenter JS, Paul SM, Conley YP, Levine JD, Miaskowski C. Patients with palpitations experience a higher symptom burden prior to breast cancer surgery. Eur J Oncol Nurs 2023; 65:102341. [PMID: 37327556 DOI: 10.1016/j.ejon.2023.102341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/11/2023] [Accepted: 04/29/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Anxiety, depression, sleep disturbance, fatigue, cognitive dysfunction, and pain are common symptoms reported by patients with breast cancer. Recent evidence suggests that palpitations, a feeling of the heart racing or pounding, may be equally common. Study purpose was to compare the severity and clinically meaningful occurrence rates of common symptoms and quality of life (QOL) outcomes between patients with breast cancer who did and did not report palpitations prior to surgery. METHODS Patients (n = 398) were classified as having or not having palpitations using a single item from the Menopausal Symptoms Scale. Valid and reliable measures were used to assess state and trait anxiety, depression, sleep disturbance, fatigue, energy, cognitive function, breast symptoms, and QOL. Between group differences were evaluated using parametric and non-parametric tests. RESULTS Patients with palpitations (15.1%) reported significantly higher severity scores for state and trait anxiety, depression, sleep disturbance, and fatigue as well as significant decrements in energy and cognitive function (all p < .05). A higher percentage of these patients had clinically meaningful levels of state anxiety, depression, sleep disturbance and decrements in cognitive function (all p < .05). Except for spiritual well-being, QOL scores were lower in the palpitations group (all p < .001). CONCLUSION Findings support the need for routine assessment of palpitations and management of multiple symptoms in women prior to breast cancer surgery.
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Affiliation(s)
- Ying Sheng
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | | | - Steven M Paul
- School of Nursing, University of California at San Francisco, San Francisco, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jon D Levine
- School of Medicine, University of California at San Francisco, San Francisco, CA, USA
| | - Christine Miaskowski
- School of Nursing, University of California at San Francisco, San Francisco, CA, USA; School of Medicine, University of California at San Francisco, San Francisco, CA, USA.
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NEGM S, MOUSA B, SHAFIQ A, ABOZAID M, ABD ALLAH E, ATTIA A, FARAG A. Enhanced recovery program after laparoscopic colorectal surgery during the era of COVID-19: a randomized controlled trial. Chirurgia (Bucur) 2023; 36. [DOI: 10.23736/s0394-9508.22.05451-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Qiu X, Jin G, Zhang X, Xu L, Ding J, Li W, Yu L, Wang Y, Shen Y, Wang H, Wang J, Xu H, Kong W, Yuan L, Bai X, Liu Y, Liu H, Cai M, Luo F, Yang Y, Xiao W, Shen L, Fang Y, Lin J, Zhao L, Qin L, Gao Y, Chang L, Dong L, Wei H, Wei L. Expert consensus on the clinical application of totally implantable venous access devices in the upper arm (2022 Edition). J Interv Med 2023; 6:53-58. [PMID: 37409058 PMCID: PMC10318320 DOI: 10.1016/j.jimed.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 07/07/2023] Open
Abstract
With the widespread adoption of ultrasound guidance, Seldinger puncture techniques, and intracardiac electrical positioning technology for the placement of peripherally inserted central catheters in recent years, an increasing number of medical staff and patients now accept peripheral placement of totally implantable venous access devices (TIVADs) in the upper arm. This approach has the advantage of completely avoiding the risks of hemothorax, pneumothorax, and neck and chest scarring. Medical specialties presently engaged in this study in China include internal medicine, surgery, anesthesiology, and interventional departments. However, command over implantation techniques, treatment of complications, and proper use and maintenance of TIVAD remain uneven among different medical units. Moreover, currently, there are no established quality control standards for implantation techniques or specifications for handling complications. Thus, this expert consensus is proposed to improve the success rate of TIVAD implantation via the upper-arm approach, reduce complication rates, and ensure patient safety. This consensus elaborates on the technical indications and contraindications, procedures and technical points, treatment of complications, and the use and maintenance of upper-arm TIVAD, thus providing a practical reference for medical staff.
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Affiliation(s)
- Xiaoxia Qiu
- Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Guangxin Jin
- Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xuebin Zhang
- Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lichao Xu
- Affiliated Cancer Hospital of Fudan University, China
| | - Jinxia Ding
- The First Affiliated Hospital of Anhui Medical University, China
| | - Weisong Li
- The First Affiliated Hospital of Anhui Medical University, China
| | - Lejing Yu
- Liao Ning Cancer Hospital & Institute, China
| | - Yapeng Wang
- The Second Xiangya Hospital of Central South University, China
| | - Yanfang Shen
- The Second Xiangya Hospital of Central South University, China
| | | | - Jue Wang
- The First Affiliated Hospital with Nanjing Medical University, China
| | - Haiping Xu
- The First Affiliated Hospital with Nanjing Medical University, China
| | | | - Lin Yuan
- Nanjing Drum Tower Hospital, China
| | - Xuming Bai
- The Second Affiliated Hospital of Soochow University, China
| | - Ye Liu
- The First Hospital of China Medical University, China
| | - Hong Liu
- The First Affiliated Hospital of Chongqing Medical University, China
| | - Ming Cai
- The First Affiliated Hospital of Chongqing Medical University, China
| | - Feng Luo
- The First Affiliated Hospital of Chongqing Medical University, China
| | - Yiqun Yang
- The First Affiliated Hospital of Soochow University, China
| | - Weizhu Xiao
- The Second Affiliated Hospital of Fujian Medical University, China
| | - Lujun Shen
- Sun Yat-sen University Cancer Center, China
| | | | - Jinxiang Lin
- The Third Affiliated Hospital of Sun Yat-sen University, China
| | - Linfang Zhao
- Affiliated Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, China
| | - Li Qin
- Henan Cancer Hospital, China
| | | | - Lei Chang
- The First Affiliated Hospital of Zhengzhou University, China
| | - Lei Dong
- The First Affiliated Hospital of Zhengzhou University, China
| | | | - Lili Wei
- The Affiliated Hospital of Qingdao University, China
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Shin HJ, Kim H, Han SH, Do SH, Na HS. Ultrasound assessment of residual gastric volume in older adults undergoing staged-bilateral total knee arthroplasty after consuming carbohydrate-containing fluids: a prospective observational study. Korean J Anesthesiol 2023; 76:128-134. [PMID: 36274254 PMCID: PMC10079000 DOI: 10.4097/kja.22378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/17/2022] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND We compared preoperative residual gastric volume (GV) between the first and second stages of total knee arthroplasty (TKA) in older adults after drinking carbohydrate-containing fluid 2 h prior to surgery. METHODS In this study, 36 patients, aged > 65 years, scheduled for staged bilateral TKA with one-week interval, were enrolled. The patients consumed 400 ml of carbohydrate-containing fluid 2 h prior to surgery. Before the induction of spinal anesthesia, the gastric antral cross-sectional area was measured at the first and second TKA using ultrasound, and the residual GV was calculated. The primary outcome was the residual GV. Qualitative GV (grades 0, 1, and 2) and analgesic consumption after the first TKA were assessed as secondary outcomes. RESULTS The GV (median [Q1, Q3]) was greater in the second-stage TKA (41.1 [22.5, 62.8] ml) than in the first-stage TKA (10.3 [0.0, 27.1] ml) (P < 0.001). In the qualitative assessment, the distribution was not different between the two stages of TKA (P = 0.219) and only one patient showed grade 2 gastric content in the second TKA. When opioid consumption was converted to an equivalent dose of morphine, an average of 53.9 mg of morphine was required after the first TKA. CONCLUSIONS Residual GV after drinking carbohydrate-containing fluid differed according to the stage of TKA, showing a larger residual GV in the second TKA than in the first one. In older adults scheduled to undergo bilateral staged TKA, caution is required in preoperative fasting practice, especially in second-stage surgery.
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Affiliation(s)
- Hyun-Jung Shin
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Heeyeon Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung-Hee Han
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Hwan Do
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo-Seok Na
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Zhang J, Sun X, Zhang F, Guo L. Perioperative nursing of patients with breast cancer undergoing modified radical mastectomy. Asian J Surg 2023; 46:1385-1386. [PMID: 36117063 DOI: 10.1016/j.asjsur.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jing Zhang
- Department of Surgical Nursing, Dongyang Maternal and Child Health Hospital, Dongyang, Zhejiang, 322100, PR China
| | - Xiaoying Sun
- Department of Nursing, Dongyang Maternal and Child Health Hospital, Dongyang, Zhejiang, 322100, PR China
| | - Fangyuan Zhang
- Department of Surgical Nursing, Dongyang Maternal and Child Health Hospital, Dongyang, Zhejiang, 322100, PR China
| | - Lanzhong Guo
- Department of Traditional Chinese Medicine, Dongyang Maternal and Child Health Hospital, Dongyang, Zhejiang, 322100, PR China.
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Lagattolla F, Zanchi B, Pietro M, Cormio C, Lorusso V, Diotaiuti S, Fanizzi A, Massafra R, Costanzo S, Caporale F, Rieti E, Romito F. Receptive music therapy versus group music therapy with breast cancer patients hospitalized for surgery. Support Care Cancer 2023; 31:162. [PMID: 36781543 PMCID: PMC9924845 DOI: 10.1007/s00520-023-07624-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
Hospitalization for breast surgery is a distressing experience for women. This study investigated the impact of music therapy (MT), an integrative approach that is characterized by the establishment of a therapeutic relationship between patients and a certified music therapist, through different musical interventions targeted to the specific needs of the patients. The impact of two different MT experiences was compared on anxiety and distressing emotions. METHODS One hundred fifty-one patients during hospitalization for breast surgery were randomly assigned to two music therapy treatment arms: individual/receptive (MTri) vs. group/active-receptive integrated (MTiGrp). Stress, depression, anger, and need for help were measured with the emotion thermometers (ET) and State Trait Anxiety Inventory Y-1 form (STAY-Y1). Data were collected before and after the MT intervention. RESULTS Both types of MT interventions were effective in reducing all the variables: stress, depression, anger, and anxiety (T Student p‹0.01). Patients' perception of help received was correlated with a significant reduction in anxiety and distressing emotions during hospitalization for breast surgery. CONCLUSION Considerations regarding the implementation of MT interventions in clinical practice are discussed. In individual receptive MT, there was a significant decrease in anxiety levels, whereas in the integrated MT group, there was a higher perception of help received and use of inter-individual resources.
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Affiliation(s)
- Fulvia Lagattolla
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Barbara Zanchi
- Department of Music Therapy, Conservatorio Di Musica “Bruno Maderna”, Cesena, Italy
| | - Milella Pietro
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
- Direzione Sanitaria, IRCCS Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Claudia Cormio
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Vito Lorusso
- Unità Operativa Complessa Di Oncologia Medica, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Sergio Diotaiuti
- Unità Operativa Complessa Di Chirurgica Senologica Plastica E Ricostruttiva, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Annarita Fanizzi
- Struttura Semplice Dipartimentale Di Fisica Sanitaria, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Raffaella Massafra
- Struttura Semplice Dipartimentale Di Fisica Sanitaria, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Silvia Costanzo
- Oncologia sperimentale - Centro Studi Tumori Eredo-Familiari, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Francesca Caporale
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Erika Rieti
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Francesca Romito
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
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Sun BF, Zhang F, Chen QP, Wei Q, Zhu WT, Ji HB, Zhang XY. Improvement of inflammatory response and gastrointestinal function in perioperative of cholelithiasis by Modified Xiao-Cheng-Qi decoction. World J Clin Cases 2023; 11:830-843. [PMID: 36818637 PMCID: PMC9928702 DOI: 10.12998/wjcc.v11.i4.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/15/2022] [Accepted: 01/09/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In the perioperative period of biliary surgery, various factors can induce the release of a large number of inflammatory factors, leading to an imbalance in pro-inflammatory and anti-inflammatory responses and resulting in gastrointestinal (GI) dysfunction. Enhanced Recovery After Surgery protocols in biliary surgery have been shown to reduce the stress response and accelerate postoperative recovery. It is crucial to reduce the inflammatory response and promote the recovery of GI function after biliary surgery, both of which are the basis and key for perioperative care and postoperative recovery.
AIM To better understand the effects of Modified Xiao-Cheng-Qi decoction (MXD) on inflammatory response and GI function in the perioperative management of cholelithiasis and their correlation.
METHODS This was a prospective randomized placebo-controlled trial, in which 162 patients who received biliary tract surgery were randomly assigned to three groups: MXD group, XD group, and placebo-control group. The observed parameters included frequency of bowel sounds, time of first flatus and defecation, time of diet, and amount of activity after surgery. The serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-10, serum amyloid A protein (SAA), and substance P were measured by the enzyme-linked immunosorbent assay. Then, the spearman correlation coefficient was used to analyze the relationship between the indicators of GI function and inflammation.
RESULTS Compared to the placebo-control, improvements in GI function were observed in the MXD groups including reduced incidence of nausea, vomiting, and bloating; and earlier first exhaust time, first defecation time, and feeding time after surgery (P < 0.05). On the 1st and 2nd d after surgery, IL-6, CRP and SAA levels in MXD group were lower than that in placebo control, but substance P level was higher, compared to the control (P < 0.05). Functional diarrhea occurred in both MXD and XD groups without any other adverse effects, toxic reactions, and allergic reactions. Diarrhea was relieved after the discontinuation of the investigational remedies. Bowel sounds at 12 h after surgery, the occurring time of the first flatus, first defecation, postoperative liquid diet and semi-liquid diet were significantly correlated with levels of IL-6, CRP, SAA and substance P on second day after surgery (P < 0.05).
CONCLUSION Treatment with MXD can relieve inflammatory response and improve GI function after surgery. Moreover, there are significant correlations between them. Furthermore, it does not cause serious adverse reactions.
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Affiliation(s)
- Bao-Fang Sun
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Fan Zhang
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Qiang-Pu Chen
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Qiang Wei
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Wen-Tao Zhu
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Hai-Bin Ji
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Xing-Yuan Zhang
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
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Latha S, Kamath N, Joseph G. Postoperative Discomfort Among Laparotomy Patients from a Selected Hospital at Mangaluru: An Observational Study. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2023. [DOI: 10.1055/s-0042-1760234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Abstract
Background Factors causing postoperative discomfort after laparotomy are numerous and must be explored in depth. The postoperative distress may significantly affect the patient's state of well-being. Hence, the present study aims to assess the factors contributing to discomfort after laparotomy.
Aim The aim was to assess and compare the discomfort between open and laparoscopic abdominal surgery.
Objectives of the Study
1. To analyze the causes of patient's discomfort after abdominal surgery.2. To compare the discomfort between open and laparoscopic abdominal surgery.3. To determine the association between pain and selected variables among open and laparoscopic abdominal surgery.
Materials and Methods An exploratory approach with a prospective observational design was adopted for this study. Using the purposive sampling technique, 100 patients were selected to open and 100 to laparoscopic abdominal surgery groups. Data were collected using demographic and clinical proforma and standardized postoperative discomfort inventory 6 and 24 hours after the surgery. The assessment focused on the study variables such as symptoms after the surgery and the factors contributing to the postoperative discomfort.
Statistical Analysis The collected data were analyzed using descriptive and inferential statistics using the SPSS software version 20.
Results Among 200 participants, most of the open (68%) and laparoscopic abdominal surgeries (42%) belong to 25 to 35 years of age. Also, 54% and 13% were diabetic in open and laparoscopic abdominal surgery groups, respectively. Most samples (56% in open and 68% in laparoscopic surgery) stayed 5 and 10 hours in postoperative ICU. In open and laparoscopic abdominal surgeries, pain is the primary (100%) cause of postoperative discomfort after 6 hours of surgery. Movement restriction is also the reason for significant discomfort both in open (98%) and laparoscopic (100%) abdominal surgeries.In contrast, pain (99% and 100%), movement restriction (92% and 95%), and abdominal distention (61% and 34%) were the major problems contributing to the patient's discomfort after 24 hours of both open and laparoscopic surgeries too. There was a significant difference in causes of patient discomfort between open and laparoscopic abdominal surgery after 6 hours (P < 0.05), except for discomfort related to IV drip (P = 0.852), constipation (P = 0.2), and chills (P = 0.6).
Conclusion Even though pain is the major distressing factor both in open and laparoscopic surgeries, the current study highlights a few other factors that affect postoperative recovery. Nurses' attention to such distressing factors will fasten patients' recovery and quality of life after abdominal surgery.
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Affiliation(s)
- S. Latha
- Department of Medical-Surgical Nursing, Nitte (Deemed to be University), Nitte Usha Institute of Nursing Sciences (NUINS), Mangaluru, Karnataka, India
| | - Neetha Kamath
- Dept of Community Health Nursing, Nitte (Deemed to be University), Nitte Usha Institute of Nursing Sciences (NUINS), Mangaluru, Karnataka, India
| | - Gincy Joseph
- Emergency Nursing and Life Support Course, RGUHS-JeevaRaksha Trust, Bengaluru, Karnataka, India
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Samaritaki E, Tsiligianni I, Basta M, Alegkakis A, Vlassiadis K, Lazopoulos G. Demographic and clinical predictors of post-operative atrial fibrillation in cardio-surgical patients. Eur J Cardiovasc Nurs 2023; 22:98-106. [PMID: 35672278 DOI: 10.1093/eurjcn/zvac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 01/14/2023]
Abstract
AIMS Post-operative atrial fibrillation is defined as an episode of atrial fibrillation that occurs 1-5 days after a surgical procedure in patients without a previous history of atrial fibrillation. Multiple factors such as demographics, cardiac surgical, endogenous, or mental health may relate to post-operative atrial fibrillation.The aim of this study was to identify multivariable high-risk factors for post-operative atrial fibrillation and to propose a risk-assessment tool. METHODS AND RESULTS A cross-sectional observational study was conducted in a University Hospital of Greece. Predictor variables examined demographic and clinical variables, anxiety, depression, health-related quality of life, frailty, perioperative mortality (European System for Cardiac Operative Risk Evaluation II), and 10-year survival/mortality risk (Charlson Comorbidity Index score). The outcome variable was post-operative atrial fibrillation. Multivariable analysis was assessed to identify predictors of post-operative atrial fibrillation.Ninety-one patients were included in our sample. Post-operative atrial fibrillation was diagnosed in 44 (48.4%). Factors associated with post-operative atrial fibrillation are the following: age group of 66-75 years [OR 5.78, 95% confidence interval (CI) 1.37-24.34], Charlson Comorbidity Index score (OR 1.42, 95% CI 1.07-1.89), and hours of mechanical ventilation (OR 1.03, 95% CI 1.00-1.06). The Charlson Comorbidity Index score was identified as an independent predictor of post-operative atrial fibrillation (exp: 1.412, 95% CI: 1.017-1.961). CONCLUSION Patients with post-operative atrial fibrillation had a higher Charlson Comorbidity Index score. The Charlson Comorbidity Index was identified as an independent clinical predictor of post-operative atrial fibrillation. The risk-assessment tool proposed includes age, Charlson Comorbidity Index score, and hours of mechanical ventilation. Future studies are needed to establish such an assessment.
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Affiliation(s)
- Evangelia Samaritaki
- School of Medicine, Department of Surgery, University of Crete, Crete, Greece.,Cardiac Surgery Department, University Hospital of Heraklion, Crete, Greece
| | - Ioanna Tsiligianni
- School of Medicine, Department of Social Medicine, University of Crete, Crete, Greece
| | - Maria Basta
- School of Medicine, Department of Psychiatry, University of Crete, Crete, Greece.,Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Athanasios Alegkakis
- School of Medicine, Department of Toxicology, University of Crete, Crete, Greece
| | - Konstantinos Vlassiadis
- School of Medicine, Laboratory of Health Planning, University of Crete, Crete, Greece.,Dental Clinic, University Hospital of Heraklion, Crete, Greece
| | - Georgios Lazopoulos
- School of Medicine, Department of Surgery, University of Crete, Crete, Greece.,Cardiac Surgery Department, University Hospital of Heraklion, Crete, Greece
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McKevitt E, Saleeb M, Liu G, Warburton R, Pao JS, Dingee C, Bazzarelli A, Tang K, Crump T, Sutherland JM. Differences in Preoperative Health-Related Quality of Life between Women Receiving Mastectomy or Breast Conserving Surgery in a Prospectively Recruited Cohort of Breast Cancer Patients. Curr Oncol 2022; 30:118-129. [PMID: 36661659 PMCID: PMC9857337 DOI: 10.3390/curroncol30010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/06/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
As rates of total mastectomy rise, the relationships between surgery modality with domains of health-related quality of life is not well understood. This study reports differences in depression, anxiety, pain, and health status among a cohort of women scheduled to receive total mastectomy or breast-conserving surgery. Patient-reported outcomes measured preoperative differences between patients receiving total mastectomy or breast-conserving surgery in a cross-sectional design. Regression analyses was used to model health outcomes and adjust for patient demographics on patient measures. Participants scheduled for total mastectomy were more likely to report more severe symptoms of depression and anxiety. This association was non-significant after adjusting for demographic differences. Younger participants were more likely to be scheduled for total mastectomy. Age was negatively associated with symptoms of depression and anxiety. Screening patients for mental health symptoms may be particularly important among younger patients who were more likely to report depression and anxiety before their surgery and were more likely to receive total mastectomy.
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Affiliation(s)
- Elaine McKevitt
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Maria Saleeb
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| | - Guiping Liu
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| | - Rebecca Warburton
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Jin-Si Pao
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Carol Dingee
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Amy Bazzarelli
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Katelynn Tang
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Trafford Crump
- Department of Surgery, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Jason M. Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
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36
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Zhao L, Wei H. The research frontier of cesarean section recovery: A bibliometric analysis. Front Med (Lausanne) 2022; 9:1071707. [PMID: 36582295 PMCID: PMC9792604 DOI: 10.3389/fmed.2022.1071707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
Background Cesarean section (CS) has become an effective means to solve dystocia and some obstetric complications, and to save the lives of women and perinatal women. Disparities in quality obstetric care and rehabilitation in CS result from differences in health care systems across regions, and more scientific and reasonable rehabilitation programmes and management measures will benefit more parturient and newborns worldwide who must take CS. In this study, we performed a bibliometric analysis to collect a graphical representation of the CS recovery. Methods A total of 995 documents of CS recovery were retrieved from the Web of Science Core Collection (WOSCC) on December 31, 2021, and then VOS viewer 1.6.18 was used for visual analysis. Results Over the last 20 years, the researches of CS recovery have gradually increased and it will continue to grow in the next period. Anesthesia and Analgesia is the most popular journal in CS recovery. Most of the representative achievements are concentrated in the relevant institutions of European and American countries, Brendan Carvalho and Ian J. Wrench are among the outstanding scholars in this field, but the overall outcome is limited by limited regional work and lack of broad cooperation and representation. "CS," "surgery," "management," "recovery," "enhanced recovery," and "risk factors" are high frequency keywords, and there is a close relationship between "management" and "enhanced recovery" around the CS and they also become one of the key factors to regulate the condition of patients. Conclusion This work firstly analyzed the research condition of CS recovery by a bibliometric analysis. According to the practice guideline, it produces some outstanding representative productions, which involves enhanced recovery after surgery (ERAS) and will continue to be the focus of researchers. More substantive research articles and large-scale clinical studies may greatly enhance the scientific value, and it is necessary to strengthen the ERAS guideline and cooperation between researchers, generate broader consensus and results, and ultimately provide help for CS recovery.
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Affiliation(s)
- Lizheng Zhao
- Department of Rehabilitation, Xiamen Humanity Rehabilitation Hospital, Xiamen, Fujian, China
| | - Hong Wei
- Department of Rehabilitation Teaching and Research, Xi’an Siyuan University, Xi’an, China,*Correspondence: Hong Wei,
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Wang L, Jia L, Jiang A. Pathology of catheter-related complications: what we need to know and what should be discovered. J Int Med Res 2022; 50:3000605221127890. [PMID: 36268763 PMCID: PMC9597033 DOI: 10.1177/03000605221127890] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite the considerable efforts made to increase the prevalence of autogenous fistula in patients on hemodialysis, tunneled cuffed catheters are still an important access modality and used in a high percentage of the hemodialysis population. However, because of the conundrum posed by tunneled cuffed catheters, patients can develop a multitude of complications, including thrombosis, infections, formation of a fibrin sheath, and central vein stenosis, resulting in increased morbidity and mortality as well as placing a heavy burden on the healthcare system. However, with an increasing number of studies now focusing on how to manage these catheter-related complications, there has been less translational research on the pathology of these complications. This review of the most recent literature provides an update on the pathological aspects of catheter-related complications, highlighting what we need to know and what is yet to be discovered. The future research strategies and innovations needed to prevent these complications are also addressed.
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Affiliation(s)
- Lihua Wang
- Lihua Wang, Department of Kidney Disease
and Blood Purification Centre, 2nd Hospital of Tianjin Medical University, 23rd
Pingjiang Road, Hexi District, Tianjin 300211, PR China.
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38
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Liu W, Jin F, Wang HM, Yong FF, Wu Z, Jia HQ. The association between double-lumen tube versus bronchial blocker and postoperative pulmonary complications in patients after lung cancer surgery. Front Oncol 2022; 12:1011849. [PMID: 36237329 PMCID: PMC9552823 DOI: 10.3389/fonc.2022.1011849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Both double-lumen tube (DLT) and bronchial blocker (BB) are used for lung isolation in patients undergoing lung cancer surgery. However, the effects of different devices for lung isolation remain inconclusive. Present study was designed to investigate the association between the choice of the two devices and postoperative pulmonary complications (PPCs) in patients with lung cancer. Methods In this retrospective cohort study, patients who underwent lung cancer surgery between January 1, 2020 and October 31, 2020 were screened. Patients were divided into two groups according to different devices for lung isolation: DLT group and BB group. Primary outcome was the incidence of a composite of PPCs during postoperative in-hospital stay. Results A total of 1721 were enrolled for analysis, of them, 868 received DLT and 853 BB. A composite of PPCs was less common in patients with BB (25.1%, [214/853]) than those received DLT (37.9% [329/868] OR 0.582 95% CI 0.461-0.735 P < 0.001). Respiratory infection was less common in BB group (14.4%, [123/853]) than DLT group (30.3%, [263/868], P<0.001). The incidence of non-PPCs complications was not statistically significant between the 2 groups. Conclusions For patients undergoing surgery for lung cancer, the use of BB for lung isolation was associated with a reduced risk of PPCs when compared with DLT.
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Affiliation(s)
- Wei Liu
- Department of Anesthesiology, The Forth hospital of Hebei Medical University, Shijiazhuang, China
| | - Fan Jin
- Department of Anesthesiology, Zhuji People’s Hospital, Shaoxing, China
| | - He-Mei Wang
- Department of Anesthesiology, The Forth hospital of Hebei Medical University, Shijiazhuang, China
| | - Fang-Fang Yong
- Department of Anesthesiology, The Forth hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhen Wu
- Department of Anesthesiology, The Forth hospital of Hebei Medical University, Shijiazhuang, China
| | - Hui-Qun Jia
- Department of Anesthesiology, The Forth hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Hui-Qun Jia,
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39
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Ji W, Sang C, Zhang X, Zhu K, Bo L. Personality, Preoperative Anxiety, and Postoperative Outcomes: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12162. [PMID: 36231463 PMCID: PMC9565184 DOI: 10.3390/ijerph191912162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Research has shown that personality is associated with anxiety levels in the general population. However, little is known about the relationship between personality and preoperative anxiety and the subsequent health outcomes in patients undergoing surgery. Therefore, this review aimed to identify studies that explored the relationship between personality traits and preoperative anxiety, as well as their association with postoperative outcomes. Existing literature shows that anxiety may play an intermediary role in the relationship between personality and postoperative outcomes. Severe anxiety may partially explain the adverse effects of certain personality traits, such as neuroticism, on postoperative outcomes. However, the relationship between personality traits, preoperative anxiety, and postoperative outcomes remains unclear. Interventions such as clinical evaluation, preoperative counseling, and management strategies can be of great value in identifying and resolving patients' anxiety and negative emotions to improve postoperative outcomes.
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Affiliation(s)
- Wentao Ji
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Chao Sang
- Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
| | - Xiaoting Zhang
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Keming Zhu
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Lulong Bo
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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40
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Li D, Li Y, Bai X, Wang M, Yan J, Cao Y. The Effects of Aromatherapy on Anxiety and Depression in People With Cancer: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:853056. [PMID: 35757624 PMCID: PMC9215260 DOI: 10.3389/fpubh.2022.853056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Anxiety and depression are highly prevalent in people with cancer. Medical therapies are usually prescribed to alleviate anxiety and depression, but they are associated with a variety of adverse effects. Recently, aromatherapy showed potential as a complementary medicine to improve psychological health and wellbeing. However, its effectiveness on relieving anxiety and depression has not been established. Objective This study explored the beneficial effects of aromatherapy on psychological symptoms such as anxiety and depression in people with cancer. Methods We searched international databases including PubMed, Web of Science, Cochrane Library, Embase, Medline, Ebscohost, ProQuest and Scopus from inception to 31 May 2021. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias. The systematic review and meta-analysis were performed according to the PRISMA guidelines. Quantitative analysis was performed on the studies that met our inclusion criteria, and Meta-analysis was performed on the studies with available data by RevMan software. Results The quality of the literatures were assessed carefully by two researchers, a total of 17 studies were included in the systematic review and 10 articles were conducted in meta-analysis. The aromatherapy was effective in relieving anxiety (SMD = -0.49, p < 0.05) in people with cancer. Subgroup analysis suggested that most effective methods were aromatic massage (SMD = -0.70, p < 0.005), aromatherapy with lavender essential oils (SMD = -1.12, p < 0.01), short-time interventions (duration < 4weeks) (SMD = -0.87, p < 0.05) and studies in Asia (SMD = -0.83, p < 0.05). Regarding depression and psychological wellbeing, there were no difference between aromatherapy and control groups. Conclusion In cancer patients, the aromatherapy was effective for relieving anxiety. However, there was no beneficial effect on depression and psychological wellbeing. Systematic Review Registration PROSPERO, identifier: CRD42021272465.
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Affiliation(s)
- Dan Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuxin Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xue Bai
- Department of Nursing and Health Management, Baotou Iron and Steel Vocational and Technical College, Baotou, China
| | - Meijuan Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jingzheng Yan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yingjuan Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Nursing Theory and Practice Innovation Research Center, Shandong University, Jinan, China
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41
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Tu DH, Qu R, Ping W, Yang G, Ma X, Fu X, Cai Y. Double-lumen tube versus bronchial blocker in lymphadenectomy along the left recurrent laryngeal nerve for esophageal cancer: a propensity-matched analysis. Langenbecks Arch Surg 2022; 407:1891-1900. [PMID: 35314875 DOI: 10.1007/s00423-022-02475-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lymph node (LN) dissection along left recurrent laryngeal nerve (RLN) is challenging in esophagectomy for esophageal cancer, and double-lumen endotracheal tube (DLT) impedes the exposure of this area. The aim of this study was to determine whether bronchial blockers (BB) could be a better choice for this procedure. METHODS The clinical characteristics of patients who received McKeown esophagectomy with radical lymph node dissection in Wuhan Tongji Hospital between August 2017 and July 2019 were retrospectively analyzed. The 1:1 propensity score match analysis was performed to compare the short-term effectiveness, the numbers of lymph nodes dissected, and the patterns of recurrence and survival between the two groups. RESULTS A total of 294 patients (192 and 102 in the DLT and BB group, respectively) were enrolled in the study. After matching, 204 patients (102 pairs) who underwent one-lung ventilation with DLT or BB displayed no significant variance in baseline characteristics. The BB group had higher number of LNs resected along left RLN (1.8 ± 2.3 vs. 2.5 ± 2.5, P = 0.001). For patients with metastatic left RLN LN, the BB group had longer medium survival time (15 vs. 32 months, P = 0.045), and tended to have longer medium recurrence-free survival time (6 vs. 15 months, P = 0.079), and lower rate of upper mediastinal and cervical LN recurrence (30.00% vs. 66.67%, P = 0.198). The postoperative complications were similar in both groups. CONCLUSIONS Compared with DLT, using BB in esophagectomy may allow more radical lymphadenectomy along left RLN.
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Affiliation(s)
- De-Hao Tu
- Department of Thoracic Surgery, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China
| | - Rirong Qu
- Department of Thoracic Surgery, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China
| | - Wei Ping
- Department of Thoracic Surgery, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China
| | - Guang Yang
- Department of Thoracic Surgery, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China
| | - Xiaoling Ma
- Department of Radiology, Tongji Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, China
| | - Xiangning Fu
- Department of Thoracic Surgery, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China.
| | - Yixin Cai
- Department of Thoracic Surgery, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China.
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Nourani A, Ayatollahi H, Solaymani Dodaran M. Data management in diabetes clinical trials: a qualitative study. Trials 2022; 23:187. [PMID: 35241149 PMCID: PMC8895796 DOI: 10.1186/s13063-022-06110-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background Clinical trials play an important role in expanding the knowledge of diabetes prevention, diagnosis, and treatment, and data management is one of the main issues in clinical trials. Lack of appropriate planning for data management in clinical trials may negatively influence achieving the desired results. The aim of this study was to explore data management processes in diabetes clinical trials in three research institutes in Iran. Method This was a qualitative study conducted in 2019. In this study, data were collected through in-depth semi-structured interviews with 16 researchers in three endocrinology and metabolism research institutes. To analyze data, the method of thematic analysis was used. Results The five themes that emerged from data analysis included (1) clinical trial data collection, (2) technologies used in data management, (3) data security and confidentiality management, (4) data quality management, and (5) data management standards. In general, the findings indicated that no clear and standard process was used for data management in diabetes clinical trials, and each research center executed its own methods and processes. Conclusion According to the results, the common methods of data management in diabetes clinical trials included a set of paper-based processes. It seems that using information technology can help facilitate data management processes in a variety of clinical trials, including diabetes clinical trials.
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Affiliation(s)
- Aynaz Nourani
- Department of Health Information Technology, Urmia University of Medical Sciences, Urmia, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. .,Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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43
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Achrekar MS. Enhanced recovery after surgery (ERAS) nursing program. Asia Pac J Oncol Nurs 2022; 9:100041. [PMID: 35620398 PMCID: PMC9126774 DOI: 10.1016/j.apjon.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Meera Sharad Achrekar
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
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44
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Kuemmerli C, Tschuor C, Kasai M, Alseidi AA, Balzano G, Bouwense S, Braga M, Coolsen M, Daniel SK, Dervenis C, Falconi M, Hwang DW, Kagedan DJ, Kim SC, Lavu H, Liang T, Nussbaum D, Partelli S, Passeri MJ, Pecorelli N, Pillai SA, Pillarisetty VG, Pucci MJ, Su W, Sutcliffe RP, Tingstedt B, van der Kolk M, Vrochides D, Wei A, Williamsson C, Yeo CJ, Zani S, Zouros E, Abu Hilal M. Impact of enhanced recovery protocols after pancreatoduodenectomy: meta-analysis. Br J Surg 2022; 109:256-266. [PMID: 35037019 DOI: 10.1093/bjs/znab436] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 11/23/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND This individual-patient data meta-analysis investigated the effects of enhanced recovery after surgery (ERAS) protocols compared with conventional care on postoperative outcomes in patients undergoing pancreatoduodenectomy. METHODS The Cochrane Library, MEDLINE, Embase, Scopus, and Web of Science were searched systematically for articles reporting outcomes of ERAS after pancreatoduodenectomy published up to August 2020. Comparative studies were included. Main outcomes were postoperative functional recovery elements, postoperative morbidity, duration of hospital stay, and readmission. RESULTS Individual-patient data were obtained from 17 of 31 eligible studies comprising 3108 patients. Time to liquid (mean difference (MD) -3.23 (95 per cent c.i. -4.62 to -1.85) days; P < 0.001) and solid (-3.84 (-5.09 to -2.60) days; P < 0.001) intake, time to passage of first stool (MD -1.38 (-1.82 to -0.94) days; P < 0.001) and time to removal of the nasogastric tube (3.03 (-4.87 to -1.18) days; P = 0.001) were reduced with ERAS. ERAS was associated with lower overall morbidity (risk difference (RD) -0.04, 95 per cent c.i. -0.08 to -0.01; P = 0.015), less delayed gastric emptying (RD -0.11, -0.22 to -0.01; P = 0.039) and a shorter duration of hospital stay (MD -2.33 (-2.98 to -1.69) days; P < 0.001) without a higher readmission rate. CONCLUSION ERAS improved postoperative outcome after pancreatoduodenectomy. Implementation should be encouraged.
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Affiliation(s)
- Christoph Kuemmerli
- Department of Surgery, Foundation Poliambulanza, Brescia, Italy
- Department of Surgery, Hepatobiliary and Pancreatic Surgical Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Department of Surgery, Clarunis-University Centre for Gastrointestinal and Liver Diseases Basle, Basle, Switzerland
| | - Christoph Tschuor
- Department of Surgery, Foundation Poliambulanza, Brescia, Italy
- Division of Hepatopancreatobiliary Surgery, Department of Surgery, Carolinas Medical Centre, Charlotte, North Carolina, USA
- Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Meidai Kasai
- Department of Surgery, Meiwa Hospital, Hyogo, Japan
| | - Adnan A Alseidi
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Gianpaolo Balzano
- Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy
| | - Stefan Bouwense
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Marco Braga
- Department of Surgery, Monza Hospital, University of Milano Bicocca, Monza, Italy
| | - Mariëlle Coolsen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Sara K Daniel
- Hepatopancreatobiliary Surgery, University of Washington, Seattle, Washington, USA
| | - Christos Dervenis
- Department of Surgery, Konstantopouleio General Hospital, Nea Ionia, Athens, Greece
| | - Massimo Falconi
- Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy
| | - Dae Wook Hwang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
| | - Daniel J Kagedan
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Song Cheol Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
| | - Harish Lavu
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Tingbo Liang
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, Zhejiang, China
| | - Daniel Nussbaum
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Stefano Partelli
- Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy
| | - Michael J Passeri
- Division of Hepatopancreatobiliary Surgery, Department of Surgery, Carolinas Medical Centre, Charlotte, North Carolina, USA
| | - Nicolò Pecorelli
- Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy
| | - Sastha Ahanatha Pillai
- Department of Surgery, Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India
| | - Venu G Pillarisetty
- Hepatopancreatobiliary Surgery, University of Washington, Seattle, Washington, USA
| | - Michael J Pucci
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Wei Su
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, Zhejiang, China
| | - Robert P Sutcliffe
- Department of Hepatobiliary and Pancreatic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Bobby Tingstedt
- Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Marion van der Kolk
- Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Dionisios Vrochides
- Division of Hepatopancreatobiliary Surgery, Department of Surgery, Carolinas Medical Centre, Charlotte, North Carolina, USA
| | - Alice Wei
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Caroline Williamsson
- Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Charles J Yeo
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sabino Zani
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Efstratios Zouros
- Department of Surgery, Konstantopouleio General Hospital, Nea Ionia, Athens, Greece
| | - Mohammed Abu Hilal
- Department of Surgery, Foundation Poliambulanza, Brescia, Italy
- Department of Surgery, Hepatobiliary and Pancreatic Surgical Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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45
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Zhang Z, Hou QQ, Luo X, Li HM, Hou Y. The role of nursing in enhanced recovery after surgery programs in accordance with spine surgery: A mini review. JOURNAL OF INTEGRATIVE NURSING 2022. [DOI: 10.4103/jin.jin_08_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wu Y, Li Y, Che L, Du X, Jin X. Citation analysis on the research frontiers and evolution of enhanced recovery after surgery. J Nurs Manag 2021; 30:827-835. [PMID: 34970786 DOI: 10.1111/jonm.13541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate the research frontiers and evolution laws in the field of enhanced recovery after surgery (ERAS) and to predict the next direction of development. BACKGROUND In recent years, the clinical applications of ERAS have been widely recognized by the medical community. Nursing work is present throughout the entire process, and nurses not only play a role in multidisciplinary coordination, but also maintain independent professional characteristics. METHODS The citation analysis method was used to analyze the research documents in the Web of Science database over the last 10 years. RESULTS The number of documents in the field published from 2011 to 2020 increased annually. The application in colorectal surgery was the most important research frontier. From 2016 to 2020, the research frontiers were diversified. The application in colorectal surgery remains the most important research frontier, and perioperative nursing will play an important role in the future. CONCLUSIONS This study used citation analysis to analyze the research frontiers and evolution of ERAS in the last 10 years. IMPLICATIONS FOR NURSING MANAGEMENT This research will help nursing managers to carry out research and clinical promotion plans in the ERAS field and guide the transformation of scientific research achievements into nursing practice.
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Affiliation(s)
- Ying Wu
- School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, China
| | - Yan Li
- School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, China
| | - Leilei Che
- School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, China
| | - Xiangyu Du
- School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, China
| | - Xing Jin
- Department of Anesthesiology, Shanxi Cancer Hospital, Taiyuan, China
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Ziacchi M, Massaro G, Angeletti A, Statuto G, Diemberger I, Martignani C, Galiè N, Biffi M, Boriani G. Preoperative checklist to reduce the risk of cardiac implantable electronic device infections. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2021; 45:262-269. [PMID: 34927271 DOI: 10.1111/pace.14429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 10/19/2022]
Abstract
Cardiac implantable electronic device (CIED) infection represents a dramatic event with a high mortality rate (>3x) despite antibiotic therapy and device extraction; therefore, the real winning strategy in this situation could be represented by prevention. Antibiotic prophylaxis and antibiotic-releasing envelope are effective in improving patient outcome; however, healthcare costs related to CIED infections remain high over the years. In this review we would keep the attention on a pre-surgical checklist to reduce the risk of CIED infections. In fact, checklist is an effective instrument for medical care quality improvement mainly used in surgery, but not very commonly in cath-lab and electrophysiology procedures. All steps of this checklist are of proven effectiveness in reducing the risk of CIED infections but, up till now, they are not considered together in a pre-surgical approach. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Matteo Ziacchi
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
| | - Giulia Massaro
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
| | - Andrea Angeletti
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
| | - Giovanni Statuto
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
| | - Igor Diemberger
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
| | - Cristian Martignani
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
| | - Nazzareno Galiè
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
| | - Mauro Biffi
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
| | - Giuseppe Boriani
- Cardiology Unit, University of Modena and Reggio Emilia, Modena, Italy
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Sneyd JR, Absalom AR, Barends CRM, Jones JB. Hypotension during propofol sedation for colonoscopy: an exploratory analysis. Br J Anaesth 2021; 128:610-622. [PMID: 34916051 PMCID: PMC9008870 DOI: 10.1016/j.bja.2021.10.044] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/11/2021] [Accepted: 10/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Intraoperative and postoperative hypotension occur commonly and are associated with organ injury and poor outcomes. Changes in arterial blood pressure (BP) during procedural sedation are not well described. METHODS Individual patient data from five trials of propofol sedation for colonoscopy and a clinical database were pooled and explored with logistic and linear regression. A literature search and focused meta-analysis compared the incidence of hypotension with propofol and alternative forms of procedural sedation. Hypotensive episodes were characterised by the original authors' definitions (typically systolic BP <90 mm Hg). RESULTS In pooled individual patient data (n=939), 36% of procedures were associated with episodes of hypotension. Longer periods of propofol sedation and larger propofol doses were associated with longer-lasting and more-profound hypotension. Amongst 380 patients for whom individual BP measurements were available, 107 (28%) experienced systolic BP <90 mm Hg for >5 min, and in 89 (23%) the episodes exceeded 10 min. Meta-analysis of 18 RCTs identified an increased risk ratio for the development of hypotension in procedures where propofol was used compared with the use of etomidate (two studies; n=260; risk ratio [RR] 2.0 [95% confidence interval: 1.37-2.92]; P=0.0003), remimazolam (one study; n=384; RR 2.15 [1.61-2.87]; P=0.0001), midazolam (14 studies; n=2218; RR 1.46 [1.18-1.79]; P=0.0004), or all benzodiazepines (15 studies; n=2602; 1.67 [1.41-1.98]; P<0.00001). Hypotension was less likely with propofol than with dexmedetomidine (one study; n=60; RR 0.24 [0.09-0.62]; P=0.003). CONCLUSIONS Hypotension is common during propofol sedation for colonoscopy and of a magnitude and duration associated with harm in surgical patients.
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Affiliation(s)
- J Robert Sneyd
- Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
| | - Anthony R Absalom
- Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Clemens R M Barends
- Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jordan B Jones
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT, USA
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Makkar JK, Dahiya D, Jain D, Kuber A, Kajal K, Singh NP. Effect of balanced anaesthesia with and without modified pectoralis nerve block on postoperative analgesia after breast surgeries: A randomised controlled trial. Indian J Anaesth 2021; 65:S110-S114. [PMID: 34703055 PMCID: PMC8500198 DOI: 10.4103/ija.ija_125_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/28/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Aims: Modified pectoral nerve block (PEC) has been reported to have variable effects on perioperative pain in patients undergoing surgery for carcinoma breast. This randomised controlled trial was conducted to study the effect of modified PEC on postoperative pain relief in patients undergoing breast surgery. Methods: Fifty patients with carcinoma breast undergoing breast surgery were randomised to receive a modified PEC block consisting of 30 ml of ropivacaine 0.2% after induction of anaesthesia (PEC group) or no block (GA group) in this prospective randomised trial. Time to first rescue analgesia was recorded as primary outcome. Other secondary outcomes recorded were postoperative visual analogue scale (VAS) scores, number of rescue boluses and 24-h fentanyl consumption. Results: There was no significant difference in time to first rescue analgesia between the two groups, with mean difference (95% confidence interval) of 22.91 (−6.8 to 52.69) min. Amount of fentanyl required to keep pain VAS less than 3 was also comparable between the two groups, mean (standard deviation) of 42.0 μg (17.42) in GA group versus 43.24 μg (17.22) in PEC group; P = 0.830.20/25 patients required rescue analgesia in GA group as compared to 17/25 in PEC group (P = 0.334). The postoperative VAS scores were also comparable between the groups at all time intervals. Conclusion: Balanced anaesthesia supplemented with modified PEC block performed after general anaesthesia did not improve the postoperative pain in patients undergoing modified radical mastectomy.
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Affiliation(s)
- Jeetinder K Makkar
- Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Dahiya
- Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Jain
- Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aswini Kuber
- Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kamal Kajal
- Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Narinder P Singh
- Department of Neuroanaesthesia, Health Sciences Centre, Winnipeg, Manitoba, Canada
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50
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Cheng W, Liu J, Zhi M, Shen D, Shao M, Zhang C, Wang G, Jiang Z. Stress and autonomic nerve dysfunction monitoring in perioperative gastric cancer patients using a smart device. Ann Noninvasive Electrocardiol 2021; 27:e12903. [PMID: 34669995 PMCID: PMC8739623 DOI: 10.1111/anec.12903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 12/22/2022] Open
Abstract
Background Heart rate variability (HRV), a sensitive marker of stress and autonomic nervous disorders, was significantly decreased in cardiovascular disease, inflammation, and surgical injury. However, the effect of radical gastrectomy on HRV parameters needs to be further investigated. Methods A prospective, observational study including 45 consecutive enrolled patients undergoing radical gastrectomy in our enhanced recovery after surgery (ERAS) programs was conducted. Frequency‐ and time‐domain parameters of HRV from 1 day prior to operation to 4 days postoperatively were continuously measured. Meanwhile, plasma cortisol and inflammatory markers were recorded and correlated to HRV parameters. Results Heart rate variability showed a solidly circadian rhythm. Anesthesia severely disturbed HRV parameters, resulting in a reduction of most of the HRV parameters. Frequency‐domain parameter (including VLF) and time‐domain parameters (including the SDNN, SDANN, and triangular index) of HRV demonstrated a significant reduction compared to preoperative values on the postoperative day 1 (Pod1), and these HRV parameters could return to baseline on Pod2 or Pod3, indicating surgical stress and autonomic nerve dysfunction existed in the early postoperative period. Inflammatory biomarkers were significantly elevated on Pod1 and Pod3. Plasma cortisol decreased significantly on Pod1 and Pod3. Both inflammatory biomarkers and plasma cortisol had no significant correlation with HRV parameters. Conclusions Compared with plasma cortisol and inflammation biomarkers, HRV is more sensitive to detect surgical stress and autonomic nervous dysfunction induced by radical gastrectomy in patients with gastric cancer.
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Affiliation(s)
- Wei Cheng
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiang Liu
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Mengwei Zhi
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Danli Shen
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Mingyue Shao
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Cheng Zhang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Gang Wang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhiwei Jiang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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