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European Journal of Vascular and... Feb 2020
Topics: Acute Disease; Angiography; Anticoagulants; Europe; Heparin; Humans; Ischemia; Peripheral Arterial Disease; Preoperative Care; Societies, Medical; Specialties, Surgical; Vascular Surgical Procedures; Vasodilator Agents
PubMed: 31899099
DOI: 10.1016/j.ejvs.2019.09.006 -
The Canadian Journal of Cardiology Aug 2021
Topics: Cardiac Surgical Procedures; Humans; Preoperative Care
PubMed: 34161802
DOI: 10.1016/j.cjca.2021.06.009 -
Dermatologic Surgery : Official... Apr 2020Telemedicine is an emerging field with numerous applications within medicine. Previous review articles describe its use within plastic surgery and otolaryngology but... (Review)
Review
BACKGROUND
Telemedicine is an emerging field with numerous applications within medicine. Previous review articles describe its use within plastic surgery and otolaryngology but none, to the authors' knowledge, within dermatologic surgery.
OBJECTIVE
To provide a review of the applications of telemedicine within dermatologic surgery.
MATERIALS AND METHODS
A PubMed search of articles published on teledermatology was conducted in July 2018. Articles were selected based on their relevance to dermatologic surgery and reviewed for their discussion of the applications of telemedicine in surgical and cosmetic dermatology.
RESULTS
The initial search resulted in 156 articles. Eleven ultimately met inclusion criteria: 2 in referral and consultation, 5 in telepathology, 2 in intraoperative uses, and 2 in postprocedural care.
CONCLUSION
For preoperative consultation, teledermatology enables the surgeon to plan ahead and increases access to care by reducing the number of clinic visits. Telepathology has the potential to allow intraoperative consultation with a dermatopathologist to achieve accurate tumor clearance without delay. Smartglasses represent a promising technology for greater care coordination and a teaching tool. Postprocedural monitoring via text messaging provides convenient access to expert advice and early detection of postoperative complications. With increasing technologic advancements, telemedicine holds great potential to augment the dermatologic surgeon's daily practice.
Topics: Cosmetic Techniques; Dermatologic Surgical Procedures; Dermatology; Humans; Intraoperative Care; Preoperative Care; Referral and Consultation; Smart Glasses; Telemedicine
PubMed: 31688234
DOI: 10.1097/DSS.0000000000002230 -
Anesthesiology Feb 2022Frailty is increasingly being recognized as a public health issue, straining healthcare resources and increasing costs to care for these patients. Frailty is the decline...
BACKGROUND
Frailty is increasingly being recognized as a public health issue, straining healthcare resources and increasing costs to care for these patients. Frailty is the decline in physical and cognitive reserves leading to increased vulnerability to stressors such as surgery or disease states. The goal of this pilot diagnostic accuracy study was to identify whether point-of-care ultrasound measurements of the quadriceps and rectus femoris muscles can be used to discriminate between frail and not-frail patients and predict postoperative outcomes. This study hypothesized that ultrasound could discriminate between frail and not-frail patients before surgery.
METHODS
Preoperative ultrasound measurements of the quadriceps and rectus femoris were obtained in patients with previous computed tomography scans. Using the computed tomography scans, psoas muscle area was measured in all patients for comparative purposes. Frailty was identified using the Fried phenotype assessment. Postoperative outcomes included unplanned intensive care unit admission, delirium, intensive care unit length of stay, hospital length of stay, unplanned skilled nursing facility admission, rehospitalization, falls within 30 days, and all-cause 30-day and 1-yr mortality.
RESULTS
A total of 32 patients and 20 healthy volunteers were included. Frailty was identified in 18 of the 32 patients. Receiver operating characteristic curve analysis showed that quadriceps depth and psoas muscle area are able to identify frailty (area under the curve-receiver operating characteristic, 0.80 [95% CI, 0.64 to 0.97] and 0.88 [95% CI, 0.76 to 1.00], respectively), whereas the cross-sectional area of the rectus femoris is less promising (area under the curve-receiver operating characteristic, 0.70 [95% CI, 0.49 to 0.91]). Quadriceps depth was also associated with unplanned postoperative skilled nursing facility discharge disposition (area under the curve 0.81 [95% CI, 0.61 to 1.00]) and delirium (area under the curve 0.89 [95% CI, 0.77 to 1.00]).
CONCLUSIONS
Similar to computed tomography measurements of psoas muscle area, preoperative ultrasound measurements of quadriceps depth shows promise in discriminating between frail and not-frail patients before surgery. It was also associated with skilled nursing facility admission and postoperative delirium.
Topics: Aged; Female; Frailty; Hand Strength; Humans; Male; Middle Aged; Point-of-Care Systems; Postoperative Complications; Predictive Value of Tests; Preoperative Care; Prospective Studies; Ultrasonography, Interventional
PubMed: 34851395
DOI: 10.1097/ALN.0000000000004064 -
BMJ (Clinical Research Ed.) Aug 2019
Topics: Exercise Therapy; Humans; Neoplasms; Nutrition Therapy; Patient Education as Topic; Postoperative Complications; Practice Guidelines as Topic; Preoperative Care; Psychotherapy; Resilience, Psychological; Social Determinants of Health; Social Support; Treatment Outcome
PubMed: 31413000
DOI: 10.1136/bmj.l5120 -
JNMA; Journal of the Nepal Medical... Oct 2022The overall outcome of the patient after any surgery is determined not only by the fineness of the surgical procedure but also by preoperative conditioning and... (Review)
Review
UNLABELLED
The overall outcome of the patient after any surgery is determined not only by the fineness of the surgical procedure but also by preoperative conditioning and postoperative care. Prehabilitation decreases the surgical stress response and increases the preparedness of the patient to undergo planned surgical insult. Preoperatively structured inspiratory muscle exercises, cardiopulmonary fitness program, and planned exercise program for muscles of limbs, back, abdomen, head, and neck allow an overall upliftment of the physiological capacity of the patient to better cope with the surgical stress. Optimization of dietary status by macronutrients, micronutrients, and the nutrients has an impact on augmenting postoperative recovery and shortening the overall hospital stay. Preparing patients for the scheduled surgery and initiating alcohol and smoking cessation programs overhaul the patient's mental health and boost the healing process. This concept of prehabilitation a few weeks before surgery is equally beneficial compared to enhancing operative procedures and postsurgical care.
KEYWORDS
length of stay; mental health; nutrients; preoperative exercise; smoking cessation.
Topics: Humans; Preoperative Exercise; Preoperative Care; Exercise; Postoperative Care; Delivery of Health Care; Postoperative Complications
PubMed: 36705159
DOI: 10.31729/jnma.7545 -
AORN Journal Feb 2022Surgical site infections (SSIs) frequently involve resident bacteria (eg, Staphylococcus aureus) on the patient's skin. Strategies to help prevent SSIs include removing...
Surgical site infections (SSIs) frequently involve resident bacteria (eg, Staphylococcus aureus) on the patient's skin. Strategies to help prevent SSIs include removing soil and transient microorganisms from the skin before surgery. Preoperative decolonization, preoperative bathing, and application of an effective skin antiseptic at the surgical site are components of a multimodal approach to reducing microorganisms to subpathogenic levels. As members of an interdisciplinary team, perioperative RNs are essential in the development and implementation of SSI prevention bundles to promote patient safety. This article discusses recommendations from the AORN "Guideline for preoperative patient skin antisepsis" for decolonization protocols, preoperative bathing, and selection of surgical site antiseptics. A scenario describes the process a facility team uses to determine components of an SSI prevention bundle after recognizing an increase in infections from multidrug-resistant organisms.
Topics: Anti-Infective Agents, Local; Antisepsis; Humans; Preoperative Care; Skin; Surgical Wound Infection
PubMed: 35084763
DOI: 10.1002/aorn.13605 -
British Journal of Anaesthesia Jun 2024The changing ethical and legal landscape in the UK means that anaesthetists should routinely be discussing the risk of death during the consent process. To do this...
The changing ethical and legal landscape in the UK means that anaesthetists should routinely be discussing the risk of death during the consent process. To do this effectively means expanding anaesthetic preassessment services for children and young people, something that has been recognised as a priority, but which still needs investment and an appreciation of its value at the trust level.
Topics: Humans; Child; Informed Consent; Preoperative Care; Adolescent; United Kingdom; Anesthesia
PubMed: 38729742
DOI: 10.1016/j.bja.2024.03.005 -
Journal of Perianesthesia Nursing :... Dec 2019
Topics: Bariatrics; Humans; Obesity; Preoperative Care
PubMed: 31801661
DOI: 10.1016/j.jopan.2019.09.001 -
European Urology Focus Jan 2024The aim of prehabilitation is to improve the physical and emotional health of patients before upcoming surgery or therapies. This mini-review focuses on current advances... (Review)
Review
The aim of prehabilitation is to improve the physical and emotional health of patients before upcoming surgery or therapies. This mini-review focuses on current advances in urological prehabilitation and how it can be used together with enhanced recovery after surgery and conventional rehabilitation protocols. Urological prehabilitation has primarily focused on improving urinary continence, erectile function, bone density, and lean body mass, with some promising results for all of these outcomes. Although all cancer patients should be considered for prehabilitation, older or medically frail individuals may derive the greatest benefit. PATIENT SUMMARY: This mini-review discusses prehabilitation as part of the care for cancer patients. Although the research on prehabilitation is evolving, current studies generally demonstrate that it may help to enhance a patient's strength and endurance before upcoming surgery or other treatments.
Topics: Male; Humans; Preoperative Care; Preoperative Exercise; Cancer Survivors; Neoplasms; Research
PubMed: 37996272
DOI: 10.1016/j.euf.2023.11.006