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Seminars in Oncology Nursing Oct 2022The purpose of this review is to describe the myriad complications of cancer and its therapies to emphasize the pathophysiological need for prehabilitation. (Review)
Review
OBJECTIVE
The purpose of this review is to describe the myriad complications of cancer and its therapies to emphasize the pathophysiological need for prehabilitation.
DATA SOURCES
The information presented in this review is from applicable, peer-reviewed scientific articles.
CONCLUSION
Cancer itself renders negative effects on the body, most notably unintentional weight loss and fatigue. Cancer treatments, especially surgical interventions, can cause detrimental short- and long-term impacts on patients, which translate to suboptimal treatment outcomes. Prehabilitation can be used to improve patient health prior to anticancer therapies to improve treatment tolerance and efficacy.
IMPLICATIONS FOR NURSING PRACTICE
Nurses play an important role in the treatment of patients with cancer throughout the cancer care continuum. Many nurses are already aiding their patients in cancer prehabilitation through education. By describing common impairments amenable to multimodal prehabilitation, nurses may better advocate for their patients and can become even more involved in this aspect of care.
Topics: Humans; Preoperative Care; Neoplasms; Treatment Outcome; Continuity of Patient Care; Preoperative Exercise
PubMed: 35989196
DOI: 10.1016/j.soncn.2022.151328 -
The American Surgeon Jul 2020
Topics: Authorship; Child; Child Welfare; Humans; Ophthalmologic Surgical Procedures; Ophthalmology; Personal Autonomy; Physician-Patient Relations; Preoperative Care; Professional-Family Relations; Television; Trust
PubMed: 32916071
DOI: 10.1177/0003134820918259 -
Instructional Course Lectures 2022The identification and preoperative optimization of modifiable risk factors is proposed to be an effective method to decrease complications and improve the value of...
The identification and preoperative optimization of modifiable risk factors is proposed to be an effective method to decrease complications and improve the value of elective total joint arthroplasty. It is important to highlight the best practices as well as controversies in the preoperative evaluation and treatment of patients undergoing total joint arthroplasty.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Elective Surgical Procedures; Humans; Preoperative Care; Retrospective Studies; Risk Factors
PubMed: 35254773
DOI: No ID Found -
Journal of Pediatric and Adolescent... Apr 2021Hematopoietic stem cell transplantation is used to treat many chronic and acute malignant and nonmalignant conditions. We review hematopoietic stem cell transplantation... (Review)
Review
Hematopoietic stem cell transplantation is used to treat many chronic and acute malignant and nonmalignant conditions. We review hematopoietic stem cell transplantation and its effect on the gynecologic health of pediatric and adolescent patients, including pretransplantation evaluation, contraception, menstrual suppression, sexual health, fertility, primary ovarian insufficiency, and graft vs host disease. Comprehensive and team-based care provides optimal anticipatory counseling, evaluation, and management of acute and ongoing gynecologic issues.
Topics: Adolescent; Child; Female; Genital Diseases, Female; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Perioperative Care; Preoperative Care; Reproductive Health; Sexual Health
PubMed: 33338627
DOI: 10.1016/j.jpag.2020.12.007 -
Advances in Anesthesia Dec 2020The incidence of liver failure continues to increase, and it is associated with increased perioperative morbidity and mortality. Liver failure is associated with... (Review)
Review
The incidence of liver failure continues to increase, and it is associated with increased perioperative morbidity and mortality. Liver failure is associated with multiorgan dysfunction, including central nervous, cardiac, respiratory, gastrointestinal, renal, and hematological systems. Preoperative identification, optimization, and tailored anesthetic management are essential for optimum outcomes in patients with liver disease undergoing surgery. The coagulopathy of liver failure is a balanced coagulopathy better assessed by thromboelastography than conventional testing, and it is not directly associated with bleeding risk.
Topics: Anesthesia; Humans; Liver Diseases; Liver Failure; Preoperative Care
PubMed: 34106838
DOI: 10.1016/j.aan.2020.09.002 -
Obstetrics and Gynecology Aug 2019In the past, best practices for perioperative management have been based as much on dogma as science. The creation of optimized perioperative pathways, known as enhanced... (Review)
Review
In the past, best practices for perioperative management have been based as much on dogma as science. The creation of optimized perioperative pathways, known as enhanced recovery after surgery, has been shown to simultaneously improve patient outcomes and reduce cost. In this article, we critically review interventions (and omission of interventions) that should be considered by every surgical team to optimize preanesthesia care. This includes patient education, properly managing existing medical comorbidities, optimizing nutrition, and the use of medications before incision that have been shown to reduce surgical stress, opioid requirements, and postoperative complications. Anesthetic techniques, the use of adjunct medications administered after incision, and postoperative management are beyond the scope of this review. When possible, we have relied on randomized trials, meta-analyses, and systematic reviews to support our recommendations. In some instances, we have drawn from the general and colorectal surgery literature if evidence in gynecologic surgery is limited or of poor quality. In particular, hospital systems should aim to adhere to antibiotic and thromboembolic prophylaxis for 100% of patients, the mantra, "nil by mouth after midnight" should be abandoned in favor of adopting a preoperative diet that maintains euvolemia and energy stores to optimize healing, and bowel preparation should be abandoned for patients undergoing gynecologic surgery for benign indications and minimally invasive gynecologic surgery.
Topics: Female; Gynecologic Surgical Procedures; Humans; Practice Guidelines as Topic; Preoperative Care
PubMed: 31349358
DOI: 10.1097/AOG.0000000000003323 -
Casopis Lekaru Ceskych 2022This document was created based on the need to standardize the psychological examination procedure prior to bariatric surgery. A valuable inspiration was the...
This document was created based on the need to standardize the psychological examination procedure prior to bariatric surgery. A valuable inspiration was the recommendations issued by the American Society for Metabolic and Bariatric Surgery. Bariatric or metabolic surgery has an undeniable positive effect in the treatment of obesity, in terms of improving somatic diseases, psychological disorders and psychosocial functioning. At the same time, it introduces major changes in the individual's life to which he or she must adapt. The treatment of obesity by surgery requires a fundamental change in lifestyle and the lifelong cooperation of the patient with the entire therapeutic team. Psychological care is a standard part of the entire treatment process. The role of the psychologist is not exclusively diagnostic. In indicated cases, it offers preoperative and postoperative psychological intervention, education and cooperation in the development of an individual treatment plan. Its aim is to deepen the patient's motivation to comply with dietary and regimen recommendations and to provide psychological support in the event of worsening psychological difficulties.
Topics: Bariatric Surgery; Female; Humans; Male; Mental Disorders; Obesity; Preoperative Care; United States
PubMed: 36100449
DOI: No ID Found -
Journal of the American Medical... Apr 2022Oral bacteria may contribute to postoperative infectious complications including postoperative pneumonia or surgical site infection. The aim of this study was to...
OBJECTIVES
Oral bacteria may contribute to postoperative infectious complications including postoperative pneumonia or surgical site infection. The aim of this study was to investigate the impact of preoperative dental care on postoperative outcomes among surgical patients under general anesthesia.
DESIGN
Retrospective cohort study.
SETTING AND PARTICIPANTS
We analyzed clinical records of major surgical patients at a university hospital between 2016 and 2018. Subjects were categorized into either the preoperative dental care group, those being referred to dentists by their surgeons based on an individual surgeon's judgment for dental care before surgery, or the control group.
METHODS
The primary outcome was postoperative infectious complications. Secondary outcomes were postoperative inflammation markers (C-reactive protein and fever), and economic outcomes (postoperative length of hospital stay and medical expenses). As the main analysis, the average treatment effects of the preoperative dental care were obtained from the augmented inverse-probability weighting (AIPW) method with consideration of demographics and perioperative risk factors to estimate causal effect of the intervention from the observational data. Then, stratified analyses by age and surgical sites were conducted with the inverse-probability weighting and linear regression methods, respectively.
RESULTS
In the AIPW estimation, compared with the control group, the care group saw a significantly lower rate of postoperative infection (average treatment effect -3.02) and shorter fever duration (-2.79 days). The stratified analysis by age revealed significant positive impact of dental care in all age groups, including the highest treatment effects observed among patients younger than 60. Also, treatment effect was observed in wider surgical sites than previously known.
CONCLUSION/IMPLICATIONS
This study indicates a significant impact of preoperative dental care on preventing postoperative infection and inflammation. Along with old age or certain types of surgeries in which advantages of dental referral have been already known, preoperative dental referral could be beneficial for broader types of patients.
Topics: Elective Surgical Procedures; Humans; Length of Stay; Postoperative Complications; Postoperative Period; Preoperative Care; Referral and Consultation; Retrospective Studies
PubMed: 35219603
DOI: 10.1016/j.jamda.2022.01.071 -
JAMA Network Open Feb 2022This cross-sectional study examines the prevalence of preoperative opioid prescribing and the specialties of clinicians who prescribe these medications.
This cross-sectional study examines the prevalence of preoperative opioid prescribing and the specialties of clinicians who prescribe these medications.
Topics: Adult; Aged; Analgesics, Opioid; Cross-Sectional Studies; Drug Prescriptions; Female; Forecasting; Humans; Male; Middle Aged; Pain; Practice Patterns, Physicians'; Preoperative Care; Prevalence; United States
PubMed: 35142837
DOI: 10.1001/jamanetworkopen.2021.47897 -
Minerva Anestesiologica May 2022Traumatic brain injury (TBI) is a leading cause of mortality and disability worldwide. Head injured patients may frequently require emergency neurosurgery. The... (Review)
Review
Traumatic brain injury (TBI) is a leading cause of mortality and disability worldwide. Head injured patients may frequently require emergency neurosurgery. The perioperative TBI period is very important as many interventions done in this stage can have a profound effect on the long-term neurological outcome. This practical concise narrative review focused mainly on: 1) the management of severe TBI patients with neurosurgical lesions admitted to a spoke center (i.e. hospital without neurosurgery) and therefore needing a transfer to the hub center (i.e. hospital with neurosurgery); 2) the management of severe TBI patients with intracranial hypertension/brain herniation awaiting for neurosurgery; and 3) the neuromonitoring-oriented management in the immediate post-operative period. The proposals presented in this review mainly apply to severe TBI patients admitted to high-income countries.
Topics: Brain; Brain Injuries, Traumatic; Emergencies; Humans; Intracranial Hypertension; Neurosurgery; Postoperative Care; Preoperative Care
PubMed: 34636222
DOI: 10.23736/S0375-9393.21.15927-9