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Anesthesiology Feb 2020
Topics: Anesthetics, Local; Cardiac Surgical Procedures; Cognition; Humans; Lidocaine; Postoperative Period
PubMed: 31939860
DOI: 10.1097/ALN.0000000000003040 -
Hand (New York, N.Y.) Nov 2022Wrist injuries are common in sports and can result in prolonged time missed from playing. This study aimed to determine in Major League Baseball-players after...
BACKGROUND
Wrist injuries are common in sports and can result in prolonged time missed from playing. This study aimed to determine in Major League Baseball-players after arthroscopic wrist surgery the return-to-sport (RTS) rate, postoperative career length, and changes in performance compared with preoperative statistics and matched controls.
METHODS
Major League Baseball players who underwent arthroscopic wrist surgery from 1990 to 2019 were identified. Demographic and performance data were collected for each player, and matched controls were identified. Comparisons were made via paired samples Student tests.
RESULTS
Twenty-six players (27 surgeries) were identified. The average age of included players was 28.9 ± 2.9 years with an average professional experience of 5.2 ± 3.4 years. Eighty-four percent of players returned to sport, with an average RTS time of 5.0 ± 2.7 months. A statistically significant ( < .05) decrease was seen in preoperative and postoperative runs scored per season (95.6 ± 91.3 vs 41.0 ± 29.5), batting average (BA) (0.270 ± 0.024 vs 0.240 ± 0.036), and average wins above replacement (WAR) (1.5 ± 1.1 vs 0.8 ± 0.9).
CONCLUSION
Major League Baseball players who underwent arthroscopic wrist surgery had an RTS rate of 84% at a mean time of 5.0 months. There was no significant difference in performance statistics between cases postoperatively and matched controls overall, with some differences in performance found when categorized by position. However, a significant decrease in performance among case players was observed between preoperative and postoperative performance, including runs per season, BA, and WAR.
Topics: Humans; Adult; Return to Sport; Arthroscopy; Wrist; Baseball; Postoperative Period
PubMed: 34433335
DOI: 10.1177/15589447211028923 -
BMC Surgery Jan 2020Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery.
METHODS
Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery.
RESULTS
A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection (RR = 0.50, 95%CI: 0.33 to 0.75), postoperative length of stay (MD = -2.53, 95%CI: - 3.42 to - 1.65), time until first postoperative flatus (MD = -0.64, 95%CI: - 0.84 to - 0.45) and time until first postoperative defecation (MD = -1.10, 95%CI: - 1.74 to - 0.47) in patients who received ERAS, compared to conventional care. However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P = 0.10), surgical site infection (P = 0.42), postoperative anastomotic leakage (P = 0.45), readmissions (P = 0.31) and ileus (P = 0.25).
CONCLUSIONS
ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.
Topics: Digestive System Surgical Procedures; Enhanced Recovery After Surgery; Humans; Length of Stay; Postoperative Period
PubMed: 31900149
DOI: 10.1186/s12893-019-0669-3 -
Revista Da Associacao Medica Brasileira... 2022There are very few studies about total knee arthroplasty biomechanical and biochemical effects in the early postoperative period. The aim of this study was to...
OBJECTIVE
There are very few studies about total knee arthroplasty biomechanical and biochemical effects in the early postoperative period. The aim of this study was to investigate the effect of total knee arthroplasty on pain intensity, knee joint valgus angle, malalignment, functional status, knee joint position sense, and cytokine levels.
METHODS
A total of 29 patients (female/male: 24/5) who underwent total knee arthroplasty were included in the late-stage knee osteoarthritis group, and 22 patients (female/male: 13/9) with grade 4 osteoarthritis were included in the early-stage knee osteoarthritis group. The visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index were used to evaluate the pain intensity and functional status. Alignment and knee position sense measurements were also calculated. Systemic venous blood samples were taken to evaluate the interleukin-6, tumor necrosis factor-alpha, and interleukin-1 beta cytokine levels.
RESULTS
In the study group, there were positive improvements in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 70° knee flexion angle parameters, and interleukin-6 of patients at the postoperative 6th week compared to the preoperative period (p<0.05). The patients in the study group had similar or better results in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 35°, 55°, and 70° knee flexion angles parameters, and in interleukin-6, compared to the control group at postoperative 6th week.
CONCLUSION
Total knee arthroplasty provides improvements in pain, function, valgus angle, joint position sense, and interleukin-6 in the early postoperative period.
Topics: Humans; Male; Female; Arthroplasty, Replacement, Knee; Osteoarthritis, Knee; Interleukin-6; Knee Joint; Postoperative Period; Retrospective Studies
PubMed: 36449795
DOI: 10.1590/1806-9282.20220734 -
British Journal of Anaesthesia Mar 2023The use of large amounts of uniform electronic data over long periods provides a step toward understanding and ultimately shaping the perioperative cognitive trajectory...
The use of large amounts of uniform electronic data over long periods provides a step toward understanding and ultimately shaping the perioperative cognitive trajectory of older patients. With the improvements in the quality, uniformity, and amount of data contained within the electronic health record, along with developments in machine learning and big data analysis, we can look forward to enhanced studies that will help advance clinical practice and scientific understanding of perioperative brain health, including the severe and debilitating risk of dementia.
Topics: Humans; Aged; Dementia; Brain; Postoperative Period; Machine Learning; Cognition
PubMed: 36697273
DOI: 10.1016/j.bja.2022.12.021 -
International Journal of Environmental... Aug 2022Preoperative anxiety has adverse effects on children and negative impacts on postoperative rehabilitation. Anesthesiologists can accurately identify children with... (Review)
Review
Preoperative anxiety has adverse effects on children and negative impacts on postoperative rehabilitation. Anesthesiologists can accurately identify children with preoperative anxiety, and individualized intervention can effectively improve their psychological state and clinical prognosis. However, a comprehensive summary of the current available evidence has yet to be conducted. Searches were conducted in Medline databases from inception to March 2022. Primary studies that reported preoperative anxiety in children and its attendant effects on postoperative recovery and prognosis were screened and included. Among the 309 publications identified, 12 related studies ( = 3540 patients) met the eligibility criteria. The incidence of preoperative anxiety in children in the included studies ranged from 41.7% to 75.44%. While 16 influencing factors were identified, only 5 factors had a significant impact on preoperative anxiety in children: younger age ( = 8), parental anxiety ( = 7), negative previous hospitalizations ( = 3), less sociableness ( = 2), and surgical setting ( = 1). The current scoping review identified risk factors for preoperative anxiety in children. Healthcare workers should identify and manage preoperatively anxious children. There are still some factors that are controversial, and large-scale clinical studies are needed.
Topics: Anxiety; Anxiety Disorders; Child; Humans; Postoperative Period; Risk Factors
PubMed: 36011459
DOI: 10.3390/ijerph19169828 -
Archivos de Cardiologia de Mexico 2022Oxygen saturation and lactate are markers of tissue hypoxia; they are obtained from central venous and mixed venous sample of the pulmonary artery. The simultaneous...
INTRODUCTION
Oxygen saturation and lactate are markers of tissue hypoxia; they are obtained from central venous and mixed venous sample of the pulmonary artery. The simultaneous behavior of these parameters in the postoperative period of cardiac surgery is unknown.
OBJECTIVE
To characterize the lactate and oxygen saturation of the venous-arterial circuit of the postoperative patient from cardiac surgery.
METHODS
Design: Analytical cross-sectional. In consecutive patients after cardiac surgery, serum lactate and oxygen saturation of the venous-arterial circuit were obtained. The variables were reported with median (25.75 percentiles). They were analyzed with Kruskal-Wallis ANOVA and respective adjustment, Spearman correlation, the descriptive Bland-Altman statistic and intraclass correlation coefficient (95% confidence interval). A p < 0.05 was considered significant.
RESULTS
244 blood samples from 61 patients were studied. Women 30 (49%). (Oxygen saturation) [lactate] were: arterial 98 (95.3, 99.4%) and 1.7 (1.1, 2.1); peripheral venous 85 (75.4, 94%) and [1.9 (1.35, 2.3)]; central venous 68.8 (58.74, 70.2%) and 1.8 (1.3, 2.3); mixed central venous 66.8 (61.2, 73.1%) and 1.8 (1.3, 2.2), p < 0.05. The best intraclass correlation coefficient for oxygen saturation were from central vein to mixed central vein 0.856 (0.760,0.914); and lactate: 0.954 (0.923, 0.972).
CONCLUSIONS
The oxygen saturation differs in the venous-arterial circuit unlike lactate where they are similar. The best values of the intraclass correlation coefficient for lactate and oxygen saturation were those obtained in central vein and mixed central vein.
Topics: Humans; Female; Cross-Sectional Studies; Oxygen Saturation; Oxygen; Cardiac Surgical Procedures; Lactic Acid; Postoperative Period
PubMed: 36413688
DOI: 10.24875/ACM.21000348 -
Revista Brasileira de Enfermagem 2021To analyze the scientific literature on the application of management tools in the postoperative period of pediatric cardiac surgery. (Review)
Review
OBJECTIVE
To analyze the scientific literature on the application of management tools in the postoperative period of pediatric cardiac surgery.
METHODS
integrative review including studies published between 2004 and 2018 in the following databases: LILACS, BDENF, coleciona SUS, MEDLINE/PUBMED, CINAHL and SCOPUS, via Portal de Periódicos da Capes, Scientific Electronic Library Online (SciELO) and Academic Google research.
RESULTS
Twelve articles that met the inclusion criteria were analyzed. The studies demonstrated that strategies such as extracorporeal membrane oxygenation, renal replacement therapy and the risk scores for Risk Adjustment for Congenital Heart Surgery 1 and Aristotle Basic Score favored the stratification the demand for care and predicted the risk for mortality.
FINAL CONSIDERATIONS
The applicability of risk scores and emerging strategies for the management of childcare in the postoperative period of cardiac surgery was described by the evaluation of possibilities of performance and/or efficiency of the treatments developed.
Topics: Cardiac Surgical Procedures; Child; Child Care; Critical Care; Humans; Pediatric Nursing; Postoperative Period; Risk Factors
PubMed: 33909809
DOI: 10.1590/0034-7167-2020-0073 -
The American Journal of Managed Care Oct 2020Surgical patients often leave the hospital with many questions and concerns after their surgery and will contact their providers to get answers. The growth of... (Review)
Review
OBJECTIVES
Surgical patients often leave the hospital with many questions and concerns after their surgery and will contact their providers to get answers. The growth of patient-provider communication (PPC) technologies allows for many new opportunities to study postoperative patient-initiated communication. We aimed to characterize a growing body of literature on postoperative patient-initiated communication.
STUDY DESIGN
Review.
METHODS
A scoping review methodology was used to identify 17 studies analyzing patient-initiated communication in the postoperative period and to characterize key results and areas of investigation in the literature. Patient-initiated communication in the postoperative period was defined as any communication initiated by the patient after discharge.
RESULTS
The majority of studies were published between 2014 and 2018 (82.4%). Telephone calls were the most common type of medium investigated (11 studies; 64.7%), followed by secure messaging (2 studies; 11.8%). Patients most commonly initiated contact regarding study results, medications, and wounds. Common areas of investigation included communication timing and sociodemographic associations.
CONCLUSIONS
As health systems adopt new technologies for PPC, understanding how and why patients initiate contact with providers postoperatively can inform efforts to strengthen PPC broadly. Moreover, research on sociodemographic variation in communication patterns after surgery can help address communication gaps that patient groups may experience. Future research can build upon this work to improve patient outcomes and increase clinic efficiency.
Topics: Communication; Humans; Patients; Postoperative Period; Surgical Procedures, Operative
PubMed: 33094946
DOI: 10.37765/ajmc.2020.88507 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Oct 2022Adenoid hypertrophy is a common disease in pediatric otorhinolaryngology. Surgical resection is the main treatment at present, but many children still face the risk of... (Review)
Review
Adenoid hypertrophy is a common disease in pediatric otorhinolaryngology. Surgical resection is the main treatment at present, but many children still face the risk of postoperative recurrence or even secondary surgery. In order to reduce the postoperative recurrence rate and provide reference information for clinical medical staff and parents of the children, this review was carried out to analyze the domestic and foreign pertinent literature in recent years and put forward overall prevention strategies base on the related factors of recurrence.
Topics: Adenoids; Child; Humans; Hypertrophy; Neoplasm Recurrence, Local; Postoperative Period; Recurrence
PubMed: 36217664
DOI: 10.13201/j.issn.2096-7993.2022.10.016