Open Gastrostomy under Local Anesthesia for Patients with Neuromuscular Disorders

2010 ◽  
Vol 76 (4) ◽  
pp. 369-371 ◽  
Author(s):  
Amit Sharma ◽  
John R. Bach ◽  
Kenneth G. Swan
Keyword(s):  
Quality Of Life ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Neuromuscular Disease ◽  
Neuromuscular Disorders ◽  
Tube Placement ◽  
Intravenous Sedation ◽  
Respiratory Complications

Patients with neuromuscular disease often require gastrostomy, yet respiratory complications in these patients can preclude the use of general anesthesia, intravenous sedation, or endoscopy. The purpose of this study is to report successful use of open gastrostomy that can be performed under local anesthesia. Fifty-four patients underwent this modified procedure. There were no deaths or complications. They lived an average of 43.4 ± 6.2 (SE) months postgastrostomy tube placement. Simplified open gastrostomy can be performed safely for patients with neuromuscular disease with resulting improvements in both longevity and quality of life.

scholarly journals Impact of COVID ‐19 on the quality of life of patients with neuromuscular disorders in the Lombardy area, Italy

2021 ◽  
Author(s):  
Delia Gagliardi ◽  
Gianluca Costamagna ◽  
Elena Abati ◽  
Eleonora Mauri ◽  
Roberta Brusa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neuromuscular Disorders

scholarly journals COMPLICATIONS OF ACUTE TRAUMATIC SPINAL INJURIES IN SAINT PETERSBURG

2020 ◽  
Vol 6 (1) ◽  
pp. 33-42
Author(s):  
S. V. Lobzin ◽  
L. M. Mirzaeva
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vertebral Fractures ◽  
Length Of Hospital Stay ◽  
Respiratory Complications ◽  
Traumatic Injuries ◽  
Cord Injury

Almost every sailor during performing his job duties aboard receives injuries of varying severity, among which the most common are deck fractures, including compression vertebral fractures, as well as open and closed vertebral fractures with spinal cord injuries. Besides the recovery of disordered functions of the spinal cord, in cases of spinal cord injury, the fight against numerous neurological, infectious and somatic complications affecting the survival and quality of life of patients is still relevant.Objective: to study the incidence of complications of traumatic injuries of the spinal cord under initial hospitalization, their impact on the length of hospital stay, to identify and evaluate the role of risk factors in the development of complications.Materials and methods. A retrospective cohort study was conducted according to the archived case histories of patients hospitalized in neurosurgical hospitals in St. Petersburg. 311 cases of acute spinal cord injury in 2012–2016 were analyzed.Results: complications not directly related to spinal cord injury, such as bronchitis, pneumonia, bedsores, sepsis, thromboembolism, urinary tract infections, postoperative wound pyogenesis and others (damage to other organs and systems), were found in one third of patients (33,8%), in half of the cases there were multiple complications (2 or more), the most frequent — respiratory (23,5%) and pressure sores (10%). Complications significantly increased the length of hospital stay. The dependence of the frequency of complications on age, the level of spinal cord damage and the severity of the injury was revealed. Risk factors such as concomitant head injury and alcohol intoxication have been found. The revealed positive effect of corticosteroids on the regression of neurological deficit was not statistically confirmed. At the same time, there was a significant increase in the frequency of respiratory complications when using corticosteroids.Conclusion: Knowledge of the factors affecting the incidence of complications, optimization of their prevention and therapy will shorten the duration of hospitalization and improve the prognosis and quality of life of patients. The issue of use of corticosteroid therapy in the acute period of traumatic injuries of the spinal cord remains debatable. When choosing therapeutic tactics for managing patients with spinal trauma, it is necessary to take into account the risk of respiratory complications and carefully evaluate the ratio of benefits to harm. 

MP80-16 QUALITY OF LIFE IN NEUROGENIC BLADDER PATIENTS AFTER SUPRAPUBIC TUBE PLACEMENT

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Rebecca Lavelle ◽  
Chasta Bacsu ◽  
Louise A. Gliga ◽  
Gary E. Lemack
Keyword(s):  
Quality Of Life ◽  
Neurogenic Bladder ◽  
Tube Placement ◽  
Suprapubic Tube

Total Hip Arthroplasty

2019 ◽  
pp. 83-95
Author(s):  
Sydney E. Rose ◽  
Julio A. Gonzalez-Sotomayor
Keyword(s):  
Quality Of Life ◽  
Total Hip Arthroplasty ◽  
General Anesthesia ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Severe Arthritis ◽  
And Cartilage ◽  
Anesthesia Spinal

This chapter discusses the goals, procedure, and potential outcomes of total hip arthroplasty (THA). Patients may be candidates for a THA when they have severe arthritis of their hip(s) (degeneration of cartilage covering the ends of the bones creating the hip joint). Arthritic hip pain is often progressive and gets worse as the cartilage continues to deteriorate. Typically, at the time a patient seeks hip arthroplasty, his or her quality of life has become very compromised. In a total hip arthroplasty, damaged bone and cartilage of the hip joint are removed and replaced with prosthetic components. THA can be performed under neuraxial anesthesia (spinal or epidural) or general anesthesia or a combination of both.

scholarly journals A Comprehensive Approach Limiting Extractions under General Anesthesia Could Improve Oral Health

2020 ◽  
Vol 17 (19) ◽  
pp. 7336
Author(s):  
Nicolas Decerle ◽  
Pierre-Yves Cousson ◽  
Emmanuel Nicolas ◽  
Martine Hennequin
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Preoperative Evaluation ◽  
Health Related Quality ◽  
Dental Surgery ◽  
Related Quality ◽  
Health Related

Access to dental treatment could be difficult for some patients due to dental phobia or anxiety, cognitive or sensorial disabilities, systemic disorders, or social difficulties. General anesthesia (GA) was often indicated for dental surgery, and there is almost no available data on adapted procedures and materials that can be applied during GA for maintaining functional teeth on the arches and limiting oral dysfunctions. This study evaluates changes in oral health-related quality of life and mastication in a cohort of uncooperative patients treated under GA according to a comprehensive and conservative dental treatment approach. Dental status, oral health-related quality of life, chewed bolus granulometry, kinematic parameters of mastication, and food refusals were evaluated one month preoperatively (T0), and then one month (T1) and six months post-operatively (T2). One hundred and two adult patients (mean age ± SD: 32.2 ± 9.9 years; range: 18–57.7) participated in the preoperative evaluation, 87 were treated under GA of which 36 participated in the evaluation at T1 and 15 were evaluated at T2. Preoperative and postoperative data comparisons demonstrated that oral rehabilitation under GA helped increase chewing activity and oral health-related quality of life. The conditions for providing dental treatment under GA could be arranged to limit dental extractions in uncooperative patients.

scholarly journals Impact of Aquatic Exercise on Respiratory Outcomes and Functional Activities in Children with Neuromuscular Disorders: Findings from an Open-Label and Prospective Preliminary Pilot Study

2020 ◽  
Vol 10 (7) ◽  
pp. 458
Author(s):  
Marta Huguet-Rodríguez ◽  
José Luis Arias-Buría ◽  
Belén Huguet-Rodríguez ◽  
Rocío Blanco-Barrero ◽  
Daniel Braña-Sirgo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Repeated Measures ◽  
Neuromuscular Disorders ◽  
Analysis Of Covariance ◽  
Aquatic Exercise ◽  
Functional Skills ◽  
Functional Activities ◽  
Significant Difference ◽  
Respiratory Outcomes

Neuromuscular disorders (NMD) lead to the progressive loss of motor and respiratory functions and a decline in daily activities and participation. We aimed to evaluate respiratory changes and functional outcomes in children attending an aquatic therapy program. Eleven patients diagnosed with NMD (4–18 years, Vignos scale 1–9) were involved in a 10-week aquatic exercise program. The ventilation variables were: peak cough flow, volumes (forced expiratory volume in one second-FEV1 and inspiratory volume) and respiratory pressures to evaluate strength and oxygen saturation (O2 sat). Functional skills were measured in the aquatic environment (Water Orientation Test Alyn 1) and on dry land, (Pediatric Evaluation of Disability Inventory), together with quality of life (Pediatric Quality of Life Inventory). Our evaluation included several 2 × 6 mixed-model repeated measures analysis of covariance (ANCOVA) with time (baseline, post 1 session, pre-post at five weeks and pre-post at 10 weeks). Important improvements in functional skills were observed in and out of the water and children under the age of 11 displayed a significant difference for inspirational volume (p = 0.002) and O2 sat (p = 0.029). Clinical, statistically insignificant changes were found for peak cough flow and expiratory pressures values after aquatic exercise. These results may support a relationship between aquatic exercise in NMD, respiratory outcomes and functional activities in water and on land.

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