scholarly journals COVID-19 and Perioperative Management Strategies for Gastrointestinal Surgery: An Experience From Jiaxing, China

2021 ◽  
pp. 000313482199508
Author(s):  
Yuan Zhou ◽  
Lusha Cen
Keyword(s):  
Emergency Surgery ◽  
Perioperative Management ◽  
Elective Surgery ◽  
Management Strategies ◽  
Gastrointestinal Surgery ◽  
Postoperative Management ◽  
Surgical Operation ◽  
Short Term ◽  
Investigation Period

Background The coronavirus disease (COVID-19) was leading to a worldwide pandemic, which affected surgical operation. This study assessed the efficacy of perioperative management of patients scheduled for gastrointestinal surgery during COVID-19 pandemic of 2020. Methods We retrospectively analyzed 188 patients who underwent gastrointestinal surgery during the COVID-19 outbreak in Jiaxing, China. Perioperative data were collected, including data on pre-, intra-, and postoperative management strategies. The same data over the same period in 2019 were also collected for comparison. Results A total of 117, 63, and 8 patients underwent emergency, semi-elective, and elective surgeries, respectively. The locals: nonlocals ratio was significantly higher during this investigation period in 2020 than during the same period in 2019 ( P < .05). After screening, 12 patients were identified as unqualified. The number of gastrointestinal surgeries was reduced in 2020. There were no differences in the ratio of emergency surgery or semi-elective surgery between in 2020 and in 2019. The elective surgery ratio between January 27 and February 28 was found to be lower in 2020 than in 2019 ( P < .05). The disease spectra of emergency surgery and semi-elective surgery were similar. A total of 31 elective surgeries were postponed. There were five cases of short-term complications for emergency surgeries and two cases of short-term complications for semi-elective surgeries. No long-term complications or COVID-19 infection occurred in any of the cases, and no medical staff member was infected. Conclusion Perioperative management strategies minimize the risk of nosocomial infection and reduce the influence of epidemics on gastrointestinal surgery.

scholarly journals Management of Geriatric Anesthesia on Emergency Surgery

2021 ◽  
Vol 2 (2) ◽  
pp. 70-75
Author(s):  
Achmad Hariyanto ◽  
◽  
Isngadi Isngadi ◽  
Keyword(s):  
Postoperative Complications ◽  
Emergency Surgery ◽  
Geriatric Patients ◽  
Elective Surgery ◽  
Medical Complications ◽  
Short Term ◽  
Term Survival ◽  
Speed Up ◽  
Geriatric Anesthesia

In geriatric patients, emergency surgery is more common than elective surgery. The incidence of medical complications increases along with aging while the rate of surgical complications remains constant. Postoperative complications escalates short-term morbidity and mortality and also associated with decreasing long-term survival. The main purposes of geriatric patients' care were to maintain hemodynamics, speed up recovery, and perform an assessment to avoid any further decline in functional capacity. The choice of anesthesia and how to administer anesthesia agents should be adjusted for the geriatric patient.

Enuresis: Myths, Misunderstandings and Solutions

1995 ◽  
Vol 1 (1) ◽  
pp. 74
Author(s):  
Martin Knapp
Keyword(s):  
Management Strategies ◽  
Short Term ◽  
Treatment Facilities ◽  
Conditioning Therapy ◽  
Treatable Condition ◽  
Term Management

Advice on enuresis has been provided by a range of individuals. Many myths and misunderstandings have been responsible for the confusing range of opinions given to those who seek help. Management should be based on an understanding of the physiology of the condition and the established facts about its treatment. There is still a lack of awareness about how effective are the management strategies now proposed by those who base their practise on the extensive research that is now documented. The best results are obtained with conditioning therapy, when this is supervised and supported. There is an important role for 'wetness' alarms in conditioning. There are now body-worn mini-alarms, established by over a decade of use, that are inexpensive and reliable. There is a decreasing role for tricyclic medication. The recently introduced pharmaceutical Minirin (desmopressin) is useful in short-term management to get dryness on social occasions and, in selected individuals, might have a role in long-term control of enuresis, when conditioning has not been effective. There is an important need to provide advice and treatment facilities for all those with enuresis - a treatable condition.

Galeazzi-equivalent Fractures: Report of Two Cases and Literature Review

2017 ◽  
Vol 22 (02) ◽  
pp. 232-235
Author(s):  
Seigo Suganuma ◽  
Kaoru Tada ◽  
Daiki Yamamoto ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Emergency Surgery ◽  
Case Reports ◽  
Growth Arrest ◽  
Short Term ◽  
Rare Injury ◽  
First Case ◽  
Long Term Follow Up ◽  
Epiphyseal Injury

The Galeazzi-equivalent fracture is a rare injury that occurs in children. The most important issue is the distal ulnar epiphyseal injury. Although there have been some case reports, most of them performed only short term follow-up. This article describes two cases of this fracture with long term follow-up until epiphyseal closure. First case is a 12-year-old girl who sustained a Galeazziequivalent fracture of her right forearm and underwent emergency surgery. At follow-up of 5 years and 10 months postsurgery, radiographs show ulnar growth arrest of one mm and she has mild pain. Second case is a 15-year-old boy who sustained an open Galeazzi-equivalent fracture of his left forearm and underwent emergency surgery. At follow-up of 3 years and 3 months postsurgery, radiographs show no growth arrest of the distal ulna. He has no residual complaint. Long term follow-up is absolutely necessary to monitor ulnar growth.

Evolutionary Stable Strategies for Supply Chains: Selfishness, Fairness, and Altruism

2018 ◽  
Vol 6 (6) ◽  
pp. 532-551 ◽  
Author(s):  
Caichun Chai ◽  
Hailong Zhu ◽  
Zhangwei Feng
Keyword(s):  
Supply Chains ◽  
Evolutionary Dynamics ◽  
Replicator Dynamics ◽  
Management Strategies ◽  
Individual Preference ◽  
Short Term ◽  
Evolutionary Stable Strategies ◽  
Pure Strategies ◽  
The Stability

Abstract The management strategies of a firm are inevitable affected by individual behavior preferences. The effect of individual preference on the evolutionary dynamics for supply chains is studied by employing replicator dynamics. Each firm has three behavior preferences: selfishness, fairness, and altruism. Firstly, the case that the strategy set of manufacturers and retailers including two pure strategies is considered and the effect of preference parameter on the equilibrium outcome in the short-term interaction is discussed. Secondly, the equilibrium state in the short-term is always disturbed because the change of the environment, firm’s structure, and so forth. Using the replicator dynamics, the evolutionary stable strategies of manufacturers and retailers in the long-term interaction are analyzed. Finally, the extend case that the strategy set of manufacturers and retailers include three pure strategies is investigated. These results are found that the strategy profile in which both manufacturer and retailer choose fairness or altruism, or one player chooses fair or altruistic strategy and the other player chooses selfish strategy may be evolutionary stable, the stability of these equilibria depends on the the preference parameters.

Long-Term Orientation and Earnings Management Strategies

2019 ◽  
Vol 18 (3) ◽  
pp. 97-119 ◽  
Author(s):  
Jesper Haga ◽  
Fredrik Huhtamäki ◽  
Dennis Sundvik
Keyword(s):  
Earnings Management ◽  
High Precision ◽  
Management Strategy ◽  
Management Strategies ◽  
Real Earnings Management ◽  
Short Term ◽  
Country Level ◽  
Earnings Benchmarks ◽  
Jel Classifications

ABSTRACT In this study, we investigate how country-level long-term orientation affects managers' willingness to engage in earnings management and choice of earnings management strategy. Using a comprehensive dataset of 47 countries for the period from 2003 to 2015, we find that firms in long-term-oriented cultures rely relatively more on earnings management through accruals, while firms in short-term-oriented cultures engage in relatively more real earnings management. Furthermore, we find a larger discontinuity around earnings benchmarks in long-term-oriented cultures suggesting that manipulation of accruals enables benchmark beating with high precision. JEL Classifications: M14; M16; M21; M41.

scholarly journals Control and remediation methods for eutrophic lakes in the past 30 years

2020 ◽  
Vol 81 (6) ◽  
pp. 1099-1113 ◽  
Author(s):  
Yuan Zhang ◽  
Pingping Luo ◽  
Shuangfeng Zhao ◽  
Shuxin Kang ◽  
Pengbo Wang ◽  
...  
Keyword(s):  
New Technologies ◽  
Management Strategies ◽  
Cyanobacterial Blooms ◽  
Small Scale ◽  
Short Term ◽  
Eutrophic Lakes ◽  
Lake Ecosystems ◽  
The Past ◽  
Incomplete Removal

Abstract Accelerated eutrophication, which is harmful and difficult to repair, is one of the most obvious and pervasive water pollution problems in the world. In the past three decades, the management of eutrophication has undergone a transformation from simple directed algal killing, reducing endogenous nutrient concentration to multiple technologies for the restoration of lake ecosystems. This article describes the development and revolution of three remediation methods in application, namely physical, chemical, and biological methods, and it outlines their possible improvements and future directions. Physical and chemical methods have obvious and quick effects to purify water in the short term and are more suitable for small-scale lakes. However, these two methods cannot fundamentally solve the eutrophic water phenomenon due to costly and incomplete removal results. Without a sound treatment system, the chemical method easily produces secondary pollution and residues and is usually used for emergency situations. The biological method is cost-effective and sustainable, but needs a long-term period. A combination of these three management techniques can be used to synthesize short-term and long-term management strategies that control current cyanobacterial blooms and restore the ecosystem. In addition, the development and application of new technologies, such as big data and machine learning, are promising approaches.

scholarly journals Emergency surgery and male gender are risk factors of postoperative delirium after general or gastrointestinal surgery in elderly patients: A multicenter cohort study

2020 ◽  
Author(s):  
Kazuyoshi Yamamoto ◽  
Noriko Shimakawa ◽  
Takao Mizumoto ◽  
Kazuhisa Shiroyama ◽  
Tsutomu Shichino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Elderly Patients ◽  
Emergency Surgery ◽  
Postoperative Delirium ◽  
Elective Surgery ◽  
Gastrointestinal Surgery ◽  
Male Gender ◽  
Hospital Organization ◽  
Multicenter Cohort Study

Objective: The aim of this study was to investigate the incidence and risk factors of postoperative delirium (PD) in elderly patients after general or gastrointestinal surgery. Summary of Background Data: Societies worldwide are rapidly aging and the number of surgeries in elderly patients has been increasing. PD, which adversely influences postoperative course, has thus become more common. Methods: The Surgery and Anesthesia Network Group of the National Hospital Organization in Japan conducted this retrospective cohort study of patients aged over 70 years who underwent general or gastrointestinal surgery. Results: A total of 219 patients from 9 participating institutes underwent surgery between July 2013 and August 2014. We excluded 2 patients who died within 2 weeks after surgery. Of the remaining 217 cases, 31 (14.3%) developed PD. These patients were older (80 vs. 76 years, P = 0.013), more likely to be male (74.2 vs. 54.8%, P = 0.039), and had higher American Society of Anesthesia Physical Status scores than those without PD. Emergency surgery was more common than elective surgery in the PD group (41.9 vs. 10.2%, P &lt; 0.0001). Multivariate analysis showed that male gender (odds ratio, 3.31; 95% confidence interval, 1.32-9.39; P = 0.0098) and emergency surgery (7.47; 2.79-20.83; P &lt; 0.0001) were independent risk factors of PD. Conclusions: The incidence of PD was high in male patients and those undergoing emergency surgery. Effective interventions in these groups will be necessary to improve treatment outcomes in elderly patients. (UMIN R000022185)

scholarly journals Self-expandable metallic stenting as a bridge to elective surgery versus emergency surgery for acute malignant right-sided colorectal obstruction

2020 ◽  
Author(s):  
Bing Li ◽  
Shi-Lun Cai ◽  
Zhen-Tao Lv ◽  
Ping-Hong Zhou ◽  
Li-Qing Yao ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Emergency Surgery ◽  
Elective Surgery ◽  
Primary Tumour ◽  
Stage Iv ◽  
Sems Placement ◽  
Short Term ◽  
Synchronous Liver Metastases ◽  
Sems Group ◽  
Significant Difference

Abstract Background: The use of a self-expandable metallic stent (SEMS) as a bridge to surgery has increased for patients with obstructing colorectal cancer. However, relatively few reports have compared SEMS as a bridge to elective surgery for acute malignant obstruction of the right-sided colon (MORC) vs. emergency surgery (ES). This study aimed to evaluate the benefits of elective surgery after SEMS placement vs. ES for patients (including stage IV cases) with acute MORC.Methods: Patients with acute MORC who underwent radical resection for a primary tumour from July 2008 to November 2016 at Zhongshan Hospital of Fudan University were retrospectively enrolled. Postoperative short-term outcomes, progression-free survival (PFS), and overall survival (OS) were compared between the SEMS and ES groups.Results: In total, 107 patients with acute MORC (35 in the SEMS group and 72 in the ES group) were included for analysis. The Intensive Care Unit admission rate was lower (11.4% vs. 34.7%, P = 0.011), the incidence of complications was reduced (11.4% vs. 29.2%, P = 0.042), and the postoperative length of hospitalisation was significantly shorter (8.23 ± 6.50 vs. 11.18 ± 6.71 days, P = 0.033) for the SEMS group. Survival curves showed no significant difference in PFS (P = 0.506) or OS (P = 0.989) between groups. Also, there was no significant difference in PFS and OS rates between patients with stage II and III colon cancer. After colectomy for synchronous liver metastases among stage IV patients, the hepatectomy rates for the SEMS and ES groups were 85.7% and 14.3%, respectively (P = 0.029). The hazard ratio for colectomy alone vs. combined resection was 3.258 (95% CI 0.858–12.370; P = 0.041).Conclusion: Stent placement offers significant advantages in terms of short-term outcomes and comparable prognoses for acute MORC patients. For synchronous liver metastases, SEMS placement better prepares the patient for resection of the primary tumour and liver metastasis, which contribute to improved survival.

scholarly journals Self-expandable metallic stenting as a bridge to elective surgery versus emergency surgery for acute malignant right-sided colorectal obstruction

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bing Li ◽  
Shi-Lun Cai ◽  
Zhen-Tao Lv ◽  
Ping-Hong Zhou ◽  
Li-Qing Yao ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Emergency Surgery ◽  
Elective Surgery ◽  
Primary Tumour ◽  
Stage Iv ◽  
Sems Placement ◽  
Short Term ◽  
Synchronous Liver Metastases ◽  
Sems Group ◽  
Significant Difference

Abstract Background The use of a self-expandable metallic stent (SEMS) as a bridge to surgery has increased for patients with obstructing colorectal cancer. However, relatively few reports have compared SEMS as a bridge to elective surgery for acute malignant obstruction of the right-sided colon (MORC) vs. emergency surgery (ES). This study aimed to evaluate the benefits of elective surgery after SEMS placement vs. ES for patients (including stage IV cases) with acute MORC. Methods Patients with acute MORC who underwent radical resection for a primary tumour from July 2008 to November 2016 at Zhongshan Hospital of Fudan University were retrospectively enrolled. Postoperative short-term outcomes, progression-free survival (PFS), and overall survival (OS) were compared between the SEMS and ES groups. Results In total, 107 patients with acute MORC (35 in the SEMS group and 72 in the ES group) were included for analysis. The Intensive Care Unit admission rate was lower (11.4% vs. 34.7%, P = 0.011), the incidence of complications was reduced (11.4% vs. 29.2%, P = 0.042), and the postoperative length of hospitalisation was significantly shorter (8.23 ± 6.50 vs. 11.18 ± 6.71 days, P = 0.033) for the SEMS group. Survival curves showed no significant difference in PFS (P = 0.506) or OS (P = 0.989) between groups. Also, there was no significant difference in PFS and OS rates between patients with stage II and III colon cancer. After colectomy for synchronous liver metastases among stage IV patients, the hepatectomy rates for the SEMS and ES groups were 85.7% and 14.3%, respectively (P = 0.029). The hazard ratio for colectomy alone vs. combined resection was 3.258 (95% CI 0.858–12.370; P = 0.041). Conclusion Stent placement offers significant advantages in terms of short-term outcomes and comparable prognoses for acute MORC patients. For synchronous liver metastases, SEMS placement better prepares the patient for resection of the primary tumour and liver metastasis, which contribute to improved survival.

A computer program for use in sheep enterprise decision making.

1981 ◽  
Vol 3 (1) ◽  
pp. 110
Author(s):  
HG Gardiner ◽  
KR Shackleton
Keyword(s):  
Computer Program ◽  
Low Cost ◽  
Management Strategies ◽  
Long Term Effects ◽  
Short Term ◽  
Management Decisions ◽  
Department Of Agriculture ◽  
Advantages And Disadvantages ◽  
Kitchen Table

The profitability and long term viability of any business enterprise depends on careful, well thought out, long term planning. The pastoral industry is no exception and management decisions need to be based on the long term as well as short term advantages and disadvantages of any parficular strategy. Examination of the long term effects of management decisions has always been difficult. Not only is the future uncertain but the necessary financial and stock calculations are tedious, particularly if several strategies are considered. A computer program, suitable for use on programmable calculators, has been designed with the specific aim of reducing the tedium of calculation. Emphasis in the design has been placed on flexibility and applicability to actual decsion making situations. The program, devised for use on the Hewlett Packard 41C calculator, is very similar in aim to the model reported by Barber (I 9801, which aimed 'to provide a tool for producers, extension workers and researchers that could be used anywhere from the office desk to the kitchen table'. A recent summary of enterprise modelling work in 'Computers in Farming' (Department of Agriculture, Victoria 1980) indicates that most of the modelling work has been centred around larger, less portable micro-computers. The ease of operation, transportability and low cost of programmable calculators should make them a valuable tool for use on properties by managers. owners, extension workers, bankers and stock agents. They will enable the manager quickly and accurately to assess the likely outcome of various management strategies.

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