Surgical prehabilitation using mobile health coaching in patients with obesity: A pilot study

Many patients spend months waiting for elective procedures, and many have significant modifiable risk factors that could contribute to an increased risk of perioperative morbidity and mortality. The minimal direct contact that usually occurs with healthcare professionals during this period represents a missed opportunity to improve patient health and surgical outcomes. Patients with obesity comprise a large proportion of the surgical workload but are under-represented in prehabilitation studies. Our study piloted a mobile phone based, multidisciplinary, prehabilitation programme for patients with obesity awaiting elective surgery. A total of 22 participants were recruited via the Wollongong Hospital pre-admissions clinic in New South Wales, Australia, and 18 completed the study. All received the study intervention of four text messages per week for six months. Questionnaires addressing the self-reported outcome measures were performed at the start and completion of the study. Forty percent of participants lost weight and 40% of smokers decreased their cigarette intake over the study. Sixty percent reported an overall improved health score. Over 80% of patients found the programme effective for themselves, and all recommended that it be made available to other patients. The cost was A$1.20 per patient per month. Our study showed improvement in some of the risk factors for perioperative morbidity and mortality. With improved methods to increase enrolment, our overall impression is that text message–based mobile health prehabilitation may be a feasible, cost-effective and worthwhile intervention for patients with obesity.

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Development and Preliminary Feasibility of iByte4Health: A Mobile Health (mHealth) Pediatric Obesity Prevention Intervention to Engage Parents with Low-Income of Children 2–9 Years

Nutrients ◽

10.3390/nu13124240 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4240

Author(s):

Gina L. Tripicchio ◽

Melissa Kay ◽

Sharon Herring ◽

Travis Cos ◽

Carolyn Bresnahan ◽

...

Keyword(s):

Obesity Prevention ◽

Mobile Health ◽

Low Income ◽

Text Messaging ◽

Vegetable Intake ◽

Text Message ◽

Text Messages ◽

Prevention Intervention ◽

Sugary Drinks ◽

Increased Risk

This research describes the development and preliminary feasibility of iByte4Health, a mobile health (mHealth) obesity prevention intervention designed for parents with a low-income of children 2–9 years of age. Study 1 (n = 36) presents findings from formative work used to develop the program. Study 2 (n = 23) presents a 2-week proof-of-concept feasibility testing of iByte4Health, including participant acceptability, utilization, and engagement. Based on Study 1, iByte4Health was designed as a text-messaging program, targeting barriers and challenges identified by parents of young children for six key obesity prevention behaviors: (1) snacking; (2) physical activity; (3) sleep; (4) sugary drinks; (5) fruit and vegetable intake; and (6) healthy cooking at home. In Study 2, participants demonstrated high program retention (95.7% at follow-up) and acceptability (90.9% reported liking or loving the program). Users were engaged with the program; 87.0% responded to at least one self-monitoring text message; 90.9% found the videos and linked content to be helpful or extremely helpful; 86.4% found text messages helpful or extremely helpful. iByte4Health is a community-informed, evidenced-based program that holds promise for obesity prevention efforts, especially for those families at the increased risk of obesity and related disparities. Future work is warranted to test the efficacy of the program.

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The Susceptibility of Healthy People to COVID-19 Infection and the Role of ACE2

Journal of Iranian Medical Council ◽

10.18502/jimc.v4i3.7212 ◽

2021 ◽

Author(s):

Mehdi Kushkestani ◽

Mohsen Parvani ◽

Bakhtyar Tartibian ◽

Rasoul Eslami

Keyword(s):

Risk Factors ◽

Cost Effective ◽

Normal Subjects ◽

Definitive Treatment ◽

Activity Levels ◽

Cost Effective Approach ◽

Increased Risk ◽

Physical Activity Levels ◽

Ace2 Gene

The COVID-19 virus has caused many deaths of people worldwide since the pandemic began. However, no definitive treatment for this infection has been discovered so far. It has been shown that comorbidities such as diabetes, hypertension and cardiovascular diseases are associated with an increased risk of SARS-COV-2 infection. Interestingly, SARS-COV-2, like SARS-COV, uses the ACE2 gene to enter the host cell. Also, changes or imbalance in ACE2.ACE can affect SARS-COV-2 susceptibility, related outcomes and mortality. Regarding the crucial role of ACE2 protein in COVID-19 infection, the effect of different factors such as age, BMI, physical activity levels, nutritional status, altitude, as well as blood group was assessed on the level of this protein. Further, to our knowledge, no study has been conducted to examine factors that increase or decrease the risk of COVID-19 and its related severity and outcome in normal subjects emphasizing the pivotal role of ACE2. Therefore, the primary purpose of this study was to investigate the involved mechanisms of ACE2 protein and other risk factors causing infection in different situations and finally, to introduce a safe, accurate, and cost-effective approach to prevent SARS-COV-2 infection and hard clinical outcomes in normal subjects.

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TEXT messages to improve MEDication adherence and Secondary prevention (TEXTMEDS) after acute coronary syndrome: a randomised clinical trial protocol

BMJ Open ◽

10.1136/bmjopen-2017-019463 ◽

2018 ◽

Vol 8 (1) ◽

pp. e019463 ◽

Cited By ~ 10

Author(s):

Clara K Chow ◽

Aravinda Thiagalingam ◽

Karla Santo ◽

Cindy Kok ◽

Jay Thakkar ◽

...

Keyword(s):

Risk Factors ◽

Clinical Trial ◽

Acute Coronary Syndrome ◽

Medication Adherence ◽

Text Message ◽

Randomised Clinical Trial ◽

Text Messages ◽

Improve Medication Adherence ◽

Coronary Syndrome ◽

Secondary Outcomes

BackgroundIdentifying simple, low-cost and scalable means of supporting lifestyle change and medication adherence for patients following a cardiovascular (CV) event is important.ObjectiveThe TEXTMEDS (TEXT messages to improve MEDication adherence and Secondary prevention) study aims to investigate whether a cardiac education and support programme sent via mobile phone text message improves medication adherence and risk factor levels in patients following an acute coronary syndrome (ACS).Study designA single-blind, multicentre, randomised clinical trial of 1400 patients after an ACS with 12 months follow-up. The intervention group will receive multiple weekly text messages that provide information, motivation, support to adhere to medications, quit smoking (if relevant) and recommendations for healthy diet and exercise. The primary endpoint is the percentage of patients who are adherent to cardioprotective medications and the key secondary outcomes are mean systolic blood pressure (BP) and low-density lipoprotein cholesterol. Secondary outcomes will also include total cholesterol, mean diastolic BP, the percentage of participants who are adherent to each cardioprotective medication class, the percentage of participants who achieve target levels of CV risk factors, major vascular events, hospital readmissions and all-cause mortality. The study will be augmented by formal economic and process evaluations to assess acceptability, utility and cost-effectiveness.SummaryThe study will provide multicentre randomised trial evidence of the effects of a text message-based programme on cardioprotective medication adherence and levels of CV risk factors.Ethics and disseminationPrimary ethics approval was received from Western Sydney Local Health District Human Research Ethics Committee (HREC2012/12/4.1 (3648) AU RED HREC/13/WMEAD/15). Results will be disseminated via peer-reviewed publications and presentations at international conferences.Trial registration numberACTRN12613000793718; Pre-results.

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Hypoalbuminemia Is Associated With Increased Postoperative Mortality and Complications in Hand Surgery

Hand ◽

10.1177/1558944718820959 ◽

2019 ◽

Vol 15 (4) ◽

pp. 547-555 ◽

Cited By ~ 1

Author(s):

Timothy J. Luchetti ◽

Andrew Chung ◽

Neil Olmscheid ◽

Daniel D. Bohl ◽

Joshua W. Hustedt

Keyword(s):

Serum Albumin ◽

Smoking Status ◽

Postoperative Mortality ◽

Hand Surgery ◽

Normal Serum ◽

Morbidity And Mortality ◽

Improvement Program ◽

Perioperative Morbidity ◽

Increased Risk ◽

Stage Renal Disease

Background: Malnutrition has been associated with increased perioperative morbidity and mortality in orthopedic surgery. This study was designed with the hypothesis that preoperative hypoalbuminemia, a marker for malnutrition, is associated with increased complications after hand surgery. Methods: A retrospective cohort study of 208 hand-specific Current Procedural Terminology codes was conducted with the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2013. In all, 629 patients with low serum albumin were compared with 4079 patients with normal serum albumin. The effect of hypoalbuminemia was tested for association with 30-day postoperative mortality, and major and minor complications. Results: Hypoalbuminemia was independently associated with emergency surgery, diabetes mellitus, dependent functional status, hypertension, end-stage renal disease, current smoking status, and anemia. Patients with hypoalbuminemia had a higher rate of mortality, minor complications, and major complications. Conclusions: Hypoalbuminemia is associated with an increased risk of postoperative morbidity and mortality in patients undergoing hand surgery. As such, increased focus on perioperative nutrition optimization may lead to improved outcomes for patients undergoing hand surgery.

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Risk factors for domestic infestation by the Chagas disease vector, Triatoma dimidiata in Chiquimula, Guatemala

Bulletin of Entomological Research ◽

10.1017/s000748531300014x ◽

2013 ◽

Vol 103 (6) ◽

pp. 634-643 ◽

Cited By ~ 8

Author(s):

E. N. I. Weeks ◽

C. Cordón-Rosales ◽

C. Davies ◽

S. Gezan ◽

M. Yeo ◽

...

Keyword(s):

Risk Factors ◽

Chagas Disease ◽

Current Method ◽

Cost Effective ◽

Subsequent Treatment ◽

Disease Vector ◽

Surrounding Environment ◽

Increased Risk ◽

High Level ◽

House Infestation

AbstractIn Guatemala prior to control initiatives, the main vectors of Trypanosoma cruzi, the causative agent of Chagas disease, were Rhodnius prolixus and Triatoma dimidiata. This study conducted in 2006 in the department of Chiquimula recorded a high level of T. dimidiata infestation and an absence of R. prolixus in all surveyed communities. In Guatemala, the presence of T. dimidiata as domestic, peridomestic and sylvatic populations results in control difficulties as houses are re-infested from the surrounding environment. Entomological surveys, the current method used to select houses in need of control efforts, are labour intensive and time consuming. A time- and cost-effective way to prioritize houses for evaluation and subsequent treatment is the stratification of houses based on the risk of triatomine infestation. In the present study, 17 anthropogenic risk factors were evaluated for associations with house infestation of T. dimidiata including: wall, floor and roof type. There was an increased likelihood of domestic infestation with T. dimidiata associated with the presence of dirt floors (18/29; OR 8.075, 95% CI 2.13–30.6), uncoated bajareque walls (12/17; OR 4.80, 95% CI 1.35–17.1) and triatomine-like faeces on walls (16/26; OR 3.89, 95% CI 1.19–12.7). These factors could be used to target control of T. dimidiata to communities with an increased risk of being infested.

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A Mobile Health Intervention for Adolescents Exposed to Secondhand Smoke: Pilot Feasibility and Efficacy Study

JMIR Formative Research ◽

10.2196/18583 ◽

2020 ◽

Vol 4 (8) ◽

pp. e18583

Author(s):

Natalie Nardone ◽

Jeremy Giberson ◽

Judith J Prochaska ◽

Shonul Jain ◽

Neal L Benowitz

Keyword(s):

Pilot Study ◽

Mobile Health ◽

Secondhand Smoke ◽

Text Messaging ◽

Text Message ◽

Preliminary Evidence ◽

Text Messages ◽

Urinary Cotinine ◽

Mhealth Intervention ◽

Shs Exposure

Background Secondhand smoke (SHS) exposure in children and adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in the measurement of urinary cotinine, a major metabolite of nicotine. Direct intervention with exposed children has been proposed as a novel method, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time and cost-effective and feasible for adolescent populations. Objective In this pilot study, we assessed the feasibility and preliminary evidence of efficacy of a 30-day text message–based mHealth intervention targeted at reducing SHS exposure in adolescent populations of low SES. Methods For the study, 14 nonsmoking and nonvaping participants between the ages of 12-21 years exposed to SHS were enrolled. The intervention consisted of a daily text message sent to the participants over the course of a month. Text message types included facts and information about SHS, behavioral methods for SHS avoidance, or true-or-false questions. Participants were asked to respond to each message within 24 hours as confirmation of receipt. Feasibility outcomes included completion of the 30-day intervention, receiving and responding to text messages, and feedback on the messages. Efficacy outcomes included a reduction in urinary cotinine, accuracy of true-or-false responses, and participants’ perceptions of effectiveness. Results Of the 14 participants that were enrolled, 13 completed the intervention. Though not required, all participants had their own cell phones with unlimited text messaging plans. Of the total number of text messages sent to the 13 completers, 91% (372/407) of them received on-time responses. Participant feedback was generally positive, with most requesting more informational and true-or-false questions. In terms of efficacy, 54% (6/11) of participants reduced their cotinine levels (however, change for the group overall was not statistically significant (P=.33) and 45% (5/11) of participants increased their cotinine levels. Of the total number of true-or-false questions sent across all completers, 77% (56/73) were answered correctly. Participants’ ratings of message effectiveness averaged 85 on a scale of 100. Conclusions In this pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged by responding to the messages. The efficacy of the study requires further replication, as only half of the participants reduced their cotinine levels. However, participants answered the majority of true-or-false questions accurately and reported that the messages were helpful.

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Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events

World Journal of Pediatric Surgery ◽

10.1136/wjps-2019-000084 ◽

2020 ◽

Vol 3 (1) ◽

pp. e000084

Author(s):

Elbert Johann Mets ◽

Ryan Patrick McLynn ◽

Jonathan Newman Grauer

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Adverse Events ◽

General Surgery ◽

Elective Surgery ◽

Cohort Analysis ◽

Adverse Outcomes ◽

Trauma Patients ◽

Improvement Project ◽

Increased Risk

BackgroundAlthough less common in adults, venous thromboembolism (VTE) in children is a highly morbid, preventable adverse event. While VTE has been well studied among pediatric hospitalized and trauma patients, limited work has been done to examine postoperative VTE in children undergoing surgery.MethodsUsing data from National Surgical Quality Improvement Project Pediatric database (NSQIP-P) from 2012 to 2016, a retrospective cohort analysis was performed to determine the incidence of, and risk factors for, VTE in children undergoing surgery. Additionally, the relationships between VTE and other postoperative adverse outcomes were evaluated.ResultsOf 361 384 pediatric surgical patients, 378 (0.10%) were identified as experiencing postoperative VTE. After controlling for patient and surgical factors, we found that American Society of Anesthesiologists (ASA) class of II or greater, aged 16–18 years, non-elective surgery, general surgery (compared with several other surgical specialties), cardiothoracic surgery (compared with general surgery) and longer operative time were significantly associated with VTE in pediatric patients (p<0.001 for each comparison). Furthermore, a majority of adverse events were found to be associated with increased risk of subsequent VTE (p<0.001).ConclusionIn a large pediatric surgical population, an incidence of postoperative VTE of 0.10% was observed. Defined patient and surgical factors, and perioperative adverse events were found to be associated with such VTE events.

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Perioperative Morbidity and Mortality of Same-day Bilateral TKAs: Incidence and Risk Factors

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-013-3156-7 ◽

2013 ◽

Vol 472 (1) ◽

pp. 111-120 ◽

Cited By ~ 25

Author(s):

Lazaros Poultsides ◽

Stavros Memtsoudis ◽

Alejandro Gonzalez Della Valle ◽

Ivan De Martino ◽

Huong T. Do ◽

...

Keyword(s):

Risk Factors ◽

Morbidity And Mortality ◽

Perioperative Morbidity ◽

Bilateral Tkas

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Influence of Hypertension and Diabetes on Postoperative Outcomes In Cancer Patients Undergoing Moderate/High Risk Surgical Procedures

10.21203/rs.3.rs-184334/v1 ◽

2021 ◽

Author(s):

Lafayete William Ferreira Ramos ◽

Beatriz Nery Nascimento ◽

Gabriel Rossi Silva ◽

Marcos Vinícius Ferreira Ramos ◽

Barbara Cristina Ferreira Ramos ◽

...

Keyword(s):

Risk Factors ◽

Postoperative Complications ◽

Cancer Patients ◽

Multiple Logistic Regression Analysis ◽

Diabetic Group ◽

Postoperative Outcomes ◽

Morbidity And Mortality ◽

Systemic Hypertension ◽

Surgical Time ◽

Increased Risk

Abstract Background: Systemic hypertension (HTN) and diabetes mellitus (DM) are believed to be risk factors for adverse postoperative outcomes in patients undergoing surgical interventions, but evidence is lacking. This retrospective study evaluated the effects of HTN and DM, alone or in combination, on postoperative outcomes of elective noncardiac surgery in cancer patients. Methods: Patients (n = 844) with malignancies, who underwent elective surgery at a tertiary hospital, were categorised into healthy (group A, n = 339), hypertensive (group B, n = 357), diabetic (group C, n = 21), and hypertensive and diabetic (group D, n = 127) groups. Preoperatively, all patients had systolic blood pressure ≤ 160 mmHg and plasma glucose level ≤ 140 mg/dl. Postoperative in-hospital morbidity and mortality were compared among groups. Results: Postoperative complications occurred in 22 (6.5%), 21 (5.9%), 2 (9.5%), and 11 (8.7%) patients in groups A, B, C, and D, respectively (p = 0.712). HTN (p = 0.538), DM (p = 0.990), and HTN+DM (p = 0.135) did not impact the occurrence of adverse events. Patients with higher surgical risk (ASA III or IV) and those with longer surgical time had higher morbidity and mortality (p = 0.001, p < 0.001, respectively). In multiple logistic regression analysis, ASA status and surgical time were independent risk factors for postoperative complications (both p < 0.001). Conclusion: Cancer patients with preoperative comorbidities, such as HTN and DM, alone or in combination, regardless of other characteristics, do not have an increased risk of adverse postoperative outcomes.Trial registration: Retrospectively registered.

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Perioperative management of patients with poorly functioning ventricles in the setting of the functionally univentricular heart

Cardiology in the Young ◽

10.1017/s1047951105002325 ◽

2006 ◽

Vol 16 (S1) ◽

pp. 47-54 ◽

Cited By ~ 5

Author(s):

Joseph W. Rossano ◽

Anthony C. Chang

Keyword(s):

Diastolic Dysfunction ◽

Perioperative Management ◽

Ventricular Dysfunction ◽

Morbidity And Mortality ◽

Univentricular Heart ◽

Perioperative Morbidity ◽

Ventricular Geometry ◽

Increased Risk ◽

Surgical Palliation

The patient with a functionally univentricular heart is at increased risk for ventricular dysfunction for a variety of reasons. At birth, the pulmonary and systemic circulations are in parallel, leading to pulmonary overcirculation and a volume-loaded functional ventricle. Significant atrioventricular valvar regurgitation, abnormal ventriculoarterial coupling, diastolic dysfunction, and altered ventricular geometry can also contribute to long-term ventricular dysfunction. These collected circumstances place the patient at increased risk for perioperative morbidity and mortality. We will discuss in this review the pathophysiology that leads to ventricular dysfunction at each stage of surgical palliation, as well as the strategies for perioperative management. In addition, we will highlight novel strategies for management of ventricular dysfunction.

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