Randomized clinical trial of the effect of simo decoction plus acupuncture and chewing gum on postoperative ileus in patients with hepatocellular carcinoma after hepatic resection.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 307-307
Author(s):  
Jian-Hong Zhong ◽  
Xue-Mei You ◽  
Liang Ma ◽  
Le-Qun Li

307 Background: Postoperative ileus (POI) is a common complication following hepatic resection that delays recovery of bowel function and increases length of hospital stay. Simo decoction (SMD) and acupuncture tsusanli acupoint are used to enhance bowel hypomotility in China. Chewing gum reducing POI is reported. The aim of study is to evaluate the effect of SMD plus acupuncture tsusanli acupoint and chewing gum alone on POI and length of hospital stay in patients with hepatocellular carcinoma (HCC) after hepatic resection. Methods: Primary HCC patients undergoing hepatic resection were randomized to SMD plus acupuncture, chewing gum, or empty control group. Interventions were started on postoperative day 1 for six consecutive days or until flatus. Primary endpoints were POI and length of hospital stay. Secondary endpoints were surgical complications. Results: Between March 2015 and August 2015, 162 patients were randomized to SMD plus acupuncture (55), chewing gum (53), or empty control (54). SMD plus acupuncture or chewing gum group have significantly shorter first peristalsis, flatus, and defaecation time than empty control group (all P< 0.05). The mean (s.d.) length of hospital stay of the three groups was 14.0 (4.9), 14.7 (6.2), and 16.5 (6.8) days. The difference between SMD plus acupuncture and empty control group was significant (P = 0.014). However, chewing gum cannot significantly shorten hospital stay than empty control (P = 0.147). Interventions groups had less grade I and II complications. Conclusions: SMD plus acupuncture or chewing gum is a safe treatment to reduce POI and shorten hospital stay. Registration number: NCT02438436 (https://clinicaltrials.gov). Clinical trial information: NCT02438436.

Author(s):  
Dr.Randa Mohammed AboBaker

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.


2020 ◽  
Vol 27 (09) ◽  
pp. 2001-2006
Author(s):  
Muhammad Kamran ◽  
Shahbaz Ahmad ◽  
Muhammad Faheem Anwer ◽  
Muhammad Hasan Anwaar ◽  
Muhammad Asif ◽  
...  

Post-operative ileus is a common compliant of patients at surgical floor. Studies have reported that gums chewing after abdominal surgeries decrease postoperative ileus (POI); but very few studies are available on role of chewing gum in ileostomy reversal cases. We concluded that post-operative gum chewing with standard post-operative care in patients undergoing elective surgery for ileostomy closure done for typhoid ileal perforation in terms of mean length of hospital stay and mean time of passage of first flatus is significantly better than those without gum chewing. Objectives: To compare post-operative gum chewing with standard care in cases having elective ileostomy closure in terms of mean length of hospital stay and mean time of passage of first flatus. Study Design: Randomized Control Trial. Setting: Department of Surgery, Allied Hospital Faisalabad. Period: 1st January 2017 to 31st December 2017. Material & Methods: Patients of 20 to 60 years undergoing elective surgery for typhoid ileal perforation were included in the study after informed consent. Two groups with A: allocated to chewing gum three times a day up to discharge; Control group: allocated to standard post-operative care without chew gum. Length of hospital stay and time of passage of first flatus was noted. Results: In this study, mean length of hospital stay in Chewing gum group was 7.73+0.74 days and 10.27+0.87 days in Control group, p value was 0.0001, mean time of passage of first flatus in Chewing gum group was 49.97+1.69 hrs and 89.17+2.07 hrs in Control group, p value was 0.0001. Conclusion: We concluded that post-operative gum chewing with standard post-operative care in patients undergoing elective surgery for ileostomy closure done for typhoid ileal perforation in terms of mean length of hospital stay and mean time of passage of first flatus is significantly better than those without gum chewing.


Author(s):  
Wesam Sourour ◽  
Valeria Sanchez ◽  
Michel Sourour ◽  
Jordan Burdine ◽  
Elizabeth Rodriguez Lien ◽  
...  

Objective This study aimed to determine if prolonged antibiotic use at birth in neonates with a negative blood culture increases the total cost of hospital stay. Study design This was a retrospective study performed at a 60-bed level IV neonatal intensive care unit. Neonates born <30 weeks of gestation or <1,500 g between 2016 and 2018 who received antibiotics were included. A multivariate linear regression analysis was conducted to determine if clinical factors contributed to increased hospital cost or length of stay. Results In total, 190 patients met inclusion criteria with 94 infants in the prolonged antibiotic group and 96 in the control group. Prolonged antibiotic use was associated with an increase length of hospital stay of approximately 31.87 days, resulting in a $69,946 increase in total cost of hospitalization. Conclusion Prolonged antibiotics in neonates with negative blood culture were associated with significantly longer hospital length of stay and increased total cost of hospitalization. Key Points


2008 ◽  
Vol 13 (4) ◽  
pp. 233-241
Author(s):  
Elisa Edwards ◽  
Kristie Fox

OBJECTIVE To determine if the asthma clinical pathway implemented at Wolfson Children's Hospital reduces the length of hospital stay. To determine if pathway use affected the use of asthma education, the use of appropriate discharge medications based on asthma classification, and readmission rates. METHODS A list of patients aged 2 to 18 years discharged from Wolfson Children's Hospital between September 1, 2004 and August 31, 2006 with the diagnosis of asthma was generated. Medical records of eligible patients were reviewed for demographic information, asthma pathway use, duration of hospital stay in days, readmission rates, receipt of asthma education, and medications prescribed upon discharge. Patients placed on the asthma clinical pathway were compared to a control group with asthma who were matched based on age and discharge date. Length of stay was averaged for each group. Asthma education, discharge medications, and readmission rates were compared between the two groups. RESULTS Forty-three patients placed on the asthma clinical pathway were compared to a 43 patients in the control group that were matched for age and discharge date. Use of the asthma clinical pathway reduced hospital stay by 0.372 days (P = .0373). Receipt of asthma education (P = .3864), the use of appropriate drug therapy prescribed upon discharge (P = .1398), and readmission rates (P = .5486) were unaffected by pathway use. CONCLUSIONS The asthma clinical pathway used at Wolfson Children's Hospital reduces length of hospital stay, but has no bearing on receipt of asthma education, use of appropriate drug therapy upon discharge, or readmission rates.


2021 ◽  
Author(s):  
Paulo Sérgio da Silva Santos ◽  
Bernardo da Fonseca Orcina ◽  
Rafael Rahal Guaragna Machado ◽  
Fabiano Vieira Vilhena ◽  
Lucas Marques da Costa Alves ◽  
...  

Abstract Background: The risk of contamination and dissemination by SARS-CoV-2 has a strong link with nasal, oral and pharyngeal cavities. Recently, our research group observed the promising performance of an anionic phthalocyanine derivative (APD) used in a mouthwash protocol without photoexcitation; this protocol improved the general clinical condition of patients infected with SARS-CoV-2. Methods: The present two-arm study evaluated in vitro the antiviral activity and cytotoxicity of APD. Additionally, a triple-blind randomized controlled trial was conducted with 41 hospitalized patients who tested positive for COVID-19. All the included patients received World Health Organization standard care hospital treatment (non-intensive care) plus active mouthwash (experimental group AM/n=20) or nonactive mouthwash (control group NAM/n=21). The adjunct mouthwash intervention protocol used in both groups consisted one-minute gargling/rinsing / 5 times/day until hospital discharge. Groups were compared considering age, number of comorbidities, duration of symptoms prior admission and length of hospital stay (LOS). The associations between group and sex, age range, presence of comorbidities, admission to Intensive care unit (ICU) and death were also evaluated. Results: The in vitro evaluation demonstrated that APD compound was highly effective for reduction of SARS-CoV-2 viral load in the 1.0 mg/mL (99.96%) to 0.125 mg/mL (92.65%) range without causing cytotoxicity. Regarding the clinical trial, the median LOS of the AM group was significantly shortened (4 days) compared with that of the NAM group (7 days) (p=0.0314). Additionally, gargling/rinsing with APD was very helpful in reducing the severity of symptoms (no ICU care was needed) compared to not gargling/rinsing with APD (28.6% of the patients in the NAM group needed ICU care, and 50% of this ICU subgroup passed way, p=0.0207). Conclusions: This study indicated that the mechanical action of the protocol involving mouthwash containing a compound with antiviral effects against SARS-CoV-2 may reduce the symptoms of the patients and the spread of infection. The use of APD in a mouthwash as an adjuvant the hospital COVID-19 treatment presented no contraindication and reduced the hospital stay period. Trial Registration: The clinical study was registered at REBEC - Brazilian Clinical Trial Register (RBR-58ftdj).


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Zhi Li ◽  
Guihe Chen ◽  
Feng Wang

This work was aimed at exploring the adoption value of the optimized and upgraded esophageal ultrasound in the treatment of patients with ventricular septal defect (VSD) by artificial fish swarm algorithm. A model was built based on artificial fish swarm algorithm. A random ultrasonic optical signal in the database was decomposed several times and sparsity was optimized to complete partial optimization, which was then extended to global optimization. A total of 100 patients with ventricular septal defect were divided into control group who underwent cardiopulmonary bypass under the guidance of three-dimensional thoracic ultrasound and experimental group of ventricular septal defect occlusion under the guidance of esophageal ultrasound based on artificial fish swarm algorithm. The results showed that the number of successful cases in the experimental group was 12 cases of perimembranous type, 10 cases of septal type, 7 cases of simple membranous type, 13 cases of muscular type, 4 cases of subdry type, and 2 cases of ridge type. The average length of operation after surgery was 70.65 minutes, the average length of ventilator ventilation was 125.8 minutes, and the average length of intensive care unit was 377.9 minutes. The average length of hospital stay after surgery was 5.6 days, and the average total length of hospital stay was 8.2 days, which were better than the control group in many aspects, with statistical significance ( P < 0.05 ). In short, the artificial fish swarm algorithm for esophageal ultrasound-guided ventricular septal defect closure had short operation time and good postoperative effect, which was of high application value in the clinical treatment of patients with ventricular septal defect.


Author(s):  
Avril Owen ◽  
Waqas Khan ◽  
Keith D Griffiths

The use of troponin T to facilitate early patient discharge was investigated in a prospective study in a district general hospital. Troponin T was measured in 91 patients admitted over a period of 6 months with chest pain but without evidence of myocardial infarction. The main outcome measure was length of hospital stay. A negative troponin T was found in 70 patients. Fifty of these were discharged within 24h of the troponin result being available and they had a significantly shorter hospital stay than a case-control group and a historical control group from the previous 6 months. Troponin T measurement has a role in altering patient management by enabling early discharge, resulting in significant cost savings and increasing bed availability.


2020 ◽  
pp. 089719002097961
Author(s):  
Daniel Colon Hidalgo ◽  
Vishali Amin ◽  
Arushi Hukku ◽  
Kathryn Kutlu ◽  
Megan A. Rech

Introduction: Etomidate is commonly used for induction of anesthesia for rapid sequence intubation (RSI). It has little impact on hemodynamic status, making it a widely used agent. Due to the inhibition of cortisol production, etomidate causes adrenal suppression. The purpose of this study is to determine whether there is a correlation with etomidate use and the incidence of secondary infections. Methods: This was a retrospective cohort of hospitalized patients who received either etomidate or control (ketamine, propofol, or no agent) for RSI. The primary endpoint was the incidence of secondary infections. Secondary outcomes included number of mechanical ventilator-free days within 28 days, 30-day mortality, length of hospital stay, and length of intensive care unit stay. Results: A total of 434 patients were reviewed, of which 129 (29.7%) met the study criteria (n = 94 etomidate; n = 35 control). The incidence of secondary infection was numerically higher in the etomidate group compared with the control group, though this was not statistically significant (38.7% vs. 28.6%, p = 0.447). Also, though the secondary outcomes showed no statistically significant difference between the groups, the patients in the control group had a longer hospital stay (14.0 vs. 18.1, p = 0.20) and a longer ICU stay (11.0 vs. 14.1, p = 030). Furthermore, the etomidate group had a non-statistically significant higher incidence of bacteremia (8 vs. 0, p = 0.17) Conclusion: The use of etomidate was not associated with increased incidence of secondary infection. To fully understand the effects of etomidate use and its subsequent adrenal suppression, larger studies are needed.


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