Multimodality Approaches to Improving Post-operative Pain and Outcomes

2009 ◽  
Vol 05 (01) ◽  
pp. 16
Author(s):  
Ronald S Chamberlain ◽  
Robert H Blackshear ◽  
◽  
Keyword(s):  
Pain Control ◽  
Fast Track ◽  
Operative Management ◽  
Control Measures ◽  
Surgical Patient ◽  
Therapeutic Approaches ◽  
Post Operative Pain ◽  
Operative Complications ◽  
Complication Of Surgery

Pain is an inevitable complication of surgery. It not only impedes healing and recovery in the surgical patient, but also imposes a great deal of strain on healthcare resources. Post-operative ileus (POI), a frequent complication following surgery (especially of the abdomen), is intimately related to modes of pain control. Important aspects of effective pain control measures include improvement in quality of life and patient satisfaction as well as the prevention or limitation of post-operative complications, particularly POI. A comprehensive review of numerous peri-operative management methods reveals only limited benefit, if any, when employed individually. Strategies incorporating various preventive–therapeutic approaches devised to manage surgical patients in a ‘fast-track’ manner peri-operatively may provide better outcomes.

scholarly journals Utilization, availability of analgesics and quality of pain control for post-operative pain in surgical patients

2018 ◽  
Vol 35 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Ya Min ◽  
Thida Tun ◽  
Ye Htut Linn ◽  
Nu Nu Aye ◽  
Nang Hla Hla Win
Keyword(s):  
Pain Control ◽  
Surgical Patients ◽  
Post Operative Pain

Fast-Track Anesthesia With Remifentanil and Spinal Analgesia for Cardiac Surgery: The Effect on Pain Control and Quality of Recovery

2008 ◽  
Vol 22 (4) ◽  
pp. 536-542 ◽  
Author(s):  
Pierre Lena ◽  
Norbert Balarac ◽  
Diane Lena ◽  
Arnaud De La Chapelle ◽  
Jean-Jacques Arnulf ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Pain Control ◽  
Fast Track ◽  
Spinal Analgesia ◽  
Quality Of Recovery

Assessment of quality of life in patients with the effects of transient ischemic stroke

2016 ◽  
pp. 37-39
Author(s):  
A. Babirad
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Large Scale ◽  
Cerebrovascular Diseases ◽  
Control Measures ◽  
Sociological Research ◽  
Cerebrovascular Events ◽  
Sf 36 ◽  
Angioplasty And Stenting

Cerebrovascular diseases are a problem of the world today, and according to the forecast, the problem of the near future arises. The main risk factors for the development of ischemic disorders of the cerebral circulation include oblique and aging, arterial hypertension, smoking, diabetes mellitus and heart disease. An effective strategy for the prevention of cerebrovascular events is based on the implementation of large-scale risk control measures, including the use of antiagregant and anticoagulant therapy, invasive interventions such as atheromectomy, angioplasty and stenting. In this connection, the efforts of neurologists, cardiologists, angiosurgery, endocrinologists and other specialists are the basis for achieving an acceptable clinical outcome. A review of the SF-36 method for assessing the quality of life in patients with the effects of transient ischemic stroke is presented. The assessment of quality of life is recognized in world medical practice and research, an indicator that is also used to assess the quality of the health system and in general sociological research.

Particularities of tinnitus in children and adolescents

ORL ro ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. 40-42
Author(s):  
Alexandra Boloș ◽  
Sebastian Cozma ◽  
Andreea Silvana Szalontay
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Children And Adolescents ◽  
Psychological Factors ◽  
Ambient Noise ◽  
Psychological Consequences ◽  
Therapeutic Approaches

Tinnitus is a common otologic symptom and probably the most troublesome. Tinnitus causes a number of physical and psychological consequences, that interfere with the quality of life of the patient. Many authors believe that the presence of tinnitus in children is a matter of lesser importance than in adults because it is met less frequently and would be a fleeting symptom, inoffensive for them (Graham, 1981). In addition, the prevalence of tinnitus during adolescence and even in young adults is increasing, possibly as a consequence of the increased ambient noise (Bulbul SF, Shargorodsky J). Various therapeutic approaches have generated different results, which led us to consider the role of psychological factors, hence the need to underline the particularities of this symptom in childhood.  

Emerging approaches for restoration of hearing and vision

2020 ◽  
Author(s):  
Sonja Kleinlogel ◽  
Christian Vogl ◽  
Marcus Jeschke ◽  
Jakob Neef ◽  
Tobias Moser
Keyword(s):  
Gene Therapy ◽  
Hearing Aids ◽  
Sensory Information ◽  
Gene Replacement ◽  
Therapeutic Approaches ◽  
Optogenetic Stimulation ◽  
Cellular Specificity ◽  
Socioeconomic Burden ◽  
Comprehensive Reference

Impairments of vision and hearing are highly prevalent conditions limiting the quality of life and presenting a major socioeconomic burden. For long, retinal and cochlear disorders have remained intractable for causal therapies, with sensory rehabilitation limited to glasses, hearing aids, and electrical cochlear or retinal implants. Recently, the application of gene therapy and optogenetics to eye and ear has generated hope for a fundamental improvement of vision and hearing restoration. To date, one gene therapy for the restoration of vision has been approved and undergoing clinical trials will broaden its application including gene replacement, genome editing, and regenerative approaches. Moreover, optogenetics, i.e. controlling the activity of cells by light, offers a more general alternative strategy. Over little more than a decade, optogenetic approaches have been developed and applied to better understand the function of biological systems, while protein engineers have identified and designed new opsin variants with desired physiological features. Considering potential clinical applications of optogenetics, the spotlight is on the sensory systems. Multiple efforts have been undertaken to restore lost or hampered function in eye and ear. Optogenetic stimulation promises to overcome fundamental shortcomings of electrical stimulation, namely poor spatial resolution and cellular specificity, and accordingly to deliver more detailed sensory information. This review aims at providing a comprehensive reference on current gene therapeutic and optogenetic research relevant to the restoration of hearing and vision. We will introduce gene-therapeutic approaches and discuss the biotechnological and optoelectronic aspects of optogenetic hearing and vision restoration.

scholarly journals Comparison of Genetic Variants and Manifestations of OTUD6B-Related Disorder: The First Mexican Case

2020 ◽  
Vol 8 ◽  
pp. 232470962095777 ◽  
Author(s):  
Maria Elena Romero-Ibarguengoitia ◽  
Consuelo Cantú-Reyna ◽  
Dalia Gutierrez-González ◽  
Héctor Cruz-Camino ◽  
Arnulfo González-Cantú ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Genetic Variants ◽  
Therapeutic Approaches ◽  
Multisystem Disorder ◽  
Related Disorder ◽  
Dysmorphic Features ◽  
The Third ◽  
The Central Nervous System ◽  
Mexican Patient

The intellectual disability syndrome characterized by seizures and dysmorphic features was initially described in 2017 and was associated with genetic variants in the OTUD6B gene, identified by exome sequencing (ES) in a large cohort. This multisystem disorder primarily affects the central nervous system, the gastrointestinal, and the skeletal systems. In this article, we describe the first Mexican patient diagnosed by ES. The homozygous c.433C>T (p.Arg145*) variant of the OTUD6B gene confirmed this intellectual disability syndrome. In addition to seizures and other more frequently reported manifestations of this condition, this is the third patient with associated hypothyroidism and hypogammaglobulinemia, underscoring the value of screening for these conditions in other patients. The current challenge with this patient is to ensure medical management of his seizures and provide him with a better quality of life. The possibilities of additional therapeutic approaches may increase by understanding the physiopathology of the involved pathways.

scholarly journals Studies on the Occurrence of Viruses in Planting Material of Grapevines in Southwestern Germany

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 248
Author(s):  
Noemi Messmer ◽  
Patricia Bohnert ◽  
Stefan Schumacher ◽  
René Fuchs
Keyword(s):  
Preventive Measures ◽  
Control Measures ◽  
Grapevine Fanleaf Virus ◽  
Arabis Mosaic Virus ◽  
Planting Material ◽  
General Decline ◽  
Grapevine Pinot Gris Virus ◽  
Propagation Material

Viral diseases in viticulture lead to annual losses in the quantity and quality of grape production. Since no direct control measures are available in practice, preventive measures are taken to keep the vines healthy. These include, for example, the testing of propagation material for viruses such as Arabis mosaic virus (ArMV), Grapevine fanleaf virus (GFLV) or Grapevine leafroll-associated virus 1 (GLRaV-1) and 3 (GLRaV-3). As long-term investigations have shown, GLRaV-1 (2.1%) occurs most frequently in southwestern German wine-growing regions, whereas GLRaV-3 (<0.1%) is almost never found. However, tests conducted over 12 years indicate that there is no general decline in virus-infected planting material. Thus, it can be assumed that a spread of the viruses via corresponding vectors still takes place unhindered. Beyond the examinations regulated within the German Wine Growing Ordinance, one-time tests were carried out on Grapevine Pinot gris virus (GPGV). This analysis showed that GPGV was found in 17.2% of the samples.

Advantages of a mini right axillary thoracotomy for congenital heart defect repair in children

2021 ◽  
pp. 1-6
Author(s):  
Jannika Dodge-Khatami ◽  
Ali Dodge-Khatami
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Global Health ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Median Sternotomy ◽  
Axillary Approach ◽  
Post Operative Pain ◽  
The Right

Abstract Objectives: The mini right axillary thoracotomy is an alternative surgical approach to repair certain congenital heart defects. Quality-of-life metrics and clinical outcomes in children undergoing either the right axillary approach or median sternotomy were compared. Methods: Patients undergoing either approach for the same defects between 2018 and 2020 were included. Demographic details, operative data, and outcomes were compared between both groups. An abbreviated quality of life questionnaire based on the Infant/Toddler/Child Health Questionnaires focused on the patient’s global health, physical activity, and pain/discomfort was administered to all parents/guardians within two post-operative years. Results: Eighty-seven infants and children underwent surgical repair (right axillary thoracotomy, n = 54; sternotomy, n = 33) during the study period. There were no mortalities in either group. The right axillary thoracotomy group experienced significantly decreased red blood cell transfusion, intubation, intensive care, and hospital durations, and earlier chest tube removal. Up to 1 month, parents’ perception of their child’s degree and frequency of post-operative pain was significantly less after the right axillary thoracotomy approach. No difference was found in the patient’s global health or physical activity limitations beyond a month between the two groups. Conclusions: With the mini right axillary approach, surrogates of faster clinical recovery and hospital discharge were noted, with a significantly less perceived degree and frequency of post-operative pain initially, but without the quality of life differences at last follow-up. While providing obvious cosmetic advantages, the minimally invasive right axillary thoracotomy approach for the surgical repair of certain congenital heart lesions is a safe alternative to median sternotomy.

scholarly journals Tolvaptan in Pediatric Autosomal Dominant Polycystic Kidney Disease: From Here to Where?

2021 ◽  
pp. 1-7
Author(s):  
Fei Liu ◽  
Chunyue Feng ◽  
Huijun Shen ◽  
Huaidong Fu ◽  
Jianhua Mao
Keyword(s):  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Pediatric Patients ◽  
Autosomal Dominant ◽  
Life Assessment ◽  
Therapeutic Approaches ◽  
Polycystic Kidney ◽  
Autosomal Dominant Polycystic Kidney ◽  
Ongoing Phase

<b><i>Background:</i></b> Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder, accounting for approximately 5% of all ESRD cases worldwide. As a vasopressin receptor 2 antagonist, tolvaptan is the FDA-approved therapeutic agent for ADPKD, which is only made available to a limited number of adult patients; however, its efficacy in pediatric patients has not been reported widely. <b><i>Summary:</i></b> Tolvaptan was shown to delay ADPKD progression in the Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and Its Outcomes (TEMPO) 3:4 study, Replicating Evidence of Preserved Renal Function: an Investigation of Tolvaptan Safety and Efficacy in ADPKD (REPRISE) trial, and other clinical studies. In addition to its effects on aquaretic adverse events and alanine aminotransferase elevation, the effect of tolvaptan on ADPKD is clear, sustained, and cumulative. While ADPKD is a progressive disease, the early intervention has been shown to be important and beneficial in hypotheses as well as in trials. The use of tolvaptan in pediatric ADPKD involves the following challenges: patient assessment, quality of life assessment, cost-effectiveness, safety, and tolerability. The ongoing, phase 3b, 2-part study (ClinicalTrials.gov identifier: NCT02964273) on the evaluation of tolvaptan in pediatric ADPKD (patients aged 12–17 years) may help obtain some insights. <b><i>Key Messages:</i></b> This review focuses on the rationality of tolvaptan use in pediatric patients with ADPKD, the associated challenges, and the suggested therapeutic approaches.

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