scholarly journals ARGON APPLICATION FOR CREATION OF PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERIES

2021 ◽  
Vol 29 (2) ◽  
pp. 167-174
Author(s):  
O.L. Tkachuk ◽  
◽  
R.L. Parakhoniak ◽  
S.A. Plaksin ◽  
A.S. Glushenkov ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Patient Reported Outcomes ◽  
Gallstone Disease ◽  
Pain Syndrome ◽  
Shoulder Girdle ◽  
Subjective Assessment ◽  
Patient Treatment ◽  
Hospitalization Period ◽  
Patient Reported ◽  
Subjective Pain

Objective. To advance the patients’ rehabilitation after laparoscopic surgeries by using insufflation with argon gas for pneumoperitoneum formation. Methods. The given study is the investigation of sequentially admitted 360patients with gallstone disease (cholelithiasis). The patients have been randomly divided into 4 groups: Group1 - uncomplicated gallstone disease, carboxyperitoneum (n=192); Group1a - acute cholelithiasis (n=37), carboxyperitoneum; Group2 - uncomplicated gallstone disease, argonperitoneum (n=102); Group2a - acute cholelithiasis (n=29), argonoperitoneum. All the patients have undergone laparoscopic cholecystectomies. Subjective assessment of the pain syndrome intensity has been studied on the basis of patient-reported outcomes questionnaire according to the visual analogue scale (VAS), need for analgesic injections, presence and intensity of the shoulder pain syndrome as well as the duration of in-patient treatment. Results. In accordance with patient-reported outcomes (with argonperitoneum application) subjective pain sensation has proved to decrease by 1.5-2 fold. On the first day of the postoperative period both in uncomplicated gallstone disease and in acute cholelithiasis, argonperitoneum has statistically significantly reduced the need for analgesics. Pain in the shoulder girdle (omalgia) was observed in 48.9% of the patients having been applied carboxyperitoneum whereas it was noticed in only 5.3% of the patients having been applied argonperitoneum during the operation. Argonperitoneum application statistically significantly reduces in-patient treatment period by 30% (from 2.3 - to 1.6 days) in uncomplicated gallstone disease and by 23% (from 4.3 - to 3.3 days) in gallstone disease complicated by acute cholelithiasis. Conclusion. Application of argon for pneumoperitoneum formation in laparoscopic cholecystectomies reliably reduces pain syndrome intensity in the postoperative period. The number of postoperative omalgia cases is reduced by 42% in patients having undergone cholecystectomies with argonperitoneum application. Application of argonperitoneum in management of patients with cholelithiasis may reduce the hospitalization period by 25-30%. What this paper adds The effect of argon application as an insufflation gas in laparoscopic operations upon the intensity of the postoperative pain syndrome has been studied for the first time. Argonperitoneum application has been found to improve the postoperative course by reducing pain irritation. Argon application leads to reduce analgesics consumption.

scholarly journals The results of surgical treatment of patients with lumbosacral radiculopathy, caused by paraarticular and disc cysts

2019 ◽  
Vol 21 (2) ◽  
pp. 63-69
Author(s):  
M N Kravtsov ◽  
D V Pomet'ko ◽  
V I Leonov ◽  
B V Gaydar ◽  
D V Svistov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Average Duration ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Subjective Assessment ◽  
Resonance Imaging ◽  
Hospitalization Period

The results of the conservative and surgical treatment of 12 patients at the Neurosurgery Clinic of the Military medical academy. CM. Kirov, in the period 2016-2018, about the paraarticular and disc cysts of the lumbar spine. Performed open microsurgical and full-endoscopic operational aids. Evaluation of the effectiveness of surgical treatment was carried out using the subjective assessment scale and magnetic resonance imaging over time. The follow-up period ranged from 6 to 24 months. Most often, extradural cysts were located at the level of the LIV-LV segment. Clinical manifestations were characterized by radiculopathy and local back pain. The average duration of pain syndrome was 3±0,7 months. Conservative treatment led to a regression of pain and resorption of a disk cyst in one patient. In other cases, surgical treatment was required. The average duration of a microsurgical operation was 131,6±73,4 minutes, video endoscopic - 80±10,8 minutes. The hospitalization period in the group of microsurgical treatment was 10,4 days, in the group of video endoscopy - 4,7 days. Control magnetic resonance imaging revealed the recurrence of paraarticular cysts in the area of the previous operation in 3 patients. Relapse in patients with disc cysts is not marked. Necessity in repeated operations did not arise in one supervision. It has been established that the main clinical manifestations of extradural cysts of the lumbar spine are local moderate pain, radiculopathy, and intermittent claudication. Microsurgical and percutaneous video endoscopic treatment of lumboischialgia due to extradural cysts is significantly more effective compared with conservative therapy. Full-endoscopic interventions in comparison with microsurgical ones are less invasive and long-lasting and can reduce the time of inpatient treatment.

scholarly journals A Smartphone App With a Digital Care Pathway for Patients Undergoing Spine Surgery: Development and Feasibility Study

10.2196/21138 ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. e21138
Author(s):  
Madison Ponder ◽  
Abena A. Ansah-Yeboah ◽  
Lefko T. Charalambous ◽  
Syed M. Adil ◽  
Vishal Venkatraman ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Postoperative Period ◽  
Spinal Surgery ◽  
Patient Reported Outcomes ◽  
Care Pathway ◽  
Smartphone App ◽  
Measurement Information ◽  
Patient Journey ◽  
Randomized Clinical Study ◽  
Patient Reported

Background There is a great unmet clinical need to provide patients undergoing spinal surgery and their caregivers with ongoing, high-quality care before and after surgery in an efficiency-focused health care environment. Objective The objective of this study is to design, develop, and evaluate the acceptability and feasibility of a novel planning-, outcomes-, and analytics-based smartphone app called ManageMySurgery (MMS) in patients undergoing elective spine surgery (MMS-Spine). Methods The development process of the MMS app was conducted over 2 sequential stages: (1) an evidence-based intervention design with refinement from surgeon and patient feedback and (2) feasibility testing in a clinical pilot study. We developed a novel, mobile-based, Health Insurance Portability and Accountability Act–compliant platform for interventional and surgical procedures. It is a patient-centric mobile health app that streamlines patients’ interactions with their care team. MMS divides the patient journey into phases, making it feasible to provide customized care pathways that meet patients’ unique needs. Patient-reported outcomes are easily collected and conform to the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) standard. Results We tested the feasibility of the MMS-Spine app with patients undergoing elective spine surgery at a large academic health system. A total of 47 patients undergoing elective spine surgery (26 cervical spine and 21 lumbar spine surgeries) downloaded and used MMS-Spine to navigate their surgical journey, quantify their baseline characteristics and postoperative outcomes, and provide feedback on the utility of the app in preparing for and recovering from their spinal surgery. The median age was 59.0 (range 33-77) years, 22 of the 47 patients (47%) were women, and 26 patients (55%) had commercial insurance. Of the 47 patients, a total of 33 (70%) logged in on an iOS device, 11 (23%) on an Android device, and 3 (6%) on a computer or tablet. A total of 17 of the 47 patients (36%) added a caregiver, of which 7 (41%) logged in. The median number of sign-ins was 2. A total of 38 of 47 patients (81%) completed their baseline preoperative PROMIS-29 outcomes, and 14 patients (30%) completed at least one PROMIS-29 survey during the postoperative period. Of the 24 patients who completed the MMS survey, 21 (88%) said it was helpful during preparation for their procedure, 16 (67%) said it was helpful during the postoperative period, and 23 (96%) said that they would recommend MMS to a friend or family member. Conclusions We used a patient-centered approach based on proven behavior change techniques to develop a comprehensive smartphone app for patients undergoing elective spine surgery. The optimized version of the app is ready for formal testing in a larger randomized clinical study to establish its cost-effectiveness and effect on patients’ self-management skills and long-term outcomes.

Using mobile app technology for patient data capture and implementation.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 317-317
Author(s):  
Steven J. Nurkin ◽  
Stephen B. Edge ◽  
Venkata R. Kakarla ◽  
Nikhil I. Khushalani
Keyword(s):  
Cancer Registry ◽  
Patient Reported Outcomes ◽  
Breast Surgery ◽  
Point Of Care ◽  
Data Entry ◽  
Patient Data ◽  
Care Plan ◽  
Patient Treatment ◽  
Patient Reported ◽  
Treatment Summary

317 Background: Mobile application technology has quickly become an integral part of clinical cancer care. While this technology is most commonly used as a point of care reference or educational tool, it may also be an effective method to capture patient data. The purpose of this project was to create a mobile solution for fast, point-of-care data capture and implementation, patient reported outcomes, to generate a patient treatment summary and provide data for cancer registry and clinical trials. Methods: Using the “MedDB app” (Bitwise Analytics) on an iPad2 (Apple) device, an application was developed to collect patient data following breast surgery for cancer. Collected data included elements required for pathologic staging using the American Joint Committee on Cancer TNM system (7th Edition) with the application deriving pathologic TNM and Stage Group. In addition, the type of breast surgery, lymph node surgery, and the expected next steps in treatment are coded for collection. Data are entered into the App in the clinic and transferred using a blinded code number to a web-based database. This database is then used to generate a patient surgical treatment summary and care plan, and is available for uploading into a research database. We then developed an individual patient App for their own personal mobile device. The purpose was to collect patient reported outcomes through their adjuvant care and surviorship. Results: The initial pilot included data entry on 20 breast cancer patients who had surgery prior to adjuvant therapy. The time to complete data entry was less than 60 seconds per case. Conclusions: Mobile communication devices are increasingly becoming key tools for clinicians. They are primarily used to search for medical resource information and the review of medical records. This pilot demonstrates the potential for use of mobile computer devices for collecting key data for clinical trials, the cancer registry, generating a patient treatment summary and care plan at the point of service as well as patient reported outcomes through personalized patient apps. Future development will include studies of integration with the electronic health record, the cancer registry systems, and expansion to a complete survivorship care plan system.

scholarly journals A Smartphone App With a Digital Care Pathway for Patients Undergoing Spine Surgery: Development and Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Madison Ponder ◽  
Abena A. Ansah-Yeboah ◽  
Lefko T. Charalambous ◽  
Syed M. Adil ◽  
Vishal Venkatraman ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Postoperative Period ◽  
Spinal Surgery ◽  
Patient Reported Outcomes ◽  
Care Pathway ◽  
Smartphone App ◽  
Measurement Information ◽  
Patient Journey ◽  
Randomized Clinical Study ◽  
Patient Reported

BACKGROUND There is a great unmet clinical need to provide patients undergoing spinal surgery and their caregivers with ongoing, high-quality care before and after surgery in an efficiency-focused health care environment. OBJECTIVE The objective of this study is to design, develop, and evaluate the acceptability and feasibility of a novel planning-, outcomes-, and analytics-based smartphone app called ManageMySurgery (MMS) in patients undergoing elective spine surgery (MMS-Spine). METHODS The development process of the MMS app was conducted over 2 sequential stages: (1) an evidence-based intervention design with refinement from surgeon and patient feedback and (2) feasibility testing in a clinical pilot study. We developed a novel, mobile-based, Health Insurance Portability and Accountability Act–compliant platform for interventional and surgical procedures. It is a patient-centric mobile health app that streamlines patients’ interactions with their care team. MMS divides the patient journey into phases, making it feasible to provide customized care pathways that meet patients’ unique needs. Patient-reported outcomes are easily collected and conform to the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) standard. RESULTS We tested the feasibility of the MMS-Spine app with patients undergoing elective spine surgery at a large academic health system. A total of 47 patients undergoing elective spine surgery (26 cervical spine and 21 lumbar spine surgeries) downloaded and used MMS-Spine to navigate their surgical journey, quantify their baseline characteristics and postoperative outcomes, and provide feedback on the utility of the app in preparing for and recovering from their spinal surgery. The median age was 59.0 (range 33-77) years, 22 of the 47 patients (47%) were women, and 26 patients (55%) had commercial insurance. Of the 47 patients, a total of 33 (70%) logged in on an iOS device, 11 (23%) on an Android device, and 3 (6%) on a computer or tablet. A total of 17 of the 47 patients (36%) added a caregiver, of which 7 (41%) logged in. The median number of sign-ins was 2. A total of 38 of 47 patients (81%) completed their baseline preoperative PROMIS-29 outcomes, and 14 patients (30%) completed at least one PROMIS-29 survey during the postoperative period. Of the 24 patients who completed the MMS survey, 21 (88%) said it was helpful during preparation for their procedure, 16 (67%) said it was helpful during the postoperative period, and 23 (96%) said that they would recommend MMS to a friend or family member. CONCLUSIONS We used a patient-centered approach based on proven behavior change techniques to develop a comprehensive smartphone app for patients undergoing elective spine surgery. The optimized version of the app is ready for formal testing in a larger randomized clinical study to establish its cost-effectiveness and effect on patients’ self-management skills and long-term outcomes.

scholarly journals Effectiveness of kinesio taping on functional outcomes in patellofemoral pain syndrome patients with abnormal patellar tracking

2021 ◽  
Author(s):  
Jin Hyuck Lee ◽  
Ki Hun Shin ◽  
Ki-Mo Jang
Keyword(s):  
Reaction Time ◽  
Patient Reported Outcomes ◽  
Pain Syndrome ◽  
Quadriceps Strength ◽  
Pain Scale ◽  
Patellar Tracking ◽  
Therapeutic Exercise ◽  
Kinesio Taping ◽  
Therapeutic Exercises ◽  
Patient Reported

Abstract This study aimed to compare quadriceps strength, muscle reaction time, and patient-reported outcomes in PFPS patients with abnormal patellar tracking with and without kinesio taping. Twenty patients with PFPS who applied kinesio taping and 19 who did not were included. Muscle strength and reaction time (acceleration time; AT) were evaluated using an isokinetic device. Patient-reported outcomes were measured using the visual analog scale (VAS) and Kujala anterior knee pain scale (AKPS). Conservative therapeutic exercises were performed in both groups. In each group, all parameters (quadriceps strength: p < 0.001, quadriceps AT: p < 0.001, patient-reported outcomes, including VAS: p < 0.001, AKPS: p < 0.001 for taping group; quadriceps strength: p < 0.001, quadriceps AT: p < 0.001, patient-reported outcomes, including VAS: p < 0.001, AKPS: p < 0.001 for non-taping group), improved after intervention in the symptomatic knees. However, there were no significant differences in quadriceps strength and AT, and patient-reported outcomes in the symptomatic knees between the groups with and without kinesio taping (all p > 0.05). In patients with PFPS with abnormal patellar tracking, the present study shows that kinesio taping seems to be ineffective for quadriceps strength and muscle reaction time, and patient-reported outcomes. Further studies are needed to clarify the effects of kinesio taping without conservative therapeutic exercise in PFPS patients with abnormal patellar tracking.

scholarly journals THE APPLICATION OF MAGNETIC FIELDS AND FLUCTUORIZATION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS AFTER RADICAL MASTECTOMY

2019 ◽  
Vol 6 (3) ◽  
pp. 157-162
Author(s):  
Marina Yu. Gerasimenko ◽  
Inna S. Evstigneyeva ◽  
O. M Perfil’yeva ◽  
L. V Tumbinskaya
Keyword(s):  
Postoperative Period ◽  
Radical Mastectomy ◽  
Pain Syndrome ◽  
Shoulder Girdle ◽  
Early Postoperative Period ◽  
Physical Factors ◽  
Operative Interference ◽  
Group 2 ◽  
Magnetic Therapy

We conducted an objective and instrumental examination in 76 patients with radical mastectomy in the early postoperative period (2-4 days), after which the patients of the 1st group (n = 38) underwent a course of fluctuation of the muscles of the shoulder girdle and upper extremity from the side of operative interference without interruption. Group 2 (n = 38) after the course, the course of fluctuation of the muscles of the shoulder girdle and upper limb from the side of operative interference without interruption was carried out extended low-intensity magnetic therapy of the postoperative area and arm. It has been proved that with this combination, the patient notes an improvement in the quality of life, postoperative swelling decreases, pain syndrome decreases, lymphorrhea periods shorten. As a result of the study, the number of postoperative complications in the wound area decreased (inflammation, infectious processes, pain, seam divergence). There is an increase in the amount and quality of movements, reduced sensitivity disorders in the upper limbs. The results of remote infrared thermography showed that the positive dynamics remained only in patients from both groups who received the combined use of two factors, which proves the prolongation of the clinical effect. Thus, the combination of two physical factors in the early postoperative period, in patients after radical mastectomy, has broad functionality and allows to obtain a more pronounced and stable clinical result.

Potential surrogates for performance status and survival in metastatic non-small cell lung cancer (NSCLC).

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 170-170
Author(s):  
Wallace L. Akerley ◽  
Sonam Puri ◽  
Yeonjung Jo ◽  
Adriana M Coletta ◽  
Kathleen Claire Kerrigan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Patient Reported Outcomes ◽  
Performance Status ◽  
Clinical Decision ◽  
Subjective Assessment ◽  
Measurement Information ◽  
Eligibility Criterion ◽  
Metastatic Nsclc ◽  
Patient Reported ◽  
Line Of Therapy

170 Background: Performance status (PS), a physician-based, subjective assessment of a patient’s symptoms and ambulatory state, is an eligibility criterion for most clinical trials and a key clinical decision tool for treatment of NSCLC. Methods: Patients with metastatic NSCLC were asked to participate in a prospective, observational study of potential prognostic factors that includes demographics, laboratory, patient reported outcomes (PROs) by the patient reported outcomes measurement information system (PROMIS), PS reported by patient, PS assessed by physician, FitBit tracker (includes steps, distance, heart rate (HR), calories, METs), physical challenge and proteomics (Veristratâ). Correlation and regression analyses were performed for the initial 55 patients enrolled prior to COVID restrictions. Tracker data was collected and averaged over the first 7 days with wear > 500 minutes/day. Other data were collected at baseline. Results: We enrolled 55 patients with metastatic NSCLC. There were 35 females and 20 males with a median age of 67 years. A majority of patients were never (38%, n = 21) or former smokers (40%, n = 22); adenocarcinoma (83%, n = 83%) was the most common histology. 30% (n = 17) patients were 2nd or greater line of therapy. 52 were included for survival analysis and 21 expired with median survival 226 days (149, NA). There were minimal gender related differences in the study population except a higher incidence of adenocarcinoma in women (94% vs 65%, p = 0.012 and longer FiTBit assessed daily “very active minutes” (defined as METs > = 6) in men compared to women (4.21 vs 0.43, p = 0.036). Patient- and physician assessed PS were not statistically different, although patients tended underestimated their PS relative to physicians. Physician assessed PS, patient assessed PS, two-minute walk distance, proteomics by Veristratâ, total daily steps, total daily distance covered, and heart rate/activity mismatch were independent predictors of survival. Age, gender, smoking, BMI, histology, and various CBC-based indices were not prognostic. Conclusions: Patient- and physician-assessment of PS do not always match, many alternate measures to PS are prognostic of survival and tracker-based methods are objective and feasible in clinical practice.

Pain catastrophizing, anxiety, and depression in hip pathology

2019 ◽  
Vol 101-B (7) ◽  
pp. 800-807 ◽  
Author(s):  
S. N. Hampton ◽  
P. A. Nakonezny ◽  
H. M. Richard ◽  
J. E. Wells
Keyword(s):  
Pain Catastrophizing ◽  
Short Form ◽  
Critical Role ◽  
Depression Scale ◽  
Pain Syndrome ◽  
Patient Characteristics ◽  
Patient Treatment ◽  
Anxiety And Depression ◽  
Patient Reported ◽  
The Impact

Aims Psychological factors play a critical role in patient presentation, satisfaction, and outcomes. Pain catastrophizing, anxiety, and depression are important to consider, as they are associated with poorer outcomes and are potentially modifiable. The aim of this study was to assess the level of pain catastrophizing, anxiety, and depression in patients with a range of hip pathology and to evaluate their relationship with patient-reported psychosocial and functional outcome measures. Patients and Methods Patients presenting to a tertiary-centre specialist hip clinic were prospectively evaluated for outcomes of pain catastrophizing, anxiety, and depression. Validated assessments were undertaken such as: the Pain Catastrophizing Scale (PCS), the Hospital Anxiety Depression Scale (HADS), and the 12-Item Short-Form Health Survey (SF-12). Patient characteristics and demographics were also recorded. Multiple linear regression modelling, with adaptive least absolute shrinkage and selection operator (LASSO) variable selection, was used for analysis. Results A total of 328 patients were identified for inclusion, with diagnoses of hip dysplasia (DDH; n = 50), femoroacetabular impingement (FAI; n = 55), lateral trochanteric pain syndrome (LTP; n = 23), hip osteoarthrosis (OA; n = 184), and avascular necrosis of the hip (AVN; n = 16) with a mean age of 31.0 years (14 to 65), 38.5 years (18 to 64), 63.7 years (20 to 78), 63.5 years (18 to 91), and 39.4 years (18 to 71), respectively. The percentage of patients with abnormal levels of pain catastrophizing, anxiety, or depression was: 22.0%, 16.0%, and 12.0% for DDH, respectively; 9.1%, 10.9%, and 7.3% for FAI, respectively; 13.0%, 4.3%, and 4.3% for LTP, respectively; 21.7%, 11.4%, and 14.1% for OA, respectively; and 25.0%, 43.8%, and 6.3% for AVN, respectively. HADS Anxiety (HADSA) and Hip Disability Osteoarthritis Outcome Score Activities of Daily Living subscale (HOOS ADL) predicted the PCS total (adjusted R2 = 0.4599). Age, HADS Depression (HADSD), and PCS total predicted HADSA (adjusted R2 = 0.4985). Age, HADSA, patient’s percentage of perceived function, PCS total, and HOOS Quality of Life subscale (HOOS QOL) predicted HADSD (adjusted R2 = 0.5802). Conclusion Patients with hip pathology may exhibit significant pain catastrophizing, anxiety, and depression. Identifying these factors and understanding the impact of psychosocial function could help improve patient treatment outcomes. Perioperative multidisciplinary assessment may be a beneficial part of comprehensive orthopaedic hip care. Cite this article: Bone Joint J 2019;101-B:800–807.

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