Renal Recovery after the Implementation of an Electronic Alert and Biomarker-Guided Kidney-Protection Strategy Following Major Surgery

Background: The facilitation of early recovery of acute kidney injury (AKI) is an important step to improve outcome, particularly because of the limited therapeutic interventions currently available for AKI. The combination of an electronic alert and biomarker-guided kidney-protection strategy implemented in the routine care may have an impact on the incidence of early complete reversal of AKI after major non-cardiac surgery. Methods: We studied 294 patients in two cohorts before (n = 151) and after protocol implementation (n = 143). Data collection required 6 months for each cohort. The kidney-protection protocol included an electronic alert to detect patients who were eligible for urinary biomarker [TIMP2 × IGFBP7]-guided kidney-protection intervention. Intervention was stratified according to three levels of immediate AKI risk: low, moderate, and high. After intervention, postoperative changes in the glomerular filtration rate (eGFR) were identified with a tracking software that included an alert for nephrology consultation if the eGFR had declined by >25% from the preoperative reference value. Primary outcome was early AKI recovery, i.e., the complete reversal of any AKI stage to absence of AKI within the first 7 postoperative days. Results: Protocol implementation significantly increased the recovery of AKI (36/46, 78% compared to control 27/48, 56%, (p = 0.025)) and reduced the length of the ICU stay (p < 0.001). There was no significant difference in the overall incidence of all AKI and moderate and severe AKI in the first 7 postoperative days: 46/143 (32%) and 12/151 (8%) in the protocol implementation group compared to 48/151 (32%) and 18/151 (12%) in the historical control group. Patients with AKI reversal within the first 7 postoperative days had lower in-hospital mortality than patients without AKI reversal. Conclusions: Implementing a combined electronic alert and biomarker-guided kidney-protection strategy in routine care improved early recovery of AKI after major surgery.

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Effect of Oromotor Stimulation on Sucking and Feeding Performance of Preterm Neonates Admitted in Neonatal Care Unit of Selected Hospital, West Bengal

International Journal of Research and Review ◽

10.52403/ijrr.20210808 ◽

2021 ◽

Vol 8 (8) ◽

pp. 40-50

Author(s):

Ishika Roy ◽

Manasi Jana

Keyword(s):

West Bengal ◽

Routine Care ◽

Neonatal Care ◽

Preterm Neonates ◽

Control Group ◽

Feeding Performance ◽

Nutritive Sucking ◽

Significant Difference ◽

And Control ◽

Experimental Group

Feeding problem remains a common problem among preterm neonates. An experimental study was undertaken to assess the effect of oromotor stimulation on feeding and sucking performance of preterm neonates admitted in selected hospital, west Bengal. Quasi experimental time series design was adopted. From the population of preterm neonates 60 samples (30 in experimental group and 30 in control group) were selected by non-probability purposive sampling. After selection, initially the baseline data was collected using a record analysis proforma. On the 1st day sucking and feeding performance scoring was done before giving the oromotor stimulation to ascertain the homogeneity of the experimental and control group. After that in two consecutive feeding, oromotor stimulation was given to the neonates in experimental group before 15 minutes of the feeding. The intervention was given to the neonates in experimental group for the next two days, twice only in two consecutive feeding. Neonates in control group received routine care. Sucking and feeding performance scoring was done in both groups using a standardized non-nutritive sucking scoring scale and a validated and reliable early feeding performance scale. The result showed that there is significant difference in sucking performance (t=3.60, p<0.05) and feeding performance (t=3.78, p<0.05) among experimental and control group in final observation. It can be concluded that oromotor stimulation is effective to improve the feeding and sucking abilities of preterm neonates. In the neonatal care units, nurses can provide oromotor stimulation to improve feeding and sucking abilities of the preterm neonates. Keywords: Feeding, Sucking, Performance, Preterm, Oromotor stimulation, Neonates, Preterm neonates.

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Intelligent Optimization of Treatment of Acupuncture based on Modern Data Analysis (Preprint)

10.2196/preprints.18572 ◽

2020 ◽

Author(s):

Xiujun Wang

Keyword(s):

Breast Cancer ◽

Data Analysis ◽

Acupuncture Therapy ◽

Cancer Patients ◽

Postoperative Treatment ◽

Major Surgery ◽

Control Group ◽

Breast Cancer Patients ◽

Significant Difference ◽

Experimental Group

BACKGROUND Background: Postoperative Fatigue Syndrome (POFS) occurs in almost every patient who has undergone major surgery. With the ever-increasing attention of people on rehabilitation treatment, POFS has received unprecedented attention. OBJECTIVE Objective: Based on modern data analysis, acupuncture treatment is optimized intelligently, and its efficacy in breast cancer patients with POFS is explored. METHODS Methods: In this study, the acupuncture and moxibustion in traditional Chinese medicine were combined to optimize the formation of warm acupuncture therapy, and then the research on warm acupuncture was optimized using modern data analysis methods. At first, the statistics of personal information and operation of 60 patients with breast cancer was carried out. The statistical results were analyzed by rank sum test and independent sample T test. The Visual Analogue Scale (VAS), Brief Profile Of Mood State (BPOMS), and Identity-Consequence Fatigue Scale (ICFS) were utilized to analyze the fatigue degree, mental state, and fatigue state of the patients. RESULTS Results: There was no significant difference in age (U = 473.34, P = 0.583) and education level (U = 479.20, P = 0.613) between the experimental group and the control group (P > 0.05), which were comparable. Compared with the control group, the VAS values of the experimental group on the 3rd day (P = 043), 7th day (P = 0.039), and 14th day (P = 0.030) of postoperative treatment were significantly reduced, with significant differences (P < 0.05). In the experimental group, the BPOMS values on the 3rd day (P = 0.042), 7th day (P = 0.035), and 14th day (P = 0.031) of postoperative treatment were significantly reduced, with significant differences (P < 0.05). The ICFS values of the experimental group on the 3rd day (P = 046), 7th day (P = 0.037), and 14th day (P = 0.031) of postoperative treatment were significantly reduced, with significant differences (P < 0.05). The variance of transferrin levels was uniform on the 7th day after operation (F = 0.679, P = 0.433 > 0.005), with a significant difference (T = -2.985, P = 0.008 < 0.05). CONCLUSIONS Conclusions: Warm acupuncture therapy could effectively improve the POFS of breast cancer patients, which was a safe and effective treatment. CLINICALTRIAL

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The Effect of Happiness Training on Psychological Well-Being in Patients with Thalassemia Major

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.8.2021.109 ◽

2021 ◽

Author(s):

Mohammad S. Sargolzaei ◽

Milad G. Shirsavar ◽

Jasem Allahyari ◽

Ali Bazi ◽

Abolghasem P. Nasirabady

Keyword(s):

Mental Health ◽

Well Being ◽

Thalassemia Major ◽

Routine Care ◽

Control Group ◽

Post Intervention ◽

Psychological Well Being ◽

Significant Difference ◽

Quasi Experimental ◽

And Control

Objectives: Thalassemia major (TM) is a chronic hematological disease that can have deep effects on patients’ mental health and psychological well-being. So, the present study was conducted to determine the effects of happiness training on the psychological well-being of TM patients. Methods: This quasi-experimental study with a pre/post-test design was performed on 52 patients with TM in Zabol city (Iran) from August to December 2020. The patients were randomly categorized into experimental and control groups. In the experimental group, happiness training was performed in eight sessions, each for 60 minutes. The control group received routine care. The data collection tool was the Ryff's Scale of Psychological Well-being (RSPWB). Data were analyzed by SPSS 16 statistical software using descriptive (mean and standard deviation) and inferential (paired and independent t-test) statistics. Results: Regarding the psychological well-being score at the pre-test stage, there was no statistically significant difference between the intervention (74.92 ± 6.36) and control (74.57 ± 5.83) groups (p = 0.83). After the intervention; however, a statistically significant difference was observed between the two groups in terms of psychological well-being (p <0.001). Also, a statistically significant difference was seen comparing the psychological well-being score between the pre- and post-intervention phases in the experimental (p = 0.01) but not control (p = 0.12) group. Conclusion: The results of this study showed that happiness training improved TM patients’ psychological well-being. Therefore, this type of training can be used as an appropriate educational strategy to improve psychological well-being in these patients.Keywords: Happiness; Education; Mental Health; Thalassemia.

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Effect of acupressure on post tonsillectomy pain in adolescents: a randomized, single-blind, placebo-controlled trial study

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2019-0065 ◽

2019 ◽

Vol 0 (0) ◽

Author(s):

Somaye Pouy ◽

Abolfazl Etebarian Khorasgani ◽

Ali Azizi-Qadikolaee ◽

Yasaman Yaghobi

Keyword(s):

Pain Control ◽

Controlled Trial ◽

Intervention Group ◽

Routine Care ◽

Control Group ◽

Significant Difference ◽

The World ◽

Before And After ◽

Positive Effect ◽

Single Blind

Abstract Introduction Tonsillectomy is one of the most common pediatric surgeries in the world and pain control following tonsillectomy is very important. Objective The aim of this study is to investigate the effect of acupressure on the amount of pain following tonsillectomy in children. Method One hundred and forty-four children aged 5–12 years old were assigned into one of three groups: interventions, control and placebo. In the intervention group, acupressure was applied at three acupoints and in the placebo group, sham acupressure was applied. In the control group routine care only was applied. Results There was a significant difference between an average of changes in pain score before and after the intervention during the 3 time periods after the tonsillectomy operation in the acupressure group (p = 0.002). Conclusion The results showed that acupressure had a positive effect on pain reduction after tonsillectomy in children in the intervention group.

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The effect of the progressive muscle relaxation combined withs lavender aromatherapy on insomnia of hemodialysis patients

Enfermería Nefrológica ◽

10.37551/s2254-28842021004 ◽

2021 ◽

Vol 24 (1) ◽

pp. 39-46

Author(s):

Ida Rosdiana ◽

Yanti Cahyati

Keyword(s):

Muscle Relaxation ◽

Sampling Technique ◽

Routine Care ◽

Hemodialysis Patients ◽

Progressive Muscle Relaxation ◽

Control Group ◽

Daily Routine ◽

Study Group ◽

Significant Difference ◽

The Mean

disorder in hemodialysis patients, which will cause a decrease in quality of life. Aromatherapy combined with progressive muscle relaxation are expected to increase the effects of relaxation on the patient so that the patient's sleep quality can improve optimally.Objective: The study aimed to investigate the effect of the progressive muscle relaxation combined with lavender aromatherapy on insomnia among patients undergoing hemodialysis. Material and Methods: The design of this study included a quasi-experiment with a pretest-posttest control group approach. The sample selection was performed using a consecutive sampling technique and involved 50 respondents, divided into two equal control and study group. Patients in study group recommended to do progressive muscle relaxation at least four times per week for three weeks and were told to drop two – three drops lavender aromatherapy on a pillow 30 minutes before bedtime at least 4 nights per week for three weeks. The control group recommended to do muscle relaxation and daily routine care at least four times per week for three weeks. Results: The results showed that both study and control groups were equal in terms of demographics, and scores of insomnia at the baseline. There no significant difference between the mean insomnia scores of two group before intervention, while the difference was statistically significant after the intervention. The mean insomnia scores were lower in study group than in the control group.Conclusion: Progressive muscle relaxation and lavender aromatherapy were effective in decreasing insomnia scores among patients undergoing hemodialysis.

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Comparative Study of the Reconstruction of Anterior Cruciate Ligament with Peroneal Longus Tendon and Hamstring Tendon Based on Magnetic Resonance Imaging

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2020.3017 ◽

2020 ◽

Vol 10 (6) ◽

pp. 1327-1332

Author(s):

Ming He ◽

Xu Sun ◽

Yonghui Fu

Keyword(s):

Treatment Group ◽

Magnetic Resonance ◽

Cruciate Ligament ◽

Hamstring Tendon ◽

Control Group ◽

Early Recovery ◽

Significant Difference ◽

Ikdc Score ◽

Anterior Cruciate ◽

Better Than

Objective: To compare the effect of reconstruction of anterior cruciate ligament (ACL) with peroneal longus tendon (PLT) and hamstring tendon (HT) using magnetic resonance image (MRI). Methods: Fifty-six patients with ACL rupture were treated with ACL reconstruction. Among them, 28 patients were treated with PLT reconstruction (treatment group) and 28 patients were treated with HT reconstruction (control group). There were no significant differences in gender, age, injury side, course of disease, preoperative Lachman test, Lysholm score, IKDC score, joint mobility, MRI image between the two groups (P > 0.05). Result: The incision healed in the first stage after operation in both groups, and there were no significant neurovascular injuries and knee synovitis complications. Comparing the MRI of the two groups after operation, the effect of the treatment group was better than that of the control group. There were no complications in both groups. The Lysholm score and IKDC score of the treatment group were better than those of the control group at 6 and 12 months after operation (P > 0.05). There was no significant difference in Lachman test between the two groups at 6 and 12 months after operation (P > 0.05). At 3 and 12 months after operation, the joint activity of the treatment group was better than that of the control group, with no significant difference (P > 0.05). The degree of tibial anterior displacement decreased significantly in both groups before and after operation (P < 0.05), but there was no significant difference between the two groups (P > 0.05). Discussion: MRI scanning technology can significantly expand the scope of human body examination, improve the detection rate and diagnostic accuracy of lesions. In traditional surgery, HT is often used as reconstruction material. However, there are many factors to be considered in the formulation of operation plan for double cruciate ligament injury, such as limb blood supply, accompanied by a variety of structural injuries, so the requirement for reconstruction is high. There was no significant difference in the recovery of knee stability between the two groups, but in terms of early recovery of knee function and subjective satisfaction of patients, the reconstruction of PLT was superior to that of HT. Conclusion: Magnetic resonance imaging can effectively diagnose the curative effect, and it is worth popularizing and applying widely. Compared with HT, ACL reconstruction with PLT is easier to operate, and the early recovery of knee joint function and it is worth popularizing and applying widely.

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A Controlled Clinical Trial of Postoperative Hand Elevation at Home Following Day-Case Surgery

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2004.04.008 ◽

2004 ◽

Vol 29 (5) ◽

pp. 458-460 ◽

Cited By ~ 23

Author(s):

D. J. FAGAN ◽

A. EVANS ◽

A. GHANDOUR ◽

P. PRABHKARAN ◽

N. R. C. CLAY

Keyword(s):

Carpal Tunnel ◽

Major Surgery ◽

Control Group ◽

Controlled Clinical Trial ◽

Day Case ◽

Day Case Surgery ◽

Significant Difference ◽

Case Surgery ◽

The Mean ◽

At Home

Although elevation of the upper limb is considered valuable for the prevention and of the reduction of swelling following major surgery or severe injuries to the hand, it is not clear how much elevation, if any, is required following minor surgery such as carpal tunnel decompression. We investigated this by randomizing patients undergoing carpal tunnel decompression into two groups – one having high elevation at home and one being treated with a simple sling. Volumetric analysis of the swelling of the hand 5 days postoperatively showed no significant difference between the two groups. In the trial group, the mean increase in volume of the operated hand was 11 ml (95% CI +4 to +17) or 2.7%. In the control group, the mean swelling was 13 ml (95% CI +4 to +21) or 3.6%. The findings of this study do not support the use of routine high arm elevation following day-case surgery of the hand.

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Ultrasound-guided Quadratus Lumborum Block for Perioperative Analgesia in Robot-assisted Partial Nephrectomy: A Randomized Controlled Trial

10.21203/rs.3.rs-19158/v1 ◽

2020 ◽

Author(s):

Jielan Lai ◽

Quehua Luo ◽

Yanling Liu ◽

Ruifeng Xue ◽

Yang Huang ◽

...

Keyword(s):

Partial Nephrectomy ◽

Case Reports ◽

Controlled Trial ◽

Opioid Consumption ◽

Control Group ◽

Robot Assisted ◽

Early Recovery ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum ◽

Significant Difference

Abstract Background Recently, several case reports and limited randomized studies have shown that the quadratus lumborum block (QLB) is effective in providing pain relief after intra-abdominal and retroperitoneal operations. Robot-assisted partial nephrectomy (RAPN) has also been proposed as a promising operative treatment for renal carcinoma because it enables early recovery and ambulation. Therefore, we aimed to evaluate the analgesic and opioid-sparing effects of a single-injection QLB, which may paly an important role on early recovery program in RAPN.MethodsFifty-six patients undergoing elective RAPN under general anesthesia were randomised to two equally sized groups. Patients were randomly allocated to receive unilateral QLB (n=28) with 0.375% bupivacaine 0.5 mL/kg (QLB group) or a conventional scheme (n=28) group (Control group). The QLB technique was performed as first described by Blanco, termed QLB2. The primary outcome was the visual analogue scale (VAS) scores with movement at 6 hours postoperatively. The secondary endpoints were the morphine consumption at different time-period after surgery, morphine-related side effects and assessment of postoperative rehabilitation. ResultsBoth VAS pain score and cumulative opioid consumption were significantly lower in the QLB group at 6 hours after surgery as compared with the control group (all P<0.05). There was significant difference in pain scores at any other time-point except at 4 hours on movement and 48 hours at rest. However, no significant difference was observed in 12-48 hours cumulative opioid consumption, and in the duration of PACU and hospital stay between the two groups. The patient recovery scores was significantly higher in the QLB group.ConclusionsSingle-injection pre-emptive QLB applied to RAPN was effective and provided satisfactory analgesia and opioids-sparing in combination with a typical patient-controlled analgesia. In addition, it may provide an effective technique for early recovery in perioperative period.

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Effect of Shared Decision-making on Decisional Conflict and Uptake of First-trimester Screening Tests

Journal of Holistic Nursing and Midwifery ◽

10.32598/jhnm.32.1.2114 ◽

2022 ◽

Vol 32 (1) ◽

pp. 20-28

Author(s):

Zahra Moudi ◽

◽

Raheleh Jam ◽

Hossein Ansari ◽

Mostafa Montazer Zohour ◽

...

Keyword(s):

Intervention Group ◽

First Trimester ◽

Decisional Conflict ◽

Routine Care ◽

Screening Tests ◽

Control Group ◽

Shared Decision ◽

Significant Difference ◽

Trimester Screening ◽

Consultation Session

Introduction: Several factors influence women’s decision to take First Trimester Screening (FTS) tests. These factors are associated with the ambivalence of women toward undergoing screening tests. Objective: This study aimed to investigate the effect of Shared Decision-Making (SDM) about undergoing FTS on Decisional Conflict (DC) immediately after consultation and uptake of FTS. Materials and Methods: This quasi-experimental study was conducted on 200 pregnant women (100 women in the intervention and 100 in the control groups) referred to health centers for prenatal care in 2019. They were selected by the block randomization sampling method. The control group received the routine care and the intervention group, in addition to routine care, attended a 90-min long consultation session based on SDM. The women were contacted via phone at 14 weeks of pregnancy to collect data on their undertaking prenatal screening tests. The demographic characteristics form and O’Conner’s decisional conflict scale were filled out immediately after the consultation session for the intervention group. The obtained data were analyzed by the Chi-square, Fisher exact-test, Mann-Whitney U, and linear regression tests. The P value less than 0.05 was considered statistically significant. Results: There was no significant difference between the two groups regarding women’s demographic characteristics, except for education level, job, and insurance coverage. The Mean±SD DC score was significantly lower in the intervention group (7.35±8.55) compared to the control group (27.32±13.81) (95%CI; 16.80-24.19, P=0.001). In addition, there was a significant difference between the two groups in terms of undergoing the offered FTS (P=0.04). The DC scores ≥25 were associated with a decreased chance of undergoing FTS (P=0.02). Women were less likely to undergo FTS when they were self-employed (OR=0.15, 95%CI; 0.03-0.71, P=0.01). Conclusion: The SDM consultation can help women experience significantly lower levels of DC. Furthermore, factors such as self-employment can prevent women from undergoing FTS despite lower levels of DC.

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The Effect of Psycho-education Program on the Affiliate Stigma in the Caregivers of Clients with Bipolar Disorder

10.21203/rs.3.rs-120409/v1 ◽

2020 ◽

Author(s):

Raheleh Bahrami ◽

Talieh Khalifi

Keyword(s):

Bipolar Disorder ◽

Education Program ◽

Intervention Group ◽

Routine Care ◽

Control Group ◽

Control Groups ◽

Affiliate Stigma ◽

Significant Difference ◽

Quasi Experimental ◽

And Control

Abstract Background Mental health experts believe that stigma is the most challenging issue for caregivers of clients with psychiatric disorders. Therefore, monitoring and assessing the affiliate stigma in the caregivers is necessary. This study is aimed to investigate the effect of psycho-education program on the affiliate stigma in the caregivers of clients with bipolar disorder. Materials and Methods This quasi-experimental study with both intervention and control groups was conducted Ghods Hospital in Sanandaj (n = 64). Psycho-education program was performed for the intervention group for 4 weeks (one session per week for 60 to 90 minutes). Data was collected using the Affiliate Stigma Scale before and after intervention (with 4 weeks gap). Results The results of study showed that there was no difference between intervention and control groups in terms of the distribution of contextual variables. The mean and the standard deviation of the affiliate stigma before the conducting the psycho-education program in the control group was (73 ± 14.72), and in the intervention group was (69.63 ± 14.66). After the intervention and administrating the post-test, the results in the control group was (74 ± 14.21) and in the intervention group was (35.06 ± 8.31) which showed a statistically significant difference (P < 0.001). Conclusions According to the obtained results in this study and based on the other studies’ result, the routine care is not able to meet the educational needs of the caregivers of clients with bipolar disorder. Psycho-education is effective on the reduction of the affiliate stigma of caregivers of clients with bipolar disorder and it can be considered as one of the stigmatization strategies.

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