scholarly journals Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

2020 ◽  
Vol 9 (11) ◽  
pp. 3615
Author(s):  
Seohee Lee ◽  
Jaeyeon Chung ◽  
Jinyoung Bae ◽  
Youn Joung Cho ◽  
Karam Nam ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Pressure ◽  
Least Squares ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Non Invasive ◽  
Significant Difference ◽  
The Difference

Measuring blood pressure (BP) via a pneumatic cuff placed around the arm has long been the standard method. However, in clinical situations where BP monitoring at the arm is difficult, the ankle is frequently used instead. We compared continuous non-invasive blood pressure (CNBP) measurements obtained at the finger, ankle BP and arm BP in patients undergoing breast cancer surgery. Arm BP, ankle BP (both obtained with a conventional pneumatic cuff) and CNBP measurements were obtained every 2.5 min during surgery. Correlation and Bland–Altman analyses were performed and differences among measurements were analyzed using a linear mixed model. A total of 245 sets of BP measurements were obtained from 10 patients. All systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) measurements of ankle BP and CNBP were positively correlated with the arm BP measurements (Spearman rho 0.688–0.836, p < 0.001 for each correlation). The difference between CNBP and arm SBP was significantly smaller (least squares mean (95% confidence interval): −6.03 (−11.40, −0.67)) compared to that between ankle and arm SBP (least squares mean (95% CI): −15.32 (−20.69, −9.96), p = 0.019). However, this significant difference was not observed in DBP and MBP (−1.23 vs. 1.75, p = 0.190 and −3.85 vs. −2.63, p = 0.604, respectively). Ankle SBP measurements showed larger differences from arm SBP measurements than did CNBP SBP measurements in patients undergoing breast cancer surgery. CNBP could serve as a useful alternative to ankle BP when standard arm BP measurements cannot be obtained.

Effect of Rapid Rehabilitation Concepts on Quality of Life and Pain in Patients Undergoing Radical Breast Cancer Surgery in Perioperative Period

2021 ◽  
Vol 7 (5) ◽  
pp. 1538-1544
Author(s):  
Xin Li ◽  
Hai-yan An ◽  
Yi Zhao ◽  
Mingli Ji ◽  
Jing An ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Perioperative Period ◽  
Nursing Intervention ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
T Lymphocyte Subsets ◽  
Significant Difference

To study the effect of rapid rehabilitation nursing on patients’ quality of life and pain level during the perioperative period of radical breast cancer surgery. Methods: 126 patients who were hospitalized in our hospital from January 2018 to February 2020 and underwent radical breast cancer surgery were divided into control group and rapid rehabilitation group according to the perioperative period intervention method. Routine nursing intervention and rapid rehabilitation nursing intervention were used respectively. The general conditions of the two groups were recorded, and the differences of T cell subsets before operation and 3 days after operation were detected. Visual analogue pain (VAS) score was used to evaluate the changes of pain degree at 1 day, 3 days and 5 days after operation and on the day of discharge. Postoperative complications and satisfaction were compared between the two groups. Quality of life (QOL) was assessed at 1 month and 3 months after operation using the CARES-SF score. Results: Anesthesia waking time (26.12 ± 5.77) min, off-bed activity time (14.25 ± 2.87) h and hospital stay (7.82 ± 2.15) d in the rapid rehabilitation group were shorter than those in the control group (P < 0.05). The operation time (92.02 ± 14.78) min and intraoperative blood loss (57.96 ± 13.96) mL in the rapid rehabilitation group were not significantly different from those in the control group (P > 0.05). In the control group, 3d after operation, T lymphocyte subsets were decreased gradually than that before operation (P < 0.05), CD3+ was decreased 3d after operation than that before operation in the rapid rehabilitation group (P < 0.05), but CD4+, CD8+, CD4+ / CD8 + 3d after operation had no significant difference than that before operation (P > 0.05). In rapid rehabilitation group, T lymphocyte subsets at 3d after operation were higher than those in the control group (P < 0.05). The postoperative complication rate of the rapid rehabilitation group was lower than that of the control group, and the satisfaction degree was higher than that of the control group, with significant difference (P < 0.05). After follow-up, it was found that the scores of qualities of life, such as physiology, psychosocial, marriage, sexual life and relationship with medical staff in the rapid rehabilitation group were lower than those in the control group at 1 month and 3 months after operation (P < 0.05). Conclusion: The concept of rapid rehabilitation nursing can stabilize the immune function of patients after radical breast cancer surgery, promote the postoperative rehabilitation and improve the quality of life after operation.

scholarly journals Dexmedetomidine as an Adjunctive Analgesic with Bupivacaine in Paravertebral Analgesia for Breast Cancer Surgery

2014 ◽  
Vol 5;17 (5;9) ◽  
pp. E589-E598 ◽  
Author(s):  
Sahar A. Mohamed
Keyword(s):  
Breast Cancer ◽  
Blood Pressure ◽  
Side Effects ◽  
Pulse Rate ◽  
Radical Mastectomy ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Postanesthesia Care Unit ◽  
Modified Radical Mastectomy ◽  
Group B

Background: There is little systematic research on the efficacy and tolerability of the addition of adjunctive analgesic agents in paravertebral analgesia. The addition of adjunctive analgesics, such as fentanyl and clonidine, to local anesthetics has been shown to enhance the quality and duration of sensory neural blockades, and decrease the dose of local anesthetic and supplemental analgesia. Objectives: Investigation of the safety and the analgesic efficacy of adding 1 µg/kg dexmedetomidine to bupivacaine 0.25% in thoracic paravertebral blocks (PVB) in patients undergoing modified radical mastectomy. Study Design: A randomized, double-blind trial. Setting: Academic medical center. Methods: Sixty American Society of Anesthesiologists physical status –I – III patients were randomly assigned to receive thoracicPVB with either 20 mL of bupivacaine 0.25% (Group B, n = 30), or 20 mL of bupivacaine 0.25% + 1 µg/kg dexmedetomidine (Group BD, n= 30). Assessment parameters included hemodynamics, sedation score, pain severity, time of first analgesics request, total analgesic consumption, and side effects in the first 48 hours. Results: There was a significant reduction in pulse rate and diastolic blood pressure starting at 30 minutes in both groups, but more evidenced in group BD (P < 0.001). Intraoperative Systolic blood pressure showed a significant reduction at 30 minutes in both groups (P < 0.001) then returned to baseline level at 120 minutes in both groups. There was a significant increase in pulse rate starting 2 hours postoperative until 48 hours postoperatively in group B but only after 12 hours until 48 hours in group BD (P < 0.001). The time of the first rescue analgesic requirement was significantly prolonged in the group BD (8.16 ± 42 hours) in comparison to group B (6.48 ± 5.24 hours) (P = 0.04). The mean total consumption of intravenous tramadol rescue analgesia in the postanesthesia care unit in the firtst 48 hours postoperatively was significantly decreased in group BD (150.19 ± 76.98 mg) compared to group B (194.44 ± 63.91 mg) (P = 0.03). No significant serious adverse effects were recorded during the study. Limitations: This study is limited by its sample size. Conclusion: The addition of dexmedetomidine 1 µg/kg to bupivacaine 0.25% in thoracic PVB in patients undergoing modified radical mastectomy improves the quality and the duration of analgesia and also provides an analgesic sparing effect with no serious side effects. Key words: Dexmedetomidine, paravertebral block, postoperative analgesia, breast cancer surgery

scholarly journals Youtube English videos as a source of information on shoulder exercise after breast cancer surgery

2021 ◽  
Author(s):  
Selen Guloglu ◽  
Yunus Ozdemir ◽  
Pelin Basim ◽  
Sena Tolu
Keyword(s):  
Breast Cancer ◽  
Cancer Surgery ◽  
Professional Organizations ◽  
Breast Cancer Surgery ◽  
Accurate Information ◽  
Misleading Information ◽  
Content Quality ◽  
Global Quality ◽  
Significant Difference ◽  
Information Group

Abstract Purpose To examine the content, quality and reliability of YouTube videos on exercises that can be performed after breast cancer surgery. Methods Videos selected from YouTube using the search terms “shoulder exercise and breast cancer surgery”, “arm exercise and breast cancer surgery”, and “physiotherapy/physical therapy and breast cancer surgery” were categorized as useful or misleading by a doctor and a physiotherapist. The videos were analyzed using the five-point DISCERN scale for reliability, the five-point Global Quality Scale (GQS) for quality, and a 10-item scale for comprehensiveness. Results Of the 180 videos initially analyzed, 82 were included in the study, and 42 (51.2%) were classified as having misleading information and 40 (48.8%) as having useful information. The reliability, content and quality scores of the videos containing useful information were higher (p<0.001). Most of the videos in the useful information group (80%) were uploaded by universities/professional organizations/physicians/physiotherapists, while the majority of those in the misleading information group (47.6%) were uploaded by websites providing independent healthcare information. The total and daily views of the videos were higher in the useful information group than in the misleading information group (p<0.001 and p=0.004, respectively). When the video parameters were evaluated between the two groups, no significant difference was found in the number of likes and comments and video length. Conclusion YouTube can be an important instrument to protect patients from musculoskeletal system complications after breast cancer surgery and improve existing complications. Universities, physicians, and physiotherapists should be encouraged to prepare more videos containing full and accurate information on this subject.

scholarly journals Quality of Life for Women with Breast Cancer-Related Lymphedema: The Importance of Collaboration between Physical Medicine and Rehabilitation and General Surgery Clinics

2021 ◽  
pp. 119-126
Author(s):  
Türkan Turgay ◽  
Pınar Günel Karadeniz ◽  
Göktürk Maralcan
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Body Image ◽  
Axillary Dissection ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Physical Medicine ◽  
Significant Difference ◽  
Breast Cancer Related Lymphedema

Background: The aim of this study was to examine the clinical characteristics and quality of life (QOL) of patients with BCRL (breast cancer-related lymphedema).Methods: In this cross-sectional descriptive study, patients' characteristics such as age, body mass index (BMI: kg/m²), history of chemotherapy (CT), radiotherapy (RT), hormone replacement therapy (HRT), neoadjuvant therapy (NT), cancer stages, and types of surgery were recorded. Patients were evaluated using the ‘Disabilities of the Arm, Shoulder and Hand questionnaire’ (DASH), the ‘Lymphedema Quality of Life Questionnaire’ (LYMQOL-ARM), and a visual analogue scale (VAS). Results: A total of 68 women with the mean age of 52.50±9.33 and BMI 29.240 ± 5.05 kg/m² were recruited after breast cancer surgery in this study: thirty-three patients (48.5%) in Stage 0; 24 (35.3%) in Stage 1; 10 (14.7%) in Stage 2; and 1 (1.5%) in Stage 3. No statistically significant difference was found in the QOL according to treatments received after the diagnosis of breast cancer surgery, RT (except the appearance domain of QOL), CT, HRT, or NT. In patients who had received axillary dissection in combination with RT, a statistically significant association was observed between QOL related to body image and symptoms (p=0.009 and p=0.017, respectively). A statistically significant difference was found only in body image and clinical symptom domains according to the lymphedema stage (p=0.027 and p=0.002, respectively). It was observed that as shoulder pain (VAS) and disability (DASH) scores increased, scores of all domains of QOL increased except the overall domain in QOL (p<0.05). Conclusion: It was observed that clinical symptoms and body image parameters in QOL were associated with the lymphedema stage and the number of lymph nodes dissected. It was concluded that axillary dissection with axillary RT and RT alone after breast cancer surgery is associated with body image. Our study revealed that body image perception is related to the quality of life in patients with BCRL. Optimal management of the negative effects of self-reported lymphedema evaluated in the latency phase on quality of life requires coordination between Physical Medicine and Rehabilitation and General Surgery Clinics.

Breast cancer surgery during pregnancy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1127-1127
Author(s):  
Rakesh Surapaneni ◽  
Jolanta Jozefara ◽  
Karen Hendershott ◽  
Krystal Hunter ◽  
Elyce Cardonick
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Node Biopsy ◽  
Significant Difference ◽  
Mastectomy Group

1127 Background: There is limited literature on breast surgery during pregnancy. We present prospective registry data on 88 breast cancer patients who underwent breast cancer surgery during pregnancy. Methods: The Cancer and Pregnancy Registry is a voluntary international registry that prospectively collects the clinical course, treatment, and disease outcome of women diagnosed with cancer during pregnancy and the perinatal and neonatal outcomes of their children. Results: We identified 88 patients who were diagnosed with breast cancer and had surgery while pregnant. 59 patients (67%) underwent Mastectomy while29 patients (32%) underwent breast conserving surgery (BCS). Out of 43 patients who underwent BCS as their first surgery 13 patients (30.23%) required subsequent mastectomy during pregnancy. 15 patients (34.88%) from the BCS group and 4 patients (8.69%) from the Mastectomy group had positive margins. There was no significant difference between patients who underwent mastectomy vs BCS based on Age (34.67 vs 34.72 P: 0.97), gestational age at surgery (14.05 vs 16.06 P: 0.23) or ER positivity (47.5% vs 46.4% P: 0.93). 2 patients had neo-adjuvant chemotherapy. 17 patients (19.31%) had sentinel lymph node biopsy. 37 patients (42%) had a pregnancy complication. There was no difference in the rate of complication based on mastectomy vs BCS(45.8% vs 34.5% P: 0.31). There was only 1 patient (from mastectomy group) that delivered within 2 weeks of surgery. Of the 17 patients (19.3%) with spontaneous preterm delivery, there was no difference between Mastectomy and BCS group (22% vs 13.2% P: 0.41). Of the 25 patients (28.4%) with birth complications, there was no significant difference between mastectomy vs BCS (30.5% vs 24.1% P: 0.53). There was also no difference in mean birth weight between the groups (2598 grams vs 2672.3 grams P: 0.57). Conclusions: The data supports the safety of breast cancer surgery during pregnancy. In addition, there were no identified adverse effects in patients who underwent BCS as opposed to mastectomy. Of note, only 19% of patients underwent sentinel node biopsy which is considered the standard of care in early breast cancer patients regardless of pregnancy status.

Remembered preoperative Quick disabilities of the arm, shoulder and hand (QuickDASH) scores

2016 ◽  
Vol 42 (1) ◽  
pp. 78-83 ◽  
Author(s):  
A. H. Wormdal ◽  
S. H. Tallaksen ◽  
Ø. Hagen ◽  
O. A. Foss ◽  
V. Finsen
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Patient Reported Outcome ◽  
Level Of Evidence ◽  
Surgery Patient ◽  
Significant Difference ◽  
Patient Reported ◽  
Basal Joint ◽  
Tunnel Syndrome ◽  
The Difference

The Quick disabilities of the arm, shoulder and hand (QuickDASH) patient-reported outcome measure is frequently used to assess disabilities and symptoms of the upper extremity. This study compares real preoperative QuickDASH scores and remembered preoperative QuickDASH scores. Remembered preoperative QuickDASH scores were obtained 45 months (39–67) after surgery. Patient material consisted of 160 patients operated for Dupuytren’s contracture, carpal tunnel syndrome, thumb basal joint arthrosis, and shoulder pain. All patients had completed QuickDASH questionnaires before surgery. Paired T-tests, linear mixed models, and limits of agreement were used for analyses. There was a significant difference between remembered and real preoperative scores (mean 7.6, SD 15.6; SEM 1.2). Neither diagnosis, age, gender, nor time between surgery and review influenced the difference significantly. A linear mixed model was constructed to investigate the ability to retrospectively predict preoperative QuickDASH scores. Remembered preoperative QuickDASH cannot be used in individual patients because of the high inaccuracy. Level of evidence: III

scholarly journals ONLINE-TICS: Internet-Delivered Behavioral Treatment for Patients with Chronic Tic Disorders

2022 ◽  
Vol 11 (1) ◽  
pp. 250
Author(s):  
Martina Haas ◽  
Ewgeni Jakubovski ◽  
Katja Kunert ◽  
Carolin Fremer ◽  
Nadine Buddensiek ◽  
...  
Keyword(s):  
Behavioral Treatment ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Secondary Analysis ◽  
Tic Disorders ◽  
Clear Trend ◽  
First Line Therapy ◽  
Significant Difference ◽  
Chronic Tic Disorders ◽  
The Difference

Comprehensive Behavioral Intervention for Tics (CBIT) is considered a first-line therapy for tics. However, availability of CBIT is extremely limited due to a lack of qualified therapists. This study is a multicenter (n = 5), randomized, controlled, observer-blind trial including 161 adult patients with chronic tic disorders (CTD) to provide data on efficacy and safety of an internet-delivered, completely therapist-independent CBIT intervention (iCBIT Minddistrict®) in the treatment of tics compared to placebo and face-to-face (f2f) CBIT. Using a linear mixed model with the change to baseline of Yale Global Tic Severity Scale-Total Tic Score (YGTSS-TTS) as a dependent variable, we found a clear trend towards significance for superiority of iCBIT (n = 67) over placebo (n = 70) (−1.28 (−2.58; 0.01); p = 0.053). In addition, the difference in tic reduction between iCBIT and placebo increased, resulting in a significant difference 3 (−2.25 (−3.75; −0.75), p = 0.003) and 6 months (−2.71 (−4.27; −1.16), p < 0.001) after the end of treatment. Key secondary analysis indicated non-inferiority of iCBIT in comparison to f2f CBIT (n = 24). No safety signals were detected. Although the primary endpoint was narrowly missed, it is strongly suggested that iCBIT is superior compared to placebo. Remarkably, treatment effects of iCBIT even increased over time.

scholarly journals The Importance and Quality of Personalized Care after Breast Cancer Surgery

2015 ◽  
Vol 4 (3) ◽  
pp. 34
Author(s):  
Danyang Yao ◽  
Guangying Zhang ◽  
Bo Wang
Keyword(s):  
Breast Cancer ◽  
Nursing Care ◽  
Nursing Intervention ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
Observation Group ◽  
Personalized Care ◽  
Significant Difference ◽  
Better Than

<strong>Objective: </strong>To investigate the effect of personalized care after breast cancer surgery. <strong>Methods: </strong>70 cases of breast cancer patients in our hospital were selected from the duration of December 2012 until December 2014. The patients were randomly divided into observation group and control group, where each group consists of 35 cases. The control group received routine professional nursing care during perioperative of breast cancer surgery. The observation group received routine professional nursing care and personalized nursing intervention during perioperative of breast cancer surgery. Comparison of two groups of patients were measured by treatment compliance, nursing satisfaction, self-rating anxiety scale and self-rating depression scale evaluation of the psychological state of the patient. <strong>Results: </strong>Observation group patient compliance and satisfaction were significantly better than the control group, as shown by statistically significant difference between groups (<em>p </em>&lt; 0.05). The observation group of SAS and SDS scores improvement were significantly better than the control group, a statistically significant difference between groups (<em>p</em> &lt; 0.05). <strong>Conclusion: </strong>Personalized nursing intervention can improve patient compliance, improve patient's mental state, and worthy of health promotion.

Effect of structured training program on arm dysfunction, lymphedema and quality of life after breast cancer surgery

2021 ◽  
pp. 1-16
Author(s):  
Havva Bozdemir ◽  
Dilek Aygin
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Intervention Group ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
Sf 36 ◽  
Significant Difference ◽  
Quality Of Life Scale

Abstract Objective: The aim of this study the effect of the education given according to daily living activities (DLA) model on arm dysfunction, lymphedema and quality of life in patients undergoing breast cancer surgery. Interventions/Methods: In the design of the research, a randomized controlled experimental model with recurrent measurement was used. The data were collected from 60 patients (control group: 30, Intervention Group: 30) at a teriary hospital. In Research ,Patient Information Form, SPOFIA, KATZ-DLA indeks, arm, shoulder and hand injuries scale (DASH) and quality of life scale short form (SF-36) were used. Three interviews (1st week, 1st and 3rd month) were performed after surgery with patients. Analysis of data; independent T-Test, Chi-squared and Repeated Measures ANOVA were utilized. Results: SPOFIA, DASH and KATZ, GYA scale averages decreased by the time, SF-36 were found to increase the average score. In the intervention group, the measurements of the upper arm circumference are significantly better than the control group and In terms of SPOFIA3, DASH2 and DASH3 scale averages, there is a statistically significant difference between the groups (P < 0.05). Conclusions: KATZ, SPOFIA, SF-36, DASH scale score averages were recovered as the time elapsed after the operation increased. Intervention group was found to recover more early. Implications for Practice: The education programme is effective in the prevention of arm dysfunction and lymphedema and in improving quality of life. Keywords: Breast cancer, lymphedema, daily life activity model, quality of life, Continuous...

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