Editorial Comment: Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the first 12hs. Mean hospitalization was 2 days (1-5). There were complications in 5 children not affecting the final outcome. Two patients had a re-obstruction requiring a second procedure with good result. The mean follow up was 18 months (13-36). The mean reduction on the postoperative APD was 41% - p
The field of abdominal organ transplantation is multifaceted, with the clinician balancing recipient comorbidities, risks of the surgical procedure, and the pathophysiology of immunosuppression to ensure optimal outcomes. An underappreciated element throughout this process is acute pain management related to the surgical procedure. As the opioid epidemic continues to grow with increasing numbers of transplant candidates on opioids as well the increase in the development of enhanced recovery after surgery protocols, there is a need for greater focus on optimal postoperative pain control to minimize opioid use and improve ou...
Conclusions: The results of this study suggest a difference in perspective between the more optimistic view of persons with dementia and their informal caregivers and the more critical view of physiotherapy experts regarding the most important factors that influence PA participation. In addition, there was a strong focus on the individual characteristics that influence PA behavior that warrant personalized interventions to promote PA in persons with dementia.
Conclusion: The current review identified strong, high-quality evidence to recommend hip muscle strengthening in the conservative management of persons with knee OA. Further research is needed to establish the underlying mechanisms for the clinical benefits.
Publication date: Available online 30 March 2020Source: Journal of Visceral SurgeryAuthor(s): A. Zarzavadjian Le Bian, L. Genser, P. Wind
Adequate pain control is essential following lung transplantation to reduce patient stress and minimize perioperative complications. Enhanced recovery after surgery (ERAS) protocols have demonstrated improvements in patient experience and reduced length of stay. However, the implementation of these protocols has not yet extended to the lung transplant population.
Patients with left ventricular assist devices (LVADs) who are morbidly obese cannot be easily bridged to heart transplantation (HT). Reported UNOS data show that the survival rate of such patients was low after HT. Some patients are obese at the time of LVAD implantation, whereas others become morbidly obese following LVAD implantation. We applied laparoscopic sleeve gastrectomy (LSG) as a treatment strategy and our study looked to determine its efficacy and safety.
We know that pain has far-reaching detrimental effects across various life-domains and also affects health related quality of life after solid organ transplantation. However, the extent to which heart recipients experience chronic bodily pain in the years after heart transplantation is a neglected field. Pain is reported to be a major problem after other types of solid organ transplantation. Neither the prevalence nor consequences of chronic pain after heart transplantation have been fully explored or understood.
Patients in end stage heart failure with a BMI>35 are considered unacceptable candidates for heart transplantation due to increased morbidity and mortality after transplant. Those with a left ventricular assist device (LVAD) may struggle losing weight (and often gain weight) and may be inactivated on the waiting list (or denied listing) until weight loss is achieved. To assist these patients in weight loss with a goal of reactivation on the transplant list, we created clinical guidelines for laparoscopic bariatric surgery.
Postoperative pain for bilateral lung transplant patients is often poorly controlled and may negatively impact recovery. Intercostal cryoanalgesia (IC-CRYO) may provide an additional modality to pain control. We hypothesize that IC-CRYO may enhance recovery compared to traditional opiate based analgesia (OBA) and thoracic paravertebral catheter (TPVC) analgesia.