• 제목/요약/키워드: Enhanced recovery program

검색결과 13건 처리시간 0.026초

Impact of Enhanced Recovery Program on Colorectal Cancer Surgery

  • Lohsiriwat, Varut
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3825-3828
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    • 2014
  • Surgical outcomes of colorectal cancer treatment depend not only on good surgery and tumor biology but also on an optimal perioperative care. The enhanced recovery program (ERP) - a multidisciplinary and multimodal approach, or so called 'fast-track surgery' - has been designed to minimize perioperative and intraoperative stress responses, and to support the recovery of organ function aiming to help patients getting better sooner after surgery. Compared with conventional postoperative care, the enhanced recovery program results in quicker patient recovery, shorter length of hospital stay, faster recovery of gastrointestinal function, and a lower incidence of postoperative complications. Although not firmly established as yet, the enhanced recovery program after surgery could be of oncological benefit in colorectal cancer patients because it can enhance recovery, maintain integrity of the postoperative immune system, increase feasibility of postoperative chemotherapy, and shorten the time interval from surgery to chemotherapy. This commentary summarizes short-term outcomes and potential long-term benefits of enhanced recovery programs in the treatment of colorectal cancer.

요추 유합술 후 기능 회복 치료법 (Functional Recovery Program after Lumbar Spinal Fusion)

  • 강태욱;박시영;이순혁
    • 대한정형외과학회지
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    • 제55권3호
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    • pp.222-228
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    • 2020
  • 노년층 인구가 증가함에 따라 요추 유합술의 빈도가 높아지면서 수술 후 빠른 회복 및 기능 회복 치료법에 대한 관심이 증가하고 있다. 수술 후 조기 회복 프로그램, 다중 통증 조절법을 통하여 합병증을 줄이고 빠른 회복을 기대할 수 있으며 유합률을 높일 수 있는 다양한 방법을 사용하고 있다.

Roles of Putative Sodium-Hydrogen Antiporter (SHA) Genes in S. coelicolor A3(2) Culture with pH Variation

  • Kim, Yoon-Jung;Moon, Myung-Hee;Lee, Jae-Sun;Hong, Soon-Kwang;Chang, Yong-Keun
    • Journal of Microbiology and Biotechnology
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    • 제21권9호
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    • pp.979-987
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    • 2011
  • Culture pH change has some important roles in signal transduction and secondary metabolism. We have already reported that acidic pH shock enhanced actinorhodin production in Streptomyces coelicolor. Among many potential governing factors on pH variation, the putative $Na^+/H^+$ antiporter (sha) genes in S. coelicolor have been investigated in this study to elucidate the association of the sha on pH variation and secondary metabolism. Through the transcriptional analysis and overexpression experiments on 8 sha genes, we observed that most of the sha expressions were promoted by pH shock, and in the opposite way the pH changes and actinorhodin production were enhanced by the overexpression of each sha. We also confirmed that sha8 especially has a main role in maintaining cell viability and pH homeostasis through $Na^+$ extrusion, in salt effect experiment under the alkaline medium condition by deleting sha8. Moreover, this gene was observed to have a function of pH recovery after pH variation such as the pH shock, being able to cause the sporulation. However, actinorhodin production was not induced by the only pH recovery. The sha8 gene could confer on the host cell the ability to recover pH to the neutral level after pH variation like a pH drop. Sporulation was closely associated with this pH recovery caused by the action of sha8, whereas actinorhodin production was not due to such pH variation patterns alone.

Acupuncture in Sport Recovery: A Brief Review

  • CHAPLEAU, Christopher
    • 식품보건융합연구
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    • 제6권2호
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    • pp.23-26
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    • 2020
  • Active and therapeutic sport recovery is becoming a popular and important component in approving performance for pro and recreational athletes alike. It is also helping in the realm of injury prevention. In the search of finding modalities that are widely effective, natural, and safe, acupuncture is a viable and cost-effective treatment for helping athletes achieve this goal. More direct related research is needed, but testimonials from pro athletes and the body of research that currently exists provides powerful evidence on acupunctures ability to help with enhancing recovery. Specializing in acupuncture and exercise science, Chris integrates acupuncture into musculoskeletal rehabilitation therapy or fitness training for pain modulation, speedy recovery, and enhanced performance. Clients can choose to focus on one-on-one corrective exercise therapy, manual and massage therapy, or acupuncture. However, for best results, Chris recommends all three. Other modalities that he uses in therapy are acu-taping, herbal therapy, nutrition supplementation, cupping, guasha, and stretching techniques. The corrective exercise component is one-on-one body balancing management, focusing on strength and conditioning, post physical rehab - exercise therapy, integrative sport specific exercise, weight loss, core strengthening, dynamic lumbar stabilization, active recovery techniques, and myo-fascial release techniques. The acupuncture component focuses on sport injuries, myofascial pain, peripheral neuropathy, arthritis, facial rejuvenation, stress, smoking cessation, addiction detoxification program, weight management, sport recovery and performance.

마취·회복실 간호사의 환자안전문화와 환자안전역량이 안전간호활동에 미치는 영향 (Effect of Patient Safety Culture and Patient Safety Competence on Safety Nursing Activity among Nurses working in Anesthetic and Recovery Rooms)

  • 김진주;정향미
    • 임상간호연구
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    • 제26권2호
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    • pp.164-174
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    • 2020
  • Purpose: This study was to investigate the relationships among patient safety culture, safety competence and safety nursing activity among nurses in anesthetic and recovery rooms, and to identify the factors contributing to safety nursing activity. Methods: A descriptive correlational study was conducted. Participants were 156 nurses from 13 hospitals. Data were collected from February 11 to March 15th, 2019, and analyzed using descriptive statistics, t-test, Mann-Whitney U test, one-way ANOVA, Pearson's correlation and multiple regression analysis with SPSS statistics 24.0 Program. Results: Safety nursing activity was significantly different in relation to nurses' level of education, position at work, clinical career, clinical career at anesthetic and recovery rooms, and work experience in patient safety. Safety nursing activity demonstrated a significant positive correlation with patient safety culture and patient safety competence. Factors contributing to safety nursing activity were patient safety knowledge, skill and attitude, clinical career, clinical career at anesthetic and recovery rooms, and the patient safety improvement system which explained 57.0% of total variance of safety nursing activity. Conclusion: To improve safety nursing activities at anesthetic and recovery rooms, it is necessary to develop patient safety programs with enhanced knowledge, skill and attitude to take patient safety as a top priority.

Implementation of Enhanced Recovery after Surgery (ERAS) Program in Perioperative Management of Gastric Cancer Surgery: a Nationwide Survey in Korea

  • Jeong, Oh;Kim, Ho Goon
    • Journal of Gastric Cancer
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    • 제19권1호
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    • pp.72-82
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    • 2019
  • Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.

Evolution of Process and Outcome Measures during an Enhanced Recovery after Thoracic Surgery Program

  • Lee, Alex;Seyednejad, Nazgol;Lawati, Yaseen Al;Mattice, Amanda;Anstee, Caitlin;Legacy, Mark;Gilbert, Sebastien;Maziak, Donna E.;Sundaresan, Ramanadhan S.;Villeneuve, Patrick J.;Thompson, Calvin;Seely, Andrew J.E.
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.118-125
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    • 2022
  • Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

1회선 송전선로 단락사고의 개선된 고장점 표정기법 (Enhanced Fault Location Algorithm for Short Faults of Transmission Line)

  • 이경민;박철원
    • 전기학회논문지
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    • 제65권6호
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    • pp.955-961
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    • 2016
  • Fault location estimation is an important element for rapid recovery of power system when fault occur in transmission line. In order to calculate line impedance, most of fault location algorithm uses by measuring relaying waveform using DFT. So if there is a calculation error due to the influence of phasor by DC offset component, due to large vibration by line impedance computation, abnormal and non-operation of fault locator can be issue. It is very important to implement the robust fault location algorithm that is not affected by DC offset component. This paper describes an enhanced fault location algorithm based on the DC offset elimination filter to minimize the effects of DC offset on a long transmission line. The proposed DC offset elimination filter has not need any erstwhile information. The phase angle delay of the proposed DC offset filter did not occurred and the gain error was not found. The enhanced fault location algorithm uses DFT filter as well as the proposed DC offset filter. The behavior of the proposed fault location algorithm using off-line simulation has been verified by data about several fault conditions generated by the ATP simulation program.

작업치료 임상에서 뇌졸중 환자의 상지기능 향상을 위한 가상현실 치료의 유용성에 관한 고찰 (Feasibility of Virtual Reality for Enhancement of Upper Extremity Function Post Stroke)

  • 권재성;양노열
    • 재활치료과학
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    • 제1권2호
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    • pp.35-40
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    • 2012
  • 본 연구에서는 가상현실 치료가 뇌졸중 환자의 뇌 가소성을 동반한 상지기능 향상에 미치는 영향을 알아보고 강도 높은 가상현실 훈련이 뇌졸중 환자의 상지기능 향상을 위한 집중치료로써 임상적으로 유용한 훈련인지 알아보고자 하였다. 뇌졸중 환자에게 있어 사용-의존성 즉 운동 강도와 반복은 마비 측 사지의 운동 기능향상에 중요한 치료적 요소이다. 최근에는 상지의 지속적 사용을 통한 뇌-가소성에 기반한 변화를 유도할 수 있는 치료방법으로 가상현실 치료가 대두되었다. 가상현실 치료는 재활 임상환경에서 운동기능 향상을 위한 훈련강도와 반복을 제공할 수 있는 기술적 방법으로 채택되기 시작하였다. 특히 뇌졸중 환자의 상지 기능을 향상시키기 위한 치료적 유용성 측면에서는 강도 높은 반복적 훈련이 가능하다는 것과 게임 같은 형식으로 높은 동기부여가 가능하다는 것, 실제 수행을 통한 다중감각적 피드백 제공, 상호작용이 가능한 과제지향적 치료가 가능하다는 장점을 가지고 있다. 임상 환경에서 작업치료와 더불어 부가적으로 가상현실 치료를 실시하는 것은 뇌졸중 환자의 상지 기능회복을 더욱 촉진할 것이다.