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| 2. |
- Hannemann, P, et al.
(författare)
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Patterns in current anaesthesiological peri-operative practice for colonic resections : a survey in five northern-European countries
- 2006
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Ingår i: Acta Anaesthesiologica Scandinavica. - Oxon, United Kingdom : Blackwell Publishing. - 0001-5172 .- 1399-6576. ; 50:9, s. 1152-60
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Tidskriftsartikel (refereegranskat)abstract
- Background: For colorectal surgery, evidence suggests that optimal management includes: no pre-operative fasting, a thoracic epidural analgesia continued for 2 days post-operatively, and avoidance of fluid overload. In addition, no long-acting benzodiazepines on the day of surgery and use of short-acting anaesthetic medication may be beneficial. We examined whether these strategies have been adopted in five northern-European countries.Methods: In 2003, a questionnaire concerning peri-operative anaesthetic routines in elective, open colonic cancer resection was sent to the chief anaesthesiologist in 258 digestive surgical centres in Scotland, the Netherlands, Denmark, Sweden and Norway.Results: The response rate was 74% (n = 191). Although periods of pre-operative fasting up to 48 h were reported, most (> 85%) responders in all countries declared to adhere to guidelines for pre-operative fasting and oral clear liquids were permitted until 2-3 h before anaesthesia. Solid food was permitted up to 6-8 h prior to anaesthesia. In all countries more than 85% of the responders indicated that epidural anaesthesia was routinely used. Except for Denmark, long-acting benzodiazepines were still widely used. Short-acting anaesthetics were used in all countries except Scotland where isoflurane is the anaesthetic of choice. With the exception of Denmark, intravenous fluids were used unrestrictedly.Conclusion: In northern Europe, most anaesthesiologists adhere to evidence-based optimal management strategies on pre-operative fasting, thoracic epidurals and short-acting anaesthetics. However, premedication with longer-acting agents is still common. Avoidance of fluid overload has not yet found its way into daily practice. This may leave patients undergoing elective colonic surgery at risk of oversedation and excessive fluid administration with potential adverse effects on surgical outcome.
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| 4. |
- Lassen, Kristoffer, et al.
(författare)
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Consensus review of optimal perioperative care in colorectal surgery : Enhanced Recovery After Surgery (ERAS) Group recommendations
- 2009
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Ingår i: Archives of surgery (Chicago. 1960). - : American Medical Association (AMA). - 0004-0010 .- 1538-3644. ; 144:10, s. 961-969
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVES: To describe a consensus review of optimal perioperative care in colorectal surgery and to provide consensus recommendations for each item of an evidence-based protocol for optimal perioperative care. DATA SOURCES: For every item of the perioperative treatment pathway, available English-language literature has been examined. STUDY SELECTION: Particular attention was paid to meta-analyses, randomized controlled trials, and systematic reviews. DATA EXTRACTION: A consensus recommendation for each protocol item was reached after critical appraisal of the literature by the group. DATA SYNTHESIS: For most protocol items, recommendations are based on good-quality trials or meta-analyses of such trials. CONCLUSIONS: The Enhanced Recovery After Surgery (ERAS) Group presents a comprehensive evidence-based consensus review of perioperative care for colorectal surgery. It is based on the evidence available for each element of the multimodal perioperative care pathway.
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| 6. |
- Wurst, FM, et al.
(författare)
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World Health Organization/International Society for Biomedical Research on Alcoholism study on state and trait markers of alcohol use and dependence: Back to the future
- 2005
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Ingår i: Alcoholism: Clinical and Experimental Research. - 0145-6008. ; 29:7, s. 1268-1275
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Tidskriftsartikel (refereegranskat)abstract
- This article summarizes content proceedings of a symposium held at the 2004 International Society for Biomedical Research on Alcoholism Congress in Mannheim, Germany. The chairs were Boris Tabakoff and Friedrich M. Wurst. The presentations were (1) Genetic associations with alcoholism and affective disorders, by Paula Hoffman; (2) Proteomic analysis of blood constituents in alcoholism, by Boris Tabakoff; (3) Contrasts between the responses of GGT and CDT to high alcohol intake, and a test of their combined use, by John Whitfield; (4) Direct ethanol metabolites such as ethyl glucuronide, fatty acid ethyl esters, phosphatidylethanol and ethyl sulfate: a new line of sensitive and specific biomarkers, by Friedrich Martin Wurst; and (5) Genetic studies of alcoholism subtypes in a Han Taiwanese population, by Ru-Band Lu.
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| 7. |
- Gohritz, A, et al.
(författare)
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Ersatzoperationen bei Ausfall motorisher Funktionen an der Hand : Tendon transposition to restore muscle function in the hand
- 2007
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Ingår i: Der Unfallchirurg. - : Springer Science and Business Media LLC. - 0177-5537 .- 1433-044X. ; 110:9, s. 759-76
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Tidskriftsartikel (refereegranskat)abstract
- Nerve injuries in the upper extremity can result in severe disability. In the last three decades, progress in microsurgical techniques has improved the outcome for nerve injuries and if the prognosis is reasonably good, nerve repair should usually be performed prior to tendon transfer procedures. However, above all proximal lesions of peripheral nerves such as high radial nerve palsy still often yield unsatisfactory results, despite a technically well-executed nerve repair. Prognosis further depends on the time interval since the injury and also on the age of the patient, as the regenerative process is delayed in older patients. The indication for tendon transfers strongly depends on the personal and professional profiles of the individual patient. Tendon transfer procedures alleviate the suffering from functional hand impairment providing a superior alternative to permanent external splints. Tendon transfers are usually secondary procedures for replacing function after evaluation of the functional motor loss. Numerous transfer procedures have been described for every nerve trunk of the upper extremity, their prognosis depending mainly on the extent and pattern of nerve loss, local effects of the trauma (e.g. involvement of soft tissues, joints), and the physiological characteristics of the transferred muscle. Even if the results of the tendon transfers may finally be less satisfactory in cases of complex nerve damage than in isolated motor nerve lesions, they offer a valuable functional benefit, often being the only possibility to restore hand function. Although regrettably underused, tendon transfer improve upper extremity function in more than 70% of patients with cervical spinal cord injury. Reconstruction of key elements such as wrist extension, key grip between the thumb and the index finger, or digital flexion and extension leads to highly improved use of the tetraplegic hand and thus provides new mobility and independence from the help of others. This article presents an overview of the most common procedures to restore hand function in peripheral nerve injuries and tetraplegia in order to provide a systematic approach for decision making.
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| 8. |
- Gohritz, A., et al.
(författare)
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[Nerve and muscle transfer surgery to restore paralyzed elbow function]
- 2008
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Ingår i: Unfallchirurg. - : Springer Science and Business Media LLC. - 0177-5537. ; 111:2, s. 85-101
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Tidskriftsartikel (refereegranskat)abstract
- Paralysis of elbow flexion or extension leads to major impairment of upper extremity function. Surgical reconstruction can be achieved using several procedures.If the time interval since the nerve injury is short, anatomic reconstruction by means of nerve suture or nerve transplantation should be attempted. Alternatively, nerve transposition is possible. If more than 12-18 months have elapsed, reinnervation of arm muscles can no longer be expected. In this case, muscle transposition is helpful. Restoring flexion is predominantly required following brachial plexus injury, when the function of the biceps, brachioradialis and brachialis muscles are lost. As donor muscles the latissimus dorsi, pectoralis major and triceps brachii can be used, alternatively a transfer of the flexor-pronator muscles of the forearm is possible. Latissimus dorsi transfer to reconstruct elbow flexion is also indicated in defects of the anterior upper arm muscle compartiment due to trauma, ischemia, or tumor. Patients with proximal radial nerve lesions may benefit from latissimus transfer to reachieve elbow flexion extension.In tetraplegic patients, elbow extension is restored mainly by transfer of the posterior deltoid muscle extended with a tendon graft, or by means of a biceps-to-triceps transfer.
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| 10. |
- Wurst, FM, et al.
(författare)
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Emerging biomarkers: New directions and clinical applications
- 2005
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Ingår i: Alcoholism: Clinical and Experimental Research. - 0145-6008. ; 29:3, s. 465-473
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Tidskriftsartikel (refereegranskat)abstract
- This article summarizes content proceedings of a symposium held at the 2004 Research Society on Alcoholism Scientific Annual Meeting in Vancouver, Canada. The chairs were Friedrich M. Wurst and Raye Litten. The presentations were (1) Introduction, by Raye Litten; (2) Direct Ethanol Metabolites-On the Threshold From Science to Routine Use, by Friedrich M. Wurst; (3) Sialic Acid Index of Plasma Apolipoprotein J (SIJ) as a Viable Marker for Chronic Alcohol Consumption, by Philippe Marmillot; (4) The Emergence of Ethyl Glucuronide (EtG) Testing as a Tool in Monitoring Healthcare Professionals, by Gregory E. Skipper; (5) Application of Biomarkers for Alcohol Use Disorders in Clinical Practice, by Tim Neumann; (6) Utility of Biomarkers in Assessing the Efficacy of Medications for Treating Alcoholism, by Marty Javors; and (7) Discussion, by Raye, Litten.
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