• Title/Summary/Keyword: Early Mobilization

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Early mobilization and delayed arterial ligation (EMDAL) as a surgical technique for splenectomy and shunt surgery in portal hypertension

  • Harilal S L;Biju Pottakkat;Kalayarasan Raja;Senthil Gnanasekaran
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.48-52
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    • 2024
  • Backgrounds/Aims: Splenectomy is the most frequently performed procedure as definitive management or as part of shunt surgery or devascularization in portal hypertension. Splenectomy is technically challenging because of the frequent coexistence of multiple collateral varices, splenomegaly, poor liver function, and thrombocytopenia. Early arterial ligation and late mobilization (EALDEM) is the traditional method for splenectomy in portal hypertension. Early spleen mobilization offers good control of the hilum. We aim to compare the effect of the early mobilization and delayed arterial ligation (EMDAL) technique with that of the conventional splenectomy technique in patients with portal hypertension. Methods: During the study period from September 2011 to September 2022, 173 patients underwent surgical intervention for portal hypertension at our institution. Among these patients, 114 underwent the conventional method of splenectomy (early arterial ligation and late splenic mobilization) while 59 underwent splenectomy with the EMDAL technique. Demographics were compared between the two groups. Intraoperative and postoperative outcomes were analyzed using the Mann-Whitney test in each group. A minimum follow-up of 12 months was performed in each group. Results: Demographics and type of surgical procedure were comparable in the two surgical method groups. Median blood loss was higher in the conventional group than in the EMDAL method. The median duration of surgery was comparable in the two surgical procedures. Clavien-Dindo grade III/IV complications were reported more frequently in the conventional group. Conclusions: The splenic hilum can be controlled well and bleeding can be minimised with early mobilization and delayed arterial ligation.

Importance-Performance Analysis about Early Mobilization after Abdominal Surgery Patients in Surgical Ward Nurses (복부수술 환자의 조기운동에 대한 외과병동 간호사의 중요도-수행도 분석)

  • Kim, Bo Eun;Choi, Hye-Ran
    • Journal of Digital Convergence
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    • v.19 no.12
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    • pp.567-575
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    • 2021
  • This study was aimed to identify surgical ward nurses' importance-performance awareness toward early mobilization after abdominal surgery patients. The date were collected from 162 nurses and the importance and performance of early mobilization were analyzed by the IPA method. The collected data were analyzed using the SPSS/WIN 25.0 by implementing descriptive statistics, independent t-test, paired t-test, and ANOVA. Early mobilization was divided into exercise of pulmonary complications and early ambulation. As a result of the study, the areas requiring concentration were 'check risk of aspiration', and areas requiring improvement were 'oral care', 'check lung sound', 'percussion/vibration', 'suction', and 'reinforcement exercise in bed'. Therefore, each item of early mobilization is recommended to reduce the gap between importance and performance in clinical care.

Early Mobilization after Operative Treatment of a ruptured Achilles tendon (아킬레스건 파열에 대한 수술 후 조기 재활 치료)

  • Chung, Hyung-Jin;Park, Joon-Suk;Kim, Hyun-Ho;Park, Yong-Won
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.78-82
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    • 2003
  • Purpose: The purpose of the study is to evaluate the clinical outcomes of acute achilles tendon rupture patients treated by early mobilization after operative repair. Materials and Methods: In this retrospective study, 12 patients of acute Achilles tendon rupture were surgically treated from May 2001 to November 2002, with follow-up period of at least 6 months. There were 10 men and 2 women, and mean age was 35.9 year. The repair method was single Krackow suture technique. Two to three weeks after the operation, early ROM with removable ankle-foot orthosis(AFO) was started. We used Amer-Lindholm scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. Results: We had 11 excellent results(92%), and 1 good results(8%). One-leg heel raising was possible in all patients. All the patients returned to the preinjury occupations and 7 patients(58%) reached the preoperative level of sports activities. There was no significant difference in ankle ROM and ankle plantar flexion isokinetic strength compared to contralateral side. There was, no reruptures. Conclusion: Early mobilization proved to be a well tolerated, safe, and effective means for the compliant patient.

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Early Mobilization and Rehabilitation of Critically-Ill Patients

  • Hye Min Ji;Yu Hui Won
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.2
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    • pp.115-122
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    • 2024
  • Post-intensive care unit (ICU) syndrome may occur after ICU treatment and includes ICU-acquired weakness (ICU-AW), cognitive decline, and mental problems. ICU-AW is muscle weakness in patients treated in the ICU and is affected by the period of mechanical ventilation. Diaphragmatic weakness may also occur because of respiratory muscle unloading using mechanical ventilators. ICU-AW is an independent predictor of mortality and is associated with longer duration of mechanical ventilation and hospital stay. Diaphragm weakness is also associated with poor outcomes. Therefore, pulmonary rehabilitation with early mobilization and respiratory muscle training is necessary in the ICU after appropriate patient screening and evaluation and can improve ICU-related muscle weakness and functional deterioration.

Analysis of Wartime Personal Mobilization Using Big-data (빅데이터를 활용한 전시 병력동원 응소율 분석)

  • Kim, Se-Yong;Koo, Hoon Young
    • Journal of the Korea Society for Simulation
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    • v.28 no.4
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    • pp.57-65
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    • 2019
  • Recently, the Korean military has been drastically reducing its active-duty troops due to rapid demographic changes and the reconciliatory mode between the two Koreas. Under these circumstances, the wartime reserve forces play an important role. In times of war, a successful personal mobilization is critical especially in early combat stage. Previous research has been carried out using insufficient data collected only within the military and there have been limitations on empirical analysis due to changes in the designation methods for personal mobilization. This study analyzes how much of the reserve forces can be filled at the prescribed time by analyzing the transportation route of the reserve forces in wartime by utilizing military-related data and credit card usage data of the reserve forces residing in Yong-in city. The analysis showed that all reserve forces could not be called up within the prescribed time. In particular, Gangwon Province has shown results of less than 70 percent call-ups, and could cause serious weakening of combat capabilities in the early stages of the war. The main reasons could be the difference between the actual residence and the residence address and the excessive time caused by the traffic congestion.

Effects of Energy Intake on Performance, Mobilization and Retention of Body Tissue, and Metabolic Parameters in Dairy Cows with Special Regard to Effects of Pre-partum Nutrition on Lactation - A Review -

  • Remppis, S.;Steingass, H.;Gruber, L.;Schenkel, H.
    • Asian-Australasian Journal of Animal Sciences
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    • v.24 no.4
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    • pp.540-572
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    • 2011
  • The present review focuses on the effects of energy intake on performance, changes in body tissue during lactation, and metabolic parameters in dairy cows. Especially, pre-partum nutrition and its influence on lactation are emphasized. In recent decades the increase in genetic potential of dairy cows has increased milk yield. This fact sharpens the problem of a negative energy balance in early lactation because the amount of energy required for maintenance and milk production exceeds the amount of energy cows can consume. Around parturition, reduced feed intake reinforces the situation. Continuing negative energy balance causes decreasing milk yield, fertility problems, and incidence of metabolic diseases. Hence, the cow has to rely on body reserves that were stored in late lactation and the dry period. It is evident that the nutritional status pre-partum acts as the key factor for milk yield and fertility parameters in the following lactation. Cows overfed during the foregoing gestation and which have gained large quantities of body fat have lower dry matter intake along with the need to mobilize larger quantities of body reserves in lactation. The milk yield in the following lactation is lower than in cows fed according to their requirements. Cows restrictively fed in late gestation have a higher feed intake in lactation and a lower mobilization of body reserves. The effect of energy intake post-partum plays only a minor role for performance parameters in lactation. Lipid mobilized from body reserves makes a substantial contribution to the energetic cost of milk production in early lactation and adipose tissue undergoes specific metabolic alterations. Adipose tissue is degraded to free fatty acids, which are used in liver for energy purposes. High lipid mobilisation promotes the development of a fatty liver and therefore a reduced gluconeogenesis.

Diagnosis and Treatment of Acute Ankle Sprain (족관절 급성 염좌의 진단과 치료)

  • Byun, Chu-Hwan;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.81-85
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    • 2015
  • Acute sprain of the ankle requires comprehensive history taking and physical examination in diagnosing the type of severity and deciding on the plan of treatment. Literature supports functional treatment as the treatment of choice for grade I and II injuries. During the acute phase, the goal of treatment focuses on controlling pain and swelling. PRICE (protection, rest, ice, compression, and elevation) is a well-established protocol at this phase. There is some evidence that application of ice and use of nonsteroidal anti-inflammatory drugs improves healing and speeds recovery. Then the functional treatment (motion restoration and strengthening exercises) is administered to progress the rehabilitation appropriately in order to facilitate healing and restore the mechanical strength and proprioception. Early mobilization has been shown to result in more rapid return to work and daily activities than immobilization. Grade III injuries still generate controversy in terms of the best management available, and more studies on early mobilization, cast immobilization, or surgery are needed. Even the Cochrane reviews published to date are not conclusive.

Roles of Epinephrine and Insulin in the Regulation of Metabolism in Dairy Cow (젖소에서 epinephrine 및 insulin에 의한 대사 조절)

  • Kim, Jin-Wook
    • Journal of agriculture & life science
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    • v.43 no.4
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    • pp.15-20
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    • 2009
  • The transition from pregnancy to lactation, commonly referred to as the "transition period" is characterized by dramatic changes in metabolic processes and their regulation in order to prepare the dairy cow for parturition and lactogenesis. An important adaptation to lactation is the increase in gluconeogenesis by the liver to meet the tremendous increase in demand of glucose for lactose synthesis, and the accumulation of lipid in adipose tissue during pregnancy, its mobilization that begins prior to lactation and the dramatic increase in plasma NEFA concentration early lactation. Epinephrine and insulin, the homeostatic regulators of metabolism are responsible for the adaptations of lipid and carbohydrate metabolism in support of milk production along with mobilization of body fat to meet overall energy demands because dry matter intake is insufficient to meet these demands during early lactation.

Study on the Classification of the Disaster Prevention Resources for Effective Disaster Management (효율적 재난관리를 위한 방재자원 분류체계 구축에 관한 연구)

  • Lee, Chang-Hee;Jung, Woo-Young;Lee, Chang-Yeol;Kang, Byung-Hwa
    • Journal of the Society of Disaster Information
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    • v.9 no.2
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    • pp.153-163
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    • 2013
  • The damage caused by natural and human disasters has been increasing year by year. While the damage from these disasters are unavoidable, reduction of damage level by proper establishment of control measures could be sufficiently achievable. Disaster prevention resources include resources introduced in the event of disaster, such as human, materials, equipments and facilities. Rapid yet proper inputs of these resources are the key factor to minimize any damages from the disaster. Currently, however, the standard and/or criteria for mobilization of the disaster prevention resources have not yet systematically established. Therefore, proper resource management as well as efficient resource input has not been in place. This research is an early stage construction of efficient mobilization resources, which had been irregularly loaded and applied before. Also this study has tried to provide a classification rule for efficient disaster prevention resource management and mobilization, and indeed, provide a foundation for efficient resource management system.