BACKGROUNDEurythmy therapy is a movement therapy of anthroposophic medicine that can have effects on a person's physical body, spirit, and soul.

OBJECTIVEThe aim of this publication was to update and summarize the relevant literature on the effectiveness of eurythmy in a therapeutic context since 2008.

SEARCH STRATEGYDifferent databases like PubMed, MEDPILOT, Research Gate, The Cochrane Library, DIMDI, Arthe and also the journal databases Der Merkurstab and the European Journal of Integrative Medicine were searched for prospective and retrospective clinical trials in German or English language.

INCLUSION CRITERIAThere were no limitations for indication, considered outcome or age of participants.

DATA EXTRACTION AND ANALYSISStudies were evaluated with regard to their description of the assembly process and treatment, adequate reporting of follow-ups, and equality of comparison groups in controlled trials.

RESULTSEleven studies met the inclusion criteria. These included two single-arm, non-controlled pilot studies, two publications on the same non-randomized controlled trial and one case study; six further studies referred to a prospective cohort study, the Anthroposophic Medicine Outcome Study. Most of these studies described positives treatment effects with varying effect sizes. The studies were heterogynous according to the indications, age groups, study design and measured outcome. The methodological quality of the studies varied considerably. There were no clear improvements since 2008, when the recommendations were published in the first review.

CONCLUSIONEurythmy seems to be a beneficial add-on in a therapeutic context that can improve the health conditions of affected persons. More methodologically sound studies are needed to substantiate this positive impression.

Arthroscopy ; Behavior Therapy ; methods ; Exercise Therapy ; methods ; Humans ; Postoperative Care ; methods

Enhanced recovery after surgery (ERAS) has been widely used in perioperative optimization. As an important component of ERAS, rehabilitation medicine mainly focuses on perioperative physical fitness management, respiratory training, exercise training to reduce the incidence of postoperative pulmonary infection, improve gastrointestinal and cardiopulmonary function. This paper explains rehabilitation medicine for respiratory, musculoskeletal, cardiovascular and digestive systems during the perioperative period.
Humans ; Perioperative Care ; Postoperative Complications ; prevention & control ; Postoperative Period ; Rehabilitation ; methods ; standards

BACKGROUND AND OBJECTIVES: Patients with aspirin-exacerbated respiratory disease (AERD) tend to have more severe clinical course and also tend to be recalcitrant to conventional medical and surgical treatment. This study aimed to assess the long-term outcome of endoscopic sinus surgery in AERD patients. SUBJECTS AND METHOD: Fifteen patients with AERD (n=15) were identified through a retro-spective chart review, and compared with 74 patients of CRSwNP (with asthma n=23; without asthma n=51) by analyzing preoperative and postoperative symptoms, endoscopic score, Lund-Mackay CT score, number of revision surgery or outpatient procedures, frequency of clinic visits and medications. The CRS control status was evaluated according to the European Position Paper on Rhinosinusitis and Nasal Polyps 2012 criteria and logistic regression analyses were conducted to investigate the determining factors of preoperative and postoperative symptoms. RESULTS: The AERD group showed higher disease severity than other groups preoperatively: endoscopic score (CRSwNP s asthma 6.3±2.6 vs. CRSwNP c asthma 6.5±2.3 vs. AERD 8.8±1.4, p<0.05), CT score (12.2±4.9 vs. 17.0±4.8 vs. 18.0±2.1, p<0.05), and overall symptom score (30.8±0.4 vs. 33.8±1.5 vs. 37.9±0.7, p<0.01). The rate of revision surgery and outpatient procedures, postoperative clinic visit and prescription rate were higher in the AERD group (p<0.05, respectively). However, postoperative symptom scores and CRS control status were not significantly different among three groups (p=0.267 and p=0.996, respectively). CONCLUSION: Although AERD patients showed higher preoperative endoscopic scores and revision surgery rates, postoperative subjective symptoms were comparable to those of other groups with long-term follow up, suggesting the importance of frequent outpatient care after endoscopic sinus surgery.
Ambulatory Care ; Asthma ; Follow-Up Studies ; Humans ; Logistic Models ; Methods ; Nasal Polyps ; Outpatients ; Postoperative Care ; Prescriptions

PURPOSE: Substantial evidence supports the benefits of an intensivist model of critical care delivery. However, currently, this mode of critical care delivery has not been widely adopted in Korea. We hypothesized that intensivist-led critical care is feasible and would improve ICU mortality after major trauma. MATERIALS AND METHODS: A trauma registry from May 2009 to April 2011 was reviewed retrospectively. We evaluated the relationship between modes of ICU care (open vs. intensivist) and in-hospital mortality following severe injury [Injury Severity Score (ISS) >15]. An intensivist-model was defined as ICU care delivered by a board-certified physician who had no other clinical responsibilities outside the ICU and who is primarily available to the critically ill or injured patients. ISS and Revised Trauma Score were used as measure of injury severity. The Trauma and Injury Severity Score methodology was used to calculate each individual patient's probability of survival. RESULTS: Of the 251 patients, 57 patients were treated by an intensivist [intensivist group (IG)] while 194 patients were not [non-intensivist group (NIG)]. The ISS of IG was significantly higher than that for NIG (26.5 vs. 22.3, p=0.023). The hospital mortality rate for IG was significantly lower than that for NIG (15.8% and 27.8%, p<0.001). CONCLUSION: The intensivist model of critical care is feasible, and there is room for improvement in the care of major trauma patients. Although trauma systems take time to mature, future studies are needed to evaluate the best model of critical care delivery for severely injured patients in Korea.
Adult ; Aged ; Critical Care/*methods ; Female ; Hospital Mortality ; Humans ; Intensive Care/*methods ; *Intensive Care Units ; Male ; Middle Aged ; Models, Theoretical ; Postoperative Care/methods ; *Specialization ; Trauma Centers

A purely laparoscopic four-port approach was created for left hepatectomy in pigs. A polyethylene loop was placed on the left two hepatic lobes for traction and lift. Next, penetrating ligation of the lobes using of a double row of silk sutures was performed to control bleeding. A direct hepatic transection was completed using a monopolar hook electrode without meticulous dissection of the left hepatic vein. The raw surface of the liver was coagulated and sealed with fibrin glue. Lobes were retrieved through an enlarged portal. Laparoscopic hepatic lobectomy was completed in all pigs without the use of specialized instruments and with a mean operative time of 179 +/- 9 min. No significant perioperative complications were observed. The average weight of each resected lobe was 180 +/- 51 g. Complete blood count as well as serum organics and enzyme levels normalized after about 2 weeks. During necropsy, adhesion of the hepatic raw surface to the gastric wall and omentum were observed. No other abnormalities were identified. This minimally invasive left hepatectomy technique in swine could serve as a useful model for investigating liver diseases and regeneration, and offer preclinical information to improve hepatobiliary surgical procedures.
Animals ; Female ; Hepatectomy/methods/*veterinary ; Laparoscopy/methods/veterinary ; Liver/surgery ; Male ; Postoperative Care/methods/veterinary ; Swine/*surgery ; Swine, Miniature/surgery

INTRODUCTIONThe efficiency of postoperative handover of paediatric patients to the children's intensive care unit (CICU) varies according to institutions, clinical setup and workflow. Reorganisation of handover flow based on findings from observational studies has been shown to improve the efficiency of information transfer. This study aimed to evaluate a new handover process based on recipients' perceptions, focusing on completeness and comprehensiveness of verbal communication, and the usability of a situation, background, assessment and recommendation (SBAR) form.

METHODSThis was a prospective interventional study conducted in the CICU of KK Women's and Children's Hospital, Singapore. It comprised four phases: (1) evaluation of the current handover process through an audit and opinion survey; (2) development of a new handover process based on the opinion survey and hospital personnel feedback; (3) implementation; and (4) evaluation of the new handover process. The new handover process was based on a PETS (pre-handover, equipment handover, timeout and sign out) protocol with a 'single traffic communication' flow and a new SBAR handover document. It included relevant patient information, and the options 'not applicable' and 'none', to increase compliance and reduce ambiguity.

RESULTSSignificantly more recipients indicated that the new SBAR form was the most important handover tool and provided more useful information. Recipients' perceptions indicated improvement in information sufficiency and clarity; reduction of omission errors; and fewer inconsistencies in patient descriptions in the new process.

CONCLUSIONDual customisation of the handover process, PETS protocol and SBAR form is necessary to meet the workflow and information demands of the receiving team.

Anesthesia ; Attitude of Health Personnel ; Child ; Critical Care ; methods ; Hospitals, Pediatric ; organization & administration ; Humans ; Intensive Care Units ; Medical Errors ; prevention & control ; Nurses ; Observational Studies as Topic ; Patient Handoff ; Pediatrics ; methods ; Postoperative Care ; methods ; Postoperative Period ; Prospective Studies ; Singapore ; Surveys and Questionnaires

We have treated three cases of bone abscesses, two in proximal tibia and one in os calcis, by radical excision and filling the remaining bone cavity with autogenous iliac bone graft. We have observed them postoperatively for one to six years. They have not shown any sign of recurrence and they are carrying out their normal daily activity without any restriction. Eventhough it is against the basic fundamental of surgery to lay bone grafts in an infected area, our treatment was successful. We believe that this was resulted from the administration of the broad spectrum antibiotics, complete excision of the diseased tissue, gentle handling of the tissue at the surgery, and relatively perfect postoperative care. When the remaining bone cavity after the surgery of the osteomyeIitis can not filled by the usual method such as muscle pedicle graft, especially in the proximal metaphyseo-epiphyseaI region of the tibia, fresh cancellous bone graft immediately after the radical excision, and primary closure of the operative wound may be tried. It seems that this method brings rapid and permanent heaIing of the chronic osteomyelitis. Thus the patient can leave hospital earlier, pays Iess expense, and returns to his work earlier.
Abscess ; Anti-Bacterial Agents ; Humans ; Methods ; Osteomyelitis ; Postoperative Care ; Recurrence ; Tibia ; Transplants ; Wounds and Injuries

Operative internal fixation of femoral fractures is widely accepted as the best method of treatment but the techniques are by no means devoid of complications, nor are they simple to execute. A method of treatment must be based on the analysis of the :"personality of the fracture", that is, the nature of the fracture and of patient. Mechanical failure such as metal failure, loosening of screw or nail after internal fixation, residual deformity, and nonunion, may impose serious problems on the surgeon and patient unless treatment is appropriate. The authors analyzed 14 mechanical failures of internal fixation in 12 femoral fractures from Dec. 1987 to Aug. 1992 in the department of orthopedic surgery, Ansan Hospital Korea University to study the possible cause of mechanical failure of internal fixation and pursue the way of reducing that complications and obtained the following results. 1. Eleven were males and one was female, most of them were in age of active life. 2. The level of fractures in 12 femorals were subtrochanteric in two, shaft in nine and supracondylar in one. 3. The time interval between internal fixation and failure in 10 failures was 5.5 months on average(range, 3month to 11months). It was uncertain in 4 failures. 4. Mechanical failure were presented as breakage in five plates, loosening of screw in five plates, loosening of screw in two DCP fixation, loosening of nail in one interlocking nail, bending of nail in one Kuntscher nail, one breakage and one bending in two condylar buttres plates, and cutting-out of hip screw in three compression hip screw. 5. The causes of failure were presumed to be improper surgical technique in 7 failures, inadequate selection of internal fixatives in 5 failures, and inadequate postoperative care in 1 case.
Congenital Abnormalities ; Female ; Femoral Fractures ; Fixatives ; Gyeonggi-do ; Hip ; Humans ; Korea ; Male ; Methods ; Orthopedics ; Postoperative Care

Preemptive analgesia refers to the use of analgesics or regional nerve block in advance of nerve conduction changing or nerve remodeling caused by traumatic stimulation, so as to achieve better postoperative pain relief and to prevent postoperative pain hypersensitivity. Preemptive analgesia minimizes or prevents postoperative pain by reducing peripheral and central sensitization, which thereby limit the pain cascade. This paper briefly introduces the mechanism and methods of preemptive analgesia, as well as its application and research progress in the field of oral treatment. With the increased requirements for comfortable medical treatments and popularization of multimodal analgesia in pain management of oral surgery, preemptive analgesia will be more widely studied and applied in oral diagnosis and treatment.
Analgesia/methods* ; Analgesics/therapeutic use* ; Dental Care ; Humans ; Pain, Postoperative/prevention & control*

With the development and application of laparoscopic hepatectomy in major medical centers, domestic and foreign guidelines have summarized the indications, surgical techniques and operational procedures of the surgery. But in primary care facilities, where the surgical equipment are available, laparoscopic hepatectomy is performed only in a small number of cases and the progress of its application remains slow. The reasons possibly lie in the failure of a full understanding of the surgery, the lack of anatomical knowledge of laparoscopic hepatectomy, the lack of close multidisciplinary cooperation in the perioperative period and insufficient training of laparoscopic technology. In this review, we elaborate on three aspects of laparoscopic hepatectomy: preoperative planning, surgical techniques and postoperative management. Before the operation, the surgeons should fully understand the anatomical structure of the liver and select appropriate cases considering both the difficulty of operation and the surgical experience of the surgeons. During the operation, the position of the patient and the layout of the stamping card should be appropriate, and the central venous pressure needs to be well controlled in close cooperation with the anesthesiologist. The surgeons should be proficient at the techniques of liver suspension and pulling and at the use of ultrasonic knife, and select correct techniques for management of bleeding and the control of blood flow in and out of the liver. The patient should receive postoperative management with standard enhanced recovery after surgery (ERAS) protocols. These experiences may help to improve the practice of laparoscopic hepatectomy in local hospitals or primary care facilities.
China ; Hepatectomy ; Humans ; Laparoscopy/methods* ; Liver Neoplasms/surgery* ; Postoperative Period ; Primary Health Care