Improving postoperative mobilisation rates in patients undergoing elective major hepatopancreatobiliary surgery

alkiviadis.1961 shared this article with you from Inoreader Improving postoperative mobilisation rates in patients undergoing elective major hepatopancreatobiliary surgery Via Postgraduate Medical Journal Online First Background Early mobilisation reduces postoperative complications such as pneumonia, deep vein thrombosis and hospital length of stay. Many authors have reported poor compliance with early mobilisation within Enhanced Recovery After Surgery initiatives. Objectives The primary objective was to increase postoperative day (POD) 2 mobilisation rate from 23% to 75% in patients undergoing elective major hepatopancreatobiliary (HPB) surgery within 6 months. Methods We report a multidisciplinary team cl inical practice improvement project (CPIP) to improve postoperative mobilisation of patients undergoing elective major HPB surgery. We identified the common barriers to mobilisation and analysed using the fishbone or cause-and-effect diagram and Pareto chart. A series of Plan–Do–Study–Act cycles followed this. We tracked the rate of early mobilisation and mean distance walked. In the post hoc analysis, we examined the potential cost savings based on reduced hospital length of stay. Results Mobilisation rate on POD 2 following elective major HPB surgery improved from 23% to 78.9%, and this sustained at 6 months after the CPIP. Wound pain was the most common reason for failure to ambulate on POD 2. Hospital length of stay reduced from a median of 8 days to 6 days with an estimated cost saving of S$2228 per hospital stay. Conclusion Multidisciplinary quality improvement intervention effort resulted in an improved POD 2 mobilisation rate for patients who underw ent elective major HPB surgery. This observed outcome was sustained at 6 months after completion of the CPIP with potential cost savings. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

'The photographic negative of pulmonary oedema in COVID-19 pneumonia

alkiviadis.1961 shared this article with you from Inoreader 'The photographic negative of pulmonary oedema in COVID-19 pneumonia Via Postgraduate Medical Journal Online First A 53-year-old man presented to the emergency room (ER) with fever, dry cough and shortness of breath for 6 days. Clinically he had tachycardia (114 beats per minute), tachypnoea (30 per minute) and was maintaining oxygen saturation of 88% on room air. He had acute respiratory distress syndrome (ARDS) (PaO2/FiO2 of 0.28), and there was no leucopaenia or lymphopaenia. Chest X-ray revealed peripheral consolidations with base towards pleura and sparing of peri-hilar region consistent with a r everse batwing appearance (figure 1). The patient's nasopharyngeal swab was tested for SARS Cov-2 RT-PCR, and it was positive. He was diagnosed to have COVID-19 pneumonia and started on oxygen supplementation and supportive care. The patient gradually improved and was discharged. In resource-constrained settings, a chest radiograph is the only investigation available for most patients. The findings have been used to support the diagnosis, determine the severity, guide the treatment and... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Iatrogenic extracranial internal carotid artery aneurysm

alkiviadis.1961 shared this article with you from Inoreader Iatrogenic extracranial internal carotid artery aneurysm Via Postgraduate Medical Journal Online First A previously healthy 25-year-old female was presented to the otorhinolaryngology outpatient clinic, complaining of painless progressive pulsatile swelling over the left side of the neck for 1 month. The patient gave a history of fine-needle aspiration cytology (FNAC) of left cervical lymph node a month ago at a peripheral hospital for reactive cervical lymphadenopathy. She noted the onset of swelling 2–3 days after the FNAC which progressively increased to the current size. Examination showed a fir m, non-tender, pulsatile swelling of size 10 x 8 cm over the left side of the neck (figure 1A), with visible pulsations and bruit on auscultation. Laryngoscopy showed a left lateral pharyngeal wall bulge without any airway compromise. MRI of the neck revealed a well-defined heterointense lesion noted arising from the left proximal internal carotid artery (ICA) displacing external carotid artery anteriorly and a peripheral T2 hyperintense thrombus with central flow voids likely an... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Randomized Clinical Trial of Greek High Phenolic Early Harvest Extra Virgin Olive Oil in Mild Cognitive Impairment: the MICOIL Pilot Study

alkiviadis.1961 shared this article with you from Inoreader A Randomized Clinical Trial of Greek High Phenolic Early Harvest Extra Virgin Olive Oil in Mild Cognitive Impairment: the MICOIL Pilot Study Via IOS Press Custom RSS Scientists from the Aristotle University of Thessaloniki and the Greek Association of Alzheimer's Disease and Related Disorders have succeeded in making the shift to MCI therapy via robust natural remedies that can be used in order to forestall cognitive deterioration. In an article published in the Journal of Alzheimer's Disease, the researchers conducted a randomized prospective study so as to examine the HP-EH-EVOO and MP-EVOO versus MeDi. Moreover, genetic predisposition (APOE ε4) to AD was tested and an extensive neuropsychological battery was administered at baseline and after 12 months. Each participant was randomized and assigned to one of three groups: (i) Group 1 received the HP-EH-EVOO (50 mL/day) plus MeDi; (ii) Group 2 received the MP-EVOO (50 mL/day) plus MeDi; and (iii) Group 3 received only the MeDi instructions. Recent literature paves the way to investigate natural compounds as alternative treatments of MCI due to AD. The MeDi is not a single prescribed diet, but rather a general food-based eating pattern, which is characterized by local and cultural differences throughout the Mediterranean region. Recent studies have proposed that more adherence to MeDi improved cognitive functions, decreased the possibility to develop MCI, and lessened the risk of MCI progression to AD. A Spanish longitudinal study showed that EVOO keeps the cognitive function better than nuts. A recent study suggests that intake of EVOO might offer a protective effect and/or slow AD pathology in transgenic mice. The results of this study suggest that the long-term consumption of an EVOO-containing diet starting at early age provides a protective effect against AD and its related disorder cerebral amyloid angiopathy (CAA), while a long-term intervention with an EVOO-rich MedDiet in 285 participants with high vascular r isk resulted in better cognitive functioning when compared to a control diet. The MICOIL study revealed better follow-up performance in Group 1 compared to Group 2 and Group 3 in almost all cognitive domains. Moreover, Group 2 showed also significant improvement compared to Group 3 in ADAS-cog (p = 0.001) and MMSE (p = 0.05), whereas Group 3 exhibited worse or similar to baseline performance in almost all domains. In particular, Group 1 and Group 2 had better outcomes with regards to ADAS-cog (p = 0.003), Digit Span (p = 0.006) and letter fluency (p = 0.003). Moreover, there was a significant difference (p = 0.001) in the presence of APOΕ ε4 between the Groups 1 and 2 vs. Group 3. Therefore, MICOIL showed that long-term intervention with HP-EH-EVOO or MP-EVOO was associated with significant improvement in cognitive function compared to MeDi, independent of the presence of APOE ε4. Our study revealed in all measures we used better performance of treatment group compared with control group in the second assessment after 12 months of follow-up. Until today there is no other study which has examined in such detailed manner the effects of Greek EVOO in elders with MCI as an effective solution for cognitive impairment. ### NOTES FOR EDITORS Full study: "A Randomized Clinical Trial of Greek High Phenolic Early Harvest Extra Virgin Olive Oil in Mild Cognitive Impairment: The MICOIL Pilot Study" by M. Tsolaki, E. Lazarou, M. Kozori, N. Petridou, I. Tabakis, I. Lazarou, M. Karakota, I. Saoulidis, E. Melliou, and P. Magiatis (DOIi: 10.3233/JAD-200405) published online in the Journal of Alzheimer's Disease in advance of Volume 78, Issue 2 by IOS Press. The article is freely available online at: content.iospress.com/articles/journal-of-alzheimers-disease/jad200405. Contact Principal investigate: Magda Tsolaki, Aristotle University of Thessaloniki, Makedonia, Greece (tsolakim1@gmail.com or +306942918933, +302310234239). About the Aristotle University of Thessaloniki The Aristotle University of Thessaloniki is the largest university in Greece. It comprises 7 faculties that consist of 33 schools, 5 faculties that consist of one school each, as well as 4 independent schools. About 81,500 students study at the Aristotle University (72,140 in undergraduate programs and 8,360 in postgraduate programs). There are 2,150 faculty members: 739 professors, 435 associate professors, 634 assistant professors, and 342 lecturers. There are also 11 teaching assistants, 58 research fellows, 248 members of the Special Laboratory Teaching Personnel, as well as 15 foreign language teachers and 4 foreign instructors. Faculty members are also assisted by 213 members of the Special Technical Laboratory Personnel. The Aristotle University of Thessaloniki conducts research projects, participates in European research programs, cooperates with international institutions and organizations and attracts outstanding researchers from within Greece and abroad. The Aristotle Univ ersity supports research projects in a wide variety of disciplines related to the environment (natural and built), computing, new technologies and nanotechnology, telecommunications, industrial technologies, transport, biotechnology, biomedicine and health, agriculture, forestry and fishery, education and language, history and archaeology, social studies and economics. auth.gr About the Greek Association of Alzheimer's disease and Related Disorders The Greek Association of Alzheimer's Disease and Related Disorders is a non-profit organization that was founded in 1995 by relatives of patients suffering from Alzheimer's disease, doctors of all specialties (mainly neurologists and psychiatrists) and other experts (such as psychologists, social workers, physiotherapists, etc.) who deal with the problems caused by this disease and other types of dementia. The Association operates two day centers in Thessaloniki with more than 130.000 visits per year and has over 6.000 members. It is a member of Alzheimer Europe and Alzheimer's disease International and has successfully participated in various national and European research projects producing new scientific knowledge and innovative interventions for cognitive disorders. The aim of the Association is to offer information and advice concerning the care of patients with cognitive disorders and provide services for patients and their families. It also strives to offer help and supp ort to caregivers in order to reduce the social, economic and emotional burden deriving from the long term care of people suffering from dementia. Lastly, the Association attempts to publicize the social needs of the affected population and inform the public on issues related to dementia and cognitive disorders in general. alzheimer-hellas.gr About the Yanni's Olive Grove Yanni's Olive Grove is a Greek family company. Through ideal production conditions following the regulations of the IOC and the collaboration with "Krinos Olive Center" of the American Farm School, our main objective is to produce EVOOs of the highest quality standards. Our high phenolic EVOOs were honored with 50 international awards in the last five years. You may watch our production process: complimentary extra virgin olive oil video. Yanni's Finest EVOO is a multi-award winning early harvest extra virgin olive oil produced only from Halkidiki green olives. It was born from Yanni's desire to offer the absolute finest extra virgin olive oil possible and is made with olives harvested from groves of some 6,000 olive trees located by the sea, in Nea Potidaia in the Chalkidiki peninsula in northern Greece. The olives are harvested by hand while still green and unripe and then pressed within hours of being picked at temperatures below 25 °C. The result is a perfect and very fresh EVOO. yannisolivegrove.gr About the Journal of Alzheimer's Disease Now in its 23rd year of publication, the Journal of Alzheimer's Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment, and psychology of Alzheimer's disease. The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. Groundbreaking research that has appeared in the journal includes novel therapeutic targets, mechanisms of disease, and clinical trial outcomes. JAD has a Journal Impact Factor of 3.909 according to Journal Citation Reports (Source: Clarivate, 2020). JAD is published by IOS Press. j-alz.com View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Psychological Status Rather Than Cognitive Status is Associated with Incorrect Perception of Risk of Falling in Patients with Moderate Stage Dementia

alkiviadis.1961 shared this article with you from Inoreader Psychological Status Rather Than Cognitive Status is Associated with Incorrect Perception of Risk of Falling in Patients with Moderate Stage Dementia Via IOS Press Custom RSS "PwD show a threefold incidence of falls and a doubled incidences of severe falls as compared to peers without dementia and an inaccurate risk-perception and associated behavioral consequences may represent a link to this traumatic event in old age," explained lead investigator Klaus Hauer, PhD, Department of Geriatric Research at the Bethanien Hospital/Geriatric Center at the Heidelberg University, Germany. Patients with neurodegenerative diseases often present with poor self-awareness that may exacerbate their already jeopardized decision-making and behavior. With respect to risk of falling and functional capacities, deficits in specific cognitive sub-performances such as executive function/working memory showed significant discriminative validity for fallers vs. non-fallers and documented restricted judgement in own motor planning while executive function also influenced overestimation of own functional abilities among fallers suggesting a potential mechanism for falling already in persons without cognitive impairment. However other factors such as psychological or functional status or adaptive behavioral strategies have shown high associations with incorrect fall risk perception in study samples without cognitive impairment or unspecified cognitive status and those factors may interfere with, facilitate, compensate or even superimpose the effects of impaired cognition. Studies on mismatch of subjective vs objective risk with focus on falls have so far not been published in PWD representing a highest risk group for falls. "Although 2/3 of the study participants had a mismatch between subjective and objective risk, study results indicate that cognitive impairment per se does not lead to underestimation of risk of falling while results of specific cognitive subdomains such as less impaired executive and memory function was only associated with overestimation of risk in this group of persons with beginning to moderate stage dementia. Other factors such as anxiety, concerns about falling, activity avoidance, history of falls, or support seeking strategies represented more relevant parameters to discriminate between match or mismatch of objective vs subjective risk of falling," commented co-investigator Ilona Dutzi, PhD, Department of Geriatric Research at the Bethanien Hospital/Geriatric Center at the Heidelberg University, Germany. Results, especially so in the largest subgroup with underestimation of risk, may indicate a rather less negative view on life perspectives and less emotional and behavioral reactivity to adverse events such as falls, leading to a higher quality of life and allowing to be more physically active thus counterbalancing objective risks. Results seem encouraging, as they translate mismatch classification (inadequate perception) into a positive direction, documenting unexpected remaining resources in a large subgroup of persons with moderate dementia. While traumatic fall events are associated to fear of falling, the study findings indicate that a mismatch of subjective and objective risk seems not to be a general and high impact factor for risk or falling even in PwD, allowing fewer concerns to motivate such persons to take part in active prevention programs with increased risk exposure such as exercise programs. Authors Ilona Dutzi & Klaus Hauer ### NOTES FOR EDITORS Full study: "Mismatch of Subjective and Objective Risk of Falling in Patients with Dementia" by Klaus Hauer, Michael Schwenk, Stefan Englert, G. A. Rixt Zijlstra, Sabine Tuerner, and Ilona Dutzi (DOI 10.3233/JAD-200572) published in the Journal of Alzheimer's Disease, Volume 78, Issue 2 by IOS Press. The article is available online at: content.iospress.com/articles/journal-of-alzheimers-disease/jad200572. Contact To request the full text of the article or further information please contact Diana Murray, IOS Press (+1 718-640-5678 or d.murray@iospress.com). To reach the authors for comment please contact Klaus Hauer (+496221319153 or khauer@bethanien-heidelberg.de). About the Journal of Alzheimer's Disease Now in its 23rd year of publication, the Journal of Alzheimer's Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment, and psychology of Alzheimer's disease. The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. Groundbreaking research that has appeared in the journal includes novel therapeutic targets, mechanisms of disease, and clinical trial outcomes. JAD has a Journal Impact Factor of 3.909 according to Journal Citation Reports (Source: Clarivate, 2020). It is published by IOS Press. j-alz.com About IOS Press IOS Press is headquartered in Amsterdam with satellite offices in the USA, Germany, India and China and serves the information needs of scientific and medical communities worldwide. IOS Press now publishes more than 80 international peer-reviewed journals and about 75 book titles each year on subjects ranging from computer science, artificial intelligence, and engineering to medicine, neuroscience, and cancer research. iospress.com View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Link Between Sleep Apnea and Increased Risk of Dementia

alkiviadis.1961 shared this article with you from Inoreader New Study Finds a Link Between Sleep Apnea and Increased Risk of Dementia Via IOS Press Custom RSS The study involved 34 individuals with recently diagnosed untreated OSA and 12 individuals who were asymptomatic for sleep disorders. It explored associations between brain amyloid burden using a PET brain scan, and measures of sleep, demographics and mood. The OSA group recorded a higher amyloid burden, poorer sleep efficiency and less time spent in stage N3 sleep (a regenerative period where your body heals and repairs itself). OSA is a common sleep disorder, affecting about 1 billion people worldwide and is caused by the collapse of the airway during sleep, resulting in intermittent dips in oxygen levels and arousals from sleep. "The significance of finding the association between increased brain amyloid in patients with OSA will allow for further research to explore in more detail the implications of treating OSA for reducing dementia risk," Dr. Jackson said. ### NOTES FOR EDITORS Full study: "Severe Obstructive Sleep Apnea Is Associated with Higher Brain Amyloid Burden: A Preliminary PET Imaging Study" by ML Jackson, M Cavuoto, R Schembri, V Doré, VL Villemagne, M Barnes, FJ O'Donoghue, CC Rowe, and SR Robinson (DOI: 10.3233/JAD-200571) published in the Journal of Alzheimer's Disease, Volume 78, Issue 2 by IOS Press. The article is available online at: content.iospress.com/articles/journal-of-alzheimers-disease/jad200571. Contact Media office of Monash University (media@monash.edu or +61 425 725 836). About the Journal of Alzheimer's Disease Now in its 23rd year of publication, the Journal of Alzheimer's Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment, and psychology of Alzheimer's disease. The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. Groundbreaking research that has appeared in the journal includes novel therapeutic targets, mechanisms of disease, and clinical trial outcomes. JAD has a Journal Impact Factor of 3.909 according to Journal Citation Reports (Source: Clarivate, 2020). It is published by IOS Press. j-alz.com View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19: Inhaled Interferon Beta-1 / Moderna Vaccine / Military / Pediatric Mental Health / Masks Protect Wearers

alkiviadis.1961 shared this article with you from Inoreader COVID-19: Inhaled Interferon Beta-1 / Moderna Vaccine / Military / Pediatric Mental Health / Masks Protect Wearers Via NEJM Journal Watch: Physician's First Watch RSS Feed Catch up on the latest developments in COVID-19: Inhaled interferon beta-1: Nebulized interferon beta-1a is associated with higher odds of clinical improvement... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.