How to Prioritise and Optimise Access to Elective Surgery in the COVID-19 Pandemic: An Interhospital Alliance Pathway Based on the SWALIS 2020 Model. A Single-Cohort Feasibility & Pilot Study

2020 ◽  
Author(s):  
Roberto Valente ◽  
Stefano Di Domenico ◽  
Matteo Mascherini ◽  
Gregorio Santori ◽  
Francesco Papadia ◽  
...  
Keyword(s):  
Pilot Study ◽  
Elective Surgery ◽  
Single Cohort

scholarly journals Protocol for a feasibility study of smoking cessation in the surgical pathway before major lung surgery: Project MURRAY

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e036568
Author(s):  
Sebastian T Lugg ◽  
Amy Kerr ◽  
Salma Kadiri ◽  
Alina-Maria Budacan ◽  
Amanda Farley ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Pilot Study ◽  
Thoracic Surgery ◽  
Elective Surgery ◽  
Primary Objective ◽  
Pulmonary Complications ◽  
University Hospitals ◽  
Patient Reported ◽  
Ethical Approval ◽  
Surgical Pathway

IntroductionSmoking prior to major thoracic surgery is the biggest risk factor for development of postoperative pulmonary complications, with one in five patients continuing to smoke before surgery. Current guidance is that all patients should stop smoking before elective surgery yet very few are offered specialist smoking cessation support. Patients would prefer support within the thoracic surgical pathway. No study has addressed the effectiveness of such an intervention in this setting on cessation. The overall aim is to determine in patients who undergo major elective thoracic surgery whether an intervention integrated (INT) into the surgical pathway improves smoking cessation rates compared with usual care (UC) of standard community/hospital based NHS smoking support. This pilot study will evaluate feasibility of a substantive trial.Methods and analysisProject MURRAY is a trial comparing the effectiveness of INT and UC on smoking cessation. INT is pharmacotherapy and a hybrid of behavioural support delivered by the trained healthcare practitioners (HCPs) in the thoracic surgical pathway and a complimentary web-based application. This pilot study will evaluate the feasibility of a substantive trial and study processes in five adult thoracic centres including the University Hospitals Birmingham NHS Foundation Trust. The primary objective is to establish the proportion of those eligible who agree to participate. Secondary objectives include evaluation of study processes. Analyses of feasibility and patient-reported outcomes will take the form of simple descriptive statistics and where appropriate, point estimates of effects sizes and associated 95% CIs.Ethics and disseminationThe study has obtained ethical approval from NHS Research Ethics Committee (REC number 19/WM/0097). Dissemination plan includes informing patients and HCPs; engaging multidisciplinary professionals to support a proposal of a definitive trial and submission for a full application dependent on the success of the study.Trial registration numberNCT04190966.

scholarly journals Effect of Preoperative Intravenous Pantoprazole in Elective-Surgery Patients: A Pilot Study

2008 ◽  
Vol 54 (5) ◽  
pp. 1041-1049 ◽  
Author(s):  
Joseph R. Pisegna ◽  
Robyn G. Karlstadt ◽  
Jeffrey A. Norton ◽  
Ronald Fogel ◽  
David S. Oh ◽  
...  
Keyword(s):  
Pilot Study ◽  
Elective Surgery

scholarly journals Early Post Operative Cognitive Dysfunction (POCD) in middle aged hypertensive patients: A pilot study

2014 ◽  
Vol 01 (03) ◽  
pp. 198-203 ◽  
Author(s):  
Nidhi Panda ◽  
Preethy Mathew ◽  
Y. Narayana ◽  
Aadarsh Kohli ◽  
Komal Gandhi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pilot Study ◽  
General Anaesthesia ◽  
Cognitive Dysfunction ◽  
Elective Surgery ◽  
Pilot Trial ◽  
Middle Aged ◽  
Hypertensive Patients ◽  
Prospective Pilot Study ◽  
Hypertensive Group

AbstractBackground: Nowadays, hypertension is prevalent in middle aged persons. Patients with hypertension are known to have cognitive dysfunction and, therefore, may be vulnerable for post-operative cognitive dysfunction (POCD) also. Intra-operative hypotension is documented to be associated with cognitive decline in hypertensive patients. Materials and Methods: A prospective pilot study was conducted in 30 hypertensive (Group H) and 30 non-hypertensive (Group N) patients, aged 40-59 years, undergoing elective surgery under general anaesthesia to estimate the incidence of early POCD in known hypertensive patients and compared with non-hypertensive patients. All patients underwent a “Neuro-psychological Test Battery” to assess cognitive function on preoperative day and on 7th postoperative day. A standard anaesthesia protocol was followed. Vasopressor boluses were used to maintain mean arterial pressure (MAP) within 20% of the baseline value in both groups. Results: The incidence of POCD was 23.3% in hypertensive patients and 20% in non-hypertensive patients. The vasopressor boluses used to maintain blood pressure was more in hypertensive patients (P = 0.041). Consequently, hypertensive patients had a significantly higher minimal MAP (P = 0.001) and a lower fractional minimal MAP (P = 0.011) compared to non-hypertensive patients. No significant correlation was observed between fractional minimal MAP and occurrence of POCD. Conclusion: This pilot trial shows that the incidence of early POCD in middle aged hypertensive and non-hypertensive patients are similar after general anaesthesia.

scholarly journals A Mobile App Specifically Designed to Facilitate Exercise in Parkinson Disease: Single-Cohort Pilot Study on Feasibility, Safety, and Signal of Efficacy

10.2196/18985 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e18985
Author(s):  
Merrill R Landers ◽  
Terry D Ellis
Keyword(s):  
Pilot Study ◽  
Adverse Events ◽  
Parkinson Disease ◽  
Exercise Program ◽  
Mobile App ◽  
Medical Attention ◽  
Timed Up And Go ◽  
Serious Adverse Events ◽  
Primary Endpoints ◽  
Single Cohort

Background Many people with Parkinson disease do not have access to exercise programs that are specifically tailored to their needs and capabilities. This mobile app allows people with Parkinson disease to access Parkinson disease–specific exercises that are individually tailored using in-app demographic questions and performance tests which are fed into an algorithm which in turn produces a video-guided exercise program. Objective To test the feasibility, safety, and signal of efficacy of a mobile app that facilitates exercise for people with Parkinson disease. Methods A prospective, single-cohort design of people with Parkinson disease who had downloaded the 9zest app for exercise was used for this 12-week pilot study. Participants, who were recruited online, were encouraged to exercise with the full automated app for ≥150 minutes each week. The primary endpoints were feasibility (app usage and usability questions) and safety (adverse events and falls). The primary endpoints for signal of efficacy were a comparison of the in-app baseline and 8-week outcomes on the 30-second Sit-To-Stand (STS) test, Timed Up and Go (TUG) test, and the Parkinson’s Disease Questionnaire 8 (PDQ8). Results For feasibility, of the 28 participants that completed the study, 12 participants averaged >150 minutes of app usage per week (3 averaged 120-150, 4 averaged 90-120, and 9 averaged less than 90 minutes). A majority of participants (>74%) felt the exercise was of value (16/19; 9 nonrespondents), provided adequate instruction (14/19; 9 nonrespondents), and was appropriate for level of function (16/19; 9 nonrespondents). For safety, there were no serious adverse events that occurred during the app-guided exercise. There were 4 reports of strain/sprain injuries while using the app among 3 participants, none of which necessitated medical attention. For signal of efficacy, there was improvement for each of the primary endpoints: STS (P=.01), TUG (P<.001), and PDQ8 (P=.01). Conclusions Independent, video-guided exercise using a mobile app designed for exercise in Parkinson disease was safe and feasible though there was variability in app usage. Despite this, the results provide evidence for a signal of efficacy as there were improvements in 3 of the 3 outcomes. Trial Registration ClinicalTrials.gov NCT03459586; https://clinicaltrials.gov/ct2/show/NCT03459586

scholarly journals A Mobile App Specifically Designed to Facilitate Exercise in Parkinson Disease: Single-Cohort Pilot Study on Feasibility, Safety, and Signal of Efficacy (Preprint)

2020 ◽  
Author(s):  
Merrill R Landers ◽  
Terry D Ellis
Keyword(s):  
Pilot Study ◽  
Adverse Events ◽  
Parkinson Disease ◽  
Exercise Program ◽  
Mobile App ◽  
Medical Attention ◽  
Timed Up And Go ◽  
Serious Adverse Events ◽  
Primary Endpoints ◽  
Single Cohort

BACKGROUND Many people with Parkinson disease do not have access to exercise programs that are specifically tailored to their needs and capabilities. This mobile app allows people with Parkinson disease to access Parkinson disease–specific exercises that are individually tailored using in-app demographic questions and performance tests which are fed into an algorithm which in turn produces a video-guided exercise program. OBJECTIVE To test the feasibility, safety, and signal of efficacy of a mobile app that facilitates exercise for people with Parkinson disease. METHODS A prospective, single-cohort design of people with Parkinson disease who had downloaded the 9zest app for exercise was used for this 12-week pilot study. Participants, who were recruited online, were encouraged to exercise with the full automated app for ≥150 minutes each week. The primary endpoints were feasibility (app usage and usability questions) and safety (adverse events and falls). The primary endpoints for signal of efficacy were a comparison of the in-app baseline and 8-week outcomes on the 30-second Sit-To-Stand (STS) test, Timed Up and Go (TUG) test, and the Parkinson’s Disease Questionnaire 8 (PDQ8). RESULTS For feasibility, of the 28 participants that completed the study, 12 participants averaged &gt;150 minutes of app usage per week (3 averaged 120-150, 4 averaged 90-120, and 9 averaged less than 90 minutes). A majority of participants (&gt;74%) felt the exercise was of value (16/19; 9 nonrespondents), provided adequate instruction (14/19; 9 nonrespondents), and was appropriate for level of function (16/19; 9 nonrespondents). For safety, there were no serious adverse events that occurred during the app-guided exercise. There were 4 reports of strain/sprain injuries while using the app among 3 participants, none of which necessitated medical attention. For signal of efficacy, there was improvement for each of the primary endpoints: STS (<i>P</i>=.01), TUG (<i>P</i>&lt;.001), and PDQ8 (<i>P</i>=.01). CONCLUSIONS Independent, video-guided exercise using a mobile app designed for exercise in Parkinson disease was safe and feasible though there was variability in app usage. Despite this, the results provide evidence for a signal of efficacy as there were improvements in 3 of the 3 outcomes. CLINICALTRIAL ClinicalTrials.gov NCT03459586; https://clinicaltrials.gov/ct2/show/NCT03459586

scholarly journals The value of the “Surgical Risk Preoperative Assessment System” (SURPAS) in preoperative consultation for elective surgery: a pilot study

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Michael R. Bronsert ◽  
Anne Lambert-Kerzner ◽  
William G. Henderson ◽  
Karl E. Hammermeister ◽  
Chisom Atuanya ◽  
...  
Keyword(s):  
Pilot Study ◽  
Elective Surgery ◽  
Preoperative Assessment ◽  
Assessment System ◽  
Surgical Risk

scholarly journals Laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting for acute cholecystitis: a pilot study of surgical feasibility

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fumihiro Kawano ◽  
Ryuji Yoshioka ◽  
Yu Gyoda ◽  
Hirofumi Ichida ◽  
Tomoya Mizuno ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Laparoscopic Cholecystectomy ◽  
Pilot Study ◽  
Acute Cholecystitis ◽  
Elective Surgery ◽  
Postoperative Hospital Stay ◽  
Urgent Surgery ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Median Blood Loss

Abstract Background Percutaneous transhepatic gallbladder drainage (PTGBD) is indicated for patients with acute cholecystitis (AC) who are not indicated for urgent surgery, but external tubes reduce quality of life (QOL) while waiting for elective surgery. The objective of the present study was to investigate the feasibility of laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting (ETGBS) comparing with after PTGBD. Methods Intraoperative and postoperative outcomes of patients with ETGBS and PTGBD were retrospectively compared. Results Eighteen ETGBS and ten PTGBD patients were compared. Differences in the duration of ETGBS and PTGBD [median 209 min (range 107–357) and median 161 min (range 130–273), respectively, P = 0.10], median blood loss [ETGBS 2 (range 2–180 ml) and PTGBD 24 (range 2–100 ml), P = 0.89], switch to laparotomy (ETGBS 11% and PTGBD 20%, P = 0.52), and median postoperative hospital stay [ETGBS 8 (range 4–24 days) and ETGBS 8 (range 4–16 days), P = 0.99]. Thickening of the cystic duct that occurred in 60% of the ETGBS patients and none of the PTGBD patients (P = 0.005) interfered with closure of the duct by clipping. No obstruction occurred in ETGBS patients. Conclusion ETGBS did not make laparoscopic cholecystectomy less feasible than after PTGBD. This is a pilot study, and further investigations are needed to validate the results of the present study.

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