Weavermaldonado6231

The purpose of this study was to describe the caregiver's proxy-report of the quality of life (QoL) of children with cancer and the main family caregiver's competence, and to examine the role of said competence and other care-related variables in their proxy-reported QoL of children with cancer.

This was a cross sectional, correlation design study conducted with 97 main family caregivers of children between the ages of 8 and 12 years with cancer residing in Colombia. The following variables were collected main family caregiver and child sociodemographic characteristics (Survey for Dyad Care; GCPC-UN-D), The Pediatric Quality of Life Inventory 4.0 Cancer Module, and the Competence Instrument (caregiver version).

The mean of the children's QoL was 102.0 points, and the caregivers' competence score was 211.24. Caregiver's competence (

= 5.814,

< .01), marital status (

= 1.925,

< .05), time as a caregiver (

= 2.087,

< .05), number of hours spent caring for the child (

= 2.621,

&rs' proxy-report about their children's QoL.

Standard preoperative protocols in total joint arthroplasty utilise the international normalised ratio (INR) to determine patient coagulation profiles. However, the relevance of preoperative INR values in joint arthroplasty remains controversial. Therefore, we examined (1) the relationship between preoperative INR values and various outcome measures, including, but not limited to surgical site complications, medical complications, bleeding, number of readmissions, and mortality. Additionally, we sought to determine (2) specific INR values associated with these complications and (3) cutoff INR levels which correlated with specific outcomes. We additionally applied these analyses to (4) examine the relationship between INR and length-of-stay (LOS).

The American College of Surgeons National Surgical Quality Improvement Program database (ACS-NSQIP) was queried for rTHA procedures performed between 2006 and 2017. INR ranges were used to stratify cohorts ⩽1.0, 1.0-⩽1.25, 1.25-⩽1.5, >1.5. INR values were deter analysis illustrates a direct relationship between specific preoperative INR levels and poor outcomes following rTHA, including increased LOS, transfusion requirements and infection. Therefore, current INR guideline targets may need to be re-examined when optimising patients for revision arthroplasty.

Our analysis illustrates a direct relationship between specific preoperative INR levels and poor outcomes following rTHA, including increased LOS, transfusion requirements and infection. Therefore, current INR guideline targets may need to be re-examined when optimising patients for revision arthroplasty.

A new regional anaesthetic technique, coined the pericapsular nerve group (PENG) block, targets the anterior hip capsule by blocking the articular branches of the femoral nerve and accessory obturator nerve. In this study, we evaluated (1) patient outcomes; (2) postoperative pain scores; and (3) postoperative opioid consumption in total hip arthroplasty (THA) patients who received a PENG block in comparison to a control group.

A retrospective chart review was performed for patients who underwent primary THA and met criteria at a single institution (

 = 48), with an additional cohort of patients collected as controls (

 = 48). Postoperative pain scores were measured by obtaining the cumulative visual analogue scores (VAS) at 12-hour intervals until the 48-hour benchmark. All administered opioids were collected from postoperative day (POD) 0 to POD2 and converted to morphine milligram equivalents (MME).

In the PENG group, length of stay was significantly shorter (

 

 0.001) and the initial postoperative distance walked was significantly farther (

 = 0.001). The PENG group consistently demonstrated significantly lower mean cumulative pain scores until the 48-hour mark (

 

 0.001 for all). Patients receiving the PENG block also experienced a significantly longer therapeutic window before requiring their first opioid (

 

 0.002). The PENG group required significantly less opioid MMEs on POD1, POD2, and cumulatively over the entire stay (

 

 0.022 for all).

Our findings suggest that the PENG block has the potential of impacting THA recovery pathways and contributing to cost savings. Thus, its use further supports the transition to the outpatient setting and drives us towards achieving value-driven healthcare.

Our findings suggest that the PENG block has the potential of impacting THA recovery pathways and contributing to cost savings. Thus, its use further supports the transition to the outpatient setting and drives us towards achieving value-driven healthcare.Background Previous studies regarding survival in patients with splanchnic vein thrombosis (SVT) are limited. This study measured overall survival in a large cohort of SVTs through linkage to population-based data. Methods and Results Using a previously derived text-search algorithm, we screened the reports of all abdominal ultrasound and contrast-enhanced computed tomography studies at The Ottawa Hospital over 14 years. Screen-positive reports were manually reviewed by at least 2 authors to identify definite SVT cases by consensus. Images of uncertain studies were independently reviewed by 2 radiologists. One thousand five hundred sixty-one adults with SVT (annual incidence ranging from 2.8 to 5.9 cases/10 000 patients) were linked with population-based data sets to measure the presence of concomitant cancer and survival status. Thrombosis involved multiple veins in 314 patients (20.1%), most commonly the portal vein (n=1410, 90.3%). Compared with an age-sex-year matched population, patients with SVT had significantly reduced survival in particular with local cancer (adjusted relative excess risk for recent cases 12.0 [95% CI, 9.8-14.6] and for remote cases 9.7 [7.7-12.2]), distant cancer (relative excess risk for recent cases 5.7 [4.5-7.3] and for remote cases 5.4 [4.4-6.6]), cirrhosis (relative excess risk 8.2 [5.3-12.7]), and previous venous thromboembolism (relative excess risk 3.8 [2.4-6.0]). One hundred fifty (23.9%) of patients >65 years of age were anticoagulated within 1 month of diagnosis. Conclusions SVT is more common than expected. ML385 manufacturer Most patients have cancer and the portal vein is by far the most common vein involved. Compared with the general population, patients with SVT had significantly reduced survival, particularly in patients with concomitant cancer, cirrhosis, and previous venous thromboembolic disease. Most elderly patients did not receive anticoagulant therapy.