1
|
Shuford R, Miller-Ocuin JL. Hyperglycemia in the Perioperative Period. Clin Colon Rectal Surg 2023; 36:198-200. [PMID: 37113276 PMCID: PMC10125294 DOI: 10.1055/s-0043-1761153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Perioperative hyperglycemia is a risk factor in surgical patients. Complications, including infection and mortality, are associated with hyperglycemia in both diabetic and nondiabetic patients. Stress hyperglycemia results in a state of insulin resistance. Insulin administration has been shown to reduce the complications associated with hyperglycemia. Glycemic targets provide goals for individualized treatment of hyperglycemia in surgical patients in the preoperative, intraoperative, and postoperative periods.
Collapse
Affiliation(s)
- Rebecca Shuford
- Department of Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - Jennifer L. Miller-Ocuin
- Division of Colorectal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| |
Collapse
|
2
|
Shuford R, Ashburn JH. Don't Forget about the K-Pouch! Clin Colon Rectal Surg 2022; 35:499-504. [PMID: 36591399 PMCID: PMC9797262 DOI: 10.1055/s-0042-1758192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The continent ileostomy (CI) was popularized by Nils Kock as a means to provide fecal continence to patients, most commonly in those with ulcerative colitis, after proctocolectomy. Although the ileal pouch-anal anastomosis (IPAA) now represents the most common method to restore continence after total proctocolectomy, CI remains a suitable option for highly selected patients who are not candidates for IPAA or have uncorrectable IPAA dysfunction but still desire fecal continence. The CI has exhibited a fascinating and marked evolution over the past several decades, from the advent of the nipple-valve to a distinct pouch design, giving the so-inclined and so-trained colorectal surgeon a technique that provides the unique patient with another option to restore continence. The CI continues to offer a means for appropriately selected patients to achieve the highest possible quality of life (QOL) and functional status after total proctocolectomy.
Collapse
Affiliation(s)
- Rebecca Shuford
- Department of Surgery, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Jean H. Ashburn
- Department of Surgery, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| |
Collapse
|
3
|
Ames N, Shuford R, Yang L, Moriyama B, Frey M, Wilson F, Sundaramurthi T, Gori D, Mannes A, Ranucci A, Koziol D, Wallen GR. Music Listening Among Postoperative Patients in the Intensive Care Unit: A Randomized Controlled Trial with Mixed-Methods Analysis. Integr Med Insights 2017; 12:1178633717716455. [PMID: 28904523 PMCID: PMC5588801 DOI: 10.1177/1178633717716455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/25/2017] [Indexed: 11/17/2022]
Abstract
Background: Music listening may reduce the physiological, emotional, and mental effects of distress and anxiety. It is unclear whether music listening may reduce the amount of opioids used for pain management in critical care, postoperative patients or whether music may improve patient experience in the intensive care unit (ICU). Methods: A total of 41 surgical patients were randomized to either music listening or controlled non-music listening groups on ICU admission. Approximately 50-minute music listening interventions were offered 4 times per day (every 4-6 hours) during the 48 hours of patients’ ICU stays. Pain, distress, and anxiety scores were measured immediately before and after music listening or controlled resting periods. Total opioid intake was recorded every 24 hours and during each intervention. Results: There was no significant difference in pain, opioid intake, distress, or anxiety scores between the control and music listening groups during the first 4 time points of the study. However, a mixed modeling analysis examining the pre- and post-intervention scores at the first time point revealed a significant interaction in the Numeric Rating Scale (NRS) for pain between the music and the control groups (P = .037). The Numeric Rating Score decreased in the music group but remained stable in the control group. Following discharge from the ICU, the music group’s interviews were analyzed for themes. Conclusions: Despite the limited sample size, this study identified music listening as an appropriate intervention that improved patients’ post-intervention experience, according to patients’ self-report. Future mixed methods studies are needed to examine both qualitative patient perspectives and methodology to improve music listening in critical care units.
Collapse
Affiliation(s)
- Nancy Ames
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Rebecca Shuford
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Li Yang
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Brad Moriyama
- Pharmacy Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Meredith Frey
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Florencia Wilson
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Danelle Gori
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Andrew Mannes
- Department of Perioperative Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Alexandra Ranucci
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Deloris Koziol
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Gwenyth R Wallen
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
4
|
Sanger D, Hernandez D, Libes S, Voulgaris G, Davis B, Smith E, Shuford R, Porter D, Koepfler E, Bennett J. A case history of the science and management collaboration in understanding hypoxia events in Long Bay, South Carolina, USA. Environ Manage 2010; 46:340-350. [PMID: 20676889 DOI: 10.1007/s00267-010-9529-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Accepted: 07/01/2010] [Indexed: 05/29/2023]
Abstract
Communication of knowledge between the scientific and management communities is a difficult process complicated by the distinctive nature of professional career goals of scientists and decision-makers. This article provides a case history highlighting a collaboration between the science and management communities that resulted from a response to a 2004 hypoxia, or low dissolved oxygen, event in Long Bay, off Myrtle Beach, South Carolina. A working group of scientists and decision-makers was established at the time of the event and has continued to interact to develop a firm understanding of the drivers responsible for hypoxia formation in Long Bay. Several factors were found to be important to ensure that these collaborative efforts were productive: (1) genuine interest in collaboratively working across disciplines to examine a problem; (2) commitment by agency leadership, decision-makers, and researchers to create successful communication mechanisms; (3) respect for each others' perspectives and an understanding how science and management are performed and that they are not mutually exclusive; (4) networking among researchers and decision-makers to ensure appropriate team members are involved in the process; (5) use of decision-maker input in the formulation of research and monitoring projects; and (6) commitment of resources for facilitation to ensure that researchers and decision-makers are communicating effectively.
Collapse
Affiliation(s)
- Denise Sanger
- South Carolina Sea Grant Consortium, Charleston, SC, 29401, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|