Seminars in Colon and Rectal Surgery最新文献

Identifying and optimizing psychosocial frailty in surgical practice 在外科实践中识别和优化社会心理脆弱性

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Seminars in Colon and Rectal Surgery Pub Date : 2024-11-06 DOI: 10.1016/j.scrs.2024.101061

Kurt S. Schultz MD, Caroline E. Richburg MD, Emily Y. Park MD, Ira L. Leeds MD MBA ScM

引用次数: 0

Improving surgical outcomes for older adults with adoption of technological advances in comprehensive geriatric assessment 采用先进技术进行老年综合评估，改善老年人的手术效果

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Seminars in Colon and Rectal Surgery Pub Date : 2024-11-06 DOI: 10.1016/j.scrs.2024.101060

Sydney F Tan MD, Benjamin Cher MD, Julia R Berian MD, MS

{"title":"Improving surgical outcomes for older adults with adoption of technological advances in comprehensive geriatric assessment","authors":"Sydney F Tan MD, Benjamin Cher MD, Julia R Berian MD, MS","doi":"10.1016/j.scrs.2024.101060","DOIUrl":"10.1016/j.scrs.2024.101060","url":null,"abstract":"<div><div>Frailty is a well-recognized predictor of poor surgical outcomes for older adults, yet effective measurements and interventions remain limited. Technological advances offer an opportunity to address this gap and improve surgical care for older adults. This paper reviews the background of frailty and comprehensive geriatric assessments in surgery, and how technological innovations can advance frailty measurement and intervention in surgical settings. We review two broad areas of technological advancement as applied to frailty in surgery: (1) Innovation in the use of electronic health records (EHR) using Artificial Intelligence (AI) and Machine Learning (ML), and (2) Novel uses for wearable sensors and mobile health (mHealth) applications. We explore the integration of AI and ML with EHR systems, which can surpass traditional comorbidity indices by providing comprehensive health assessments and enhancing prediction models. Innovations like the electronic Frailty Index (eFI) show promise in expanding the reach of frailty assessments and facilitating real-time screening. Additionally, wearable devices and mobile health (mHealth) applications offer new ways to monitor and improve physical activity, nutrition, and psychological well-being, supporting perioperative rehabilitation. While these technologies present challenges, such as the need for infrastructure, training, and data interoperability, they offer promising strategies to facilitate the assessment and management of frailty among surgical patients. Continued research and tailored implementation strategies will be essential to fully realize the potential of these advancements in improving surgical outcomes for frail older adults.</div></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 4","pages":"Article 101060"},"PeriodicalIF":0.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pearls for counseling older adults on the indications for stopping colon cancer screening 向老年人提供有关停止结肠癌筛查指征的指导原则

IF 0.4

Seminars in Colon and Rectal Surgery Pub Date : 2024-11-06 DOI: 10.1016/j.scrs.2024.101065

Josh Sommovilla MD

{"title":"Pearls for counseling older adults on the indications for stopping colon cancer screening","authors":"Josh Sommovilla MD","doi":"10.1016/j.scrs.2024.101065","DOIUrl":"10.1016/j.scrs.2024.101065","url":null,"abstract":"<div><div>Colorectal cancer remains a leading cause of mortality, making effective screening procedures like colonoscopy essential in reducing associated risks. The cessation of colorectal cancer screening in older adults presents complex challenges, particularly as guidelines recommend screening initiation at age 45 and emphasize individualized decision-making for older populations. Key considerations include balancing procedural risks, cancer risk, overall health prognosis, and patient preferences. The risks associated with colonoscopy are especially pertinent for older patients with comorbidities, necessitating the use of prognostic tools like ePrognosis and the Charlson Comorbidity Index to inform screening decisions. High-risk individuals may experience increased anxiety about cancer, complicating the decision-making process, as many have historically relied on regular surveillance. Perspectives from both physicians and patients reveal significant uncertainty regarding screening cessation, highlighting the importance of patient involvement in these discussions. Effective communication strategies are crucial, advocating for recommendations that align with patients' broader health goals rather than focusing solely on age-related actuarial data. Ultimately, navigating the intricacies of colorectal cancer screening cessation in older adults requires a patient-centered approach that minimizes risks while respecting individual values and health goals.</div></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 4","pages":"Article 101065"},"PeriodicalIF":0.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utilizing a defined multiphase, multispecialty perioperative pathway to achieve functional recovery after surgery 利用确定的多阶段、多专科围手术期路径实现术后功能恢复

IF 0.4

Seminars in Colon and Rectal Surgery Pub Date : 2024-11-06 DOI: 10.1016/j.scrs.2024.101064

Federica Greco MD , Isacco Montroni MD, PhD

{"title":"Utilizing a defined multiphase, multispecialty perioperative pathway to achieve functional recovery after surgery","authors":"Federica Greco MD , Isacco Montroni MD, PhD","doi":"10.1016/j.scrs.2024.101064","DOIUrl":"10.1016/j.scrs.2024.101064","url":null,"abstract":"<div><div>This article emphasizes the need for a personalized approach in managing older cancer patients, highlighting the importance of a multidisciplinary team that tailors treatment to the patient's specific health conditions and goals. The objective is to balance positive oncological outcomes with the restoration of independence, reduction of disabilities and enhancement of quality of life. Functional recovery is central to treatment decisions as disability can impact cancer patients more than the prognosis itself. The paper stresses the value of frailty screening tools, nutritional assessment and physical evaluation which help predict postoperative outcomes and guide clinical management. It advocates for comprehensive preoperative evaluations, including geriatric assessments, to prevent both undertreatment and overtreatment. Multimodal prehabilitation can improve postoperative outcomes, reduce healthcare costs, and help older patients remain engaged in society. The article concludes by recommending a patient-centered, individualized approach to optimize functional recovery and alleviate the economic burden on healthcare systems.</div></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 4","pages":"Article 101064"},"PeriodicalIF":0.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When and how to adapt care in frail older adults 何时以及如何调整对体弱老年人的护理

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Seminars in Colon and Rectal Surgery Pub Date : 2024-11-06 DOI: 10.1016/j.scrs.2024.101063

Erin Isenberg MD , Maedeh Marzoughi BS , Pasithorn A. Suwanabol MD, MS

引用次数: 0

Ensuring goal-aligned care in a busy surgical practice 在繁忙的外科实践中确保目标一致的护理

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Seminars in Colon and Rectal Surgery Pub Date : 2024-11-06 DOI: 10.1016/j.scrs.2024.101062

Jessica N. Cohan MD, MAS, FACS, FASCRS

引用次数: 0

The impact of federally legislated colon and rectal cancer screening programs and policy in the United States 美国联邦立法的结肠癌和直肠癌筛查计划和政策的影响

IF 0.4

Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101040

Sarah M. Kling MD, MPH , Simran Kripalani MD , Valeda Yong MD, MSEd , Juan Lucas Poggio MD

{"title":"The impact of federally legislated colon and rectal cancer screening programs and policy in the United States","authors":"Sarah M. Kling MD, MPH , Simran Kripalani MD , Valeda Yong MD, MSEd , Juan Lucas Poggio MD","doi":"10.1016/j.scrs.2024.101040","DOIUrl":"10.1016/j.scrs.2024.101040","url":null,"abstract":"<div><h3>Introduction</h3><p>Colorectal cancer (CRC) is the third leading cause of cancer deaths for men and women separately and the second leading cause of cancer deaths for men and women combined. CRC screening allows for cancer prevention, early treatment, or cure. Thus, screening can decrease the incidence and mortality of CRC. This supports the importance of making efforts to improve screening rates through public health programs and policy.</p></div><div><h3>Programs and Policy</h3><p>Government sponsored public health programs have been shown to be effective at increasing CRC screening rates at comparable costs across multiple regions and populations in the United States. Additionally, policy has been evolving to provide more comprehensive coverage of CRC screening tests.</p></div><div><h3>Conclusion</h3><p>Both public health programming and policy are important tools to increase CRC screening rates, with the ultimate goals of decreasing CRC incidence and mortality. CRC screening and its dissemination has been shown to be adoptable and cost effective, and should continue to be the focus of public health programming and policy efforts.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 3","pages":"Article 101040"},"PeriodicalIF":0.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advanced practice providers: An evolution of scope of practice and clinical integration across the surgical healthcare landscape 高级实践提供者：整个外科医疗领域的执业范围和临床整合的演变

IF 0.4

Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101039

Kelly M. Tyler M.D.

{"title":"Advanced practice providers: An evolution of scope of practice and clinical integration across the surgical healthcare landscape","authors":"Kelly M. Tyler M.D.","doi":"10.1016/j.scrs.2024.101039","DOIUrl":"10.1016/j.scrs.2024.101039","url":null,"abstract":"<div><p>Advanced practice providers (APPs) have become an integral part of surgical practice over the past 50 years. Understanding the clinical roles of Physician Assistants (PAs) and Nurse Practitioners (NPs) provides insight into practice norms, collaborative opportunities, the nuances of APP independent practice trends, billing practices, and current practice challenges.</p><p>Exploring the history, education, and current practice environment of APPs allows a sophisticated understanding of their roles in the inpatient/facility and outpatient/office settings. This article explores the impact of APPs on access to care, and their role across the overall healthcare landscape in the United States particularly as government and healthcare continue to intersect.</p><p>The aim of this work is to provide the reader with a nuanced understanding of the factors influencing the current practice of APPs working in surgical fields in the United States and to foster an authentic appreciation of the existing complexities of APPs practicing in the field of surgery in the context of the current evolving national healthcare landscape.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 3","pages":"Article 101039"},"PeriodicalIF":0.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effects of current health policy on social determinants of health, implications in colon and rectal surgery 当前卫生政策对健康的社会决定因素的影响，对结肠和直肠外科的影响

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Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101041

Abdul S Hassan MD , David A Swift MD MPH , Courtney L Devin MD

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The importance of physician engagement in healthcare policy and advocacy 医生参与医疗政策和宣传的重要性

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Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101043

By Ross F. Goldberg MD

引用次数: 0