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JMIR Perioperative Medicine (JPOP, Editor-in-chief: John F. Pearson MD, Harvard Medical School) is a new sister journal of JMIR (the leading open-access journal in health informatics (Impact Factor 2016: 5.175), focusing on technologies, medical devices, apps, engineering, informatics and patient education for perioperative medicine and nursing, including pre- and post-operative education, preventative interventions and clinical care for surgery and anaesthesiology patients, as well as informatics applications in anesthesia, surgery, critical care and pain medicine.
As open access journal we are read by clinicians and patients alike and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews).
During a limited period of time, there are no fees to publish in this journal. Articles are carfully copyedited and XML-tagged, ready for submission in PubMed Central.
Be a founding author of this new journal and submit your paper today!
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Background: Proof-of-concept study to determine the feasibility of incorporating a virtual reality tour for children scheduled to receive radiation therapy. The secondary objective was to qualitativel...
Background: Proof-of-concept study to determine the feasibility of incorporating a virtual reality tour for children scheduled to receive radiation therapy. The secondary objective was to qualitatively describe each subject's virtual reality experience. Methods: Children ages 13 or older scheduled to receive proton radiation therapy were included in the study. Subjects watched the virtual reality tour of the radiation therapy facility with a child life therapist experienced in coaching children receiving radiation therapy and completed a survey after the tour. Results: Eight subjects consented for participation and 6 completed the virtual reality tour. All of the enrolled patients completed the virtual reality tour successfully. Two subjects did not complete the survey. Two subjects requested to pause the tour to ask questions about the facility. Five subjects said the virtual reality tour was helpful preparation before undergo proton radiation therapy. Subjects stated that the tour was helpful because ‘it showed me what’s to come’ and it was helpful to see ‘what it’s like to lay in the machine.’ One subject said ‘it made me feel less nervous.’ Six subjects stated that they would like to see this type of tour available for other areas of the hospital, such as diagnostic imaging rooms. None of the subjects experienced nausea or vomiting. Conclusions: The virtual reality video tour allowed patients to explore the treatment facility in a comfortable environment. Participants expressed that the tour was beneficial and would appreciate seeing other parts of the hospital in this way.
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Background: Postoperative cognitive decline (POCD) is defined as a new cognitive impairment arising after surgical intervention. Aspects of cognitive function can be assessed using various validated c...
Background: Postoperative cognitive decline (POCD) is defined as a new cognitive impairment arising after surgical intervention. Aspects of cognitive function can be assessed using various validated cognitive function tests including: N back; Stroop; and Lexical Decision Making Task (LDT). There is some concern that prolonged Trendelenburg positioning during laparoscopic colorectal surgery may cause POCD. Objective: To assess the effect of the time spent in Trendelenburg position on cognitive function. Methods: Volunteers were placed in Trendelenburg for 3 hours, then supine for 30 minutes. Validated cognitive function tests including: 1,2, 3 back; Stroop; and LDT were performed at baseline and every 30 minutes after Trendelenburg position. Cognitive decline was defined as per the ISPOCD trial : a decrease in accuracy from the volunteers’ baseline or an increase in response time (RT) from the volunteers’ baseline by > 2 control group standard deviations (SD). Results: Fifteen healthy volunteers were recruited (8 male, 7 female), average age of 69 years (range:57-81) and average BMI of 27.7 kg/m2 (range:20.9-33). Accuracy remained within 2 SDs at all time-points. An increase in RT did occur with 20% showing cognitive decline after 30 minutes in Trendelenburg position, 26.7% after 1 hour, 33.3% after 90 minutes, 26.7% after 120 and 150 minutes; and 40% after 180 minutes. When moved supine, 33.3% had cognitive decline. Conclusions: The results of this study indicate that Trendelenburg positioning appears to lead to cognitive decline. This may have implications for patients undergoing prolonged Trendelenburg positioning in laparoscopic colorectal surgery.
Background: The incidence of perioperative visual loss following colorectal surgery is quoted as 1.24 per 10,000 in USA. Raised IOP during extreme Trendelenburg position leading to reduced optic nerve...
Background: The incidence of perioperative visual loss following colorectal surgery is quoted as 1.24 per 10,000 in USA. Raised IOP during extreme Trendelenburg position leading to reduced optic nerve perfusion is thought to be a cause. Objective: Assess the effect of the degree of Trendelenburg tilt and time spent in Trendelenburg on IOP during laparoscopic colorectal surgery. Methods: Fifty patients undergoing laparoscopic colorectal surgery were recruited. IOP measurements using a Tonopen® XL applanation tonometer were taken, and repeated hourly during surgery and each time the operating table was tilted. A correlation coefficient for the degree of Trendelenburg tilt and IOP was calculated for each patient. Group 1 included patients undergoing a right-sided colonic procedure and Group 2 included all left-sided colonic procedures. Results: Group 1 (n=25) had a mean age of 68.7years (SD=13.9) and Group 2 (n=25) 62.5years (SD=16.4), (p>0.05). The average length of surgery for Group 1 was 141.6minutes (SD=48.3) and Group 2 was 267.7minutes (SD=99) (P≤0.05). The mean maximum degree of Trendelenburg tilt in Group 1 was 9.7o (SD=7.4) and Group 2 was 18.6o (SD=5.8), (p≤0.05). The mean IOP rise was 9.3mmHg (SD=5.3) in Group 1 and 15.2mmHg (SD=5.2) in Group 2 (p≤0.05). An overall correlation coefficient for the degree of Trendelenburg tilt and IOP change (n=48) was 0.78. Conclusions: There is a strong correlation between IOP rises during laparoscopic colorectal surgery and the degree of Trendelenburg tilt. This may be significant for patients undergoing prolonged surgery and especially those with glaucoma.