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Purpose: To summarize the best evidence for preventing delayed recovery (DR) after general anesthesia in older patients.
Design: Summary of best evidence.
Methods: A comprehensive literature search was conducted in both Chinese and international databases to identify evidence on preventing DR after general anesthesia in older patients. The databases searched included BMJ Best Practice, UpToDate, Joanna Briggs Institute, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, The Association of Perioperative Registered Nurses, American Society of Anesthesiologists, Canadian Anesthetists Society, Cochrane Library, PubMed, Medlive, Chinese Anesthesia website, China National Knowledge Infrastructure, and Wanfang Data. The search encompassed clinical decisions, guidelines, evidence summaries, systematic reviews, and expert consensus statements, spanning from the establishment of the database to September 2024. Two reviewers independently screened and evaluated the literature, and then extracted and summarized the evidence according to the Joanna Briggs Institute Grades of Recommendation and Levels of Evidence.
Findings: A total of 13 articles were included, namely 3 clinical decisions, 5 guidelines, and 5 expert consensus statements. Thirty-one best evidence points were derived across nine areas, including preoperative assessment, brain protection strategies, fluid management, circulation management, respiratory management, temperature regulation, internal environment stabilization, neuromuscular monitoring, and recovery management.
Conclusions: The integration and clinical application of best evidence by health care professionals can reduce the incidence of DR after general anesthesia in older patients.
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http://dx.doi.org/10.1016/j.jopan.2025.04.001 | DOI Listing |
Bone Marrow Transplant
September 2025
Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain.
For over two decades, the EBMT has updated recommendations on indications for haematopoietic cell transplantation (HCT) practice based on clinical and scientific developments in the field. This is the ninth special EBMT report on indications for HCT for haematological diseases, solid tumours and immune disorders. Our aim is to provide guidance on HCT indications according to prevailing clinical practice in EBMT countries and centres.
View Article and Find Full Text PDFCuad Bioet
September 2025
Facultad de Farmacia y Nutrición de la Universidad de Navarra, Irunlarrea, 1, 31008 Pamplona.
In recent years, there has been a significant increase in minors with gender dysphoria (GD) seeking transition treatments, including puberty blockers and cross-sex hormones. The developing child's brain exhibits structural and functional differences in children with GD compared to cisgender children, particularly in areas where sex differences exist. Brain development during childhood and adolescence is strongly influenced by sex hormones.
View Article and Find Full Text PDFJMIR Med Inform
September 2025
Department of Radiology, Air Force Medical Center, Air Force Medical University, Fucheng Road 30, Haidian District, Beijing, CN.
Background: Lateral malleolar avulsion fracture (LMAF) and subfibular ossicle (SFO) are distinct entities that both present as small bone fragments near the lateral malleolus on imaging, yet require different treatment strategies. Clinical and radiological differentiation is challenging, which can impede timely and precise management. On imaging, magnetic resonance imaging (MRI) is the diagnostic gold standard for differentiating LMAF from SFO, whereas radiological differentiation on computed tomography (CT) alone is challenging in routine practice.
View Article and Find Full Text PDFAnim Cogn
September 2025
Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.
Although many animal species are known to learn to respond to human verbal commands, this ability is understudied, as are the cues used to do so. For the best-studied species, the dog, domestication itself is used to justify successful attending to human communicative cues. However, the role of domestication in sensitivity to human cues remains debated.
View Article and Find Full Text PDFHernia
September 2025
Center for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, Herlev, DK-2730, Denmark.
Purpose: Primary ventral hernia repair is a common elective procedure; however, mesh placement practices vary widely, and there is limited evidence to guide optimal placement. This international study examined surgeons' preferences and considerations regarding mesh placement in elective primary ventral hernia repair.
Methods: We conducted an international cross-sectional survey targeting surgeons experienced in primary ventral hernia repair.