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Available from: Joshua Beckman, Apr 01, 2014
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    ABSTRACT: INTRODUCTION: The outcome of patients who are scheduled for gastrointestinal surgery is influenced by various factors, the most important being the age and comorbidities of the patient, the complexity of the surgical procedure and the management of postoperative recovery. To improve patient outcome, close cooperation between surgeons and anaesthesiologists (joint risk assessment) is critical. This cooperation has become increasingly important because more and more patients are being referred to surgery at an advanced age and with multiple comorbidities and because surgical procedures and multimodal treatment modalities are becoming more and more complex. OBJECTIVE: The aim of this review is to provide clinicians with practical recommendations for day-to-day decision-making from a joint surgical and anaesthesiological point of view. The discussion centres on gastrointestinal surgery specifically.
    Langenbeck s Archives of Surgery 03/2011; 396(5):591-606. DOI:10.1007/s00423-011-0782-y · 2.16 Impact Factor
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    ABSTRACT: Purpose Measures of cardiorespiratory fitness (CRF) and heart rate recovery (HRR) can improve risk stratification for cardiovascular disease, but these measurements are rarely made in asymptomatic individuals due to cost. An exercise field test (EFT) to assess CRF and HRR would be an inexpensive method for cardiovascular disease risk assessment in large populations. This study assessed 1) the predictive accuracy of a 12-minute run/walk EFT for estimating CRF () and 2) the accuracy of HRR measured after an EFT using a heart rate monitor (HRM) in an asymptomatic population. Methods Fifty subjects (48% women) ages 18–45 years completed a symptom-limited exercise tolerance test (ETT) (Bruce protocol) and an EFT on separate days. During the ETT, was measured by a metabolic cart, and heart rate was measured continuously by a HRM and a metabolic cart. Results EFT distance and sex independently predicted. The average absolute difference between observed and predicted was 0.26±3.27 ml·kg−1·min−1 for our model compared to 7.55±3.64 ml·kg−1·min−1 for the Cooper model. HRM HRR data were equivalent to respective metabolic cart values during the ETT. HRR at 1 minute post-exercise during ETT compared to the EFT had a moderate correlation (r = 0.75, p<0.001). Conclusion A more accurate model to estimate CRF from a 12-minute run/walk EFT was developed, and HRR can be measured using a HRM in an asymptomatic population outside of clinical settings.
    PLoS ONE 05/2014; 9(5):e97704. DOI:10.1371/journal.pone.0097704 · 3.53 Impact Factor
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    BMJ (online) 01/2010; 340:b4616. · 16.38 Impact Factor