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Background: Preoperative malnourishment has been consistently associated with poor outcomes after radical cystectomy and other major abdominal surgeries. Most enhanced recovery after surgery (ERAS) studies have examined preoperative nutrition and its relationship to outcomes after gastrointestinal surgery. Although numerous studies have demonstrated the benefits of using an ERAS protocol, this study in unique in comparing 2 ERAS protocols, with and without a nutrition component., Methods: A formalized preoperative nutrition protocol (PNP) recommending use of preoperative immunonutrition and carbohydrate drink was introduced in June 2018. A total of 78 consecutive patients who drank both beverages were compared with 92 historical controls. Multivariable logistic regression analyses were sequentially performed to determine if preoperative nutrition was associated with binary outcome variables (30-day complication, infectious complication, and readmission within 30 days)., Results: The preoperative nutrition group and control group were statistically similar in distribution of age, sex, American Society of Anesthesiologists physical status classification, clinical stage, and body mass index. Return of bowel function was found to occur earlier in the preoperative nutrition group than in the control group (3.12 vs 3.74 days; relative risk, 0.82; CI, 0.73-0.93; P = .0029). Complications within 30 days were similar in both groups (63.6% vs 55.4%; P = 0.36). Infectious complications (42.9% vs 37%; P = .53) and readmission within 30 days (22.1% vs 15.2%; P = .34) were also similar in both groups., Conclusions: Use of a PNP including immunonutrition and carbohydrate drink may be associated with earlier return of bowel function after radical cystectomy., (© 2021 American Society for Parenteral and Enteral Nutrition.)

Two groups of chronically ill patients, alike in some respects of psychological stress and physical limitations but differing in degrees of physical threat to life because of treatment, were compared in terms of quality of life. Twenty patients undergoing hemodialysis at a satellite center and 20 patients with severe osteoarthritis receiving care at a hospital clinic, ranging in age from 40 to 60 years, were randomly selected and asked to rate themselves on Cantril's self-anchoring scale in relation to pase, present, and future life satisfaction. An ANOVA for simple main effects indicated that patients undergoing hemodialysis viewed present life satisfaction significantly higher, F = 4.81, p less than .05, than did patients with arthritis. Expectation for greater life satisfaction tended to be slightly better for dialysis patients, but not significantly so; past life satisfaction was the same for both groups. Dialysis patients viewed their present life better than past life, whereas arthritis patients had the opposite viewpoint. The increased life satisfaction among dialysis patients may be the result of an increased sense of physical well-being because of the dialysis procedure, and chronic pain may be a factor in the decreased life satisfaction among arthritis patients.

The purpose of this study was to assess life satisfaction in osteoarthritics and to explore relationships between that variable and health perception, health locus of control, and illness-related factors. The study group consisted of 160 osteoarthritics from four different types of settings. The osteoarthritics rated their present life satisfaction and recent health as relatively good and were externally controlled in terms of their health beliefs. Present life satisfaction was related to better health perception, internal locus of control, and less joint pain.