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| 1 | Management of femoral neck fractures in the young patient: A critical analysis review显示文摘Femoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls.Currently there may be sufficient evidence to support the routine use of hip replacement surgery for low demand elderly patients in all but non-displaced and valgus impacted femoral neck fractures.However for the physiologically young patients,preservation of the natural hip anatomy and mechanics is a priority in management because of their high functional demands.The biomechanical challenges of femoral neck fixation and the vulnerability of the femoral head blood supply lead to a high incidence of non-union and osteonecrosis of the femoral head after internal fixation of displaced femoral neck fractures.Anatomic reduction and stable internal fixation are essentials in achieving the goals of treatment in this young patient population.Furthermore,other management variables such as surgical timing,the role of capsulotomy and the choice of implant for fixation remaincontroversial.This review will focus both on the demographics and injury profile of the young patient with femoral neck fractures and the current evidence behind the surgical management of these injuries as well as their major secondary complications. | Thierry Pauyo Justin Drager Anthony Albers Edward J Harvey | 2014 | World Journal of Orthopedics2014,5,3: | 70 |
| 2 | Pathological evidence for residual SARS-CoV-2 in pulmonary tissues of a ready-for-discharge patient显示文摘Dear Editor,SARS-CoV-2,a novel coronavirus and causing COVID-19,has given rise to a worldwide pandemic.1,2 So far,tens of thousands of COVID-19 patients have been clinically cured and discharged,but multiple COVID-19 cases showed SARS-CoV-2 positive again in discharged patients,3 which raises an attention for the discharged patients.Also,there is an urgent need to understand the pathogenesis of SARS-CoV-2 infection.Here,we conducted postmortem pathologic study in a ready-fordischarge COVID-19 patient who succumbed to sudden cardiovascular accident.Pathological examination revealed SARSCoV-2-viruses remaining in pneumocytes and virus-caused pathological changes in the lungs.Our study provided new insights into SARS-CoV-2 pathogenesis and might facilitate the improvement of clinical guideline for virus containment and disease management. | Xiao-Hong Yao Zhi-Cheng He Ting-Yuan Li Hua-Rong Zhang Yan Wang Huaming Mou Qiaonan Guo Shi-Cang Yu Yanqing Ding Xindong Liu Yi-Fang Ping Xiu-Wu Bian | 2020 | Cell Research2020,30,6: | 35 |
| 3 | Gastroesophageal reflux disease: Important considerations for the older patients显示文摘Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder seen in the elderly. The worldwide incidence of GERD is increasing as the incidence of Helicobacter pylori is decreasing. Although elderly patients with GERD have fewer symptoms, their disease is more often severe. They have more esophageal and extraesophageal complications that may be potentially life threatening. Esophageal complications include erosive esophagitis, esophageal stricture, Barrett's esophagus and adenocarcinoma of the esophagus. Extraesophageal complications include atypical chest pain that can simulate angina pectoris; ear, nose, and throat manifestations such as globus sensation, laryngitis, and dental problems; pulmonary problems such as chronic cough, asthma, and pulmonary aspiration. A more aggressive approach may be warranted in the elderly patient, because of the higher incidence of severe complications. Although the evaluation and management of GERD are generally the same in elderly patients as for all adults, there are specific issues of causation, evaluation and treatment that must be considered when dealing with the elderly. | Maxwell M Chait | 2010 | World Journal of Gastrointestinal Endoscopy2010,2,12: | 22 |
| 4 | Clinical study of anesthetization by dezocine combined with propofol for indolent colonoscopy显示文摘AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjiang people's Hospital was conducted from April 1 to April 30, 2015. The survey collected patient general information and anesthesia data, including overall medical experience and pain management. Thirty minutes after colonoscopy surgery, samples of venous blood were collected and the biochemical indicators of gastrointestinal function were analyzed. RESULTS: There were 98 female and 62 male respondents. Indolent colonoscopy was found to be more suitable for mid to older-aged patients. The necessary conditions for the diagnosis of digestive diseases were required in 65 of the 73 inpatients. Adverse reactions to the intraoperative process included two cases of body movement and two cases of respiratory depression. Gastrin and vasoactive intestinal peptide levels were slightly increased. However, somatostatin and endothelin levels were slightly decreased. CONCLUSION: This study revealed that dezocine combined with propofol can be successfully used for the anesthetization of indolent colonoscopy patients without pain and should be widely used. | Bin-Bin Xu Xiao-liang Zhao Gui-ping Xu | 2016 | World Journal of Gastroenterology2016,22,24: | 23 |
| 5 | Clinical significance of diabetes on symptom and patient delay among patients with acute myocardial infarction——an analysis from China Acute Myocardial Infarction(CAMI) registry显示文摘Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI)patients.Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment.Few studies have reported detailed AMI symptoms in patients with diabetes.This study compared AMI symptoms and presentation characteristics between diabetics and non-diabetics.Methods We included patients from the China AMI registry diagnosed with AMI between January 2013 and September 2014.Baseline characteristics,symptomology,and delay in treatment were compared between diabetics and non-diabetics.Multivariable logistic regression analysis was used to explore independent predictors of atypical symptoms.Results A total of 4450(20.2%)patients had diabetes.They were older,more often women,higher in body mass index,and more likely to have non-ST segment elevation myocardial infarction.Fewer diabetic patients presented with persistent precordial chest pain(63.1%vs.68%,P<0.0001),diaphoresis(60.1%vs.65.6%,P<0.0001),fatigue(16.7%vs.18.3%,P=0.0123),and incontinence(0.4%vs.0.7%,P=0.0093).Time to hospital presentation was longer among patients with diabetes than those without.In multivariable analysis,diabetes was identified as an independent predictor of atypical symptoms(OR:1.112,95%CI:1.034?1.196).Conclusions Our study is the first large-scale study providing evidence that diabetics are less likely to present with typical chest pain and more likely to experience treatment delay when suffering from an AMI.Our results may increase clinician awareness of recognizing AMI patients rapidly to reduce diagnosis and treatment delay,particularly in the context of diabetes. | Rui FU Si-Dong LI Chen-Xi SONG Jing-Ang YANG Hai-Yan XU Xiao-Jin GAO Yi XU Jian-Ping ZENG Jun-Nong LI Ke-Fei DOU Yue-Jin YANG on behalf of the CAMI Registry study group Beijing,China | 2019 | Journal of Geriatric Cardiology2019,16,5: | 21 |
| 6 | Plasma endothelin and nitric oxide levels in patients with acute pancreatitis显示文摘Objective: To explore the changes of plasma endothelin(ET) and nitric oxide (NO) levels in patients with a-cute pancreatitis.Methods: The level of plasma ET was measured by ra-dioactive-immunoassay, and NO by spectrophotometry.Results: The levels of ET, NO and the ET/NO ratioin patients with severe acute pancreatitis(SAP) within24 hours in hospital were all significantly higher thanthose in other groups of patients [(176±8)pg/ml,(97±11) μmol/L, and 1.83±0.12, P<0.01]. Com-pared to healthy controls(N), the levels of ET and NOin patients without pancreatitis acute abdomen (NAP)and patients with mild acute pancreatitis (MAP) in-creased significantly (P<0.01). After appropriate treat-ment, the levels of ET and NO in the MAP groupwere lower (P<0.01). Compared with those beforetreatment, the levels of ET and NO in the SAP groupon the 3rd and 7th day in hospital dropped signifi-cantly(P<0.01).The ET/NO ratio on the 7th daywas also lower than that on admission (P<0.01).Conclusions: The malfunction of endothelial cells andthe increased ET/NO ratio may be related to the mecha-nism of pancreatic microcirculatory disturbance in pa-tients with SAP; early dynamic determination of theseparameters may help predict the prognosis of SAP. | Xiao-Hua Zeng Shi-Qin Zhu Xing-Ming Zhang Wen-Jun Luo Sheng-Wei Li From the Department of General Surgery, Second Clinical College, Chongqing University of Medical Sciences, Chongqing 400010, China | 2002 | Hepatobiliary & Pancreatic Diseases International2002,1,1: | 19 |
| 7 | Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective显示文摘Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease(ESLD); spontaneous fungal peritonitis(SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients,not even the antifungals used for the prophylaxis,neither optimal treatment. We reviewed,in order to focus the epidemiology,characteristics,and,considering the high mortality rate of SFP,the use of optimal empirical antifungal therapy the current literature. | Marco Fiore Sebastiano Leone | 2016 | World Journal of Gastroenterology2016,22,34: | 19 |
| 8 | 到用结构化的问询表的口头的抗病毒的肝炎 B 治疗的坚持的评估显示文摘 AIM:To assess adherence rates to nucleos(t)ide analogues(NUCs) therapy in patients with chronic hepatitis B virus infection and determine factors associated with adherence.METHODS:The questionnaire study was conducted in the liver clinics at Concord Repatriation General Hospital.All patients who were currently taking one or more NUCs were asked to complete a structured,selfadministered 32-item questionnaire.Adherence was measured using visual analogue scales.The patient’s treating clinician was also asked to assess their patient’s adherence via a structured questionnaire.RESULTS:A total of 80 patients completed the questionnaire.Sixty six percent of the patients(n = 49) reported optimal adherence whilst 25(33.8%) graded their adherence to NUCs as suboptimal.Thirty four(43%) patients reported to have omitted taking their NUCs sometime in the past.Recent non-adherence was uncommon.Amongst the patients who reported skipping medications,the most common reason cited was 'forgetfulness'(n = 27,56.25%).Other common reasons included:ran out of medications(n = 5,10.42%),being too busy(n = 4,8.33%) and due to a change in daily routine(n = 5,10.42%).Patients who reported low adherence to other prescription pills were also more likely to miss taking NUCs(P = 0.04).Patients who were under the care of a language-discordant clinician were also more likely to report suboptimal adherence to NUCs(P = 0.04).CONCLUSION:Adherence rates were much less than that expected by the physician and has potential adverse affect on long term outcome.Communication and education appear central and strategies need to be implemented to improve ongoing adherence. | Leesa Giang Christian P Selinger Alice Unah Lee | 2012 | World Journal of Hepatology2012,4,2: | 16 |
| 9 | 胃肠外营养支持治疗在恶性肿瘤化疗中的应用显示文摘The effect of parenteral nutrition (PN) on patients with malignant carcinoma was reviewed in this paper. PN support was very necessary and useful for the cancer patients during chemotherapy, which could improve the patients’ nutritional condition, attenuate the body weight loss and decrease chemotherapy side efffect of the gut. That PN could stimulate tumor growth was lack of evidence. The nitrogen and fat should be enough for these patients and the regimen should be balanced and individualized according the patient’s body surface, activity score and nutritional status. That large dose of VitC, B and A could inhibit the tumor growth was controversial. The clinical surveillance to patients receiving PN should be stressed and EN or free diet was encouraged as the gut could be used. | 李苏宜 王瑞林 | 1997 | 中华临床营养杂志1997,15,3: | 14 |
| 10 | Preoperative selection of patients with colorectal cancerliver metastasis for hepatic resection显示文摘Surgical resection of colorectal liver metastases(CRLM) has a well-documented improvement in survival. To benefit from this intervention, proper selection of patients who would be adequate surgical candidates becomes vital. A combination of imaging techniques may be utilized in the detection of the lesions. The criteria for resection are continuously evolving; currently, the requirements that need be met to undergo resection of CRLM are: the anticipation of attaining a negative margin(R0 resection), whilst maintaining an adequate functioning future liver remnant. The timing of hepatectomy in regards to resection of the primary remains controversial; before, after, or simultaneously. This depends mainly on the tumor burden and symptoms from the primary tumor. The role of chemotherapy differs according to the resectability of the liver lesion(s); no evidence of improved survival was shown in patients with resectable disease who received preoperative chemotherapy. Presence of extrahepatic disease in itself is no longer considered a reason to preclude patients from resection of their CRLM, providing limited extra-hepatic disease, although this currently is an area of active investigations. In conclusion, we review the indications, the adequate selection of patients and perioperative factors to be considered for resection of colorectal liver metastasis. | Rafif E Mattar Faisal A Al-alem Eve Simoneau Mazen Hassanain | 2016 | World Journal of Gastroenterology2016,22,2: | 13 |
| 11 | Rare etiology of mechanical intestinal obstruction: Abdominal cocoon syndrome显示文摘Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Ab-dominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of 'recurrent characteristics of the complaints' that can be learned by a careful history, may be helpful in diagnosis. | Yener Uzunoglu Fatih Altintoprak Omer Yalkin Yasemin Gunduz Guner Cakmak Orhan V Ozkan Fehmi Celebi | 2014 | World Journal of Clinical Cases2014,2,11: | 13 |
| 12 | Endoscopic papillary large balloon dilation for the removal of bile duct stones显示文摘Endoscopic papillary large balloon dilation(EPLBD)with endoscopic sphincterotomy(EST)has been widely used as the alternative to EST along with endoscopic mechanical lithotripsy(EML)for the removal of large or difficult bile duct stones.Furthermore,EPLBD without EST was recently introduced as its simplified alternative technique.Thus,we systematically searched PubMed,Medline,the Cochrane Library and EMBASE,and analyzed all gathered data of EPLBD with and without EST,respectively,by using a single standardized definition,reviewing relevant literatures,published between 2003and June 2013,where it was performed with largediameter balloons(12-20 mm).The outcomes,including the initial success rate,the rate of needs for EML,and the overall success rate,and adverse events were assessed in each and compared between both of two procedures:'EPLBD with EST'and'EPLBD without EST'.A total of 2511 procedures from 30 published articles were included in EPLBD with EST,while a total of413 procedures from 3 published articles were included in EPLBD without EST.In the results of outcomes,the overall success rate was 96.5%in EPLBD with EST and97.2%in EPLBD without EST,showing no significant difference between both of them.The initial success rate(84.0%vs 76.2%,P<0.001)and the success rate of EPLBD without EML(83.2%vs 76.7%,P=0.001)was significantly higher,while the rate of use of EML was significantly lower(14.1%vs 21.6%,P<0.001),in EPLBD with EST.The rate of overall adverse events,pancreatitis,bleeding,perforation,other adverse events,surgery for adverse events,and fatal adverse events were 8.3%,2.4%,3.6%,0.6%,1.7%,0.2%and 0.2%in EPLBD with EST and 7.0%,3.9%,1.9%,0.5%,0.7%,0%and 0%in EPLBD without EST,respectively,showing no significant difference between both of them.In conclusion,recent accumulated results of EPLBD with or even without EST suggest that it is a safe and effective procedure for the removal of large or difficult bile duct stones without any additional risk of severe adverse events,when performed under appropriate guidelines. | Jin Hong Kim Min Jae Yang Jae Chul Hwang Byung Moo Yoo | 2013 | World Journal of Gastroenterology2013,19,46: | 12 |
| 13 | Angiographic characteristics and in-hospital mortality among patients with ST-segment elevation myocardial infarction presenting without typical chest pain: an analysis of China Acute Myocardial Infarction registry显示文摘Background:Patients with ST-segment elevation myocardial infarction(STEMI)who present without typical chest pain are associated with a poor outcome.However,whether angiographic characteristics are related to a higher risk of mortality in this population is unclear.This study aimed to investigate whether the higher mortality risk in patients with STEMI without chest pain could be explained by their'high-risk'angiographic characteristics.Methods:We used data of 12,145 patients with STEMI who was registered in China Acute Myocardial Infarction registry from January 2013 to September 2014.We compared the infarct-related artery(IRA),thrombolysis in myocardial infarction(TIMI)flow grade in the IRA,and other angiographic characteristics between patients without and those with chest pain.Multivariable logistic regression model was used to identify independent risk factor of in-hospital mortality.Results:The 2922(24.1%)patients with STEMI presented without typical chest pain.These patients had a higher TIMI flow grade(mean TIMI flow grade:1.00 vs.0.94,P=0.02)and a lower rate of IRA disease of the left anterior descending artery(44.6%vs.51.2%,χ^2=35.63,P<0.01)than did those with typical chest pain.Patients without chest pain were older,more likely to have diabetes,longer time to hospital and higher Killip classification,and less likely to receive optimal medication treatment and primary percutaneous coronary intervention and higher In-hospital mortality(3.3%vs.2.2%,χ^2=10.57,P<0.01).After adjusting for multi-variables,presentation without chest pain was still an independent predictor of in-hospital death among patients with STEMI(adjusted odds ratio:1.36,95%confidence interval:1.02–1.83).Conclusions:Presentation without chest pain is common and associated with a higher in-hospital mortality risk in patients with acute myocardial infarction.Our results indicate that their poor prognosis is associated with baseline patient characteristics and delayed treatment,but not angiographic lesion characteristics.Clinical trial registration:NCT01874691,https://clinicaltrials.gov. | Chen-Xi Song Rui Fu Jin-Gang Yang Hai-Yan Xu Xiao-Jin Gao Chun-Yue Wang Yang Zheng Shao-Bin Jia Ke-Fei Dou Yue-Jin Yang on behalf of the CAMI Registry study group | 2019 | Chinese Medical Journal2019,,19: | 11 |
| 14 | Systematic review of laparoscopic vs open surgery for colorectal cancer in elderly patients显示文摘AIM: To verify the safety and validity of laparoscopic surgery for the treatment of colorectal cancer in elderly patients.METHODS: A meta-analysis was performed of a systematic search of studies on an electronic database. Studies that compared laparoscopic colectomy(LAC) in elderly colorectal cancer patients with open colectomy(OC) were retrieved, and their short and long-term outcomes compared. Elderly people were defined as 65 years old or more. Inclusion criteria were set at: Resection of colorectal cancer, comparison between laparoscopic and OC and no significant difference in backgrounds between groups.RESULTS: Fifteen studies were identified for analysis. LAC was performed on 1436 patients, and OC performed on 1810 patients. In analyses of short-term outcomes, operation time for LAC was longer than for OC(mean difference = 34.4162, 95%CI: 17.8473-50.9851, P < 0.0001). The following clinical parameters were lower in LAC than in OC: Amount of estimated blood loss(mean difference =-93.3738, 95%CI:-132.3437 to-54.4039, P < 0.0001), overall morbidity(OR = 0.5427, 95%CI: 0.4425-0.6655, P < 0.0001), incisional surgical site infection(OR = 0.6262, 95%CI: 0.4310-0.9097, P = 0.0140), bowel obstruction and ileus(OR = 0.6248, 95%CI: 0.4519-0.8638, P = 0.0044) and cardiovascular complications(OR = 0.4767, 95%CI: 0.2805-0.8101, P = 0.0062). In analyses of long-term outcomes(median follow-up period: 36.4 mo in LAC, 34.3 mo in OC), there was no significant difference in overall survival(mean difference = 0.8321, 95%CI: 0.5331-1.2990, P = 0.4187) and disease specific survival(mean difference = 1.0254, 95%CI: 0.6707-1.5675, P = 0.9209). There was also no significant difference in the number of dissected lymph nodes(mean difference =-0.1360, 95%CI:-4.0553-3.7833, P = 0.9458).CONCLUSION: LAC in elderly colorectal cancer patients had benefits in short-term outcomes compared with OC except operation time. The long-term outcomes and oncological clearance of LAC were similar to that of OC. These results support the assertion that LAC is an effective procedure for elderly patients with colorectal cancer. | Shoichi Fujii Mitsuo Tsukamoto Yoshihisa Fukushima Ryu Shimada Koichi Okamoto Takeshi Tsuchiya Keijiro Nozawa Keiji Matsuda Yojiro Hashiguchi | 2016 | World Journal of Gastrointestinal Oncology2016,8,7: | 10 |
| 15 | Management of gastroesophageal reflux disease: Patient and physician communication challenges and shared decision making显示文摘Gastroesophageal reflux disease(GERD) is a common upper esophageal condition and typical symptoms can include heartburn and sensation of regurgitation while atypical symptoms include chronic cough, asthma, hoarseness, dyspepsia and nausea. Typically, diag-nosis is presumptive given the presence of typical and atypical symptoms and is an indication for empiric therapy. Treatment management can include lifestyle modifications and/or medication therapy with proton pump inhibitor(PPI) class being the preferred and most effective. Complete symptom resolution is not always achieved and long-term PPI therapy can put patients at risk for serious side effects and needless expense. The brain-gut connection and hypervigilance plays an important role in symptom resolution and treatment success, especially in the case of non-PPI responders. Hypervigilance is a combination of increased esophageal sensory sensitivity in combination with exaggerated threat perception surrounding esophageal symptoms. Hypervigilance requires a different approach to GERD managements, where continued PPI therapy and surgery are usually not recommended. Rather, helping physicians and patients understand the brain-gut connection can guide and improve care.Education and reassurance should be the main pillars or treatment. However, it is important not to suggest the symptoms are due to anxiety alone, this often leads to patient dissatisfaction. Patient dissatisfaction with treatment reveals the need for a more patient-centered approach to GERD management and better communication between patients and providers. Shared decision making(SDM) with the incorporation of patient-reported outcomes(PRO) promotes patient adherence and satisfaction. SDM is a joint discussion between clinician and patient in which a mutually shared solution is explored for GERD symptoms. For SDM to work the physician needs to capture patients' perceptions which may not be obtained in the standard interview. This can be done through the use of PROs which promote a dialogue with patients about their symptoms and treatment priorities in the context of the SDM patient encounter. SDM could potentially help in the management of patient expectations for GERD treatment, ultimately positively impacting their health-related quality of life. | Scott Klenzak Igor Danelisen Grace D Brannan Melissa A Holland Miranda AL van Tilburg | 2018 | World Journal of Clinical Cases2018,6,15: | 10 |
| 16 | Comparison of perceived pain and patients’ satisfaction with traditional local anesthesia and single tooth anesthesia: A randomized clinical trial显示文摘BACKGROUND Contemporary innovations in the area of local anesthesia have attempted to provide an absolutely pain free experience for patients.Since the introduction of Computer-Controlled Local Anesthetic Delivery Systems to dentistry,many studies have compared its efficacy and safety to conventional anesthesia.However,very few studies have compared single tooth anesthesia(STA)and traditional local anesthesia.AIM To compare pain rating,changes in blood pressure,and heart rate during the local anesthetic injection.The secondary objectives were to measure the patients’level of satisfaction and the differences in anesthetic efficiency between the STA system and traditional local infiltration.METHODS A randomized controlled trial was conducted and a total of 80 patients with dental restorative needs were enrolled for the study.The patients were evaluated for their general physical status and oral clinical findings before enrollment.Information regarding perceived pain,changes in heart rate and blood pressure,and patients’satisfaction was collected using an electronic data form and was analyzed using paired and unpaired t-tests.RESULTS No significant difference was noted in perceived pain(P=0.59)and systolic blood pressure(P=0.09)during anesthetic injection using both traditional and STA techniques.STA patients had a significantly higher heart rate during anesthesia,although a statistically significant difference was noted among the traditional anesthesia and the STA groups even before anesthesia.During the restorative procedure,less pain was perceived by STA patients on the Wong-Baker FACES pain scale,which was statistically significant(P<0.001).Analyses of post-procedure patient responses showed that STA patients had a significantly better treatment experience and preferred to have the same method of injection in the future(P=0.04).CONCLUSION STA system can provide less painful and more comfortable restorative treatment procedures in comparison to the traditional infiltration technique. | Mohammad I Al-Obaida Mehdiya Haider Rawan Hashim Wafa AlGheriri Sree Lalita Celur Samar A Al-Saleh Ebtissam M Al-Madi | 2019 | World Journal of Clinical Cases2019,7,19: | 8 |
| 17 | Complications associated with prone positioning in elective spinal surgery显示文摘Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity.Although many ofthese complications remain uncommon,the range of possible morbidities is wide and includes multiple organ systems.Perioperative visual loss(POVL)is a well described,but uncommon complication that may occur due to ischemia to the optic nerve,retina,or cerebral cortex.Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery.Peripheral nerve injuries,such as those caused by prolonged traction to the brachial plexus,are more commonly encountered postoperative events.Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning,albeit rarely.Other uncommon positioning complications such as tongue swelling resulting in airway compromise,femoral artery ischemia,and avascular necrosis of the femoral head have also been reported.Many of these are well-understood and largely avoidable through thoughtful attention to detail.Other complications,such as POVL,remain incompletely understood and thus more difficult to predict or prevent.Here,the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity. | J Mason De Passe Mark A Palumbo Maahir Haque Craig P Eberson Alan H Daniels | 2015 | World Journal of Orthopedics2015,6,3: | 7 |
| 18 | Surgical outcome and patient satisfaction after Z-epicanthoplasty and blepharoplasty显示文摘AIM: To evaluate surgical outcomes of modified Z-epicanthoplasty with blepharoplasty that we previously reported from the patient's perspective using patient-reported outcome measures(PROMs) and patient satisfaction scores.METHODS: A total of patients(n=180) who underwent the surgery between January 2013 and June 2016 were randomly selected. Standardized patient satisfaction forms(total score, 40) and validated PROMs questionnaires(total score, 12) were sent to patients for completion. PROMs assesses the severity of scarring, pain and asymmetry, as well as functional and appearance issues.RESULTS: All patients were female, ranging from 18 to 35 years old(mean=24). The response rate was 73.3%(n=132). The majority of patients reported good or excellent outcomes based on PROM analysis. Patients reported minimum or non-visible scarring at both the double eyelid surgical scar(85.6%) and the inner canthus(80.3%). Issues concerning function and appearance were minimal as 80.3% reported satisfaction with both domains. Notably, the majority of patients reported either a high or very high satisfaction rate to yield a mean score of 104 out of 120(P<0.05).CONCLUSION: Integration of our modified Z-epicanthoplasty with blepharoplasty produces good outcomes based on PROM results, which shows a positive linear relationship with patient satisfaction scores. | Jing-Yi Zhao Xiao-Shuang Guo Guo-Dong Song Xian-Lei Zong Xiao-Nan Yang Le Du Chen-Zhi Lai Zuo-Liang Qi Xiao-Lei Jin | 2018 | International Journal of Ophthalmology(English edition)2018,11,12: | 7 |
| 19 | Characteristics of postintensive care syndrome in survivors of pediatric critical illness: A systematic review显示文摘AIM To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome(PICS) in adults, including physical, neurocognitive and psychological morbidities.METHODS A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, Psyc INFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit(PICU) patients. Two reviewers independently screened all titles and abstracts and performed data extraction. From the 3176 articles identified in the search, 252 abstracts were identified for full text review and nineteen were identified for inclusion in the review. All studies reporting characteristics of PICS in PICU patients were included in the final synthesis. RESULTS Nineteen studies meeting inclusion criteria published between 1995 and 2016 were identified and categorized into studies reporting morbidities in each of three categories-physical, neurocognitive and psychological. The majority of included articles reported prospective cohort studies, and there was significant variability in the outcome measures utilized. A synthesis of the studies indicate that morbidities encompassing PICS are well-described in children who have survived critical illness, often resolving over time. Risk factors for development of these morbidities include younger age, lower socioeconomic status, increased number of invasive procedures or interventions, type of illness, and increased benzodiazepine andnarcotic administration.CONCLUSION PICS-related morbidities impact a significant proportion of children discharged from PICUs. In order to further define PICS in children, more research is needed using standardized tools to better understand the scope and natural history of morbidities after hospital discharge. Improving our understanding of physical, neurocognitive, and psychological morbidities after critical illness in the pediatric population is imperative for designing interventions to improve long-term outcomes in PICU patients. | Elizabeth A Herrup Beth Wieczorek Sapna R Kudchadkar | 2017 | World Journal of Critical Care Medicine2017,6,2: | 7 |
| 20 | Comprehensive reform of community health service in east,middle and west regions of China:from patients’perspective显示文摘Objectives:To analyze the satisfaction of patients with community health service(CHS)and the changes of the CHS delivered before and after the new health reform in different regions of China,and to put forward relevant policy recommendations for CHS development.Methods:Twelve community health centers were selected by random sampling in each of the eight typical cities in the east,middle and west regions of China.Questionnaire survey was conducted among patients visiting these institutions during daily work hours.Results:The proportions of the participants who stated that the medical environment,service attitude and medical skills of the doctors were improved were higher in the west region than those of the east and middle regions;but the percentage of patients who held that the drug price had lowered was higher in the east region than those of the middle and west region,the differences were of statistical significance(P<0.0125).The patients’satisfaction rates with medical environment,service attitude,and technical skills of the medical staff in the west region were 88.9%,91.5%and 81.6%respectively,which were higher than those in the east and middle regions.In the east region,the satisfaction rate with the reimbursement for this visit was 58.5%,which was highest among the three regions;in the west region,patients’satisfaction rates with drug types and preventive care were 51.5%and 65.9%,respectively,which was significantly higher than those in the east and middle regions(P<0.0125).As recommended by the participants,the top three aspects of health services that need to be improved were drug type and quality(25.3%),drug prices(21.8%)and technical skills(18.2%)in the east region;infrastructure(28.2%),drug prices(21.8%)and drug types and quality(21.2%)in the middle region;infrastructure(30.8%),drug types and quality(28.1%)and reimbursement(27.9%)in the west region.Conclusions:The comprehensive CHS reform should take the opinions of patients into account;essential drug system should be consolidated continually;and the reform of the payment system should be promoted by actively cooperating with the health insurance organizations. | JIANGMEI QIN YANCHUN ZHANG LIFANG ZHANG LIQUN LIU WEI ZHOU CAILING LIU LIKUN WANG JING LI | 2013 | Family Medicine and Community Health2013,1,2: | 6 |