Journal of the Chinese Medical Association : JCMA
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The wide-awake local anesthesia no tourniquet (WALANT) technique, which is based on the local infiltration of lidocaine and epinephrine, is widely used in hand and wrist surgery. However, few studies have been conducted on the cost-benefit analysis of phalanx fracture surgery using the WALANT technique. This study aimed to investigate the clinical condition, time spent on anesthesia and operation. We also perform an economic analysis among general anesthesia, local anesthesia with a tourniquet, and the WALANT technique for plate fixation of phalanx fractures. ⋯ Open reduction with plate fixation of phalanx fractures using the WALANT technique and local anesthesia was cost-effective compared with general anesthesia. Patients who underwent phalanx fracture surgery using the WALANT technique experienced less pain on the first postoperative day than those who underwent surgery using general or local anesthesia with a tourniquet because of the adequate tumescent technique and not using a tourniquet during surgery.
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Thyroid ablation techniques are becoming increasingly popular across various specialties, leading to significant advancements in the treatment of thyroid and head and neck diseases. Head and neck surgeons (HNS) play a pivotal role in advancing thyroid ablation practices due to several key advantages: their detailed understanding of the thyroid and head and neck anatomy, extensive experience with ultrasound and ultrasound-guided interventions, ability to manage post-ablation conditions, capability to perform surgeries if necessary, and expertise in voice assessment, rehabilitation, and management. In this narrative review, we combine a comprehensive literature review with our own decade-long experience in promoting thyroid ablation to demonstrate that HNS are essential in advancing these techniques, ensuring safety, and improving patient quality of life.
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The COVID-19 pandemic has had a profound impacted on various aspects of society, including the healthcare system and patient care. In this context, this study aims to evaluate the impact of COVID-19 control strategies on the lipid profile and blood sugar levels of peritoneal dialysis (PD) patients in Taiwan, a crucial focus for understanding the pandemic's influence on individuals with chronic kidney disease (CKD). ⋯ Our findings underscore the significant impact of COVID-19 pandemic-related disruptions in the healthcare system and the subsequent management strategies on dyslipidemia in PD patients while not affecting dysglycemia. These results provide valuable insights for healthcare professionals to enhance their strategies and interventions for CKD patients undergoing PD during a pandemic.
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The primary objective of this study was to elucidate the impact of sentinel lymph node (SLN) mapping and biopsy techniques on the clinical outcomes of women with early primary cervical cancer. ⋯ SLN biopsy does not seem to be associated with an inferior survival outcome compared with conventional lymphadenectomy in women with early primary cervical cancer. In addition, it is associated with less blood loss and a shorter length of hospital stay.
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Limited knowledge exists regarding the interrelations between sleep quality and resilience within the demographic of healthy, community-residing middle-aged and older adults, with a particular dearth of information regarding sex-specific associations. This study aimed to examine the sex-specific associations between sleep quality, resilience, and biomarkers in community-dwelling middle-aged and older adults. ⋯ This study highlights the association between sleep quality and resilience in older adults. Good sleep quality is related to better resilience, but greater depressive symptoms are also linked to poorer resilience in both sexes. Nevertheless, the low habitual sleep efficiency and frequent use of sleeping medications in women but not men with poor sleep quality highlight the need to explore sex-specific approaches to address the interplay of sleep quality, resilience and other demographic factors (such as depressive symptoms) in healthy aging.