Medicine
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The aim of the present study was to describe the application of 3D printed templates for intraoperative navigation and simulation of periacetabular osteotomies (PAOs) in a cadaveric model. Five cadaveric specimens (10 sides) underwent thin-slice computed tomographic scans of the ala of ilium downwards to the proximal end of femoral shaft. Bernese PAO was performed. ⋯ No osteotomy entered the hip joint and a single posterior column fracture was observed. Comparison of preoperative and postoperative measurements of the 10 sides showed statistically significant changes, whereas no statistically significant differences between postsimulation and postoperative values were noted, demonstrating the accuracy and utility of the 3D printed templates. The application of patient-specific 3D printed bone-drilling and rotation templates in PAO is feasible and may facilitate improved clinical outcomes, through the use of precise presurgical planning and reduced surgical complications with the precisely guided bone drilling.
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Observational Study
Risk of infection is associated more with drain duration than daily drainage volume in prosthesis-based breast reconstruction: A cohort study.
In prosthesis-based breast reconstruction, drains are used to prevent seroma formation and to reduce the risk of infection. However, prolonged drainage increases the risk of ascending infection. Although the volume often accepted for drain removal is ≤30 mL per day, the optimal timing to remove the drain for best clinical outcome remains controversial. ⋯ Breast weight also had a significant influence on risk of infection. Chemotherapy and drain size showed borderline effect on risk of infection whereas the last daily drainage volume was not associated with risk of infectionIn summary, our study revealed that drain duration, rather than the last daily drainage volume, significantly affects the infection rate in prosthesis-based breast reconstruction. We recommend that the drain is better removed no longer than 3 weeks postoperatively and can be removed as early as postoperative day 7, even when the drainage is over 30 mL in a 24-hour period.
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A variety of therapeutic modalities are available for the treatment of interstitial cystitis. However, among them, the less invasive therapies are usually ineffective, whereas the invasive ones carry potential risks of serious side effects and complications. Pulsed radiofrequency (PRF) treatment of the superior hypogastric plexus may be an alternative to conventional treatments, as it provides nondestructive neuromodulation to the superior hypogastric plexus, which transmits the majority of pain signals from the pelvic viscera. ⋯ PRF treatment of the superior hypogastric plexus results in long-term improvements in the pain and symptoms associated with interstitial cystitis.
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The aim of this study is to evaluate the effect of diabetes disease management program (DMP) on glycemic control in type 1 diabetes mellitus (T1DM) patients in Shantou China. A sample of 240 participants recruited from 3C study Shantou subgroup was followed up in DMP for 3 years. The DMP provided self-management education, individualized therapy plan, diabetes complications screening, and laboratory examination periodical according to clinical practice guidelines. ⋯ General linear mixed model analyse demonstrated that changes in glycemic control were associated with insulin treatment regimen, frequency of Self-Monitoring of Blood Glucose (SMBG), diabetes diet adherence, physical activity, and duration of diabetes. DMP helped to improve glycemic control and should be general implemented in China's T1DM. Individuals with basal-bolus regimen (multiple daily injections or pump therapy), more frequency of SMBG, following a diabetes diet, more physical activity, shorter diabetes duration may derive greater benefits from DMP.
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We aimed to compare the efficacy of paclitaxel and carboplatin followed by gemcitabine-based combination chemotherapy with paclitaxel-carboplatin for treating advanced epithelial ovarian cancer in this retrospective, STROBE-compliant study. Patients' tolerance to treatment was also assessed. We retrospectively analyzed the records of 178 women who underwent initial optimal debulking surgery between January 2003 and December 2011 to treat FIGO stage IIIc epithelial ovarian cancer. ⋯ The neurotoxicity rate was significantly higher in arm 2 than in arm 1 (45.2% vs 27.1%, P = 0.026). There was no significant difference between study arms in hematological toxicity. The sequential regimen significantly improved PFS and 5-year OS with tolerable toxicity compared with the single regimen, and offers an alternative for treating patients with advanced epithelial ovarian cancer.