Medicine
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Observational Study
Effectiveness of continuous epidural analgesia on acute herpes zoster and postherpetic neuralgia: A retrospective study.
Despite early treatment of herpes zoster (HZ), postherpetic neuralgia (PHN) can persist. This study was designed to compare the therapeutic and pain relief effects of continuous epidural analgesia (CEA) on the chronic phase as well as the acute phase of HZ with standard medical treatment. Medical records of 227 patients with moderate to severe zoster-associated pain that had not responded to standard medications were retrospectively reviewed. ⋯ The adjusted OR for complete remission in the epidural group versus the medical group was 3.05 (95% CI: 1.20-7.73) in the acute group and 4.46 (95% CI: 1.20-16.54) in the chronic group. CEA can effectively relieve pain caused by PHN and acute HZ and increase remission rates. Combining CEA with standard medical treatment may offer a clinical advantage in the management of pain caused by PHN as well as acute HZ.
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Meta Analysis
Enhanced recovery after surgery (ERAS) programs for esophagectomy protocol for a systematic review and meta-analysis.
Esophageal cancer is one of the worst malignant digestive neoplasms with poor treatment outcomes. Esophagectomy plays an important role and offers a potential curable chance to these patients. However, esophagectomy with radical lymphadenectomy is known as one of the most invasive digestive surgeries which are associated with high morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition, and psychology, which is designed for reducing complications, promoting recovery, and improving treatment outcomes. This systematic review and meta-analysis is aiming at how beneficial, and to what extent ERAS really will be. ⋯ Our study will draw an objective conclusion of the comparisons between ERAS and conventional care in aspects of perioperative outcomes and provide level I evidences for clinical decision makings.
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Randomized Controlled Trial
Cardiorespiratory parameters and glycated hemoglobin of patients with type 2 diabetes after a rehabilitation program.
Cardiovascular autonomic dysfunction reflex of the pathophysiology of diabetes mellitus (DM) favors an increase in morbidity and mortality related to cardiovascular events, and for this reason has been one of the most studied clinical entities. ⋯ The protocol is approved by the host institution's ethics committee under the number 1.616.721. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT3094767.
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Case Reports
Amputation of multiple limbs caused by use of inotropics: Case report, a report of 4 cases.
We present 4 cases of symmetrical peripheral gangrene (SPG) associated with use of inotropic agent to elevate blood pressure. SPG is a relatively rare phenomenon characterized by symmetrical distal ischemic damage that leads to gangrene of 2 or more sites in the absence of large blood vessel obstruction, where vasoconstriction rather than thrombosis is implicated as the underlying pathophysiology. We present 4 SPG cases of the multiple limbs amputation, associated with inevitable use of inotropic agents. ⋯ It is important to alert the possibility of amputations, according to the use of inevitable inotropics. We recommended the careful use of the inotropic agents to the physicians in treating septic shock.
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This study was conducted with the aim to investigate the relationship between Tetranectin (TN) and efficiency of posterior spinal V osteotomy in patients with traumatic kyphosis. ⋯ Serum TN level is proved to be related to the efficiency of posterior spinal V osteotomy in patients with traumatic kyphosis, and may serve as a possible indicator for clinical treatment.