Medicine
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Randomized Controlled Trial Comparative Study
Posterior paraspinal muscle versus post-middle approach for the treatment of thoracolumbar burst fractures: A randomized controlled trial.
This randomized controlled trial (RCT) aimed to compare the clinical outcomes of thoracolumbar burst fractures (TLBFs) treated with open reduction and internal fixation via the posterior paraspinal muscle approach (PPMA) and the post-middle approach (PA). ⋯ Although PPMA required a longer operative time and x-ray exposure time, PPMA provided several advantages over PA, including less intra-operative blood loss and lower postoperative drainage volume, and greater satisfaction with postoperative pain relief and functional improvement, than PA, especially at the 6-month follow-up after surgery. Further high-quality multicenter studies are warranted to validate our findings.
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Case Reports
Ultrasound-guided perineural injection with dextrose for treatment of radial nerve palsy: A case report.
Perineural injection with dextrose could be a novel intervention for peripheral entrapment neuropathy. However, this intervention has not been reported for treating radial nerve palsy (RNP). Here, we present a case with RNP having outstanding improvement after 2 sessions of ultrasound-guided perineural injection with 5% dextrose (D5W). ⋯ This case shows that ultrasound-guided perineural injection with D5W may be an effective and novel intervention for RNP.
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Observational Study
Cross-cultural adaptation and validation of the Chinese version of the shoulder pain and disability index in patients with symptomatic shoulder pain: A prospective case series.
The aim of this study is to cross-culturally adapt and translate the original version of SPADI into Chinese (C-SPADI), and to test the reliability, validity, and responsiveness of the C-SPADI.This research was a test of previously developed diagnostic criteria in a series of consecutive patients with universally applied gold standard. The original version was translated into Chinese according to international recognized standards. Patients who were diagnosed with a shoulder disorder and underwent shoulder arthroscopic treatments from 2014 to 2015 were enrolled in our study. Each participant was asked to finish the C-SPADI, the Short-Form 36 (SF-36), and the Oxford Shoulder score (OSS) at first visit. The C-SPADI was completed a second time with an interval of 7 days. Six months after arthroscopic treatments, the C-SPADI was completed a third time for responsiveness evaluation. The Cronbach alpha, intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimally detectable change (MDC), Pearson correlation coefficient (r), effect size (ES), and standardized response mean (SRM) were calculated to evaluate the reliability, validity, and responsiveness of C-SPADI respectively.The original version of the SPADI was well adapted and translated into Chinese. The Cronbach alpha ranged from 0.812 to 0.912 in all subscales and total scale of the C-SPADI, indicating good or excellent internal consistency. The test-retest reliability (ICC = 0.887-0.915, SEM = 5.47, MDC = 15.16) was proved to be good or excellent. Moderate or good correlations (r = 0.556-0.672) were obtained between the C-SPADI and the OSS, physical subscales of SF-36; and poor, fair, or moderate correlations (r = 0.038-0.492) were obtained between the C-SPADI and mental subscales of SF-36, which, adequately illustrated good discriminant validity in the C-SPADI. Additionally, the responsiveness was considered good in the C-SPADI (SRM = 1.58-2.44, ES = 1.79-2.17).The C-SPADI was documented to be a reliable, valid, and responsible instrument for self-assessment of patients with shoulder disorders in China. ⋯ Level II.
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Observational Study
Soluble levels of receptor for advanced glycation endproducts and dysfunctional high-density lipoprotein in persons infected with human immunodeficiency virus: ACTG NWCS332.
The role of high-density lipoprotein (HDL) function and advanced glycation end products (AGEs) in HIV-related atherosclerotic cardiovascular disease (CVD) is unclear. Both glycation and oxidation (HDLox) are major modifications of HDL that can alter its composition and function. Therefore, we explored the longitudinal association of HDLox with progression of glycation, as evaluated by measurement of circulating forms of receptor for AGE that predict morbidity (soluble Receptors for Advanced Glycation Endproducts [sRAGE], endogenous secretory Receptors for Advanced Glycation Endproducts [esRAGE]), in people with HIV-1 (PWH; HIV-1) and uninfected (HIV-1) individuals. ⋯ EsRAGE, but not sRAGE, had consistent inverse relationships with ΔHDLox in both HIV-1 and HIV-1 persons at baseline. In HIV-1 but not in HIV-1 persons, ΔHDLox had positive and inverse relationships with ΔRAGE and ΔesRAGE, respectively. Glycation and oxidation of HDL may contribute to impaired HDL function present in PWH.
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Observational Study
A novel heart rate variability based risk prediction model for septic patients presenting to the emergency department.
A quick, objective, non-invasive means of identifying high-risk septic patients in the emergency department (ED) can improve hospital outcomes through early, appropriate management. Heart rate variability (HRV) analysis has been correlated with mortality in critically ill patients. We aimed to develop a Singapore ED sepsis (SEDS) predictive model to assess the risk of 30-day in-hospital mortality in septic patients presenting to the ED. ⋯ Of the 214 patients included in this study, 40 (18.7%) met the primary endpoint. The SEDS model comprises of 5 components (age, respiratory rate, systolic blood pressure, mean RR interval, and detrended fluctuation analysis α2) and performed with an area under the ROC curve (AUC) of 0.78 (95% confidence interval [CI]: 0.72-0.86), compared with 0.65 (95% CI: 0.56-0.74), 0.70 (95% CI: 0.61-0.79), 0.70 (95% CI: 0.62-0.79), 0.56 (95% CI: 0.46-0.66) by qSOFA (initial), qSOFA (worst), NEWS, and MEWS, respectively. HRV analysis is a useful component in mortality risk prediction for septic patients presenting to the ED.