Medicine
-
Observational Study
The valuation of concave-side thoracoplasty on the treatment of extremely severe scoliosis with severe pulmonary dysfunction on the base of halo-pelvic traction.
Extremely severe scoliosis patients, especially main thoracic Cobb' s angle >150°, often have severe thoracic deformity and pulmonary dysfunction, even the scoliosis is reduced by halo-pelvic traction, the improvement of pulmonary function is not satisfactory, the risk of spinal osteotomy in the next stage is still very high and left with obvious thoracic deformity. How to further improve the pulmonary function and appearance of these patients is a difficult problem to be solved. Twenty extremely severe scoliosis patients with severe pulmonary dysfunction who underwent concave-side thoracoplasty in our hospital from September 2014 to September 2017 were included, data of thoracic volume and pulmonary function were collected before and after operation. ⋯ Both the difference has statistical significance (P < .01). Concave-side thoracoplasty based on the halo-pelvic traction cannot only enlarge the volume of the concave thoracic cavity, lighten the compression of lung and further improve the pulmonary function of extremely severe scoliosis, but also can strengthen the correction of scoliosis and spinal rotation. Therefore, it is a safe and effective surgical approach.
-
The decision as to whether patients should be admitted to a medical intensive care unit (ICU), in the absence of information concerning survival rates or prognostic factors in survival, is often challenging. We analyzed survival trends in relation to hospital discharge and examined patient and hospital characteristics associated with survival following ICU care, using a sample of nationwide claims data in Korea from 2002 through 2013. The Korean government implements a compulsory social insurance program that covers the country's entire population, and the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) data from 2002 based on this program were used for this study. ⋯ The mean number of mechanical equipment items applied consistently increased, while no difference was observed in the trend for overall 1-year survival in patients following ICU treatment across the study period: the 1-year survival rate ranged from 66.7% (year 2003) to 64.2% (year 2010). Advanced age, cancer, renal failure, pneumonia, and influenza were all associated with heightened risk of mortality within 1 year. Our results should prove useful to older patients and their clinicians in their decisions regarding whether to seek ICU care, with the goals of improving the end-of life care and optimizing resource utilization.
-
To investigate the clinicopathological features and prognostic impact of Fusobacterium nucleatum (F nucleatum) status in patients with colorectal cancer (CRC) and its relationships with microsatellite instability (MSI) status. Retrospective analysis of consecutive 91 CRC tissues from surgically resected specimens of stage III or high-risk stage II CRC patients who had received curative surgery in Wuhan Union Hospital from January, 2017 to January, 2019 was conducted. F nucleatum DNA was quantitatively measured and classified into 1 of the 2 categories: F nucleatum-high, or F nucleatum-low/negative. ⋯ The F nucleatum status, peripheral nerve invasion, vascular tumor thrombus, lymph node metastasis, and TNM staging were related factors affecting the prognosis of patients with CRC. The Cox risk ratio model analysis showed that the F nucleatum (odds ratio [OR] 2.094, 95% confidence interval [CI] 1.178-8.122, P = .032) and MSI status (OR 2.243, 95% CI 1.136-5.865, P = 0.039) were independent prognostic factors. Intratumoral F nucleatum load has a poor prognostic effect of CRC by increasing nerve invasion, vascular tumor thrombus, and microsatellite mutation.
-
This is the first systematic review evaluating and statistically synthesis the current studies regarding the effects of Tai Chi on pain and disability in patients with low back pain (LBP). ⋯ We drew a cautious conclusion that Tai Chi alone or as additional therapy with routine physical therapy may decrease pain and improve function disability for patients with LBP. Further trials are needed to be conducted with our suggestions mentioned in the systematic review.
-
Most systematic reviews have explored the efficacy of treatments on symptoms associated with post-traumatic stress disorder (PTSD), which is a chronic and often disabling condition. Previous network meta-analysis (NMA) had limitations such as focusing on pharmacological or psychotherapies. Our review is aims to explore the relative effectiveness of both pharmacological and psychotherapies and we will establish the differential efficacy of interventions for PTSD in consideration of both symptom reduction and functional recovery. ⋯ This network meta-analysis will determine the comparative effectiveness of therapeutic options for PTSD on both symptom reduction and functional recovery. Our results will be helpful to clinicians and patients with PTSD, by providing a high-quality evidence synthesis to guide shared-care decision making.