Medicine
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Clinical Trial
Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation.
Proper selection for catheter ablation (CA) for atrial fibrillation (AF) is still an issue. Echocardiographic assessment of left atrium (LA) is complex and challenging. Speckle tracking echocardiography (STE) with recent standardized LA deformation analysis allows for the quantitative assessment of various LA function parameters. ⋯ The opportunity of CA success was 135 fold higher for each 1% increase in global LASr. The receiver operating characteristic (ROC) analysis identified global LASr and left atrial conduit strain (LAScd) as the most powerful parameters for predicting of CA outcome with an area under the curve of 0.896 and 0.860, respectively, in the whole study group, and 0.922 and 0.938, respectively, in patients with not enlarged LA. In patients with paroxysmal AF and normal standard echocardiographic assessment, parameters reflecting LA compliance - reservoir and conduit strain, are independent and strong predictors of CA outcome.
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Observational Study
Analysis of changes in the volume of edema around brain contusions and the influencing factors: A single-center, retrospective, observational study.
Traumatic brain injury (TBI), a common neurosurgical condition, has well-known treatment guidelines. However, the mechanisms underlying the varying severity of brain edema secondary to TBI are largely unknown, leading to controversial treatments. This study seeks to measure edema volumes around brain contusions in different regions, analyze factors related to differences in edema volume and provide a theoretical basis for brain edema treatment. ⋯ Cortical venous obstruction may be the most important factor influencing edema around brain contusions. The Fg level decreased slightly, and the D-D level increased to its peak rapidly after mild-moderate TBI. This change was followed by a gradual increase in the former and a gradual decrease in the latter.
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The goals of surgical treatment of the perilunate dislocation (PLD) are confirmation of reduction, ligament repair, and supplemental fixation of the bony architecture. Open reduction and direct repair of the torn ligament are recommended for acute PLD. However, repair of the scapholunate interosseous ligament (SLIL) and lunotriquetral interosseous ligament (LTIL) is often unreliable, and secure repair is challenging. Internal bracing (IB) is an augmentation method that uses high-strength non-absorbable tape and enhances strength and support during the critical period of ligamentous healing. However, there is a paucity of data on the application of IB for PLD in the wrist. We report 3 cases of PLD that were augmented with IB after SLIL and LTIL repair. ⋯ IB augmentation can reduce the period of K-wire fixation and cast immobilization and can enable early joint motion. We believe that interosseous ligament augmentation using IB is a reasonable treatment option for PLD.
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Golimumab is a fully human antitumor necrosis monoclonal antibody that can be administered by either subcutaneous injection or intravenous infusion. Golimumab is approved for the treatment of the adults with rheumatic diseases, and ulcerative colitis, Whereas in children, golimumab is indicated only for the treatment of active polyarticular juvenile idiopathic arthritis. We have written on the off-label use of subcutaneous golimumab, which helped to induce and maintain remission on a low-weight biologically experienced child with steroid-refractory ulcerative colitis flare. ⋯ Golimumab has shown potential efficacy and safety in the treatment of ulcerative colitis in children which may indicate a significant future role for subcutaneous golimumab in pediatrics ulcerative colitis.
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To summarize the surgical technique and clinical effects of the extended anterolateral approach for the treatment of Schatzker type II and Schatzker type V/VI involving the posterolateral column tibial plateau. From January 2015 through December 2018, 28 patients with tibial plateau fractures involving the posterolateral column were included in the study. Among them, 16 patients were Schatzker type II treated using an extended anterolateral approach with lateral tibial locking compression plate fixation. ⋯ Additionally, up to the last follow-up, the Lachman and knee Valgus (Varus) stress test results of the 2 groups were negative. No complications were found. The extended anterolateral approach is a good choice to treat tibial plateau fractures involving the posterolateral column.