Medicine
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Observational Study
Reoperation after short-segment lumbar spinal fusion surgery in dialysis patients: A retrospective cohort study.
Patients with dialysis are at high risk of reoperation after lumbar spinal fusion surgery. However, the risk of reoperation after short-segment (≤2 fusion levels) lumbar spinal fusion surgery in this patient group has not been completely investigated. This study aimed to compare the risk of reoperation after short-segment lumbar spinal fusion surgery between patients with dialysis and matched controls without dialysis. ⋯ Moreover, the dialysis group had a significantly higher rate of whole reoperation (8.8% vs 41.2%, P = .003), reoperation due to ASD (4.4% vs 23.5%, P = .027), and reoperation due to implant failure (0.8% vs 11.8%, P = .038) than in the non-dialysis group. Based on a propensity-score-matched analysis, the dialysis group had a significantly higher rate reoperation rate after short-segment lumbar spinal fusion surgery than the non-dialysis group (0.0% vs 58.3%, P = .005). The current study firstly clarified that patients with dialysis are at significantly high risk of reoperation even after short-segment lumbar spinal fusion surgery.
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Thoracolumbar burst fracture treatment in neurologically intact patients is controversial with many classification systems to help guide management. Thoracolumbar Injury Classification and Severity score (TLICS) provides a framework, but evidence is limited, and recommendations are primarily based on expert opinion. In this retrospective cohort study, data was reviewed for patients with thoracolumbar burst fractures at a Level-1 Trauma Center in New England from 2013 to 2018. ⋯ Two patients (6%) developed radicular pain with mobilization, which resolved after surgical intervention. No patients experienced decline in neurologic function. A trial of mobilization for neurologically intact TLICS grade 4 and 5 thoracolumbar burst fractures is a safe and reasonable treatment option that resulted in successful nonoperative management of 21 out of 31 (68%) patients.
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Observational Study
Characteristics of gastric cancers developed more than 10 years after eradication of Helicobacter pylori.
Helicobacter pylori (H pylori) eradication is expected to effectively prevent gastric cancer (GC). However, GC cases may occur even longer than 10 years after H pylori eradication (L10AE). Moreover, the associated factors and characteristics are unknown. ⋯ SI was significantly longer in GC that developed at L10AE than at S10AE. In addition, GC with SMD invasion was more frequently detected in L10AE than in S10AE. Our data indicated that SI should not be groundlessly extended in patients at L10AE.
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The increasing use of electric scooters (e-scooters) has been accompanied by an increase in the number of traumas. Noncompliance with regulations and the effectiveness of legal measures remain subjects of ongoing debate. This study aimed to investigate the demographic characteristics of patients with e-scooter-related orthopedic injuries, temporal distribution of trauma, and patterns of these injuries. ⋯ The increasing use of e-scooters among young people has increased trauma cases, with a growing proportion of fractures over time. The higher incidence of injuries, particularly in the elbow and knee joints, underscores the importance of protective equipment. Therefore, additional legal regulations can help to prevent such injuries.
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Observational Study
A retrospective study for clinical characteristics of 293 patients with dermatomyositis.
This retrospective study aimed to investigate differences in clinical characteristics between different antibody phenotypes in patients with dermatomyositis (DM). Two hundred and ninety-three patients with DM were included in this study from September 2018 to September 2023. We collected basic clinical data from the patients, using statistical methods to analyze the clinical characteristics, and used survival analysis and COX regression to assess the prognosis of the patients. ⋯ The clinical features of DM are associated with myositis-specific antibodies. At the same time, advanced age, fever, elevated γ-glutamyl transferase levels, and reduced C3 and eosinophil levels may be associated with poor prognosis in patients with DM. These data may provide useful information for clinical management of patients with DM.