Medicine
-
Adult degenerative scoliosis associated with lumbar stenosis has become a common issue in the elderly population. But its surgical management is on debating. The main issue condenses on the management priority of scoliosis or stenosis. ⋯ It was effective to perform decompression and short fusion for Group 1 and correction surgery and long fusion for Group 3. For Group 2, the compensated imbalance symptom was always provoked by the symptomatic lumbar stenosis. The cases in the Group 2 got well clinical improvements after local surgical intervene on the symptomatic spinal stenosis and short fusion, leaving the deformity untreated.
-
Comparative Study Observational Study
Retrospective Comparison of Radiological and Clinical Outcomes of PLIF and TLIF Techniques in Patients Who Underwent Lumbar Spinal Posterior Stabilization.
Degenerative disc disease and spinal stenosis lead to various symptoms. Degeneration of facet joints is added to this degenerative process with aging. ⋯ Mean age was 54.86 ± 7.87 years (range 34-74). Although we did not detect a difference between the two surgical methods with regard to clinical improvement, transforaminal lumbar interbody fusion (TLIF) is preferred due to radiological advantages observed one year later, ease of application, and the development of fewer complications.
-
Observational Study
Epidemiological Trends of Drug-Resistant Tuberculosis in China From 2007 to 2014: A Retrospective Study.
The emergence and spread of drug-resistant tuberculosis (DR-TB) has become the major concern in global TB control nowadays due to its limited therapy options and high mortality. A comprehensive evaluation for the epidemiological trends of DR-TB in mainland China, of which TB incidences remain high, is essential but lacking. This study aimed to describe the trends of DR-TB overtime, especially multidrug-resistant TB (MDR-TB); and to identify unique characteristics of MDR-TB cases compared with drug-susceptible TB cases in Mainland China. ⋯ Among those with known treatment histories, a higher MDR rate of 8.7% was observed, in which 53.9% were primary MDR-TB patients, and this rate was increasing at a yearly rate of 4.1% over our study period. MDR-TB patients were more likely to be female (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.05-1.34), aged 25 to 44 years (OR, 1.67; 95%CI, 1.45-1.93), retreated (OR, 11.95; 95%CI, 9.68-14.76), having prior TB contact (OR, 1.89; 95%CI, 1.19-2.78) and having cavity (OR, 1.57; 95%CI 1.36-1.81), or bilateral disease (OR, 1.45; 95%CI 1.19-1.76) on chest radiology. Persistent high levels of MDR-TB, increasing rates of primary MDR-TB and RMR characterize DR-TB cases in mainland China; community-acquired drug resistance may be one of the most modifiable factors in future TB control strategies.
-
Observational Study
The Incidence of Cardiovascular Events Is Comparable Between Normoalbuminuric and Albuminuric Diabetic Patients With Chronic Kidney Disease.
Diabetic kidney disease leads to microalbuminuria and gradually progresses to overt proteinuria with renal insufficiency. Recent studies have demonstrated that 20% to 40% of patients with diabetic kidney disease are normo- to microalbuminuric, despite reduced renal function. We investigated renal and cardiovascular outcomes in patients with diabetes and renal insufficiency who were normo-, micro-, and macroalbuminuric. ⋯ Multivariate Cox analysis identified macroalbuminuria and estimated glomerular filtration rate as independent predictors of renal outcomes. The amount of albuminuria was not associated with cardiovascular events in this population. Although cardiovascular events were similar in patients with diabetic kidney disease and renal insufficiency, renal outcomes differed significantly according to the amount of albuminuria.
-
Enhanced recovery after surgery (ERAS) is increasingly used in several abdominal surgeries to accelerate postoperative recovery and reduce the length of stay. The aim of this study was to investigate the pattern of functional recovery after gastrectomy in patients undergoing ERAS and to analyze factors that affect postoperative recovery. In all, 168 gastric cancer patients enrolled in a clinical trial evaluating ERAS compliance after gastrectomy were prospectively assessed with respect to postoperative functional recovery using discharge criteria, evaluating 4 major functional outcomes: adequate pain control, ability to mobilize and self-care, tolerance of oral intake, and no abnormal physical findings or laboratory test. ⋯ Female sex (P < 0.001) and age (≥ 65 years; P = 0.049) were significantly associated with a slower recovery in tolerance of oral intake, and total gastrectomy was significantly associated with delayed completion of adequate pain control (P = 0.003). Functional recovery after gastrectomy can be achieved after about 5 days in patients undergoing ERAS. Female sex, old age, and total gastrectomy are factors that delay normal functional recovery after gastrectomy.