Medicine
-
Randomized Controlled Trial
Efficacy of radial incision combined with tunnel floating line drainage in the treatment of high posterior horseshoe anal fistula and perianal flora: Randomized control trial.
Due to the high prevalence of posterior horseshoe anal fistula and causing numerous complications, this study aimed to investigate the clinical effect of radial incision combined with tunnel floating line drainage (RCTD) and arc incision internal drainage in the treatment of the disease and the influence on perianal flora. ⋯ RCTD can be the best choice for patients with high posterior horseshoe anal fistula. This operation method has the advantages of short operation time, less trauma, fewer complications, fast recovery of anal function, and can also reduce perianal pathogenic bacteria infection.
-
Gremlin-1 is associated with lung disease and plays a role in the initiation and progression of pulmonary fibrosis. This suggests that Gremlin-1 may be associated with lung involvement in COVID-19 and poor clinical outcomes and warrants further investigation. This prospective, cross-sectional, single-blind study was the first to investigate Gremlin-1 levels in COVID-19 patients and whether Gremlin-1 levels could be used to predict and guide clinical follow-up in outpatients and inpatients. ⋯ The median Gremlin-1 values were statistically significantly different between outpatients and intensive care unit patients (0.367 ng/mL [IQR = 0.377], 1.858 ng/mL [IQR = 2.245], respectively) (P < .0001). The area under the ROC curve value to determine the discriminative power of Gremlin-1 was found to be 0.772 (95% CI: 0.672-0.871; P < .0001), and the cutoff value of Gremlin-1 to discriminate between outpatients and hospitalized patients was found to be 1.242 ng/mL with 66.7% sensitivity and 67.2% specificity. Serum Gremlin-1 level is an important biomarker that can be used as a clinical decision-making tool for COVID-19 positive patients.
-
Comparative Study Observational Study
Comparison of third-generation minimally invasive surgery, split-drill osteotomy, and triplanar chevron osteotomy for treating mild to moderate hallux valgus with metatarsalgia in middle-aged women: An observational study.
This retrospective study compared the clinical efficacy of third-generation minimally invasive surgery (3rd-MIS) split-drill osteotomy with soft tissue release to that of triplanar chevron osteotomy (TCO) for treating mild to moderate hallux valgus (HV) with metatarsalgia in middle-aged women. This study compared the efficacy of 3rd-MIS using split-drill osteotomy to that of TCO in treating mild to moderate HV with metatarsalgia in 52 middle-aged women from March 2022 to June 2023. Retrospectively analyzing a total of 52 patients (26 patients per group), we employed 2 distinct surgical methods across 2 groups in this study: the TCO group received a traditional TCO accompanied by soft tissue release, whereas the MIS group underwent a split-drill osteotomy with soft tissue release. ⋯ Both surgical techniques effectively corrected the HV angle without significant changes in the first metatarsal length. The MIS group experienced significantly less pain on the second day postsurgery, as indicated by lower Visual Analogue Scale scores (P < .05). Both techniques were similarly effective in treating metatarsalgia. 3rd-MIS split-drill osteotomy with soft tissue release offers several advantages over TCO techniques for treating mild to moderate HV with metatarsalgia in middle-aged women, such as reduced trauma, quicker healing, smaller scars, and less pain after surgery.
-
Comparative Study Observational Study
C-arm-guided versus ultrasound volumetric navigation-guided percutaneous transforaminal endoscopic discectomy for the treatment of lumbar disc herniation: A retrospective study.
To compare the clinical efficacy of lumbar percutaneous transforaminal endoscopic discectomy (PTED) for lumbar disc herniation (LDH) guided by C-arm fluoroscopy and ultrasound volumetric navigation (UVN). Fifty patients with LDH treated with PTED were retrospectively evaluated in this study. Groups A (n = 25) and B (n = 25) had intervertebral foramina punctures guided by C-arm fluoroscopy and UVN, respectively. ⋯ Both C-arm-guided and the UVN-guided PTED are safe and effective methods for the treatment of LDH. UVN-guided technique has the advantage of reducing puncture time and the number of punctures. However, UVN also has the disadvantage of high hospitalization costs.
-
Observational Study
Evaluation of lateral sagittal infraclavicular block according to inferior vena cava collapsibility index (VCI-CI): An observational study.
Depending on the total amount of fluid, changes occur in the amount of fluid in the peripheral area. The aim of this study was to observe the differences caused by hemodynamic changes after lateral sagittal infraclavicular block (LS-ICB) according to the inferior vena cava collapsibility index (VCI-CI). In this prospective, observational study (Clinical Trial Number: NCT05968105), patients undergoing elective hand and wrist surgery with LS-ICB were classified according to VCI-CI, with Group 1 defined as inferior vena cava (VCI) diameter < 1.5 cm and VCI-CI > 50% and Group 2 defined as VCI diameter > 1.5 cm and VCI-CI < 50%. ⋯ The dosage and number of patients requiring rescue analgesics were similar across both groups, and no complications were reported. Blood flow increased after LS-ICB without a corresponding increase in axillary artery diameter. Group 1 showed a tendency toward a lower perfusion index in the postoperative period.