Medical science monitor : international medical journal of experimental and clinical research
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Randomized Controlled Trial
Application of Optimized Ultrasonic Localization System for Radial Artery Puncture by Intern Doctors: A Randomized Trial.
BACKGROUND Ultrasound with developing line may by suitable for medical personnel who are inexperienced in the use of ultrasound-guided radial artery puncture. In this trial, we assessed whether this technology could increase the success rate of radial artery puncture performed by interns. MATERIAL AND METHODS Seventy-seven patients undergoing general anesthesia were enrolled and randomly divided into 2 groups: an ultrasound with developing line group and a traditional ultrasound group. ⋯ However, no significant between-group difference was observed with respect to failure rate (mean difference 95% CI, (-0.0084 to 0.2743; P=0.0866). The ultrasonic location time in the ultrasound with developing line group was significantly lower than that in the traditional ultrasound group (mean difference -12.4 seconds, 95% CI, 10.64 to 13.98 s; P<0.0000). CONCLUSIONS Use of ultrasound with developing line significantly improved the success rate of radial artery puncture performed by interns as compared to that with use of traditional dynamic ultrasound guidance technology.
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BACKGROUND Anterior cervical plate and cage fixation system (ACPC) used in anterior cervical corpectomy and fusion (ACCF) is reported to incur excess complications. This study aimed to introduce integrated fixation cage (IFC) into ACCF to eliminate the anterior cervical plate (ACP)-related complications. MATERIAL AND METHODS One validated intact and 3 ACCF-simulated C3-C7 cervical spine models were developed. ⋯ The IFC model showed a higher maximal von Mises stress on cage-endplate interface in all motion planes. CONCLUSIONS Based on finite element analysis, IFC provided identical C3-C7 construct stability as ACPC. Compared with ACPC, IFC showed better biomechanical performance on screw-vertebra interface and bone graft, but worse biomechanical performance on cage-endplate interface.
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Randomized Controlled Trial
Effect of 3D Printing Individualized Ankle-Foot Orthosis on Plantar Biomechanics and Pain in Patients with Plantar Fasciitis: A Randomized Controlled Trial.
BACKGROUND Traditional ankle-foot orthoses (AFOs) are not effective in treating plantar fasciitis, while customized 3-dimensional (3D) printed ankle-foot orthoses are effective in treating many ankle-foot diseases. This study investigated the effects of customized 3D printed AFOs on biomechanics and comfort of the plantar foot in plantar fasciitis. MATERIAL AND METHODS Sixty patients with bilateral plantar fasciitis aged 31-60 years participated in this study. ⋯ The comfort scores reported by the experimental group were significantly lower than those of the control group (P<0.05). CONCLUSIONS This study supports the efficiency of customized 3D printing AFO for reducing damage associated with plantar lesions and improving comfort in patients with plantar fasciitis compared with prefabricated AFO. Customized AFO is useful in the treatment of plantar fasciitis compared with prefabricated AFOs.
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BACKGROUND Currently, proton pump inhibitors (PPIs) are the first-line treatment for ulcers resulting from endoscopic submucosal dissection (ESD). Vonoprazan is a new oral potassium-competitive acid blocker (P-CAB). The aim of this systematic review and meta-analysis was to compare the efficacy, safety, and tolerance of vonoprazan with PPIs in the treatment of peptic ulcers resulting from ESD. ⋯ No statistical evidence of publication bias was found. CONCLUSIONS The findings of the systematic review and meta-analysis showed that the efficacy of vonoprazan was comparable with PPIs for the treatment of peptic ulcers following ESD. Further studies are required to support the safety and efficacy of vonoprazan compared with different types of PPIs.
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BACKGROUND This study aimed to compare the efficacy and safety of bolus norepinephrine, phenylephrine, and ephedrine in parturient with preeclampsia who had hypotension during cesarean delivery under spinal anesthesia. MATERIAL AND METHODS One hundred and sixty-six parturient women with preeclampsia who had a baseline systolic blood pressure (SBP) <80% during spinal anesthesia for cesarean section were divided into three treatment groups; bolus norepinephrine 4 μg (group N) (n=56), phenylephrine 50 μg (group P) (n=55), and ephedrine 4 mg (group E) (n=55). Primary outcomes included overall SBP and heart rate (HR) until delivery. ⋯ RESULTS Overall HR in group N was significantly increased compared with group P (80.5±12 vs. 76.6±6.9 bpm; P=0.04), and significantly lower compared with group E (80.5±12 vs. 84.9±7.1 bpm; P=0.02). Parturients in group N had fewer episodes of bradycardia compared with group P (3.6% vs. 21.8%; RR=0.26l; 95% CI, 0.07-0.73; P=0.004) and fewer episodes of tachycardia compared with group E (16.1% vs. 36.4%; RR 0.54; 95% CI, 0.29-0.90; P=0.02). CONCLUSIONS A bolus dose of norepinephrine showed similar efficacy to phenylephrine but improved maternal and neonatal safety in parturients with preeclampsia with hypotension during cesarean section under spinal anesthesia.