Chinese Med J Peking
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Chinese Med J Peking · Jan 2013
Predicted lower limit of normal reduces misclassification risk of airflow limitation in asymptomatic elderly never-smokers.
It remains controversial what better defines abnormal lung function at the extremes of age. This study aimed to establish new spirometric reference equations for residents in Jinan and compare the most accepted two spirometric definitions of chronic obstructive pulmonary disease (COPD)-a fixed post-bronchodilator ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) below 70% vs. FEV1/FVC < lower limit of normal (LLN)-in an elderly population (age ≥60 years). ⋯ The Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion probably leads to overdiagnosis in asymptomatic elderly never-smokers. Our study suggests that the predicted LLN values will reduce the misclassification risk instead. However, cohort studies are urgently needed for clinical validation.
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Chinese Med J Peking · Jan 2013
Risk factors for perioperative major cardiac events in Chinese elderly patients with coronary heart disease undergoing noncardiac surgery.
Few studies have investigated perioperative major adverse cardiac events (MACEs) in elderly Chinese patients with coronary heart disease (CHD) undergoing noncardiac surgery. This study examined the incidence and risk factors for perioperative MACE in elderly patients who underwent noncardiac surgery, and established a risk stratification system. ⋯ Elderly Chinese patients with CHD who undergo noncardiac surgery have a high risk of perioperative MACE. Five independent risk factors for perioperative MACE were identified. Our risk stratification system may be useful for assessing perioperative cardiac risk in elderly patients undergoing noncardiac surgery.
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Chinese Med J Peking · Jan 2013
Training for percutaneous renal access on a virtual reality simulator.
The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC Mentor(TM) is designed to train the user in percutaneous renal collecting system access puncture. This study aimed to validate the use of this kind of simulator, in percutaneous renal access training. ⋯ The training on the virtual reality simulator, PERC Mentor(TM), can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently. This virtual reality simulator may become an important training and evaluation tool in teaching fluoroscopy-guided percutaneous renal access.
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Chinese Med J Peking · Jan 2013
Spine surgery may cause more spinal epidural hematomas than spinal puncture.
Spinal epidural hematoma (SEH) is a rare but acute and possibly devastating clinical event. The purpose of this study is to assess the multiple etiologies of SEH seen in an academic medical center over a 15-year span. We have examined the etiologies of SEH occurring in a single institution, the University of Pittsburgh Medical Center (UPMC) over the last fifteen years using an electronic record keeping system and database: the Medical Archive Retrieval System (MARS). ⋯ Spontaneous bleeding is by far the leading cause of SEH with spinal surgery being the second leading cause. Patients with multiple co-morbidities that result in coagulopathy from a variety of causes include liver or renal disease, alcohol abuse, radiation therapy, or chemotherapy. Neuraxial anesthesia is an extremely rare cause of SEH.
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Chinese Med J Peking · Jan 2013
Effect of total lumbar disc replacement on the treatment of discogenic low lumbar pain: preliminary outcomes.
Lumbar pedicle screw fixation and fusion are major procedures for treating discogenic low back pain (DLBP). However, due to its advantages of preserving the segmental motion and biomechanical simulation, artificial total lumbar disc replacement (TDR) is increasingly popular. ⋯ With similar clinical improvements as the traditional spinal fusion method, TDR offered significantly better ROM and intervertebral foramen height.