International journal of clinical and experimental medicine
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Balloon kyphoplasty has been shown to be safe in treatment of vertebral compression fractures refractory to conservative management. However, few reports have focused on lateral wedging of cemented vertebra after kyphoplasty. A 72-year-old woman with a T12 osteoporotic compression fracture underwent kyphoplasty using polymethylmethacrylate (PMMA) via a bipedicular approach. ⋯ Twelve months later, lateral wedging of the cemented vertebra was detected in plain radiographs. In the kyphoplasty procedure, symmetric cement filling should be achieved to avoid lateral wedging of the cemented vertebra. Postoperative anti-osteoporotic medication treatment is also very important.
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Locking of central venous catheters with heparin is an accepted practice to maintain catheter patency between dialysis sessions. However, this practice may cause other adverse reactions. Although many studies suggest benefits of other catheter lock solutions over heparin on these grounds, no consensus has been reached for clinical practice. ⋯ Compared with heparin, antimicrobial-containing lock solutions more effectively prevent CRB and clinical sepsis. Antibiotics + heparin and gentamicin + citrate solutions showing better prevention of CM. Citrate-alone lock solutions result in fewer CRB, bleeding and ESI episodes.
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This study aimed to investigate the clinical effect of percutaneous kyphoplasty and the precautions against adjacent vertebral refractures in the treatment of multiple osteoporotic vertebral compression fractures. 54 cases (128 vertebrae) with multiple osteoporotic vertebral compression fractures from July 2007 to December 2013 treated with percutaneous kyphoplasty were retrospectively reviewed. 36 cases of them suffered from bi-segment vertebral fractures, 16 cases with tri-segment vertebral fractures and 2 cases with quadri-segment vertebral fractures. The operative effect was evaluated by visual analogue scale (VAS) score and oswestry disability index (ODI) score. Then the reasons for adjacent vertebral refractures were analyzed and the precautions were proposed. 54 cases (128 vertebrae) were admitted with percutaneous kyphoplasty successfully. ⋯ In conclusion, percutaneous kyphoplasty is safe and effective to treat multiple osteoporotic vertebral compression fractures. However, the risk of new adjacent vertebral fractures in the multiple osteoporotic vertebral compression fractures is higher than that in the single osteoporotic vertebral compression fracture. Timely and proper treatment can reduce refractures.
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Mechanical ventilation using lower tidal volume ventilation with associated hypercapnia is supported to avoid ventilator-induced lung injury, but the underlying mechanism is not clear. This study was intended to explore whether low tidal volume ventilation with associated hypercapnia would ameliorate pneumoperitoneum-induced lung injury and whether this protection strategy might work through mediating inflammation and oxidative stress via TLR 4 signaling pathway. ⋯ Low tidal volume ventilation with associated hypercapnia ameliorated pneumoperitoneum-induced lung injury by reducing TLR 4-mediated inflammation and oxidative stress.
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Although quantitative computed tomography (CT) has been used to analyze the lungs of patients with confirmed diagnoses of acute respiratory distress syndrome (ARDS), there are few reports to show the diagnosis during the early stage of ARDS. Using a canine model and quantitative CT, we aimed to develop an oleic acid (OA) induced ARDS regarding the early stage of ARDS that could improve in the early diagnosis of ARDS. ⋯ Quantitative CT analysis can detect ARDS at an early stage with high sensitivity and specificity, providing a minimum of assistance in the early diagnosis of ARDS.