Articles: surgery.
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Several studies have explored strategies to prevent proximal junctional kyphosis (PJK) which is the unresolved issue in adult spinal deformity (ASD) surgery. This study aimed to investigate the preventive effects of upper instrumented vertebrae (UIV) recombinant human bone morphogenetic protein-2 (rhBMP-2) with beta-tricalcium phosphate (β-TCP) carrier injection on PJK. ⋯ The transpedicular injection of rhBMP-2/β-TCP carrier at the UIV significantly contributed to the prevention of PJK and effectively increased trabecular bone density at the UIV.
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To create a novel comorbidity score tailored for surgical database research. ⋯ The CORE score may better predict in-hospital mortality after surgery due to comorbid diseases in outcome-based research.
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The wide-awake local anesthesia no tourniquet (WALANT) technique, which is based on the local infiltration of lidocaine and epinephrine, is widely used in hand and wrist surgery. However, few studies have been conducted on the cost-benefit analysis of phalanx fracture surgery using the WALANT technique. This study aimed to investigate the clinical condition, time spent on anesthesia and operation. We also perform an economic analysis among general anesthesia, local anesthesia with a tourniquet, and the WALANT technique for plate fixation of phalanx fractures. ⋯ Open reduction with plate fixation of phalanx fractures using the WALANT technique and local anesthesia was cost-effective compared with general anesthesia. Patients who underwent phalanx fracture surgery using the WALANT technique experienced less pain on the first postoperative day than those who underwent surgery using general or local anesthesia with a tourniquet because of the adequate tumescent technique and not using a tourniquet during surgery.
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Randomized Controlled Trial Multicenter Study Comparative Study
Continuation vs Discontinuation of Renin-Angiotensin System Inhibitors Before Major Noncardiac Surgery: The Stop-or-Not Randomized Clinical Trial.
Before surgery, the best strategy for managing patients who are taking renin-angiotensin system inhibitors (RASIs) (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) is unknown. The lack of evidence leads to conflicting guidelines. ⋯ Among patients who underwent major noncardiac surgery, a continuation strategy of RASIs before surgery was not associated with a higher rate of postoperative complications than a discontinuation strategy.