Articles: surgery.
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Avascular necrosis of femoral head (AVNFH) is a debilitating disease of the young, affecting the quality of life significantly and eventually leading to total hip replacement surgery. The disease is diagnosed clinico-radiologically and MRI is the investigation of choice to diagnose the early stages of the disease. There is neither an early biomarker for detection nor is there a permanent cure for the disease and most of the patients are managed with various combinations of surgical and medical management protocols. ⋯ The cell types involved include mesenchymal stem cells, osteoblasts, osteoclasts, endothelial and immune cells. Biochemical, hematological, histopathology, IHC, and other bone remodeling and degradation marker studies have been performed. A systems analysis using multi-omic data sets from published literature was carried out, the relevance of which is discussed to delineate potential mechanisms in etiopathogenesis, diagnosis, and effective management of this debilitating disease.
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Observational Study
[Activity of internal medicine services in the surgical area in Argentina].
The aim of the study was to determine the organization of healthcare activity of internal medicine (IM) services in the surgical area of general acute care hospitals in Argentina. ⋯ The activity of the internist in the surgical area is mainly through the MI and in less than half it is through SC. In Argentina, there is no uniform pattern in the organization of activity of the internist in response to the demand for IMC and in the practice of SC. The activities are subordinate to the activities of the internal medicine service, and it is a statistically hidden activity.
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This article's objectives are to develop a model to predict children's recovery of elbow function following supracondylar fracture, analyze the risk factors affecting those children's elbow function after surgery, and propose a individualized treatment strategy for elbow function in various children. We retrospectively analyzed clinical data from 410 children with supracondylar humerus fracture. A modeling set and a validation set of kids in the included studies were arbitrarily split into 2 groups on a 7:3 basis. ⋯ There were no significant changes in the afflicted limb's lateral difference, surgical method, onset season, and number of K-wires, according to univariate logistic regression analysis. Age (P < .001), weight (P < .001), height (P < .001), preoperative elbow soft tissue injury (OR = 1.724, 95% CI: 1.040-2.859, P = .035), sex (OR = 2.220, 95% CI: 1.299-3.794, P = .004), fracture classification (Gartland IIb) (OR = 0.252, 95% CI: 0.149-0.426, P < .001), no nerve injury before surgery (OR = 0.304, 95% CI: 0.155-0.596, P = .001), prying technique (OR = 0.464, 95% CI: 0.234-0.920, P = .028), postoperative daily light time > 2 hours (OR = 0.488, 95% CI: 0.249-0.955, P = .036) has a significant difference in univariate analysis; Multivariate regression analysis yielded independent risk factors: fracture classification; No nerve injury before surgery; The daily light duration after surgery was > 2 hours; soft tissue injury; Age, postoperative cast fixation time. The establishment of predictive model is of significance for pediatric orthopedic clinicians in the daily diagnosis and treatment of supracondylar humerus fracture.
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Review Case Reports
Pelvic metastatic squamous cell carcinoma of unknown primary site: A case report and brief literature review.
Cancer with unknown primary site is a kind of disease that is difficult to deal with clinically, accounting for 2% to 9% of all newly diagnosed cancer cases. Here, we report such a case with pelvic metastatic squamous cell carcinoma of an unknown primary site and review the relevant literature. ⋯ Our case demonstrates that surgery combined with chemotherapy could be helpful for pelvic metastatic squamous cell carcinoma of unknown primary site.
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Randomized Controlled Trial Comparative Study
Effects of blue-light-filtering intraocular lenses on contrast sensitivity in patients with glaucoma.
To compare the effects of blue-light-filtering intraocular lenses (BF-IOLs) and conventional ultraviolet-blocking intraocular lenses (UVB-IOLs) on contrast sensitivity in patients with concurrent cataracts and glaucoma. This prospective randomized comparative interventional study enrolled glaucomatous patients with concurrent cataracts scheduled for cataract surgery with IOL implantation at Siriraj Hospital, Bangkok, Thailand, between October 2016 and March 2018. The patients were randomly assigned to receive BF-IOLs or UVB-IOLs. ⋯ However, the 2 groups had no significant differences in log contrast sensitivity values at each spatial frequency (P = .20, .37, .30, .28, and .68, respectively). Cataract surgery with IOL implantation improved contrast sensitivity in glaucomatous patients. The BF-IOLs and UVB-IOLs showed no statistically significant difference in the postoperative contrast sensitivity achieved at each spatial frequency.