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1.
BMC Musculoskelet Disord ; 22(1): 716, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419028

RESUMO

OBJECTIVE: The objective of this study was to assess the accuracy and reliability of and time taken by a novel method using the built-in photo-edit function of smartphones compared with PACS in measuring hallux valgus parameters. METHODS: Seventy patients (124 ft) admitted to our hospital with a diagnosis of hallux valgus without previous surgical procedures were retrospectively reviewed. The foot radiographs of all the patients were extracted from PACS. The hallux valgus angle (HVA) and the first and second intermetatarsal angles (IMAs) were measured by PACS and by this novel method using the built-in photo-edit function of a smartphone. The results of these two methods were compared, and the accuracy and reliability were assessed between these two methods. RESULTS: The average parameters measured by PACS were as follows: HVA average: 37.43 ± 9.61°; IMA average: 13.37 ± 4.01°. The average parameters measured by smartphones were as follows: HVA average: 37.09 ± 9.52° and IMA average: 13.49 ± 3.91°. When compared by the independent-samples T test, the average parameters between PACS and smartphones were not significantly different (HVA PACS vs HVA smartphones: P = 0.776; IMA PACS vs IMA smartphones: P = 0.816). The variability of the HVA (F = 0.166, P = 0.992) and IMA (F = 0.215, P = 0.982) measurements was similar for the PACS and smartphones. The ICCs of the average parameters of four measurements of HVA and IMA between PACS and smartphones were 0.995 (0.991-0.997) and 0.970 (0.958-0.979), indicating that the two methods were highly correlated. For the smartphone measurement, the interobserver and intraobserver reliability was very good for HVA and IMA. The average measurement time of PACS was 25.41 ± 0.86 s, and the average measurement time of smartphones was 20.29 ± 1.22 s. The smartphone time was significantly faster than that of PACS by approximately 5 s (P<0.001). CONCLUSION: This novel method using the built-in photo-edit function of smartphones is accurate, reliable, convenient and time-saving in measuring the angles of hallux valgus.


Assuntos
Hallux Valgus , Ossos do Metatarso , Hallux Valgus/diagnóstico por imagem , Humanos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Smartphone
2.
Medicine (Baltimore) ; 100(34): e27123, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34449517

RESUMO

ABSTRACT: The specific method and dose of tranexamic acid (TXA) topically applied for intertrochanteric fractures have not been well established. The aim of this study is to investigate the efficacy and safety of TXA topically administered via our protocol for perioperative bleeding management in elderly patients with intertrochanteric fractures who underwent proximal femoral nail anti-rotation (PFNA).A retrospective comparative analysis was performed. The TXA group was composed of 82 patients with topical use of TXA, and the control group was composed of 82 patients without TXA use during the PFNA procedure. Intraoperative, total and hidden amounts of blood loss, drainage volumes, postoperative blood transfusion volumes and complications were compared between the 2 groups.The intraoperative, total and hidden amounts of blood loss and the drainage volumes were significantly lower in the TXA group than in the control group (P = .012, P < .01, P < .01, P = .014, respectively). The volume and rate of blood transfusion in the TXA group were significantly lower than those in the control group (P < .01). There were no significant differences in complications between the 2 groups (P > .05).Topical application of TXA offers an effective and safe option for reducing perioperative blood loss and transfusion in elderly patients with intertrochanteric fractures undergoing PFNA.


Assuntos
Antifibrinolíticos/administração & dosagem , Perda Sanguínea Cirúrgica/prevenção & controle , Fixação Intramedular de Fraturas/métodos , Fraturas do Quadril/cirurgia , Ácido Tranexâmico/administração & dosagem , Administração Tópica , Idoso , Idoso de 80 Anos ou mais , Transfusão de Sangue/estatística & dados numéricos , Feminino , Fixação Intramedular de Fraturas/efeitos adversos , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos
3.
Sci Rep ; 11(1): 15328, 2021 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-34321580

RESUMO

Enhancer RNAs (eRNAs) are a subclass of non-coding RNAs that are generated during the transcription of enhancer regions and play an important role in tumourigenesis. In this study, we focused on the crucial eRNAs that participate in immune responses in invasive breast cancer (IBC). We first used The Cancer Genome Atlas and Human enhancer RNA Atlas to screen for tissue-specific eRNAs and their target genes. Through Pearson correlation analysis with immune genes, the eRNA WAKMAR2 was identified as a key candidate involved in IBC. Our further research suggested that WAKMAR2 is crucial in regulating the tumour microenvironment and may function by regulating immune-related genes, including IL27RA, RAC2, FABP7, IGLV1-51, IGHA1, and IGHD. Quantitative reverse transcription-polymerase chain reaction was used to detect the expression of WAKMAR2 in IBC and normal tissues, and the effect of WAKMAR2 on the regulation of downstream genes in MB-231 and MCF7 cells was studied in vitro. WAKMAR2 was found to be highly involved in tumour immunity and was downregulated in IBC tissues. Furthermore, the expression of WAKMAR2 and its target genes was observed at the pan-cancer level. This study provides evidence to suggest new potential targets for the treatment of breast cancer.

4.
J Orthop Surg Res ; 16(1): 75, 2021 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-33478509

RESUMO

BACKGROUND: The rapid progressive cervical spondylotic myelopathy (rp-CSM) which had a course of CSM less than 1 month and suffered rapidly progressive neurological deterioration had few reports. Therefore, it is important for us to recognize the pathophysiology of CSM especially the rp-CSM. The study aimed to investigate the risk factors for rapidly progressive (rp) neurological deterioration in patients with cervical spondylotic myelopathy (CSM). METHODS: A total of 159 patients were reviewed and divided into an rp-CSM group and a chronic-CSM (c-CSM) group. Various clinical indexes, including age, sex, Japanese Orthopaedic Association (JOA) score, intramedullary MR T2-hyperintensity, congenital/degenerative spinal stenosis, and local type of ossification of the posterior longitudinal ligament (OPLL), were analyzed, and independent risk factors were investigated. RESULTS: Thirty-four of 159 patients (21.4%) were diagnosed with rp-CSM. All patients were followed up for a mean of 68.56 ± 14.00 months in the rp-CSM group and 62.66 ± 19.95 months in the c-CSM group. No significant difference was found in sex, mean age, smoking and drinking status, diabetes mellitus (DM), hypertension, surgery time, blood loss, JOA score, degenerative spinal stenosis, or OPLL (local). Univariate analyses demonstrated that rp-CSM patients tended to have MR T2-hyperintensity, longer hospital stay, shorter waiting time for surgery, more congenital spinal stenosis, and worse neurological function and to prefer more posterior surgeries than c-CSM patients. A multiple logistic regression analysis showed that congenital spinal stenosis and MR T2-hyperintensity were independently related to the presence of rp-CSM. CONCLUSIONS: MR T2-hyperintensity and congenital spinal stenosis were risk factors for rp-CSM. Although neurological function deteriorates rapidly, early surgical decompression is recommended and can achieve good neurological recovery after surgery, indicating that rp-CSM could be a reversible condition.


Assuntos
Deterioração Clínica , Espondilose/etiologia , Espondilose/fisiopatologia , Adulto , Doença Crônica , Descompressão Cirúrgica , Imagem de Tensor de Difusão , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação do Ligamento Longitudinal Posterior , Fatores de Risco , Estenose Espinal , Espondilose/diagnóstico por imagem , Espondilose/cirurgia , Fatores de Tempo
5.
Sci Rep ; 10(1): 22036, 2020 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-33328557

RESUMO

A retrospective study investigated the results of the lamina with spinous process (LSP) as a bone graft in one-level thoracic or lumbar spinal tuberculosis with the one-stage posterior approach of debridement, fusion and internal instrumentation. Data from 35 patients from January 2013 to December 2015 were analysed. Surgery time, blood loss, hospitalization time, drainage volume, and follow-up (FU) duration were recorded. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), American Spinal Injury Association (ASIA) grade, segmental angle, and bone fusion were compared between preoperative and final FU. All of the patients were followed up for a mean 43.90 ± 10.39 months. The mean age, surgery time, blood loss, hospitalization time, hospital cost and drainage volume were 33.65 ± 11.06 years, 182.40 ± 23.82 min, 280.80 ± 76.82 mL, 14.05 ± 3.58 days, 74,382.00 ± 11,938.00 yuan, and 340.00 ± 167.20 mL, respectively. VAS and ODI were significantly improved at the final FU. The ESR and CRP recovered to normal. The mean angle of 24.35 ± 5.74°preoperatively showed a significant difference between 1 week, postoperatively and final FU. Although there were the loss of angle at final FU comparing with the 1 week postoperatively, it still maintain the good alignment and the segmental stability. All patients achieved bony fusion with a mean time of 12.90 ± 3.91 months. In conclusion, the LSP as a structural bone graft is reliable, safe and effective for segmental stability reconstruction, which could be one choice for surgical management of thoracic or lumbar spinal TB.


Assuntos
Vértebras Lombares/cirurgia , Vértebras Torácicas/cirurgia , Tuberculose da Coluna Vertebral/cirurgia , Adulto , Sedimentação Sanguínea , Proteína C-Reativa/metabolismo , Avaliação da Deficiência , Feminino , Humanos , Masculino , Estudos Retrospectivos , Tuberculose da Coluna Vertebral/sangue , Tuberculose da Coluna Vertebral/diagnóstico por imagem , Escala Visual Analógica
6.
Int J Med Sci ; 17(17): 2844-2849, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33162812

RESUMO

A retrospective study investigated and compared the results of lamina with spinous process (LSP), transverse process strut (TPS) and iliac graft (IG) as bone graft in thoracic single-segment spinal tuberculosis(TB) with the one-stage posterior approach of debridement, fusion and internal instrumentation. 99 patients treated from January 2012 to December 2015 were reviewed. LSP was performed in 35 patients (group A), TPS was undertaken in 33 patients (group B), and IG was carried out in 31 patients (group C). Surgical time, blood loss, hospitalization time, drainage volume, and follow-up (FU) duration were recorded. The visual analog scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), American Spinal Injury Association (ASIA) grade, segmental angle, intervertebral height and bone fusion time were compared between preoperative and final FU. All the patients were followed up for a mean 43.90±10.39 months in group A, 45.30±6.20 months in group B, 44.32±7.17 months in group C without difference(P>0.05). The mean age was younger, the blood loss was less, the hospitalization time and the surgical time were shorter in group A than those in group B and C (P<0.05). The drainage volume was less in group A than that in group B and group C. The CRP, ESR, VAS, and ODI were significantly decreased and there were no significant difference among the groups at the final FU. The neurological function after surgery was improved compared with preoperation among the groups. The bony fusion at a mean time 12.90±3.91 months in group A was longer than that in group B (6.75±1.55 months) and group C (5.52±1.64 months) (P<0.05). No significant difference was found at the mean segmental angle, mean intervetebral height of preoperation and final FU among the groups (P>0.05). In conclusion, the LSP and TPS as bone graft are reliable, safe, and effective for single-segment stability reconstruction for surgical management of thoracic TB and TPS could be new bone graft methods.

7.
BMC Geriatr ; 20(1): 301, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32831034

RESUMO

BACKGROUND: The study was to investigate the complications rate of and risk factors for unplanned reoperation among elderly patients who underwent posterior lumbar fusion (PLF) for degenerative lumbar spondylolisthesis (DLS). METHODS: A total of 1100 DLS patients who were older than 60 years were reviewed from January 2006 to December 2016. 33 patients underwent unplanned reoperations and were analysed and divided into two groups (group A: posterolateral fusion, 650 patients; group B: intervertebral fusion, 450 patients). Sex, body mass index (BMI), radiographic data and clinical outcome data were analysed to evaluate the complications rate of and the risk factors for unplanned reoperations. RESULTS: A total of 33 patients underwent unplanned reoperations (3%). The patients were followed up for an average of 4.20 ± 2.25 years (group A) and 4.32 ± 2.54 years (group B) without a significant difference. Significant differences were found in mean age, levels of involvement, hospital stay, surgery time, and blood loss between the groups. The causes of unplanned operation were wound infection, screw misplacement, neurological deficit, nonunion, and screw fracture, which were significant except for wound infection between the groups. Higher BMI (obesity), diabetes mellitus (DM), more bleeding and sex (female) were risk factors for complications. Cases of screw misplacement, neurological deficit, nonunion and screw fracture in group A were more significant than those in group B. CONCLUSION: Patients with higher BMI, DM, older age, posterolateral fusion, and female sex predicted a higher incidence of unplanned reoperations. Spine surgeons may need to pay more attention to their preoperative training and to improving surgical techniques that could reduce the reoperation rate.


Assuntos
Fusão Vertebral , Espondilolistese , Idoso , Estudos de Coortes , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Reoperação , Estudos Retrospectivos , Fatores de Risco , Fusão Vertebral/efeitos adversos , Espondilolistese/diagnóstico por imagem , Espondilolistese/epidemiologia , Espondilolistese/cirurgia , Resultado do Tratamento
8.
J Orthop Surg Res ; 15(1): 280, 2020 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-32711560

RESUMO

BACKGROUND: The study aimed to investigate the correlation between type 1 diabetes (T1D) and lumbar disc degeneration (LDD). METHODS: A retrospective analysis of 118 patients with T1D recruited from January 2014 to March 2019 was performed, and multivariate logistic regression was used to analyse the incidence of T1D; the age, sex, and body mass index (BMI) of the patients; the disease duration and the glycosylated haemoglobin and venous blood glucose levels. All patients who suffered low back pain were assessed by MRI using the Pfirrmann grading system. RESULTS: A total of 118 patients with an average age of 36.99 ± 17.01 (8-85 years) were reviewed. The mean hospitalization duration, venous glucose fluctuation range, glycated haemoglobin level, highest venous glucose level, venous glucose level, and disease course duration were 13.98 ± 10.16 days, 14.99 ± 5.87 mmol/L, 9.85 ± 2.52 mmol/L, 25.29 ± 7.92 mmol/L, 13.03 ± 5.75 mmol/L and 7.30 ± 8.41 years. The average Pfirrmann scores of the different discs were 2.20 ± 0.62 (L1-2), 2.35 ± 0.67 (L2-3), 2.90 ± 0.45 (L3-4), 4.20 ± 0.52 (L4-5) and 4.10 ± 0.72 (L5-S1). The patients with T1D showed severe disc degeneration. The male sex, glycosylated haemoglobin, venous glucose and venous glucose fluctuations were significantly associated with LDD (P < 0.05). CONCLUSIONS: Glycosylated haemoglobin, the male, venous glucose and the venous glucose fluctuation range were risk factors for LDD.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Degeneração do Disco Intervertebral/etiologia , Vértebras Lombares , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia , Índice de Massa Corporal , Criança , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Hemoglobina A Glicada , Humanos , Degeneração do Disco Intervertebral/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
9.
Spine (Phila Pa 1976) ; 45(12): E721-E728, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31972744

RESUMO

STUDY DESIGN: Bibliometric analysis. OBJECTIVE: This study aims to identify and summarize the articles related to sacral fracture surgery, to compare the papers from different countries and journals, to show the trends of researches on sacral fracture surgery. SUMMARY OF BACKGROUND DATA: In recent years, studies on sacral fracture are growing rapidly, but there were no bibliometric studies regarding sacral fracture surgery. METHODS: Excel 2016 and VOSviewer were used to identify and summarize the articles from Web of Science between 1900 and 2018. Publication number, publication year, publication country, publication organization, publication source, author, sum of times cited, H-index, and journal's impact factors were recorded and analyzed. Bibliometric maps of co-citations and maps of co-occurrence of keywords are drawn. RESULTS: A total of 611 publications were extracted. United States published most articles (227, 37.2%), both total citations (3536) and H-index (32) of United States ranked first of all the countries. The most productive organization on sacral fracture surgery is Johns Hopkins University (14). Spine (43) published the most articles on sacral fracture surgery. The latest keyword "patterns" appeared in 2017 in 5 articles. Other relatively new keywords include "proximal junctional kyphosis," "spondylopelvic dissociation," "fragility fracture," "lumbopelvic fixation" that appeared in 2017 in eight, six, six, and 25 articles, respectively. CONCLUSION: This bibliometric study showed that there is a growing trend both in published articles related to sacral fracture surgery and relative research interest in the last 30 years. United States dominates the research regarding sacral fracture surgery. Johns Hopkins University, Johannes Gutenberg University of Mainz, and Harborview Medical Center are the best institutions related to sacral fracture surgery research. Spine, J Orthop Trauma, and Injury are the top three productive journals on sacral fracture surgery. Sacral fracture patterns, proximal junctional kyphosis, spondylopelvic dissociation, fragility fracture, and lumbopelvic fixation may be the new research hotspot in this field. LEVEL OF EVIDENCE: 5.


Assuntos
Bibliometria , Fraturas da Coluna Vertebral/história , Eficiência , Eficiência Organizacional , História do Século XX , História do Século XXI , Humanos , Fator de Impacto de Revistas , Cifose , Publicações
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