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1.
Ann Transl Med ; 8(13): 824, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32793669

RESUMO

This systematic review and meta-analysis investigated differences in accuracy, operation time, and radiation exposure time between robot-assisted and freehand techniques for pedicle screw insertion. Two investigators independently searched for articles on randomized controlled trials (RCTs) published from 2012 to 2019. The final meta-analysis included seven RCTs. We compared the accuracy of pedicle screw placement, operation time, and radiation exposure time between robot-assisted and conventional freehand groups. Seven RCTs included 540 patients and placement of 2,476 pedicle screws, of which 1,220 were inserted using the robot-assisted technique and 1,256 were inserted using the conventional freehand technique. The pedicle screw positions were classified using the Gertzbein and Robbins classification (grade A-E). The combined results of Grade A [odds ratio (OR) =1.68; 95% confidence intervals (CI): 0.82-3.44; P=0.16), Grade A+B (OR =1.70; 95% CI: 0.47-6.13; P=0.42), and Grade C+D+E (OR =0.59; 95% CI: 0.16-2.12; P=0.42) for the accuracy rate revealed no significant difference between the two groups. Subgroup analysis results revealed that the TiRobot-assisted technique presented a significantly improved pedicle screw insertion accuracy rate compared with that of the conventional freehand technique, based on Grade A, Grade A+B, and Grade C+D+E classifications. The SpineAssist-assisted technique presented an inferior pedicle screw insertion accuracy rate compared with that of the conventional freehand technique, based on Grade A, Grade A+B, and Grade C+D+E classifications. No difference between the Renaissance-assisted and conventional freehand techniques was noted for pedicle screw insertion accuracy rates, based on both Grade A (OR =1.58; 95% CI: 0.85-2.96; P=0.15), Grade A+B (OR =2.20; 95% CI: 0.39-12.43; P=0.37), and Grade C+D+E (OR =0.45; 95% CI: 0.08-2.56; P=0.37) classifications. Regarding operation time, robot-assisted surgery had significantly longer operation time than conventional freehand surgery. The robot-assisted group had significantly shorter radiation exposure time. Regarding the pedicle screw insertion accuracy rate, the TiRobot-assisted technique was superior, the SpineAssist-assisted technique was inferior, and Renaissance was similar to the conventional freehand technique.

2.
Artigo em Inglês | MEDLINE | ID: mdl-30709020

RESUMO

Background: We aimed to review published studies to obtain the best estimate of the risk of depression and anxiety among colorectal cancer (CRC) patients. Methods: We searched the PubMed/Medline database, Web of Science, and Google Scholar on the prevalence of depression or anxiety in CRC patients. A review of 15 studies published between June 1967 and June 2018 were conducted, and 93,805 CRC patients were included. Results: The prevalence of depression among patients diagnosed with CRC ranged from 1.6%⁻57%, and those of anxiety ranged from 1.0%⁻47.2%. Studies in which an expert (psychiatrist) administered the interviews reported lower prevalence of both depression and anxiety. Conclusion: The findings of this review suggest that patients with CRC exhibited a significantly high prevalence of both depression and anxiety, and these symptoms can persist even after cancer treatment is completed. However, the correlation of age and the emergence of depression or anxiety in CRC patients still remain controversial.


Assuntos
Ansiedade/epidemiologia , Neoplasias Colorretais/psicologia , Depressão/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
3.
Materials (Basel) ; 12(2)2019 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-30634440

RESUMO

Recently, cases of bone defects have been increasing incrementally. Thus, repair or replacement of bone defects is gradually becoming a huge problem for orthopaedic surgeons. Three-dimensional (3D) scaffolds have since emerged as a potential candidate for bone replacement, of which titanium (Ti) alloys are one of the most promising candidates among the metal alloys due to their low cytotoxicity and mechanical properties. However, bioactivity remains a problem for metal alloys, which can be enhanced using simple immersion techniques to coat bioactive compounds onto the surface of Ti⁻6Al⁻4V scaffolds. In our study, we fabricated magnesium-calcium silicate (Mg⁻CS) and chitosan (CH) compounds onto Ti⁻6Al⁻4V scaffolds. Characterization of these surface-modified scaffolds involved an assessment of physicochemical properties as well as mechanical testing. Adhesion, proliferation, and growth of human Wharton's Jelly mesenchymal stem cells (WJMSCs) were assessed in vitro. In addition, the cell attachment morphology was examined using scanning electron microscopy to assess adhesion qualities. Osteogenic and mineralization assays were conducted to assess osteogenic expression. In conclusion, the Mg⁻CS/CH coated Ti⁻6Al⁻4V scaffolds were able to exhibit and retain pore sizes and their original morphologies and architectures, which significantly affected subsequent hard tissue regeneration. In addition, the surface was shown to be hydrophilic after modification and showed mechanical strength comparable to natural bone. Not only were our modified scaffolds able to match the mechanical properties of natural bone, it was also found that such modifications enhanced cellular behavior such as adhesion, proliferation, and differentiation, which led to enhanced osteogenesis and mineralization downstream. In vivo results indicated that Mg⁻CS/CH coated Ti⁻6Al⁻4V enhances the bone regeneration and ingrowth at the critical size bone defects of rabbits. These results indicated that the proposed Mg⁻CS/CH coated Ti⁻6Al⁻4V scaffolds exhibited a favorable, inducive micro-environment that could serve as a promising modification for future bone tissue engineering scaffolds.

4.
Medicine (Baltimore) ; 97(50): e13583, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30558026

RESUMO

INTRODUCTION: The aim of this systematic review is to investigate the effects of perioperative intravenous administration of MgSO4 on postoperative pain, analgesic consumption and adverse effects in patients undergoing orthopedic surgery. METHODS: Two investigators independently searched for articles on randomized controlled trials (RCTs) from 1998 to 2016 in Pubmed, Web of science and Google scholar. We evaluated clinical outcomes, comparing postoperative pain scores, cumulative analgesic consumption, time to first analgesia, and adverse effects between orthopedic surgery patients with and without the administration of MgSO4. RESULTS: After screening 2350 articles, 11 RCTs (with a total sample size of 535 subjects) were included in this systematic review. Perioperative intravenous administered MgSO4 could reduce postoperative pain intensity compared with control in 6 trials (55%), but without significant difference in 5 trials (45%). With MgSO4 treatments, postoperative analgesic consumption was significantly reduced in 8 trials (73%), and without significant difference in 2 trials (18%). Two trials evaluated the time to first request of analgesic after surgery and showed prolong of 2.3 hours and 93 minutes respectively. MgSO4 group had less postoperative nausea (relative risk [RR] = 0.32, 95% confidence interval [CI] = 0.12-0.82, number needed to harm [NNH] = 8.8), vomiting (RR = 0.38, 95% CI = 0.15-0.92, NNH = 9.7), and shivering (RR = 0.31, 95% CI = 0.11-0.88, NNH = 5.2). CONCLUSION: Perioperative intravenous administration of MgSO4 in orthopedic surgery could reduce postoperative analgesic consumption and adverse effects such as vomiting, nausea, and shivering. These trials do not provide convincing evidence of beneficial effects on postoperative pain intensity and the time to first analgesic request. More trials should be conducted for the roles of MgSO4 in pain management for orthopedic surgery. However, intravenous MgSO4 administration should be considered as a strategy to relieve postoperative pain in orthopedic surgery patients.


Assuntos
Analgesia/normas , Sulfato de Magnésio/efeitos adversos , Procedimentos Ortopédicos/normas , Administração Intravenosa , Analgesia/métodos , Humanos , Sulfato de Magnésio/uso terapêutico , Procedimentos Ortopédicos/métodos , Medição da Dor/métodos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Cuidados Pós-Operatórios/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
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