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1.
Chin J Integr Med ; 28(4): 312-318, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34874517

RESUMO

OBJECTIVE: To explore the effect of Shenmai Injection (SMI) on the long-term prognosis of patients with chronic heart failure (CHF). METHODS: The Hospital Information System was used to extract data of CHF patients, and the retrospective cohort study was conducted for analysis. In non-exposed group, standardized Western medicine treatment and Chinese patent medicine or decoction were applied without combination of SMI while in the exposed group, SMI were applied for more than 7 days. Evaluation indicators are followed with New York Heart Association functional classification (NYHA classification), left ventricular ejection fraction (LVEF), N-terminal brain natriuretic peptide precursor (NT-ProBNP), cardiogenic death and heart failure (HF) readmission. Statistical analysis includes Kaplan-Meier analysis and Cox regression which are used to explore the relationship between SMI and outcome events. RESULTS: A total of 1,211 eligible CHF patients were involved and finally 1,047 patients were followed up successfully. After treatment, the cases of NYHA classification decline in the exposed and non-exposed groups accounted for 64.30% and 43.45%, respectively; the improvement values of LVEF were 8.89% and 7.91%, respectively; the improvement values of NT-ProBNP were 909 pg/mL and 735 pg/mL, respectively. After exposure on SMI, the rates of cardiogenic death and HF readmission reduced from 15.43% to 10.18% and 38.93% to 32.37%. According to Kaplan-Meier analysis, the log-rank P value of SMI and cardiogenic death was 0.014, while the counterpart of SMI and HF readmission was 0.025. Cox regression analysis indicated that for cardiogenic death, age, cardiomyopathy, diabetes, and NYHA classification were risk factors while ß-blockers, aldosterone receptor antagonists, Chinese patent medicine/decoction and SMI were protective factors. Likewise, for HF readmission, age, cardiomyopathy, and NYHA classification were risk factors while SMI was a protective factor. CONCLUSION: Combination with SMI on the standardized Western medicine treatment can effectively reduce cardiogenic mortality and readmission rate in CHF patients, and thereby improve the long-term prognosis.


Assuntos
Insuficiência Cardíaca , Função Ventricular Esquerda , Biomarcadores , Combinação de Medicamentos , Medicamentos de Ervas Chinesas , Seguimentos , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Prognóstico , Estudos Retrospectivos , Volume Sistólico
2.
Curr Opin Ophthalmol ; 33(5): 453-463, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35916572

RESUMO

PURPOSE OF REVIEW: To review all phakic intraocular lenses (pIOLs) available in the United States for the correction of myopia or myopic astigmatism and offer a clinical approach to their proper use, postoperative follow-up, and analysis of visual and adverse outcomes. RECENT FINDINGS: In March 2022, the FDA approved the EVO/EVO+ Visian ICL for widespread use, adding this lens to the two others available (Verisyse, Visian ICL). Cataract formation, endothelial cell loss (ECL) and surgical reintervention remain the most common adverse events. There are discrepancies between studies on ECL following implantation with pIOLs, although trends can be deduced with meta-analysis. Posterior Chamber-pIOLs (PC-pIOLs), especially the EVO/EVO+, have an overall lower mean adverse effect and subjective patient symptom profile when compared to Iris Fixated-pIOLS (IF-pIOLs). Advancements in PC-pIOL sizing have provided a noticeable difference in visual and safety outcomes. SUMMARY: All pIOLs available in the United States provide high-quality visual correction of moderate to high myopia and/or myopia with astigmatism. Proper follow-up for ECL and cataract formation is warranted.


Assuntos
Astigmatismo , Catarata , Lentes Intraoculares , Miopia , Lentes Intraoculares Fácicas , Astigmatismo/cirurgia , Catarata/etiologia , Seguimentos , Humanos , Miopia/cirurgia , Lentes Intraoculares Fácicas/efeitos adversos , Refração Ocular , Estados Unidos , Acuidade Visual
3.
Indian J Ophthalmol ; 70(8): 2915-2921, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35918943

RESUMO

Purpose: To evaluate the incidence of shallow anterior chamber in the early postoperative period following Ahmed glaucoma valve (AGV) implantation and its effect on the hypertensive phase (HP), intermediate-term intraocular pressure (IOP) control, and success rate. Methods: A retrospective analysis of 369 eyes of 360 patients who underwent AGV implantation between January 2005 and January 2020 with a minimum follow-up of 2 months was performed. Twenty-six patients developed shallow anterior chamber (AC) within 8 weeks following surgery (cases). They were compared with 39 randomly selected controls (no shallow AC post AGV). HP (IOP spike >21 mmHg), use of ocular hypotensive medications, and other associations were compared. Results: Incidence of shallow AC post AGV was 7% (95% confidence interval [CI] 4, 9). The onset of shallow AC was 3 ± 2.1 days and resolved within 6 ± 4.7 days. Hypotony (12 [47%] vs. 1 [2.5%], P 0.0001) and choroidal detachment (CD; 7 [27%] vs. 3 [8%], P 0.03) were more common in cases compared to controls. The HP occurred in 11 (43%) cases versus 13 (34%) controls (P 0.4). Cases required more ocular hypotensive medications than controls at the end of 8 weeks (1.1 ± 1 vs. 0.5 ± 0.5, P 0.01). There was no significant difference in the qualified success between the groups at 1 year. Conclusion: The development of postoperative shallow AC post AGV implantation was not detrimental to IOP control at 1 year. However, there is a need to monitor the occurrence of HP in these eyes.


Assuntos
Implantes para Drenagem de Glaucoma , Glaucoma , Câmara Anterior/cirurgia , Anti-Hipertensivos/uso terapêutico , Seguimentos , Implantes para Drenagem de Glaucoma/efeitos adversos , Humanos , Pressão Intraocular , Implantação de Prótese , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual
4.
Minerva Obstet Gynecol ; 74(4): 393-397, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35920359

RESUMO

Placenta accreta spectrum (PAS) is a condition of abnormal placental invasion including placenta accreta, increta and percreta and is a major cause of maternal morbidity and mortality. Recently, a conservative surgical technique has been proposed as a valid alternative to peri-partum hysterectomy to reduce the short- and long-term risks for the mothers and to preserve fertility. Magnetic resonance imaging (MRI) seems to be useful first of all at the time of diagnosis and furthermore to investigate the course of conservative management of PAS. We describe three cases of PAS treated with conservative procedure and managed with clinic, ultrasound and MRI by a multidisciplinary equipe.


Assuntos
Placenta Acreta , Hemorragia Pós-Parto , Cesárea/métodos , Feminino , Seguimentos , Humanos , Placenta , Placenta Acreta/diagnóstico por imagem , Gravidez
5.
PLoS One ; 17(8): e0272369, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35930578

RESUMO

PURPOSE: To analyze ocular biometric changes following unilateral cataract surgery in children. METHODS: A total of 57 children aged under 13 years who underwent unilateral cataract surgery were analyzed. Groups were classified according to their age at surgery: group I (age <3), II (3≤ age <6), III (6≤ age <9), and IV (age ≥9). The myopic shift, axial growth, and corneal curvature changes were compared between the pseudophakic eyes and the fellow phakic eyes. RESULTS: During 7.81 ± 4.39 years, the overall myopic shift (D) and the rate of myopic shift (D/year) were significantly higher at -3.25 ± 3.21 D and -0.45 ± 0.44 D/year in the pseudophakic eyes than -1.78 ± 2.10 D and -0.22 ± 0.29 D/year in the fellow phakic eyes (P = 0.01, 0.004). Group I (-1.14 ± 0.66 vs -0.02 ± 0.45 D/year) and group II (-0.63 ± 0.37 vs -0.31 ± 0.29 D/year) showed significantly higher rate of myopic shift in the pseudophakic eyes than in the phakic eyes. The rate of myopic shift in the pseudophakic eyes decreased in the older age groups (P = 0.001). There was no significant between-eye difference in the changes in axial length and keratometric values postoperatively. CONCLUSION: Following unilateral cataract surgery, a significant postoperative myopic shift was noticed in the pseudophakic eyes compared to the fellow phakic eyes in groups under 6 years old. Postoperative myopic shift and the resultant anisometropia should be considered when selecting the optimal power of IOL in young children requiring unilateral cataract surgery.


Assuntos
Extração de Catarata , Catarata , Miopia , Idoso , Biometria , Criança , Pré-Escolar , Córnea , Seguimentos , Humanos , Implante de Lente Intraocular , Miopia/cirurgia , Refração Ocular
6.
Age Ageing ; 51(8)2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35930724

RESUMO

INTRODUCTION: multimorbidity has become an increasingly important issue for many populations around the world, including Canada. The objectives of this study were to estimate the prevalence of multimorbidity at first follow-up and to identify factors associated with multimorbidity using data from the Canadian Longitudinal Study on Aging (CLSA). METHODS: this study included 27,701 community-dwelling participants in the first follow-up of the CLSA. Multimorbidity was operationalised using two definitions (Public Health and Primary Care), as well as the cut-points of two or more chronic conditions (MM2+) and three or more chronic conditions (MM3+). The prevalence of multimorbidity was calculated at first follow-up and multivariable regression models were used to identify correlates of multimorbidity occurrence. RESULTS: the prevalence of multimorbidity at first follow-up was 32.3% among males and 39.3% among females when using the MM2+ Public Health definition, whereas the prevalence was 67.2% among males and 75.8% among females when using the MM2+ Primary Care definition. Older age, lower alcohol consumption, lower physical activity levels, dissatisfaction with sleep quality, dissatisfaction with life and experiencing social limitations due to health conditions were significantly associated with increased odds of multimorbidity for both males and females, regardless of the definition of multimorbidity used. CONCLUSION: various sociodemographic, behavioural and psychosocial factors are associated with multimorbidity. Future research should continue to examine how the prevalence of multimorbidity changes with time and how these changes may be related to specific risk factors. This future research should be supplemented with studies examining the longitudinal impacts of multimorbidity over time.


Assuntos
Vida Independente , Multimorbidade , Idoso , Envelhecimento/psicologia , Canadá/epidemiologia , Doença Crônica , Estudos Transversais , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Prevalência
7.
J Orthop Traumatol ; 23(1): 37, 2022 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-35932367

RESUMO

BACKGROUND: With the development of radiology and three-dimensional (3D) printing technology, custom-made 3D-printed titanium augments have been more widely used. However, the radiological and clinical outcomes of custom-made augments lack reports. To better understand the clinical effect of using 3D-printed titanium augments and the significance of accurate placement, the aim of this study was to assess the outcomes when using custom-made 3D-printed titanium augments and to validate the idea that surgical simulation should be done before designing custom-made augments. METHODS: A retrospective review was conducted on 31 surgical simulations and revision total hip arthroplasties using custom-made 3D-printed titanium augments. The safe zone, cup position, and hip rotation center were measured on anteroposterior radiographs. Clinical outcomes were assessed with a mean 21.1 months of follow-up. RESULTS: All patients were positioned within the safe zone, and none of the acetabular cups nor the custom-made augments had any evidence of migration at the latest follow-up. A strong correlation was found between the planned cup position and the postoperative position. The average vertical position of the center of rotation was significantly increased from 3.55 cm to 2.35 cm. The mean Harris Hip Score was increased from 40.81 preoperatively to 65.46 postoperatively. Complications included gait abnormality, groin pain, fracture of the greater trochanter, and partial palsy of the sciatic nerve. However, patient satisfaction reached 92.3%. CONCLUSION: Surgical simulations help to design custom-made augments accurately and improve surgical plans. Acetabular components supported with custom-made 3D-printed augments is a useful method to bridge severe bone deficiencies. In this study, both the radiologic results and clinical outcomes were favorable. LEVEL OF EVIDENCE: Level 4.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Acetábulo/cirurgia , Artroplastia de Quadril/métodos , Seguimentos , Humanos , Impressão Tridimensional , Reoperação , Estudos Retrospectivos , Titânio
8.
PLoS One ; 17(8): e0272358, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35921384

RESUMO

INTRODUCTION: Tuberculosis (TB) is the leading killer of people living with HIV (PLHIV) and almost one-third of deaths in the world are attributed to it and many of these deaths occur in developing countries. Despite these evidences, after the implementation of universal test and treat (UTT) strategy, information regarding the incidence and predictors of tuberculosis among PLHIV is limited in Ethiopia. Therefore, this study aimed to assess the incidence and predictors of tuberculosis among patients enrolled in Anti-Retroviral Therapy (ART) after universal test and treat program at St. Peter hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia. METHODS: Institutional-based retrospective cohort study was conducted from November 1 to 30, 2020. Simple random sampling was used to select a total of 539 adults records which was enrolled on ART. Data was collected and entered into EPI DATA 3.1 and analyzed using STATA version 14.1. Time-to-event distributions were estimated using Kaplan-Meier estimates. Hazards across different categories were compared using log-rank tests. Predictors were identified using the Cox proportional hazards model. The hazard ratio (HR) and 95% confidence interval (CI) were computed. Variables having P-value < 0.05 from the multivariable analysis were considered as a statistically significant. RESULT: Among 539 records reviewed, 529 (98%) were included in the final analysis. The total follow-up period was 1529 Person-Year (PY). The incidence rate in this cohort was found to be 4.84 per 100-person year (95%CI,3.83-6.11). CD4 count<200 (AHR: 3.14,95% CI:1.64-7.10), poor adherence (AHR:2.16, 95% CI:1.21-3.85), underweight (AHR:2.42, 95% CI: 1.30-4.51), not taking isoniazid prophylaxis therapy (AHR: 2.78,95% CI: 1.06-7.30), being bedridden 3.06; (AHR: 3.06, 95% CI: 1.50-6.24), and baseline WHO stage three or four (AHR:2.33, 95% CI:1.08-5.02) were independent predictors for the incidence of TB among HIV positive patients. CONCLUSION: In this study, the incidence of tuberculosis is relatively low as compared to studies done before the initiation of test and treat program in Ethiopia. low CD4count, poor level of adherence, low BMI, not taking IPT prophylaxis, bedridden functional status, and being on baseline WHO stage III or IV were found to increase the hazard of tuberculosis. Hence, close follow up, reminders, surveillance, and tracing mechanisms targeting this higher risk group would decrease Tuberculosis among PLHIV.


Assuntos
Infecções por HIV , Tuberculose , Adulto , Etiópia/epidemiologia , Seguimentos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Incidência , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia
9.
Sci Rep ; 12(1): 13322, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922465

RESUMO

Acetabular defects are a challenging condition for surgeons in revision THA. A crucial aim is an anatomical restoration of the centre of rotation (COR) through grafts. The aim of this study was to determine the cup survival after biological restoration of acetabular defects in THA and the effect of Paprosky classification, age, BMI, and number of previous operations on cup survival. Retrospectively patients with a cup exchange and an impaction of cortico-cancellous or bulk grafts between 2009 and 2012 were included with a follow up with a minimum of 5 year. Implant failure was defined as radiographic loosening or explantation of the cup. The acetabular defect situation was classified to Paprosky. 82 patients (58 female 70.7%) were included. 26 patients were not available to contact. 56 patients (40 female 71.4%) remained for survival analysis with mean age of 75.6 ± 8 years. Survival of the cup after 5 years was 90% and after 7.8 years 88%. There was no difference in survival concerning defect classification, type of implant or graft, age, BMI, and number of previous operations. Patients on the follow up reached an HHS of 67.4 ± 19, a WOMAC Score of 33.4 ± 25.4 points and an unsatisfactory result in the SF-36. Impaction bone grafting of acetabular defects is a good option with satisfactory biomechanical results and survival for small defects. Predictive factors for cup survival could not be clarified in our study. So, the correct indication, knowing the limits of the methods and the correct choice of implant allow a defect-oriented approach and are decisive for the success of the operation.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Acetábulo/cirurgia , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril/métodos , Transplante Ósseo/métodos , Feminino , Seguimentos , Humanos , Reoperação/métodos , Estudos Retrospectivos , Resultado do Tratamento
10.
Sci Rep ; 12(1): 13318, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922473

RESUMO

Cervical disc arthroplasty is an established procedure, but studies with data on long-term clinical outcome, reoperation for symptomatic adjacent segment degeneration (sASD), and degenerative changes based on MRI findings are rare. Thus, a file review was performed and patients with complete documentation of neurological status at preoperative, postoperative, 12 month, 3-4 years follow-up including surgical reports for reoperation with a minimum follow-up of 9 years were included. Final follow-up assessment included a physical examination, assessment of pain levels, Odoms criteria, Neck disability index. The degeneration of each cervical segment at preoperative and at final follow-up was assessed using an MRI. Forty-six out of 68 included patients participated, the mean follow-up was 11 (range 9-15) years, at which 71.7% of patients were free of arm pain, 52.2% of patients were free of neck pain, 63% of patients had no sensory dysfunction, and full motor strength was noted in 95.6% of patients. The clinical success rate was 76.1%, the mean NDI was 12%. Overall repeated procedure rate was 17%, the reoperation rate for sASD was 9%, and removal of CDA was performed in 4%. MRI showed progressive degeneration but no significant changes of SDI from preoperative to final follow-up.


Assuntos
Degeneração do Disco Intervertebral , Fusão Vertebral , Artroplastia/efeitos adversos , Artroplastia/métodos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Discotomia/métodos , Seguimentos , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/cirurgia , Imageamento por Ressonância Magnética , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Resultado do Tratamento
11.
BMC Musculoskelet Disord ; 23(1): 739, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922798

RESUMO

BACKGROUND: We report the clinical evaluation, quality of life and pain assessment in patients who had a femoral neck SPIRON endoprosthesis. METHODS: The study group consisted of 27 men in whom 35 femoral neck endoprosthesis were implanted (8 on the left side, 12 on the right side and 7 bilateral) due to idiopathic osteoarthritis of the hip (20 patients) or avascular femoral osteonecrosis (7 patients) in a mean 7-year follow-up. RESULTS: The median pre-operative Harris Hip score (HHS) was 35.5 and post-operative 98.5 (p < 0.001). The median WOMAC HIP score was pre-operatively 57 and post-operatively 0 (p < 0.001). The median SF-12 score was pre-operatively 4 and post-operatively 33 (p < 0.001). The median pain assessment in VAS scale was 7 pre-operatively and 0 post-operatively (p < 0.001). CONCLUSIONS: The results of all examined patients have changed significantly in every category showing that SPIRON endoprosthesis improved their quality of life and statistically reduced pain ailments. Moreover we have proved that higher BMI (> 30) is associated with worse operation outcomes.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Osteonecrose , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Colo do Fêmur/diagnóstico por imagem , Colo do Fêmur/cirurgia , Seguimentos , Prótese de Quadril/efeitos adversos , Humanos , Masculino , Osteonecrose/cirurgia , Próteses e Implantes , Qualidade de Vida , Resultado do Tratamento
12.
BMC Geriatr ; 22(1): 642, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927717

RESUMO

BACKGROUND: Frailty is a common condition in older adults that is characterized by transitions between frailty states in both directions (progression and reversion) over time. Loneliness has been reported to be associated with the incidence of frailty, but few studies have explored the impact of persistent loneliness over time on frailty. In this study, we aimed to whether and how two different types of loneliness, transient and chronic, were associated with changes in frailty status in older adults. METHODS: The analytic sample contained 2961 adults aged ≥ 60 years who completed interviews for both the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. The logistic regression model was used to examine the relationship between transient and chronic loneliness and progression and reversion of frailty. Demographics (age, sex, education level, marital status, urban-rural residence), living alone, chronic conditions, physical function, and depressive symptoms from the 2011 wave were adjusted. RESULTS: After four years, 21% of the studied sample reported progression, 20% reported reversion in frailty, 31% reported transient loneliness, and 14% reported chronic loneliness. There was no significant difference in participants who reported transient loneliness (OR = 1.10, 95% CI [0.89,1.37]), or chronic loneliness (OR = 1.14, 95% CI [0.84,1.57]) on the progression of frailty, compared with no report of loneliness. Participants reporting chronic loneliness (OR = 0.68, 95% CI [0.50,0.93]) were less likely to report reversion in their level of frailty compared to participants who did not report loneliness but not transient loneliness (OR = 0.87, 95% CI [0.70,1.08]). CONCLUSIONS: Roughly the same percentage, a fifth, of older Chinese adults progressed or reversed in frailty status without active intervention. Chronic loneliness was related to a lower probability of reversion in the frail group than in the no loneliness group, but not in the transient loneliness group. More attention should be given to older adults with chronic loneliness.


Assuntos
Fragilidade , Idoso , Seguimentos , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Humanos , Vida Independente , Estudos Longitudinais , Pessoa de Meia-Idade
13.
J Refract Surg ; 38(8): 520-528, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35947000

RESUMO

PURPOSE: To investigate new intrastromal histological structures that develop after myopic human lenticular implantation in keratoconus with femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery using transmission electron microscopy. METHODS: Sixty eyes with advanced keratoconus indicated for corneal transplantation were included in this study. Fresh myopic lenticular implants were placed in all eyes through SMILE surgery. Lenticular implants were extracted from patients with myopic refractive errors of the cornea, untreated keratoconus, and treated keratoconus following 1, 2, and 3 years of surgery. These five lenticular samples were examined under the electron microscope and compared. RESULTS: Disorganized and thinned collagen fibers were observed in the stroma with degenerative stromal cells (telocyte-like cells and keratocytes) in the keratoconic cornea. Apoptotic bodies and cell debris were easily observed near the disorganized fibers. In contrast, the myopic refractive error of the control and treatment groups demonstrated well-organized parallel lamellar structures. Healthy keratocytes and telocyte-like cells were observed in samples obtained 1, 2, and 3 years after lenticular implantation. Thus, telocyte-like cells may be activated by appropriate stimuli, such as stem cells, and be involved in stromal regeneration. CONCLUSIONS: Fresh myopic intrastromal lenticular implantation is a safe, economical, and reliable technique that leads to increased corneal thickness, improved visual acuity, and the regeneration of healthy keratocytes and telocyte-like cells that are involved in stromal regeneration. [J Refract Surg. 2022;38(8):520-528.].


Assuntos
Cirurgia da Córnea a Laser , Ceratocone , Miopia , Ferida Cirúrgica , Substância Própria/patologia , Substância Própria/cirurgia , Cirurgia da Córnea a Laser/métodos , Topografia da Córnea , Seguimentos , Humanos , Ceratocone/patologia , Ceratocone/cirurgia , Microscopia Eletrônica de Transmissão , Miopia/patologia , Miopia/cirurgia , Refração Ocular , Ferida Cirúrgica/patologia
14.
J Appl Oral Sci ; 30: e20220089, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35920448

RESUMO

OBJECTIVE: This study aimed to retrospectively collect clinical data to evaluate the influence of possible risk factors on the long-term success of implant treatment with extra-narrow (2.9 mm diameter) implants in a daily dental practice setting. METHODOLOGY: Data were collected from records of patients who received at least one extra-narrow implant from 2012 to 2017, regarding implant survival, prosthesis survival, patient characteristics, and implant characteristics. The association between the dependent variables "implant survival", "prosthesis survival," and "adverse events" related to patient and implant characteristics was statistically evaluated by chi-square tests. Moreover, implant and prosthesis survival were analyzed by Kaplan-Meier survival curves. RESULTS: The sample was constituted of 58 patients (37 women and 21 men) with a mean age of 54.8 years old (SD: 12.5), followed up for up to eight years. In total, 86 extra-narrow implants were placed within this sample. Four implants were lost, resulting in an implant survival rate of 95.3%. A total of 55 prostheses were inserted and only one (1.8%) was lost, resulting in a prosthesis survival rate of 98.2%. The mean implant and prosthesis survival time was, respectively, 7.1 years and 6.3 years, according to the Kaplan-Meier survival analysis. A correlation was found between smoking and implant loss, which makes implant loss eight times more likely to occur in smokers than non-smokers. A significant association was also found between prosthesis loss and previous need of prosthesis repair. However, it was not considered clinically relevant. No association was found between the occurrence of adverse events and later implant or prosthesis loss. CONCLUSION: High implant and prosthesis survival rates were found in the long term for treatment with extra-narrow implants. Moreover, a significant correlation between smoking and implant loss was observed.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/etiologia , Implantação Dentária Endóssea/métodos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Falha de Prótese , Estudos Retrospectivos , Fatores de Risco
15.
Optom Vis Sci ; 99(8): 645-651, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35930259

RESUMO

SIGNIFICANCE: There is a clinical need for a quantitative test to objectively diagnose negative dysphotopsia, especially because the diagnosis is generally assessed using patients' subjective descriptions. In the search of a clinical test to objectify the shadow experienced in negative dysphotopsia, this study excludes static perimetry as suitable evaluation method. PURPOSE: This study aimed to evaluate the value of static perimetry in the objective assessment and follow-up of negative dysphotopsia. METHODS: Peripheral 60-4 full-threshold visual field tests were performed in 27 patients with negative dysphotopsia and 33 pseudophakic controls. In addition, 11 patients with negative dysphotopsia repeated the test after an intraocular lens exchange. Both the total peripheral visual field and the averaged peripheral visual field from 50 to 60° eccentricity were compared between patients and controls, and pre-operatively and post-operatively in patients who had an intraocular lens exchange. RESULTS: The peripheral visual fields from 30 to 60° did not show significant differences between patients with negative dysphotopsia and pseudophakic controls. Analysis of the peripheral visual field from 50 to 60° showed a median [Q1, Q3] of 20.0 [17.1, 22.5] dB in the negative dysphotopsia group compared with 20.1 [15.5, 21.3] dB in the control group (P = .43). Although 82% of patients treated with an intraocular lens exchange subjectively reported improvement of their negative dysphotopsia complaints post-operatively, there were no significant differences in their total peripheral visual field or averaged peripheral visual field from 50 to 60° (P = .92). CONCLUSIONS: Full-threshold static perimetry with a Goldmann size III stimulus up to 60° eccentricity does not show significant differences between patients with negative dysphotopsia and pseudophakic controls or between measurements before and after intraocular lens exchange. Therefore, this type of static perimetry cannot be used as a quantitative objective test for diagnosis or follow-up of patients with negative dysphotopsia.


Assuntos
Lentes Intraoculares , Testes de Campo Visual , Seguimentos , Humanos , Implante de Lente Intraocular/efeitos adversos , Implante de Lente Intraocular/métodos , Lentes Intraoculares/efeitos adversos , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia
16.
BMJ Open ; 12(8): e060632, 2022 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-35940829

RESUMO

INTRODUCTION: The use of low-dose aspirin by pregnant women to prevent preterm pre-eclampsia is gradually increasing. The administration of aspirin during pregnancy improves perinatal outcome, which could translate into improved child outcome in the long term. However, antenatal exposure to aspirin could have adverse effects on child development that may manifest later in life. The aim of this follow-up study is to assess the long-term effects of antenatal exposure to low-dose aspirin compared with placebo on survival, (neuro)development, behaviour and general health at 4 years corrected age. METHODS AND ANALYSIS: This is a follow-up study of the Dutch double-blind randomised controlled APRIL trial which assessed the effectiveness of treatment with aspirin (80 mg daily) compared with placebo for the prevention of preterm birth in women with a previous spontaneous preterm birth. Treatment was initiated before 16 weeks of gestation and continued until 36 weeks or birth. We aim to follow-up all 379 children born to women who participated in the APRIL trial and survived the neonatal period, at the corrected age of 4 years. The main outcomes are (neuro)development as assessed by the Ages and Stages Questionnaire, and behaviour as assessed by the Strength and Difficulties Questionnaire. Additional outcomes include mortality, growth and general health from birth up to 4 years, and a composite outcome including mortality, abnormal (neuro)development and problem behaviour. Analyses will be performed by intention-to-treat using a superiority design. ETHICS AND DISSEMINATION: Institutional Review Board approval was obtained from the Medical Research Ethics Committee from Amsterdam Medical Center (no. W20 289#20.325). The results will be published in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION NUMBER: The APRIL trial (NTR5675, NL5553; EudraCT number 2015-003220-31) and the APRIL follow-up study (NL8950) are registered in the Dutch trial register. The study is funded by the Amsterdam Reproduction & Development research institute.


Assuntos
Nascimento Prematuro , Aspirina/efeitos adversos , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Membro 13 da Superfamília de Ligantes de Fatores de Necrose Tumoral
17.
BMC Musculoskelet Disord ; 23(1): 758, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941682

RESUMO

OBJECTIVES: To evaluate the oncologic and functional results of scapular reconstruction after partial or total scapulectomy for chondrosarcoma. MATERIALS AND METHODS: Twenty-one patients with chondrosarcoma who underwent partial or total scapulectomy between January 2005 and July 2019 were reviewed retrospectively. RESULTS: At a mean follow-up of 62.6 months (range, 13-123 months), four patients developed local recurrence, and three developed distant metastases, one of which developed both recurrence and metastasis. The overall survival rate of patients at 5 years was 84.6%, the disease-free survival rate was 69.3%, and the complication rate was 19% (4/21). The 1993 American Musculoskeletal Tumor Society (MSTS93) scores of patients in the partial scapulectomy group, total scapulectomy + humeral suspension group and prosthetic reconstruction group were 26.50 ± 1.38, 19.00 ± 2.58, and 21.38 ± 2.62, respectively. There was a statistically significant difference between the partial scapulectomy group and the total scapulectomy + humeral suspension or prosthetic reconstruction group ( P = 0.006 and 0.0336, respectively). The range of motion of the shoulder joint for forward flexion was 80.83° ± 11.14°, 51.25° ± 21.36°, and 52.50° ± 11.02°, respectively. The p-values for the comparison between the partial scapulectomy group and the total scapulectomy + humeral suspension or prosthetic reconstruction group were 0.0493 and 0.0174, respectively. And the range of motion of abduction was 75.00° ± 10.49°, 32.50° ± 11.90°, 41.88° ± 11.63°, respectively. Patients in the partial scapulectomy group had significantly better postoperative shoulder abduction function than the total scapulectomy + humeral suspension or prosthetic reconstruction group (P = 0.0035 and 0.0304, respectively). There was no significant difference in MSTS93 scores and flexion and abduction function of the shoulder joint in the upper extremity after total scapulectomy with humeral suspension or prosthetic reconstruction (P > 0.05). CONCLUSIONS: Surgical treatment of chondrosarcoma of the scapula can achieve a satisfactory prognosis and shoulder function. Total scapulectomy followed by prosthetic reconstruction or humeral suspension are both feasible treatments.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Articulação do Ombro , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Seguimentos , Humanos , Amplitude de Movimento Articular , Estudos Retrospectivos , Escápula/patologia , Escápula/cirurgia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/patologia , Articulação do Ombro/cirurgia
19.
J Urol ; 208(3): 658-667, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35942796

RESUMO

PURPOSE: We sought to determine whether polyacrylamide hydrogel (PAHG) is noninferior to tension-free vaginal tape (TVT) in the treatment of women with primary stress urinary incontinence (SUI). MATERIALS AND METHODS: In this noninferiority trial, 223 women eligible for operative SUI treatment were randomized for TVT (110) or PAHG (113). Primary outcome was patient satisfaction and the noninferiority margin for the difference was 20%. Secondary outcomes were effectiveness and complications. RESULTS: At 3 years, 188 (84.3%) women attended the followup. The satisfaction score (visual analogue scale 0-100) median was 98.5 (IQR 90-100) in the TVT group and 90.0 (IQR 70-100) in the PAHG group, whereas a score ≥80 was reached in 87 (94.6%) and 65 (67.7%), respectively (difference 26.9%, 95% CI 16.7% to 36.8%). Thus, PAHG did not meet the noninferiority criteria set in our study. The cough stress test was negative in 88 (95.7%) of TVT patients vs 75 (78.1%) of PAHG patients (difference 17.5%, 95% CI 8.6% to 26.9%). Any peri- or postoperative complication before crossover between the groups was detected in 40 (43.5%) women in the TVT group and 23 (24.0%) women in the PAHG group (difference 19.5%, 95% CI 6.8% to 31.4%). CONCLUSIONS: In midterm followup, PAHG did not reach in patient satisfaction the noninferiority set in our study. Furthermore, mid urethral TVT slings show better subjective and objective cure rates than PAHG. However, complications were more often associated with TVT. Since the majority of PAHG treated women were also cured or improved, primary SUI women can be offered PAHG as a safe and durable alternative treatment.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse , Resinas Acrílicas , Feminino , Seguimentos , Humanos , Masculino , Slings Suburetrais/efeitos adversos , Resultado do Tratamento , Incontinência Urinária por Estresse/cirurgia
20.
J Oral Facial Pain Headache ; 36(2): 141-146, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35943324

RESUMO

AIMS: To compare the clinical effectiveness of conventional double-puncture vs single-puncture type 2 arthrocentesis for management of temporomandibular joint (TMJ) disc displacement without reduction (DDWOR) after 3 years of follow-up. METHODS: A total of 26 patients with DDWOR were randomly and blindly allocated into two treatment groups (n = 13 each): group 1 = conventional double-puncture arthrocentesis; group 2 = single-puncture type 2 arthrocentesis. Data on gender, side of painful joint complaint, age (years), duration of joint pain (months), maximum interincisal distance (MID, mm), and pain intensity (self-reported with a 0-10 visual analog scale [VAS]) were collected. VAS scores and MID were measured before (baseline) and 3 years after (final) the arthrocentesis. RESULTS: Twenty-three patients completed the study (group 1, n = 11; group 2, n = 12). Both techniques resulted in significantly reduced VAS scores and increased MID (P = .001) after the 3 years of follow-up; however, there were no statistically significant differences between techniques (P > 0.05). CONCLUSION: The two arthrocentesis methods tested were both effective in reducing VAS scores and increasing MID in patients with DDWOR.


Assuntos
Artrocentese , Transtornos da Articulação Temporomandibular , Artralgia , Artrocentese/métodos , Seguimentos , Humanos , Medição da Dor , Punções , Amplitude de Movimento Articular , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/cirurgia , Resultado do Tratamento
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