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《European journal of surgical oncology》2019,45(10):1812-1816
ObjectivesMeshes/matrices are commonly used in immediate breast reconstruction. There are few studies comparing biological and synthetic meshes and it is unknown what type of mesh gives the best long-term results. The aim of this study was to compare long-term health-related quality of life (HrQoL) and patient satisfaction in implant-based immediate breast reconstruction with a biological mesh (Surgisis®) with that of patients reconstructed with a synthetic mesh (TIGR ® Matrix Surgical Mesh).Material and methodsBoth cohorts were prospectively included and consecutively operated. Clinical data was collected. HrQoL was evaluated with EuroQoL-5 dimension – 3 levels questionnaire (EQ-5D-3L) and the Hospital Anxiety and Depression Scale (HADS) and the Breast-Q.Results and conclusionSeventy-one patients were operated on in the biological group and 49 in the synthetic group. The response rates were 75 and 84 per cent, respectively. Mean follow-up time was 74 months and 23 months, respectively. There were no statistical differences in satisfaction and quality of life between the two groups. Complications and radiation seem to lead to a lower satisfaction. Our findings could indicate that biological and synthetic meshes give an equal long-term result as regards patients’ perceived quality of life. 相似文献
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Sarah Averbach Othman Kakaire Rachel McDiehl Christine Dehlendorf Felicia Lester Jody Steinauer 《Contraception》2019,99(2):87-93
Objective
This study assessed whether immediate postpartum insertion of levonorgestrel contraceptive implants is associated with a difference in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 and 6 months postpartum compared to delayed insertion at 6 to 8 weeks postpartum.Study design
We conducted a randomized trial of women in Uganda who desired contraceptive implants postpartum. We randomly assigned participants to receive either immediate (within 5 days of delivery) or delayed (6 to 8 weeks postpartum) insertion of a two-rod levonorgestrel contraceptive implant system. This is a prespecified secondary analysis evaluating breastfeeding outcomes. The primary outcome of this secondary analysis was change in infant weight; infants were weighed and measured at birth and 6 months. We used a validated questionnaire to assess onset of lactogenesis daily in person while participants were in the hospital, and then daily by phone after they left the hospital, until lactogenesis was documented. We used interviewer-administered questionnaires to assess breastfeeding continuation and concerns at 3 months and 6 months postpartum.Results
Among the 96 women randomized to the immediate group and the 87 women to the delayed group, the mean change in infant weight from birth to 6 months was similar between groups: 4632?g in the immediate group and 4407?g in the delayed group (p=.26). Among the 97 women who had not experienced lactogenesis prior to randomization, the median time to onset of lactogenesis did not differ significantly between the immediate and delayed groups (65?h versus 63?h; p=.84). Similar proportions of women in the immediate and delayed groups reported exclusive breastfeeding at 3 months (74% versus 71%; p=.74) and 6 months (48% versus 52%; p=.58).Conclusion
We found no association between the timing of postpartum initiation of levonorgestrel contraceptive implants and change in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 or 6 months postpartum.Implications
This study provides evidence that immediate postpartum initiation of contraception implants does not have a deleterious effect on infant growth or initiation or continuation of breastfeeding. 相似文献5.
AimTo compare the accuracy of the inverted greyscale CT versus the conventional CT in the assessment of post-operative spinal orthopaedic implants and osseous fusion.Methods50 patients who had CT as part of their routine spinal implant follow up were evaluated for the presence of fusion, fracture and loosening with conventional CT and with greyscale inverted CT images. 3 independent observers assessed the images 2 months apart. Diagnostic performance (sensitivity and specificity) of the conventional and greyscale inversion images relative to the reference standard were calculated. Agreement with the reference standard was assessed using Cohen's kappa for conventional and greyscale inversion images.ResultsCorrect classifications increased when using the greyscale inverted CT images for each reader compared to conventional CT images (40–46, 39 to 42 and 41 to 44 (out of 50)). Inverted images demonstrated better agreement with the reference standard than conventional grayscale images for assessment of fusion (kappa of 0.588 for inverted CT versus 0.484 for conventional CT) and loosening (kappa 0.386 for inverted versus 0.293 for conventional). Sensitivity was increased for assessment of fusion and loosening. McNemar's test performed for assessment of sensitivity differences showed statistical significance (p = 0.038 for fusion and p = 0.0313 for loosening).ConclusionGreyscale inversion CT is a useful adjunct which has advantages (improved sensitivity and better agreement) over conventional CT imaging in cases of fusion and loosening of metallic implants following spinal instrumentation. We recommend the use of both the greyscale inversion CT images and conventional CT imaging when assessing post-operative spinal orthopaedic implants. 相似文献
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组织工程用外科植入物-高分子材料的加工、改性及应用 总被引:2,自引:0,他引:2
胡平 《中国医疗器械信息》2006,12(7):13-21,35
介绍了组织工程用外科植入物-生物医用高分子材料基本情况.重点从三个方面介绍了我们的工作,首先我们合成了三种可降解材料:聚羟基烷酸酯、两亲性聚氯酯弹性体、可注射性水凝胶.利用各种方法制造了多种复杂形状的组织工程支架,并对医用支架材料表面进行了改性。 相似文献
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微型种植体支抗愈合期稳定性的比较 总被引:10,自引:0,他引:10
目的比较不同愈合时间种植体支抗的稳定性。方法10只新西兰大白兔应用种植体60枚,均分为种植即刻组、种植后1周组、2周组、4周组、8周组进行拉出实验和转矩实验。采用单因素方差分析组间差异,相关性分析愈合时间、最大剪切力、最大力矩两两之间的相关性。结果4周与8周组最大剪切力分别为(179·68±24·65)N、(212·06±42·51)N;4周与8周组的最大力矩分别为(0·47±0·13)N·m、(0·61±0·16)N·m,与其他组相比差异均有统计学意义(P<0·05)。愈合时间、最大剪切力、最大力矩两两之间均呈正相关。结论4周是种植体愈合期生物稳定性的一个关键时间点。8周内种植体的生物力学性能与愈合时间呈正相关。 相似文献