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991.
BackgroundDespite proposals and guidelines to prevent baseball injuries in young players by societies and organizations, many shoulder and elbow injuries continue to occur among junior high school baseball players. In order to investigate the training conditions of junior high school baseball players and the risk factors for shoulder and elbow pain in the players, we conducted a questionnaire survey among junior high school baseball players throughout the country.MethodsThe questionnaire survey was conducted among junior high school baseball players in September 2016.ResultsA total of 11,134 junior high school baseball players belonging to 495 teams responded to the survey. Among these, 4004 players trained every day of the week and 1151 players played baseball games every month with no off-season. Among 9752 players who did not have shoulder and/or elbow pain in the spring and summer of 2015, 19.2% of players experienced elbow pain over the course of one year, 13.6% of players experienced shoulder pain, and 28.0% complained of shoulder and/or elbow pain. The frequency of elbow pain was more than that of shoulder pain. At risk for shoulder pain were pitchers and catchers and second-year students, while risk factors for elbow pain were playing pitcher and catcher positions, pitching or throwing ≥300 balls per week, playing ≥10 games on average per month and being left-handed.ConclusionRisk factors for shoulder pain were different from those for elbow pain. To prevent elbow pain, coaches should pay attention to pitchers and catchers and left-handed players and not allow players to pitch or throw ≥300 full-power balls per week or participate in ≥10 games per month. They should also pay attention to pitchers and catchers and second-year students to prevent shoulder pain. It is important for coaches to train multiple pitchers and catchers.  相似文献   
992.
Laser therapy could amplify the oral wound healing process by stimulating cell regeneration after injury, attenuating pain, and modulating the immune system. The purpose of this systematic review was to evaluate whether the application of laser therapy improved alveolar healing after tooth extractions. Eight electronic databases were screened: MedLine (PubMed), The Cochrane Library, Web of Science, Scopus, Lilacs, Ibecs, Scielo, and BBO. Three reviewers independently assessed the title and abstracts of potentially relevant studies. Only clinical trials and animal experiments that evaluated the wound healing effect of laser therapy after tooth extraction were included. A total of 16 studies fulfilled all criteria, thus 8 animal experiments and 8 clinical trials were included. Different types of laser were evaluated, such as CO2, GaAlAs, Nd:YAG, Diode Laser, HeNe, and High‐frequency Pulsed Diode Laser. Although HF, Diode and GaAs lasers were able to enhance wound healing process in clinical studies, four trials and one animal experiment showed no improvement in wound healing with laser therapy after tooth extractions. In general, the current available evidence in the literature showed that laser therapy improved the wound healing process, but these findings were limited to the type of laser applied and its specific settings. Further well‐designed and randomized controlled trials are needed to support a benefit effect of using laser therapy after tooth extraction. PROSPERO registration number: CRD42014007509 (2014).  相似文献   
993.
BackgroundObesity is a major health risk factor associated with medical complications, such as cardiovascular disease, that may compromise outcomes. Furthermore, obesity may lead to difficulties in daily life, altering the quality of life and generating psychological disorders such as devalued self-image and depression.ObjectivesThis study evaluated the quality of life and predictive factors of postoperative complications in patients who underwent abdominoplasty after Roux-en-Y gastric bypass.SettingBariatric and postbariatric center, North Wing Regional Hospital, Brasília, Brazil.MethodsData were analyzed from a prospective registry of postbariatric patients who underwent abdominoplasty from January 2011 to December 2016. Variables examined included age, sex, body mass index (BMI), complications, and comorbidities. Multivariate analyses were performed to assess outcome measures. The quality-of-life assessment was measured with the Moorehead-Ardelt quality-of-life questionnaire.ResultsOne hundred and seven postbariatric patients were included. The mean age of the patients was 41 years. BMI at the time of abdominoplasty (current BMI) was 27.6 ± 3.7 kg/m2, and the average weight loss before abdominoplasty was 47.7 ± 17.3 kg. Pre-weight loss BMI (max BMI) was 45.5 ± 7.6 kg/m2, and ?BMI was 18.6 ± 9.3 kg/m2. The overall rate of complications was 23.4%. Among the studied factors in the multivariate analysis, amount of removed tissue in the abdomen >2000 g, ?BMI >20 kg/m2, and age >40 years significantly increased the rates of postoperative complications. In our study, abdominoplasty improved the quality of life of patients (mean quality-of-life scores, 2.1 ± 0.9).ConclusionThe amount of removed tissue in the abdomen, ?BMI >20 kg/m2, and age >40 years led to significantly more complications in patients undergoing abdominoplasty after gastroplasty. In addition, this study demonstrated that abdominoplasty should be proposed to patients with massive weight loss to improve quality of life.  相似文献   
994.
The main objective of this study was to characterize spatial patterns of white‐tailed deer (Odocoileus virginianus) movement related to bovine tuberculosis (bTB) transmission risk to cattle in north‐western Minnesota. Twenty‐one adult deer (16 females and 5 males) were captured during winter (January–March) 2011 in areas adjacent to where an outbreak (2005–2009) of bTB occurred in deer and cattle. Deer were fitted with GPS collars programmed to collect deer location information every 90 min over a 15‐month period. The exact locations of cattle, cattle feeding areas, and stored forage that were available to collared deer were assessed seasonally. In total, 47% (n = 9) of collared deer survived to the end of the study. Causes of mortality included wolves (n = 6), hunters (n = 1) and unknown (= 2); additionally, 2 deer were censored due to collar malfunctions. Our results indicated that 5 deer (25%) had home ranges that included 6 cattle farms (20%). Most (77%) of the deer visits occurred in areas where cattle were present, with most visits (60%) from 00:00 to 06:00. March to May revealed the most farm visitations by deer (37%). This study provided baseline information regarding cattle–deer interactions critical to transmission of bTB in this region and suggested that risk mitigation practices should be implemented to separate wildlife and domestic livestock when feasible.  相似文献   
995.
996.
Minimally invasive treatment of early-stage rectal lesion has presented good results, with lower morbidity than surgical resection. Transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS) are the main methods of transanal surgery. However, endoscopic submucosal dissection (ESD) has been gaining ground because it allows en bloc resections with low recurrence rates. The aim of this study was to analyze ESD in comparison with transanal endoscopic surgery. We searched MEDLINE, EMBASE, SciELO, Cochrane CENTRAL, and Lilacs/Bireme with no restrictions on the date or language of publication. The outcomes evaluated were recurrence rate, complete (R0) resection rate, en bloc resection rate, length of hospital stay, duration of the procedure, and complication rate. Six retrospective cohort studies involving a collective total of 326 patients—191 in the ESD group and 135 in the transanal endoscopic surgery group were conducted. There were no statistically significant differences between the groups for any of the outcomes evaluated. For the minimally invasive treatment of early rectal tumor, ESD and surgical techniques do not differ in terms of local recurrence, en bloc resection rate, R0 resection rate, duration of the procedure, length of hospital stay, or complication rate, however, evidence is very low.  相似文献   
997.
998.
Low-level laser therapy (LLLT) promotes biomodulation of wound healing and literature reports that light delivery during the inflammation could play a different role compared with latter phases of the healing process. The objective of this study was to investigate whether single dose of a red laser (λ?=?660 nm) is different from fractionated delivery protocol in full thickness burns. Two lesions were inflicted on the back of 36 rats. In the fractionated dose group (FG), the lesions were irradiated with 1 J/cm² on days 1, 3, 8, and 10 post-wounding. In the single dose group (SG), the lesions were irradiated with 4 J/cm² on day 1, immediately after injury. Control lesions (CG) received no light and were left to heal spontaneously. Blood flow was measured on days 1, 3, 8, 10, 15, and 21 using laser Doppler flowmetry. Animals were killed on days 3, 8, 10, 15, and 21. Skin specimens were obtained and routinely processed for hematoxylin and eosin. The specimens were evaluated according to differential leukocyte counting and angiogenesis. Statistical analysis was performed, and significance was accepted at p?<?0.05. Irradiated groups showed a peak of new vessels on day 15 while, for CG, the peak was on day 21. On day 21, FG exhibited a significantly greater number of cumulative neutrophils while SG showed a higher number of mononuclear cells. Our results confirm that both protocols used accelerate angiogenesis and stimulate leukocyte chemotaxis on burn treatment. In addition, this work suggests that a single-dose LLLT accelerates the inflammatory phase of skin repair.  相似文献   
999.
We report the 5-year results of our simultaneous pancreas-kidney transplantation (SPKT) program, started on May 2, 2000. Forty-two SPKT were performed on 42 type I diabetic patients with chronic renal failure. The procedure was performed with enteric diversion and vascular anastomosis to the iliac vessels. Immunosuppressive protocol included antithymocyte globulin, tacrolimus, mycophenolate mofetil, and steroids. The 24 women and 18 men had a mean age of 33.5 +/- 6.3 years and mean 22.8 +/- 14.2 years time of diabetes evolution. Forty patients had been on dialysis for 34.3 +/- 24.1 months, and two were preemptive transplantations. Acute rejection episodes were treated in eight patients (19.1%): in three cases they affected both organs; in two only the kidney was affected; and the other three were pancreas graft rejections. The incidence of postoperative complications requiring re-operation was 42.9%, mostly pancreas graft related. Two patients died, one due to cardiovascular disease; the other was transplant related. Three kidney grafts were lost, and the causes were immunologic, thrombosis, and patient death. Pancreas graft loss occurred in seven patients: thrombosis (n = 3); infection (n = 3); immunologic (n = 1). The patients with surviving grafts were doing well, with normal kidney and pancreas function: serum creatinine = 0.89 +/- 0.15 mg/dL; fasting blood glucose = 79 +/- 16 mg/dL; HbA1c = 4.7 +/- 1.1%. The 1-year patient, kidney, and pancreas survival rates were 97.3%, 94.6%, and 83.8% and 5-year values, 91.7%, 89.2%, and 78.7%, respectively. In conclusion, these results are similar to the most recent UNOS/IPTR reports, leading us to consider our experience with SPKT very positive.  相似文献   
1000.
HYPOTHESIS: While simultaneous resection has been shown to be safe and effective in patients with synchronous metastasis, neoadjuvant chemotherapy followed by hepatectomy has gradually gained acceptance for both initially nonresectable metastasis and resectable metastasis. The boundary between these treatments is becoming unclear. We hypothesized that factors associated with colorectal cancer may play an important role in the prognosis of patients with synchronous metastasis and may be useful for identifying patients who can be expected to have adequate results following simultaneous resection. DESIGN: Outcome study. SETTING: Tertiary referral center. PATIENTS: From January 1980 to December 2002, 187 patients underwent curative resection for synchronous liver metastasis from colorectal cancer. One hundred forty-two patients received simultaneous resection, 18 underwent staged resection, and 27 underwent delayed hepatic resection. Twenty-one clinicopathological factors were analyzed, and long-term prognosis was assessed. MAIN OUTCOME MEASURES: Prognostic factors and patient survival. RESULTS: There was no in-hospital death. In a multivariate analysis, the factors that significantly affected the prognosis of synchronous metastasis were 4 or more lymph node metastases around the primary cancer (P<.001) and multiple liver metastases (P = .003). In patients with 3 or fewer lymph node metastases around the primary cancer, the 5-year survival rates of those with 1, 2 to 3, and 4 or more liver metastases were 63%, 33%, and 40%, respectively, but these rates were 15%, 22%, and 0%, respectively, in patients with 4 or more lymph node metastases around the primary cancer. CONCLUSIONS: The results support the application of simultaneous resection in patients with 0 to 3 colorectal lymph node metastases. However, in patients with 4 or more colorectal lymph node metastases, biological selection by neoadjuvant chemotherapy may be more suitable.  相似文献   
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