Total ankle replacement in patients under the age of 50. Should the indications be revised?

BackgroundHigh physical demand and young age are currently considered contraindications for total ankle replacement. This study aimed to compare its results between patients under the age of 50 and those aged 50 or older.Methods103 patients derived from an ongoing prospective multicentric study with a mean follow-up of 41 (range, 24–72) months were included in this study. Clinical status (AOFAS score), range of motion (ROM), complication and survivorship rates were compared between <50 and ≥50 patients.ResultsROM and AOFAS score were significantly higher, as were their increases relatively to pre-operative values in patients <50. Complication and survivorship rates were comparable between both groups.ConclusionsAt medium-term, ankle replacement is at least as effective in patients under the age of 50 as in those with aged 50 or older. Long-term results will allow to assess whether surgical indications for should be revised.     

护患情境会话

抑郁病人的护理 交流 护士:既然医生没告诉你病看不好了,就表明你的病是有希望治好的.你的各项检查报告显示你的不适感并非由器质性疾病引起,而是抑郁症的一种典型临床表现.像你这样的抑郁症我们遇到的不少,他们都痊愈出院了.你要对自己有信心,医生、护士会帮助你战胜病魔的. 病人:可是,我身体不好,不能工作,也不能照顾家人,反而拖累他们,要他们一天到晚陪着我,照顾我,觉得自己真是没用,还不如死了算了.     

Antiresorptive treatment,when initiated after a first hip fracture,may not protect of a second contralateral episode in elderly population: A study with 685 patients

IntroductionOsteoporosis predisposes for a higher risk of hip fracture and its treatment is frequently underprescribed. Our purpose was to assess the relation between having a second hip fracture and receiving osteoporosis treatment. Also to assess the relation between this second fracture and using central nervous system drugs or being institutionalised.Patients and methodsWe reviewed all the patients that were admitted to our hospital with an osteoporotic proximal femoral fracture between September 2009 and February 2011. We identified 685 patients, 74 of which presented a contralateral fracture. We evaluated if they were receiving osteoporosis treatment or taking any medication that could affect the central nervous system and if they were institutionalised.ResultsA 10.8% of patients had a second fracture and the mean time between the two of them was 20 months (1–122). There was a clear female predominance (76.35%). The mean age at occurrence of the primary fracture was 83.02 years and 85 for the second. A 90.8% did not follow any type of osteoporosis medication before the first fracture. A 50.9% did not receive central nervous system drugs and 79.1% lived at home at the time of the first fracture. 12.8% of the patients that did not follow the osteoporosis treatment, had a contralateral fracture, 3% more than those that did follow some kind of treatment, but this difference was not significant (p = 0.2).DiscussionWe identified a similar number of patients undergoing osteoporotic treatment as registered in literature. There was no significant difference between suffering a second hip fracture and following osteoporosis treatment, using psychotropic drugs or being institutionalised.     

年轻乳腺癌患者社会支持状况调查及护理对策

目的 探讨年轻乳腺癌患者的社会支持状况及护理对策.方法 选取100例年龄＜40岁的年轻乳腺癌患者作为观察组,选取80例年龄≥40岁的乳腺癌患者作为对照组,对两组采取社会支持评定量表调查问卷进行社会支持情况调查,将年轻乳腺癌患者的社会支持总分并与国内常模进行比较,并将两组不同年龄的乳腺癌患者的社会支持状况进行比较.结果 观察组社会支持总分较国内常模高,差异有统计学意义（P ＜ 0.05）,与对照组比较,观察组的社会支持总分、主观支持分、客观支持分以及对支持的利用度均明显较低,差异有统计学意义（P ＜ 0.05）.结论 年轻乳腺癌患者较正常人能获得较高的社会支持,但其社会支持度低于年龄≥40岁的乳腺癌患者,需要护理人员充分评估并给予护理干预,帮助其优化社会支持网络.     

宫腔镜下输卵管插管通液在不孕不育症患者临床治疗中的效果观察

目的:观察宫腔镜下输卵管插管通液在不孕不育症患者临床治疗中的效果。方法:回顾性分析本院2011年4月-2013年2月收治的100例不孕不育症患者的临床资料。结果:术前两组患者的输卵管双侧通畅和一侧不通或通而不畅的发生率明显比术后低,双侧阻塞的发生率明显比术后高,两者比较差异有统计学意义(P0.01);原发不孕组和继发不孕组患者通液后各种情况的输卵管通畅率比较差异均无统计学意义(P0.05);原发不孕组和继发不孕组患者3个月~1.5年后的受孕率比较差异均无统计学意义(P0.05)。结论:宫腔镜下输卵管插管通液在不孕不育症患者临床治疗中的效果良好,能够有效改善各种类型不孕不育症患者输卵管的通畅性,值得在临床广为推广。