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排序方式: 共有98条查询结果,搜索用时 62 毫秒
1.
Aftahy A. Kaywan Barz Melanie Wagner Arthur Liesche-Starnecker Friederike Negwer Chiara Meyer Bernhard Gempt Jens 《Neurosurgical review》2021,44(4):2099-2110
Neurosurgical Review - Exposure of the anterior skull base is challenging due to strategic structures. The interhemispheric approach (IHA) has turned out to be a feasible technique. We report our... 相似文献
2.
Nonoperative treatment, e.g. with a sling or a figure-of-eight bandage, has so far been considered to be the gold standard for midshaft clavicle fractures even when substantial displacement has been present. However, more recent studies have shown poorer results following nonoperative treatment of dislocated clavicle fractures compared with operative treatment. The main reasons are a higher nonunion and shortening rate of displaced midshaft fractures, which often result in poor functional outcome and low patient satisfaction. Operative methods, e.g. locking plates or intramedullary fixation technique have proven to have much better outcome in the treatment of midshaft clavicle fractures with displacement and comminution than conservative methods. Adults with a displaced midshaft fracture have for example a nonunion rate of up to 15% after conservative therapy whereas it is 2–3% after operative treatment. The traditional view that clavicular midshaft fractures no matter what grade of dislocation and what type of fracture should be treated conservatively is no longer valid today. Instead possible complications and risks of the conservative and operative treatment always have to be taken into account and weighed individually for therapy decision-making in the clinical routine. The analysis of current studies shows that patients with dislocated comminuted fractures benefit from surgery. 相似文献
3.
Ahmed MS Ibrahim Hani H Sinno Ali Izadpanah Joshua Vorstenbosch Tassos Dionisopoulos Mark K Markarian Bernard T Lee Samuel J Lin 《CANADIAN JOURNAL OF PLASTIC SURGERY》2015,23(2):103-107
BACKGROUND:
Breast ptosis can occur with aging, and after weight loss and breastfeeding. Mastopexy is a procedure used to modify the size, contour and elevation of sagging breasts without changing breast volume. To gain more knowledge on the health burden of living with breast ptosis requiring mastectomy, validated measures can be used to compare it with other health states.OBJECTIVE:
To quantify the health state utility assessment of individuals living with breast ptosis who could benefit from a mastopexy procedure; and to determine whether utility scores vary according to participant demographics.METHODS:
Utility assessments using a visual analogue scale (VAS), time trade-off (TTO) and standard gamble (SG) methods were used to obtain utility scores for breast ptosis, monocular blindness and binocular blindness from a sample of the general population and medical students. Linear regression and the Student’s t test were used for statistical analysis; P<0.05 was considered to be statistically significant.RESULTS:
Mean (± SD) measures for breast ptosis in the 107 volunteers (VAS: 0.80±0.14; TTO: 0.87±0.18; SG: 0.90±0.14) were significantly different (P<0.0001) from the corresponding measures for monocular blindness and binocular blindness. When compared with a sample of the general population, having a medical education demonstrated a statistically significant difference in being less likely to trade years of life and less likely to gamble risk of a procedure such as a mastopexy. Race and sex were not statistically significant independent predictors of risk acceptance.DISCUSSION:
For the first time, the burden of living with breast ptosis requiring surgical intervention was determined using validated metrics (ie, VAS, TTO and SG). The health burden of living with breast ptosis was found to be comparable with that of breast hypertrophy, unilateral mastectomy, bilateral mastectomy, and cleft lip and palate. Furthermore, breast ptosis was considered to be closer to ‘perfect health’ than monocular blindness, binocular blindness, facial disfigurement requiring face transplantation surgery, unilateral facial paralysis and severe lower extremity lymphedema.CONCLUSIONS:
Quantifying the health burden of living with breast ptosis requiring mastopexy indicated that is comparable with other breast-related conditions (breast hypertrophy and bilateral mastectomy). Numerical values have been assigned to this health state (VAS: 0.80±0.14; TTO: 0.87±0.18; and SG: 0.90±0.14), which can be used to form comparisons with the health burden of living with other disease states. 相似文献4.
Subramanyam N. Murthy Edward A. Pankey Ajaz A. Banka Adeleke M. Badejo Ryan Wekerle Vaitaitis Vilija Reza Izadpanah Philip J. Kadowitz Vivian A. Fonseca 《Journal of diabetes and its complications》2012,26(6):470-475
ObjectiveWe compared the effect of the long acting basal insulin analog detemir with neutral protamine Hagedorn (NPH) insulin, and normal saline on recovery from vascular injury (balloon catheter mediated) in an animal model of insulin resistance.MethodsFemale Zucker fatty rats were administered NPH/detemir/saline for 7 days following which, they underwent balloon catheter mediated injury of left carotid artery, and were continued on the respective regimen for an additional 21 days when they were sacrificed. We evaluated the injured carotid artery for intimal hyperplasia (Intima/Media ratio) and also, aortic arch protein for markers of oxidative stress and inflammation, in addition to expression and phosphorylation of eNOS using well established methods.ResultsThere was a significant difference in intimal hyperplasia (Intima/Media ratio) between control and detemir treated rats (1.3 ± 0.09, 0.82 ± 0.08; p < 0.001) whereas the IM ratio in NPH treated rats was not significantly different from saline (1.17 ± 0.1). Expression of p-eNOS (ser-1177) in both NPH and insulin detemir (1.3 ± 0.15, 1.11 ± 0.12) was significantly higher than controls (0.56 ± 0.13; p < 0.05). We did not find significant differences in the expression of MnSOD, eNOS and NFκB-p65.ConclusionWe conclude that in insulin resistant states, treatment with Insulin detemir but not NPH is associated with less intimal hyperplasia, although both insulins increased eNOS phosphorylation. 相似文献
5.
Metacarpophalangeal (MP) joint injuries and dislocations of the fingers and thumb are not uncommon. They can be classified directionally as either being volar or dorsal, and are further categorized as incomplete, simple complete or complex complete. Complex dislocations are described as dislocations that are irreducible and often require surgical intervention. This is often because tissue has become entrapped within the MP joint, precluding its anatomical reduction. For the thumb MP joint, anatomical structures that may become trapped include the volar plate, sesamoid bones, bony fracture fragments or the flexor pollicis longus tendon. Both dorsal and volar surgical approaches have been described, and their relative merits will be discussed. The unusual case of a late presentation (two months postinjury) of a complex complete dorsal dislocation of the thumb MP joint approached from a dorsal incision is presented. 相似文献
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8.
Andreas Fuchs Ferdinand Kloos Gerrit Bode Kaywan Izadpanah Norbert P. Südkamp Matthias J. Feucht 《BMC musculoskeletal disorders》2018,19(1):446
Background
Failure of isolated primary meniscal repair must be expected in approximately 10–25% of cases. Patients requiring revision surgery may benefit from revision meniscal repair, however, the results of this procedure remain underreported. The purpose of this study was therefore to evaluate the outcome and failure rates of isolated revision meniscal repair in patients with re-tears or failed healing after previous meniscal repair in stable knee joints.Methods
A chart review was performed to identify all patients undergoing revision meniscal repair between 08/2010 and 02/2016. Only patients without concomitant procedures, without ligamentous insufficiency, and a minimum follow-up of 24?months were included. The records of all patients were reviewed to collect patient demographics, injury patterns of the meniscus, and details about primary and revision surgery. Follow-up evaluation included failure rates, clinical outcome scores (Lysholm Score, KOOS Score), sporting activity (Tegner scale), and patient satisfaction.Results
A total of 12 patients with a mean age of 22?±?5?years were included. The mean time between primary repair and revision repair was 27?±?21?months. Reasons for failed primary repairs were traumatic re-tears in 10 patients (83%) and failed healing in two patients (17%). The mean follow-up period after revision meniscal repair was 43 (± 23.4) months. Failure of revision meniscal repair occurred in 3 patients (25%). In two of these patients, successful re-revision repair was performed. At final follow-up, the mean Lysholm Score was 95.2 (± 4.2) with a range of 90–100, representing a good to excellent result in all patients. The final assessment of the KOOS subscores also showed good to excellent results. The mean Tegner scale was 6.8?±?1.8, indicating a relatively high level of sports participation. Ten patients (83%) were either satisfied or very satisfied with the outcome.Conclusion
In patients with re-tears or failed healing after previous isolated meniscal repair, revision meniscal repair results in good to excellent knee function, high level of sports participation, and high patient satisfaction. The failure rate is slightly higher compared to isolated primary meniscal repair, but still acceptable. Therefore, revision meniscal repair is worthwhile in selected cases in order to save as much meniscal tissue as possible.9.
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