Mccormacklindahl8910
al.
Percutaneous transhepatic gallbladder drainage (PTGBD) is indicated for patients with acute cholecystitis (AC) who are not indicated for urgent surgery, but external tubes reduce quality of life (QOL) while waiting for elective surgery. The objective of the present study was to investigate the feasibility of laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting (ETGBS) comparing with after PTGBD.
Intraoperative and postoperative outcomes of patients with ETGBS and PTGBD were retrospectively compared.
Eighteen ETGBS and ten PTGBD patients were compared. Differences in the duration of ETGBS and PTGBD [median 209min (range 107-357) and median 161min (range 130-273), respectively, P = 0.10], median blood loss [ETGBS 2 (range 2-180ml) and PTGBD 24 (range 2-100ml), P = 0.89], switch to laparotomy (ETGBS 11% and PTGBD 20%, P = 0.52), and median postoperative hospital stay [ETGBS 8 (range 4-24days) and ETGBS 8 (range 4-16days), P = 0.99]. Thickening of the cystic duct that occurred in 60% of the ETGBS patients and none of the PTGBD patients (P = 0.005) interfered with closure of the duct by clipping. No obstruction occurred in ETGBS patients.
ETGBS did not make laparoscopic cholecystectomy less feasible than after PTGBD. This is a pilot study, and further investigations are needed to validate the results of the present study.
ETGBS did not make laparoscopic cholecystectomy less feasible than after PTGBD. This is a pilot study, and further investigations are needed to validate the results of the present study.
The aim of this study was to determine in vitro the bactericidal potential of 38% silver diamine fluoride (SDF) alone, potassium iodide (PI) alone, and the two in combination (SDF + PI) against three bacterial species commonly found in root canal samples (Enterococcus faecalis, Actinomyces naeslundii and Parvimonas micra).
The potential bactericidal rates for SDF, PI and SDF + PI against E. faecalis, A. naeslundii and P. micra were calculated as reduction of bacteria colony forming units.
The bactericidal potential of SDF was at 99.97-100% against E. faecalis and 100% against A. naeslundii and P. micra. SDF + PI showed a 100% bactericidal effect against P. micra, 99.89-99.98% against E. faecalis and 99.98-100% against A. naeslundii. The bactericidal effect of PI was 99.51-99.98% against E. faecalis, 99.27-99.95% against A. naeslundii and 99.93-100% against P. micra. The differences between controls and bacteria exposed to the antibacterial agents were statistically significant (p < 0.05).
SDF had an effective bactericidal effect against the examined bacteria. However, the limitations of this in vitro study do not allow a recommendation of the employment of these solutions as root canal irrigants. Additional investigations are necessary to assess their endodontic clinical applicability.
SDF had an effective bactericidal effect against the examined bacteria. However, the limitations of this in vitro study do not allow a recommendation of the employment of these solutions as root canal irrigants. Additional investigations are necessary to assess their endodontic clinical applicability.
Chronic intercondylar fractures of the distal humerus with massive bone defects and severe comminution in the metaphysis are rare and complex injuries that are challenging for surgeons to treat, as reconstructing the triangular structure of the distal humerus is difficult and may have a severe impact on functional outcomes, especially in young patients, for whom total elbow arthroplasty is usually not a suitable option due to significant impairment in upper limb strength. Here, we report a patient in such scenario who was young and active and was treated by structural iliac bone autografting and internal fixation.
A 26-year-old male patient experienced a major car accident and was diagnosed with an open fracture (Gustilo-Anderson type IIIB) of the right distal humerus with massive bone defects and severe intra-articular involvement, without neurovascular injuries or other associated injuries. Surgical debridement, negative pressure vacuum sealing drainage, and immobilization by braces were initially perfores associated with massive bone defects and severe articular involvement in young and active patients using metaphyseal shortening and structural iliac crest bone autografting together with open reduction and internal fixation via a parallel configuration.
In this study, we proposed a surgical reconstruction strategy for complex chronic distal humeral fractures associated with massive bone defects and severe articular involvement in young and active patients using metaphyseal shortening and structural iliac crest bone autografting together with open reduction and internal fixation via a parallel configuration.
Misdiagnosis or failure to intraoperatively detect occult hernia in the inguinal region can lead to the recurrence of postoperative hernia and the appearance of local pain symptoms, which affect the patient's quality of life and make it difficult to reperform hernia repair.
This study included 1066 inguinal hernia patients who underwent surgical treatment at Shanghai Tongren Hospital between January 2016 and October 2018 to investigate ipsilateral occult hernia epidemiology, to analyze the characteristics of ipsilateral occult hernias with regards to patient age, gender, classification and anatomical site, and to explore the superiority and inferiority of the expert hernia surgeons/ non-expert hernia surgeons group and of operation methods in finding occult inguinal hernias.
The incidence of ipsilateral occult hernia in the surgical population was 8.26%. Ipsilateral occult hernia included indirect inguinal hernia, direct inguinal hernia, femoral hernia, obturator hernia, and spigelian hernia, among whic; therefore, it is necessary for experienced surgeons to carefully detect for possible occult hernia during the operation and in elderly patients.
Ipsilateral occult inguinal hernia has a higher incidence in patients with inguinal hernia, especially older patients; therefore, it is necessary for experienced surgeons to carefully detect for possible occult hernia during the operation and in elderly patients.
Globally 70.8 million people have been forcibly displaced from their homes and are at disproportionally high risk for trauma. At the time of this study, there was an estimated 1.6 million internally displaced persons (IDP) in Iraq, more than two-thirds of whom reside in private, urban settings. This study aims to understand the impact of post-displacement accommodation on mental well-being of the Yazidi minority group displaced in Iraq.
Multi-stage stratified sampling was used to randomly select IDPs in camp and out of camp settlements in northern Iraq. Standardized questionnaires evaluated factors including exposure to violence and self-reported distress symptoms (measured by Impact of Event Scale-Revised). Tiplaxtinin A multi-variate linear model assessed the relationship between settlement setting and distress symptoms.
One thousand two hundred fifty-six displaced Yazidi participants were included in the study 63% in camps and 37% out of camps. After controlling for exposure to violence, social cohesion, unemploving conditions for both displaced populations and their host communities.
The role of data in informing decision makers in formulating policy to improve population health is undeniably important. During the past few years, the Thai government has undertaken continuous health promotion campaigns and programs. Nevertheless, evidence of how physical activity (PA) has improved is lacking. This study aims to present PA prevalence and trends from nationally-representative surveillance data collected during 2012-2019.
This study employed 8 rounds of Thailand's Surveillance on Physical Activity (SPA) survey from 2012 to 2019 as a pooled analysis from two-panel data (SPA2012-2016 and SPA2017-2019). Multistage random sampling was applied to select Thai adults aged 18 or over to produce a nationally-representative dataset, by considering the place of residence (urban or rural), gender, and single year of age. Face-to-face interviews using a structured questionnaire were conducted in 5 regions, 13 provinces, and 36 villages to follow up 5648 individuals in Panel 1 (SPA2012-2016) and 6074 pupational PA.
The prevalence of sufficient MVPA has fluctuated over time with a tendency to increase in the most recent years. Work-related is the most common modes of PA among Thai adults, implying further improvement in recreational physical activity is required. Workplace intervention should also be the focus in improving PA of Thai adults by encouraging their work force to engage in more occupational PA.
Elderberry has traditionally been used to prevent and treat respiratory problems. During the COVID-19 pandemic, there has been interest in elderberry supplements to treat or prevent illness, but also concern that elderberry might overstimulate the immune system and increase the risk of 'cytokine storm'. We aimed to determine benefits and harms of elderberry for the prevention and treatment of viral respiratory infections, and to assess the relationship between elderberry supplements and negative health impacts associated with overproduction of pro-inflammatory cytokines.
We conducted a systematic review and searched six databases, four research registers, and two preprint sites for studies. Two reviewers independently assessed studies for inclusion, extracted data from studies, assessed risk of bias using Cochrane tools, and evaluated certainty of estimates using GRADE. Outcomes included new illnesses and the severity and duration of illness.
We screened 1187 records and included five randomized trials ctive than diclofenac in cytokine reduction over time.
Elderberry may be a safe option for treating viral respiratory illness, and there is no evidence that it overstimulates the immune system. However, the evidence on both benefits and harms is uncertain and information from recent and ongoing studies is necessary to make firm conclusions.
Elderberry may be a safe option for treating viral respiratory illness, and there is no evidence that it overstimulates the immune system. However, the evidence on both benefits and harms is uncertain and information from recent and ongoing studies is necessary to make firm conclusions.
Intravesical instillation of bacillus Calmette-Guérin (BCG) as a treatment for superficial bladder cancer rarely causes pulmonary complications. While published cases have been pathologically characterized by multiple granulomatous lesions due to disseminated infection, no case presenting as a solitary pulmonary nodule has been reported.
A man in his 70s was treated with intravesical BCG for early-stage bladder cancer. After 1year, he complained of productive cough with a solitary pulmonary nodule at the left lower lobe of his lung being detected upon chest radiography. His sputum culture result came back positive, with conventional polymerase chain reaction (PCR) identifying Mycobacterium tuberculosis complex. However, tuberculosis antigen-specific interferon-gamma release assay came back negative. Considering a history of intravesical BCG treatment, multiplex PCR was conducted, revealing the strain to be Mycobacterium tuberculosis var. BCG. The patient was then treated with isoniazid, ethambutol, levofloxacin, and para-aminosalicylic acid following an antibiotic susceptibility test showing pyrazinamide resistance, after which the size of nodule gradually decreased.
