Linkkhan4626
Th), trabecular number (Tb.N), and structure model index were analyzed. Kruskal-Wallis and Mann-WhitneyU tests were used for multiple comparisons of the nonparametric distributed data and binary comparisons, respectively.
When using the long-term retention protocol, PBM and HFMV treatment increased Tb.N (p < 0.05) and decreased COX‑2 mRNA gene expression levels (p < 0.05) and Tb.Th (p < 0.05) compared to controls. Entinostat mw For short-term retention, PBM and HFMV decreased the amount of relapse tooth movement compared to controls. In addition, Tb.Th (p < 0.05) and the mRNA gene expression levels of COX‑2 and RANKL (p < 0.05) were decreased.
PBM and HFMV might be able to support retention after orthodontic tooth movement by reducing bone resorption and increasing bone quality.
PBM and HFMV might be able to support retention after orthodontic tooth movement by reducing bone resorption and increasing bone quality.Manual medicine is the medical discipline that comprehensively deals with the diagnosis, treatment and prevention of reversible functional disorders of the musculoskeletal system and other related organ systems. The article illustrates the neuroanatomical and neurophysiological basic elements and mechanisms of manual medical diagnostics and treatment. Based on the most recent literature and in consideration of various scientific guidelines, the evidence-based effectiveness of manual medical procedures is presented. In detail acute and chronic low back pain, cervicogenic headache, neck and shoulder pain, radicular arm pain, dysfunctional thoracic pain syndromes, diseases of the rotator cuff, carpal tunnel syndrome and plantar fasciitis. Clinical case examples illustrate the clinical approach. The terminology, origin and clinical presence of "osteopathy" are described in detail and the national and international associations and societies of manual medicine, the German Society for Manual Medicine (DGMM), the European Scientific Society of Manual Medicine (ESSOMM) and the Fédération Internationale de Medicine Manuelle (FIMM) are lexically presented. Finally, contraindications for manual interventions and an outlook on requirements and possibilities of the scientific analysis of pain are presented, as they are postulated in the preamble of the guidelines on specific low back pain of the German Society for Orthopedics and Orthopedic Surgery (DGOOC).The article is part of the series of articles on radiation protection. You can find further articles in the special section of the CVIR issue. The expanding applications of interventional procedures coupled with the potential harmful effects of ionizing radiation highlight the need to assess the delivered radiation dose and establish an effective radiation protection program, particularly in the radiosensitive pediatric population. Given the complexity and heterogeneity of interventional procedures as well as the unique characteristics of children, the management of radiation dose is proving to be quite challenging. The aim of the current article is to provide an overview of the radiation exposure in pediatric patients during interventional procedures focusing on the importance of radiation protection in the pediatric population, the reported radiation doses and the techniques of minimizing radiation dose.Choroid plexus papillomas (CPPs) are benign but rare neuroepithelial neoplasms of the choroid plexus that represent the non-malignant form of a spectrum of tumors of the choroid plexus. The vast majority of CPPs present in children under 5 years of age. Some CPPs are diagnosed prenatally, but many of them reach a large size before diagnosis. CPPs typically present with signs and symptoms of hydrocephalus. Treatment of these tumors has traditionally been with surgical resection. Large CPPs in young children present a challenge due to risk of high blood loss during resection. Here, the authors describe the case of a 3-month-old presenting with hydrocephalus and a large CPP of the third ventricle that was managed with a staged strategy of embolization followed by a delayed resection, allowing the tumor to involute prior to surgery.
The effects of immediate operation on hip fracture (HF) are unclear. Therefore, we investigated the influence of time to operation within 12h vs. > 12-24h on survival and adverse events.
This retrospective study was based on our database from 2006 to 2019. Patients ≥ 20years of age with operations for HF were included. A total of 40 characteristics were analyzed for operations within 12h (group 1) and > 12-24h (group 2) after admission. The primary endpoint was survival at 1year after operation. Secondary endpoints were revision surgery for any reason, infection, and serious adverse events.
A total of 1015 patients received operations within 12h (group 1), and 985 patients received operations > 12-24h (group 2) after admission. The mean age of the patients was 78.8 ± 12.3years. Patients in group 1 were younger and had better health status and shorter hospitalizations than those in group 2. However, no differences were found for revision surgery, infection or adverse events. The mortality rates at 30days, 90days, 6months, and 1year were 6.2, 11.8, 15.9, and 21.0%, respectively. The mortality rate at day 30 was significantly better (p = 0.04) in group 1, but no further differences in survival were observed (hazard ratio 1.071; 95% confidence interval 0.864-1.328; log rank 0.179). A subgroup analysis of geriatric patients ≥ 65years assessed no differences according the primary and secondary endpoints.
Within the limits of single-center analysis, the patients receiving treatment for HF within 12h were younger and healthier and had the benefits of shorter hospitalizations and a higher 30-day survival rate than patients treated > 12-24h after admission. At the endpoint 1year after operation, no differences were observed in adverse events or survival rates.
12-24 h after admission. At the endpoint 1 year after operation, no differences were observed in adverse events or survival rates.
This systematic literature review aimed to make a detailed overview on the clinical and functional outcomes and to get insight into the possible superiority of a treatment method for extra-articular distal radius fractures.
Embase, Medline, Cochrane Library, Web of Science, and Google Scholar were searched for studies describing treatment results. Five treatment modalities were compared plaster cast immobilization, K-wire fixation, volar plating, external fixation, and intramedullary fixation.
Out of 7,054 screened studies, 109 were included in the analysis. Overall complication rate ranged from 9% after plaster cast treatment to 18.5% after K-wire fixation. For radiographic outcomes, only volar tilt in the plaster cast group was lower than in the other groups. Apart from better grip strength after volar plating, no clear functional differences were found across treatment groups.
Current literature does not provide uniform evidence to prove superiority of a particular treatment method when looking at complications, re-interventions, and long-term functional outcomes.
Current literature does not provide uniform evidence to prove superiority of a particular treatment method when looking at complications, re-interventions, and long-term functional outcomes.
We aim to report clinical and radiological results of triangular osteosynthesis for a homogenous group of vertically unstable transforaminal sacral fractures.
Between 2013 and 2018, 22 consecutive patients with unstable sacral fractures were treated with triangular osteosynthesis consisting of iliosacral screw augmented by spinopelvic fixation. Patients were followed up prospectively as a single cohort. Bone union, complications, clinical and radiological outcomes were investigated.
Mean follow-up was 3.1 years (12-76 months). There was one bilateral fracture. Two patients underwent anterior plating for pubic symphyseal disruption. Based on Majeed and Iowa pelvic scores, 13 patients had excellent, seven had good and two had fair clinical outcome. All the patients could perform squatting, sitting cross-legged and kneeling without any restrictions. There were no additional neurological injuries. One patient had non-union of sacral fracture, one patient had deep infection, one patient had marginal wound necrosis and two patients complained of pain related to implant prominence. Two patients had connecting rod backout. All but one patient attained pre-operative work status.
Triangular osteosynthesis is a reliable procedure in treating unstable transforaminal sacral fractures. It permits early weight-bearing and facilitates faster functional recovery. Careful attention to details such as sacral dysmorphism, soft tissue injury, implant placement and anterior pelvic injury helps in keeping complications to an acceptable rate.
Triangular osteosynthesis is a reliable procedure in treating unstable transforaminal sacral fractures. It permits early weight-bearing and facilitates faster functional recovery. Careful attention to details such as sacral dysmorphism, soft tissue injury, implant placement and anterior pelvic injury helps in keeping complications to an acceptable rate.
New biomarkers may contribute to avoid unnecessary biopsies resulting from the suboptimal performance of prostate-specific antigen (PSA) testing. This study aimed to assess serum endoglin as a prostate cancer (PCa) diagnostic tool among biopsy candidates.
A total of 262 consecutive patients referred for prostate biopsy based on abnormal digital rectal examination and/or elevated total PSA (tPSA) who had serum endoglin assessed by solid-phase enzyme-linked immunosorbent assay were selected. Receiver operating characteristic curves were used to compare the predictive accuracy of different combinations of biomarkers to distinguish between PCa and benign prostatic conditions, and to identify cut-offs that maximize the ability of endoglin to rule out patients for biopsy (highest sensitivities).
Serum endoglin levels were higher in patients with PCa (median 7.86 vs. 5.88 pg/mL, P < 0.001). Among patients with baseline tPSA ≤ 10 ng/mL the area under the curve was 0.69 for endoglin. Approximately one-quarter of the patients had serum endoglin < 4.92 ng/mL (sensitivity 90.3%; specificity 32.8%), and the probability of PCa varied from 37.7% before testing to 15.2% among those with low endoglin levels [negative predictive value (NPV) = 84.8%]. When restricting the analyses to patients with free/total PSA ratio > 0.25, the probability of cancer was less than 5% among those with serum endoglin < 6.04 ng/mL (sensitivity 93.8%; specificity 56.1%), corresponding to a NPV of 95.8%; this could allow sparing approximately 40% of patients from biopsy.
Serum endoglin may be useful in clinical practice to distinguish between PCa and non-cancer patients among prostatic biopsy candidates.
Serum endoglin may be useful in clinical practice to distinguish between PCa and non-cancer patients among prostatic biopsy candidates.Although ventricular pre-excitation via accessory pathways (APs) causes cardiac dysfunction in children and young adults with Wolff-Parkinson-White (WPW) syndrome, the underlying cardiac dysfunction mechanisms are unclear. This study aimed to characterize cardiac dysfunction and clarify sensitive cardiac dysfunction indicators in WPW syndrome patients classified by the APs location with a layer-specific strain analysis. Twenty-four patients with WPW syndrome with a mean age of 14.1 years (6.9-21.6 years) (11 cases type A with a left-sided AP [WA group], 13 cases type B with a right-sided AP [WB group]), and 37 age-matched normal controls (N group) were examined. We measured the left ventricle (LV), base-, mid-, and apical-level of circumferential strain (CS), and longitudinal strain (LS) using a layer-specific strain with speckle tracking imaging. Dyssynchrony was also measured based on the timing of the radial strain at each segment. Peak endomyocardial base- and mid-level of CS was lower in both the WA and WB groups compared to the N group.
