International journal of surgery
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Review Meta Analysis Comparative Study
Arthroscopic partial meniscectomy combined with medical exercise therapy versus isolated medical exercise therapy for degenerative meniscal tear: A meta-analysis of randomized controlled trials.
Degenerative meniscal tear is a chronic disorder which presents with knee pain, swelling and loss of motion. It is currently unknown whether arthroscopic partial meniscectomy combined with medical exercise therapy is superior to isolated medical exercise therapy for degenerative meniscal tear. ⋯ Arthroscopic partial meniscectomy combined with medical exercise therapy is effective in reducing pain and improving range of motion in the early postoperative period. Therefore, arthroscopic partial meniscectomy combined with medical exercise therapy may be recommended for the treatment of degenerative meniscal tear. Further research is necessary to determine the type, frequency, and duration of the best exercise program. Systematic review registration number: Reviewregistry884.
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Randomized Controlled Trial
The efficacy of transversus abdominis plane block with or without dexmedetomidine for postoperative analgesia in renal transplantation. A randomized controlled trial.
Current options for effective postoperative analgesia after renal transplantation are limited, due to altered renal clearance and the risk of renal damage. This study compared the analgesic effect of the transversus abdominis plane block, with or without dexmedetomidine, in renal transplant recipients. ⋯ The transversus abdominis plane block reduced morphine consumption in the first 24 h following renal transplantation, and the addition of dexmedetomidine provided a more effective analgesic effect.
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The COVID-19 pandemic resulted in significant changes in health care systems worldwide, with low- and middle-income countries (LMIC) sustaining important repercussions. Specifically, alongside cancellation and postponements of non-essential surgical services, emergency and essential surgical care delivery may become affected due to the shift of human and material resources towards fighting the pandemic. For surgeries that do get carried through, new difficulties arise in protecting surgical personnel from contracting SARS-CoV-2. ⋯ Reducing the devastating consequences of the COVID-19 pandemic on LMIC emergency and essential surgical services can be achieved through empowering communities with accurate information and knowledge on prevention, optimizing surgical material resources, providing quality training of health care personnel to treat SARS-CoV-2, and ensuring adequate personal protection equipment for workers on the frontline. While LMIC health systems are under larger strain, the experience from previous outbreaks may aid in order to innovate and adapt to the current pandemic. Protecting LMIC surgical ecosystems will be a pivotal process in ensuring that previous health system strengthening efforts are preserved, comprehensive care for populations worldwide are ensured, and to allow for future developments beyond the pandemic.