Medicine
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Randomized Controlled Trial Comparative Study
Posterior paraspinal muscle versus post-middle approach for the treatment of thoracolumbar burst fractures: A randomized controlled trial.
This randomized controlled trial (RCT) aimed to compare the clinical outcomes of thoracolumbar burst fractures (TLBFs) treated with open reduction and internal fixation via the posterior paraspinal muscle approach (PPMA) and the post-middle approach (PA). ⋯ Although PPMA required a longer operative time and x-ray exposure time, PPMA provided several advantages over PA, including less intra-operative blood loss and lower postoperative drainage volume, and greater satisfaction with postoperative pain relief and functional improvement, than PA, especially at the 6-month follow-up after surgery. Further high-quality multicenter studies are warranted to validate our findings.
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Observational Study
Diagnostic value of fractional exhaled nitric oxide for asthma-chronic obstructive pulmonary disease overlap syndrome.
To examine the difference in the fractional exhaled nitric oxide (FeNO) between chronic obstructive pulmonary disease (COPD) patients with asthma-COPD overlap syndrome (ACOS) and patients with Non-ACOS COPD (Non-ACOS) and to investigate the correlation between FeNO levels and the differential cell counts of eosinophils in induced sputum, in order to explore the diagnostic value of FeNO in ACOS. A prospective, case-control study was performed on 53 cases of ACOS group and 53 cases of Non-ACOS group in the Respiratory Medicine Outpatient of Zhangzhou Municipal TCM Hospital, Affiliated to Fujian University of Traditional Chinese Medicine. The FeNO levels and induced sputum cell counts were determined and the correlation between FeNO levels and eosinophile percentage was analyzed by Pearson linear correlation analysis. ⋯ The area under the receiver operating curve of FeNO for the diagnosis of ACOS phenotype was 0.815 (P < .01), the sensitivity and specificity reach highest when the cut off value was 25.50 ppb. The FeNO in patients from the ACOS group were significantly higher than those in Non-ACOS group and were moderately correlated with the percentage of eosinophils in induced sputum. The results indicated that FeNO may be used as a diagnostic index for ACOS, in addition to the induced sputum.
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Positional asphyxia is a rare cause of sudden death and a difficult diagnosis, based mostly on the circumstances of the incident, along with particular external and internal findings, frequent in asphyxia (signs of sudden death). ⋯ Therefore, the current criteria for positional asphyxia are based on the obstruction of normal gas exchange caused by the body position, the impossibility to move to another position, and the exclusion of other causes of death. The forensic medical examination must also be started at the scene of the incident.
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A 67-year-old, right-handed male patient underwent craniotomy and drainage for hematoma removal related to an intracerebral hemorrhage (ICH) in the right thalamus and basal ganglia at the neurosurgery department of a university hospital. ⋯ Recovery of a severely injured medial lemniscus with concurrent recovery of impaired proprioception and pusher syndrome.
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Review Meta Analysis
Diaphragmatic ultrasonography for predicting ventilator weaning: A meta-analysis.
Weaning failure is common in mechanically ventilated patients. Whether ultrasound can predict weaning outcome remains controversial. This meta-analysis was performed to assess the accuracy of diaphragmatic ultrasonography for predicting reintubation within 48 hours of extubation. ⋯ Diaphragmatic ultrasonography is a promising tool for predicting reintubation within 48 hours of extubation. However, due to heterogeneities among the included studies, large-scale studies are warranted to confirm our findings.