Medicine
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Observational Study
Is biopsy enough for papillary thyroid microcarcinoma?: An analysis of the SEER database 2004 to 2013 with propensity score matching.
The treatment of papillary thyroid microcarcinoma (PTMC) remains deeply controversial. In this study, we investigated the prognosis of patients who underwent biopsy alone, as compared with other forms of thyroidectomy approaches. We sought to provide reference information for treatment selection in cases of PTMC. ⋯ According to multivariate Cox regression analyses, patients undergoing biopsy had similar cancer-specific survival rates and higher all-cause survival rates in comparison with patients undergoing other surgical approaches. After matching for influential factors using propensity scores, Kaplan-Meier analyses also showed that patients undergoing biopsy had similar cancer-specific survival rates and lower all-cause survival rates in comparison with patients undergoing other surgical approaches. Our results provided helpful implications for the treatment of patients with PTMC.
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It is difficult to repair knee deep burn wounds in elderly patients. In this study, we observed the therapeutic effects of descending genicular artery-saphenous artery perforator flaps on knee deep burn wounds in elderly patients. Between December 2013 and February 2018, we repaired knee third-degree burn wounds using descending genicular artery-saphenous artery perforator flaps of 20 × 12 cm to 23 × 13 cm in 56 elderly patients. ⋯ In the 8 patients with completely necrotic patella and patellar ligament as well as open knee joint, the weight-bearing function of knee joint was retained, which met patients' requirements of limb salvage and weight-bearing function. In the other 48 patients with partially necrotic patella and patellar ligament as well as open joint capsule, the postoperative flexion and extension of the knee joint were good. In elderly patients, it is an effective method to repair knee deep burn wounds using the descending genicular artery-saphenous artery perforator flaps.
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Observational Study
A qualitative evaluation of an implementation study for cryptococcal antigen screening and treatment in Uganda.
Cryptococcal meningiti s causes 15% of AIDS-related deaths globally. Screening and preemptive treatment for cryptococcal antigen (CrAg) in the blood of persons with advanced HIV/AIDS reduces mortality. National and international HIV guidelines recommend CrAg screening; however, implementation studies and evaluations of how to integrate CrAg screening programs into existing HIV care infrastructure are lacking. ⋯ Collaboration with Ministries of Health for support with enforcing national guidelines, and procuring supplies is paramount to a successful CrAg screening program. Development of a CrAg screening and treatment program within the HIV clinic infrastructure has a number of barriers. Education and training of clinic staff, along with partnership with the Ministry of Health to ensure adequate supplies, facilitated the program.
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Randomized Controlled Trial Multicenter Study
Oxycodone versus sufentanil in adult patient-controlled intravenous analgesia after abdominal surgery: A prospective, randomized, double-blinded, multiple-center clinical trial.
A randomized controlled trial was performed to compare analgesic effects and adverse effects of oxycodone and sufentanil in patient-controlled intravenous analgesia (PCIA) after abdominal surgery under general anesthesia. ⋯ Compared with sufentanil PCIA, oxycodone PCIA showed better analgesic effects, lower incidence of adverse complications, and less analgesic drug consumption during postoperative pain management.
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Review Meta Analysis
Patent foramen ovale closure or medical therapy for secondary prevention of cryptogenic stroke: An update meta-analysis of randomized controlled trials.
It was under debate whether cryptogenic stroke patients benefited from patent foramen ovale (PFO) closure. We sought to determine secondary prevention strategy in these patients. ⋯ PFO closure, as compared with medical therapy, was associated with decreased risk of recurrent stroke and increased risk of atrial fibrillation in cryptogenic stroke patients with PFO.