Medicine
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Case Reports
Novel surgical treatment of abdominal aortic aneurysm complicated with primary aorto-colonic fistula: A case report.
Primary aorto-colonic fistula is a rare complication of an abdominal aortic aneurysm. Without surgical treatment, the associated mortality rate is 100%. Even if patients receive timely surgical treatment, they may still die of complications such as infection. ⋯ This surgical treatment is suitable for patients with abdominal aortic aneurysms complicated with primary aorto-colonic fistula in which the intestine is very difficult to repair or resect.
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Observational Study
Posterior surgical treatment of ankylosing spondylitis with spinal tuberculosis: A case series and long-term follow-up.
This retrospective cohort study aimed to evaluate the clinical outcomes of posterior surgical treatment of ankylosing spondylitis (AS) with spinal tuberculosis (STB). This was a retrospective study including 12 patients treated between January 2004 and April 2014 for AS with STB at our department. All patients underwent 1-stage posterior internal fixation, debridement, and bone fusion. ⋯ The VAS significantly was considerably improved between the preoperative and the last clinical visits. These positive results demonstrate that 1-stage surgical treatment for AS with STB by posterior debridement, fusion, and instrumentation can be an effective and feasible treatment method for this specific condition. It should be noted that it is necessary to carry out antiosteoporosis treatment and perform long-segmental instrumentation in order to obtain spinal stabilization.
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Adult fracture nonunion risk is related to injury severity and surgical technique, yet nonunion is not fully explained by these risk factors alone; biological risk factors are also important. We test a hypothesis that risk factors associated with pediatric fracture nonunion are similar to adult nonunion risk factors. Inception cohort study in a large payer database of pediatric fracture patients (0-17 years) in the United States in calendar year 2011. ⋯ We confirm a hypothesis that risk factors for pediatric nonunion are similar to adult nonunion risk factors. Scaphoid fractures in adolescents have nearly the same risk of nonunion as in adults. Opioids should be used cautiously in pediatric patients, as they are associated with a significant and substantial elevation of nonunion risk.
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Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder characterized by vascular dysplasia, including typically systemic telangiectases and arteriovenous malformations (AVMs). Due to its variable clinical manifestations, HHT patients often seek medical care from different medical subspecialties and thus experience delays in diagnosis and treatment. This study is designed to analyze the clinical features and treatment options for patients with HHT. ⋯ Patients with HHT have variable clinical characteristics, and their diagnoses were delayed on average by about 26 years. An experienced multidisciplinary team is needed for the early diagnosis and optimal management of patients with HHT. Thalidomide may be an effective choice to alleviate the bleeding symptoms of patients with HHT.