Medicine
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Comparative Study
Comparison of breast ductal carcinoma in situ and ductal carcinoma in situ with microinvasion, and analysis of axillary lymph node metastasis.
To compare the clinicopathologic features and long-term outcomes for women with ductal carcinoma in situ (DCIS) vs DCIS with microinvasion (DCISM), to assess the impact of microinvasion on tumor size and determine relationships between the number of microinvasive lesions and clinicopathological factors. A total of 493 patients with DCIS or DCISM from our database were analyzed to assess differences in clinicopathologic features and outcomes between the 2 cohorts. The median follow-up was 3.9 years, 229 patients had DCIS and 264 had DCISM, and the mean age was 46.8 years for the entire group. ⋯ Our data imply that for breast DCIS patients, axillary lymph node operation can be avoided, but for DCISM patients, surgical evaluation of the axilla is necessary. In addition, having no less than 3 microinvasive lesions in DCISM indicates poor prognosis. In the pathological staging of DCISM, tumor size and number of microinvasive lesions should be considered.
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Pressure injuries (PIs) bring a considerable physical and mental burden on immobile patients, and have put families and government under tremendous pressure to cover the cost of treatment. Therefore, this protocol proposes to identify risk factors of developing PIs in immobile patients from systematic reviews (SRs) and clinical practice guidelines (CPGs), in order to establish a risk prediction model for developing PIs and identify individual risk factors that can be modified to aid prevention. ⋯ INPLASY2020100097.
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Multicenter Study
Primary care pathway- a novel way to reduce the burden on orthopaedic fracture clinics within the pediatric subgroup: A Queensland multi-centered review.
Emergency departments receive an increasing amount of musculoskeletal injuries, with the majority referred to a fracture clinic (FCs). A literature review revealed certain orthopaedic injuries can be safely managed away from the FC pathway by general practitioners (GPs) or allied health professionals (AHPs). The present study aims to review all paediatric presentations to FCs at 2 Queensland hospitals, identifying low risk injuries that could potentially be managed by GPs or AHPs. ⋯ Total failure to attend rate in the PCP group was 6.7%. Adopting the PCP has the potential to significantly reduce FC referrals. With proven success of similar pathways abroad, the PCP may generate significant time and financial savings for both the health care system and patient.
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Cardiac arrest refers to the sudden termination of cardiac ejection function due to various causes. Adrenaline is an important component of resuscitation among individuals experiencing cardiac arrest. The adrenaline delivery method chiefly involved intraosseous infusion and intravenous access. However, the impact of different adrenaline delivery methods on cardiac arrest has been unclear in previous research. Thus, the present study aimed to synthesize the available evidence regarding intravenous vs intraosseous adrenaline administration in cardiac arrest. ⋯ INPLASY202090100 (DOI:10.37766/inplasy2020.9.0100).
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Idiopathic facial nerve palsy (Bells palsy) is the most common acute mono-neuropathy which lack of effective treatments. Kinesitherapy as an alternative therapeutic approach was widely used in clinical. But the effects on Bells palsy outcome are still debated. ⋯ PROSPERO CRD42020215109.