Medicine
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Spinal canal stenosis is a dynamic phenomenon that becomes apparent during spinal loading. Current diagnostic procedures have considerable short comings in diagnosing the disease to full extend, as they are performed in supine situation. Upright MRI imaging might overcome this diagnostic gap. ⋯ The lordosis angle at level L5/S1 was 49.4° in 0° position, 55.8° in 80° position, and 64.7 mm in the 80° position with hyperlordosis. Spinal canal stenosis is subject to a dynamic process, that can be displayed in upright MRI imaging. The range of anomalies is clinically relevant and dynamic positioning of the patient during MRI can provide essential diagnostic information which are not attainable with other methods.
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To investigate whether the platelets can improve liver function by mediating liver regeneration. Using a retrospective cohort with 234 consecutive adult-to-adult living donor liver transplantation recipients, we have discussed the relationship between immediate postoperative platelet count and outcome. Patients have been stratified into Low Platelet Group (106 patients) with platelet ≤68 × 10/L and High Platelet Group (128 patients) with platelet >68 × 10/L. ⋯ The 90-day mortality between the 2 groups is similar. The multivariate analysis has found that postoperative platelet ≤68 × 10/L is an independent risk factor for EAD. Platelet maybe influences the functional status of the liver by promoting graft regeneration after liver transplantation.
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Bad Sobernheim Stress Questionnaire (BSSQ)-Deformity and BSSQ-Brace are the most widely used instruments for evaluating stress levels in adolescent idiopathic scoliosis (AIS) patients under brace treatment, and good reliability and validity have been demonstrated across different cultures. Great stress has been found among many adolescents, becoming a major concern for professionals. However, no previous research has addressed the cultural adaptations and psychometric testing of BSSQ-Deformity and BSSQ-Brace in China or the stress levels in AIS patients. ⋯ The correlation coefficients of BSSQ-Deformity, BSSQ-Brace and SRS-22 were 0.48 and 0.63, respectively. In conclusion, BSSQ-Deformity and BSSQ-Brace have been successfully adapted to a Chinese background and psychometrically validated with excellent reliability and construct validity. Brace wearing is considered the main cause of stress in AIS patients under brace treatment.
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Ventriculoperitoneal (VP) shunt complications are common, but abdominal complications are rare. The objective of this report is to present 2 cases of intestinal obstruction due to a VP shunt and review the literature for data on this rare occurrence. A 4-month-old boy received surgical resection of a medulloblastoma and a VP shunt was inserted to manage progressive hydrocephalus. ⋯ Only 1 case in the literature review was related to intestinal adhesions. Treatment in most cases was laparotomy. Although intestinal obstruction is a rare complication of a VP shunt, it should be considered in the presence of abdominal symptoms and prompt treatment provided to have a good outcome.
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Observational Study
Understanding the Racial and Ethnic Differences in Cost and Mortality Among Advanced Stage Prostate Cancer Patients (STROBE).
The aims of the study were to understand the racial/ethnic differences in cost of care and mortality in Medicare elderly with advanced stage prostate cancer. This retrospective, observational study used SEER-Medicare data. Cohort consisted of 10,509 men aged 66 or older and diagnosed with advanced-stage prostate cancer between 2001and 2004. ⋯ In conclusion, relationship between race/ethnicity, cost of care, and mortality is intricate. For non-Hispanic black men, disparity in mortality can be attributed to treatment differences. To reduce racial/ethnic disparities in prostate cancer care and outcomes, tailored policies to address underuse, overuse, and misuse of treatment and health services are necessary.