Therapeutics and clinical risk management
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Ther Clin Risk Manag · Jan 2016
Kinetics of circulating endothelial progenitor cells in patients undergoing carotid artery surgery.
Endothelial progenitor cells (EPCs) are primitive cells found in the bone marrow and peripheral blood (PB). In particular, the potential of EPCs to differentiate into mature endothelial cells remains of high interest for clinical applications such as bio-functionalized patches for autologous seeding after implantation. The objective of this study was to determine EPCs' kinetics in patients undergoing carotid artery thromboendarterectomy (CTEA) and patch angioplasty. ⋯ CTEA results in short-term downregulation of circulating EPCs and SDF-1α levels. Rapid return to baseline levels might indicate participation of EPCs in repair mechanisms following vascular injury.
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Ther Clin Risk Manag · Jan 2016
Comparison of anterior decompression and fusion versus laminoplasty in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: a systematic review and meta-analysis.
A meta-analysis was conducted to evaluate the clinical outcomes, complications, reoperation rates, and late neurological deterioration between anterior decompression and fusion (ADF) and laminoplasty (LAMP) in the treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL). ⋯ Our meta-analysis suggested that ADF was associated with better postoperative neurological function, neurological recovery rate, and less late neurological deterioration than LAMP in the treatment of multilevel cervical OPLL with a high mean occupation ratio. LAMP was associated with a decreased postoperative cervical lordosis, which might be a cause of late neurological deterioration. The complication rates of both groups showed no statistical difference. However, the reoperation rate was significantly higher in ADF group compared with LAMP group. Benefits and risks should be balanced when ADF or LAMP is selected.
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Ther Clin Risk Manag · Jan 2016
Microplasma radiofrequency technology combined with triamcinolone improved the therapeutic effect on Chinese patients with hypertrophic scar and reduced the risk of tissue atrophy.
The current study aimed to assess the value of microplasma radiofrequency technology combined with triamcinolone for the therapy of Chinese patients with hypertrophic scar. ⋯ Microplasma radiofrequency technology combined with triamcinolone improved the therapeutic effect on Chinese patients with hypertrophic scar and reduced the risk of tissue atrophy compared with the use of either microplasma radiofrequency technology or triamcinolone injection alone.
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Ther Clin Risk Manag · Jan 2016
Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study.
Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA). To date, no reports compare the efficacy of spinal anesthesia (SA) with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA. ⋯ TEP inguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better patient satisfaction than GA.
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Ther Clin Risk Manag · Jan 2016
ReviewPatient considerations and drug selection in the treatment of idiopathic pulmonary fibrosis.
Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease of unknown cause. Approximately 5,000 people are diagnosed with IPF in the UK every year. People with IPF suffer significant morbidity and, without any curative treatment at present, survival rates remain poor with a median survival of 3 years. ⋯ We discuss pharmacological and nonpharmacological aspects of providing best supportive care for patients with IPF. However, few good quality studies exist focusing on controlling symptoms specifically in patients with IPF, and recommendations are often extrapolated from evidence in other chronic diseases. In covering these topics, we hope to provide readers with a comprehensive review of the available evidence pertaining to all aspects of care for patients suffering with IPF.