Articles: middle-aged.
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Arch Orthop Trauma Surg · Dec 2018
Meta AnalysisArthroscopic meniscal surgery versus conservative management in patients aged 40 years and older: a meta-analysis.
The efficacy of arthroscopic meniscus surgery in old aged patients remains controversial. The purpose of the present study was to review published studies comparing arthroscopic meniscal surgery with conservative management to treat meniscal injuries in patients 40 years of age and older. ⋯ The efficacy of arthroscopic surgery was not superior to conservative management in this type of patients. Therefore, arthroscopic meniscal surgery should not be recommended as a first choice of treatment for degenerative meniscal tears. In patients over 40 years of age, arthroscopic surgery should be cautiously considered for degenerative meniscal tears and only when there has not been a satisfactory response to conservative management.
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In the past a mastectomy was the first approach of treating breast cancer. Oncoplastic techniques combined with breast conserving surgery (BCS) and radiotherapy has become an alternative to mastectomy in patients with non-metastasized breast cancer. The aim of this study was to analyse the amount and types of complications occurring after oncoplastic BCS before and after adjuvant radiotherapy and the delay of adjuvant therapy due to the complications. ⋯ This study provides a detailed overview of the used techniques of oncoplastic BCS and their postoperative complications. Most complications occurred before the start of the adjuvant radiotherapy. Just a small amount caused a delay for the radiotherapy to start.
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Abscess coexisting within a brain tumor is rare. Case reports in the literature primarily consist of sellar pathology and parenchymal lesions, including meningioma, glioma, and metastases. We report a case of glioblastoma with an intratumoral abscess in a middle-aged patient with no prior invasive procedure or systemic focus of infection. ⋯ It is important for neurosurgeons to be aware of this rare entity. The treatment protocol remains controversial and is primarily guided by expert opinion. It is important to aggressively treat the patient with antibiotics followed by adjuvant therapy for malignancy. The timing and administration of adjuvant therapy are unclear. We suggest a delay of chemotherapy until at least 4 weeks of therapy with sensitive antibiotics.
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Risk factors of overactive bladder syndrome and its relation to sexual function in menopausal women.
Overactive bladder syndrome is a common and annoying complication worldwide that could negatively affect the quality of life of afflicted individuals. We aimed to determine the prevalence and risk factors of overactive bladder syndrome and its relation to sexual function in healthy menopausal women. ⋯ The prevalence of overactive bladder was quite high in this study. Since sexual dysfunction is not an easy topic to talk about and can affect women's quality of life, physicians should consider talking about these issues besides urinary issues to all middle-aged women.
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Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. ⋯ Suicides are probably undercounted or frequently misclassified in reports of opioid-related poisoning deaths. Greater understanding and better assessment are needed of the risk associated with suicide risk in patients with pain. Clinical tools and an evolving evidence base are available to assist clinicians with identifying patients whose risk factors put them at risk for adverse outcomes with opioids.