Articles: surgery.
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Congenital factor VII deficiency is the most common among rare bleeding disorders, characterized by spontaneous or traumatic bleeding. The clinical manifestation is heterogeneous, ranging from asymptomatic phenotype to life-threatening hemorrhages. Intracranial hemorrhage is a common complication of brain tumor neurosurgery, which significantly challenges the perioperative management of patients with hemostatic defects. ⋯ This is the first reported case in which surgical hemorrhage secondary to brain tumor resection was successfully controlled in the presence of congenital factor VII deficiency. Perioperative coagulation state, hemostasis, and thrombosis events should be closely observed, and the interval and dosage of recombinant factor VIIa should be adjusted accordingly.
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Randomized Controlled Trial Comparative Study
Effects of blue-light-filtering intraocular lenses on contrast sensitivity in patients with glaucoma.
To compare the effects of blue-light-filtering intraocular lenses (BF-IOLs) and conventional ultraviolet-blocking intraocular lenses (UVB-IOLs) on contrast sensitivity in patients with concurrent cataracts and glaucoma. This prospective randomized comparative interventional study enrolled glaucomatous patients with concurrent cataracts scheduled for cataract surgery with IOL implantation at Siriraj Hospital, Bangkok, Thailand, between October 2016 and March 2018. The patients were randomly assigned to receive BF-IOLs or UVB-IOLs. ⋯ However, the 2 groups had no significant differences in log contrast sensitivity values at each spatial frequency (P = .20, .37, .30, .28, and .68, respectively). Cataract surgery with IOL implantation improved contrast sensitivity in glaucomatous patients. The BF-IOLs and UVB-IOLs showed no statistically significant difference in the postoperative contrast sensitivity achieved at each spatial frequency.
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Review Case Reports
Pelvic metastatic squamous cell carcinoma of unknown primary site: A case report and brief literature review.
Cancer with unknown primary site is a kind of disease that is difficult to deal with clinically, accounting for 2% to 9% of all newly diagnosed cancer cases. Here, we report such a case with pelvic metastatic squamous cell carcinoma of an unknown primary site and review the relevant literature. ⋯ Our case demonstrates that surgery combined with chemotherapy could be helpful for pelvic metastatic squamous cell carcinoma of unknown primary site.
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This article's objectives are to develop a model to predict children's recovery of elbow function following supracondylar fracture, analyze the risk factors affecting those children's elbow function after surgery, and propose a individualized treatment strategy for elbow function in various children. We retrospectively analyzed clinical data from 410 children with supracondylar humerus fracture. A modeling set and a validation set of kids in the included studies were arbitrarily split into 2 groups on a 7:3 basis. ⋯ There were no significant changes in the afflicted limb's lateral difference, surgical method, onset season, and number of K-wires, according to univariate logistic regression analysis. Age (P < .001), weight (P < .001), height (P < .001), preoperative elbow soft tissue injury (OR = 1.724, 95% CI: 1.040-2.859, P = .035), sex (OR = 2.220, 95% CI: 1.299-3.794, P = .004), fracture classification (Gartland IIb) (OR = 0.252, 95% CI: 0.149-0.426, P < .001), no nerve injury before surgery (OR = 0.304, 95% CI: 0.155-0.596, P = .001), prying technique (OR = 0.464, 95% CI: 0.234-0.920, P = .028), postoperative daily light time > 2 hours (OR = 0.488, 95% CI: 0.249-0.955, P = .036) has a significant difference in univariate analysis; Multivariate regression analysis yielded independent risk factors: fracture classification; No nerve injury before surgery; The daily light duration after surgery was > 2 hours; soft tissue injury; Age, postoperative cast fixation time. The establishment of predictive model is of significance for pediatric orthopedic clinicians in the daily diagnosis and treatment of supracondylar humerus fracture.