Articles: disease.
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J Coll Physicians Surg Pak · Nov 2020
A Comparison of Hyperextension versus Neutral Positions for Vertebroplasty to Treat Neurologically Intact Kümmell Disease.
To compare the efficacy between hyperextension position (HPVP) and neutral position for vertebroplasty (NPVP) in treating Kümmell disease. ⋯ This study demonstrated that HPVP could achieve a lower cement leakage rate with similar operative time, lower VAS and ODI scores, as well as better kyphosis restoration and AR recovery at the 1-year follow-up than NPVP. HPVP is thus superior to NPVP in treating KD. Key Words: Kyphosis, Cobb's angle, Cement leakage, Intervertebral stability, Surgical outcome, Kümmell disease, Vertebroplasty, Hyperextension position.
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Ann Acad Med Singap · Nov 2020
Observational StudyPregnancy Outcomes in COVID-19: A Prospective Cohort Study in Singapore.
Pregnant women are reported to be at increased risk of severe coronavirus disease 2019 (COVID-19) due to underlying immunosuppression during pregnancy. However, the clinical course of COVID-19 in pregnancy and risk of vertical and horizontal transmission remain relatively unknown. We aim to describe and evaluate outcomes in pregnant women with COVID-19 in Singapore. ⋯ The majority of COVID-19 infected pregnant women had mild disease and only 2 women with risk factors (obesity, older age) had severe infection; this represents a slightly higher incidence than observed in age-matched non-pregnant women. Among the women who delivered, there was no definitive evidence of mother-to-child transmission via breast milk or placenta.
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Dtsch. Med. Wochenschr. · Nov 2020
Review[Depressive disorders: An often underestimated comorbidity in diabetes].
People with diabetes often have a depressive disorder in addition to diabetes, which makes therapy more difficult and worsens the prognosis of the disease. Depression is an often underestimated risk factor in the context of diabetes. The aim of this article is to illustrate the significance of depression in diabetes for the course of the disease and to provide an overview of the most important diagnostic and therapeutic recommendations for practice.
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J Coll Physicians Surg Pak · Nov 2020
Variability of Breast Density Assessment and the Need for Additional Imaging: A Comparison between Computed Mammography and Digital Mammography.
To determine the variability of breast density assessment and the need for additional imaging using computed radiography (CR) mammography versus digital radiography (DR) mammography. ⋯ Patients who underwent screening CR mammography, followed by DR mammography a year later, were selected. Only disease-free individuals were included in the study. Evaluation of breast density was done subjectively, using the breast imaging reporting and data system (BI-RADS) by two independent experienced radiologists. Statistical analysis was performed using the Wilcox Signed Rank-sum test to compare both modalities. Fisher Exact method was used to compare the need for ultrasound imaging. Results: A total of 295 patients were included in the study. The mean age of the patients was 52.76 ± 0.64 years. There was a significant difference in the change of breast density when comparing both modalities (Z= -11.839, p <0.001). A statistically significant reduction in the need for further breast ultrasound was observed after DR mammography than with CR mammography (p <0.001). Conclusion: Use of DR mammography, especially in patients with dense breast parenchyma, is a better screening tool overall. It translates to better feasibility for the radiologist and is more economical for the patient. DR mammography decreases unnecessary imaging and leads to better visualisation, thus providing a more accurate categorisation of breast density. Key Word: Computed radiography mammography, Breast density, Screening, Breast cancer, Digital mammography, Ultrasound.
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J Coll Physicians Surg Pak · Nov 2020
Evaluation of the Mechanical Properties of Anorectal Tissues and Muscles by Shear Wave Elastography in Anal Fıssure Disease.
To evaluate the mechanical properties of the tissues and muscles in the anal region with the shearwave elastography for anal fissure etiology. ⋯ In elastographic measurement of fissure area (fissure) and normal anorectal tissue (control, AFE); control group values were significantly higher than the fissure group values (p<0.001, and padj <0.001, respectively). Control group valuesof internal anal sphincter in rest and Valsalva maneuver (IAS-R, and IAS-V, respectively) were significantly higher than the fissure group values (p<0.001, padj< 0.001, and p<0.001, padj <0.001, respectively). There was no significant difference between the elastographic measurement values in rest and valsalva maneuver of the external anal sphincter (EAS-R and EAS-V) (p>0.05). Elastographic measurement values of levator ani muscle (LAM) resting state; were significantly higher in thefissure group than the control group (p<0.001, and padj <0.001, respectively). Elastographic cut-off values that differentiate the fissure group from control group were found to be ≤1kPa forAFE group, ≤44 kPa forIAS-R, ≤0.4kPa forIAS-V,and >11kPa for LAM,respectively. Conclusıon: In anal fissure disease, tissues mechanical properties measured by shear wave elastography showed increased tissue stiffness, which may be added to etiology of this disease. Key Words: Anal fissure, Ultrasonography, Shear wave elastography, Anal sphincter, Tissue elasticity, Tissue stiffness.