Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypert...Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypertension, dyslipidemia, sleep apnea, and joint pain. Traditionally, bariatric surgeries have been categorized into hypoabsorptive, restrictive, or hybrid approaches. However, these classifications inadequately reflect the complex anatomical and physiological alterations associated with modern surgical methodologies. This paper explores the evolution of metabolic surgeries, emphasizing the integration of physiological concepts into classic procedures to provide more tailored and effective treatment options for obesity and its comorbidities. Finally, the proposal for a new classification based on current metabolic concepts will facilitate communication among patients, doctors, and healthcare professionals. Additionally, it will enable a more didactic and standardized approach to data collection for conducting studies and publications.展开更多
Hirschsprung’s disease (HSCR) is a developmental disorder characterized by the absence of ganglion cells in the distal colon, leading to functional obstruction. Bardet-Biedl syndrome (BBS) is a rare ciliopathy associ...Hirschsprung’s disease (HSCR) is a developmental disorder characterized by the absence of ganglion cells in the distal colon, leading to functional obstruction. Bardet-Biedl syndrome (BBS) is a rare ciliopathy associated with various clinical features, including HSCR. This review article aims to explore the underlying causes of HSCR in children with BBS, focusing on the genetic and developmental factors contributing to the pathogenesis of both conditions. We reviewed relevant literature, including peer-reviewed journal articles and case reports, to provide a comprehensive overview of the current understanding of the relationship between HSCR and BBS. Our findings highlight the complex interplay of genetic mutations, signaling pathways, and developmental processes involved in the pathogenesis of HSCR in BBS. Further research is needed to elucidate the precise mechanisms underlying this association and to develop targeted therapeutic strategies for children with HSCR and BBS.展开更多
Obesity is a significant global health concern, often leading to comorbidities such as cardiovascular diseases, diabetes, and hypertension. Bariatric surgery, including sleeve gastrectomy (SG), is a proven treatment f...Obesity is a significant global health concern, often leading to comorbidities such as cardiovascular diseases, diabetes, and hypertension. Bariatric surgery, including sleeve gastrectomy (SG), is a proven treatment for morbid obesity, offering substantial weight loss and resolution of comorbidities. However, post-surgical complications, particularly anorectal disorders such as hemorrhoids and anal fissures, remain underexplored, especially in Saudi Arabia. This retrospective cohort study aimed to assess the prevalence, risk factors, and impact of anal complications following SG at Almoosa Specialist Hospital in Alhassa, Saudi Arabia. A total of 205 patients who underwent SG between January 2020 and December 2021 were surveyed, with 148 eligible participants included in the final analysis. Results indicated that 8.8% of patients experienced anal complications, with anal fissures (53.8%) and hemorrhoids (38.5%) being the most common. These complications typically occurred 2 - 6 months post-surgery. Lifestyle factors such as physical activity and fluid intake were found to significantly reduce the likelihood of anal issues. Moreover, 69.2% of patients with anal problems reported a negative impact on their quality of life. The study highlights the importance of targeted post-operative care, including lifestyle modifications, to mitigate the impact of anal complications. The findings suggest that ongoing education and comprehensive support for bariatric surgery patients, particularly regarding physical activity and hydration, are critical for improving long-term health outcomes. Further research is needed to explore the long-term progression of anal complications and effective interventions for enhancing patient satisfaction and quality of life.展开更多
Introduction: Conjunctival granulomas are tumor pathologies of various origins. A foreign body, whatever its nature, is often involved in its genesis. To date, there is very little data on foreign body conjunctival gr...Introduction: Conjunctival granulomas are tumor pathologies of various origins. A foreign body, whatever its nature, is often involved in its genesis. To date, there is very little data on foreign body conjunctival granulomas, the prevalence would be approximately 10% and their underestimation is probably linked to the inconsistency of their clinical presentation. Patient and Observations: We report a case of conjunctival granuloma caused by a metallic foreign body that went unnoticed in a young boy, the interest of rigor on primary protection measures for high-risk occupations, and of the strict application of the diagnostic protocol relating to ocular trauma. Discussion: foreign body granulomas, despite their usually harmless nature, can jeopardize the anatomical and functional prognosis of the affected eye. Only a detailed interview and a meticulous clinical examination allow the diagnosis to be made and the distinction to be made with conjunctival granulomas of different causes. Conclusion: the possibility of the involvement of a foreign body in the genesis of conjunctival granulomas must impose the rigorous application of diagnostic and therapeutic protocols.展开更多
Objective: Chronic osteomyelitis represents a frequent complication in young children, especially those with sickle cell disease. The aim of this study was to describe the epidemiological aspects and therapeutic impli...Objective: Chronic osteomyelitis represents a frequent complication in young children, especially those with sickle cell disease. The aim of this study was to describe the epidemiological aspects and therapeutic implications of chronic long-bone osteomyelitis in sickle-cell subjects aged 0 to 5 years at Zinder National Hospital. Methodology: This is a descriptive study with retrospective data collection of sickle cell subjects hospitalized and treated for chronic osteomyelitis from November 2023 to October 2024 at Zinder National Hospital. Results: Of the 16 patients included, male sex predominated in 56.25% (9/16). The mean age of patients was 32.69 months, ranging from 12 to 54 months. Involvement was multifocal in 75% (12/16) and bilateral in 37.5% (6/16). Bone involvement was predominantly in the pelvic limbs (87.5%). Among the bones affected, the femur was the most frequent site of involvement. All patients presented clinical symptoms such as pain, fever and swelling. Hyperleukocytosis was present in all subjects. Abscesses were present in 93.75% of cases, and sequestration was observed in 37.5% of patients. All cases were managed medico-surgically. Complications were noted in 25% (4/16), and involved residual bone deformities. Cure was confirmed in 43.75% (7/16). Conclusion: Chronic osteomyelitis in sickle-cell patients is a serious complication of acute osteomyelitis. Early management of acute osteomyelitis helps to avoid.展开更多
A spontaneous splenic rupture is one of the rarest encounters in our field. It is a potentially fatal condition if not diagnosed early and treated promptly. Moreover, several preexisting diseases contribute to the occ...A spontaneous splenic rupture is one of the rarest encounters in our field. It is a potentially fatal condition if not diagnosed early and treated promptly. Moreover, several preexisting diseases contribute to the occurrence of spontaneous splenic rupture, which includes hematological disease, infectious, malignancy, and immune-compromised disease. In our case, we report a 37-year-old male with a known case of diabetes mellitus who presented with generalized abdominal pain and was diagnosed with spontaneous splenic rupture. He was treated with splenic artery embolization and discharged with a good outcome. Despite the rarity of the disease, it is important to keep it in mind when a patient presents to you with abdominal pain.展开更多
Periprosthetic fracture of femur is a common and complex complication after joint replacement. With the increase of operation volume, its incidence is increasing year by year. The treatment of this fracture is affecte...Periprosthetic fracture of femur is a common and complex complication after joint replacement. With the increase of operation volume, its incidence is increasing year by year. The treatment of this fracture is affected by many factors, including fracture type, prosthesis stability, patient age and comorbidities, and individualized treatment strategy is needed. In recent years, the internal fixation technology and prosthetic revision technology have made significant progress in surgical treatment, such as locking steel plate, titanium cable and bridge combined internal fixation system and other new technologies have effectively improved the treatment effect. In addition, the application of new materials and 3D printing technology, as well as the optimization of multidisciplinary cooperation mode, also provide new ideas for the treatment of complex fractures. However, there are still some problems such as inaccurate diagnosis, difficult choice of treatment options and high incidence of postoperative complications. In the future, technological innovation, the introduction of artificial intelligence and big data, and the further development of personalized treatment will bring more possibilities to improve the prognosis and quality of life of patients. This study summarizes the relevant research results and prospects the future development direction, providing references for clinical practice and subsequent research.展开更多
Introduction: Open leg fracture is a diaphyseal or metaphyseal, extra-articular fracture of one or both leg bones, with communication between the fracture site and the external environment. To provide a broader contex...Introduction: Open leg fracture is a diaphyseal or metaphyseal, extra-articular fracture of one or both leg bones, with communication between the fracture site and the external environment. To provide a broader context, studies conducted globally have highlighted the significance of understanding open leg fractures due to their complex management and potential complications. Previous research in Africa and Europe provides comparative data that emphasizes regional differences in fracture types, causes, and treatment outcomes. This study aims to contribute to improving the management of theses fractures in Niger. Materials and Methods: This was a prospective, descriptive study carried out in the Traumatology-Orthopedics Department of the Zinder National Hospital, Niger, from December 8, 2020 to June 8, 2022 (18 months). We included all patients over 15 years of age in whom an open leg fracture was diagnosed and managed. Inclusion criteria focused on patients aged over 15 years with confirmed diagnoses of open leg fractures. Results: Over an 18-month period, the frequency of open leg fractures was 16.28%. There was a predominance of males (85.93% or n = 116). The average age of patients was 31.79 years. Road accidents were the primary circumstance of occurrence (93.33% or n = 126). The fracture line was simple in 74 patients (54.81%) and complex in 61 cases (45.19%). Surgically, the external fixator was used in 78 cases (57.80%). Postoperative follow-up was mostly straightforward. The main complications were infection (4 cases) and delayed consolidation (4 cases). Conclusion: Open leg fractures in adults are frequent at Zinder National Hospital. Public road accidents were the main cause of occurrence. An external fixator osteosynthesis was the most commonly used surgical option. These findings have important implications for healthcare policy, particularly in improving trauma care infrastructure and road safety initiatives in Niger. Future studies should prioritize the development of standardized treatment protocols and investigate the long-term outcomes of different surgical approaches.展开更多
Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospit...Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospital Center of Kpalimé (PHC-K) in Togo. Methodology: It was a retrospective, descriptive and comparative study carried out over five years (2018-2022) focusing on abdominal wall hernias in adults. Information was gathered from the patients’clinical notes and registers on the frequency of hernias, the anatomo-clinical forms of hernias, the type of anesthesia, the hernia repair technique and the postoperative evolution. Results: Of the 1022 and 1026 operations performed, 312 and 412 were hernial repairs, representing 30.5% and 41.2% of operations at RHC-T and PHC-K respectively (p = 0.001). The inguinal hernia was the most often found in 83.7% (n = 261) at RHC-T versus 76.6% (n = 324) at PHC-K. Herniorrhaphy was the most frequently used repair method, in 93.6% (n = 292) of patients at RHC-T and in 91.3% (n = 376) at PHC-K (p = 0.11). Postoperative complications were noted in 5.1% of cases (n = 16) at RHC-T versus 3.5% of cases (n = 15) at PHC-K (p = 0.307). These complications included scrotal hematomas, surgical areas infections, and orchitis. We recorded 1.3% (n = 4) and 0.8% (n = 3) deaths at RHC-T and PHC-K respectively (p = 0.496). Conclusion: There is homogeneity in the treatment of hernia in these two hospitals in Togo.展开更多
Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical managemen...Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.展开更多
Introduction: Childbirth on a scarred uterus is a major issue for health centers, especially peripheral, due to the major obstetric risks it presents. The objectives were to evaluate the frequency, route of delivery a...Introduction: Childbirth on a scarred uterus is a major issue for health centers, especially peripheral, due to the major obstetric risks it presents. The objectives were to evaluate the frequency, route of delivery and maternal-fetal prognosis of this type of delivery at csref of Kolondiéba. Materials and Methods: This was a retrospective cross-sectional study for one year (1 January 2023-31 December 2023). All patients admitted to the maternity ward of the center with at least one uterine scar and treated in the center were included. We extracted data from partograms, OR records, birth records and obstetric records. Input was done on Excel 2010 and analysis on SPSS.23. Results: The frequency of scarring uterus was 16.8% (217/1285 births). The average age was 27. Pauciparous were most represented (59%). Patients were received from community health centers (44.7%). Prenatal consultation sessions (1 - 3 sessions) were performed at (64.9%). Uterine scars were obstetric in (99%). The cesarean section was performed immediately in (59.4%), it was prophylactic in 17%. The uterine test was attempted in (25.34%) with (69%) success. We recorded 3.6% uterine ruptures, 8.7% postoperative complications, 5.5% stillbirths and one maternal death (0.46%). Conclusion: Births on a scarred uterus are frequent and associated with a high rate of complications.展开更多
Background: Laparoscopic surgery has many advantages among which are, decrease post operatory pain and complications. It’s practice in the capital of Cameroon is still a luxury and it is almost non-existent in periph...Background: Laparoscopic surgery has many advantages among which are, decrease post operatory pain and complications. It’s practice in the capital of Cameroon is still a luxury and it is almost non-existent in peripheral zones. The aim of this study is to present the results of the first laparoscopy surgeries done at the Yokadouma district hospital located in the east region at 600 km from Yaoundé. Methods: This is a descriptive prospective study carried out from march 2020 to march 2021 in the general surgery department of the Yokadouma district hospital. Patients operated by laparoscopy during this period were included in the study giving a sample size of 40 patients. The data collected were analyzed by “Census software and Survey Processing System” (CSPRO). Results: Majority of patients, 57.5% were males and aged between 16 and 30 years (32.5% of cases). Most patients (30% of patients) were farmers. Transabdominal preperitoneal prosthesis plasty for hernia represented 55% of interventions followed by appendicectomy (15%) and cholecystectomy (7.5%). Two procedures (0.8%) required conversion into open surgery. Post-operative complications were very rare and were encountered just by one patient who presented a parietal suppuration. Interventions in 77% of cases cost less than 200,000 CFA FRANCS (400$). Conclusion: The example of Yokadouma shows that laparoscopy should be developed in peripheral zones so that its residents can benefit from its multiple advantages.展开更多
Objective: This study aimed to demonstrate the feasibility of laparoscopic-resection of the abdominal cystic lymphangiomas in Pediatric Surgery and describe the morbidity associated to this management in Queen fabiola...Objective: This study aimed to demonstrate the feasibility of laparoscopic-resection of the abdominal cystic lymphangiomas in Pediatric Surgery and describe the morbidity associated to this management in Queen fabiola children’s university hospital (HUDERF) in Brussels. Methods: We retrospectively conducted a study at the Pediatric Surgery Department of HUDERF, Brussels. The studied period was from January 1, 2014, to January 1, 2024;a span of 10 years. All patients with a confirmed diagnosis of cystic lymphangiomas and who underwent laparoscopic surgery were included in our study. Those who have been operated exclusively by open surgery have been excluded. The technique involved either total laparoscopic resection or laparoscopic-assisted with extra-abdominal resection of the tumor. Parameters that were studied included age, sex, weight, symptoms, preoperative diagnosis, imaging assessment, location, size of the tumor, type of mass, surgical procedure, duration of the surgery, conversion to open surgery, morbidity, and histopathology. Data were analyzed using Microsoft Office Excel 2010 and SPSS. Results: We retrieved 10 files of patients presenting with abdominal cystic lymphangiomas within two patients underwent exclusive open surgery and have excluded from our study. Then our sample was constituted with 8 patients. The mean age of the patients was 6.4 years (standard deviation: 3.6 years, range: 1 to 11 years). Male patients were predominant. The mean weight was 26.7 kg (standard deviation: 14.7 kg, range: 10 to 55 kg). The most common symptom was abdominal pain. Preoperative diagnosis of abdominal cystic lymphangioma was made in 8 cases. Abdominal ultrasound was performed in all patients. MRI was done in 5 patients, and CT scan in 2 patients. All patients presented a multicystic mass. Pure laparoscopic resection of the cyst was done in 2 cases. Laparoscopic-assisted resection in 4 cases (with extra-peritoneal with small bowel resection and mesenteric detorsion in 1 case), and conversion in 2 cases due to the complex location of the cyst. After a follow-up period of 5 years, morbidity was noted in one patient (Patient 3) who developed postoperative bowel obstruction 1 month post-surgery. This patient was re-operated on with a favorable clinical outcome following conventional small bowel resection and anastomosis. The other patients (1, 2, 4, 5, 6, 7 and 8) had a simple clinical course, and no recurrence was observed in our series. Conclusion: Laparoscopic-resection of the abdominal cystic lymphangiomas is feasible in Pediatric Surgery. As minimally invasive surgery it gives many advantages even for complex abdominal cystic lymphangiomas with less morbidity as shown in our series.展开更多
Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly ...Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly assigned to five drug treatment regimens. Results: Combination therapy with doxycycline, rifampin and sulfamethoxazole for 56 consecutive days showed the highest cure rate of 20% after a single course and of 85% after a double course with affectivity rates of 55% and 95%. Cure rate and affectivity rate was significant better (P 0.05) than for patients receiving doxycycline, rifampin and streptomycin for the same period and regimens containing doxycycline were significant better than regimens without this drug. Conclusion: Combination therapy of doxycycline, rifampin and sulfamethoxazole for 8 weeks using one or two full courses should be recommended for Brucella spondylitis.展开更多
Objective: To improve the clinical differential diagnosis level, the clinical manifestation of the brucellar spondylitis and the spine turberculosis were discussed in this paper. Method: The study was completed in the...Objective: To improve the clinical differential diagnosis level, the clinical manifestation of the brucellar spondylitis and the spine turberculosis were discussed in this paper. Method: The study was completed in the No. 1 Affiliated Hospital of Hebei North University in Zhangjiakou City, Hebei Province, China, from January 2001 to December 2013 by Analyzing the X-ray, CT scanning and MRI of 257 cases of the brucellar spondylitis retrospectively and comparing with the clinical imageology and pathology 332 cases of turberculosis of the spine diagnosed finally. Results: The brucellar spondylitis: The focuses usually locate in the lumbar vertebra and L4, 5 has the highest occurrence rate. The focuses are often small but multiple, and limited to the edge of the vertebra. Hyperostosis and osteoscterosis are usually found in the tissuses around the focuses. There are often new focuses in the newborn bones, and the destruction of intervertebral discs is usually slight. Hyperostosis and osteoscterosis might be found in the surfaces of the joints. The densites of the bones close to the focuses become high. There were less or no paravertebral abscesses but inflammational granuloma can be found frequently. Turberculosis of the spine: The focuses are usually located in the thoracic and lumbar vertebra, and are characterized by the destruction of the vertebra and the intervertebral discs, accompanied by the appearance of dead bones. In most cases, paravertebral abscesses and osteoporosis might be found. Conclusions: The specific manifestation of the clinical imageology can help to differentiate the brucelar spondylitis from the turberculosis of the spine.展开更多
Introduction: Gastritis cystica profunda (GCP) is a rare tumor which occurs more commonly in patients with prior gastric surgery. The nonspecific symptoms and radiographic appearance of this tumor mimic that of other ...Introduction: Gastritis cystica profunda (GCP) is a rare tumor which occurs more commonly in patients with prior gastric surgery. The nonspecific symptoms and radiographic appearance of this tumor mimic that of other hyperproliferative conditions making diagnosis difficult without definitive surgical resection. This report provides a comprehen-sive review of GCP and all GCP cases reported to date. Methods: A comprehensive literature search (1972-2011) was conducted with all reported GCP cases analyzed. Keywords searched included gastritis cystica profunda, submucosal cysts of the stomach, and heterotopic submucosal gastric glands. Results: Thirty-seven GCP cases have been reported since 1972, which includes 29 (78%) men and 8 (21%) women (M:F ratio, 3.6:1). The overall mean age was 60.5 years (range, 39 - 81 years) with 55.6 years (range, 39 - 79) and 62.2 years (range, 39 - 81 years) in women and men, respectively. 65% (N = 24) had prior gastric surgery. 62% (N = 23) of GCP tumors were located in the body;24% (N = 9) in the fundus;8% (N = 3) in the antrum;or 6% (N = 2) in the cardia of the stomach. GCP was an incidental finding in 19% of patients. Complete excision was performed most often (73%) followed by endomucosal resection (18%), and polypectomy (4.5%). One patient underwent surveillance (4.5%). Conclusions: GCP is a rare gastric tumor, which is difficult to diagnose preoperatively and masquerades as a malignancy. GCP is more common in men and typically presents with nonspecific symptoms. Although a benign lesion, GCP may represent an intermediate histology in the malignant progression to gastric neoplasia. To date, there have been no reports of local recurrence or distant metastasis following definitive surgical excision, which remains the standard of care.展开更多
Objective: To review the characteristics of and the procedure for preventing postoperative bleeding after neck surgery. Materials and Methods: A retrospective review of 9 patients (9/893;1.0%) with postoperative bleed...Objective: To review the characteristics of and the procedure for preventing postoperative bleeding after neck surgery. Materials and Methods: A retrospective review of 9 patients (9/893;1.0%) with postoperative bleeding who required reoperation was performed to analyze clinical findings. Results: There was no significant difference in the incidence of bleeding between types of surgical procedures. Postoperative bleeding occurred within 24 hours in all cases except 2, in which it occurred 7 days or more after the operation. Seven cases showed bleeding from the cut surface of the muscle. Other bleeding points included vessels and the Berry ligament. There were no additional complications after reoperation. Conclusion: When separating the muscles in neck surgery, it is important to sufficiently ligate vessels and induce coagulation with an ultrasonically activated scalpel to prevent postoperative bleeding.展开更多
Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on...Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on clinical findings as well as radiological investigations. Treatment of choice of these conditions is on the basis of the patient conditions. Surgical treatment is the option only when the conservative treatment does not improve the patient’s clinical condition. Advancement and improvement of the technology have resulted in the traditional open surgical treatment into minimal invasive surgery. Intervention of the different surgical instruments with expert spinal surgeons had made percutaneous endoscopic lumbar Spine surgery as one of the preferred choices of surgery for treating Lumbar Disc Herniation and Lumbar Spine Stenosis. The concept of percutaneous endoscopic surgery for lumbar region is to provide surgical options without producing iatrogenic morbidity associated with the open surgical procedures. Conventionally, there are different approaches/techniques for Percutaneous Endoscopic Lumbar Spine Surgery, but in this review we are mainly focusing on the Transforaminal Technique. Regarding the Lumbar Disc Herniation treatment with transforaminal approach, a number of articles have been published due to which we mainly focused on those articles which were published after 2009 onwards. While fewer articles related to Lumbar Spine Stenosis treatment with Transforaminal approach were found, we tried to brief out all those articles. On the basis of comparative study of different surgeries done for Lumbar Disc Herniation and Lumbar Spine Stenosis, Percutaneous Transforaminal endoscopic Lumbar Surgery provides a substantial benefit. Transforaminal approach for treating Lumbar Disc Herniation and Lumbar Spine Stenosis is safe and effective. The Percutaneous Transforaminal Endoscopic Lumbar Surgery has advantage as it is performed under local anesthesia with shorter length of hospitalization and early return to normal life. The clinical outcome of the patient that underwent Percutaneous Transforaminal Endoscopic Lumbar Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis is quite good in regard of its fewer complication and more benefits.展开更多
Objective: To assess the curative effect of the stage II femoral head necrosis treated by arthroscopy assisted lesion clearance, bone graft and titanium rod support. Methods: All the patients (including 58 patients 74...Objective: To assess the curative effect of the stage II femoral head necrosis treated by arthroscopy assisted lesion clearance, bone graft and titanium rod support. Methods: All the patients (including 58 patients 74 hips) were diagnosed as stage II femoral head necrosis according to the ARCO staging system during 2003-2013. In these patients, 15 hips were stage IIA, 34 hips were stage IIB and 25 hips were stage IIC. Located by C-arm and assisted by arthroscopy, minimally-invasive percutaneous pulp core decompression and lesion clearance within the femoral head were accurately performed, and then, the OAM composite of autologous bone marrow was implanted and the femoral head was supported using the titanium rod. Follow-up including the pain score, the Harris hip score and X-ray observation for disease progression were achieved at 6, 12, 24 and 36 months postoperatively, Kaplan-Meier survival curve was used for the survival analysis. Result: The VAS score and the Harris score after operation were better THRAn THRAt of before the surgery, the difference had statistical significance (p Conclusion: Arthroscopy assisted lesion clearance, bone graft and titanium rod support to treat the stage II osteonecrosis of the femoral head are effective and can prevent the femoral head from collapsing. But for stage IIC patients who had a history of the use of hormone, this surgery should be chosen carefully because the outcome is always very poor.展开更多
[Aim] To investigate the action of cytokines in patients with chronic liver failure and to explore the roles of cytokines in chronic liver failure. [Methods] Thirty-one patients with chronic liver failure admitted fro...[Aim] To investigate the action of cytokines in patients with chronic liver failure and to explore the roles of cytokines in chronic liver failure. [Methods] Thirty-one patients with chronic liver failure admitted from May 2006 to November 2009 were included. Thirty cases with mild to moderate chronic type B hepatitis admitted concomitantly were regarded as control. IL-1, TNF-alpha, IL-12, IL-10 Levels in serum was the factors to determine at clinical diagnosis and 2-week treatment. We analyzed levels of cytokines action in 31 chronic liver failure patients both at clinical diagnosis and 2-week treatment in comparison with control group. [Results] We analyzed IL-1 level in death group at clinical diagnosis and 2-week treatment were sig- nificant higher than in survival and control groups, furthermore it was also higher in survival group than in control group. At clinical diagnosis, TNF-alpha level in death group was higher than that in control. How- ever, there was no obviously difference between the death group and the survival group in TNF-alpha level. With the progression of the disease, TNF-alpha level was remarkably risen in death group, but decreased in survival group. IL-10 level was dramatically increased in death group, but no changed in survival group. IL-12 level in death group was higher than in survival group, but lower than in control group. [Conclusions] The levels of TNF-alpha, IL-1, IL-10 and IL-12 in patients with chronic liver failure was increased and the increase of IL-10 is secondary to elevation of IL-12.展开更多
文摘Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypertension, dyslipidemia, sleep apnea, and joint pain. Traditionally, bariatric surgeries have been categorized into hypoabsorptive, restrictive, or hybrid approaches. However, these classifications inadequately reflect the complex anatomical and physiological alterations associated with modern surgical methodologies. This paper explores the evolution of metabolic surgeries, emphasizing the integration of physiological concepts into classic procedures to provide more tailored and effective treatment options for obesity and its comorbidities. Finally, the proposal for a new classification based on current metabolic concepts will facilitate communication among patients, doctors, and healthcare professionals. Additionally, it will enable a more didactic and standardized approach to data collection for conducting studies and publications.
文摘Hirschsprung’s disease (HSCR) is a developmental disorder characterized by the absence of ganglion cells in the distal colon, leading to functional obstruction. Bardet-Biedl syndrome (BBS) is a rare ciliopathy associated with various clinical features, including HSCR. This review article aims to explore the underlying causes of HSCR in children with BBS, focusing on the genetic and developmental factors contributing to the pathogenesis of both conditions. We reviewed relevant literature, including peer-reviewed journal articles and case reports, to provide a comprehensive overview of the current understanding of the relationship between HSCR and BBS. Our findings highlight the complex interplay of genetic mutations, signaling pathways, and developmental processes involved in the pathogenesis of HSCR in BBS. Further research is needed to elucidate the precise mechanisms underlying this association and to develop targeted therapeutic strategies for children with HSCR and BBS.
文摘Obesity is a significant global health concern, often leading to comorbidities such as cardiovascular diseases, diabetes, and hypertension. Bariatric surgery, including sleeve gastrectomy (SG), is a proven treatment for morbid obesity, offering substantial weight loss and resolution of comorbidities. However, post-surgical complications, particularly anorectal disorders such as hemorrhoids and anal fissures, remain underexplored, especially in Saudi Arabia. This retrospective cohort study aimed to assess the prevalence, risk factors, and impact of anal complications following SG at Almoosa Specialist Hospital in Alhassa, Saudi Arabia. A total of 205 patients who underwent SG between January 2020 and December 2021 were surveyed, with 148 eligible participants included in the final analysis. Results indicated that 8.8% of patients experienced anal complications, with anal fissures (53.8%) and hemorrhoids (38.5%) being the most common. These complications typically occurred 2 - 6 months post-surgery. Lifestyle factors such as physical activity and fluid intake were found to significantly reduce the likelihood of anal issues. Moreover, 69.2% of patients with anal problems reported a negative impact on their quality of life. The study highlights the importance of targeted post-operative care, including lifestyle modifications, to mitigate the impact of anal complications. The findings suggest that ongoing education and comprehensive support for bariatric surgery patients, particularly regarding physical activity and hydration, are critical for improving long-term health outcomes. Further research is needed to explore the long-term progression of anal complications and effective interventions for enhancing patient satisfaction and quality of life.
文摘Introduction: Conjunctival granulomas are tumor pathologies of various origins. A foreign body, whatever its nature, is often involved in its genesis. To date, there is very little data on foreign body conjunctival granulomas, the prevalence would be approximately 10% and their underestimation is probably linked to the inconsistency of their clinical presentation. Patient and Observations: We report a case of conjunctival granuloma caused by a metallic foreign body that went unnoticed in a young boy, the interest of rigor on primary protection measures for high-risk occupations, and of the strict application of the diagnostic protocol relating to ocular trauma. Discussion: foreign body granulomas, despite their usually harmless nature, can jeopardize the anatomical and functional prognosis of the affected eye. Only a detailed interview and a meticulous clinical examination allow the diagnosis to be made and the distinction to be made with conjunctival granulomas of different causes. Conclusion: the possibility of the involvement of a foreign body in the genesis of conjunctival granulomas must impose the rigorous application of diagnostic and therapeutic protocols.
文摘Objective: Chronic osteomyelitis represents a frequent complication in young children, especially those with sickle cell disease. The aim of this study was to describe the epidemiological aspects and therapeutic implications of chronic long-bone osteomyelitis in sickle-cell subjects aged 0 to 5 years at Zinder National Hospital. Methodology: This is a descriptive study with retrospective data collection of sickle cell subjects hospitalized and treated for chronic osteomyelitis from November 2023 to October 2024 at Zinder National Hospital. Results: Of the 16 patients included, male sex predominated in 56.25% (9/16). The mean age of patients was 32.69 months, ranging from 12 to 54 months. Involvement was multifocal in 75% (12/16) and bilateral in 37.5% (6/16). Bone involvement was predominantly in the pelvic limbs (87.5%). Among the bones affected, the femur was the most frequent site of involvement. All patients presented clinical symptoms such as pain, fever and swelling. Hyperleukocytosis was present in all subjects. Abscesses were present in 93.75% of cases, and sequestration was observed in 37.5% of patients. All cases were managed medico-surgically. Complications were noted in 25% (4/16), and involved residual bone deformities. Cure was confirmed in 43.75% (7/16). Conclusion: Chronic osteomyelitis in sickle-cell patients is a serious complication of acute osteomyelitis. Early management of acute osteomyelitis helps to avoid.
文摘A spontaneous splenic rupture is one of the rarest encounters in our field. It is a potentially fatal condition if not diagnosed early and treated promptly. Moreover, several preexisting diseases contribute to the occurrence of spontaneous splenic rupture, which includes hematological disease, infectious, malignancy, and immune-compromised disease. In our case, we report a 37-year-old male with a known case of diabetes mellitus who presented with generalized abdominal pain and was diagnosed with spontaneous splenic rupture. He was treated with splenic artery embolization and discharged with a good outcome. Despite the rarity of the disease, it is important to keep it in mind when a patient presents to you with abdominal pain.
文摘Periprosthetic fracture of femur is a common and complex complication after joint replacement. With the increase of operation volume, its incidence is increasing year by year. The treatment of this fracture is affected by many factors, including fracture type, prosthesis stability, patient age and comorbidities, and individualized treatment strategy is needed. In recent years, the internal fixation technology and prosthetic revision technology have made significant progress in surgical treatment, such as locking steel plate, titanium cable and bridge combined internal fixation system and other new technologies have effectively improved the treatment effect. In addition, the application of new materials and 3D printing technology, as well as the optimization of multidisciplinary cooperation mode, also provide new ideas for the treatment of complex fractures. However, there are still some problems such as inaccurate diagnosis, difficult choice of treatment options and high incidence of postoperative complications. In the future, technological innovation, the introduction of artificial intelligence and big data, and the further development of personalized treatment will bring more possibilities to improve the prognosis and quality of life of patients. This study summarizes the relevant research results and prospects the future development direction, providing references for clinical practice and subsequent research.
文摘Introduction: Open leg fracture is a diaphyseal or metaphyseal, extra-articular fracture of one or both leg bones, with communication between the fracture site and the external environment. To provide a broader context, studies conducted globally have highlighted the significance of understanding open leg fractures due to their complex management and potential complications. Previous research in Africa and Europe provides comparative data that emphasizes regional differences in fracture types, causes, and treatment outcomes. This study aims to contribute to improving the management of theses fractures in Niger. Materials and Methods: This was a prospective, descriptive study carried out in the Traumatology-Orthopedics Department of the Zinder National Hospital, Niger, from December 8, 2020 to June 8, 2022 (18 months). We included all patients over 15 years of age in whom an open leg fracture was diagnosed and managed. Inclusion criteria focused on patients aged over 15 years with confirmed diagnoses of open leg fractures. Results: Over an 18-month period, the frequency of open leg fractures was 16.28%. There was a predominance of males (85.93% or n = 116). The average age of patients was 31.79 years. Road accidents were the primary circumstance of occurrence (93.33% or n = 126). The fracture line was simple in 74 patients (54.81%) and complex in 61 cases (45.19%). Surgically, the external fixator was used in 78 cases (57.80%). Postoperative follow-up was mostly straightforward. The main complications were infection (4 cases) and delayed consolidation (4 cases). Conclusion: Open leg fractures in adults are frequent at Zinder National Hospital. Public road accidents were the main cause of occurrence. An external fixator osteosynthesis was the most commonly used surgical option. These findings have important implications for healthcare policy, particularly in improving trauma care infrastructure and road safety initiatives in Niger. Future studies should prioritize the development of standardized treatment protocols and investigate the long-term outcomes of different surgical approaches.
文摘Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospital Center of Kpalimé (PHC-K) in Togo. Methodology: It was a retrospective, descriptive and comparative study carried out over five years (2018-2022) focusing on abdominal wall hernias in adults. Information was gathered from the patients’clinical notes and registers on the frequency of hernias, the anatomo-clinical forms of hernias, the type of anesthesia, the hernia repair technique and the postoperative evolution. Results: Of the 1022 and 1026 operations performed, 312 and 412 were hernial repairs, representing 30.5% and 41.2% of operations at RHC-T and PHC-K respectively (p = 0.001). The inguinal hernia was the most often found in 83.7% (n = 261) at RHC-T versus 76.6% (n = 324) at PHC-K. Herniorrhaphy was the most frequently used repair method, in 93.6% (n = 292) of patients at RHC-T and in 91.3% (n = 376) at PHC-K (p = 0.11). Postoperative complications were noted in 5.1% of cases (n = 16) at RHC-T versus 3.5% of cases (n = 15) at PHC-K (p = 0.307). These complications included scrotal hematomas, surgical areas infections, and orchitis. We recorded 1.3% (n = 4) and 0.8% (n = 3) deaths at RHC-T and PHC-K respectively (p = 0.496). Conclusion: There is homogeneity in the treatment of hernia in these two hospitals in Togo.
文摘Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.
文摘Introduction: Childbirth on a scarred uterus is a major issue for health centers, especially peripheral, due to the major obstetric risks it presents. The objectives were to evaluate the frequency, route of delivery and maternal-fetal prognosis of this type of delivery at csref of Kolondiéba. Materials and Methods: This was a retrospective cross-sectional study for one year (1 January 2023-31 December 2023). All patients admitted to the maternity ward of the center with at least one uterine scar and treated in the center were included. We extracted data from partograms, OR records, birth records and obstetric records. Input was done on Excel 2010 and analysis on SPSS.23. Results: The frequency of scarring uterus was 16.8% (217/1285 births). The average age was 27. Pauciparous were most represented (59%). Patients were received from community health centers (44.7%). Prenatal consultation sessions (1 - 3 sessions) were performed at (64.9%). Uterine scars were obstetric in (99%). The cesarean section was performed immediately in (59.4%), it was prophylactic in 17%. The uterine test was attempted in (25.34%) with (69%) success. We recorded 3.6% uterine ruptures, 8.7% postoperative complications, 5.5% stillbirths and one maternal death (0.46%). Conclusion: Births on a scarred uterus are frequent and associated with a high rate of complications.
文摘Background: Laparoscopic surgery has many advantages among which are, decrease post operatory pain and complications. It’s practice in the capital of Cameroon is still a luxury and it is almost non-existent in peripheral zones. The aim of this study is to present the results of the first laparoscopy surgeries done at the Yokadouma district hospital located in the east region at 600 km from Yaoundé. Methods: This is a descriptive prospective study carried out from march 2020 to march 2021 in the general surgery department of the Yokadouma district hospital. Patients operated by laparoscopy during this period were included in the study giving a sample size of 40 patients. The data collected were analyzed by “Census software and Survey Processing System” (CSPRO). Results: Majority of patients, 57.5% were males and aged between 16 and 30 years (32.5% of cases). Most patients (30% of patients) were farmers. Transabdominal preperitoneal prosthesis plasty for hernia represented 55% of interventions followed by appendicectomy (15%) and cholecystectomy (7.5%). Two procedures (0.8%) required conversion into open surgery. Post-operative complications were very rare and were encountered just by one patient who presented a parietal suppuration. Interventions in 77% of cases cost less than 200,000 CFA FRANCS (400$). Conclusion: The example of Yokadouma shows that laparoscopy should be developed in peripheral zones so that its residents can benefit from its multiple advantages.
文摘Objective: This study aimed to demonstrate the feasibility of laparoscopic-resection of the abdominal cystic lymphangiomas in Pediatric Surgery and describe the morbidity associated to this management in Queen fabiola children’s university hospital (HUDERF) in Brussels. Methods: We retrospectively conducted a study at the Pediatric Surgery Department of HUDERF, Brussels. The studied period was from January 1, 2014, to January 1, 2024;a span of 10 years. All patients with a confirmed diagnosis of cystic lymphangiomas and who underwent laparoscopic surgery were included in our study. Those who have been operated exclusively by open surgery have been excluded. The technique involved either total laparoscopic resection or laparoscopic-assisted with extra-abdominal resection of the tumor. Parameters that were studied included age, sex, weight, symptoms, preoperative diagnosis, imaging assessment, location, size of the tumor, type of mass, surgical procedure, duration of the surgery, conversion to open surgery, morbidity, and histopathology. Data were analyzed using Microsoft Office Excel 2010 and SPSS. Results: We retrieved 10 files of patients presenting with abdominal cystic lymphangiomas within two patients underwent exclusive open surgery and have excluded from our study. Then our sample was constituted with 8 patients. The mean age of the patients was 6.4 years (standard deviation: 3.6 years, range: 1 to 11 years). Male patients were predominant. The mean weight was 26.7 kg (standard deviation: 14.7 kg, range: 10 to 55 kg). The most common symptom was abdominal pain. Preoperative diagnosis of abdominal cystic lymphangioma was made in 8 cases. Abdominal ultrasound was performed in all patients. MRI was done in 5 patients, and CT scan in 2 patients. All patients presented a multicystic mass. Pure laparoscopic resection of the cyst was done in 2 cases. Laparoscopic-assisted resection in 4 cases (with extra-peritoneal with small bowel resection and mesenteric detorsion in 1 case), and conversion in 2 cases due to the complex location of the cyst. After a follow-up period of 5 years, morbidity was noted in one patient (Patient 3) who developed postoperative bowel obstruction 1 month post-surgery. This patient was re-operated on with a favorable clinical outcome following conventional small bowel resection and anastomosis. The other patients (1, 2, 4, 5, 6, 7 and 8) had a simple clinical course, and no recurrence was observed in our series. Conclusion: Laparoscopic-resection of the abdominal cystic lymphangiomas is feasible in Pediatric Surgery. As minimally invasive surgery it gives many advantages even for complex abdominal cystic lymphangiomas with less morbidity as shown in our series.
文摘Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly assigned to five drug treatment regimens. Results: Combination therapy with doxycycline, rifampin and sulfamethoxazole for 56 consecutive days showed the highest cure rate of 20% after a single course and of 85% after a double course with affectivity rates of 55% and 95%. Cure rate and affectivity rate was significant better (P 0.05) than for patients receiving doxycycline, rifampin and streptomycin for the same period and regimens containing doxycycline were significant better than regimens without this drug. Conclusion: Combination therapy of doxycycline, rifampin and sulfamethoxazole for 8 weeks using one or two full courses should be recommended for Brucella spondylitis.
文摘Objective: To improve the clinical differential diagnosis level, the clinical manifestation of the brucellar spondylitis and the spine turberculosis were discussed in this paper. Method: The study was completed in the No. 1 Affiliated Hospital of Hebei North University in Zhangjiakou City, Hebei Province, China, from January 2001 to December 2013 by Analyzing the X-ray, CT scanning and MRI of 257 cases of the brucellar spondylitis retrospectively and comparing with the clinical imageology and pathology 332 cases of turberculosis of the spine diagnosed finally. Results: The brucellar spondylitis: The focuses usually locate in the lumbar vertebra and L4, 5 has the highest occurrence rate. The focuses are often small but multiple, and limited to the edge of the vertebra. Hyperostosis and osteoscterosis are usually found in the tissuses around the focuses. There are often new focuses in the newborn bones, and the destruction of intervertebral discs is usually slight. Hyperostosis and osteoscterosis might be found in the surfaces of the joints. The densites of the bones close to the focuses become high. There were less or no paravertebral abscesses but inflammational granuloma can be found frequently. Turberculosis of the spine: The focuses are usually located in the thoracic and lumbar vertebra, and are characterized by the destruction of the vertebra and the intervertebral discs, accompanied by the appearance of dead bones. In most cases, paravertebral abscesses and osteoporosis might be found. Conclusions: The specific manifestation of the clinical imageology can help to differentiate the brucelar spondylitis from the turberculosis of the spine.
文摘Introduction: Gastritis cystica profunda (GCP) is a rare tumor which occurs more commonly in patients with prior gastric surgery. The nonspecific symptoms and radiographic appearance of this tumor mimic that of other hyperproliferative conditions making diagnosis difficult without definitive surgical resection. This report provides a comprehen-sive review of GCP and all GCP cases reported to date. Methods: A comprehensive literature search (1972-2011) was conducted with all reported GCP cases analyzed. Keywords searched included gastritis cystica profunda, submucosal cysts of the stomach, and heterotopic submucosal gastric glands. Results: Thirty-seven GCP cases have been reported since 1972, which includes 29 (78%) men and 8 (21%) women (M:F ratio, 3.6:1). The overall mean age was 60.5 years (range, 39 - 81 years) with 55.6 years (range, 39 - 79) and 62.2 years (range, 39 - 81 years) in women and men, respectively. 65% (N = 24) had prior gastric surgery. 62% (N = 23) of GCP tumors were located in the body;24% (N = 9) in the fundus;8% (N = 3) in the antrum;or 6% (N = 2) in the cardia of the stomach. GCP was an incidental finding in 19% of patients. Complete excision was performed most often (73%) followed by endomucosal resection (18%), and polypectomy (4.5%). One patient underwent surveillance (4.5%). Conclusions: GCP is a rare gastric tumor, which is difficult to diagnose preoperatively and masquerades as a malignancy. GCP is more common in men and typically presents with nonspecific symptoms. Although a benign lesion, GCP may represent an intermediate histology in the malignant progression to gastric neoplasia. To date, there have been no reports of local recurrence or distant metastasis following definitive surgical excision, which remains the standard of care.
文摘Objective: To review the characteristics of and the procedure for preventing postoperative bleeding after neck surgery. Materials and Methods: A retrospective review of 9 patients (9/893;1.0%) with postoperative bleeding who required reoperation was performed to analyze clinical findings. Results: There was no significant difference in the incidence of bleeding between types of surgical procedures. Postoperative bleeding occurred within 24 hours in all cases except 2, in which it occurred 7 days or more after the operation. Seven cases showed bleeding from the cut surface of the muscle. Other bleeding points included vessels and the Berry ligament. There were no additional complications after reoperation. Conclusion: When separating the muscles in neck surgery, it is important to sufficiently ligate vessels and induce coagulation with an ultrasonically activated scalpel to prevent postoperative bleeding.
文摘Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on clinical findings as well as radiological investigations. Treatment of choice of these conditions is on the basis of the patient conditions. Surgical treatment is the option only when the conservative treatment does not improve the patient’s clinical condition. Advancement and improvement of the technology have resulted in the traditional open surgical treatment into minimal invasive surgery. Intervention of the different surgical instruments with expert spinal surgeons had made percutaneous endoscopic lumbar Spine surgery as one of the preferred choices of surgery for treating Lumbar Disc Herniation and Lumbar Spine Stenosis. The concept of percutaneous endoscopic surgery for lumbar region is to provide surgical options without producing iatrogenic morbidity associated with the open surgical procedures. Conventionally, there are different approaches/techniques for Percutaneous Endoscopic Lumbar Spine Surgery, but in this review we are mainly focusing on the Transforaminal Technique. Regarding the Lumbar Disc Herniation treatment with transforaminal approach, a number of articles have been published due to which we mainly focused on those articles which were published after 2009 onwards. While fewer articles related to Lumbar Spine Stenosis treatment with Transforaminal approach were found, we tried to brief out all those articles. On the basis of comparative study of different surgeries done for Lumbar Disc Herniation and Lumbar Spine Stenosis, Percutaneous Transforaminal endoscopic Lumbar Surgery provides a substantial benefit. Transforaminal approach for treating Lumbar Disc Herniation and Lumbar Spine Stenosis is safe and effective. The Percutaneous Transforaminal Endoscopic Lumbar Surgery has advantage as it is performed under local anesthesia with shorter length of hospitalization and early return to normal life. The clinical outcome of the patient that underwent Percutaneous Transforaminal Endoscopic Lumbar Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis is quite good in regard of its fewer complication and more benefits.
文摘Objective: To assess the curative effect of the stage II femoral head necrosis treated by arthroscopy assisted lesion clearance, bone graft and titanium rod support. Methods: All the patients (including 58 patients 74 hips) were diagnosed as stage II femoral head necrosis according to the ARCO staging system during 2003-2013. In these patients, 15 hips were stage IIA, 34 hips were stage IIB and 25 hips were stage IIC. Located by C-arm and assisted by arthroscopy, minimally-invasive percutaneous pulp core decompression and lesion clearance within the femoral head were accurately performed, and then, the OAM composite of autologous bone marrow was implanted and the femoral head was supported using the titanium rod. Follow-up including the pain score, the Harris hip score and X-ray observation for disease progression were achieved at 6, 12, 24 and 36 months postoperatively, Kaplan-Meier survival curve was used for the survival analysis. Result: The VAS score and the Harris score after operation were better THRAn THRAt of before the surgery, the difference had statistical significance (p Conclusion: Arthroscopy assisted lesion clearance, bone graft and titanium rod support to treat the stage II osteonecrosis of the femoral head are effective and can prevent the femoral head from collapsing. But for stage IIC patients who had a history of the use of hormone, this surgery should be chosen carefully because the outcome is always very poor.
文摘[Aim] To investigate the action of cytokines in patients with chronic liver failure and to explore the roles of cytokines in chronic liver failure. [Methods] Thirty-one patients with chronic liver failure admitted from May 2006 to November 2009 were included. Thirty cases with mild to moderate chronic type B hepatitis admitted concomitantly were regarded as control. IL-1, TNF-alpha, IL-12, IL-10 Levels in serum was the factors to determine at clinical diagnosis and 2-week treatment. We analyzed levels of cytokines action in 31 chronic liver failure patients both at clinical diagnosis and 2-week treatment in comparison with control group. [Results] We analyzed IL-1 level in death group at clinical diagnosis and 2-week treatment were sig- nificant higher than in survival and control groups, furthermore it was also higher in survival group than in control group. At clinical diagnosis, TNF-alpha level in death group was higher than that in control. How- ever, there was no obviously difference between the death group and the survival group in TNF-alpha level. With the progression of the disease, TNF-alpha level was remarkably risen in death group, but decreased in survival group. IL-10 level was dramatically increased in death group, but no changed in survival group. IL-12 level in death group was higher than in survival group, but lower than in control group. [Conclusions] The levels of TNF-alpha, IL-1, IL-10 and IL-12 in patients with chronic liver failure was increased and the increase of IL-10 is secondary to elevation of IL-12.
