BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as...BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs.There are various trials being carried out to date;however,a thorough review regarding the usage of meal replacement on its types,dosage and associated outcomes and adverse events is still lacking.AIM To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D,and map out glycemic and weightrelated outcomes along with adverse effects incidences.METHODS This scoping review is conducted based on Arksey and O’Malley’s seminal framework for scoping reviews.A systematic search has been done for studies published between January 2020 and January 2024 across six online databases(Cochrane Library,PubMed,Science Direct,Scopus,Web of Science and Ebscohost Discovery)using specific keywords.Two researchers independently assessed the eligibility of the studies and extracted the data.The selected articles and extracted data were reviewed by all researchers.RESULTS The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening.Included studies were categorized based on meal replacement type into low calorie/energy,low glycemic index,protein-rich,low-fat,diabetes-specific formulas,and combined lifestyle intervention programs.Fifty-nine studies reported improvements on hemoglobin A1c,and 70 studies reported positive changes in weight or BMI after the meal replacement intervention.The combination of meal replacements with education,counseling or structured lifestyle interventions has proved to be effective.Only 13 studies reported occurrence of adverse events related to the intervention.Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.CONCLUSION The results suggest that meal replacements,especially when combined with lifestyle intervention programs and counseling,are an effective and safe strategy in glycemic and weight management among patients with T2D.展开更多
BACKGROUND Difficult total hip replacements(THRs)are hip arthroplasties performed on patients with compromised or severely altered bone or soft tissue.Difficult THR indications are common in low-income countries,where...BACKGROUND Difficult total hip replacements(THRs)are hip arthroplasties performed on patients with compromised or severely altered bone or soft tissue.Difficult THR indications are common in low-income countries,where access to care is often delayed.In these contexts,patients generally consult us with severe impairments that require significant technical adaptations,as well as adaptation to available resources and local conditions.AIM To describe the results and difficulties encountered following difficult THR in the study center.METHODS This bi-centric retrospective study was conducted over a 10-year period(2013-2023)and included 50 patients operated on for difficult THR.The mean age of the patients was 37.8 years.Surgical difficulties were recorded from operative reports,and the strategies employed to overcome these difficulties were analyzed,taking into account the types of implants used.RESULTS At last follow-up,functional results were considered good to excellent according to the Postel-Merle d'Aubignéscore,with significant improvement after surgery(P<0.005).Mean operative time was 177 minutes(range:90-290 minutes),with a mean blood loss of 568 mL(range:200-900 mL).The short-term and medium-term post-operative complication rate was 6%.CONCLUSION Even in difficult conditions,THR can produce favorable results through careful planning,adaptation of techniques and targeted approaches to overcoming challenges.展开更多
目的观察浮针疗法对老年患者全膝关节置换术(total knee arthroplasty,TKA)后早期康复及股直肌超声剪切波弹性成像指标的影响。方法纳入膝关节骨性关节炎(knee osteoarthritis,KOA)拟行TKA手术患者64例,按照随机数字表法分为治疗组(32例...目的观察浮针疗法对老年患者全膝关节置换术(total knee arthroplasty,TKA)后早期康复及股直肌超声剪切波弹性成像指标的影响。方法纳入膝关节骨性关节炎(knee osteoarthritis,KOA)拟行TKA手术患者64例,按照随机数字表法分为治疗组(32例)和对照组(32例)。两组均接受标准的围手术期治疗和康复运动,治疗组另予浮针疗法治疗。观察两组围术期膝关节疼痛视觉模拟量表(visual analog scale,VAS)评分、膝关节屈曲角度、美国特种外科医院(hospital for special surgery,HSS)评分、超声剪切波弹性成像指标(股直肌厚度、股直肌横截面积和剪切波速度)、血清C反应蛋白(C-reactive protein,CRP)水平。结果与对照组比较,治疗组术后静息及运动VAS评分均显著降低(P<0.05),且改善趋势更明显(交互效应P<0.05)。治疗组术后第1、3、5天膝关节屈曲角度和HSS评分均优于对照组(P<0.05)。超声弹性成像显示,术后第5天,治疗组发力状态下股直肌横截面积和剪切波速度较对照组提高(P<0.05),放松状态下股直肌厚度亦较对照组增加(P<0.05)。治疗组术后肌力恢复更快(P<0.05),术后第3、5天血清CRP水平低于对照组(P<0.05)。结论在围手术期治疗和康复运动基础上,浮针疗法治疗可有效缓解TKA患者术后早期疼痛,改善膝关节屈曲角度,提高股四头肌肌肉力量,从而改善膝关节功能,且促进炎性吸收。展开更多
文摘BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs.There are various trials being carried out to date;however,a thorough review regarding the usage of meal replacement on its types,dosage and associated outcomes and adverse events is still lacking.AIM To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D,and map out glycemic and weightrelated outcomes along with adverse effects incidences.METHODS This scoping review is conducted based on Arksey and O’Malley’s seminal framework for scoping reviews.A systematic search has been done for studies published between January 2020 and January 2024 across six online databases(Cochrane Library,PubMed,Science Direct,Scopus,Web of Science and Ebscohost Discovery)using specific keywords.Two researchers independently assessed the eligibility of the studies and extracted the data.The selected articles and extracted data were reviewed by all researchers.RESULTS The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening.Included studies were categorized based on meal replacement type into low calorie/energy,low glycemic index,protein-rich,low-fat,diabetes-specific formulas,and combined lifestyle intervention programs.Fifty-nine studies reported improvements on hemoglobin A1c,and 70 studies reported positive changes in weight or BMI after the meal replacement intervention.The combination of meal replacements with education,counseling or structured lifestyle interventions has proved to be effective.Only 13 studies reported occurrence of adverse events related to the intervention.Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.CONCLUSION The results suggest that meal replacements,especially when combined with lifestyle intervention programs and counseling,are an effective and safe strategy in glycemic and weight management among patients with T2D.
文摘BACKGROUND Difficult total hip replacements(THRs)are hip arthroplasties performed on patients with compromised or severely altered bone or soft tissue.Difficult THR indications are common in low-income countries,where access to care is often delayed.In these contexts,patients generally consult us with severe impairments that require significant technical adaptations,as well as adaptation to available resources and local conditions.AIM To describe the results and difficulties encountered following difficult THR in the study center.METHODS This bi-centric retrospective study was conducted over a 10-year period(2013-2023)and included 50 patients operated on for difficult THR.The mean age of the patients was 37.8 years.Surgical difficulties were recorded from operative reports,and the strategies employed to overcome these difficulties were analyzed,taking into account the types of implants used.RESULTS At last follow-up,functional results were considered good to excellent according to the Postel-Merle d'Aubignéscore,with significant improvement after surgery(P<0.005).Mean operative time was 177 minutes(range:90-290 minutes),with a mean blood loss of 568 mL(range:200-900 mL).The short-term and medium-term post-operative complication rate was 6%.CONCLUSION Even in difficult conditions,THR can produce favorable results through careful planning,adaptation of techniques and targeted approaches to overcoming challenges.
文摘目的观察浮针疗法对老年患者全膝关节置换术(total knee arthroplasty,TKA)后早期康复及股直肌超声剪切波弹性成像指标的影响。方法纳入膝关节骨性关节炎(knee osteoarthritis,KOA)拟行TKA手术患者64例,按照随机数字表法分为治疗组(32例)和对照组(32例)。两组均接受标准的围手术期治疗和康复运动,治疗组另予浮针疗法治疗。观察两组围术期膝关节疼痛视觉模拟量表(visual analog scale,VAS)评分、膝关节屈曲角度、美国特种外科医院(hospital for special surgery,HSS)评分、超声剪切波弹性成像指标(股直肌厚度、股直肌横截面积和剪切波速度)、血清C反应蛋白(C-reactive protein,CRP)水平。结果与对照组比较,治疗组术后静息及运动VAS评分均显著降低(P<0.05),且改善趋势更明显(交互效应P<0.05)。治疗组术后第1、3、5天膝关节屈曲角度和HSS评分均优于对照组(P<0.05)。超声弹性成像显示,术后第5天,治疗组发力状态下股直肌横截面积和剪切波速度较对照组提高(P<0.05),放松状态下股直肌厚度亦较对照组增加(P<0.05)。治疗组术后肌力恢复更快(P<0.05),术后第3、5天血清CRP水平低于对照组(P<0.05)。结论在围手术期治疗和康复运动基础上,浮针疗法治疗可有效缓解TKA患者术后早期疼痛,改善膝关节屈曲角度,提高股四头肌肌肉力量,从而改善膝关节功能,且促进炎性吸收。
