Hindfoot osteoarthritis(HFOA)leads to pain,impaired function,and reduced quality of life.Conservative management aims to alleviate symptoms and delay surgical interventions such as arthrodesis,particularly in young pa...Hindfoot osteoarthritis(HFOA)leads to pain,impaired function,and reduced quality of life.Conservative management aims to alleviate symptoms and delay surgical interventions such as arthrodesis,particularly in young patients with post-traumatic HFOA.Intra-articular injections of corticosteroids and hyaluronic acid are widely used as alternatives for treating foot and ankle osteoarthritis to provide temporary pain relief and functional improvement.Recently,orthobiologic treatments have gained interest for their potential regenerative effects.This review aims to summarize the current evidence on intra-articular injections for HFOA,highlighting the potential benefits,perspectives,and mechanisms of action of conventional and orthobiologic treatments such as platelet-rich plasma,bone marrow aspirate concentrate,and adipose-derived stem cells.展开更多
The red blood cell distribution width(RDW)is a routinely measured and automatically reported blood parameter,which reflects the degree of anisocytosis.Recently,the baseline RDW was found to have clinical significance ...The red blood cell distribution width(RDW)is a routinely measured and automatically reported blood parameter,which reflects the degree of anisocytosis.Recently,the baseline RDW was found to have clinical significance for assessing clinical outcome and severity of various pathological conditions including cardiovascular diseases,sepsis,cancers,leukemia,renal dysfunction and respiratory diseases.A myriad of factors,most of which ill-defined,have an impact on the red cell population dynamics(i.e.,production,maturation and turnover).A delay in the red blood cell clearance in pathological conditions represents one of the leading determinants of increased anisocytosis.Further study of RDW may reveal new insight into inflammation mechanisms.In this review,we specifically discuss the current literature about the association of RDW in various disease conditions involving the gastrointestinal and hepatobiliary systems.We also present some of the related measurements for their value in predicting clinical outcomes in such conditions.According to our data,RDW was found to be a valuable prognostic index in gastrointestinal disorders along with additional inflammatory biomarkers(i.e.,C reactive protein,erythrocyte sedimentation rate,and platelet count)and current disease severity indices used in clinical practice.展开更多
The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the regi...The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved(cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive surgery to the reduction of complication rate. In this paper the most common surgical complications in degenerative spinal surgery are outlined and discussed.展开更多
To assess the potential health risks of mixed rare earths Changle for human embryo, whether it crosses placenta membrane or placenta barrier should be determined. In order to arrive at the aim placenta tissue was obs...To assess the potential health risks of mixed rare earths Changle for human embryo, whether it crosses placenta membrane or placenta barrier should be determined. In order to arrive at the aim placenta tissue was observed after contamination with optical and electron microscope to show distribution and destiny of mixed rare earth Changle in placenta tissue. Meanwhile the amount of rare earths in serum of pregnant rat, amniotic fluid and extract of embryo tissue were measured by using Inductively Coupled Plasma Mass Spectrometer (ICP MS). The rats were administered to 0 3, 2, 5 and 20 mg·kg -1 mixed rare earths Changle every day, respectively by oral from the 6th to 18th day after pregnancy. The results show that many particles are found in syncytiotrophoblast around capillaries of placental villi in contaminated groups under light microscope, and there are more particles following increased dose. It also was observed that some dense bodies with the envelope in placenta membrane and to difference extent damages the mitochondria crista within syncytiotrophoblast cytoplasm in contaminated groups under transmission electron microscope (TEM). Results of ICP MS assay indicate that the level of Ce increases with contamination dose in the serum of pregnant rats, and the level of total rare earth element remarkably rises in amniotic fluid and serum of pregnant rats for 20 mg·kg -1 group as compared with the control without change for the other groups.展开更多
Retroperitoneal fibrosis (RPF) is a rare condition of unclear etiology. It can cause ureteral obstruction. We present the unique case of a 54 years old female, who initially presented with spontaneous perforation of t...Retroperitoneal fibrosis (RPF) is a rare condition of unclear etiology. It can cause ureteral obstruction. We present the unique case of a 54 years old female, who initially presented with spontaneous perforation of the cecum. Upon exploring the abdomen, the classical glistening white, unyielding retroperitoneal fibrosis was encountered. A right hemicolectomy was performed. Subsequently, the patient presented with bilateral ureteral obstruction, and later on with small bowel obstruction. Ureteral obstruction was treated with stents, and small bowel obstruction was treated with bypass. To our knowledge no case of idiopathic RPF presenting with features of both bilateral ureteral and small bowel obstruction has been reported in the literature.展开更多
Purpose: To review current practice in the use of Prostate Specific Antigen (PSA) testing and assess the overall risks and benefits of PSA testing for Adenocarcinoma of the Prostate, specifically in men under age 65, ...Purpose: To review current practice in the use of Prostate Specific Antigen (PSA) testing and assess the overall risks and benefits of PSA testing for Adenocarcinoma of the Prostate, specifically in men under age 65, and those living with risk factors for the disease. Materials and Methods: An extensive literature review of PSA testing in various age groups was conducted with the goal being to review PSA screening trends and assess current recommendations regarding PSA Screening for Adenocarcinoma of the Prostate in various age groups, focusing on studies directed towards patients under the age of 65 and the long-term risks and benefits of PSA screening in the diagnostic algorithm. In order to reduce bias, we assessed our sources for variables such as reporting, measurement and/or selection bias. Our conclusions were then compared with current recommendations. Relevant studies with data compiled after 2004, centered around PSA screening in men under the age of 65 in general and specifically in men with risk factors for developing Adenocarcinoma of the Prostate were included. Editorials, newspaper articles and other non-scholarly and non-peer reviewed sources were automatically excluded.展开更多
Introduction: Blunt trauma to the penis is a rare but potentially serious injury that can occur by various mechanisms (e.g., kicks, accidents, sexual activity, and falls). The most common clinical presentation is sudd...Introduction: Blunt trauma to the penis is a rare but potentially serious injury that can occur by various mechanisms (e.g., kicks, accidents, sexual activity, and falls). The most common clinical presentation is sudden pain, swelling, and discoloration. Depending on the type and severity of injury, management can include conservative treatment or surgery, with the ultimate goal being the prevention of delayed complications. Case presentation: A 30-year-old male presented with penile pain, swelling, and redness as a result of blunt trauma to his penis 1 week after penile enhancement surgery using a subcutaneous soft silicone implant. Once the patient’s blood pressure was stabilized, surgical management consisted of exploration with evacuation of a large hematoma and removal of the subcutaneous penile implant to avoid further perioperative and postoperative bleeding. Discussion: Postoperative bleeding is a risk factor associated with almost all types of surgical procedures, and its prevention is best achieved by identification and elimination of potential causes pre- and postoperatively. Hypertension is another risk factor for excessive postsurgical bleeding, particularly bleeding associated with prosthetic implant surgeries, and should be considered for any potential surgical patient. Conclusion: With penile prosthesis and implant surgery, hypertension is an especially serious risk factor. Early surgical management is warranted in cases involving a major hematoma and swelling. Even cases with minimal bleeding should be evaluated in a timely manner, with surgical treatment indicated, rather than watchful waiting, to prevent further damage to the penis.展开更多
BACKGROUND The endoscopic management of benign short post-anastomotic ileocolonic stricture(PAICS) that is refractory to primary and secondary treatment modalities remains challenging.The lumen-apposing metal stent(LA...BACKGROUND The endoscopic management of benign short post-anastomotic ileocolonic stricture(PAICS) that is refractory to primary and secondary treatment modalities remains challenging.The lumen-apposing metal stent(LAMS) is a novel device recently developed for therapeutic gastrointestinal endoscopy.LAMSs have demonstrated significantly better results with regard to stent migration than fully covered self-expandable metal stents(FCSEMSs).CASE SUMMARY This article presents six cases of symptomatic PAICS successfully treated with a LAMS and a review of the relevant literature.We report a life-saving technique not previously documented and the use of technology to improve patient outcomes.The six patients(median age,75 years) suffered from vomiting,constipation and recurrent abdominal pain,with symptoms starting 23-25 wk post-surgery.The median stricture length was 1.83 cm.All six patients underwent successful and uneventful bi-flanged metal stent(BFMS)-LAMS placement for benign PAICS.All patients remained asymptomatic during the three months of stent indwelling and up to a median of 7 mo after stent removal.According to the literature,the application of LAMS for PAICS is associated with a < 10% risk of migration and a < 5% risk of bleeding.Conversely,FCSEMS has a high migration rate(15%-50%).CONCLUSION The evolving role of interventional endoscopy and the availability of LAMSs provide patients with minimally invasive treatment options,allowing them to avoid more invasive surgical interventions.The BFMS(NAGI stent) is longer and larger than the prototype AXIOS-LAMS,which should be considered in the management of short ileocolonic post-anastomotic strictures longer than 10 mm and shorter than 30 mm.展开更多
We describe the case of a nine-month-old patient with a nasopharyngeal choristoma.The case presented includes the retrospective review of the historical,radiological,surgical and histological assessment of this pathol...We describe the case of a nine-month-old patient with a nasopharyngeal choristoma.The case presented includes the retrospective review of the historical,radiological,surgical and histological assessment of this pathology as well as a literature review of this entity.This case was presented in an infant with difficulty feeding,nasal obstruction and failure to thrive,evaluated with flexible nasal endoscopy,CT and MRI.The lesion was then surgically removed without complications.Nasopharyngeal choristoma is a rare congenital nonmalignant mass,which may present within a range of symptoms and severity according to its size,growth and location.展开更多
It's not too cold in the southern U.S.city of Dallas,'Texas,inlate fall,and we can see peoplestill wearing T-shirts outside.Butevery time I entered the classroom,l would put on my coat,and carrymy thermos with...It's not too cold in the southern U.S.city of Dallas,'Texas,inlate fall,and we can see peoplestill wearing T-shirts outside.Butevery time I entered the classroom,l would put on my coat,and carrymy thermos with hot watcr.It mademc look different from the otherstudents.展开更多
如果根据一种名叫伟哥(Viagra,即Sildenafil)的药物最近在市场上大获成功这一现象来判断,外星人可能会得出一个结论:人类与其它生物最重大的区别在于他为了增强生殖能力而不惜服用药物。因为现在出现了一种引起巨大轰动的蓝色钻石形状...如果根据一种名叫伟哥(Viagra,即Sildenafil)的药物最近在市场上大获成功这一现象来判断,外星人可能会得出一个结论:人类与其它生物最重大的区别在于他为了增强生殖能力而不惜服用药物。因为现在出现了一种引起巨大轰动的蓝色钻石形状的药丸,每丸售价达7～10美元(4～6英镑)。这种药物强烈抑制 V 型磷酸二酯酶活性,使阴茎海绵体环一磷酸鸟苷水平升高。展开更多
文摘Hindfoot osteoarthritis(HFOA)leads to pain,impaired function,and reduced quality of life.Conservative management aims to alleviate symptoms and delay surgical interventions such as arthrodesis,particularly in young patients with post-traumatic HFOA.Intra-articular injections of corticosteroids and hyaluronic acid are widely used as alternatives for treating foot and ankle osteoarthritis to provide temporary pain relief and functional improvement.Recently,orthobiologic treatments have gained interest for their potential regenerative effects.This review aims to summarize the current evidence on intra-articular injections for HFOA,highlighting the potential benefits,perspectives,and mechanisms of action of conventional and orthobiologic treatments such as platelet-rich plasma,bone marrow aspirate concentrate,and adipose-derived stem cells.
文摘The red blood cell distribution width(RDW)is a routinely measured and automatically reported blood parameter,which reflects the degree of anisocytosis.Recently,the baseline RDW was found to have clinical significance for assessing clinical outcome and severity of various pathological conditions including cardiovascular diseases,sepsis,cancers,leukemia,renal dysfunction and respiratory diseases.A myriad of factors,most of which ill-defined,have an impact on the red cell population dynamics(i.e.,production,maturation and turnover).A delay in the red blood cell clearance in pathological conditions represents one of the leading determinants of increased anisocytosis.Further study of RDW may reveal new insight into inflammation mechanisms.In this review,we specifically discuss the current literature about the association of RDW in various disease conditions involving the gastrointestinal and hepatobiliary systems.We also present some of the related measurements for their value in predicting clinical outcomes in such conditions.According to our data,RDW was found to be a valuable prognostic index in gastrointestinal disorders along with additional inflammatory biomarkers(i.e.,C reactive protein,erythrocyte sedimentation rate,and platelet count)and current disease severity indices used in clinical practice.
文摘The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved(cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive surgery to the reduction of complication rate. In this paper the most common surgical complications in degenerative spinal surgery are outlined and discussed.
文摘To assess the potential health risks of mixed rare earths Changle for human embryo, whether it crosses placenta membrane or placenta barrier should be determined. In order to arrive at the aim placenta tissue was observed after contamination with optical and electron microscope to show distribution and destiny of mixed rare earth Changle in placenta tissue. Meanwhile the amount of rare earths in serum of pregnant rat, amniotic fluid and extract of embryo tissue were measured by using Inductively Coupled Plasma Mass Spectrometer (ICP MS). The rats were administered to 0 3, 2, 5 and 20 mg·kg -1 mixed rare earths Changle every day, respectively by oral from the 6th to 18th day after pregnancy. The results show that many particles are found in syncytiotrophoblast around capillaries of placental villi in contaminated groups under light microscope, and there are more particles following increased dose. It also was observed that some dense bodies with the envelope in placenta membrane and to difference extent damages the mitochondria crista within syncytiotrophoblast cytoplasm in contaminated groups under transmission electron microscope (TEM). Results of ICP MS assay indicate that the level of Ce increases with contamination dose in the serum of pregnant rats, and the level of total rare earth element remarkably rises in amniotic fluid and serum of pregnant rats for 20 mg·kg -1 group as compared with the control without change for the other groups.
文摘Retroperitoneal fibrosis (RPF) is a rare condition of unclear etiology. It can cause ureteral obstruction. We present the unique case of a 54 years old female, who initially presented with spontaneous perforation of the cecum. Upon exploring the abdomen, the classical glistening white, unyielding retroperitoneal fibrosis was encountered. A right hemicolectomy was performed. Subsequently, the patient presented with bilateral ureteral obstruction, and later on with small bowel obstruction. Ureteral obstruction was treated with stents, and small bowel obstruction was treated with bypass. To our knowledge no case of idiopathic RPF presenting with features of both bilateral ureteral and small bowel obstruction has been reported in the literature.
文摘Purpose: To review current practice in the use of Prostate Specific Antigen (PSA) testing and assess the overall risks and benefits of PSA testing for Adenocarcinoma of the Prostate, specifically in men under age 65, and those living with risk factors for the disease. Materials and Methods: An extensive literature review of PSA testing in various age groups was conducted with the goal being to review PSA screening trends and assess current recommendations regarding PSA Screening for Adenocarcinoma of the Prostate in various age groups, focusing on studies directed towards patients under the age of 65 and the long-term risks and benefits of PSA screening in the diagnostic algorithm. In order to reduce bias, we assessed our sources for variables such as reporting, measurement and/or selection bias. Our conclusions were then compared with current recommendations. Relevant studies with data compiled after 2004, centered around PSA screening in men under the age of 65 in general and specifically in men with risk factors for developing Adenocarcinoma of the Prostate were included. Editorials, newspaper articles and other non-scholarly and non-peer reviewed sources were automatically excluded.
文摘Introduction: Blunt trauma to the penis is a rare but potentially serious injury that can occur by various mechanisms (e.g., kicks, accidents, sexual activity, and falls). The most common clinical presentation is sudden pain, swelling, and discoloration. Depending on the type and severity of injury, management can include conservative treatment or surgery, with the ultimate goal being the prevention of delayed complications. Case presentation: A 30-year-old male presented with penile pain, swelling, and redness as a result of blunt trauma to his penis 1 week after penile enhancement surgery using a subcutaneous soft silicone implant. Once the patient’s blood pressure was stabilized, surgical management consisted of exploration with evacuation of a large hematoma and removal of the subcutaneous penile implant to avoid further perioperative and postoperative bleeding. Discussion: Postoperative bleeding is a risk factor associated with almost all types of surgical procedures, and its prevention is best achieved by identification and elimination of potential causes pre- and postoperatively. Hypertension is another risk factor for excessive postsurgical bleeding, particularly bleeding associated with prosthetic implant surgeries, and should be considered for any potential surgical patient. Conclusion: With penile prosthesis and implant surgery, hypertension is an especially serious risk factor. Early surgical management is warranted in cases involving a major hematoma and swelling. Even cases with minimal bleeding should be evaluated in a timely manner, with surgical treatment indicated, rather than watchful waiting, to prevent further damage to the penis.
文摘BACKGROUND The endoscopic management of benign short post-anastomotic ileocolonic stricture(PAICS) that is refractory to primary and secondary treatment modalities remains challenging.The lumen-apposing metal stent(LAMS) is a novel device recently developed for therapeutic gastrointestinal endoscopy.LAMSs have demonstrated significantly better results with regard to stent migration than fully covered self-expandable metal stents(FCSEMSs).CASE SUMMARY This article presents six cases of symptomatic PAICS successfully treated with a LAMS and a review of the relevant literature.We report a life-saving technique not previously documented and the use of technology to improve patient outcomes.The six patients(median age,75 years) suffered from vomiting,constipation and recurrent abdominal pain,with symptoms starting 23-25 wk post-surgery.The median stricture length was 1.83 cm.All six patients underwent successful and uneventful bi-flanged metal stent(BFMS)-LAMS placement for benign PAICS.All patients remained asymptomatic during the three months of stent indwelling and up to a median of 7 mo after stent removal.According to the literature,the application of LAMS for PAICS is associated with a < 10% risk of migration and a < 5% risk of bleeding.Conversely,FCSEMS has a high migration rate(15%-50%).CONCLUSION The evolving role of interventional endoscopy and the availability of LAMSs provide patients with minimally invasive treatment options,allowing them to avoid more invasive surgical interventions.The BFMS(NAGI stent) is longer and larger than the prototype AXIOS-LAMS,which should be considered in the management of short ileocolonic post-anastomotic strictures longer than 10 mm and shorter than 30 mm.
文摘We describe the case of a nine-month-old patient with a nasopharyngeal choristoma.The case presented includes the retrospective review of the historical,radiological,surgical and histological assessment of this pathology as well as a literature review of this entity.This case was presented in an infant with difficulty feeding,nasal obstruction and failure to thrive,evaluated with flexible nasal endoscopy,CT and MRI.The lesion was then surgically removed without complications.Nasopharyngeal choristoma is a rare congenital nonmalignant mass,which may present within a range of symptoms and severity according to its size,growth and location.
文摘It's not too cold in the southern U.S.city of Dallas,'Texas,inlate fall,and we can see peoplestill wearing T-shirts outside.Butevery time I entered the classroom,l would put on my coat,and carrymy thermos with hot watcr.It mademc look different from the otherstudents.
文摘如果根据一种名叫伟哥(Viagra,即Sildenafil)的药物最近在市场上大获成功这一现象来判断,外星人可能会得出一个结论:人类与其它生物最重大的区别在于他为了增强生殖能力而不惜服用药物。因为现在出现了一种引起巨大轰动的蓝色钻石形状的药丸,每丸售价达7～10美元(4～6英镑)。这种药物强烈抑制 V 型磷酸二酯酶活性,使阴茎海绵体环一磷酸鸟苷水平升高。
