Notes

Whenever obstetrics-gynecology specialists have to contact an ophthalmologist immediately: in a situation document.
D was performed successfully. Bone grafting in the anterior column is unnecessary for patients without massive bone defects.
Single-hospital cross-sectional study.

The aim of the present study was to investigate the physical functions influencing dynamic postural change in patients with adult spinal deformity (ASD).

Dynamic postural change leading to increased forward lean during gait is a problem in patients with ASD; however, the relationship between this change and trunk and hip extensor strength is unclear.

Thirty patients with ASD aged ≥50 years who were admitted to our hospital between July 2016 and September 2019 were included in this study. X-ray parameters (i.e., sagittal vertical axis, pelvic tilt, and pelvic incidence minus lumbar lordosis) were evaluated from the full-length standing radiographs of the subjects. Trunk and hip extensor strength was evaluated using a hand-held dynamometer. Dynamic postural changes (i.e., sagittal trunk shift during standing, sagittal trunk shift during gait, and delta sagittal trunk shift) were assessed using a three-dimensional motion analysis system. The relationships between dynamic postural change and various X-ray parameters, as well as trunk and hip extensor strength, were examined using multivariable analysis.

Multivariable analysis showed that hip extensor strength is the factor most strongly associated with dynamic postural change among the X-ray parameters and physical functions assessed in this study (β=-0.41, R2=0.12).

We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. see more Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.
We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.
This is a virtual three-dimensional (3D) imaging study examining computed tomography (CT) data to investigate instrumentation placement.

In this study, we aim to clarify the ideal entry point and trajectory of the sacral alar iliac (SAI) screw in relationship to the dorsal foramen at S1 and the respective nerve root.

To the best of our knowledge, there is yet no detailed 3D imaging study on the ideal entry point of the SAI screw. Despite the evidence suggesting that the dorsal foramen at S1 is a landmark on the sacrum, the S1 nerve root disruption is a general concern during the insertion of SAI screws. No other study has been published examining the nerve root location at the S1and SAI screw insertions.

Preoperative CT data from 26 patients pertaining to adult spinal deformities were investigated in this study. We applied a 3D image processing method for a detailed investigation. Virtual cylinders were used to mimic SAI screws. These were placed to penetrate the sacral iliac joint without violating ted on 3D digital mapping. It is also shown that this entry point spares the S1 nerve root from possible iatrogenic injuries.
Randomized, double-blind, controlled trial study.

This study aimed to evaluate the safety and efficacy of topical tranexamic acid (TXA) on intraoperative blood loss (IBL) in patients that have degenerative lumbar canal stenosis and undergo posterior lumbar laminectomy and discectomy.

The volume of IBL is directly proportional to potential surgical complications. Recent reports have shown that the topical use of antifibrinolytic drugs, such as TXA, during surgery might decrease IBL and improve patient outcomes.

A total of 104 patients with lumbar canal stenosis were enrolled in this randomized, double blinded clinical trial. Participants were randomized and divided into two groups TXA (54 cases) and control (50 cases). In the TXA group, a TXA solution was used for washing and soaking, whereas, in the control group, irrigation of wound was with normal saline. IBL, pre- and postoperative coagulative studies, operation time, conventional hemostatic agent usage, systemic complications, and length of hospit the potential for complications seen with intravenous TXA usage.
Retrospective national database study design.

This study was designed to determine whether acute percutaneous vertebral augmentation (PVA) alters morbidity compared with nonoperative management.

Osteoporotic vertebral compression fractures (OCFs) are common and represent a large economic and patient burden. Several recent studies have focused on whether PVA offers benefits compared with nonoperative treatment.

A retrospective cohort analysis was conducted using the Nationwide Inpatient Sample from 2015 to 2018. Patients with nonelective admissions for OCFs were identified using International Classification of Diseases (10th edition) codes. The exclusion criteria included age of less than 50 years, fusion and decompression procedures, and the presence of neoplasms and infections. Propensity score matching was implemented to construct 21 matched cohorts with similar comorbidities at admission. The patients were divided into the operative and nonoperative treatment groups. Univariate and multivariate regr risk of acute renal failure.
Patients who undergo acute PVA for OCFs have lower rates of respiratory complications, cardiac complications, sepsis, and pressure ulcerations while having a higher risk of acute renal failure.
Craniopharyngiomas (CPs) are associated with hypothalamic damage that causes hypothalamic obesity, however, the mechanisms underlying CP-related postoperative weight gain remain debatable. This study aimed to elucidate whether the major determinant of postoperative weight gain in patients with CP is hypothalamic injury or steroid replacement therapy.

We included 48 adult patients with CP (age ≥18 years) who underwent transsphenoidal surgery between 2010 and 2018 in a single tertiary center, and whose body weight was measured pre- and postoperatively (<120 days after the surgery). We recruited 144 age- and body mass index-matched patients with non-functioning pituitary adenoma (NFPA) as controls.

Patients with CP experienced greater postoperative weight gain than patients with NFPA (3.0±5.1 vs. 0.1±3.6 kg, p<0.001). The prevalence of postoperative steroid use was significantly higher in patients with CP than in those with NFPA (89.6% vs. 34.0%, p<0.001). Steroid replacement therapy and CP were associated with postoperative weight gain after adjusting for covariates in overall patients (p=0.032 and 0.007, respectively). In subgroup analysis with postoperative steroid users, weight gain was significantly greater in patients with CP (n=43, 0.96±0.25 kg/month) than in patients with NFPA (n=49, 0.26±0.23 kg/month) even after adjusting for the daily steroid dose (p=0.048).

Patients with CP experience greater postoperative weight gain than those with NFPA. Hypothalamic damage itself as well as steroid replacement may contribute to the postoperative weight gain in patients with CP.
Patients with CP experience greater postoperative weight gain than those with NFPA. Hypothalamic damage itself as well as steroid replacement may contribute to the postoperative weight gain in patients with CP.Severe asthma constitutes a serious health burden with significant morbidity and socioeconomic costs. The development and introduction of new biologics targeting type 2 inflammation changed the paradigm for management of severe asthma and initiated a biological era. These changes impose a challenge to clinicians in managing difficult-to-treat and severe asthma. To understand the characteristics and heterogeneity of severe asthma and to develop a better strategy to manage it, the Korean Academy of Asthma, Allergy and Clinical Immunology, Working Group on Severe Asthma, has organized the Korean Severe Asthma Registry (KoSAR). In this review, we describe the challenges of severe asthma management regarding diagnosis, disease burden, heterogeneity, guidelines, and organization of severe asthma clinics. This review also examines the current global activities of national and regional registries and study groups. In addition, we present the KoSAR vision and organization and describe the findings of KoSAR in comparison with those of other countries.
Endoscopic band ligation (EBL) is used to treat colonic diverticular bleeding (CDB). An endoscopic variceal ligation device for esophageal varices is used as a conventional EBL device (C-EBL). A new EBL device (N-EBL) was developed by Sumitomo Bakelite Co. in August 2018. We aimed to evaluate the clinical outcomes of N-EBL compared with those of C-EBL.

Seventy-nine patients who underwent EBL for CDB at St. Luke's International Hospital, Japan, between 2017 and 2020 were included in this retrospective study. Patients were divided into the C-EBL and N-EBL groups. Their clinical outcomes, including achieving initial hemostasis, early rebleeding, procedure time, and EBL-associated adverse events, were evaluated.

Of the 79 patients, 36 (45.6%) were in the C-EBL group and 43 (54.4%) were in the N-EBL group. The rate of achieving initial hemostasis was 100% in the C-EBL group and 93.0% in the N-EBL group. No significant difference was noted in the early rebleeding rate between the groups (p=0.24). The N-EBL group achieved a shorter median EBL procedure time than the C-EBL group (18.2 minutes vs. 14.2 minutes, p=0.02). No adverse events were observed in either group.

The N-EBL device is safe and useful and may reduce EBL procedure time.
The N-EBL device is safe and useful and may reduce EBL procedure time.This commentary discusses Edelman et al 2020's recent exploratory study of the early development of 4 Academic Health Services Centres (AHSCs) in Australia. AHSCs were originally invented in the United States, but have then diffused to the United Kingdom and Canada over the last decade or so and now to Australia so they are a good example of health policy transfer. They are dedicated to advancing more speedy knowledge translation (KT)/mobilization ('from bench to bedside') and also the more effective commercialization of scientific inventions. The commentary argues some interesting if preliminary findings are identified in their study. Its limitations will also be considered. Finally, suggestions for future research are made, including more cross national and comparative studies.Verkerk and colleagues explored the key drivers of low-value care from the perspective of 18 policy-makers and researchers who had led and evaluated at least one initiative to reduce low-value care or had been responsible for reducing low-value care in an organisation. They identified several drivers of low-value care presented in the 2017 Lancet Right Care Series (eg, fee for service payment systems, the pharmaceutical and medical device industry, fear of malpractice litigation, issues with research conduct and reporting, a culture of 'more is better' and 'new technology is better') but did not discuss some other important ones. In this commentary, we aim to extend the work of Verkerk and colleagues and provide some additional perspectives on the drivers of low-value care within the following categories Economic incentives; Money, finance, and organisation; Knowledge beliefs, assumptions, bias and uncertainty; and Power and human relationships.
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