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The interaction term PPI use × age was not statistically significant, in any of the categories of medication use time, any of the cognitive function tests evaluated, indicating that PPI use time is not associated with decrease in cognitive scores as the time interval between visits increases.
In this cohort middle-aged and elderly adults, after average interval of 3.9years (relatively short time to detect cognitive decline in a young cohort), the use and time of use of PPIs at the beginning of the study were not associated with a decline in cognitive performance in these tests between visits.
In this cohort middle-aged and elderly adults, after average interval of 3.9 years (relatively short time to detect cognitive decline in a young cohort), the use and time of use of PPIs at the beginning of the study were not associated with a decline in cognitive performance in these tests between visits.
To correct and prevent the proximalisation of the 1st ray by safe stabilisation using an autologous costochondral graft. Reduction of pain and maintaining good pinch and grip strength while preserving the important opposition of the thumb.
Painful proximalisation of the 1st ray after failed trapeziectomy with contact between the base of the 1st metacarpal and the trapezoid or scaphoid.
Painful conditions following trapeziectomy for other causes.
Perioperative antibiotic prophylaxis is required. Extension of the previous incision and exposure of the sensitive radial branches and the radial artery. Longitudinal incision of the capsule and excision of the scar from the trapezium cavity. Dissection of the scar tissue directly around the metacarpal1 base. After longitudinal resection of the oblique trapezoid surface, insertion of asuture anchor into the scaphoid joint surface close to the trapezoid. Removal of an approximately 2 cm long piece of rib cartilage from the middle costal arch. Insertion of the costochondral graft into the trapezium space and fixation with the suture anchor. Stable capsule closure. Suction drain. Skin suture. Thumb-forearm splint.
Postoperative immobilisation of the carpometacarpal (CMC)-1 joint for 4weeks in medium abduction position. In case of uneventful wound healing also with awell-fitting orthosis. Afterwards independent movement exercises and exercises in warm water. Hand therapy only in case of difficult mobilisation at the earliest 2months after surgery.
From 2015-2018, 18patients underwent surgery using this technique. The follow-up was at least 2years after surgery. Of the 15patients available for follow-up, 93% were classified as good and improved according to the Conolly-Rath score.
From 2015-2018, 18 patients underwent surgery using this technique. The follow-up was at least 2 years after surgery. Of the 15 patients available for follow-up, 93% were classified as good and improved according to the Conolly-Rath score.
When treating olecranon fractures surgically, surgeons rely on the contour of the posterior cortex of the proximal ulna. However, it is unclear whether the greater sigmoid notch (GSN) is restored anatomically by this method. We analyzed whether reduction of fractures based on the posterior ulnar cortex contour is reliable for restoration of the GSN contour in displaced olecranon fractures with no or minimal dorsal cortex comminution.
We performed a retrospective review of 23 patients with Mayo type 2 olecranon fractures with no or minimal dorsal cortex comminution who were treated surgically. We analyzed pre- and postoperative elbow CT images and measured the interfragmentary distance (IFD), articular step-off, articular gap, contour defect and GSN angle to evaluate the restoration of the GSN contour.
The mean preoperative IFD and contour defect were 16.5 mm (range 4.3-35.6 mm) and 4.3 mm (range 0.7-13.3 mm), respectively. Postoperatively, there was no residual IFD, and the mean contour defect decreased significantly to 1.4 mm (range 0-3.7 mm). The residual articular step-off and gap were 0.2 mm (range 0-3.8 mm) and 1.0 mm (range 0-5.9 mm), respectively. I-BET-762 mw Acceptable GSN restoration was achieved in 14 of 23 patients (60.9%). Sixteen patients had > 2 mm of preoperative contour defect, and 7 (43.8%) achieved acceptable GSN restoration; the remaining 7 patients (100%) who had < 2 mm of the contour defect achieved acceptable GSN restoration. Patients whose preoperative contour defect was > 2 mm had a higher risk of unacceptable GSN restoration, with an odds ratio of 2.29 (p = 0.019).
In displaced olecranon fractures without significant dorsal cortex comminution, reduction based on the posterior ulnar cortex could be reliable for fractures with under 2 mm of preoperative contour defect, but not for those with > 2 mm of contour defect.
IV.
IV.
Japan is a super-aging society, the geriatric care system establishment for hip fractures is at an urgent task. This report described our concept of multidisciplinary care model for geriatric hip fractures and 5-year outcomes at the Toyama City Hospital, Japan.
In this retrospective cohort study, a multidisciplinary treatment approach was applied for elderly patients with hip fracture since 2014. These patients (n = 678, males n = 143, mean age 84.6 ± 7.5years), were treated per the multidisciplinary care model. Time to surgery, length of hospital stays, complications, osteoporosis treatment, mortality, and medical costs were evaluated.
The mean time to surgery was 1.7days. Overall, 78.0% patients underwent surgery within 2days. The mean duration of hospital stay was 21.0 ± 12.4days. The most frequent complication was deep venous thrombosis (19.0%) followed by dysuria (14.5%). Severe complications were pneumonia 3.4%, heart failure 0.8% and pulmonary embolism 0.4%. The in-hospital mortality rate was 1.2atric hip fracture. This approach resulted in a shorter time to surgery and hospital stay than the national average. The incidence of severe complications and mortality was low. The multidisciplinary treatment has maintained a high rate of osteoporosis treatment after discharge and at follow-up. Furthermore, the total medical cost per person was less than the national average. Thus, the multidisciplinary treatment approach for geriatric hip fractures was effective and feasible to conduct in Japan.
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