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Immune system checkpoint inhibitor-associated intense renal injury and also fatality: A great observational study.
016, p = 0.03). Training under cognitive load benefitted performance on an actual surgical task under similar conditions. AIM The incidence of esophageal malignancies is higher in cirrhotic patients due to the fact that cirrhosis and esophageal cancer share common risk factors. Our goal was to define the impact of cirrhosis on postoperative outcomes following esophagectomy for esophageal cancer. METHODS This study was performed according to the PRISMA guidelines. Eligible studies were identified through search of PubMed, Scopus, and Cochrane (end-of-search date March 8th, 2019). A meta-analysis was conducted using random effects modeling. RESULTS We included 12 observational studies reporting on a total of 1938 patients who underwent surgery for esophageal cancer. Cirrhotic patients were more likely to develop postoperative pulmonary complications (OR 2.60; 95% CI 1.53-4.42), ascites (OR 37.77; 95% CI 10.95-130.28) and anastomotic leak/fistula within 30 days (OR 2.81; 95% CI 1.05-7.49) after esophageal cancer surgery. Cirrhotic patients had higher 30-day (OR 3.04; 95% CI 1.71-5.39) mortality rate. Liver disease did not appear to influence 90-day (OR 2.84; 95% CI 0.94-8.93) or late mortality rates (at a mean of 24 months of postoperative follow up) (OR 1.70; 95% CI 0.53-5.51). Esophagectomy for carcinoma in Child-Turcotte-Pugh class A cirrhotic patients was associated with significantly lower 30-day mortality rates compared to class B patients (OR 0.14; 95% CI 0.04-0.54). CONCLUSIONS Cirrhotic patients have higher odds of developing pulmonary complications, ascites, and anastomotic leak during the first postoperative month. Although, 30-day mortality was higher among cirrhotic patients after esophagectomy, liver disease does not seem to influence long-term prognosis. INTRODUCTION The surgical, arthroscopic synovectomy and radiosynovectomy (radiosynoviorthesis, RSO) all have great practical importance, since they can eliminate the posttraumatic joint bleedings and prevent the further joint destructions in hemophilic patients. The aim of this study was to examine the role of RSO in the prevention of joint bleedings in hemophilic patients. METHODS 54 out of 684 RSO patients were hemophiliacs. Mean age of the patients was 32 years (range 14-51), therefore this is a relatively young patients' cohort. Radiosynovectomy was performed in 37 patients with hemophilia A and in 17 patients suffering from hemophilia B. Since hemophilia is a sex-linked (x-linked) recessive disorder, all of the patients were male. There was no acquired hemophiliac among the treated patients. RESULTS The RSO resulted in a 95% decline in bleedings per year and eliminated the incidence of further bleedings in 55% of the treated joints. CONCLUSION Our findings support the view that radiosynoviorthesis can be considered as the first choice treatment for posttraumatic joint bleedings of hemophilic patients. INTRODUCTION Anterior pubic symphyseal plate fixation is the recommended treatment for disruption of pubic symphysis in an unstable pelvic ring injury. The rigid construct offered by locking symphyseal plate has the theoretical advantage of allowing patients to weight bear early. However, there are concerns of catastrophic failure about the locked plate construct. The purpose of the study was to establish if locking plate fixation for pubic symphysis disruption was effective to allow patients to mobilise weight bearing immediately after surgery. PATIENT AND METHODS Retrospective analysis of a prospectively collected database from a single centre was performed. The study period was from 2008 to 2017. Radiographic evidence of fixation failure, revision surgery, removal of metalwork and follow up duration was noted. RESULTS We identified 46 patients (FM 838) with a mean age of 46 years (range 14 to 74 years). Based on the mechanism of injury patients were classified into Antero-posterior compression (28), VerticOBJECTIVE The treatment of femoral nonunion is challenging for both the surgeon and the patient. Strut allografts increase the bone stock, enhance fracture healing and increase stability by acting as a biological plate. In this study, we aimed to report the results of the sandwich technique with two-strut allograft in the treatment of oligotrophic or atrophic femoral nonunions. METHODS Medical records of the patients who were treated due to femoral nonunion in a single center were retrospectively reviewed. Twenty-one patients (10 males, 11 females) with a mean age of 49 (range 21 to 79) years were included in the study. Carfilzomib cost The left side was affected in 11 patients, whereas the right side was affected in ten. The patients had 11 femoral shaft fractures, seven proximal femoral fractures and three distal femoral fractures. The mean time from the previous operation to the nonunion surgery was 9.6 (range 6 to 22) months. RESULTS Union was achieved in all patients after a mean period of 6.2 (range 4 to 10) months. The mean follow-up time was 46.8 (range 12 to 86) months. One patient had superficial surgical site infection in the autologous graft donor site. CONCLUSION The sandwich technique with two-strut allograft provides good results in the treatment of femoral nonunion. The technique can be used on any type of nonunion, at any segment of the femur and can be combined with different fixation techniques. BACKGROUND Limited studies have been conducted to determine the minimum amount and sensitivity of the saline load test of the ankle. Prior studies, only performed in arthroscopic models, have suggested a wide range of volumes necessary to confirm arthrotomy. The purpose of this study was to investigate the amount of fluid required and the sensitivity of the saline load test to identify an intra-articular arthrotomy of the ankle. Using cadavers without prior ankle trauma or surgeries we aim to assess volume needed to detect ankle arthrotomies at varying arthrotomy locations. We hypothesized that the volume needed would vary based on site of arthrotomy. METHODS Twenty thawed, fresh-frozen below knee cadavers were divided into four groups based on arthrotomy location. An ankle arthrotomy was made using a 4 mm trochar at the four standard ankle portal sites; anteromedial, anterolateral, posteromedial, and posterolateral. To confirm intra-articular location, a arthroscope was inserted for direct visualization of the ankle joint.
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