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Epidural analgesia for pain relief following hip or knee replacement.

BACKGROUND: Hip and knee replacement are common operative procedures to improve mobility and quality of life. Adequate pain relief is essential in the postoperative period to enable ambulation and initiation of physiotherapy. Lumbar epidural analgesia is a common modality for pain relief following these procedures. However, there is no systematic review of the evidence comparing the efficacy of epidural analgesia with other postoperative analgesic modalities. As the use of epidural analgesia may delay the initiation of anticoagulant thromboprophylaxis due to the potential risk of epidural hema

Is Ankle Arthrodesis With an Ilizarov External Fixator an Effective Treatment for Septic Ankle Arthritis? A Study With a Minimum of 6 Years of Follow-up.

BACKGROUND: Septic ankle arthritis is a devastating clinical problem with a high potential for permanent disability and amputation. Successful treatment of septic ankle arthritis remains a challenge for the surgeon and patient. Ankle arthrodesis combined with radical debridement may be an effective option to eradicate infection and salvage the limb. Although numerous fusion methods have been proposed, there is controversy about the most effective technique. QUESTIONS/PURPOSES: At a minimum follow-up of 6 years after ankle arthrodesis performed using an Ilizarov external fixator, we asked, (1)

Beyond the Algorithm: The ERC Guidelines 2025 and the Maturity of Resuscitation Medicine.

The European Resuscitation Council Guidelines 2025, officially launched as the Guidelines on Cardiopulmonary Resuscitation 2025 on 22 October 2025 in Rotterdam and published in Resuscitation (1) as a thematic collection of guideline papers, represent far more than a scheduled update of resuscitation algorithms. That reading would be too narrow. The ERC Guidelines 2025 are better understood as a portrait of a discipline that has entered a new phase in its understanding of the continuum of resuscitation care. In these guidelines, resuscitation medicine is not reduced to the dramatic moment of ca

Ambulation Recovery After Surgery for Metastases to the Femur.

BackgroundPostoperative ambulation recovery after surgery for femur metastases has significant implications for not only the patient's quality of life but also administration of further cancer treatment. Thus, identification of preoperative predictors of ambulation recovery is necessary to set appropriate expectations and guide treatment. This study aimed to assess ambulation recovery rate and identify predictors of ambulation recovery in patients undergoing surgery for femur metastases.Materials and methodsA total of 244 patients who underwent surgery for femur metastases at our institution w

Survival and ambulatory function after endoprosthetic replacement for metastatic bone tumor of the proximal femur.

The purpose of this study was to clarify the ambulatory functional and oncological outcomes of tumor excision and endoprosthetic reconstruction for a metastatic lesion of the proximal femur. Subjects comprised 40 patients (18 women, 22 men; average age 63.4 years). The mean follow-up periods were 15.2 months for patients dying of the disease, and 38.7 months for survivors. Seven patients were lost to follow-up for 1.9 to 13.1 months. Endoprosthesis was performed after intralesional aggressive curettage in 20 patients and following excision of the lesion with a clear margin, in another 20. Post

Functional Recovery Following Intensive Upfront Therapy in Multiple Myeloma Patients With Poor Performance Status: A Case Series.

Patients with newly diagnosed multiple myeloma (MM) may present with profound functional impairment due to high disease burden, and an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 4 is often viewed as a barrier to intensive therapy despite potential reversibility. We report six newly diagnosed, bedbound MM patients (ECOG 4) treated with individualized multi-agent regimens incorporating proteasome inhibitors, immunomodulatory agents, and anti-CD38 monoclonal antibodies when feasible. Advanced features included extensive skeletal disease, renal dysfunction, hyperviscosity

Spinal Epidural Abscess.

AUDIENCE: The aim of this simulation case is to educate senior medical students, resident physicians, and advanced practice providers on the recognition, diagnosis, and management of spinal epidural abscesses. This scenario is most applicable to the emergency medicine setting but can be applied to the outpatient office or urgent care settings. INTRODUCTION: Spinal epidural abscess is an infection leading to an epidural collection of purulent material. This uncommon condition is estimated to occur less than 12 times per 100,000 hospital admissions.1,2 However, this infection can lead to devast

Evaluation of the Enhanced Recovery After Surgery (ERAS) Guidance for Patients With Spinal Metastasis.

Surgery continues to remain the most effective treatment for spinal metastasis (SM). As the number of surgeries continues to grow, the need for consensus guidelines for optimal perioperative care is imperative. Enhanced recovery after surgery (ERAS) protocols were created for this purpose. The objective of this study is to review evidence-based ERAS guidelines for SM surgery. A group of multiple experienced spine surgeons was invited to participate in this study. This group identified 19 ERAS items for SM surgery. The principal literature search utilized MEDLINE, Embase, and Cochrane databases

Совпадение в полном тексте источника
… The simplest VTE prevention was early ambulation [ 48 , 49 ]. … Besides, a study showed that awake spinal fusion under spinal anesthesia was related to early ambulation in patients [ 110 ]. Early ambulation and independent ambulation were recommended by ERAS protocol for all included studies. …

Percutaneous Vertebral Reconstruction (PVR) Technique of Pathological Compression Fractures: An Innovative Combined Treatment of Microwave Ablation, Bilateral Expandable Titanium SpineJack Implants Followed by Vertebroplasty.

(1) Background: to retrospectively evaluate safety and efficacy of combined microwave ablation (MWA) and bilateral expandable titanium SpineJack (SJ) implants followed by vertebroplasty (VP) for the treatment of painful thoracolumbar pathological vertebral compression fracture. (2) Methods: from July 2017 to October 2022, twenty-eight patients (13 women and 15 men; mean age 68 ± 11 years) with a history of primary neoplasm and thirty-six painful vertebral metastases with vertebral compression fracture underwent combined MWA and bilateral expandable titanium SpineJack implants with vertebroplas

Percutaneous lumbopelvic fixation for pathologic sacral fractures and spinopelvic dissociation: patient series.

BackgroundBecause patients with advanced cancer live longer, the number of patients with the sequelae of metastatic spine disease has increased. Pathologic instability of the mobile spine has been classified, and minimally invasive surgery has been well described. However, pathologic sacral instability is uncommon and often underdiagnosed. Although most sacral fractures are stable, patients with unstable U- or H-type fractures have spinopelvic dissociation and can experience progressive pain, sacral kyphosis, and neurological injury. Open lumbopelvic fusion carries a high perioperative risk fo

Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis.

STUDY DESIGN: Prospective cohort study. PURPOSE: To report the outcome of 50 patients with spinal metastases treated with minimally invasive stabilization (MISt) using fluoroscopic guided percutaneous pedicle screws with/without minimally invasive decompression. OVERVIEW OF LITERATURE: The advent of minimally invasive percutaneous pedicle screw stabilization system has revolutionized the treatment of spinal metastasis. METHODS: Between 2008 and 2013, 50 cases of spinal metastasis with pathological fracture(s) with/without neurology deficit were treated by MISt at our institution. The patien

Симптомы расстройства питания при множественном склерозе: взаимосвязь между нейротикой, дисфункцией тела и самоэстеемом.

Предыстория/цели: Исследования нарушений питания (РУ) у лиц с множественным склерозом (МС) являются ограниченными. В популяциях эпидемиологов нейротицизм связан с симптомами эдактики из-за более низкой самооценки и большего недовольства телом, но эти отношения остаются неизученными в MS. Цель этого исследования заключалась в изучении вопроса о том, являются ли самоуважение и неудовлетворенность тела посредником в установлении связи между нейротикализмом и симптомами ЭД у отдельных лиц, имеющих MS. Методы: Нынешняя выборка состояла из 275 участников, которые сообщили о подтвержденном неврологом

A Prospective Study of the IlluminOss Photodynamic Nail System for Pelvic Stabilization: Treatment of Impending and Actual Fractures from Metastatic Bone Disease, Multiple Myeloma, and Primary Bone Lymphoma.

BackgroundThe stabilization of metastatic lesions in the periacetabular region can be successfully performed using percutaneous techniques. Photodynamic nails (PDNs) are among the available tools for stabilization. Data on postoperative complications and functional outcomes are, however, scarce.MethodsPatients undergoing percutaneous stabilization using PDNs (IlluminOss Medical) for impending or actual minimally displaced pathological fractures of the pelvis from metastatic bone disease, multiple myeloma, or primary bone lymphoma were enrolled prospectively. Outcomes were assessed preoperative

Совпадение в полном тексте источника
… Early ambulation was evident for most patients, with 89.3% bearing weight as tolerated 2 days after surgery (Fig. 6 -C). …

Показатели качества консенсуса для мониторинга множественного склероза.

Множественный склероз (МС) как хроническое, дегенеративное аутоиммунное заболевание центральной нервной системы имеет продольный и разнородный курс с увеличением вариантов лечения и профилей рисков, требующих постоянного мониторинга растущего числа параметров. Несмотря на руководящие принципы лечения, отсутствуют стратегические и индивидуализированные пути мониторинга, включая соответствующие показатели качества (КИ). Для решения этой проблемы мы систематически разрабатывали транспарентные, отслеживаемые и измеримые КИ для мониторинга НР. С помощью обзора литературы, дискуссий экспертов и форм

Essential Concepts for the Management of Metastatic Spine Disease: What the Surgeon Should Know and Practice.

Study designLiterature review.ObjectiveTo provide an overview of the recent advances in spinal oncology, emphasizing the key role of the surgeon in the treatment of patients with spinal metastatic tumors.MethodsLiterature review.ResultsTherapeutic advances led to longer survival times among cancer patients, placing significant emphasis on durable local control, optimization of quality of life, and daily function for patients with spinal metastatic tumors. Recent integration of modern diagnostic tools, precision oncologic treatment, and widespread use of new technologies has transformed the tre

Защитное воздействие кварчена на экспериментальный склероз, вызванный купризоном, у самца C57BL/6 Мыши.

Цель этого исследования состояла в том, чтобы определить защитное воздействие Quercetiна на экспериментальный склероз (MS) в C57BL (Male)/6 Мыши. Forty мужского пола C57BL/6 Мыши были разделены на 4 Экспериментальные группы. Контрольная группа получила стандартную диету. Группа 2, мыши получили питание, содержащее 0.2 % (w/w) CPZ смешивается с наземным чау в течение всего периода 4 недель (Чху и др., 2021). Группа 3, мыши получили Quercetin150 мг/кг) в устной форме каждый день 4 недель. Группа 4, мыши получили диету 0.2 % CPZ и Quercetin150 мг/кг) перорально для 4 недель. После обнаружения при

Сочетание подтвержденной инвалидности - это полезный клинический конечный пункт для многоразовых склерозных клинических испытаний.

СПРАВОЧНАЯ ИНФОРМАЦИЯ И ЦЕЛИ: Чувствительные и значимые меры по ухудшению положения инвалидов по-прежнему остаются неудовлетворенной медицинской потребностью в множественных склерозах (МС). Совокупное подтвержденное ухудшение/прогрессирование инвалидности (CCDW/cCDP) сочетает расширенную шкалу взносов для инвалидов (EDSS) с испытаниями на аммуляцию и декстерность (время) 25-Foot ходовое испытание [T25FWT] и Nine- Тест на петлю [9HPT]. Мы провели оценку взаимосвязи между изменениями в этих мерах, с тем чтобы понять полезность КБРВ/КРХВ в качестве конечной точки для испытаний НР.МЕТОДЫ: Для анал

Trends and outcomes of chemotherapy timing in critically ill patients with hematologic malignancies using a Japanese national database.

Hematologic malignancies are a global public health concern, with high mortality rates in patients requiring critical care. The role of chemotherapy during intensive care unit (ICU) admission in this context remains unclear. This study aimed to analyze trends in survival rates based on chemotherapy timing and examine patient characteristics, ICU treatments, and clinical outcomes in each group. Using the Japanese Diagnosis Procedure Combination inpatient database, data from 21,837 patients aged ≥ 18 years who were hospitalized for hematologic malignancies and admitted to ICUs between April 1, 2

What are safe hemoglobin, neutrophil and platelet counts for people with hematological malignancies to participate in exercise and activities of daily living: a scoping review.

PurposeThe aim of this scoping review was to summarize the extent of the literature in relation to safe levels of platelet, hemoglobin and neutrophil count for people with hematological cancers to participate in exercise or activities of daily living (ADLs).MethodsA comprehensive search for this scoping review was completed in July 2024 across five databases: the Cochrane Library, Embase, PEDro, PubMed and OTSeeker. Original studies, reviews and expert opinion papers were included if they focused on people with active hematological cancer diagnoses or those undergoing treatment affecting bone

Риск инфицирования в реальном мире у многочисленных склерозов при долгосрочном лечении иммуномудулятора.

ВВЕДЕНИЕ: Существует множество методов иммуномодуляционного лечения для нескольких склерозов (MS), включая те из них, которые истощают иммунные клетки (например, лекарства против CD20), переносимые иммунные клетки (например, натализумаб, S1P модуляторы) или модулирующие иммунные поднаборы (например, фумараты). Все методы лечения, корректирующие заболевания (ДМТ), могут повысить риск инфицирования, который может ухудшиться в результате длительного применения. МЕТОДЫ: Это ретроспективное, одноцентральное, когортное исследование. Мы проанализировали медицинские записи взрослых людей с MS, которые