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OVERVIEW OF EXFOLIATION SYNDROME

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国际眼科杂志 2003年第1期3卷 100-101页

作者： R.Ritch The New York Eye and Ear infirmary NY USA

Exfoliation syndrome (XFS) is an age-related disease characterized by the production and progressive accumulation of a fibrillar extracellular material in many ocular tissues. It has only recently been recognized to be the overall most common identifiable cause of glaucoma, and in some countries accounts for the majority of the glaucoma Its ocular manifestations affect all of

关键词：假性磷片样脱皮综合征青光眼病理变化综述

Robotic-assisted versus open total pancreatectomy: a propensity score-matched study

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Hepatobiliary Surgery and Nutrition 2020年第6期9卷 759-770页

作者： Yuanchi Weng Mengmin Chen Georgios Gemenetzis Yusheng Shi Xiayang Ying Xiaxing Deng Chenghong Peng Jiabin Jin Baiyong Shen Department of General Surgery Pancreatic Disease CenterRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina Department of Surgery Glasgow Royal InfirmaryGlasgowScotlandUK

Background:Total pancreatectomy(TP)is a complex surgical procedure with significant postoperative *** the narrowed range of indications for TP,the introduction of neoadjuvant chemotherapy and the increasing complexity of surgical resections performed in high-volume centers has increased the number of annually performed TPs,especially regarding malignant *** introduction of robotic-assisted pancreatic surgery has provided a novel and minimally invasive approach for TP,yet the feasibility of this technique is still *** study assessed the safety and efficacy of robotic-assisted total pancreatectomy(RTP)compared to conventional open total pancreatectomy(OTP).Methods:All patients who underwent TP between March 2015 and July 2019 in a high-volume institution for pancreatic surgery were included in this retrospective *** data and perioperative outcomes were derived from the prospectively maintained institutional database.A 1:1 propensity score matching(PSM)method was utilized to compare the RTP and OTP cohorts to minimize ***:A standardized surgical protocol was utilized for RTP following a learning curve of RPD and *** median operative time for patients who underwent RTP was significantly decreased compared to those who underwent OTP[300(IQR,250-360)vs.360 min(IQR,300-525),P=0.031].Additionally,en bloc resection and spleen-preserving rates were also higher in the RTP *** 30-day morbidity(Clavien-Dindo>IIIa)and 90-day mortality were similar between the two *** a median follow-up time of 15(IQR,8-24)months,both the RTP and OTP cohorts had a comparable quality of life regarding exocrine and endocrine ***:RTP appears to be safe and feasible when utilized in high-volume centers for the indicated management of benign and highly selected malignant pancreatic ***,further prospective randomized studies are needed to assess the feasibility of this approach.

关键词： Robotic-assisted total pancreatectomy(RTP) open total pancreatectomy(OTP) propensity score matching(PSM)

Comparason of Peri-Articular Multimodal Drug Injection with Femoral and Sciatic Nerve Block after Total Knee Arthroplasty

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Open Journal of Orthopedics 2012年第4期2卷 155-158页

作者： Calum H. C. Arthur Alexander M. Wood Charles Leeson-Payne Steffen J. Breusch Orthopaedic Department Royal Infirmary of Edinburgh Edinburgh UK

Good perioperative analgesia following total knee arthroplasty facilitates rehabilitation and may reduce hospital stay. We present the patient analgesic requirements and rehabilitation of a prospective single surgeon series after the introduction of a multimodal drug injection during his total knee arthroplasty. Basic epidemiological data as well as analgesic, antiemetic requirements and time to straight leg raised was collected on 27 consecutive patients (group 1) whom received the multimodal drug injection, consisting of levobupivacaine, ketorolac and adrenaline at the time of their total knee arthroplasty under spinal anaesthesia. Their rehabilitation was compared to a retrospective review of patients who were case matched by age and sex (group 2n = 26), whom had received the unit standard of spinal anaesthetic and a femoral and sciatic block at the time of their operation. Patients in group 1 had significantly lower analgesic and antiemetic requirements than group 2. Group 1 also had a significantly shorter hospital stay. We have demonstrated that periarticular multimodal drug injection can improve perioperative analgesia and mobilisation following total knee arthroplasty as well as reducing opioid requirements and side effects.

关键词： Analgesia Total Knee Replacement Multimodal Drug Injection Peripheral Nerve Blocks Rehabilitation

Understanding the health and social care needs of people living with IBD: A meta-synthesis of the evidence

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World Journal of Gastroenterology 2012年第43期18卷 6240-6249页

作者： Karen Kemp Jane Griffiths Karina Lovell School of Nursing Midwifery and Social Work University of Manchester Manchester M13 9PL United Kingdom Department of Gastroenterology Manchester Royal Infirmary Manchester M13 9WL United Kingdom

AIM:To undertake a metasynthesis of qualitative studies to understand the health and social needs of people living with inflammatory bowel disease (IBD). METHODS:A systematic search strategy identified qualitative studies exploring the phenomenon of living with inflammatory bowel disease. Databases included MEDLINE, PsychInfo, EMBASE, CINAHL and the British Nursing Index via the OVID platform. Qualitative search filters were adapted from Hedges database (http://***/hslt/miner/ digital_library/tip_sheets/Cinahl_eb_***). Qualitative empirical studies exploring the health and social needs of people living with inflammatory bowel disease were selected. Study eligibility and data extraction were independently completed using the Critical Appraisal Skills Programme for qualitative studies. The studies were analysed and synthesised using metasynthesis methodology. The themes from the studies allowed for common translations into a new interpretation of the impact of living with inflammatory bowel disease. RESULTS:Of 1395 studies, six published studies and one unpublished thesis fulfilled the inclusion criteria. First iteration of synthesis identified 16 themes, 2nd iteration synthesised these into three main 2nd order constructs:"detained by the disease"; "living in a world of disease" and "wrestling with life". "Detained by the disease" is the fear of incontinence, the behaviour the patients display due to the fear, and the impact this has on the individual, such as social isolation and missing out on life events. All of these serve to "pull" the patient back from normal living. "Living in a world of disease" is the long term effects of living with a long term condition and the fear of these effects. "Wrestling with life" is the continued fight to thrive, the "push" to continue normal living. CONCLUSION:The metasynthesis provides a comprehensive representation of living with IBD. The unmistakeable burden of incontinence is exposed and its ongoing

关键词：生活事件社会需求鸡传染性法氏囊病健康综合集成方法肠道疾病 MEDLINE 证据

Communication after cancellations in orthopaedics: The patient perspective

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World Journal of Orthopedics 2014年第1期5卷 45-50页

作者： Saurabh S Mehta David J Bryson Jitendra Mangwani Lucy Cutler Department of Orthopaedics University Hospitals of Leicester NHS Trust Leicester General Hospital Department of Orthopaedics University Hospitals of Leicester NHS Trust Leicester Royal Infirmary

AIM: To examine patients' perceptions on communication surrounding the cancellation of orthopaedic operations and to identify areas for improvement in ***: A prospective survey was undertaken at a university teaching hospital within the department of Trauma and Orthopaedics. Patients admitted to an acute orthopaedic unit, whose operations were cancelled, were surveyed to assess patient satisfaction and preferences for notification of cancellation of their operations. Patients with an abbreviated mental test score of < 9, patients unable to complete the survey independently, those under 16 years of age, and any patient notified of the cancellation by any of the authors were excluded from this study. Patients were surveyed themorning after their operation had been cancelled thus ensuring that every opportunity was given for the medical staff to discuss the cancellation with the patient. The survey included questions on whether or not patients were notified of the cancellation of their surgery, the qualifications of the person discussing the cancellation, and patient preferences on the process. Satisfaction was assessed via 5-point Likert scale ***: Sixty-five consecutive patients had their operations cancelled on 75 occasions. Fifty-four point seven percent of the patients who had cancellations were notified by a nurse and 32% by a doctor. No formal communication occurred for 13.3% cancellations and no explanation was provided for a further 16%. Patients reported that they were dissatisfied with the explanation provided for 36 of the 75(48%) cancellations. Of those patients who were dissatisfied, 25(69.4%) were notified by a nurse. Twenty-three of the 24(96%) patients notified by a doctor were satisfied with the explanation and that communication. Of those patients who were notified by a nurse 83% patients reported that they would have preferred it if a doctor had discussed the cancellation with them. There was a significant difference

关键词： Communication Patient satisfaction Orthopaedic surgery Cancellation

Retinal blood flow velocity in patients with active uveitis using the retinal function imager

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Chinese Medical Journal 2013年第10期126卷 1944-1947页

作者： FENG Xing Kedhar Sanjay Bhoomibunchoo Chavakij Beijing Tongren eye Center Beijing Tongren Hospital CapitalMedical University Beijing Ophthalmology and Visual SciencesKey Laboratory Beiiing 100730 China Department of Ophthalmology New York Eye and Ear InfirmaryNew York NY 10003 USA

Background Previous studies suggest a link between macular edema and retinal blood flow velocity （RBFV）. The effects of inflammation in the retinal blood vessels are not clearly understood. We want to evaluate the differences in retinal blood flow velocities of patients with active uveitis and healthy controls using the retinal function imager （RFI） and determine the correlation between retinal blood flow velocity and central macular thickness in uveitis patients. Methods Twenty-eight eyes of 24 patients with active anterior uveitis and 51 eyes of 51 normal control subjects were enrolled. Retinal blood flow velocities evaluated by RFI and central macular thickness evaluated by optical coherence tomography （SLO-OCT） were obtained. Differences among the groups were assessed using Stata statistical software. Results Ten eyes had uveitic cystoid macular edema （CME）. Median （first quartile, third quartile） venous velocity for uveitic eyes with CME, uveitic eyes without CME, and controls were 2.09 （1.92, 2.44）, 2.64 （2.32, 2.86）, and 2.82 （2.39, 3.53） mm/s respectively. Median （first and quartile） arterial velocity for uveitic eyes with CME, uveitic eyes without CME, and controls were 3.79 （3.61, 4.09）, 3.46 （2.86, 4.12）, and 3.93 （3.35, 4.65） mm/s. Uveitic eyes with CME had significantly lower venous velocity than controls （P=0.044）. There was a strong linear relationship between venous velocity and central retinal thickness （P=0.007）. Conclusions Retinal venous velocities were significantly decreased in eyes with uveitic CME relative to *** venous velocity was correlated with increased central retinal thickness in uveitic eyes.

关键词： blood supply inflammation edema

Mastectomy—A Critical Review

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Open Journal of Clinical Diagnostics 2017年第2期7卷 58-66页

作者： Gabija Lazaraviciute Shailesh Chaturvedi Department of Breast and General Surgery Aberdeen Royal Infirmary Aberdeen UK

History of breast cancer dates back to at least 1600 B.C. and treatment methods have undergone significant progress over the last hundred years. We are moving away from frighteningly radical, and towards increasingly more conservational breast cancer surgery. And while mastectomy is no longer a first-line choice for all breast cancers, it is still an important and, really, an essential procedure to discuss and research about. Different types and techniques exist and evidence regarding each is vast-with novel techniques appearing even nowadays. For example, robotic surgery is increasingly more common in many surgical specialties and procedures, and mastectomy is no exception. With several high-profile celebrities recently discussing their experiences of breast cancer and mastectomies, this article covers a multitude of essential aspects relevant to this topic, in turn, hopefully, helping patients and doctors deal with the diagnosis and plan the treatment accordingly. Current breast cancer care and mastectomy trends are also discussed here, giving the readers an up-to-date overview of how breast cancer can and should be managed.

关键词： Mastectomy Breast Cancer Halsted Mastectomy Patey Mastectomy Total Mastectomy Skin Sparing Mastectomy Breast Conserving Surgery Prophylactic Mastectomy

Return to sport following scaphoid fractures:A systematic review and meta-analysis

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World Journal of Orthopedics 2019年第2期10卷 101-114页

作者： Joaquim S Goffin Quintin Liao Gregory AJ Robertson Department of Orthopaedic and Trauma Surgery Ninewells Hospital Department of Orthopaedic and Trauma Surgery Forth Valley Royal Hospital Edinburgh Orthopaedic Trauma Unit Royal Infirmary of Edinburgh

BACKGROUND Scaphoid fracture is the most commonly fractured carpal bone in the athletic patient, accounting for over 85% of all sport-related carpal bone fractures, and is particularly common in sports involving high impact injuries to the wrist. The management of such injuries comprises both conservative and surgical techniques, as guided by fracture location and type. Athletes demonstrate a unique challenge with regards to the management of scaphoid fractures due to their requirement to return to sport, as soon as *** To review systemically all studies recording return to sport following scaphoid fractures, to collate information on return rates to sport(RRS) and mean return times(RTS) to sport and to determine differences in sporting outcome for the various treatment *** A systematic search of MEDLINE, EMBASE, CINAHAL, Cochrane, Google Scholar, Physiotherapy Evidence Database, SPORTDiscus, Web of Science and Scopus was performed in August 2018 using the keywords "scaphoid","fracture", "acute", "carpal", "athletes", "sports", "non-operative","conservative", "operative" and "return to sport". All studies that recorded RRS and RTS following scaphoid fractures were included. RTS was recorded as the length of time from commencement of either primary conservative management or primary surgical procedure to return to *** Eleven studies were included: Two randomised controlled trials, six retrospective cohort studies and three case series. Seven studies reported on conservative management(n = 77), and eight studies reported on surgical management(n =83). For conservative management, RRS was 90%(69/77), and the mean RTS was9.6 wk. Three studies allowed to return to sport in cast [RRS 89%(25/28); RTS 1.9 wk], and four studies required completion of cast treatment prior to returning to sport [RRS 90%(44/49); RTS 13.9 wk]. Four studies recorded fracture union data:Union rate 85%(47/55); mean time to union 14.0 wk. For surgical management,RRS was 98

关键词： Acute Fracture Scaphoid Carpal Return Sport Rate Time

Bypass Grafting of Aberrant Circumflex Artery with Anomalous Origin and Course

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Open Journal of Thoracic Surgery 2012年第4期2卷 121-125页

作者： Marios E. Patronis Sotiris C. Papaspyros Kasra Shaikhrezai Sai Prasad Dharmendra Agrawal Department of Cardiothoracic Surgery Royal Infirmary of Edinburgh Edinburgh Scotland

We present a case of a rarely seen anomalous circumflex (C x) artery originating from the proximal right coronary artery. This was an incidental finding during a diagnostic coronary angiogram performed to investigate a patient with acute coronary syndrome. Surgically significant disease was present in four left-sided vessels. The patient underwent coronary artery bypass grafts using left internal thoracic artery and long saphenous vein grafts to all four left sided vessels including the aberrant C x. We also present a discussion of current relevant literature and guidelines in relation to definition, classification, incidence, diagnosis, clinical relevance and treatment of this type of coronary artery anomalies.

关键词： Coronary Artery Anomalies Coronary Artery Bypass Grafts