Introduction: Standard procedures for surgical fixation of proximal femoral fractures (PFF) require an image intensifier which in developing countries remains a luxury. We hypothesized that, with a well-codified techn...Introduction: Standard procedures for surgical fixation of proximal femoral fractures (PFF) require an image intensifier which in developing countries remains a luxury. We hypothesized that, with a well-codified technique, the Watson Jones approach (WJA) without image intensifier nor traction table, can allow open reduction and internal fixation (ORIF) of PFF using Dynamic hip screw (DHS), with satisfactory outcome. Patients and methods: Forty one consecutive patients (mean age 59.5 ± 21.6 years, 61% males) who were followed in a Teaching Hospital for PFF treated by ORIF using the WJA and DHS from January 2016 to December 2020 were reassessed. The outcome measures were the quality of the reduction, the positioning of the implants, the tip-apex distance (TAD), the rate and delay of consolidation, the functional results using Postel Merle d’Aubigné (PMA) score, the rate of surgical site infection (SSI) and the overall mortality. Logistic regression was used to determine factors associated with mechanical failure. Results: The mean follow-up period was 33.8 ± 15.0 months. Fracture reduction was good in 31 (75.6%) cases and acceptable in 8(19.5%) cases. Implant position was fair to good in 37 (90.2%) patients. The mean TAD was 26.1 ± 3.9 mm. Three patients developed SSI. Consolidation was achieved in 38 (92.6%) patients. The functional results were good to excellent in 80.5% of patients. The overall mortality rate was 7.3%. There were an association between mechanical failure and osteoporosis (p = 0.04), fracture reduction (p = 0.003), and TAD (p = 0.025). In multivariate logistic regression, no independent factors were predictive of mechanical failure. Conclusion: This study shows that ORIF using DHS for PFF via the Watson-Jones approach without an image intensifier can give satisfactory anatomical and functional outcomes in low-resource settings. It provides and validates a reliable and reproducible technique that deserves to be diffused to surgeons in austere areas over the world.展开更多
Africa faces significant challenges in terms of material and personnel resources for oncology interventions. This is particularly evident in South Africa, where resources are divided into high- and low-resource settin...Africa faces significant challenges in terms of material and personnel resources for oncology interventions. This is particularly evident in South Africa, where resources are divided into high- and low-resource settings. High-resource settings cater to those with financial means to access private oncology facilities. However, many breast cancer patients receive care in South Africa’s low-resource settings, such as public hospital oncology clinics. Unfortunately, these settings have limited service providers and fail to offer comprehensive interventions, resulting in poor outcomes. However, recent research has highlighted the significance of socially supportive relationships in promoting healing and overall individual well-being, and spirituality has been identified as a source of positive outcomes in cancer patients. This systematic review paper explores the feasibility of implementing support group cancer care and interventions that incorporate social support networks available in community settings, and spiritual practices facilitated by traditional healers, and religious/spiritual leaders. These interventions can be provided within low-resource settings to women diagnosed with breast cancer. Inclusive participation of spouses, children, and extended family in the support group cancer care can facilitate healing for the entire system. Focusing on the strengths and resources within communities and incorporating these complementary services, can enhance the well-being and quality of life for Black African women diagnosed with breast cancer, despite low-resource settings. This approach acknowledges the potential of community-based support networks and encourages collaboration between various stakeholders, including community health educators, nurses, lay counselors, and community volunteers, to address the complex needs of these patients.展开更多
Objective: Intravenous labetalol and hydralazine are both considered first-line medications for the management of acute-onset, severe hypertension in pregnant and postpartum women. The study compared the efficacy and ...Objective: Intravenous labetalol and hydralazine are both considered first-line medications for the management of acute-onset, severe hypertension in pregnant and postpartum women. The study compared the efficacy and safety profile of intravenous labetalol and hydralazine in the control hypertension in severe pre-eclampsia. Materials and Methods: One hundred patients who presented with severe pre-eclampsia were randomized into two study groups. The fifty patients in each arm of the study received either intravenous labetalol or intravenous hydralazine for the control of blood pressure. Results: The mean age of the labetalol subjects was 28.6 ± 5.47 years while that of their hydralazine counterparts was 29.12 ± 5.77 years. The majority of respondents in both groups were primigravidae (76% vs. 78%) (P = 0.813). The number of doses of drug needed to significantly lower the mean systolic blood pressure was slightly lower in the labetalol group (2 doses) compared to the hydralazine group (5 doses) (t = 0.803<sup>Y</sup>, P = 0.977). The incidence of headaches which were the commonest complaints was comparable in both groups 8% and 10% of respondents respectively (P > 0.05). Conclusion: Although both intravenous labetalol and hydralazine are useful in patients with severe pre-eclampsia, the response to labetalol was better with comparable side effects.展开更多
Low alkaline liquid state setting accelerator（LSA） for Portland cement was prepared in laboratory from aqueous solution of several inorganic sulfate salts and some organic chemical substances. Properties of cement w...Low alkaline liquid state setting accelerator（LSA） for Portland cement was prepared in laboratory from aqueous solution of several inorganic sulfate salts and some organic chemical substances. Properties of cement with addition of LSA relating to its setting time and strength development as well as its resistance to sulfate attack for short and long term exposure were experimentally examined. The experimental results showed that 5%-7% addition of LSA significantly accelerated the initial and final setting of Portland cement in the presence or absence of the blending of mineral admixtures, the initial and final setting time being less than 3 min and 6 min respectively. Meanwhile, the early 1 day curing age compressive strength increased remarkably by 20%, while the late 28 th day curing age compressive strength remained almost unchanged as compared with that of the reference accelerator free cement mortar specimen. Furthermore, mortar specimens of cement added with LSA and exposed to 5% Na2SO4 solution showed their excellent resistance to sulfate attack, with their short and long term curing age resistance coefficient to sulfate attack being around 1.04 to 1.17, all larger than 1.0. XRD analysis on hardened cement paste specimens at very early curing ages of several minutes disclosed the existence of more ettringite in specimens added with LSA than that of the reference specimens, meanwhile SEM observation also revealed the existence of well crystallized ettringite at very early hydration stage, suggesting that the accelerated setting of Portland cement can be attributed to the early and rapid formation of ettringite over the whole cement paste matrix due to the introduction of LSA. MIP measurement revealed that hardened cement paste specimens with the addition of LSA presented less medium diameter pores, more proportion of small pores and less proportion of large capillary pores, which is in a very good coincidence with the improvement of strength development of cement mortars added with LSA.展开更多
文摘Introduction: Standard procedures for surgical fixation of proximal femoral fractures (PFF) require an image intensifier which in developing countries remains a luxury. We hypothesized that, with a well-codified technique, the Watson Jones approach (WJA) without image intensifier nor traction table, can allow open reduction and internal fixation (ORIF) of PFF using Dynamic hip screw (DHS), with satisfactory outcome. Patients and methods: Forty one consecutive patients (mean age 59.5 ± 21.6 years, 61% males) who were followed in a Teaching Hospital for PFF treated by ORIF using the WJA and DHS from January 2016 to December 2020 were reassessed. The outcome measures were the quality of the reduction, the positioning of the implants, the tip-apex distance (TAD), the rate and delay of consolidation, the functional results using Postel Merle d’Aubigné (PMA) score, the rate of surgical site infection (SSI) and the overall mortality. Logistic regression was used to determine factors associated with mechanical failure. Results: The mean follow-up period was 33.8 ± 15.0 months. Fracture reduction was good in 31 (75.6%) cases and acceptable in 8(19.5%) cases. Implant position was fair to good in 37 (90.2%) patients. The mean TAD was 26.1 ± 3.9 mm. Three patients developed SSI. Consolidation was achieved in 38 (92.6%) patients. The functional results were good to excellent in 80.5% of patients. The overall mortality rate was 7.3%. There were an association between mechanical failure and osteoporosis (p = 0.04), fracture reduction (p = 0.003), and TAD (p = 0.025). In multivariate logistic regression, no independent factors were predictive of mechanical failure. Conclusion: This study shows that ORIF using DHS for PFF via the Watson-Jones approach without an image intensifier can give satisfactory anatomical and functional outcomes in low-resource settings. It provides and validates a reliable and reproducible technique that deserves to be diffused to surgeons in austere areas over the world.
文摘Africa faces significant challenges in terms of material and personnel resources for oncology interventions. This is particularly evident in South Africa, where resources are divided into high- and low-resource settings. High-resource settings cater to those with financial means to access private oncology facilities. However, many breast cancer patients receive care in South Africa’s low-resource settings, such as public hospital oncology clinics. Unfortunately, these settings have limited service providers and fail to offer comprehensive interventions, resulting in poor outcomes. However, recent research has highlighted the significance of socially supportive relationships in promoting healing and overall individual well-being, and spirituality has been identified as a source of positive outcomes in cancer patients. This systematic review paper explores the feasibility of implementing support group cancer care and interventions that incorporate social support networks available in community settings, and spiritual practices facilitated by traditional healers, and religious/spiritual leaders. These interventions can be provided within low-resource settings to women diagnosed with breast cancer. Inclusive participation of spouses, children, and extended family in the support group cancer care can facilitate healing for the entire system. Focusing on the strengths and resources within communities and incorporating these complementary services, can enhance the well-being and quality of life for Black African women diagnosed with breast cancer, despite low-resource settings. This approach acknowledges the potential of community-based support networks and encourages collaboration between various stakeholders, including community health educators, nurses, lay counselors, and community volunteers, to address the complex needs of these patients.
文摘Objective: Intravenous labetalol and hydralazine are both considered first-line medications for the management of acute-onset, severe hypertension in pregnant and postpartum women. The study compared the efficacy and safety profile of intravenous labetalol and hydralazine in the control hypertension in severe pre-eclampsia. Materials and Methods: One hundred patients who presented with severe pre-eclampsia were randomized into two study groups. The fifty patients in each arm of the study received either intravenous labetalol or intravenous hydralazine for the control of blood pressure. Results: The mean age of the labetalol subjects was 28.6 ± 5.47 years while that of their hydralazine counterparts was 29.12 ± 5.77 years. The majority of respondents in both groups were primigravidae (76% vs. 78%) (P = 0.813). The number of doses of drug needed to significantly lower the mean systolic blood pressure was slightly lower in the labetalol group (2 doses) compared to the hydralazine group (5 doses) (t = 0.803<sup>Y</sup>, P = 0.977). The incidence of headaches which were the commonest complaints was comparable in both groups 8% and 10% of respondents respectively (P > 0.05). Conclusion: Although both intravenous labetalol and hydralazine are useful in patients with severe pre-eclampsia, the response to labetalol was better with comparable side effects.
基金Funded by the Major State Basic Research Development Program of China(No.2011CB013800)
文摘Low alkaline liquid state setting accelerator（LSA） for Portland cement was prepared in laboratory from aqueous solution of several inorganic sulfate salts and some organic chemical substances. Properties of cement with addition of LSA relating to its setting time and strength development as well as its resistance to sulfate attack for short and long term exposure were experimentally examined. The experimental results showed that 5%-7% addition of LSA significantly accelerated the initial and final setting of Portland cement in the presence or absence of the blending of mineral admixtures, the initial and final setting time being less than 3 min and 6 min respectively. Meanwhile, the early 1 day curing age compressive strength increased remarkably by 20%, while the late 28 th day curing age compressive strength remained almost unchanged as compared with that of the reference accelerator free cement mortar specimen. Furthermore, mortar specimens of cement added with LSA and exposed to 5% Na2SO4 solution showed their excellent resistance to sulfate attack, with their short and long term curing age resistance coefficient to sulfate attack being around 1.04 to 1.17, all larger than 1.0. XRD analysis on hardened cement paste specimens at very early curing ages of several minutes disclosed the existence of more ettringite in specimens added with LSA than that of the reference specimens, meanwhile SEM observation also revealed the existence of well crystallized ettringite at very early hydration stage, suggesting that the accelerated setting of Portland cement can be attributed to the early and rapid formation of ettringite over the whole cement paste matrix due to the introduction of LSA. MIP measurement revealed that hardened cement paste specimens with the addition of LSA presented less medium diameter pores, more proportion of small pores and less proportion of large capillary pores, which is in a very good coincidence with the improvement of strength development of cement mortars added with LSA.
