Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by...Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by him is the first extant monography on traumatology and orthopedics in China.According to the preface of the book,he had profound medical knowledge especially about the theory,diagnosis and treatment for wounds and fractures.展开更多
Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital....Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.展开更多
According to the latest data released by the National Bureau of Statistics, the total population of the mainland of China is 1.33 billion in 2010, including 177 million people aged 60 years or older, accounting for 13...According to the latest data released by the National Bureau of Statistics, the total population of the mainland of China is 1.33 billion in 2010, including 177 million people aged 60 years or older, accounting for 13.25% of the total population, which increased to 15.53% in 2014. With the degree of growing aging population in our country, patients with musculoskeletal diseases increased greatly, which are the most common cause of severe chronic pain and physical disability among older people. Meanwhile, with the fast development of economy and industrialization in China, the number of patients of traffic injury and construction injury increases rapidly. Taken together, the expenses in orthopedics and traumatology will inevitably increase, challenging the existed medical and health system, presenting significant financial and emotional burden on the society. To address this challenge and improve the patient＇s care, the innovation of advanced concepts, surgical skills, and novel instruments for accurate diagnostic and treatment methods in orthopedics and traumatology has become more and more vital and imperative in our country.展开更多
Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures t...Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures that meet the increased requirements are a priority in our time. X-ray examinations are of particular importance for the orthopedic and traumatological clinics, where they provide information about presence of a fracture in the patient’s body, about the concrete operation performed or about the effect of a suitable treatment. Along with their benefits X-rays have also a harmful effect. This requires special care to protect from this radiation. In this direction, research is constantly being done to improve the quality of radiation protection. Park MR, Lee KM and co-authors, compare the dose load obtained using C-arm and O-arm X-ray systems (which have the capability of combined 2D fluoroscopy and 3D computed tomography imaging). In their study, an orthopedic surgical procedure using C-arm and O-arm systems in 2D fluoroscopy modes was simulated. The radiation doses to susceptible organs of the operators were investigated. He results obtained show that the O-arm system delivered higher doses to the sensitive organs of the operator in all configurations [1]. The article of Stephen Balte briefly reviews the available technologies for measuring or estimation of patient skin dose in the interventional fluoroscopic environment, created by various X-ray equipment including C-arm systems. Given that many patients require multiple procedures, this documentation also aids in the planning of follow up visits [2]. Chong Hing Wong, Yoshihisa Kotani and co-authors evaluate the radiation exposures (RE) to the patient and surgeon during minimally invasive lumbar spine surgery with instrumentation using C-arm image intensifier or O-arm intraoperative CT. The results they get are in favor of the O-arm system [3]. The article “Virtual fluoroscopy for intraoperative C-arm positioning and radiation dose reduction” discusses positioning of an intraoperative C-arm system to achieve clear visualization of a particular anatomical feature by a system for virtual fluoroscopy (called FluoroSim) that could dramatically reduce time and received dose during the procedures. FluoroSim was found to reduce the radiation exposure required for C-arm positioning without reducing positioning time or accuracy, providing a potentially valuable tool to assist surgeons [4]. In our study, we performed practical measurements to show how the patient can be treated by applying most effective radiation protection when using a mobile C-arm X-ray system. For the study, we used exposure upon a phantom placed on the patient’s table. For an X-ray shielding, we used a protective apron with a lead equivalent of 1 mm, placed in two layers on the phantom. In each subsequent series of exposures, the protective apron was placed on the phantom, in a different position relative to the X-ray beam. The general conclusion of our study is that in order to obtain maximum protection from scattered radiation when using C-arm X-ray systems, the patient must be protected by a shielding with a suitable lead equivalent for the procedure performed which must be placed between patient’s body and X-ray tube, perpendicular to the X-ray beam pointed toward the region of interest.展开更多
背景确立手法治疗中医骨伤科领域的优势病种,将对推动手法技术和骨伤科优势专科的发展起到促进作用,但目前其评价和筛选尚缺乏基于循证医学证据的量化评价过程。目的应用证据图方法,系统梳理手法治疗中医骨伤科领域疾病的系统评价,探索...背景确立手法治疗中医骨伤科领域的优势病种,将对推动手法技术和骨伤科优势专科的发展起到促进作用,但目前其评价和筛选尚缺乏基于循证医学证据的量化评价过程。目的应用证据图方法,系统梳理手法治疗中医骨伤科领域疾病的系统评价,探索手法治疗中医骨伤科领域的优势病种。方法计算机检索Pub Med、Embase、Cochrane Library、Web of Science、中国生物医学文献服务系统、中国知网、维普网和万方数据知识服务平台,搜集手法治疗中医骨伤科领域疾病的系统评价,检索时限均为建库至2023-03-05,运用图表结合文字的方式呈现证据分布特点。结果纳入的126篇系统评价发表年限为2003—2023年,国内外相关研究数量总体呈增长趋势。方法学质量评价结果显示13篇为中等质量、64篇为低质量、49篇为极低质量。证据图显示,手法治疗中医骨伤科领域研究证据主要分布于18个临床病种包括颈椎病、腰痛、膝关节炎、腰椎间盘突出症、踝关节扭伤、肩周炎、颈源性头痛、寰枢关节半脱位、桡骨远端骨折、肱骨外上髁炎、腕管综合征、腰扭伤、脊柱侧弯、髋关节炎、纤维肌痛综合征、肌筋膜疼痛综合征、肩袖损伤、肱骨髁上骨折,呈现出有益或可能有益的效应。结论手法治疗在中医骨伤科的临床应用广泛,但由于方法学质量存在不足,并且缺乏安全性和经济性的研究证据,未来仍需多层级机构间联动合作,建立健全评价标准和体系,提高研究质量,更新研究证据,进一步探索手法在中医骨伤科领域中的优势所在。展开更多
文摘Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by him is the first extant monography on traumatology and orthopedics in China.According to the preface of the book,he had profound medical knowledge especially about the theory,diagnosis and treatment for wounds and fractures.
文摘Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.
文摘According to the latest data released by the National Bureau of Statistics, the total population of the mainland of China is 1.33 billion in 2010, including 177 million people aged 60 years or older, accounting for 13.25% of the total population, which increased to 15.53% in 2014. With the degree of growing aging population in our country, patients with musculoskeletal diseases increased greatly, which are the most common cause of severe chronic pain and physical disability among older people. Meanwhile, with the fast development of economy and industrialization in China, the number of patients of traffic injury and construction injury increases rapidly. Taken together, the expenses in orthopedics and traumatology will inevitably increase, challenging the existed medical and health system, presenting significant financial and emotional burden on the society. To address this challenge and improve the patient＇s care, the innovation of advanced concepts, surgical skills, and novel instruments for accurate diagnostic and treatment methods in orthopedics and traumatology has become more and more vital and imperative in our country.
文摘Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures that meet the increased requirements are a priority in our time. X-ray examinations are of particular importance for the orthopedic and traumatological clinics, where they provide information about presence of a fracture in the patient’s body, about the concrete operation performed or about the effect of a suitable treatment. Along with their benefits X-rays have also a harmful effect. This requires special care to protect from this radiation. In this direction, research is constantly being done to improve the quality of radiation protection. Park MR, Lee KM and co-authors, compare the dose load obtained using C-arm and O-arm X-ray systems (which have the capability of combined 2D fluoroscopy and 3D computed tomography imaging). In their study, an orthopedic surgical procedure using C-arm and O-arm systems in 2D fluoroscopy modes was simulated. The radiation doses to susceptible organs of the operators were investigated. He results obtained show that the O-arm system delivered higher doses to the sensitive organs of the operator in all configurations [1]. The article of Stephen Balte briefly reviews the available technologies for measuring or estimation of patient skin dose in the interventional fluoroscopic environment, created by various X-ray equipment including C-arm systems. Given that many patients require multiple procedures, this documentation also aids in the planning of follow up visits [2]. Chong Hing Wong, Yoshihisa Kotani and co-authors evaluate the radiation exposures (RE) to the patient and surgeon during minimally invasive lumbar spine surgery with instrumentation using C-arm image intensifier or O-arm intraoperative CT. The results they get are in favor of the O-arm system [3]. The article “Virtual fluoroscopy for intraoperative C-arm positioning and radiation dose reduction” discusses positioning of an intraoperative C-arm system to achieve clear visualization of a particular anatomical feature by a system for virtual fluoroscopy (called FluoroSim) that could dramatically reduce time and received dose during the procedures. FluoroSim was found to reduce the radiation exposure required for C-arm positioning without reducing positioning time or accuracy, providing a potentially valuable tool to assist surgeons [4]. In our study, we performed practical measurements to show how the patient can be treated by applying most effective radiation protection when using a mobile C-arm X-ray system. For the study, we used exposure upon a phantom placed on the patient’s table. For an X-ray shielding, we used a protective apron with a lead equivalent of 1 mm, placed in two layers on the phantom. In each subsequent series of exposures, the protective apron was placed on the phantom, in a different position relative to the X-ray beam. The general conclusion of our study is that in order to obtain maximum protection from scattered radiation when using C-arm X-ray systems, the patient must be protected by a shielding with a suitable lead equivalent for the procedure performed which must be placed between patient’s body and X-ray tube, perpendicular to the X-ray beam pointed toward the region of interest.
文摘背景确立手法治疗中医骨伤科领域的优势病种,将对推动手法技术和骨伤科优势专科的发展起到促进作用,但目前其评价和筛选尚缺乏基于循证医学证据的量化评价过程。目的应用证据图方法,系统梳理手法治疗中医骨伤科领域疾病的系统评价,探索手法治疗中医骨伤科领域的优势病种。方法计算机检索Pub Med、Embase、Cochrane Library、Web of Science、中国生物医学文献服务系统、中国知网、维普网和万方数据知识服务平台,搜集手法治疗中医骨伤科领域疾病的系统评价,检索时限均为建库至2023-03-05,运用图表结合文字的方式呈现证据分布特点。结果纳入的126篇系统评价发表年限为2003—2023年,国内外相关研究数量总体呈增长趋势。方法学质量评价结果显示13篇为中等质量、64篇为低质量、49篇为极低质量。证据图显示,手法治疗中医骨伤科领域研究证据主要分布于18个临床病种包括颈椎病、腰痛、膝关节炎、腰椎间盘突出症、踝关节扭伤、肩周炎、颈源性头痛、寰枢关节半脱位、桡骨远端骨折、肱骨外上髁炎、腕管综合征、腰扭伤、脊柱侧弯、髋关节炎、纤维肌痛综合征、肌筋膜疼痛综合征、肩袖损伤、肱骨髁上骨折,呈现出有益或可能有益的效应。结论手法治疗在中医骨伤科的临床应用广泛,但由于方法学质量存在不足,并且缺乏安全性和经济性的研究证据,未来仍需多层级机构间联动合作,建立健全评价标准和体系,提高研究质量,更新研究证据,进一步探索手法在中医骨伤科领域中的优势所在。
