Comparison of compression plate and flexible intramedullary nail fixation in pediatric femoral shaft fractures

The purpose of this study was to compare the results of compression plating and flexible intramedullary nailing for pediatric femoral shaft fractures. Thirty-eight consecutive patients with 40 femoral shaft fractures were evaluated. Twenty-two femoral segments were treated with a compression plate and 18 femoral segments were treated with flexible intramedullary nailing. The time to healing, operation time and complications were evaluated. The average operation time was statistically significantly shorter in the nailing group (P=0.039). Four implant failures occurred in the compression plate group whereas one non-union was observed in the flexible nailing group. Flexible intramedullary nailing seems to provide a high union rate with a shorter operation time when compared with plate fixation

The Influence of Class III Obesity on Subarachnoid Depth of Turkish Parturient: A Prospective Observational Study

Introduction: This observational study aimed to investigate the effects of morbid obesity on the subarachnoid depth and spinal anaesthesia technique

The Influence of Class III Obesity on Subarachnoid Depth of Turkish Parturient: A Prospective Observational Study

Seyhan, Tulay Ozkan/0000-0002-7070-8827WOS: 000535666500001Introduction: This observational study aimed to investigate the effects of morbid obesity on the subarachnoid depth and spinal anaesthesia technique. Methods: Sixty American Society of Anesthesiologists Classification II women with term pregnancy who were candidates for elective caesarean section under spinal anaesthesia were enrolled in this prospective, observational study. Only patients with a Body Mass index (BMI) of = 40 kg/m(2) (obesity group) were included in the study. Spinal anaesthesia was performed in the sitting position via a midline approach at either L3-4 or L4-5 level by using a 25G 90-mm Quincke spinal needle with an introducer. Demographic data of the parturient, visual characteristics of the lumbosacral region, palpation of landmarks, depth of the spine, technical characteristics of the block, time of block performance and satisfaction of patients were recorded. Results: the spinal depth of the control and obesity groups were 51.7 +/- 4.4 and 69 +/- 10.4 mm, respectively (p<0.001). Although needle change was not necessary for any of the patients in the control group, a 120-mm long needle change was required in six patients in the obesity group (p<0.024). We found that the incidence of patients with landmarks that were difficult to palpate was higher in the obesity group, and significantly increased attempt number, skin puncture and needle pass were also required in this group. Conclusion: Anaesthesiologists should be prepared for a longer attempt in patients with obesity but should not be discouraged as the increase in the number of attempts or prolonged initiation time of spinal anaesthesia was not associated with patient dissatisfaction or discomfort

Retrospective review of modified dose docetaxel, cisplatin, and 5-flourouracil (DCF) for the treatment of first-line metastatic gastric carcinomas.

e15175 Background: Docetaxel, cisplatin, and 5FU (DCF) has been shown to be an effective regimen for metastatic gastric carcinomas. However, treatment-related adverse events is quite high with original dose DCF. We evaluated the outcomes of the metastatic gastric carcinomas who treated with modified dose DCF (mDCF) in our institution. Methods: A single institution retrospective review of patients with metastatic gastric cancer treated with three weekly mDCF from 1/2006 to 1/2013 was evaluated. Over this time period a standard order-set was in place in which cisplatin 60 mg/m2, 5FU 600 mg/m2 and docetaxel 60 mg/m2 was given three weekly. Tumor response was calculated retrospectively using RECIST criteria. Results: One hundred and ninety-one patients were included the study. The median age was 55 years (23 to 76), 74% were male, and 82% were chemo-naive. Eighty percent of the patients were metastatic at the time of diagnosis. The median number of cycles administered was 6 (2-10). Hematological toxicity was mild with grade 3/4 granulocytopenia in 25% of the patients, grade 3/4 thrombocytopenia in 4% of the patients, and grade 3/4 anemia in 9% of the patients. Neutropenic infection occurred in 9 (%5) patients. Grade 3/4 nausea/vomiting was reported by 10% of the patients, and diarrhea by 7%. A total of 19 (10%) patients had dose delays or dose reductions related to toxicity. Six (3%) patients had complete response and 43 (23%) patients had partial response. Stable disease were occurred in 83 (45%) patients and 56 (23%) progressive disease. Ninety percent of the patients have died with median follow-up of 8 months. Progression-free survival was 7 months (95% CI 6 to 7.8 m) and overall survival was 10 months (95% CI 8.7 to 11.2 m). Conclusions: mDCF has mild hematological toxicity and overall excellent tolerance in first line metastatic gastric cancer patients. Response rate and the survival of these patients with a minimal toxicity are comparable with the original dose DCF. </jats:p

Effect of ozone and methylprednisolone treatment following crush type sciatic nerve injury

PURPOSE: To assess and compare the histopathological effects of ozone therapy and/or methylprednisolone (MPS) treatment on regeneration after crush type sciatic nerve injury