Keywords: acupuncture body mass index osteoarthritis knee physiotherapy a b s t r a c tFrom the year 2006 to 2008, 69 patients of symptomatic osteoarthritis of the knees were divided randomly and entered into three non-operative treatment protocols. It included 4 weeks of pharmacological treatment followed by 4 weeks of specific treatments (physiotherapy, acupuncture, and combined). The pretreatment and post-treatment physical and functional statuses were evaluated. Their body mass index (BMI) was measured. The patients with below-normal BMI did not benefit from all the three treatment protocols. However, all other groups of increased BMI did benefit from all three treatment protocols in terms of pain score, analgesic sparing, and knee scores.
Studies have been conducted to evaluate the efficacy of dehydrated human amnion chorion membrane (dHACM) in treating recalcitrant diabetic foot ulcers. A literature search was performed to review the data collected from the use of dHACM allografts. Two products were explicitly named in these publications, EpiFix and AmnioBand Membrane. Relevant results included the healing rate, number of wounds healed, and number of grafts used. Data had supported the potential of lowering the overall cost to manage a wound despite a relatively higher cost per dressing. However, discrepancy was observed in the rate of healing between several of the studies. Nonetheless, dHACM had demonstrated improvement in healing of recalcitrant diabetic foot ulcers compared to standard of care alone. These results provide grounds for more inclusive research on dHACM in the future.
a b s t r a c tPurpose: This prospective study was to investigate the incidence and the fate of deep vein thrombosis (DVT) among Chinese patients following unilateral primary total knee replacement (TKR). The influence of tourniquet time and the mode of anaesthesia on DVT were evaluated. Method: 390 patients who underwent unilateral cemented primary TKR were investigated. Patients whose body-mass-index (BMI) exceeded 30kg/m 2 were given chemoprophylaxis with low molecular heparin postoperatively. DVT was diagnosed using duplex ultrasonography on 4 th to 7 th days after operation. DVT was classified into two groups, distal and proximal. Patients who had DVT on the first scan were assigned two follow-up scans. Result: The incidence of DVT was 25.7%. 97 patients (24.9%) had distal DVT, whereas 3 had proximal DVT (0.8%). Among patients with DVT, 18 (18%) of them resolved at first follow up scan, 82 persisted, and there were no proximal progression. At the 6 th week scanning, 57 patients (57%) were free from DVT, while 42 patients (42%) had persistent DVT. There was one (1%) case which the distal DVT had proximal migration, but there was no pulmonary embolism. Tourniquet time and mode of anaesthesia did not reveal any statistical significance on the incidence of DVT. Conclusion: This prospective study showed that the incidence of DVT after unilateral primary TKR in Hong Kong Chinese patient was high. However, most of them are distal to popliteal vein with low risk of proximal migration. More than half of them resolved at about two months after the operation. 中 文 摘 要 目的: 本前瞻性研究是調查本地中國籍患者接受單側全膝關節置換 (total knee replacement,TKR) 後出現深部 靜脈栓塞 (deep vein thrombosis,DVT) 的發病率和結果。止血帶使用時間和麻醉模式對 DVT 的影響也進行了 評估。 方法: 我們調查了 390 個接受 TKR 的患者。如果患者的身體質量指數 (body mass index, BMI) 超過 30 公斤/ 平方米,我們便給予低分子肝素藥物作為術後預防。我們採用術後 4 日至 7 天的多普勒超聲波來診斷 DVT。深 部靜脈栓塞被劃分成兩組:遠端和近端。患者在第一次掃描為診斷有 DVT 後,會再接受兩次後續掃描。 結果: DVT 的發生率為 25.7%。 97 例 (24.9%) 有DVT 遠端,而 3 例有近端 DVT (0.8%)。在 DVT 患者中, 18 (18%) 在第一次後續掃描時發現已經消失, 82 例依然存在,卻並沒有向近端進展。在術後第 6 週的掃描中, 57 例 (57%) DVT 已經消失, 而 42 例 (42%) 有持續性的深部靜脈栓塞。有一例 (1%) 遠端 DVT 出現向近端進展的 情況,但沒有出現肺栓塞。止血帶時間和麻醉模式對 DVT 發病率並沒有統計學上有意義的影響。 結論: 這項前瞻性研究表明,在香港中國患病者接受單側全膝關節置換後出現深部靜脈栓塞的發病率是很高 的。然而,他們大多是遠端 DVT, 近端進展的風險低。其中一半以上的 DVT 在手術後約兩個月內消失。J o u rn a l h o m e p a g e s : w w w . e -j o t r . c o m & w w w . e j o t r . o r g http://dx.
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