A high index of suspicion for BRBNS and adequate endoscopy examination will help to identify the origin of refractory IDA in older children, particularly in patients with vascular lesions of the skin.

Introduction Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach is a novel minimally invasive surgical technique for total hip arthroplasty (THA). This meta-analysis was conducted to evaluate the outcomes following THA via the SuperPATH approach in elderly patients with femoral neck fractures (FNFs), compared with those via traditional surgical approaches. Methods Eligible studies were retrieved through searching 7 electronic databases and manually screening related references. Objectives were surgical-related parameters, functional outcomes, and incidence of postoperative complications. Results 9 comparative studies were included. Pooled results suggested that at the cost of longer operative time (WMD: 14.25, 95% CI: 3.25 to 25.25), the SuperPATH technique was superior to traditional approaches regarding incision length (WMD: −4.51, 95% CI: −6.46 to −2.56), intraoperative blood loss (WMD: −80.47, 95% CI: −122.36 to −38.57), and hospital stays (WMD: −3.35, 95% CI: −5.05 to −1.65). SuperPATH groups exhibited significantly increased Harris Hip Scores within 1 month after surgery (7d, WMD: 9.85, 95% CI: 6.40 to 13.30; 14d, WMD: 10.68, 95% CI: 8.29 to 13.08; 1 month, WMD: 6.17, 95% CI: 3.56 to 8.78) and had a reduced incidence of overall complications (OR: .19, 95% CI: .09 to .41). No significant differences were found between the 2 groups regarding postoperative pain relief. Conclusion Elderly patients with FNFs are potential candidates for THA treatment via the SuperPATH technique, which is associated with improved surgical outcomes, better short-term functional recovery, and lower risk of total complications as compared to traditional approaches. Additional studies are needed to further confirm our conclusions and validate the long-term efficacy of SuperPATH.

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BackgroundThymic carcinomas (TCs) are rare aggressive tumors with no standard first‐line treatment. This study was conducted to determine the optimal chemotherapy regimen for advanced TC.MethodsThis retrospective study included 67 patients treated for stage IV TC in 2006–2015. The primary endpoints were the objective response rate (ORR) and progression‐free survival (PFS) with different chemotherapy regimens. Multivariate Cox regression analysis was used to identify factors associated with PFS, including metastatic status, radiotherapy post‐chemotherapy, primary lesion resection before chemotherapy, and chemotherapy regimen.ResultsA total of 36 patients received a paclitaxel‐platinum regimen, 31 received a gemcitabine‐platinum regimen, 14 underwent primary lesion resection, and 33 underwent radiotherapy. ORR was 31% (11/36) and 29% (9/31) in the paclitaxel‐platinum and gemcitabine‐platinum groups, respectively (P = 0.890). Median PFS, one‐year PFS rate, and two‐year PFS rate were 7.0 months, 26%, and 6% with paclitaxel‐platinum treatment and 12 months, 48%, and 24% with gemcitabine‐platinum treatment (log‐rank P = 0.030). Median PFS, one‐year PFS rate, and two‐year PFS rate were 18.0 months, 57%, and 33% with surgical resection and 7.3 months, 31%, and 7% without resection (log‐rank P = 0.030). Median PFS, one‐year PFS rate, and two‐year PFS rate were 13.0 months, 52%, and 20% with radiotherapy and 4.3 months, 22%, and 7% without radiotherapy (log‐rank P = 0.001). In multivariate analysis, metastatic status (hazard ratio [HR], 0.33, P = 0.004), surgical resection (HR, 0.32; P = 0.004), and radiotherapy (HR, 0.32; P < 0.001) were associated with superior PFS.ConclusionsBoth gemcitabine‐platinum and paclitaxel‐platinum regimens were efficacious for advanced TC. Primary lesion resection and radiotherapy may also benefit selected patients.