bilateral

双边
  • 文章类型: Case Reports
    疱疹性上皮性角膜炎是由单纯疱疹病毒(HSV)引起的角膜病毒感染。它通常表现为单侧疾病。双侧受累是疱疹性上皮性角膜炎的罕见表现,只占病例的一小部分。通过分享这个案例,我们的目标是有助于了解双侧疱疹性上皮性角膜炎,并促进该领域的进一步研究,以优化患者护理和结果一个13岁的儿童,一个已知的过敏病例,因疼痛而被送到眼科诊所,畏光,右眼发红(OD)三天。患者被诊断为双侧疱疹性上皮性角膜炎;他开始每天四次莫西沙星滴眼液,Artelac(透明质酸钠)每两小时,卡波姆HS,更昔洛韦软膏每天五次。双侧疱疹性上皮性角膜炎是HSV感染的罕见表现,与单侧疾病相比,其管理带来了独特的挑战。双侧疱疹性上皮性角膜炎的诊断主要基于临床表现。包括角膜上的双侧树突状或地理溃疡。荧光素染色是观察角膜溃疡的有价值的工具。在我们的案例中,尽管关于双侧疱疹性上皮性角膜炎的文献有限,但在没有明显前房炎症的情况下,双侧树突状溃疡的存在支持了双侧疱疹性上皮性角膜炎的诊断,管理原则与单侧疾病的原则保持一致.早期识别,迅速开始抗病毒治疗,密切的后续行动对于成功的结果至关重要。
    Herpetic epithelial keratitis is a viral infection of the cornea caused by the herpes simplex virus (HSV). It typically presents as a unilateral disease. Bilateral involvement is a rare manifestation of herpetic epithelial keratitis, accounting for only a small percentage of cases. By sharing this case, we aim to contribute to the understanding of bilateral herpetic epithelial keratitis and stimulate further research in this area to optimize patient care and outcomes A 13-year-old child, a known case of atopy, presented to the ophthalmology clinic with a complaint of pain, photophobia, and redness in the right eye (OD) for three days. The patient was diagnosed as a case of bilateral herpetic epithelial keratitis; he was started on moxifloxacin eye drops four times a day, Artelac (sodium hyaluronate) every two hours, carbomer HS, ganciclovir ointment five times per day. Bilateral herpetic epithelial keratitis is a rare manifestation of HSV infection, and its management poses unique challenges compared to unilateral disease. The diagnosis of bilateral herpetic epithelial keratitis is primarily based on clinical findings, including bilateral dendritic or geographic ulcers on the cornea. Fluorescein staining is a valuable tool for visualizing corneal ulcers. In our case, the presence of bilateral dendritic ulcers in the absence of significant anterior chamber inflammation supported the diagnosis of bilateral herpetic epithelial keratitis Despite the limited literature on bilateral herpetic epithelial keratitis, the principles of management remain consistent with those of unilateral disease. Early recognition, prompt initiation of antiviral therapy, and close follow-up are crucial for successful outcomes.
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  • 文章类型: Case Reports
    先兆子痫,一种复杂的多系统疾病,主要影响肾脏和肝脏,通过孕妇的高血压和器官功能障碍表现出来。先兆子痫也可引起眼部体征,但它们并不常见。渗出性视网膜脱离(ERD)是一种不寻常但危险的后果。本研究提供了在经历先兆子痫时经历渗出性视网膜脱离的患者的全面临床描述和治疗。一名28岁的沙特女性,没有病史或手术史,由于严重先兆子痫和引产失败,接受了紧急剖宫产(CS)。病人抱怨无痛的视力模糊,从分娩白天开始,中央黑斑和视力下降。该患者被送往医院进行血压监测和进一步调查。患者开始静脉注射肼屈嗪(IV)和拉贝洛尔PO以控制BP。该患者因引产失败后出现重度子痫前期,经剖宫产分娩,产后四周她的视力得到了改善。作为先兆子痫的结果的视网膜脱离是保守的管理,预后普遍良好。以前的研究一直强调多学科方法的重要性,促进产科医生和眼科医生之间的合作。这种协作策略不仅确保全面的护理,而且有助于早期发现,及时干预,并改善了妊娠期间影响孕产妇健康和眼科健康的疾病的管理结果。
    Preeclampsia, a complex multisystem disorder predominantly impacting the kidneys and liver, manifests through hypertension and organ dysfunction in expectant mothers. Preeclampsia can also cause ocular signs, but they are uncommon. Exudative retinal detachment (ERD) is one such unusual but dangerous consequence. A thorough clinical description and therapy of a patient who experienced exudative retinal detachment while experiencing preeclampsia are provided in this study. A 28-year-old Saudi female, with no medical or surgical history, underwent an emergency cesarean section (CS) due to severe preeclampsia and failed induction of labor. The patient complained of painless blurry vision, with central dark spot and decreased vision starting from labor daytime. The patient was admitted to the hospital for blood pressure monitoring and further investigations. The patient was started on hydralazine intravenous (IV) and labetalol PO to control BP. The patient was delivered by cesarean section for preeclampsia with severe features after the failure of labor induction, and she had improved her vision by four weeks postpartum. Retinal detachment as a consequence of preeclampsia is conservatively managed, with a generally favorable prognosis. Previous studies have consistently emphasized the critical importance of a multidisciplinary approach that fosters collaboration between obstetricians and ophthalmologists. This collaborative strategy not only ensures comprehensive care but also facilitates early detection, timely intervention, and improved management outcomes for conditions affecting both maternal health and ophthalmic well-being during pregnancy.
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  • 文章类型: Journal Article
    喉头膨出,充满空气的喉室阑尾的异常扩张,是一种罕见的情况,主要是单方面出现。然而,双边事件极为罕见。在这篇文章中,我们介绍了一例双侧喉膨出的病例,并进行了全面的文献综述。一名57岁男性出现呼吸困难,stridor,和双侧颈部肿块。他的病史包括慢性咳嗽和间歇性声音嘶哑。在三个月的时间里,颈部肿块逐渐扩大,导致呼吸窘迫.有趣的是,他否认经历过减肥,食欲下降,或发烧。临床检查显示相当大,颈部两侧柔软的肿块,阻塞淋巴结评估。计算机断层扫描(CT)成像证实存在左合并喉囊肿和右合并喉囊肿。随后,患者接受了气管造口术。良性活检结果排除恶性肿瘤。双侧喉癌的手术切除导致了顺利的恢复。“喉癌”一词由Virchow于1867年引入,用于描述与Morgagni心室相关的囊的异常扩张。诊断涉及全面的病史,体检,和放射成像,尤其是CT,将喉癌与其他疾病区分开来。通常无症状,它们通常在50岁左右偶然发现,尽管声音变化或呼吸困难等症状可能会出现。对文献的审查确定了77起记录在案的案件,主要是男性,表现出各种症状和治疗方式。该病例强调了双侧合并喉膨出的罕见性,强调及时诊断和手术干预以获得良好结果的重要性。综合研究揭示了不同的临床方面,强调继续调查以加强管理策略的必要性。
    Laryngocele, an abnormal dilation of the appendix of the laryngeal ventricle filled with air, is a rare condition predominantly presenting unilaterally. However, bilateral occurrences are exceedingly rare. In this article, we present a case of bilateral laryngocele along with a comprehensive literature review. A 57-year-old male presented with dyspnea, stridor, and bilateral neck masses. His medical history included chronic cough and intermittent hoarseness. Over a 3 month period, the neck masses progressively enlarged, resulting in respiratory distress. Interestingly, he denied experiencing weight loss, decreased appetite, or fever. Clinical examination revealed sizable, soft masses on both sides of the neck, obstructing lymph node assessment. Computed tomography (CT) imaging confirmed the presence of a left combined laryngopyocele and a right combined laryngocele. Subsequently, the patient underwent tracheostomy. Benign biopsy results excluded malignancy. Surgical excision of bilateral laryngoceles resulted in an uneventful recovery. The term \"laryngocele\" was introduced by Virchow in 1867 to describe the abnormal dilation of the saccule associated with Morgagni\'s ventricle. Diagnosis involves a thorough patient history, physical examination, and radiological imaging, notably CT, to differentiate laryngoceles from other conditions. Typically asymptomatic, they are often incidentally discovered around age 50, although symptoms such as voice changes or breathing difficulties can manifest. A review of the literature identified 77 documented cases, primarily in males, exhibiting various symptoms and treatment modalities. This case underscores the rarity of bilateral combined laryngocele, emphasizing the importance of timely diagnosis and surgical intervention for favorable outcomes. Comprehensive research reveals diverse clinical aspects, highlighting the necessity for continued investigation to enhance management strategies.
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  • 文章类型: Journal Article
    为了汇编有关双侧肩关节前脱位(BASD)的现有文献并分析患者的人口统计学,损伤机制,损伤特征,管理,和结果。
    本系统评价按照系统评价和荟萃分析(PRISMA)指南的首选报告项目进行。在线数据库,包括OvidMedline1946-,Embase.com1947-,Scopus1960-,CochraneCentral,和Clinicaltrials.gov被系统地查询。符合纳入条件的研究是病例报告或病例系列,记录BASD。两名评审员独立筛选并将一组先验排除标准应用于每个返回的研究。数据被提取,编译,并从每例报告的BASD病例中合成。应急表/卡方分析,T-tests,进行单变量回归分析以评估不同变量之间的关系。
    纳入81项研究(87例BASD)。患者年龄为41.1(SD±19.5)岁,大多数为男性(n=63;72.4%)。大约四分之一的患者(28.7%)有癫痫/癫痫发作史或正在接受治疗。年轻男性更容易因癫痫发作或触电而患BASD(P<0.05)。近三分之一的病例(n=27;31.0%)延迟出现。那些持续发作或触电的患者更有可能延迟出现(P=0.013)。大多数事件导致简单的位错,这些位错被成功闭合。癫痫发作或电击导致的BASD更可能是骨折脱位(P=0.018);在年轻的骨折脱位患者中,闭合复位失败或不尝试的频率更高(P<0.05)。中位随访时间为6个月(IQR:3个月-12个月)。7例患者(10.6%)出现并发症,4例(2.3%)出现复发性不稳定。
    在没有已知创伤的情况下出现BASD的年轻男性中,对惊厥事件的怀疑应该很高。在已知的癫痫患者中,出现慢性双侧肩或手臂疼痛,应考虑BASD,并应加快检查以避免误诊。
    UNASSIGNED: To compile the existing literature on bilateral anterior shoulder dislocation (BASD) and analyze patient demographics, mechanisms of injury, injury characteristics, management, and outcome.
    UNASSIGNED: This systematic review was conducted in accordance with Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) guidelines. Online databases, including Ovid Medline 1946-, Embase.com 1947-, Scopus 1960-, Cochrane Central, and Clinicaltrials.gov were systematically queried. Studies eligible for inclusion were case reports or case-series, documenting BASD. Two reviewers independently screened and applied a set of a priori exclusion criteria to each returned study. Data were extracted, compiled, and synthesized from each reported case of BASD. Contingency tables/Chi-Square Analyses, T-tests, and univariate regression analyses were conducted to assess relationships between different variables.
    UNASSIGNED: Eighty-one studies (87 cases of BASD) were included. Patients were 41.1 (SD± 19.5) years old and most were male (n=63; 72.4%). Around a quarter of patients (28.7%) had a history of epilepsy/seizures or were being worked-up for such. Younger males were more likely to have BASD due to a seizure or electrocution (P<0.05). Close to a third of cases (n=27; 31.0%) were delayed in presentation. Those sustaining seizures or electrocutions were more likely to be delayed in presentation (P=0.013). Most events resulted in simple dislocations that were closed reduced successfully. BASD resulting from seizures or electrocutions were more likely to be fracture-dislocations (P=0.018); and in younger patients with fracture-dislocations, closed reduction was more often to fail or not be attempted (P<0.05). Median follow-up was 6 months (IQR: 3 months - 12 months). Seven patients (10.6%) had complications and 4 (2.3%) demonstrated recurrent instability.
    UNASSIGNED: In young males presenting with BASD without known trauma, suspicion should be high for a convulsant event. In patients with a known seizure disorder who present with chronic bilateral shoulder or arm pain, BASD should be considered and work-up should be expedited to avoid misdiagnosis.
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  • 文章类型: Journal Article
    目的:全面检查双侧突发性感音神经性耳聋(BSSHL)及其亚型与单侧突发性感音神经性耳聋(USSHL)的特征和预后。
    方法:PubMed,Scopus,和CINAHL。
    方法:从开始到2023年12月5日检索数据库,研究报告BSSHL及其同时亚型(Si-BSSHL)和序贯亚型(Se-BSSHL)的患者特征和听力测定结果。连续测量的荟萃分析,比例(%),平均差(Δ),进行比值比(OR)。
    结果:纳入了11项研究,由368例BSSHL患者和2,705例USSHL患者组成。所有SSHL病例的合并患病率USSHL为88.1%(95%CI:81.2%-93.6%),BSSHL为11.9%(95%CI:6.4%-18.8%)。与USSHL患者相比,BSSHL患者接受类固醇治疗后的PTA改善明显更差(Δ15.3dB;95%CI:14.6至15.9;p<0.0001)。BSSHL亚型之间的治疗后PTA改善没有显着差异。Si-BSSHL患者具有特发性病因的可能性显着降低(OR:0.4;95%CI:0.2至0.8;p=0.01),并且具有自身免疫性疾病病因的可能性显着增加(OR:27.4;95%CI:2.2至336.1;p=0.01),心血管疾病合并症(OR:2.3;95%CI:1.1至5.1;p=0.03),与USSHL患者相比,高血压合并症(OR:2.5;95%CI:1.6至3.8;p<0.0001)。
    结论:与USSHL相比,BSSHL是一种罕见的SSHL,预后较差。BSSHL,特别是Si-BSSHL,与USSHL相比,与全身病理的相关性明显更大。喉镜,2024.
    OBJECTIVE: To comprehensively examine the characteristics and prognosis of bilateral sudden sensorineural hearing loss (BSSHL) and its subtypes compared to unilateral sudden sensorineural hearing loss (USSHL).
    METHODS: PubMed, Scopus, and CINAHL.
    METHODS: Databases were searched from inception to December 5, 2023, for studies reporting patient characteristics and audiometric outcomes for BSSHL and its simultaneous (Si-BSSHL) and sequential (Se-BSSHL) subtypes. Meta-analysis of continuous measures, proportions (%), mean differences (Δ), and odds ratio (OR) were performed.
    RESULTS: Eleven studies were included, consisting of 368 patients with BSSHL and 2,705 patients with USSHL. The pooled prevalence among all SSHL cases was 88.1% (95% CI: 81.2%-93.6%) for USSHL and 11.9% (95% CI: 6.4% to 18.8%) for BSSHL. PTA improvement following treatment with steroids was significantly worse in patients with BSSHL (Δ15.3 dB; 95% CI: 14.6 to 15.9; p < 0.0001) compared to patients with USSHL. There was no significant difference in post-treatment PTA improvement between the BSSHL subtypes. Patients with Si-BSSHL were significantly less likely to have an idiopathic etiology (OR: 0.4; 95% CI: 0.2 to 0.8; p = 0.01) and significantly more likely to have an autoimmune disease etiology (OR: 27.4; 95% CI: 2.2 to 336.1; p = 0.01), comorbid cardiovascular disease (OR: 2.3; 95% CI: 1.1 to 5.1; p = 0.03), and comorbid hypertension (OR: 2.5; 95% CI: 1.6 to 3.8; p < 0.0001) compared to patients with USSHL.
    CONCLUSIONS: BSSHL is a considerably rarer form of SSHL with worse prognosis compared to USSHL. BSSHL, and Si-BSSHL in particular, has significantly greater associations with systemic pathologies compared to USSHL. Laryngoscope, 2024.
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  • 文章类型: Case Reports
    Coloboma在希腊语中表示缩减。它主要用于自出生以来眼睛或其他器官的正常组织不存在时。结肠瘤是一种先天性异常,主要是由眼睛脉络膜部分的胚胎裂隙不完全闭合引起的。
    本病例报告的目的是分享一名双侧虹膜缺损患者的临床发现,低视力,和头痛。
    病例报告。
    一名患有低视力和头痛的11岁男孩前往喀布尔医科大学大学眼科医院(UEHKUMS)进行咨询。眼科检查发现双侧虹膜缺损,无脉络膜视网膜缺损,屈光不正,和双眼的高眼压。患者的屈光不正通过建议适当的眼镜来矫正,高眼压通过抗青光眼滴剂控制。经过多次跟踪访问,患者不再抱怨头痛和低视力。
    对于虹膜缺损患者,应考虑进行眼压(IOP)检查,对其他家庭成员进行筛查是强制性的。
    UNASSIGNED: Coloboma means curtailed in Greek language. It is mainly used when normal tissue of the eye or another organ is not present since birth. Coloboma is a congenital abnormality mainly caused by incomplete closure of the embryonic fissure of the choroid part of eye.
    UNASSIGNED: The aim of this case report is to share the clinical findings in a patient with bilateral iris coloboma, low vision, and headache.
    UNASSIGNED: Case report.
    UNASSIGNED: An eleven-year-old boy with low vision and headache visited the University Eye Hospital of Kabul University of Medical Science (UEHKUMS) for consultation. Ophthalmic examination revealed a bilateral iris coloboma without concomitant chorioretinal defect, refractive error, and high intraocular pressure in both eyes. The refractive error of the patient was corrected by advising proper glasses, and the high intraocular pressure was controlled by anti-glaucoma drops. After several follow-up visits, the patient no longer complained of headache and low vision.
    UNASSIGNED: Visiting patients with iris coloboma should be considered for intraocular pressure (IOP) check, and screening of other family members is mandatory.
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  • 文章类型: Journal Article
    全膝关节置换术是最常见的骨科手术之一。同时进行的双侧膝关节置换术涉及在一次麻醉中对两个膝盖进行全膝关节置换术。这项系统评价和荟萃分析遵循了2020年系统评价和荟萃分析首选报告项目的指南。主要搜索是使用PubMed,EBSCO,Scopus,WebofScience,Clarivate,和谷歌学者数据库。使用MedCalc®统计软件20.115版进行定量数据合成,以确定同时接受双侧膝关节置换术的患者感染的合并患病率。纽卡斯尔-渥太华量表用于评估研究质量。我们在定量数据综合中纳入了30项研究,总人口118,502名患者(237,004膝盖)。合并的浅表感染患病率,深部感染,未指明手术部位感染估计为0.86%(95%置信区间:0.62-1.13%),0.84%(95%置信区间:0.64-1.05%),和1.18%(95%置信区间:0.45-2.27%),分别。在所有分析中都存在显著的异质性(I2>50%),漏斗图的检查显示了绘制数据的对称分布。我们发现,同时双侧膝关节置换术后的感染率相对较低,但不均匀,因为数据显示出明显的变异性。浅表感染比深部感染更常见;然而,他们的患病率差异很小。此外,由于显著的异质性,我们研究结果的可靠性有限.
    Total knee arthroplasty is one of the most common orthopedic procedures. Simultaneous bilateral knee arthroplasty involves performing total knee arthroplasty on both knees in a single anesthetic session. This systematic review and meta-analysis followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. A primary search was performed using PubMed, EBSCO, Scopus, Web of Science, Clarivate, and Google Scholar databases. Quantitative data synthesis was performed using MedCalc® Statistical Software version 20.115 to determine the pooled prevalence of the infection among patients who underwent simultaneous bilateral knee arthroplasty. The Newcastle-Ottawa Scale was used to assess study quality. We included 30 studies in our quantitative data synthesis, with a total population of 118,502 patients (237,004 knees). The pooled prevalence of superficial infection, deep infection, and unspecified surgical site infection was estimated to be 0.86% (95% confidence interval: 0.62-1.13%), 0.84% (95% confidence interval: 0.64-1.05%), and 1.18% (95% confidence interval: 0.45-2.27%), respectively. There was significant heterogeneity (I2 >50%) in all analyses, and inspection of funnel plots revealed a symmetrical distribution of plotted data. We found that the infection rates following simultaneous bilateral knee arthroplasty were relatively low but heterogeneous, as the data showed marked variability. Superficial infections were more common than deep infections; however, there was a small difference in their prevalence. Furthermore, the reliability of our findings was limited owing to significant heterogeneity.
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  • 文章类型: Case Reports
    此病例报告介绍了一例罕见的成人隐睾病例,偶然发现于一位25岁的绅士,他最初表现为腹部和耻骨上疼痛,并成功进行了分阶段的睾丸固定术。据我们所知,到目前为止,我们的病例是首次在成人出现非特异性耻骨上疼痛的双侧隐睾病例.隐睾是新生儿最常见的生殖器异常,由于它与不孕和恶性肿瘤的风险增加有关,目前的管理包括12至18个月的寿命内进行睾丸固定术的手术矫正。由于早期干预,成人隐睾的表现非常不寻常;因此,双侧隐睾更为罕见。因此,目前的指南没有解决成人隐睾的适当管理。因此,在对当代隐睾管理指南的文献进行了全面审查之后,我们的目标是强调我们在这种罕见的成人双侧隐睾病例中的管理方法。我们建议双侧睾丸切除术是最安全的选择,如果病人是可以接受的,或双侧睾丸固定术,长期随访睾丸癌。尽管美国泌尿外科协会的指南建议对青春期后隐睾患儿进行睾丸切除术,目前,对于治疗成人隐睾的首选方法,目前尚无明确的指南.由于隐睾不孕和睾丸癌的风险增加,在某些情况下,睾丸切除术代替睾丸固定术可能是首选的手术方法。尽管如此,在双侧隐睾的情况下,睾丸切除术可能并不总是最可行的解决方案,使睾丸固定术与睾丸癌的长期随访成为最佳选择,就像我们的情况一样。
    This case report presents a rare case of adult cryptorchidism, found incidentally in a 25-year-old gentleman who initially presented with abdominal and suprapubic pain and was successfully treated with staged orchidopexy. To our knowledge, to date, our case is the first published instance of bilateral cryptorchidism in an adult presenting with nonspecific suprapubic pain. Cryptorchidism is the most common genital abnormality in newborn boys, and due to its association with an increased risk of infertility and malignancy, current management involves surgical correction with orchidopexy by 12 to 18 months of life. Adult presentation of cryptorchidism is very unusual due to early intervention; therefore, bilateral cryptorchidism is even more rare. As a result, current guidelines do not address proper management for adult cryptorchidism. Therefore, after performing a thorough review of the literature on contemporary guidelines for cryptorchidism management, we aim to highlight our approach to management in this rare case of adult bilateral cryptorchidism. We suggest bilateral orchiectomy as the safest option, if the patient is amendable, or bilateral orchiopexy with long-term follow-up for testicular cancer. Although the American Urological Association guidelines recommend orchiectomy for postpubertal cryptorchid children, currently, no explicit guidelines exist for the preferred method of managing adult cryptorchidism. Due to the increased risk of infertility and testicular cancer with cryptorchidism, orchiectomy instead of orchiopexy may be the preferred surgical approach in some instances. Still, in the case of bilateral cryptorchidism, orchiectomy may not always be the most viable solution, making orchiopexy with long-term follow-up for testicular cancer the best option, such as in our case.
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  • 文章类型: Journal Article
    背景:发育性髋关节发育不良(DDH)影响1-3%的新生儿,20%的病例是双侧的。支持失败的双侧DDH患者的最佳手术管理策略,封闭还原或使用这些方法太晚尚不清楚。内侧入路切开复位(MAOR)和前路切开复位(AOR)都有支持者;然而,几乎没有证据可以说明这场辩论。
    方法:我们将根据系统评价和荟萃分析方案的首选报告项目进行系统评价。我们将搜索医学和科学数据库,包括灰色和难以定位的文献。医学主题词“髋关节发育不良”,“先天性髋关节发育不良”,“先天性髋关节脱位”,“发育性髋关节脱位”,和它们的缩写,将使用“DDH”和“CDH”,以及限定词“双边”。评审员将独立筛选纳入的记录,然后独立提取研究设计的数据,人口特征,手术干预和结果的详细信息来自选定的记录。如果可能,将合成数据并进行荟萃分析。如果不可能,我们将根据没有荟萃分析指导的系统评价分析数据。所有研究都将评估偏倚风险。对于每个结果指标,将在表格中列出调查结果摘要,并使用“建议评估发展和评估”方法评估建议的总体质量。
    结论:对保守治疗失败的双侧DDH患者进行MAOR或AOR的决定,目前的文献并不十分清楚。高品质,对这一患者人群进行比较研究非常具有挑战性,而且可能非常罕见.系统评价为双侧DDH手术管理提供尽可能高质量的证据提供了最佳机会。
    背景:该方案已在国际前瞻性系统审查注册(PROSPEROIDCRD42022362325)中注册。
    BACKGROUND: Developmental dysplasia of the hip (DDH) affects 1-3% of newborns and 20% of cases are bilateral. The optimal surgical management strategy for patients with bilateral DDH who fail bracing, closed reduction or present too late for these methods to be used is unclear. There are proponents of both medial approach open reduction (MAOR) and anterior approach open reduction (AOR); however, there is little evidence to inform this debate.
    METHODS: We will perform a systematic review designed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. We will search the medical and scientific databases including the grey and difficult to locate literature. The Medical Subject Headings \"developmental dysplasia of the hip\", \"congenital dysplasia of the hip\", \"congenital hip dislocation\", \"developmental hip dislocation\", and their abbreviations, \"DDH\" and \"CDH\" will be used, along with the qualifier \"bilateral\". Reviewers will independently screen records for inclusion and then independently extract data on study design, population characteristics, details of operative intervention and outcomes from the selected records. Data will be synthesised and a meta-analysis performed if possible. If not possible we will analyse data according to Systematic Review without Meta-Analysis guidance. All studies will be assessed for risk of bias. For each outcome measure a summary of findings will be presented in a table with the overall quality of the recommendation assessed using the Grading of Recommendations Assessment Development and Evaluation approach.
    CONCLUSIONS: The decision to perform MAOR or AOR in patients with bilateral DDH who have failed conservative management is not well informed by the current literature. High-quality, comparative studies are exceptionally challenging to perform for this patient population and likely to be extremely uncommon. A systematic review provides the best opportunity to deliver the highest possible quality of evidence for bilateral DDH surgical management.
    BACKGROUND: The protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO ID CRD42022362325).
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  • 文章类型: Systematic Review
    目的:回顾当天双侧注射抗VEGF的眼内炎风险。
    方法:我们检索了12个关于当天双侧玻璃体内注射抗VEGF后眼内炎风险的研究文献。数据提取由两位作者独立进行,然后进行讨论,直到达成共识。
    结果:共纳入17项研究,在至少7579例患者中给予138,478次玻璃体内抗VEGF注射(69,239次双侧注射)。总的来说,发生眼内炎33例,没有病例是双边的。在整个研究中,每次玻璃体内注射的眼内炎发生率为0-0.53%。
    结论:我们建议临床医生可以考虑对需要双侧玻璃体腔注射抗VEGF治疗的患者的双眼进行同一天治疗,但需要更大规模的研究来量化眼内炎的确切风险.
    OBJECTIVE: To review the risk of endophthalmitis in same-day bilateral anti-VEGF injections.
    METHODS: We searched 12 literature databases for studies on the risk of endophthalmitis after same-day bilateral intravitreal anti-VEGF injections. Data extraction was made independently by two authors and discussed afterward until reaching consensus.
    RESULTS: Seventeen studies were included with a total of 138,478 intravitreal anti-VEGF injections (69,239 bilateral injections sessions) given in at least 7579 patients. In total, 33 cases of endophthalmitis had occurred, and no cases were bilateral. The incidence of endophthalmitis ranged from 0 to 0.53% per intravitreal injection across studies.
    CONCLUSIONS: We suggest that clinicians can consider same-day treatment of both eyes of patients in need of bilateral intravitreal anti-VEGF injection therapy, but larger studies are needed to quantify the exact risk of endophthalmitis.
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