ABSTRACT
Survival data and prognostic factors may help to provide insight when deciding on the appropriate orthopaedic treatment for patients presenting with metastatic bone disease. This review was conducted to look at the outcomes following orthopaedic surgery for metastatic lesions in the extremities. The literature was identified through the Medline and Embase database and further refined via a set of inclusion and exclusion criteria. Overall, patients presenting with metastatic bone disease from renal cell cancer or breast cancer had the longest survival rate. Important factors found to predict prognosis was the presence of visceral metastasis, multiple metastases, pathological fracture and the type of primary tumour involved. These prognostic factors may help to direct future inquiry into metastatic bone disease and help determine the type of surgery to use in a metastatic setting in order to avoid complications and unnecessary revisions as well as provide durability.
Subject(s)
Bone Neoplasms/surgery , Carcinoma, Hepatocellular/surgery , Carcinoma, Renal Cell/surgery , Fractures, Spontaneous/surgery , Orthopedic Procedures/methods , Bone Neoplasms/complications , Bone Neoplasms/mortality , Bone Neoplasms/secondary , Breast Neoplasms/mortality , Breast Neoplasms/pathology , Carcinoma/complications , Carcinoma/mortality , Carcinoma/secondary , Carcinoma/surgery , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/secondary , Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell/mortality , Carcinoma, Renal Cell/secondary , Extremities , Female , Fractures, Spontaneous/etiology , Fractures, Spontaneous/prevention & control , Humans , Kidney Neoplasms/mortality , Kidney Neoplasms/pathology , Liver Neoplasms/mortality , Liver Neoplasms/pathology , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Mortality , Prognosis , Prostatic Neoplasms/mortality , Prostatic Neoplasms/pathology , Survival Rate , Thyroid Neoplasms/mortality , Thyroid Neoplasms/pathology , Treatment OutcomeABSTRACT
Seventeen patients 2.5 to 20 years old with neurovesical dysfunction (10 myelomeningocele, 2 lipomeningocele, 2 spinal cord injury, 2 primary tethered spinal cord, 1 transverse myelitis) completed a total of 41 series (605 individual sessions) of transurethral electrical bladder stimulation. Ultimately, all patients demonstrated detrusor contraction during therapy, and 88% had sensation of contractions, usually developing later in therapy. Of 12 patients with carefully documented serial urodynamic studies 8 (67%) demonstrated a measurable (14 to 158%) increase in bladder capacity but 3 subsequently had capacities near baseline. Two patients demonstrated long-term improvement in fecal continence but none had voluntary control of micturition.
Subject(s)
Electric Stimulation Therapy , Urinary Bladder, Neurogenic/therapy , Urinary Bladder/physiopathology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Muscle Contraction , Urinary Bladder, Neurogenic/physiopathology , UrodynamicsABSTRACT
Since 1970, 19 persons with the r'r' phenotype have been detected at the Auckland Blood Transfusion Centre. All have been Maoris or Pacific Islanders. This study reports the detailed serological investigations on 11 r'r' samples. No evidence was found for the presence of the Du antigen, and there was no evidence that the Polynesian r' was related to the Negroid r'. It is postulated that the r' (Cde) of Polynesians arose from a mutation of CDe. No morphological abnormalities of r'r' red cells were found. Blood samples were also tested for various high- and low-frequency antigens, and one specimen was found to be r'r' Jk(a-b-).
