Browsing by Subject "CONSERVATIVE TREATMENT"

Sort by: Order: Results:

Now showing items 1-4 of 4
  • Shaw, Vanessa; Polderman, Nonnie; Renken-Terhaerdt, Jose; Paglialonga, Fabio; Oosterveld, Michiel; Tuokkola, Jetta; Anderson, Caroline; Desloovere, An; Greenbaum, Laurence; Haffner, Dieter; Nelms, Christina; Qizalbash, Leila; Vande Walle, Johan; Warady, Bradley; Shroff, Rukshana; Rees, Lesley (2020)
    Dietary management in pediatric chronic kidney disease (CKD) is an area fraught with uncertainties and wide variations in practice. Even in tertiary pediatric nephrology centers, expert dietetic input is often lacking. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, was established to develop clinical practice recommendations (CPRs) to address these challenges and to serve as a resource for nutritional care. We present CPRs for energy and protein requirements for children with CKD stages 2-5 and those on dialysis (CKD2-5D). We address energy requirements in the context of poor growth, obesity, and different levels of physical activity, together with the additional protein needs to compensate for dialysate losses. We describe how to achieve the dietary prescription for energy and protein using breastmilk, formulas, food, and dietary supplements, which can be incorporated into everyday practice. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgment. Research recommendations have been suggested. The CPRs will be regularly audited and updated by the PRNT.
  • Chirica, Mircea; Kelly, Michael D.; Siboni, Stefano; Aiolfi, Alberto; Riva, Carlo Galdino; Asti, Emanuele; Ferrari, Davide; Leppäniemi, Ari; ten Broek, Richard P. G.; Brichon, Pierre Yves; Kluger, Yoram; Fraga, Gustavo Pereira; Frey, Gil; Andreollo, Nelson Adami; Coccolini, Federico; Frattini, Cristina; Moore, Ernest E.; Chiara, Osvaldo; Di Saverio, Salomone; Sartelli, Massimo; Weber, Dieter; Ansaloni, Luca; Biffl, Walter; Corte, Helene; Wani, Imtaz; Baiocchi, Gianluca; Cattan, Pierre; Catena, Fausto; Bonavina, Luigi (2019)
    The esophagus traverses three body compartments (neck, thorax, and abdomen) and is surrounded at each level by vital organs. Injuries to the esophagus may be classified as foreign body ingestion, caustic ingestion, esophageal perforation, and esophageal trauma. These lesions can be life-threatening either by digestive contamination of surrounding structures in case of esophageal wall breach or concomitant damage of surrounding organs. Early diagnosis and timely therapeutic intervention are the keys of successful management.
  • Gregson, Barbara A.; Broderick, Joseph P.; Auer, Ludwig M.; Batjer, Hunt; Chen, Xian-Cheng; Juvela, Seppo; Morgenstern, Lewis B.; Pantazis, George C.; Teernstra, Onno P. M.; Wang, Wen-Zhi; Zuccarello, Mario; Mendelow, A. David (2012)
  • Cederqvist, Sanna; Flinkkilä, Tapio; Sormaala, Markus; Ylinen, Jari; Kautiainen, Hannu; Irmola, Tero; Lehtokangas, Heidi; Liukkonen, Juho; Pamilo, Konsta; Ridanpää, Tero; Sirnio, Kai; Leppilahti, Juhana; Kiviranta, Ilkka; Paloneva, Juha (2021)
    Background Rotator cuff disease (RCD) causes prolonged shoulder pain and disability in adults. RCD is a continuum ranging from tendinopathy to full-thickness tendon tear. Recent studies have shown that subacromial decompression and non-surgical treatments provide equivalent results in RCD without a full-thickness tendon lesion. However, the importance of surgery for full-thickness tendon tears remains unclear. Methods In a pragmatic, randomised, controlled trial, 417 patients with subacromial pain underwent 3-month initial rehabilitation and MRI arthrography (MRA) for the diagnosis of RCD. Of these, 190 shoulders remained symptomatic and were randomised to non-surgical or surgical treatments. The primary outcomes were the mean changes in the Visual Analogue Scale for pain and the Constant Murley Score for shoulder function at the 2-year follow-up. Results At the 2-year follow-up, both non-surgical and surgical treatments for RCD reduced pain and improved shoulder function. The scores differed between groups by 4 (95% CI -3 to 10, p=0.25) for pain and 3.4 (95% CI -0.4 to 7.1, p=0.077) for function. Among patients with full-thickness ruptures, the reduction in pain (13, 95% CI 5 to 22, p=0.002) and improvement in function (7.0, 95% CI 1.8 to 12.2, p=0.008) favoured surgery. Conclusions Non-surgical and surgical treatments for RCD provided equivalent improvements in pain and function. Therefore, we recommend non-surgical treatment as the primary choice for patients with RCD. However, surgery yielded superior improvement in pain and function for full-thickness rotator cuff rupture. Therefore, rotator cuff repair may be suggested after failed non-surgical treatment.