PURPOSE: To retrospectively review our current clinical experience with a more upgraded treatment algorithm of the talar neck fracture dislocation. MATERIALS AND METHODS: We evaluated the clinical results of treatment of fifty-three talar neck fractures dislocations for average of 50A months (type 1, 10 fractures; type 2, 26; type 3, 13; type 4, 2; total dislocation, 2). Principally anterolateral approach was used for accurate reduction and firm fixation without damaging the deltoid arterial circulation, which is usually intact in fracture dislo cation. RESULTS: The overall clinical results were satisfactory in these patients (excellent, 36%; good, 36%; fair, 24%; failure 4%). Avascular necrosis of the talar body occurred in 23.5 percent (12/51) of the talar neck fractures (type 2, 15.4%; type3, 53.8%; type 4, 50%) and 50 percent (1/2) of total dislocations of the talar body. The traumatic osteoarthritis in the subtalar, ankle and talonavicular joints was the most frequent complication (41.5%). CONCLUSIONS: This study revealed relatively better results than previous reports and supports that early anatomical reduction and rigid internal fixation using anterolateral approach and lag screws followed by prompt aftercare could obtain promising good clinical results.
Aftercare ; Ankle ; Dislocations* ; Humans ; Joints ; Neck* ; Necrosis ; Osteoarthritis ; Retrospective Studies*

The use of osseointegrated implants is an accepted procedure for the treatment of Total, or partial edentulism and offers good predictability of long-term success. Osseointegration implies a firm and direct interlocking between vital bone and screw-shaped titanium implants. There should be not to interposed tissue between fixture and bone. This study was undertaken to assess the clinical condition, complication, and prosthodontic aftercare of different implant systems. One hundred fifty-nine patients treated with a total of 503 endosseous implants (364 Steri-oss threaded type, 69 Integral cylinder with HA coated type, 35 Steri-oss threaded with HA coated type, 21 Steri-oss cylinder with HA coated type and 14 3i implant type), Most of the implant were placed in type B and C bone quantity and type 2 and 3 bone quality according to Lekhorm and Zarb. The success rate of Steri-oss threaded type during healing and function was 92%, Steri-oss threaded type with hydroxyapatite coated was 91%, Steri-oss cylinder type with hydroxyapatite coated was 90%, Integral cylinder type with hydroxyapatite coated was 90% and 3i implant type was 93%. One hundred twenty-nine patients had been treated with implant prosthesis. 79 of these patients had received a fixed type prosthesis and 50 patients had received a removable type prosthesis. There were no differences between the implant systems with regard to age, gender. Failures were associated with poor bone quality, smaller implant sizes, a surgical installation technique and stress distribution when in function. Visual analgoue scales recorded as satisfied results functionally and esthetically, but 15% dissatified with chewing ability.
Aftercare ; Dental Implants* ; Durapatite ; Humans ; Mastication ; Mouth Rehabilitation* ; Mouth* ; Osseointegration ; Prostheses and Implants ; Prosthodontics ; Titanium ; Weights and Measures

Recent advances in techniques and strategies use to detect cancer in its early stages and to treat it effectively has the survival rate of cancer patients and the number of long-term cancer survivors continually increasing. Unfortunately, many cancer survivors are at risk for various late and long-term effects of cancer treatments including the radiotherapy. Long-term cancer survivors can be also seen for a hospice and palliative care because of cancer recurrence and they are at risk of delayed reactions to radiotherapy. So, the understanding and knowledge of radiation reactions is required for the proper medical diagnosis, management, and coordination of the potential reactions that may occur in these care setting. In effort to increase the survival rate in cancer patients and to decrease the adverse effects of cancer treatment, many clinical studies have been and continue to be conducted. The efforts of these studies have thus resulted in the advancement of cancer treatments. Regrettably, the overall interest in how to manage adverse effects of cancer treatment such as radiotherapy appears seemingly low in clinical practice and its advanced studies as a whole are delayed and deficient. It is imperative that the medical community show an enthusiastic interest in the aftercare of cancer patients and cancer survivors in order to create a complementary integrative approach that will eliminate radiotherapy related pain/discomfort or illness in hospice and palliative care settings.
Aftercare ; Hospice Care ; Hospices ; Humans ; Palliative Care ; Recurrence ; Survival Rate ; Survivors

Kidney transplantation has become an important method in treating advanced renal failure. Immunosuppressants play a key tool in this progress. It is important to understand the goal, mechanism, and adverse effects of immunosuppressive therapy, so as to appropriately use these drugs in post-transplantation patients on a customized basis.
Aftercare ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Kidney Transplantation ; Long-Term Care

Follow-up after renal transplantation is vital to improve allograft long-term survival and quality of life. This article describes the awareness, frequency, patterns, and contents of the follow-up after renal transplantation, especially 6 factors that may adversely influence the long-term survival of renal transplant recipients.
Aftercare ; Graft Survival ; Humans ; Kidney Transplantation ; mortality ; Long-Term Care ; Postoperative Complications ; prevention & control ; Risk Factors

Gastrostomy placement for nutritional support for patients with inadequate oral intake has been attempted using surgical, endoscopic, and, more recently, percutaneous radiologically guided methods. Surgical gastrostomy has been superseded by both endoscopic and radiologic gastrostomy. We describe herein the indications, contraindications, patient preparations, techniques, complications, and aftercare with regard to radiologic gastrostomy. In addition, we discuss the available tube types and their perceived advantages. There remain some controversies regarding gastropexy performance and primary percutaneous gastrojejunostomy. Percutaneous jejunostomy is indicated for patients whose stomach is inaccessible for gastrostomy placement or for those who have had a previous gastrectomy.
Aftercare ; Enteral Nutrition ; Gastrectomy ; Gastric Bypass ; Gastropexy ; Gastrostomy ; Humans ; Jejunostomy ; Nutritional Support ; Stomach

Metabolic bone disease of prematurity (MBDP) is a systemic bone disease with a reduction in bone mineral content due to disorder of calcium and phosphorus metabolism. There is still a lack of in-depth research and systematic understanding of MBDP in China, and there are many irregularities in clinical management of this disease. Based on relevant studies in China and overseas, Grading of Recommendations Assessment, Development and Evaluation was used to develop the expert consensus on the clinical management of MBDP, which provides recommendations from the following five aspects: high-risk factors, screening/diagnosis, prevention, treatment, and post-discharge follow-up of MBDP, so as to provide relevant practitioners with recommendations on the clinical management of MBDP to reduce the incidence rate of MBDP and improve its short- and long-term prognosis.
Aftercare ; Bone Diseases, Metabolic/therapy* ; Consensus ; Humans ; Infant, Newborn ; Infant, Premature ; Patient Discharge

OBJECTIVES: This study aimed to develop a school-centered healthy eating environment for children in elementary care classrooms and prevent incorrect eating habits and obesity through the development and application of standardized healthy eating habit-forming educational materials.METHODS: Ten schools in eight districts of Gyeonggi-do and 400 students from 19 care classes were selected. Based on the developed educational materials, the program was applied to students once in two weeks. ‘Notices for Parents’ forms were also sent to the students' home to educate their parents. Pre and post-surveys were conducted to evaluate the effectiveness of the education. The pre-education, education, and aftercare were conducted from September 28 to September 31, 2016, from October 3 to November 30, 2016, and from December 5 to December 9, 2016, respectively.RESULTS: The healthy eating program for elementary care classes was designed to develop a school-centered healthy eating environment and provide standardized educational material for healthy eating habits. Twelve educational topics were developed: 〈Eat Evenly〉, 〈Eat Breakfast〉, 〈Eat vegetables and Fruits〉, 〈Clean Body, Strong Body〉, 〈Healthy and Tasty Snacks〉, 〈Keep Healthy Weight〉, 〈Food that enters our body〉, 〈What is safe food?〉, 〈Food selection and Storage〉, 〈Our land, Our grain〉, 〈Enjoy Traditional Food〉, and 〈Food manners〉. Moreover, the materials were produced in four forms: for students, for after school caring teachers, for external specialists, and for parents. The effectiveness evaluation was conducted to confirm the application of the program. The average eating habits score was 3.3 ± 0.6, with no significant difference between before and after application. The score of overall satisfaction of the education was 3.9 ± 0.9. The most satisfying content was ‘Did you get to know how to eat evenly?’. Significant increases were observed in two contents for parents regarding their children's knowledge changes after the education: ‘Five nutrients needed for growing children’ and ‘Knowing sugar foods and sugar-containing foods’. On the other hand, their educational satisfaction was 3.6 ± 0.6, which was lower than the children's satisfaction. This might be because their education was conducted only through the ‘Notices for Parents’ form.CONCLUSIONS: In the long term, the healthy eating habit-formation education for lower elementary school children is expected to be beneficial. To prevent obesity and establish healthy eating habits of children, it is important to develop healthy eating education programs centered on elementary school aftercare classes, including the development of educational materials and an application system through connection with the home and community.
Aftercare ; Child ; Eating ; Education ; Gyeonggi-do ; Hand ; Humans ; Obesity ; Parents ; Specialization ; Vegetables

INTRODUCTION: There are limited studies exploring functional improvement in relation to characteristics of patients who, following acute hospital care, receive inpatient rehabilitation in community hospitals. We evaluated the association of acute hospital admission-related factors with functional improvement on community hospital discharge. METHODS: We conducted a retrospective cohort study among patients who were transferred to community hospitals within 14-day post-discharge from acute hospital between 2016 and 2018. Modified Barthel Index (MBI) on a 100-point ordinal scale was used to assess functional status on admission to and discharge from the community hospital. We categorised MBI into 6 bands: 0-24, 25-49, 50-74, 75-90, 91-99 and 100. Multivariable logistic regression models were constructed to determine factors associated with categorical improvement in functional status, defined as an increase in at least one MBI band between admission and discharge. RESULTS: A total of 5,641 patients (median age 77 years, interquartile range 69-84; 44.2% men) were included for analysis. After adjusting for potential confounders, factors associated with functional improvement were younger age, a higher MBI on admission, and musculoskeletal diagnosis for the acute hospital admission episode. In contrast, a history of dementia or stroke; lower estimated glomerular filtration rate; abnormal serum albumin or anaemia measured during the acute hospital episode; and diagnoses of stroke, cardiac disease, malignancy, falls or pneumonia; and other chronic respiratory diseases were associated with lower odds of functional improvement. CONCLUSION Clinicians may want to take into account the presence of these high-risk factors in their patients when planning rehabilitation programmes, in order to maximise the likelihood of functional improvement.
Aftercare ; Aged ; Female ; Hospitals, Community ; Humans ; Inpatients ; Male ; Patient Discharge ; Retrospective Studies ; Stroke/complications* ; Stroke Rehabilitation

INTRODUCTION: Hospital-at-home programmes are well described in the literature but not in Asia. We describe a home-based inpatient substitutive care programme in Singapore, with clinical and patient-reported outcomes. METHODS: We conducted a retrospective cohort study of patients admitted to a hospital-at-home programme from September 2020 to September 2021. Suitable patients, who otherwise required hospitalisation, were admitted to the programme. They were from inpatient wards, emergency department and community nursing teams in the western part of Singapore, where a multidisciplinary team provided hospital-level care at home. Electronic health record data were extracted from all patients admitted to the programme. Patient satisfaction surveys were conducted post-discharge. RESULTS: A total of 108 patients enrolled. Mean age was 67.9 (standard deviation 16.7) years, and 46% were male. The main diagnoses were skin and soft tissue infections (35%), urinary tract infections (29%) and fluid overload (18%). Median length of stay was 4 (interquartile range 3-7) days. Seven patients were escalated back to the hospital, of whom 2 died after escalation. One patient died at home. There was 1 case of adverse drug reaction and 1 fall at home, and no cases of hospital-acquired infections. Patient satisfaction rates were high and 94% of contactable patients would choose to participate again. CONCLUSION Hospital-at-home programmes appear to be safe and feasible alternatives to inpatient care in Singapore. Further studies are warranted to compare clinical outcomes and cost to conventional inpatient care.
Aftercare ; Aged ; Female ; Hospitalization ; Humans ; Length of Stay ; Male ; Patient Discharge ; Retrospective Studies ; Singapore