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Background The purpose of this study is to analyze the long-term clinical and radiological results of a series of patients with early stages of the Kienbock disease treated with radius core decompression. Methods This retrospective study included 23 patients with Kienböck’s disease (Lichtman stage II and IIIA) who underwent distal radius metaphyseal core decompression that were followed-up for at least 10 years. At the last follow-up, the patients were evaluated for wrist range of motion and grip strength. The overall results were evaluated by the modified Mayo wrist score and visual analogue scale pain score. We also compared the radiological changes between the preoperative and final follow-up in their Lichtman classification and the modified carpal height ratio. Results The mean follow-up period was 13 years (range 10-18). Based on the modified Mayo Wrist Score, clinical results were excellent in 9 patients, good in 11 patients, fair in 2 and poor in one patient. The mean preoperative pain according to VAS was 7 (range 6-10) and was 1.1 (range 0-6) at the final follow-up. Compared with the opposite side, the average flexion/extension arc was 78% and the grip strength was 81%. Radiographic disease progression according to the Lichtman classification occurred in four wrists. Conclusion This long-term follow-up study shows that radius core decompression is a valid alternative for the treatment of the early stages of the kienbock disease.

Introduction. Based on the results of our own clinical studies, we have developed a program for comprehensive diagnosis and treatment of postoperative intra-abdominal infiltration in children with appendicular peritonitis by using a diagnostic algorithm and complex saving measures in a hospital setting and at the stage of ambulatory-polyclinic treatment. Aim: To study the remote results of children's treatment with postoperative intra-abdominal infiltrates. Material and methods. With the help of quasi-monitoring, we have received information about the state of 109 children one year after inpatient treatment. Complex treatment of children was carried out according to the program we have developed. Results. Combined use of therapeutic and physical factors in the complex treatment of children with PII, using the developed program in conditions of inpatient and outpatient treatment favorably affected the restoration of impaired functions of the child's body in general and specifically of the abdominal organs, providing a higher effect compared to patients receiving limited complex treatment Conclusions. Disappearance of palpated "tumor", ultrasound signs of intra-abdominal infiltration and the occurrence of adhesive intestinal obstruction can be considered as the main clinical response throughout the treatment process. Final analysis of the late period results of integrated treatment indicated a probable increase in the number of MG patients with an overall assessment of the outcome of the treatment as "good" (95.1% of children versus 72.1% in the CG) and a decrease in the "unsatisfactory" outcome of treatment in 2 times among children of MG (2.4%) against children of the CG (4.4%). Primary laparoscopic intervention in children (CS 2, MS 2) contributed to the favorable course of the disease, and after ambulatory-polyclinic treatment resulted in the absence of "unsatisfactory" results.

The rationale for the use of high-protein diets is that they offer a higher level of satiety for a longer period of time when compared with carbohydrates or fats; this diminishes calorie consumption in the long-run. The purpose of this review was to assess the efficacy of long-term randomized clinical trials. We used Pubmed, EBSCO and SCIELO to conduct our searches. Inclusion criteria were: randomized clinical trials conducted in adults, with an intervention/follow-up of at least 24 weeks, stating the specific amount of energy protein (in percentages) in the diet; with a control group with either a conventional energy restricted diet or a high-fat/high-carbohydrate diet, also the studies should provide at least body weight or body mass index (BMI) at the beginning and at the end of the intervention. A total of 481 studies were found. Eight studies met the inclusion criteria. Weight loss difference in those with the highest weight loss with the highprotein diet ranged from 3.7 kg in a six month trial to 1.2 kg in a 17 month trial. The average weight loss of the eight studies in the high-protein diet was 6.3 kg and in the standard diet was 5.0 kg. Although half of the studies showed a higher weight loss with a high-protein diet, three out of four studies with the longest intervention show no statistical difference in weight loss. In this systematic review it was observed that the long-term effect of high-protein diets is neither consistent nor conclusive.La justificación para el uso de dietas altas en proteínas (DAP) es que las proteínas ofrecen una mayor saciedad por un periodo prolongado de tiempo comparado con carbohidratos o lípidos, lo que disminuye la ingesta calórica a largo plazo. El propósito de esta revisión fue evaluar la eficacia a largo plazo de las DAP, en ensayos clínicos aleatorizados (RCT en inglés). Se realizaron las búsquedas en Pubmed, EBSCO y SCIELO. Los criterios de inclusión fueron: RCT, adultos, intervención y seguimiento igual o mayor de 24 semanas, estudios que presentaran la cantidad de proteína (en porcentajes) en la dieta, la presencia de un grupo control con una dieta convencional restringida en energía o una dieta alta en lípidos/carbohidratos. Además, la inclusión de peso corporal o índice de masa corporal al inicio y al final de la intervención. Se encontraron 481 estudios. Ocho estudios cumplieron los criterios de inclusión. La diferencia de la pérdida de peso en aquellos con la mayor pérdida con la DAP varió de 3,7 kg en un estudio de seis meses a 1,2 kg en un estudio de diecisiete meses. La pérdida de peso promedio de los ocho estudios en el grupo de DAP fue 6,3 kg y en la dieta estándar fue 5,0 kg. La mitad de los estudios mostró una mayor pérdida de peso en la DAP, tres de los cuatro estudios con mayor tiempo de intervención no muestran diferencia significativa en la pérdida de peso. En conclusión, se observó que el efecto a largo plazo de las DAP no es consistente ni concluyente.