Transfusional iron overload is a major target in the care of patients with transfusion-dependent thalassemia (TDT) and other refractory anemias. Iron accumulates in the liver, heart, and endocrine organs leading to a wide array of complications. In this review, we summarize the characteristics of the approved iron chelators, deferoxamine, deferiprone, and deferasirox, and the evidence behind the use of each, as monotherapy or as part of combination therapy. We also review the different guidelines on iron chelation in TDT. This review also discusses future prospects and directions in the treatment of transfusional iron overload in TDT whether through innovation in chelation or other therapies, such as novel agents that improve transfusion dependence.
In upper lumbar burst fractures, complete lamina fracture is an indicator of injury severity. When detected preoperatively on CT or MRI scanning, it should be operated by open book laminectomy even if the patient is neurologically intact since it carries a high risk of neural entrapment, and its presence affects the intraoperative postural and instrumental trials for anterior vertebral height restoration.
Our study confirms that, across different surgical subspecialties, resident involvement in surgery is associated with comparable morbidity and lower mortality outcomes. This provides a reassuring answer to patients, attending surgeons, and surgical program directors.
The new MIDHS technique is a trustable procedure that may help the surgeon to perform DHS fixation in a proper way. It offers a better motoric function, less pain. However, further studies should be conducted to evaluate the validity of such radiological land marks in proximal femoral surgery.
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