POS1280 SPINAL LOCATION OF TUBERCULOSIS: WHAT HAS CHANGED OVER THE LAST YEARS?

Background:Tuberculosis (TB) is no longer a disease limited to developing nations and is still a major cause of significant morbidity and mortality worldwide. It can affect the different parts of the spine.Objectives:The aim of this study was to determine the preferred spinal location of TB.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from observations of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with tuberculous spondylodiscitis (TS).Results:Fifty-two patients were included (37F/15M). Their mean age was 55.21 years ± 17.79 [19-91]. TS was more frequently unifocal (75%) than multifocal (25%). Lumbar spine involvement was the most common (57.7%) and more frequent in women (63.3%) but with no statistically significant difference (p = 0.2). Other localizations were described such as: dorso-lumbar (21.2%), dorsal (15.4%), lumbosacral (3.8%) and cervical (1.9%). Lumbar pain was present in 34 patients (65.4%) and 29 patients (55.8%) suffered from segmental lumbar stiffness. Imaging was contributive by showing the vertebral location using standard X-rays, computed tomography and magnetic resonance imaging. Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively).Conclusion:TS is a rare but serious clinical condition which may lead to severe deformity and early or late neurological complications. Spinal involvement is often unifocal and mostly diagnosed with lumbar pain or stiffness. Multifocal forms, touching several parts of the spine, however remain rare. Our findings remain consistent with those of the literature.Disclosure of Interests:None declared

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POS1288 TUBERCULOUS SPONDYLODISCITIS IN ELDERLY: EPIDEMIOLOGY, CLINICAL, FEATURES, TREATMENT AND OUTCOMES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4129 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 926.1-926

Author(s):

M. Mrabet ◽

S. Boussaid ◽

S. Jemmali ◽

H. Sahli ◽

H. Ajlani ◽

...

Keyword(s):

Clinical Features ◽

The Elderly ◽

Lumbar Pain ◽

Elderly Subjects ◽

Normocytic Anemia ◽

Imaging Features ◽

X Rays ◽

Significant Difference ◽

Young Subjects ◽

Tuberculous Spondylodiscitis

Background:Tuberculosis is still endemic all over the world. The incidence of tuberculous spondylodiscitis (TS) is steadily increasing. Clinical features and outcomes of this affection are various and depending on various parameters, including age.Objectives:Our objective was to explore the differences in presentation and the results of further investigations and the prognosis of TS between young and elderly subjects.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from files of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with TS. We carried out a comparative study concerning the clinical biological, imaging features and outcomes between young subjects and subjects aged over 65 years.Results:Fifty-two cases of TS were collected (37F/15M). The mean age of the population was 55.21 years ± 17.79 [19-91]. Thirty-three patients (69.2%) were classified as young versus 16 elderly patients (30.8%), with female predominance in both groups (69.4% and 75% respectively, p = 0.57). Young subjects was more frequently vaccinated (88.9%) by Bacillus Calmette–Guérin (BCG) (p < 0.001). A delayed diagnosis was noted in both groups (p = 0.24). Lumbar spine involvement was the most common (57.7%). In the two age ranges, the onset of the disease was progressive (p = 0.22), characterized by segmental spine stiffness (p = 0.57) and lumbar pain with general signs (p = 0.27), such as: impaired general condition, fever, night sweats and weight loss. Biological inflammatory syndrome and normochrome normocytic anemia were encountered in both cases (p = 0.08 and p = 0.2, respectively). Standard X-rays and Computed tomography were more performed in young subjects (94.4% and 69.4%, respectively; p < 0.001), unlike magnetic resonance imaging which was more common in elderly subjects but with no statistically significant difference (p = 0.22). Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively). Clinical, biological and imaging arguments contributed to positive diagnosis in both groups (p = 0.24). Common medical treatment was anti-tuberculosis: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E) and physical treatment such as immobilization witch was more common in the eldery (56.3%, p = 0.16). The evolution of the disease was characterized by a clear improvement of young subjects during the second week of treatment (p < 0.001). A more frequent clinical improvement in older subjects was during the fourth week but with no statistically significant difference (p = 0.13). The occurrence of immediate complications was more frequent in the elderly (p = 0.23) with a predominance for drug complications (56.3%) such as: hepatic cytolysis (12.5%), hyperuricemia (18.8%) and major intolerance to anti-tuberculosis (18.8%).Conclusion:TS is a frequent condition that needs to be treated rapidly. the clinical presentation of TS in the elderly is less noisy which leads to more frequent complications and mortality.Disclosure of Interests:None declared

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Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

Reumatismo ◽

10.4081/reumatismo.2016.885 ◽

2016 ◽

Vol 68 (2) ◽

pp. 72 ◽

Cited By ~ 8

Author(s):

M. Lorenzin ◽

A. Ortolan ◽

P. Frallonardo ◽

S. Vio ◽

C. Lacognata ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Disease Activity ◽

Axial Spondyloarthritis ◽

X Rays ◽

Resonance Imaging ◽

Diagnostic Significance ◽

Significant Difference ◽

Spine Mri ◽

Activity Indices

Our aim was to determine the prevalence of spine and sacroiliac joint (SIJ) lesions on magnetic resonance imaging (MRI) in patients with early axial spondyloarthritis (axSpA) and their correlation with disease activity indices. Sixty patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years), attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE) study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI. Positive spine and SIJ MRI and X-rays images were scored independently by 2 readers using the SPARCC method, modified Stoke ankylosing spondylitis spine score and New York criteria. The axial pain and localization of MRI-lesions were referred to 4 sites: cervical/thoracic/lumbar spine and SIJ. All patients were classified into three groups: patients with signs of radiographic sacroiliitis (r-axSpA), patients without signs of r-axSpA but with signs of sacroiliitis on MRI (nr-axSpA MRI SIJ+), patients without signs of sacroiliitis on MRI and X-rays (nr-axSpA MRI SIJ-). The median age at LBP onset was 29.05±8.38 years; 51.6% of patients showed bone marrow edema (BME) in spine-MRI and 56.7% of patients in SIJ-MRI. Signs of enthesitis were found in 55% of patients in the thoracic district. Of the 55% of patients with BME on spine-MRI, 15% presented presented a negative SIJMRI. There was a significant difference between these cohorts with regard to the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ score. The site of pain correlated statistically with BME lesions in thoracic and buttock districts. Since positive spine-MRI images were observed in absence of sacroiliitis, we can hypothesize that this finding could have a diagnostic significance in axSpA suspected axSpA.

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IMAGING OF THE CEREBRUM

Neurosurgery ◽

10.1227/01.neu.0000279316.03266.cd ◽

2007 ◽

Vol 61 (suppl_1) ◽

pp. SHC-123-SHC-146 ◽

Cited By ~ 1

Author(s):

Paul E. Kim ◽

Chi Shing Zee

Keyword(s):

Magnetic Resonance Imaging ◽

Nuclear Magnetic Resonance ◽

Rapid Development ◽

Historical Context ◽

X Rays ◽

Resonance Imaging ◽

Cerebral Imaging ◽

The Past ◽

History Of ◽

The Individual

Abstract The history of the development of cerebral imaging is a complex combination of the forces of innovation at both the individual and industrial levels. Principal paradigms of neuroimaging shifted as a result of technological breakthroughs, beginning with the discovery of x-rays and continuing with the development of computerized imaging to the latest imaging paradigm, nuclear magnetic resonance imaging. We discuss these landmarks in neuroimaging in historical context, with emphasis on the particularly rapid development of imaging technology during the past 30 to 40 years, including the most recent emerging technologies.

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Risk factors associated with the presentation of brucellosis in the spine

Coluna/Columna ◽

10.1590/s1808-1851201514010r124 ◽

2015 ◽

Vol 14 (1) ◽

pp. 33-36 ◽

Cited By ~ 1

Author(s):

Alberto Aceves Pérez

Keyword(s):

Risk Factors ◽

Lumbar Pain ◽

X Rays ◽

C Reactive Protein ◽

Factors Associated ◽

Reactive Protein ◽

Significant Difference ◽

Place Of Origin ◽

Age Range ◽

Strength Of Association

OBJECTIVE: The aim of this study is to describe the risk factors associated with the presentation of brucellosis on the spine, and determine the strength of association between these factors. METHODS: The medical records of patients with brucellosis on the spine were analyzed and a spreadsheet was created to compile the following data: age, sex, place of origin and residence, risk factors (exposure at work, consumption of unpasteurized products and comorbidities), clinical presentation (lumbar pain, anorexia, headache, myalgia, fatigue, paresthesia, dysesthesia, muscle weakness, weight loss, fever), affected spine level, presence of abscesses, disease duration (acute, subacute, chronic), laboratory studies (erythrocyte sedimentation rate, C-reactive protein, serology, blood culture, Rose Bengal test, histopathological reports), imaging studies (x-rays, MRI, bone gammagraphy), established treatment (medical and/or surgical), therapeutic failure and sequelae. RESULTS: A total of 17 patients, 10 women (58.8%) and seven men (41.2%), were reviewed from January 2007 to January 2011. The group had a mean age of 57.8 years with a standard deviation of +13.91 and age range between 16-74 years. CONCLUSIONS: There is no significant difference between the groups compared with respect to age and sex, however, improvement of the neurological deficit was observed in eight patients who underwent surgical procedure.

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FRI0433 HAS THE PROFILE OF INFECTIOUS SPONDYLODISCITIS CHANGED IN 20 YEARS?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4814 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 814.2-815

Author(s):

A. Ben Tekaya ◽

L. Ben Ammar ◽

M. Ben Hammamia ◽

O. Saidane ◽

S. Bouden ◽

...

Keyword(s):

Neurological Complications ◽

The Other ◽

Disc Space Narrowing ◽

Disc Space ◽

Male Predominance ◽

Other Hand ◽

Significant Difference ◽

Infectious Spondylodiscitis ◽

Bacteriological Investigation ◽

Tuberculous Spondylodiscitis

Background:Infectious spondylodiscitis represents 2 to 4% of osteoarticular infections. Their incidence is constantly increasing. Early microbiological diagnosis and targeted multidisciplinary management are the main prognostic factors for infectious spondylodiscitis.Objectives:To compare the epidemiological, clinical, biological, radiological, bacteriological profile as well as the management and prognosis of spondylodiscitis over the last 20 years.Methods:Retrospective study including 113 patients hospitalized in our department between 1999 and 2018. The diagnosis was based on clinical, biological, radiological and bacteriological data. Spondylodiscitis were divided into two groups: spondylodiscitis occurring between 1998 and 2008 (1stdecade) and those between 2009 and 2018 (2nddecade).Results:Of the 113 identified patients, 54 (47.8%) occurred between 1998 and 2008, with male predominance in both groups (50.2 and 59.3% respectively; p=0.3). The average age was 55 years (p=0.7). Diabetes was more frequent in the 1stdecade but without a statistically significant difference (p=0.1). On the other hand, consumption of unpasteurized dairy products was more frequent during the 2nddecade (p<0.001) as well as the presence of intercurrent infection (p=0.01).The estimated delay between symptom onset and diagnosis was longer between 1998 and 2008 (5.6 months and 3.2 months respectively, p=0.005). The presence of neurological signs was more frequent between 2009 and 2018 (p=0.001), especially radiculalgia (p=0.02). The sedimentation rate was higher in the 1stdecade (93mm and 72mm respectively, p=0.002).We found no statistically significant difference in the location of spondylodiscitis (p=0.4) and the multifocal involvement (p=0.5).Radiographic signs were significantly more prevalent in the 1stdecade (p=0.002), in particular disc space narrowing (p=0.03) and irregularity of the intervertebral plates (p=0.01). Computed tomography was more often performed during the 1stdecade (p = 0.008), unlike magnetic resonance imaging, performed in 88.1% of cases during the 2nddecade (p <0.001). In contrast, the frequency of para-vertebral abscesses, epiduritis and spinal cord compressions were similar in the two groups (p = 0.6; p = 0.9 and p = 0.3, respectively).Tuberculosis was more frequent in the 1stdecade (p=0.009). Disco-vertebral biopsy was more often performed in the 1stdecade (p=0.04), but its efficiency was similar between the two groups (p=0.1). For pyogenic spondylodiscitis, blood cultures were more often positive in the 2nddecade but without a statistically significant difference (p=0.6). On the other hand, the anatomopathological aspect was more frequently suggestive of a pyogenic germ in the 2nddecade (p=0.04).A surgical procedure was more frequently performed between 2009 and 2018 but with no statistically significant difference (p = 0.2). All patients received antibiotic therapy. A change in treatment was made in 23.7% of cases between 2009 and 2018 (p = 0.01). The prognosis was better during the 1stdecade (p = 0.01). On the other hand, the occurrence of immediate complication during tuberculous spondylodiscitis was more frequent during the 2nddecade (p = 0.03), in particular the toxicity of anti-tuberculosis treatment (p = 0.04).Conclusion:In the last decade, the diagnosis of spondylodiscitis has been made earlier. However, these are more severe forms with an increased frequency of neurological complications, probably due to an increase in the proportion of virulent germs. Moreover, the effectiveness of the bacteriological investigation does not differ between the two periods studied.Disclosure of Interests:None declared

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Evaluation of genotoxicity in buccal mucosa of patients subjected to X-rays by degenerative nuclear alterations study

Research Journal of Pharmacy and Technology ◽

10.52711/0974-360x.2021.01017 ◽

2021 ◽

pp. 5845-5848

Author(s):

Alexander M. Luke ◽

Al Moutassem B. Khair ◽

Syed Kudrutullah ◽

Simy Mathew ◽

Salem A. Fanas ◽

...

Keyword(s):

Buccal Mucosa ◽

Micronucleus Assay ◽

X Rays ◽

Cell Turnover ◽

Multinucleated Cell ◽

Exclusion Criteria ◽

The Past ◽

Multinucleated Cells ◽

Significant Difference ◽

Nuclear Alterations

The aim of this study is to explore the genotoxicity of cells obtained from the buccal mucosa in patients who were exposed to dental X-rays using micronucleus analysis. All the subjects underwent a routine oral clinical examination and subjects with any visible or symptomatic change in the buccal mucosa were excluded. Subjects who were expose to X rays in the past 6 months were also excluded. Based on the inclusion and exclusion criteria a total of 116 subjects were recruited. The included subjects were all nonsmokers. The genotoxicity was studied by micronucleus assay. There was significant difference in the frequency of multinucleated cell numbers from before exposure to after exposure to OPG. In patients having exposed to CBCT, a higher cell turnover was detected. The number of multinucleated cells gradually increases after panoramic radiographs, hence dental X-rays should be prescribed only when absolutely necessary.

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Track 2.b Introduction: Design & Democracy

Conference Proceedings of the Academy for Design Innovation Management ◽

10.33114/adim.2019.2b ◽

2019 ◽

Vol 2 (1) ◽

pp. 213

Author(s):

Virginia TASSINARI ◽

Ezio MANZINI ◽

Maurizio TELI ◽

Liesbeth HUYBRECHTS

Keyword(s):

At Risk ◽

Design Research ◽

Core Theme ◽

The Past ◽

Noam Chomsky ◽

Local Contexts ◽

Democratic Discourse ◽

Different Parts

The issue of design and democracy is an urgent and rather controversial one. Democracy has always been a core theme in design research, but in the past years it has shifted in meaning. The current discourse in design research that has been working in a participatory way on common issues in given local contexts, has developed an enhanced focus on rethinking democracy. This is the topic of some recent design conferences, such PDC2018, Nordes2017 and DRS2018, and of the DESIS Philosophy Talk #6 “Regenerating Democracy?” (www.desis-philosophytalks.org), from which this track originates. To reflect on the role and responsibility of designers in a time where democracy in its various forms is often put at risk seems an urgent matter to us. The concern for the ways in which the democratic discourse is put at risk in many different parts of the word is registered outside the design community (for instance by philosophers such as Noam Chomsky), as well as within (see for instance Manzini’s and Margolin’s call Design Stand Up (http://www.democracy-design.org). Therefore, the need to articulate a discussion on this difficult matter, and to find a common vocabulary we can share to talk about it. One of the difficulties encountered for instance when discussing this issue, is that the word “democracy” is understood in different ways, in relation to the traditions and contexts in which it is framed. Philosophically speaking, there are diverse discourses on democracy that currently inspire design researchers and theorists, such as Arendt, Dewey, Negri and Hardt, Schmitt, Mouffe, Rancière, Agamben, Rawls, Habermas, Latour, Gramsci, whose positions on this topic are very diverse. How can these authors guide us to further articulate this discussion? In which ways can these philosophers support and enrich design’s innovation discourses on design and democracy, and guide our thinking in addressing sensitive and yet timely questions, such as what design can do in what seems to be dark times for democracy, and whether design can possibly contribute to enrich the current democratic ecosystems, making them more strong and resilient?

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Levels of Evidence in Rhinology and Skull Base Surgery Research

Otolaryngology ◽

10.1177/0194599820987131 ◽

2021 ◽

pp. 019459982098713

Author(s):

Jennifer A. Silver ◽

Marco Mascarella ◽

George Tali ◽

Rickul Varshney ◽

Marc A. Tewfik ◽

...

Keyword(s):

Skull Base ◽

Skull Base Surgery ◽

Absolute Number ◽

High Quality ◽

Level Of Evidence ◽

Levels Of Evidence ◽

The Past ◽

Significant Difference ◽

Surgery Research ◽

Based Medicine

Objective The purpose of this study was to evaluate the quality of evidence of rhinology and rhinologic skull base surgery (RSBS) research and its evolution over the past decade. Study Design Review article. Setting We reviewed articles from 2007 to 2019 in 4 leading peer-reviewed otolaryngology journals and 3 rhinology-specific journals. Methods The articles were reviewed and levels of evidence were assigned using the Oxford Centre for Evidence-Based Medicine 2011 guidelines. High quality was defined as level of evidence 1 or 2. Results In total, 1835 articles were reviewed in this study spanning a 13-year period. Overall, the absolute number of RSBS publications increased significantly 22.6% per year, from 108 articles in 2007 to 481 in 2019 ( P < .001; 95% CI, 7.9-37.2). In 2007, only 13 articles, or 15%, were high quality, and this grew to 146 articles, or 39%, in 2019. A 14.0% per year exponential increase in the number of high-quality publications was found to be statistically significant ( P < .001; 95% CI, 7.2, 20.7). Overall, high-quality publications represented just 25.8% of RSBS articles overall. There was no significant difference in quality between rhinology-specific journals and general otolaryngology journals (χ2 = 3.1, P = .077). Conclusion The number of overall publications and of high-quality RSBS publications has significantly increased over the past decade. However, the proportion of high-quality studies continues to represent a minority of total RSBS research.

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Integration of Dental Implants in Conjunction with EDTA-Conditioned Dentin Grafts: An Experimental Study

Dentistry Journal ◽

10.3390/dj9060063 ◽

2021 ◽

Vol 9 (6) ◽

pp. 63

Author(s):

Payam Farzad ◽

Ted Lundgren ◽

Adel Al-Asfour ◽

Lars Andersson ◽

Christer Dahlin

Keyword(s):

Direct Contact ◽

Mineral Content ◽

X Rays ◽

X Ray ◽

Dentin Surface ◽

Significant Difference ◽

C And N ◽

Micro Implants ◽

Demineralized Dentin

This study was undertaken to investigate the integration of titanium micro-implants installed in conjunction with previously dentin-grafted areas and to study the morphological appearance, mineral content, and healing pattern of xenogenic EDTA-conditioned dentin blocks and granules grafted to cavities in the tibial bone of rabbits. Demineralized and non-demineralized dentin blocks and granules from human premolars were implanted into cavities prepared on the lateral aspects of the tibias of rabbits. After a healing period of six months, micro-implants were installed at each surgical site. Histological examinations were carried out after 24 weeks. Characterization of the EDTA-conditioned dentin blocks was performed by means of light microscopy, dental X-rays, scanning electron microscopy, and energy dispersive X-ray analysis (EDX). No implants were found to be integrated in direct contact with the dentin particles or blocks. On the EDTA-conditioned dentin surface, the organic marker elements C and N dominated, as revealed by EDX. The hydroxyapatite constituents Ca and P were almost absent on the dentin surface. No statistically significant difference was observed between the EDTA-conditioned and non-demineralized dentin, as revealed by BIC and BA. The bone-inductive capacity of the dentin material seemed limited, although demineralization by means of EDTA indicated higher BIC and BA values in conjunction with the installed implants in the area. A 12 h EDTA treatment did not fully decalcify the grafts, as revealed by X-ray analysis.

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Assessment of the Use of Humidified Nasal Cannulas for Oxygen Therapy in Patients with Epistaxis

ORL ◽

10.1159/000514460 ◽

2021 ◽

pp. 1-5

Author(s):

Jingjing Liu ◽

Tengfang Chen ◽

Zhenggang Lv ◽

Dezhong Wu

Keyword(s):

Flow Rate ◽

Oxygen Therapy ◽

Preliminary Investigation ◽

Nasal Cannula ◽

Low Flow ◽

Antiplatelet Drugs ◽

Flow Rates ◽

The Past ◽

Oxygen Inhalation ◽

Significant Difference

Introduction: In China, nasal cannula oxygen therapy is typically humidified. However, it is difficult to decide whether to suspend nasal cannula oxygen inhalation after the nosebleed has temporarily stopped. Therefore, we conducted a preliminary investigation on whether the use of humidified nasal cannulas in our hospital increases the incidence of epistaxis. Methods: We conducted a survey of 176,058 inpatients in our hospital and other city branches of our hospital over the past 3 years and obtained information concerning their use of humidified nasal cannulas for oxygen inhalation, nonhumidified nasal cannulas, anticoagulant and antiplatelet drugs, and oxygen inhalation flow rates. This information was compared with the data collected at consultation for epistaxis during these 3 years. Results: No significant difference was found between inpatients with humidified nasal cannulas and those without nasal cannula oxygen therapy in the incidence of consultations due to epistaxis (χ2 = 1.007, p > 0.05). The same trend was observed among hospitalized patients using anticoagulant and antiplatelet drugs (χ2 = 2.082, p > 0.05). Among the patients with an inhaled oxygen flow rate ≥5 L/min, the incidence of ear-nose-throat (ENT) consultations due to epistaxis was 0. No statistically significant difference was found between inpatients with a humidified oxygen inhalation flow rate <5 L/min and those without nasal cannula oxygen therapy in the incidence of ENT consultations due to epistaxis (χ2 = 0.838, p > 0.05). A statistically significant difference was observed in the incidence of ENT consultations due to epistaxis between the low-flow nonhumidified nasal cannula and nonnasal cannula oxygen inhalation groups (χ2 = 18.428, p < 0.001). The same trend was observed between the 2 groups of low-flow humidified and low-flow nonhumidified nasal cannula oxygen inhalation (χ2 = 26.194, p < 0.001). Discussion/Conclusion: Neither high-flow humidified nasal cannula oxygen inhalation nor low-flow humidified nasal cannula oxygen inhalation will increase the incidence of recurrent or serious epistaxis complications; the same trend was observed for patients who use anticoagulant and antiplatelet drugs. Humidification during low-flow nasal cannula oxygen inhalation can prevent severe and repeated epistaxis to a certain extent.

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