O2–O3 chemodiscolysis: How much, how long? Retrospective outcome evaluation of different treatment sessions in partially-responder patients

2021 ◽  
pp. 159101992110399
Author(s):  
Federico Bruno ◽  
Nicola Carboni ◽  
Pierpaolo Palumbo ◽  
Francesco Arrigoni ◽  
Marco Varrassi ◽  
...  
Keyword(s):  
Correlation Analysis ◽  
Intervertebral Disc ◽  
Morphological Changes ◽  
Lumbar Disc ◽  
Outcome Evaluation ◽  
Post Treatment ◽  
Injection Group ◽  
Significant Difference ◽  
Disc Area ◽  
Group B

Purpose To retrospectively evaluate the clinical and instrumental outcome of different treatment sessions of oxygen–ozone (O2–O3) chemodiscolysis in patients with lumbar disc herniation Methods We evaluated 73 patients partially responders to a single session of oxygen–ozone (O2–O3) chemodiscolysis and submitted to multiple injections sessions. All patients completed a pre- and post-treatment clinical (VAS and modified McNab score) and instrumental MRI follow-up. Imaging evaluation included assessment of intervertebral disc area (IDA). Pre- and post-treatment differences were compared to evaluate differences in variation between groups. Correlation analysis was used to evaluate the relationship between morphological and clinical parameters. Results Based on the type and number of treatments performed, patients were divided into three groups: Group A) patients submitted to an additional periradicular anaesthetic/steroid injection; Group B) patients submitted to an additional session of intradiscal O2–O3 injection; Group C) patients submitted to two further sessions of intradiscal O2–O3 injection. The results showed an improvement of pain scores in all groups, and a smaller disc area change in group B. Comparing the differences between pre- and post-treatment features among the three different groups of patients, we did not find any statistically significant difference. Correlation analysis did not show any statistically significant correlation between the morphological changes of the intervertebral disc and the clinical output scores. Conclusions In our retrospective observation of partially responder patients, multiple intradiscal ozone injections were not associated with a higher disc shrinkage nor superior clinical outcome compared to a single intradiscal O2–O3 application with an additional periradicular injection session.

scholarly journals Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain

2015 ◽  
Vol 16 (12) ◽  
pp. 939-943 ◽  
Author(s):  
Leena Alsomadi ◽  
Riyad Al Habahbeh
Keyword(s):  
Pain Scale ◽  
Prophylactic Antibiotics ◽  
Post Treatment ◽  
Endodontic Treatment ◽  
Significant Difference ◽  
Group A ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Group B

ABSTRACT Aim To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. Materials and methods After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Results Peak postoperative pain occurred at 16 hours posttreatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). Conclusion Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Clinical significance Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients. How to cite this article Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015;16(12):939-943.

Intervertebral Disc Function Is Restored in an In Vivo Model of Chronic Nucleus Pulposus Glycosaminoglycan Reduction

2008 ◽  
Author(s):  
John I. Boxberger ◽  
Joshua D. Auerbach ◽  
Sounok Sen ◽  
George R. Dodge ◽  
Dawn M. Elliott
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Disc Degeneration ◽  
Lumbar Disc ◽  
Post Treatment ◽  
In Vivo Model ◽  
Long Term Effects ◽  
Early Human

Reduced nucleus pulposus glycosaminoglycan (GAG) content is one of the earliest clinically detectable changes during the course of intervertebral disc degeneration [1,2]. Depletion of nucleus GAG by small percentages consistent with this early loss has been experimentally linked to altered motion segment mechanical function, and thus, potentially increases the risk of damage accumulation directly due to elevated stresses and strains and through altered cellular function [3]. Recently, our laboratory has established an in vivo model in a rat lumbar disc which moderately decreases nucleus GAG to levels observed in early human degeneration. In this model, GAG loss is accompanied by a state of hypermobility at both 4 and 12 weeks post treatment [4], potentially making the disc susceptible to mechanical failure. The objective of this study was to determine the long term effects of nucleus GAG depletion and to determine if altered discs demonstrate hallmark features of disc degeneration. We hypothesized that GAG will remain depleted 24 weeks post treatment, potentially decreasing to lower levels, and further that geometrical and mechanical changes consistent with degeneration will be observed.

scholarly journals Elemental and morphological analysis of enamel following the application of two bleaching systems with amorphous calcium phosphate: effect on enamel erosion susceptibility

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Shaymaa M. Nagi ◽  
Shahinaz H. Nabil ◽  
Mohamed H. Zaazou
Keyword(s):  
Calcium Phosphate ◽  
Amorphous Calcium Phosphate ◽  
Morphological Changes ◽  
Enamel Surface ◽  
Control Group ◽  
Bleaching Agent ◽  
Bleaching Procedure ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Using remineralizing agents during and after bleaching procedures could maintain enamel surface, decreasing its erosive susceptibility. This study evaluated the efficacy of an in-office and at-home bleaching materials with amorphous calcium phosphate (ACP) on the susceptibility of the enamel to erosion. Forty-five bovine specimens were separated into three groups. Group A: no bleaching (control). Group B: Zoom 2 bleaching followed by ACP application. Group C: Nite White ACP. All specimens in all groups were subjected to an erosive challenge for five days. Using Energy Dispersive X-ray all specimens were subjected to elemental analysis and were examined for morphological changes under Scanning Electron Microscope (SEM). Results Group B showed the highest mean calcium, phosphorus and sodium weight percent (wt%). Both Groups B and C showed statistically significant difference. While, there was no statistically significant difference between both Groups A and B.The sodium mean wt% showed a statistically significant difference in all groups. The magnesium mean wt% showed no statistically significant difference in all groups. SEM photomicrograph revealed hollowing of prism cores with intact prisms peripheries for group A. Group B showed relativity smooth surface with minor pores, while Group C showed an increase in the depth of surface irregularities and depressions. Conclusions Enamel susceptibility to erosion after bleaching procedure was material dependent. Zoom 2 bleaching agent followed by ACP application did not increase the susceptibility of the enamel surface to erosion. Adding ACP to Nite White bleaching agent had no benefit on reducing enamel susceptibility to erosion.

scholarly journals Classification of previously unclassified cases of craniosynostosis

1996 ◽  
Vol 1 (6) ◽  
pp. E1 ◽  
Author(s):  
Paul D. Chumas ◽  
Giuseppe Cinalli ◽  
Eric Arnaud ◽  
Daniel Marchac ◽  
Dominique Renier
Keyword(s):  
Morphological Changes ◽  
Statistical Significance ◽  
Frontal Bone ◽  
Complex Group ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Lower Intelligence ◽  
Second Procedure

Cases of craniosynostosis usually fall into well-demarcated categories: those related to a syndrome or identified by a combination of suture involvement and morphological appearance. Between 1976 and 1995, 53 (3.6%) of 1474 cases in the craniofacial databank were assessed and designated as nonsyndromic but unclassifiable. The records and radiological studies obtained in these patients were retrospectively analyzed and comparisons were made with patients classified in the databank as having simple craniosynostoses. It proved possible to divide the formerly unclassifiable cases into two groups: those with “two-suture disease” (Group A) and a “complex” group (Group B) in which more than two sutures were affected. Group A consisted of 36 cases (68%) of patients presenting with clear evidence of simultaneous involvement of two sutures but with no progression over time to suggest a more diffuse pansynostosis. Suture involvement was as follows: 17 of 36 sagittal plus one coronal; seven of 36 sagittal plus metopic; six of 36 sagittal plus one lambdoid; and six of 36 metopic plus one coronal. The only significant difference between the Group A cases and the cases of simple craniosynostoses was in the percentage requiring a second operation (24% vs. 5%, p < 0.0001). Group B consisted of 17 cases in which the patients presented at a slightly earlier age (mean 1 year) with severe morphological changes and multiple suture involvement. At the time of surgery, six of 17 patients showed large areas of lacunae within the cranial vault, making craniectomy the only option. In Group B, 10 of 17 patients displayed bilateral lambdoid plus sagittal suture involvement resulting in marked occipital recession posteriorly, whereas anteriorly in six of these 10 patients there was a massive frontal bone associated with posteriorly located coronal sutures. In contrast, there were also four patients in Group B with bilateral coronal plus metopic involvement resulting in a small frontal bone. There was a trend toward a lower intelligence quotient and a worse morphological outcome in the patients in Group B, but again the only result attaining statistical significance when compared to the databank was the rate of second operation (37.5 vs. 5%, p < 0.0001). “Two-suture synostosis” is a relatively straightforward condition and is treatable with standard craniosynostosis techniques. However, possibly as a result of surgical compromise when two sutures are involved, the rate of reoperation is far higher than in simple suture cases. In contrast, patients in the “complex” group presenting with severe multisuture involvement require a more tailor-made approach to their management that often entails a second procedure.

scholarly journals Efficacy of Oral Bilastine in Comparison with Levocetirizine in Allergic Rhinitis- A Randomised Clinical Study

2021 ◽  
Author(s):  
M Vanitha ◽  
K Sowmini ◽  
K Santha Sheela Kumari ◽  
Resu Neha Reddy
Keyword(s):  
Allergic Rhinitis ◽  
Immunoglobulin E ◽  
Statistical Significance ◽  
Post Treatment ◽  
Once Daily ◽  
Treatment Groups ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Antihistaminic Drugs

Introduction: Allergic rhinitis is a heterogeneous disorder characterised by major symptoms like sneezing, itching, nasal congestion and rhinorrhea. Because of bothersome side effects of first-generation antihistaminic drugs, second generation antihistaminic drugs have been used since few years. Recent studies have showed that novel drug Bilastine has been approved as an effective treatment in Allergic rhinitis. Aim: To evaluate Total Nasal Symptom Scores (TNSS), Serum Immunoglobulin E (IgE), Serum Absolute Eosinophil Count (AEC) in patients with allergic rhinitis, pre and post-treatment with Bilastine and Levocetirizine. Materials and Methods: A randomised, open-labelled, study was conducted between January 2020 to March 2020. Hundred patients with allergic rhinitis were enrolled into the study. They were randomised into two groups of which group A received tablet Bilastine 20 mg once daily for two weeks and group B received tablet Levocetirizine 5 mg once daily for two weeks. The results of TNSS, IgE, AEC and pre and post-treatment values were compared in both the treatment groups. Unpaired t-test was used as the test of significance between the two treatment groups. Results: The prevalence of allergic rhinitis in the study was 49% in males and 51% in females. The mean difference in pre and post-treatment in TNSS (group A=1.627, group B=1.143), serum IgE (A=33.118, B=49.653), serum AEC (A=28.00, B=27.245) showed no statistically significant difference between two groups (p-value >0.05). Conclusion: Bilastine and levocetirizine are equally efficacious. Though there is clinical significance in treatment of allergic rhinitis between the groups, there is no statistical significance which would prove Bilastine is clinically superior to Levocetirizine for the allergic rhinitis treatment.

scholarly journals Clinical Effect of Lateral Transforaminal Endoscopic Surgery in the Treatment of Lumbar Disc Herniation

2021 ◽  
Vol 5 (6) ◽  
pp. 68-72
Author(s):  
Weiya Zhang
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Endoscopic Surgery ◽  
Early Stage ◽  
Lumbar Disc ◽  
Normal Function ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Transforaminal Endoscopic Surgery

Objective: To analyze the efficacy of lateral transforaminal endoscopic surgery in the treatment of lumbar disc herniation. Methods: A total of 44 patients with lumbar disc herniation, treated in Yancheng No.1 People’s Hospital from January 2019 to June 2020, were randomly divided into two groups; the 24 patients in group A were treated by lateral transforaminal endoscopic surgery, while the 20 patients in group B were treated by routine lamina fenestration and nucleus pulposus surgery. Results: The curative effect of group A (91.67%) was higher than that of group B (85.0%), P > 0.05; there was no significant difference in the angle from straight leg raise between group A and group B (P > 0.05); the Oswestry Disability Index (ODI) and the visual analogue scale (VAS) of group A were lower than those of group B (P < 0.05); the incision length, intraoperative blood loss, and hospital stay of the patients in group A were better than those in group B, P < 0.05. Conclusion: Lateral transforaminal endoscopic surgery can significantly reduce pain, improve symptoms, and help to restore normal function in the early stage for patients with lumbar disc herniation.

scholarly journals Postoperative Wound Pain and Hospital Stay in Patients of Open Lumbar Discectomy (OLD) Versus Endoscopic Lumbar Discectomy (ELD) in Lumbar Disc Herniation (LDH)

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
SYED SHAHZAD HUSSAIN ◽  
USMAN AHMED KAMBOOH ◽  
ASIF RAZA ◽  
ADIL AMIN ◽  
SAMAN SHAHID ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Lumbar Disc ◽  
Invasive Procedure ◽  
Lumbar Discectomy ◽  
Postoperative Wound ◽  
Significant Difference ◽  
Wound Pain ◽  
The Mean ◽  
Group B ◽  
Endoscopic Lumbar Discectomy

Background: Endoscopic lumbar discectomy is also beneficial regarding relieving wound pain, less hospital stay and smaller incisions. We compared visual analog scores (VAS) and hospital stay in patients treated with either endoscopic lumbar discectomy or open lumbar discectomy postoperatively.Material and Methods: Half patients underwent open lumbar discectomy – OLD (group A) and half operated with endoscopic lumbar discectomy – ELD (group B). The pain was quantified through visual analog score (VAS) observation in all patients. A preoperative medical management included prescribing a combination of an analgesic and a muscle relaxant along with physiotherapy with an avoidance of lifting heavy loads. Mann- Whitney (U) tests were applied for the comparison of postoperative VAS and hospital stay between groups.Results: 85% patients were having left sided prolapsed paracentral disc, and 15% were having right sided prolapsed paracentral disc. The mean postoperative VAS was 4 in patients treated with ELD and it was 1.32 in patients treated with OLD. The mean hospital stay was 1.5 days in ELD treatment, whereas, it was 2.5 days in OLD treatment. A significant difference (p=0.037) was found in the comparison of mean post-operative VAS between two vertebral levels (i.e., L4-L5 & L5-S1). The post-operative VAS and hospital stay (days) in ELD group were statistically significantly higher than the OLD group (p values 0.000).Conclusion: ELD procedure was effective as compared to open lumbar discectomy in terms of postoperative wound site pain and hospital stay. Endoscopic Lumbar discectomy is a minimally invasive procedure for discectomy.

scholarly journals Topical vancomycine and bacterial culture from intervertebral herniated disc prevent postoperative osteodiscitis

2014 ◽  
Vol 21 (4) ◽  
pp. 417-422
Author(s):  
Danil Adam ◽  
Toma Papacocea ◽  
Ioana Hornea ◽  
Cristiana Moisescu
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Bacterial Infections ◽  
Lumbar Disc ◽  
Postoperative Treatment ◽  
Herniated Disc ◽  
Open Approach ◽  
Group A ◽  
Group B

Abstract Osteodiscitis represents a serious complication of lumbar disc herniation operations. The treatment of osteodiscitis is controversial and expensive to society. It extends over a period of several months from diagnosis. Reducing postoperative osteodiscitis by using simple measures may limit patient's suffering and reduce costs. The purpose of this study is to evaluate the early diagnosis of bacterial infections of the intervertebral disc by isolating germs located in the herniated disc fragment and topical Vancomycine powder application, along with the conventional anti-infective therapy. Medical files of patients who were operated on for lumbar disc herniations during 01.01.2013 - 30.06.2014 were reviewed. The diagnosis of lumbar disc herniation was established based on the clinical evaluation, confirmed by MRI results. The surgical intervention was performed by mini-open approach: fenestration and foraminotomy completed with removal of the herniated disc fragment and disc remnants from the intervertebral space. A group of 162 patients (group A) received conventional therapy for prevention of post-operative infections with 2 doses of cephalosporin. In the second group of 137 patients (group B), after the removal of the herniated disc fragments, 1g of Vancomycine powder was topically applied and the disc fragments were bacteriologically analyzed. They received the conventional treatment of preventing post-operative infections with cephalosprin - 2 doses. The two groups of patients were similar in terms of demographic characteristics: age, sex, operative level. Out of the 162 patients of group A, one patient developed postoperative osteodiscitis and was treated for 3 months with antibiotics. Regarding patients in group B, in four cases Staphylococcus was isolated from the disc fragments. Postoperative treatment for these patients with prolonged antibiotic therapy over the standard period avoided the developement of the clinical picture of osteodiscitis. Postoperative osteodiscitis requires prolonged antibiotherapy. By using simple measures, like topical Vancomycine powder application and early isolation of germs from the herniated intervertebral disc, followed by the immediate establishment of appropriate antibiotic treatment, this serious complication is avoided.

scholarly journals Tubular Microdiscectomy versus Conventional Surgery for Sciatica. A Comparative Prospective Enzyme Study

2020 ◽  
Author(s):  
Mandour Cherkaoui ◽  
Kasouati Jalal ◽  
Laaguili Jawad ◽  
Gazzaz Miloudi ◽  
El Mostarchid Brahim
Keyword(s):  
Muscle Injury ◽  
Creatine Phosphokinase ◽  
Lumbar Disc ◽  
Significant Difference ◽  
Postoperative Serum ◽  
Group A ◽  
Enzyme Study ◽  
The Mean ◽  
Total Creatine ◽  
Group B

Abstract Objective Muscle injury is inevitable during surgical exposure of the spine, and it is quantified by the release of creatine phosphokinase. The aim of the present study is to make a comparison between tubular microdiscectomy and conventional microdiscectomy by using the pre- and postoperative serum concentrations of creatine phosphokinase as an indicator of muscle injury. Materials and Methods A total of 28 patients who underwent surgery for lumbar disc herniation were allocated into 2 groups: 12 patients (group A) operated by transflaval microdiscectomy, and 16 patients (group B) operated by tubular microdiscectomy. The serum concentration of total creatine phosphokinase was measured before surgery (creatine phosphokinase 1) and 1 day after surgery (creatine phosphokinase 2). Results There were 12 women and 16 men; the mean age of the patients and the mean duration of the surgery were respectively 49.5 years and 56 minutes for group A, and 47.3 years and 60 minutes for group B. The p-values of creatine phosphokinase 1, creatine phosphokinase 2 and the creatine–phosphokinase ratio were respectively 0,34; 0,31; and 0,57 (p < 0.05). Conclusion The present study demonstrated that there was no significant difference between tubular microdiscectomy and conventional microdiscectomy according to the analysis of the levels of creatine phosphokinase.

scholarly journals Stool examination and rectal biopsy in the diagnosis and evaluation of therapy of schistosomiasis mansoni

1992 ◽  
Vol 34 (6) ◽  
pp. 601-608 ◽  
Author(s):  
Ana Lúcia Teles Rabello ◽  
Roberto Sena Rocha ◽  
João Paulo Mendes de Oliveira ◽  
Naftale Katz ◽  
José Roberto Lambertucci
Keyword(s):  
Rectal Mucosa ◽  
Test Group ◽  
Rectal Biopsy ◽  
Post Treatment ◽  
Stool Examination ◽  
Adult Males ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Individual

From each of a group of 217 adult males selected through enzyme-immunoassay or skin-test (Group A), six stool samples were examined by both the Lutz/Hoffman, Pons & Janer (Lutz/HPJ) and Kato/Katz methods. In addition, one oogram of the rectal mucosa was performed. By these methods, schistosomiasis was detected in 44.7%, 47.5% and 40.1% of the individuals respectively. To evaluate the methods in the assessment of cure, the last 40 patients from group A, treated with a single oral dose of oxamniquine at 15 mg/kg were followed up for six months (Group B). The criteria for parasitological cure included three stool examinations by Kato/Katz and Lutz/HPJ methods, one, three and six months post-treatment and a rectal biopsy between the fourth and sixth months post-treatment. The examinations were negative in 87.5%, 90% and 95% of the patients, respectively. The efficacy of oxamniquine was 82.5% when the three methods were considered together and there was no statistically significant difference between the sensitivity of the individual methods.

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