scholarly journals Clinical research about the improved PVP method in treatment of acute osteoporotic vertebral compression fractures

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986466 ◽  
Author(s):  
Yao Zhang ◽  
JiPeng Song ◽  
Yu Hou ◽  
GenAi Zhang ◽  
LiXiang Ding
Keyword(s):  
Digital Design ◽  
Trial Registration ◽  
Vertebral Compression Fractures ◽  
Clinical Trial Registration ◽  
Traditional Group ◽  
X Ray ◽  
Compression Fractures ◽  
Registration Number ◽  
Operation Duration ◽  
Radiological Dose

Objective: The traditional percutaneous vertebroplasty (PVP) could induce massive radiation and side injuries to the tissues around the fractured centrum. This study was designed to reduce the radiation and damage and improve the treatment efficiency of PVP. Methods: Forty four patients who diagnosed to be acute osteoporotic single vertebral compression fractures were collected and randomly divided into traditional group and improved group, and these two groups were separately treated by the traditional and improved PVP which assisted by the preoperative digital design. The treatment outcome between these two groups was compared and analyzed by Students’ t test and χ 2 test. Results: Compared with the traditional PVP, the improved PVP could significantly reduce the X-ray fluoroscopy times for determining puncture point (14.41 ± 4.00 vs. 6.82 ± 2.15, p < 0.001) and puncture route (22.73 ± 3.89 vs. 13.36 ± 3.39, p < 0.001), the X-ray fluoroscopy times during the operation (76.59 ± 12.4 vs. 34.82 ± 6.74, p < 0.001), operation duration (28.64 ± 7.43 min vs. 15.23 ± 4.4 min, p < 0.001), and total radiological dose (588.85 ± 53.86 cGycm2 vs. 276.5 ± 58.17 cGycm2, p < 0.001). The improved PVP could also significantly decrease the visual analog score at intra-operation (7.68 ± 0.78 vs. 4.50 ± 0.67, p < 0.001) and 1 day after the operation (2.45 ± 0.51 vs. 2.16 ± 0.36, p < 0.05). Besides, the improved PVP could not significantly affect the Oswestry disability index after operation ( p > 0.05). Conclusion: The improved PVP operation could significantly reduce the total radiological dose and X-ray fluoroscopy times, protect the patients and medical staff, and reduce the pain caused by the operation. Trial registration: This trial was registered in China clinical trial registration center and the registration number was ChiCTR-INR-17011557.

Bone density and bone health alteration in boys with Duchenne Muscular Dystrophy: a prospective observational study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Renu Suthar ◽  
B. V. Chaithanya Reddy ◽  
Manisha Malviya ◽  
Titiksha Sirari ◽  
Savita Verma Attri ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Bone Health ◽  
Prospective Observational Study ◽  
Bone Fractures ◽  
Long Bone ◽  
Vertebral Compression Fractures ◽  
Serum Osteocalcin ◽  
Z Score ◽  
X Ray ◽  
Compression Fractures

Abstract Objectives Boys with Duchenne Muscular Dystrophy (DMD) are at increased risk for compromised bone health, manifesting as low-impact trauma long bone fractures and vertebral compression fractures. Methods In a prospective observational study, we studied bone health parameters in North Indian boys with DMD. We consecutively enrolled ambulatory boys with DMD on glucocorticoid therapy. Bone health was evaluated with X-ray spine, Dual-energy X-ray absorptiometry (DXA), serum calcium, vitamin D3 (25[OH]D), 1,25-dihyroxyvitamin D3 (1,25[OH]2D3), serum osteocalcin, osteopontin, and N terminal telopeptide of type 1 collagen (Ntx) levels. Results A total of 76 boys with DMD were enrolled. The median age was 8.5 (interquartile range [IQR] 7.04–10.77) years. Among these, seven (9.2%) boys had long bone fractures, and four (5.3%) had vertebral compression fractures. Fifty-four (71%) boys underwent DXA scan, and among these 31 (57%) had low bone mineral density (BMD, ≤−2 z-score) at the lumbar spine. The mean BMD z-score at the lumbar spine was −2.3 (95% confidence interval [CI] = −1.8, −2.8), and at the femoral neck was −2.5 (95% CI = −2, −2.9). 25(OH)D levels were deficient in 68 (89.5%, n=76) boys, and 1,25(OH)2D3 levels were deficient in all. Mean serum osteocalcin levels were 0.68 ± 0.38 ng/mL (n=54), serum osteopontin levels were 8.6 ± 4.6 pg/mL (n=54) and serum Ntx levels were 891 ± 476 nmol/L (n=54). Boys with low BMD received glucocorticoids for longer duration, in comparison to those with normal BMD (median, IQR [16.9 (6–34) months vs. 7.8 (4.8–13.4) months]; p=0.04). Conclusions Bone health is compromised in North Indian boys with DMD. BMD at the lumbar spine is reduced in more than half of boys with DMD and nearly all had vitamin D deficiency on regular vitamin D supplements. Longer duration of glucocorticoid therapy is a risk factor for low BMD in our cohort.

Randomized controlled trial of vertebroplasty versus kyphoplasty in the treatment of vertebral compression fractures

2015 ◽  
Vol 8 (7) ◽  
pp. 756-763 ◽  
Author(s):  
Avery J Evans ◽  
Kevin E Kip ◽  
Waleed Brinjikji ◽  
Kennith F Layton ◽  
Mary L Jensen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Vertebral Body ◽  
Controlled Trial ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Time Points ◽  
Randomized Controlled ◽  
Primary Endpoints ◽  
Average Pain ◽  
Registration Number

BackgroundWe present the results of a randomized controlled trial evaluating the efficacy of vertebroplasty versus kyphoplasty in treating vertebral body compression fractures.MethodsPatients with vertebral body compression fractures were randomly assigned to treatment with kyphoplasty or vertebroplasty. Primary endpoints were pain (0–10 scale) and disability assessed using the Roland–Morris Disability Questionnaire (RMDQ). Outcomes were assessed at 3 days, 1 month, 6 months, and 1 year following the procedure.Results115 subjects were enrolled in the trial with 59 (51.3%) randomly assigned to kyphoplasty and 56 (48.7%) assigned to vertebroplasty. Mean (SD) pain scores at baseline, 3 days, 30 days, and 1 year for kyphoplasty versus vertebroplasty were 7.4 (1.9) vs 7.9 (2.0), 4.1 (2.8) vs 3.7 (3.0), 3.4 (2.5) vs 3.6 (2.9), and 3.0 (2.8) vs 2.3 (2.6), respectively (p>0.05 at all time points). Mean (SD) RMDQ scores at baseline, 3 days, 30 days, 180 days, and 1 year were 17.3 (6.6) vs 16.3 (7.4), 11.8 (7.9) vs 10.9 (8.2), 8.6 (7.2) vs 8.8 (8.5), 7.9 (7.4) vs 7.3 (7.7), 7.5 (7.2) vs 6.7 (8.0), respectively (p>0.05 at all time points). For baseline to 12-month assessment in average pain and RMDQ scores, the standardized effect size between kyphoplasty and vertebroplasty was small at −0.36 (95% CI −1.02 to 0.31) and −0.04 (95% CI −1.68 to 1.60), respectively.ConclusionsOur study indicates that vertebroplasty and kyphoplasty appear to be equally effective in substantially reducing pain and disability in patients with vertebral body compression fractures.Trial registration numberNCT00279877.

scholarly journals FEATURES OF THE DIAGNOSIS OF UNCOMPLICATED COMPRESSION FRACTURE OF THE THORACIC SPINE IN CHILDREN

2019 ◽  
Vol 20 (5) ◽  
pp. 307-311
Author(s):  
Yakhya M. Yakhyaev ◽  
M. I. Izrailov ◽  
V. N. Merkulov ◽  
A. M. Aliskandiev ◽  
T. Ya. Yakhyaeva
Keyword(s):  
Thoracic Spine ◽  
Compression Fracture ◽  
Diagnostic Process ◽  
Vertebral Compression Fractures ◽  
Thoracic Vertebrae ◽  
Healthy Children ◽  
X Ray ◽  
Compression Fractures ◽  
Fractures In Children ◽  
Ct And Mri

X-ray diagnostics of compression fractures of bodies of the thoracic vertebrae in children not seldom causes great difficulties due to the fact that even in healthy children vertebrae have a number of features, particularly, the wedge shape. For the purpose of differential diagnosis there was performed chest X-ray examination of the thoracic vertebrae in healthy children and cases after the compression damage. The wedge index and the disk coefficient for various segments of the thoracic spine were calculated. The diagnostic efficiency of radionuclide studies was estimated to reaches 79%. The useof highly informative modern medical techniques (CT and MRI) in the diagnosis of vertebral compression fractures in children allows accurately and timely make the diagnosis and determine the condition of the surrounding tissues. Based on the analysis of medical records, radiographs, identification of options of radionuclide, CT and MRI studies, there was elaborated an algorithm for the diagnosis of compression fractures of vertebrae, which allowed optimize the diagnostic process. There are determined advantages of this algorithm.

scholarly journals Unilateral Transforaminal Approach (UTFA) in Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Novel Puncture Technique

2021 ◽  
Author(s):  
wang yefeng ◽  
Li suoyuan ◽  
Cai xiaoqiang ◽  
Shen jun ◽  
Zou tianming
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Vertebral Compression Fractures ◽  
X Rays ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Invasive Treatment ◽  
X Ray ◽  
Compression Fractures ◽  
Transforaminal Approach

Abstract Background: Percutaneous vertebroplasty (PVP) via various puncture approaches was an effective minimally invasive treatment for osteoporotic vertebral compression fractures (OVCFs). In recent years, unilateral puncture techniques had been increasingly used with advantages of shorter operation time, lower X-ray exposure. The aim of this study was to explore the safety and efficacy of the unilateral transforaminal approach (UTFA) in PVP for the treatment of OVCFs. Methods: A retrospective study was designed to review 155 cases of single-level OVCFs from July 2018 to December 2019. We treated 77 patients with PVP via the UTFA and 78 via the bilateral transpedicular approach (BTPA). Operation time, number of intraoperative fluoroscopic X-rays, volume of bone cement injection and distribution of bone cement were recorded. We used Visual Analog Scale (VAS) score and Oswestry disability index (ODI) presurgery and at 1 day, 3 months and last follow-up after surgery to assess clinical outcomes. Results: The operation was successfully completed in both groups, with no complications of neurovascular injuries or bone cement embolism. UTFA group had significantly shorter operation time and less-frequent fluoroscopy than BTPA group (P < 0.05). There were no significant differences between the two groups in volume or distribution of injected bone cement (P > 0.05). Postoperative VAS scores and ODI of the two groups were significantly improved over their presurgical values (P < 0.05), but there were no significant differences in VAS or ODI at each time point between the two groups (P > 0.05). Conclusions: Both unilateral transforaminal PVP and bilateral transpedicular PVP were safe and effective treatments for OVCFs, but the former approach had the advantages of shorter operation time and less X-ray radiation exposure and therefore is worthy of greater clinical application.

scholarly journals Comparison of IOL Power Calculated by Preoperative Biometry versus Intraoperative Wavefront Aberrometry in Thai Cataract Patients.

2020 ◽  
Author(s):  
Bharkbhum Khambhiphant ◽  
Sribenjapanon Thanyaporn
Keyword(s):  
Trial Registration ◽  
Altman Analysis ◽  
Clinical Trial Registration ◽  
Bland Altman Analysis ◽  
Multifocal Iol ◽  
Registration Number ◽  
Wavefront Aberrometry ◽  
Iol Power ◽  
The One ◽  
Cataract Patients

Abstract Background: To find agreement between the calculated intraocular lens (IOL) power from using the SRK/T based preoperative biometry and the intraoperative wavefront aberrometry (ORA®) in Thai cataract patients, and to compare the accuracy of each method with the postoperative refraction results.Methods: Eyes that underwent cataract surgery with monofocal or multifocal IOL implantation were enrolled in this prospective study. All eye biometry was measured preoperatively and the ORA intraoperatively. The SRK/T suggested IOL from the preoperative biometry was chosen in all cases. The suggested power and the estimated refraction (EST) from both devices were collected. Bland Altman analysis was used to find the agreement between them. The predicted EST of implanted IOL from both devices were compared with the one-month postoperative SE. Results: The study comprised 97 eyes (79 patients). Of these, 38 eyes (39.2%) had the same suggested IOL power, 36 eyes (37.1%) were within ±0.5D, 20 eyes (20.6%) were within ±1.0D and 3 eyes were beyond ±1.0D. Bland-Altman analysis found the mean difference between IOL power calculated from both devices was 0.39 with LoA of -0.54 to 1.31. The correlation was 98.50% (95%CI 98%- 99.10%). In the same suggested IOL power group, the median difference of EST by preoperative biometry and ORA compared with one-month postoperative SE were -0.08 (95%CI: -0.08, 1.11), and -0.14 (95%CI: -0.88, 1.2), respectively. Conclusions:The ORA and preoperative biometry results were in concordance with each other. The result of preoperative biometry was more accurate than ORA in this study. Trial Registration: The thai clinical trial registration number: TCTR20171005001Registration Date: October 3rd, 2017First Enrollment: November 10th, 2017

scholarly journals Comparison of IOL Power Calculated by Preoperative Biometry versus Intraoperative Wavefront Aberrometry in Thai Cataract Patients.

2020 ◽  
Author(s):  
Bharkbhum Khambhiphant ◽  
Sribenjapanon Thanyaporn
Keyword(s):  
Trial Registration ◽  
Altman Analysis ◽  
Clinical Trial Registration ◽  
Bland Altman Analysis ◽  
Multifocal Iol ◽  
Registration Number ◽  
Wavefront Aberrometry ◽  
Iol Power ◽  
The One ◽  
Cataract Patients

Abstract Background: To find agreement between the calculated intraocular lens (IOL) power from using the SRK/T based preoperative biometry and the intraoperative wavefront aberrometry (ORA®) in Thai cataract patients, and to compare the accuracy of each method with the postoperative refraction results.Methods: Eyes that underwent cataract surgery with monofocal or multifocal IOL implantation were enrolled in this prospective study. All eye biometry was measured preoperatively and the ORA intraoperatively. The SRK/T suggested IOL from the preoperative biometry was chosen in all cases. The suggested power and the estimated refraction (EST) from both devices were collected. Bland Altman analysis was used to find the agreement between them. The predicted EST of implanted IOL from both devices were compared with the one-month postoperative SE. Results: The study comprised 97 eyes (79 patients). Of these, 38 eyes (39.2%) had the same suggested IOL power, 36 eyes (37.1%) were within ±0.5D, 20 eyes (20.6%) were within ±1.0D and 3 eyes were beyond ±1.0D. Bland-Altman analysis found the mean difference between IOL power calculated from both devices was 0.39 with LoA of -0.54 to 1.31. The correlation was 98.50% (95%CI 98%- 99.10%). In the same suggested IOL power group, the median difference of EST by preoperative biometry and ORA compared with one-month postoperative SE were -0.08 (95%CI: -0.08, 1.11), and -0.14 (95%CI: -0.88, 1.2), respectively. Conclusions:The ORA and preoperative biometry results were in concordance with each other. The result of preoperative biometry was more accurate than ORA in this study. Trial Registration: The thai clinical trial registration number: TCTR20171005001Registration Date: October 3rd, 2017First Enrollment: November 10th, 2017

scholarly journals Patient expectations are better for immunotherapy than traditional chemotherapy for cancer

2020 ◽  
Vol 146 (12) ◽  
pp. 3189-3198
Author(s):  
Andreas Ihrig ◽  
Jenniffer Richter ◽  
Carsten Grüllich ◽  
Leonidas Apostolidis ◽  
Peter Horak ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Cancer Patients ◽  
Checkpoint Inhibitors ◽  
Mixed Methods Study ◽  
Trial Registration ◽  
Risk Awareness ◽  
Structured Interviews ◽  
Clinical Trial Registration ◽  
Registration Number ◽  
Advanced Stage Cancer

Abstract Purpose The main aim of the study was to explore the expectations and knowledge of advanced-stage cancer patients about immunotherapy. Methods This mixed methods study included 53 cancer patients on immune checkpoint inhibitors (ICIs), 55 cancer patients undergoing chemotherapy (CT), and 53 non-cancer patients. Participants’ expectations about ICIs and CT were compared. Additional qualitative data were derived from semi-structured interviews. Results Among patients who did not receive ICIs, 63 (58%) had never heard of ICIs and 94 (87%) had large gaps in their knowledge of ICIs. Among ICI patients, 33 (62%) simply described ICIs without errors. ICI perception was positive, regardless of whether respondents received or had heard of ICIs, which became particularly evident when compared to CT. ICIs were rated as more promising, and all adverse effects were expected to be significantly lower than those of CT. Knowledge about ICIs was also limited in the interviewed ICI patients. Some patients reported adverse effects of ICIs that were mostly mild and well-tolerated or easily treated. Conclusions The lack of understanding of ICIs should be improved by activities to increase the knowledge of ICI patients and the general population. In contrast to CT, ICIs invoked fewer negative associations with efficacy and toxicity. Therefore, attention should be paid to risk awareness when educating patients. (Clinical trial registration number: DRKS00011868) Trial Registration: German clinical trials register, www.germanctr.de, number DRKS00011868.

scholarly journals Serum TNFα levels at 24 h after certolizumab pegol predict effectiveness at week 12 in patients with rheumatoid arthritis from TSUBAME study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Yusuke Miyazaki ◽  
Kazuhisa Nakano ◽  
Shingo Nakayamada ◽  
Satoshi Kubo ◽  
Shigeru Iwata ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Certolizumab Pegol ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Trial Registration ◽  
Clinical Parameters ◽  
Characteristic Analysis ◽  
Clinical Trial Registration ◽  
Registration Number ◽  
The Relationship

Abstract Objective To estimate the relationship between serum TNFα, IL-6, and serum CZP levels and the clinical response to CZP in RA patients in the TSUBAME study. Methods One hundred patients with RA who received CZP were enrolled and multiple clinical parameters, serum TNFα, IL-6, and CZP levels, were assessed at 0, 24, and 48 h and 12 weeks after first administration of CZP. Results The CZP therapy significantly improved the DAS28(ESR) at 12 weeks. Serum TNFα and IL-6 levels significantly decreased from baseline at 24 h after the first administration of CZP. Serum TNFα levels at baseline were not related to clinical parameters at baseline and improvement in DAS28(ESR) at week 12 of the CZP therapy. However, serum levels of CZP at 24 h were strongly and negatively correlated with TNFα levels at 24 h, which were negatively correlated with improved rate in DAS28(ESR) at week 12. Only serum levels of TNFα, but not IL-6, at 24 h had a negative correlation with achievement of DAS28(ESR)<2.6 at week 12 by the multivariate analysis (odds ratio 0.01, 95% confidence interval 0.04e−2–0.22, p < 0.01). A receiver operating characteristic analysis was conducted to estimate the achievement of DAS28(ESR)<2.6 at week 12 after the CZP therapy and cut-off value of 0.76 pg/ml for serum levels of TNFα at 24 h was yielded (area under the curve=0.75). DAS28(ESR)<2.6 was achieved at week 12 significantly more patients with lower serum TNF levels (≦0.76 pg/ml) at 24 h than those with higher TNF levels. Conclusions CZP was highly effective in RA patients who had low serum TNFα levels at 24 h after the initial administration of CZP. Therefore, we propose that serum TNFα levels at 24 h could serve as a biomarker predicting effectiveness to CZP at week 12 in patients with RA. Trial registration Clinical trial registration number: UMIN ID:000022831

scholarly journals DETECT Schools Study Protocol: A Prospective Observational Cohort Surveillance Study Investigating the Impact of COVID-19 in Western Australian Schools

2021 ◽  
Vol 9 ◽  
Author(s):  
Marianne J. Mullane ◽  
Hannah M. Thomas ◽  
Melanie Epstein ◽  
Joelie Mandzufas ◽  
Narelle Mullan ◽  
...  
Keyword(s):  
School Setting ◽  
Trial Registration ◽  
Surveillance Study ◽  
Clinical Trial Registration ◽  
School Communities ◽  
Peace Of Mind ◽  
Psychosocial Wellbeing ◽  
Registration Number ◽  
Observational Cohort ◽  
The Impact

Introduction: Amidst the evolving COVID-19 pandemic, understanding the transmission dynamics of the SARS-CoV-2 virus is key to providing peace of mind for the community and informing policy-making decisions. While available data suggest that school-aged children are not significant spreaders of SARS-CoV-2, the possibility of transmission in schools remains an ongoing concern, especially among an aging teaching workforce. Even in low-prevalence settings, communities must balance the potential risk of transmission with the need for students' ongoing education. Through the roll out of high-throughput school-based SARS-CoV-2 testing, enhanced follow-up for individuals exposed to COVID-19 and wellbeing surveys, this study investigates the dynamics of SARS-CoV-2 transmission and the current psychosocial wellbeing impacts of the pandemic in school communities.Methods: The DETECT Schools Study is a prospective observational cohort surveillance study in 79 schools across Western Australia (WA), Australia. To investigate the incidence, transmission and impact of SARS-CoV-2 in schools, the study comprises three “modules”: Module 1) Spot-testing in schools to screen for asymptomatic SARS-CoV-2; Module 2) Enhanced surveillance of close contacts following the identification of any COVID-19 case to determine the secondary attack rate of SARS-CoV-2 in a school setting; and Module 3) Survey monitoring of school staff, students and their parents to assess psycho-social wellbeing following the first wave of the COVID-19 pandemic in WA.Clinical Trial Registration: Trial registration number: ACTRN12620000922976

scholarly journals CSF MicroRNAs Reveal Impairment of Angiogenesis and Autophagy in Parkinson Disease

2021 ◽  
Vol 7 (6) ◽  
pp. e633
Author(s):  
Alan J. Fowler ◽  
Jaeil Ahn ◽  
Michaeline Hebron ◽  
Timothy Chiu ◽  
Reem Ayoub ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Mirna Expression ◽  
Trial Registration ◽  
Whole Genome ◽  
Autophagy Flux ◽  
Clinical Trial Registration ◽  
Mirna Sequencing ◽  
Registration Number ◽  
Disease Modifying

Background and ObjectivesWe assessed longitudinal changes in CSF microRNAs (miRNAs) in patients with moderately severe Parkinson disease.MethodsWe used next-generation whole-genome miRNA sequencing to determine CSF miRNA expression in 75 patients with Parkinson disease after single random ascending doses of nilotinib and longitudinal miRNA expression after daily nilotinib, 150 and 300 mg, vs placebo for 1 year.ResultsSignificant changes in the expression of miRNAs that control genes and pathways that regulate angiogenesis, autophagy, and the blood-brain-barrier components, primarily collagen, were observed over 1 year, suggesting impairment of these pathways in Parkinson progression in these patients. Different miRNAs that indicate activation of genes associated with autophagy flux and clearance and angiogenesis were significantly altered in the nilotinib, 300 mg vs 150 mg, or placebo group, and these changes correlated with clinical outcomes. No changes were observed in miRNAs after a single dose of nilotinib vs placebo.DiscussionThis study suggests vascular and autophagy defects in Parkinson progression. Nilotinib, 300 mg, reverses these effects via alteration of miRNA expression, suggesting epigenomic changes that may underlie long-term disease-modifying effects.Trial Registration InformationClinical trial registration number: NCT02954978.

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