scholarly journals Role of Supine and Standing Radiography in Vertebroplasty for Osteoporotic Compression Fractures"

The Nerve ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 41-48
Author(s):  
Jae Hyun Park ◽  
Sang Hyun Kim ◽  
Noh Sung Hyun ◽  
Pyung Goo Cho
Keyword(s):  
Retrospective Analysis ◽  
Patient Selection ◽  
Weight Bearing ◽  
Compression Fracture ◽  
Bed Rest ◽  
X Rays ◽  
Radiographic Study ◽  
Compression Fractures ◽  
Patient’S Outcome

Objective: To confirm the benefits of vertebroplasty (VP) in selected patients with acute vertebral compression fracture (VCF) and analyze whether the study of a weight dynamic plain lateral radiograph would help in making decisions to perform VP. Using retrospective analysis, we aimed to determine the radiological characteristics of patients benefiting from VP.Methods: Data were collected from 54 patients (age, 56-97 years) diagnosed with osteoporosis and compression fractures between December 2013 and January 2018. Each patient was hospitalized with ≥2 weeks of absolute bed rest (ABR) and treated for osteoporosis. Plain lateral supine radiography of the fractured spine was performed prior to diagnosis, and both supine and standing spinal radiographs were taken 1 and 2 weeks after ABR. Patients were categorized into the VP and non-VP groups 2 weeks after ABR.Results: Although patients with worse pain and functional progress were selected to undergo VP, patients in the VP group presented better outcomes in the fourth week of evaluation than those in the non-VP group. In a retrospective analysis of the radiographic study, changes in the compression rate between supine and standing (weight-bearing) X-rays (ΔCR), showed a statistically significant correlation with the patient’s outcome in the second week.Conclusion: VP was found to be an effective management option for patients with VCF. A weightbearing radiographic study of VCFs provided valuable information on patient selection for VP. Therefore, patient selection based on subjective surveys and radiological studies to determine the benefits of VP could be a beneficial management strategy.

scholarly journals Retrospective analysis of 5 years results of first metatarsophalangeal joint arthroplasty, Single surgeon series

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Khalid Merghani Saleh Mohammed ◽  
Yasser Aljabi ◽  
Ara Francis ◽  
Robert Flavin
Keyword(s):  
Retrospective Analysis ◽  
Weight Bearing ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Joint Arthroplasty ◽  
Joint Surface ◽  
X Rays ◽  
Medium Term ◽  
First Metatarsophalangeal Joint

Category: Bunion Introduction/Purpose: First Metatarsophalangeal joint (MTPJ) osteoarthritis is a common forefoot disease. It leads to joint surface destruction and erosions limiting function and causing pain. The disease can be classified to mobile and non mobile or traumatic and atraumatic disease. The gold standard for treatment of stage III and IV remains MTPJ arthrodesis. In this case series we demonstrate MTPJ arthroplasty in mobile MTPJ with stable first interphalangeal joint (IPJ) can achieve short and medium-term results that are comparable to arthrodesis with high satisfaction rate. Methods: Retrospective analysis of 48 MTPJ arthroplasties performed by single surgeon in the period between 2011 to 2016. Patient were included if they had mobile first MTPJ osteoarthritis in the absence of IPJ hypermobility. The Surgical procedure included resurfacing the 1st metatarsal head using Arthrosurface® Hemicap implant and Extensor Digitorum Brevis (EDB) graft on the phalangeal surface of the joint. Radiological parameters collected using weight bearing x-rays prior to surgery, immediate radiological correction after surgery, 6 month and 2 years radiological analysis following the index surgery. Physiotherapy data were collected by senior physiotherapist prospectively during the time of postoperative rehabilitations and it included AOFAS and VAS scores. Results: 48 patients underwent 1st MTP joint arthroplasty using Arthrosurface® Hemicap implant for the metatarsal head with EDB graft on the phalangeal aspect. 44 patients had primary OA of the 1st MTP joint, 4 were conversion of MTPJ arthrodesis to arthroplasty and 3 were treated for non-union of MTP joint arthrodesis. Average postoperative ROM in the sagittal plane was 30 degrees and no valgus deformity in the coronal plane. 3 Patients (0.68%) had residual pain following the surgery due to soft tissue impingement and required further surgical intervention. 1 patient remained dissatisfied after the revision surgery. Conclusion: In short to medium-term follow up, the first MTP joint arthroplasty with Arthrosurface® implant and EDB graft provides an excellent functional outcome in the management of moderate to severe OA. In some selected cases this can be an option for treatment of patient with failed arthrodesis or patients requiring the reversal of the arthrodesis due to other issues.

Digital x-ray mapping of nanometer-size supported bimetallic catalysts

1988 ◽  
Vol 46 ◽  
pp. 530-531
Author(s):  
L. T. Germinario
Keyword(s):  
Background Radiation ◽  
Metal Cluster ◽  
Single Element ◽  
Beam Diameter ◽  
X Rays ◽  
X Ray ◽  
Major Interest ◽  
Induced Changes

Understanding the role of metal cluster composition in determining catalytic selectivity and activity is of major interest in heterogeneous catalysis. The electron microscope is well established as a powerful tool for ultrastructural and compositional characterization of support and catalyst. Because the spatial resolution of x-ray microanalysis is defined by the smallest beam diameter into which the required number of electrons can be focused, the dedicated STEM with FEG is the instrument of choice. The main sources of errors in energy dispersive x-ray analysis (EDS) are: (1) beam-induced changes in specimen composition, (2) specimen drift, (3) instrumental factors which produce background radiation, and (4) basic statistical limitations which result in the detection of a finite number of x-ray photons. Digital beam techniques have been described for supported single-element metal clusters with spatial resolutions of about 10 nm. However, the detection of spurious characteristic x-rays away from catalyst particles produced images requiring several image processing steps.

A scientific research study on the management of Manyasthamba (Cervical Spondylosis) with Nasya and Nasapana

2019 ◽  
Vol 4 (04) ◽  
Author(s):  
Unnikrishnan V S ◽  
Prashanth A S ◽  
Madhusudan Kulkarni
Keyword(s):  
Spinal Cord ◽  
Clinical Data ◽  
Food Habits ◽  
Cervical Spondylosis ◽  
Research Study ◽  
Weight Bearing ◽  
Scientific Research ◽  
Modern Era ◽  
Treatment Aspect

The science of life Ayurveda, not only deals with the prevention of diseases by maintaining health but also with the alleviation of diseases. In this ultra modern era due to change in lifestyles, sedentary works and food habits, people are unable to follow the Dinacharya and Ritucharya as explained in the classics, which may lead to different diseases. Due to improper postural habits, weight bearing and other unwholesome diets and habits there are higher the chances of discomfort and disease pertaining to spinal cord. Manyasthambha is one such condition that disturbs a big population due to today’s alterations in lifestyle. Here an effort is made to study and understand the role of Nasya Karma, Nasaapana and Shamanaushadhi like Vyoshadi Guggulu in the treatment aspect of this disease. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Manyasthambha. As per the clinical data, ‘Nasaapana is found to be more effective than Nasya Karma’. So it can be concluded that better results can be obtained with Shaddharana Yoga as Amapachana, Nasaapana with Mashabaladi Kwatha followed by Vyoshadi Guggulu as Shamanoushadhi.

scholarly journals The analgesic efficacy of extracorporeal shock wave combined with percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaowei Liu ◽  
Hui Wang ◽  
Yang Zhang ◽  
Mingling Wang ◽  
Yujin Qiu ◽  
...  
Keyword(s):  
Shock Wave ◽  
Postmenopausal Women ◽  
Percutaneous Vertebroplasty ◽  
Reduction Rate ◽  
Compression Fracture ◽  
Analgesic Efficacy ◽  
Small Sample ◽  
Compression Fractures ◽  
Extracorporeal Shock Wave ◽  
Post Operation

Abstract Background To explore the analgesic efficacy of extracorporeal shock wave (ESW) combined with percutaneous vertebroplasty (PVP) after reduction in overextension position in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women. Methods The data of postmenopausal women with osteoporotic thoracolumbar compression fracture admitted in our department from January 2017 to October 2019 were analyzed retrospectively. They were divided into groups of unipedicular percutaneous kyphoplasty (U-PKP n = 21), bipedicular PKP (B-PKP n = 20), and ESW combined with PVP after reduction in overextension position (EP-PVP n = 18). The improvement of pain and vertebral height in three groups was compared. Results Postoperative compression rate and Cobb angle of vertebral fractures in the three groups were all lower than those before surgery, and the differences between pre-operation and post-operation were statistically significant (P < 0.05). The visual analog scale (VAS) and Oswestry dysfunction index (ODI) scores of the three groups decreased significantly after the operation (P < 0.05). The ODI scores of the EP-PVP group in the third months after the operation were significantly improved compared with the other two groups, and the difference was statistically significant (P < 0.05). Conclusions In our small-sample study, all three treatment schemes can treat osteoporotic compression fracture of thoracolumbar vertebrae in postmenopausal women, relieve pain, and improve quality of life. ESW combined with PVP after reduction in overextension position could achieve a good vertebral reduction rate and improve kyphosis, and may reduce the application of analgesic drugs.

scholarly journals ROLE OF PHYSICAL THERAPY IN THE TREATMENT OF POSTERIOR ANKLE IMPINGEMENT IN PEDIATRIC ATHLETES - A PROSPECTIVE STUDY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Adam Saloom ◽  
Nick Purcell ◽  
Matthew Ruhe ◽  
Jorge Gomez ◽  
Jonathan Santana ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Prospective Study ◽  
Conservative Management ◽  
Pediatric Patients ◽  
Weight Bearing ◽  
Return To Sport ◽  
Time To Surgery ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement

Background: Posterior ankle impingement (PAI) is a known cause of posterior ankle pain in athletes performing repetitive plantarflexion motion. Even though empirically recommended in adult PAI, there is minimal literature related to the role of conservative physical therapy (PT) in pediatric patients. Purpose: To identify patient characteristics and determine if there is a difference in pediatric patients with PAI who were successful with conservative PT and those who were unsuccessful, requiring surgical intervention. Methods: Prospective study at a tertiary children’s hospital included patients <18 years diagnosed with PAI and underwent PT. Patients who received PT at an external facility were excluded. Collected data included demographics, initial presentation at PT evaluation, treatment throughout PT, patient presentation at PT discharge, time to return to sport (RTS) from initial PT evaluation (if successful), time to surgery from initial PT evaluation (if unsuccessful). Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were collected. Group comparisons were conducted using independent t-tests or chi-square analyses (alpha level set at .05). Results: 31 (12 males, 19 females) patients diagnosed with PAI were enrolled with a mean age 12.61 years (range: 8-17). Gymnastics, football, and basketball were the most commonly implicated sports (42% patients). All patients underwent initial conservative PT for an average of 16.24 weeks (9.23 visits ±7.73). 20/31(64.5%) patients failed conservative management and underwent arthroscopic debridement. PAI pathology was predominantly bony in 61.3% and soft tissue 38.7%. Between the successful PT group and unsuccessful PT group, there was no difference in the proportion of athletes/non-athletes (p=.643). Average RTS time for successful group was 11.47 weeks and average time to surgery for unsuccessful group was 17.82 weeks. There were no significant differences in sex (p=.332), age (p=.674), number of PT visits (p=.945), initial weight-bearing status (p=.367), use of manual therapy (p=.074) including manipulation (p=.172) and mobilization (p=.507), sport (p=.272), initial evaluation ankle ROM (p>.05). Initial AOFAS scores for pain, function, alignment, or total were not significantly different (p=.551, .998, .555, .964 respectively). Conclusion: The first prospective study in pediatric patients with PAI demonstrates that even though success of PT is not dependent on age, sex, sport or PAI pathology, a notable proportion of patients who undergo PT do not need surgery. Conservative management including PT should be the initial line of management for PAI. PT treatment and surgery (if unsuccessful with PT) allowed patients to return to prior level of activity/sports. Tables/Figures: [Table: see text]

Description of the role of pharmacist independent double checks during cognitive order verification of outpatient parenteral anti-cancer therapy

2021 ◽  
pp. 107815522199431
Author(s):  
Jennifer P Booth ◽  
Julie M Kennerly-Shah ◽  
Amber D Hartman
Keyword(s):  
Cancer Therapy ◽  
Medication Error ◽  
Retrospective Analysis ◽  
Error Reporting ◽  
Single Center ◽  
Medication Error Reporting ◽  
Anti Cancer ◽  
Secondary Endpoints ◽  
Type Frequency

Introduction To describe pharmacist interventions as a result of an independent double check during cognitive order verification of outpatient parenteral anti-cancer therapy. Methods A single-center, retrospective analysis of all individual orders for outpatient, parenteral anti-cancer agents within a hematology/oncology infusion center during a 30 day period was conducted. The primary endpoint was error identification rates during first and second verification. Secondary endpoints included the type, frequency, and severity of errors identified during second verification using a modified National Coordinating Council for Medication Error Reporting and Prevention Index. Results A total of 1970 anti-cancer parenteral orders were screened, from which 1645 received an independent double check and were included. The number of errors identified during first and second verification were 30 (1.8%) and 10 (0.6%) respectively; second verification resulted in a 33.3% increase in corrected errors. The 10 errors identified during second verification included: four rate transcriptions to optimize pump interoperability, three rate and/or volume modifications, two dosage adjustments, and one treatment deferral due to toxicity. The severity was classified as Category A for four (40%), Category C for three (30%), and Category D for three (30%) errors. This correlated to a low capacity for harm for seven (70%) and a serious capacity for three (30%) errors. Conclusions Second verification of outpatient, parenteral anti-cancer medication orders resulted in a 33.3% increase in corrected errors. Three errors detected during second verification were determined to have a serious capacity for harm, supporting the value of independent double checks during pharmacist cognitive order verification.

scholarly journals Kindlin-2 mediates mechanotransduction in bone by regulating expression of Sclerostin in osteocytes

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Lei Qin ◽  
Xuekun Fu ◽  
Jing Ma ◽  
Manxia Lin ◽  
Peijun Zhang ◽  
...  
Keyword(s):  
Bone Loss ◽  
Mechanical Stimulation ◽  
Fluid Shear Stress ◽  
Weight Bearing ◽  
Underlying Mechanism ◽  
Long Bones ◽  
Cell Orientation ◽  
Cytoskeleton Organization

AbstractOsteocytes act as mechanosensors in bone; however, the underlying mechanism remains poorly understood. Here we report that deleting Kindlin-2 in osteocytes causes severe osteopenia and mechanical property defects in weight-bearing long bones, but not in non-weight-bearing calvariae. Kindlin-2 loss in osteocytes impairs skeletal responses to mechanical stimulation in long bones. Control and cKO mice display similar bone loss induced by unloading. However, unlike control mice, cKO mice fail to restore lost bone after reloading. Osteocyte Kindlin-2 deletion impairs focal adhesion (FA) formation, cytoskeleton organization and cell orientation in vitro and in bone. Fluid shear stress dose-dependently increases Kindlin-2 expression and decreases that of Sclerostin by downregulating Smad2/3 in osteocytes; this latter response is abolished by Kindlin-2 ablation. Kindlin-2-deficient osteocytes express abundant Sclerostin, contributing to bone loss in cKO mice. Collectively, we demonstrate an indispensable novel role of Kindlin-2 in maintaining skeletal responses to mechanical stimulation by inhibiting Sclerostin expression during osteocyte mechanotransduction.

scholarly journals The Role of Retrospective Analysis in an Era of Deregulation: Lessons from the US Mercury and Air Toxics Standards

2021 ◽  
pp. 000-000
Author(s):  
Mary Evans ◽  
Karen Palmer ◽  
Joseph Aldy ◽  
Meredith Fowlie ◽  
Matthew Kotchen ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Air Toxics ◽  
The Us
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