scholarly journals Analysis of risk factors for cement leakage in percutaneous kyphoplasty - does sedoanalgesia increase the risk?

2021 ◽  
pp. 65-65
Author(s):  
Evren Aydogmus

Introduction/Objective. Several studies have evaluated anaesthesia type as a possible risk factor for cement leakage in percutaneous vertebral augmentation procedures. This study has the largest series in the literature revealing data on the incidence of cement leakage in percutaneous kyphoplasty under sedoanalgesia. The aim of the study was evaluating the possible association between sedoanalgesia and cement leakage in percutaneous kyphoplasty procedures. Methods. In this study, 195 vertebral compression fractures treated with percutaneous kyphoplasty under sedoanalgesia in 165 patients were retrospectively reviewed. The association between sedoanalgesia and cement leakage in percutaneous kyphoplasty procedures was evaluated. (3) Results: The mean age (years) of study population was 64.37 years (range, 24-108 years), and the male-female ratio was 71/94. No significant difference in the proportion of males (n = 71, 43.03%) and females (n = 94, 56.96%) was observed between groups. Among the 195 fractured segments, most frequent fractures were observed at the T12 (n = 41, 21.02%) and L1 (n = 65, 33.33%) levels. Conclusion. Sedoanalgesia is not a risk factor for cement leakage in PK and offers a safe anaesthesia option to avoid possible complications.

Author(s):  
Anchal Gupta ◽  
Palak Gupta ◽  
Padam Singh Jamwal

<p class="abstract"><strong>Background:</strong> Septoplasty is one the most commonly performed surgery in ENT. The aim of this study was to evaluate change in voice after septoplasty using voice handicap index (VHI).</p><p class="abstract"><strong>Methods:</strong> The current study was conducted at Department of ENT, SMGS Hospital, Government Medical College, Jammu, from October 2017 to November 2018. The study population was the patients who had come to the department with deviated nasal septum admitted for septoplasty. Voice assessment was done by Subjective Voice evaluation using VHI. It was done at three times i.e. preoperatively, postoperatively at 1 week and then postoperatively at 1 month.  </p><p class="abstract"><strong>Results:</strong> Out of 50 cases operated, 84% patients of present study were in the age group of 18-30 years. The mean age was 25 years. The eldest patient in our study was 55 years old. 40 patients were males and 10 were females with male: female ratio of 4:1. Mean VHI score at preoperative, postoperative 1 week and postoperative 1 month were 23.2, 22 and 21.5 respectively. No statistical difference was obtained while comparing the mean VHI score at different time intervals. The scores between 0-30 are in the mild category i.e. minimal amount of handicap.</p><p><strong>Conclusions:</strong> According to our experience a widened nasal cavity has no effect on voice quality and procedures about nasal obstruction like septoplasty can be performed safely. However, professional voice users, in particular, should be informed about the possible minor postoperative changes, before the septoplasty procedure. </p>


2020 ◽  
Vol 4;23 (7;4) ◽  
pp. E409-E416
Author(s):  
Tianming Zou

Background: Bone cement distribution patterns in percutaneous kyphoplasty (PKP) is the key factor in keeping the vertebral stabilization and curative effect. However, the same cement volume can result in different bone cement distribution patterns and can thereby lead to different clinical outcomes. Therefore we investigated associations between cement distribution patterns and the occurrence rates of recompression in cemented vertebrae after PKP for patients with osteoporotic vertebral compression fractures (OVCFs). Objectives: The study focuses attention on the influence of compact and dispersive cement distribution patterns in PKP for patients with OVCFs. Study Design: A retrospective cohort study. Setting: An affiliated people’s hospital of a university. Methods: According to different cement distribution patterns, patients were assigned to 4 groups. The demographic data, radiographic data, and clinical outcomes were compared between the 4 groups. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were evaluated before and 2 days after PKP. Moreover, the relationships between bone cement and clinical outcomes were analyzed. The epidemiologic data, clinical outcomes, and complications of the 4 groups were assessed. Comparisons of the radiologic and clinical results of the 4 groups were made pre- and postoperatively. Anterior height of fractured vertebrae (AH), the kyphotic Cobb angle, and the volumetric cubage index of the fractured vertebrae were measured. Results: A total of 104 subjects were retrospectively analyzed and followed up (median age, 75.01 ± 8.42 years; age range, 56–94 years). The mean procedure duration was 61.26 ± 23.05 minutes (range, 30–140 minutes). The mean follow-up was 12.1 ± 2.2 months (range, 2–15 months). Statistically, there was no significant difference in terms of gender, age, body mass index, and bone mineral density (P > 0.05). The incidence of cement leakage was significantly lower in group A than those in the other groups. The total amount of bone cement injected into 104 cases (104 vertebral bodies in total) was 848.5 mL, and the amount of bone cement injected into a single vertebral body was 7.94 ± 1.38 mL. The amount of bone cement injection in each group was the lowest (6.80 ± 1.66 mL) in group D, followed by (7.94 ± 1.38 mL) group B, and the highest (8.96 ± 1.68 mL) in group A, with a statistically significant difference between the 4 groups (P < 0.05). No serious complications were observed during the follow-up periods. The AH and Cobb angle improved significantly for the 4 groups (P < 0.05). The VAS score decreased from 3.55 ± 0.54, 3.53 ± 0.65, 3.40 ± 0.58, and 3.40 ± 0.66 preoperatively to 0.18 ± 0.39, 0.23 ± 0.41, 0.20 ± 0.40, and 0.15 ± 0.36 at 48 hours postoperatively. The ODI score dropped from 35.65 ± 4.54, 36.45 ± 4.72, 34.12 ± 4.86, and 35.65 ± 4.34 preoperatively to 15.47 ± 1.32, 15.32 ± 1.34, 15.23 ± 1.26, and 15.73 ± 1.17 at 48 hours postoperatively. Limitations: Our estimation of the vertebral body volume is imprecise. In addition, the number of subjects with OVCFs was small in this retrospective study. The volume of the fractured vertebra was not calculated accurately. Conclusions: Significant associations between cement distribution patterns and bone cement leakage affected the clinical outcome in patients after PKP. A higher incidence of bone cement leakage was observed in patients with treated vertebrae exhibiting a single-dispersive or single-compact pattern. Key words: Percutaneous kyphoplasty, osteoporotic vertebral compression fracture, bone cement distribution patterns


2012 ◽  
Vol 13 (4) ◽  
pp. 509-514 ◽  
Author(s):  
Santosh Hunasgi ◽  
Vandana Raghunath

ABSTRACT Aims and objectives To study the clinical, histological features of peripheral and central ossifying fibromas and also to compare between them. Materials and methods The sample comprised a total 50 cases of ossifying fibromas [25 central ossifying fibromas (COF) and 25 peripheral ossifying fibromas (POF)] inclusive of cemento-ossifying fibromas. Results The mean age is 28.2 years in POF and 24.7 years in COF. The male: female ratio was 1:1.5 in POF and 1:1.8 in COF. The size of the lesions varied from 0.45 to 2.75 cm in cases of POF and in COF, it ranged from 1.25 to 13.5 cm. COF showed more duration (1-8 years) when compared with POF (1-3). Majority of cases of COF showed radiolucent, mixed radiolucent and radiopaque unilocular lesions. The predominant cell type in both POF and COF was a combination of both ovoid and spindle cells. Regarding vascularity it showed mild, moderate and intense vascularity. On comparison of all stromal changes between POF and COF showed no statistically significant difference. Conclusion The clinical parameters and radiographic changes of POF and COF in our study were similar to the previous studies. Histopathological features like type of cells, cellularity and vascularity in POF and COF were similar to previous studies. However, when clinical and histopathological features were compared between POF and COF showed no statistical significance except for site of the lesion. These features signify the behavior of two lesions. Further research on larger sample might give more insights into these lesions. How to cite this article Hunasgi S, Raghunath V. A Clinicopathological Study of Ossifying Fibromas and Comparison between Central and Peripheral Ossifying Fibromas. J Contemp Dent Pract 2012;13(4):509-514.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fei Lei ◽  
Wen He ◽  
Xinggui Tian ◽  
Zhongyang Li ◽  
Lipeng Zheng ◽  
...  

Purpose. The occurrence of new vertebral compression fractures (VCFs) is a common complication after percutaneous kyphoplasty (PKP). Secondary VCFs after PKP occur predominantly in the thoracolumbar segment (T11 to L2). Prophylactic injections of cement into vertebral bodies in order to reduce new VCFs have rarely been reported. The main purpose of this study was to investigate whether prophylactically injecting cement into a nonfractured vertebral body at the thoracolumbar level (T11-L2) could reduce the occurrence of new VCFs. Methods. From July 2011 to July 2018, PKP was performed in 86 consecutive patients with osteoporotic vertebral compression fractures (OVCFs) in the thoracolumbar region (T11-L2). All patients selected underwent PKP because of existing OVCFs (nonprophylactic group). Additionally, 78 consecutive patients with fractured vertebrae in the thoracolumbar region (T11-L2) with OVCFs underwent PKP and received prophylactic injections of cement into their nonfractured vertebrae in the thoracolumbar region (T11-L2) (prophylactic group). The visual analog scale (VAS) scores and incidence of new VCFs after PKP were compared between the two groups. Results. The mean VAS scores improved from 8.00±0.79 preoperatively to 1.62±0.56 at the last follow-up in the nonprophylactic group and improved from 8.17±0.84 to 1.76±0.34 in the prophylactic group (P>0.05). In the nonprophylactic group, 21 of 86 patients (24.4%) developed new VCFs within one year after PKP, of whom 15 patients (71.4%) developed VCFs within 3 months. In the prophylactic group, 8 of 78 patients (10.3%) developed new VCFs within one year, and 6 of these 8 patients (75%) developed new VCFs within 3 months. The incidence of new VCFs was significantly higher in the nonprophylactic group than that in the prophylactic group at one year (P=0.018), but there were no statistically significant differences at three months (P=0.847). Conclusions. Prophylactic injections of cement into nonfractured (T11-L2) vertebral bodies reduced the incidence of secondary VCFs after PKP in patients with OVCFs, but there was no significant difference in local back pain (VAS) scores between the two groups.


2019 ◽  
Vol 5 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Olusoga Ogunfowora ◽  
Tinuade Ogunlesi ◽  
Victor Ayeni ◽  
Tessie Shorunmu

Background: The incidence of neonatal macrosomia is on the increase in many parts of the world. The impact of the condition on baby and child health has not received adequate research attention. Objective: To determine the prevalence, baby and maternal characteristics, the pattern of neonatal morbidity and perinatal outcome of macrosomia. Methods: A retrospective study of all singleton deliveries with birth weight ≥ 4.0 kg was conducted at a tertiary facility in the south-western part of Nigeria between January 2013 and December 2014. Results: Eighty-eight newborn babies were macrosomic out of 1854 deliveries, resulting in a prevalence rate of 4.7%. The male-to-female ratio was 1: 0.54, while the mean (±SD) birth weight was 4.23 ± 0.29 kg. There was no significant difference in the mean birth weights of the male and female babies (t = 1.24, p = 0.218). The mean maternal age was 31.7 ± 5.1 years.  Multiparous mothers had the highest proportion of macrosomic babies, while a majority of mothers (77.3%) were either overweight or obese. One-minute Apgar score <7 was observed among 28 (31.8%) babies. Twenty-three (26.1%) babies were hospitalized for further management. Birth asphyxia, hypoglycaemia and hyperbilirubinaemia were the leading morbidities. The perinatal mortality rate for macrosomic babies was 102.2 per 1000 total births. Conclusion: The incidence of neonatal macrosomia is relatively low in our study population but falls within the range of prevalence rates reported from other parts of the country. Birth asphyxia, hypoglycaemia and hyperbilirubinemia are common morbidities among affected babies.


2019 ◽  
Vol 6 (6) ◽  
pp. 2150
Author(s):  
Dhananjay Bansal ◽  
Soumya Guha ◽  
Ashish Sharma ◽  
Anubhav Gupta ◽  
Narender Singh Jhajhria ◽  
...  

Background: Placement of mediastinal drains after cardiac surgery is standard of care. However, there is no consensus over the number of drains to be placed. Is there any advantage of multiple drains over a single drain? This question formed the premise of this study.Methods: All consecutive patients operated between 2014 and 2015 were included. Those with pleural drains were excluded. Patients had either a single drain in the pericardial cavity or had two drains, one in the pericardial and the other in retrostenal area. A total of 244 patients were included in the study group.Results: Out of 244 patients, 122 had single drain and 122 had 2 mediastinal drains. The mean age was 24.38±17.08 (Age range 6 months to 66 years) and male: female ratio was 1.5:1. There was no statistically significant difference in single drain vs double drain group in terms of the number of days of drainage (1.65 vs 1.55, p 0.325), time to mobilize (36.57 vs 35.23 hours, p=0.684), ICU stay (2.62 vs 2.63 days, p=0.96)and re-exploration (5.7%, vs 9.8%, p=0.34). However, patients with two mediastinal drains had higher requirement of analgesia (p=0.004).Conclusions: The use of two mediastinal drains does not confer any advantage over a single mediastinal drain after cardiac surgery in assessing or controlling bleed or recovery. However, the post-operative pain is significantly higher with use of two mediastinal drains.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1442.2-1442
Author(s):  
H. Bettaieb ◽  
S. Boussaid ◽  
S. Jemmali ◽  
S. Rekik ◽  
E. Cheour ◽  
...  

Background:During the last decade, the treatment of chronic inflammatory rheumatism (CIR) has been greatly improved with the advent of biotherapy.However, the use of biological treatment can lead to a number of side effects including abnormalities in the blood count.Objectives:The aim of this study was to assess the different hematological side effects of biological treatment in patients with rheumatoid arthritis (RA) and spondyloarthitis (SA).Methods:This study included patients with RA (ACR/EULAR 2010) and SA (ASAS 2009) registred with the Tunisian Biologic National Registry (BINAR).Patients were followed and treated with biologics for 2 years of less. Clinical data relative to biological treatment, including haematological side effects, have been collected.Results:Two hundred and ninety-eight patients (178 women and 111 men) were included in the study.The mean age was 49.2 ± 14.1 years. The male/female ratio was 0.6. The mean diseases durations for RA and SA were respectively 6.7 ± 3.5 years and 6.5 ±3.6 years.Anti-TNFα agents were prescribed in 87.9% of patients (n = 263) with respectively: Infliximab (20.4%) Etanercept (23.1%), Adalimumab (24.6%) and Certolizumab (26.5%).Tocilizumab and Rituximab were prescribed in 10.4% and 5% of the patients, respectively.Blood count abnormalities were noted in 15.4 % of patients (n=46).Neutropenia was the most frequently anomaly met on the hemogram (9.1%) followed by anemia (3.4%) and thrombocytopenia (3%). Pancytopenia was found in 11.4% of patients (n=34).The median time between biological therapy initiation and the onset of hematologic manifestations was 4.8 months [1-12]. Biological treatment was interrupted in two patients.In the other cases, the biological treatment was maintained with close monitoring of blood cell count. No case of death related to these hematological disturbances has been reported.Conclusion:In our registry, hematological side effects of biological treatment were found in 15.4% of cases and were noted with a median delay of 4.8 [1-12] months after the treatment initiation. Further studies are needed to confirm our preliminary results.Disclosure of Interests:None declared


Author(s):  
Harukuni Akita ◽  
Miyao Matsubara ◽  
Hitoshi Shibuya ◽  
Hirotoshi Fuda ◽  
Hitoshi Chiba

Background Lipoprotein(a) [Lp(a)] is a risk factor for atherosclerosis and increases with age. The purpose of this study was to determine the effect of ageing on Lp(a) for three different apo(a) phenotypes. Methods We measured plasma Lp(a) concentrations in 551 unrelated Japanese subjects (20-88 years of age). We performed statistical analyses separately for three apo(a) phenotypes: the low-molecular-weight (LMW) phenotype with the F, B or S1 isoform, the intermediate-molecular-weight (IMW) phenotype with the S2 isoform and the high-molecular-weight (HMW) phenotype with the S3 or S4 isoform. Results For each phenotype, the mean plasma Lp(a) concentration and the frequency of Lp(a) concentrations ≥ 250 mg/L increased with age. Further, a statistically significant difference was always found between the younger subjects (20-39 years of age) and the elderly (over 60 years). The frequency of coronary heart disease increased with age, particularly for the LMW and IMW phenotypes. Conclusions We conclude that ageing elevates plasma Lp(a) concentrations, which may have a role in the prevalence of coronary heart disease in the elderly, especially those with the LMW or IMW phenotypes.


2017 ◽  
Vol 7 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Rajesh Vishwakarma ◽  
Ruta V Shah

ABSTRACT Aim The aim of this study is to evaluate the role of laryngopharyngeal reflux (LPR) in patients with laryngeal complaints and study the correlation between reflux symptom index (RSI) and reflux finding score (RFS). Materials and methods This is a study of 104 patients, who presented in the ear, nose, and throat outpatient department at the Civil Hospital, Ahmedabad, India, from April 2015 to April 2016, with complaints like change of voice, chronic cough, foreign body sensation, throat clearing, difficulty swallowing, and regurgitation. All the patients were examined with 90° endoscope by a single examiner, and an RSI ≥13 was considered as indicative of reflux. Observation and discussion The mean age of the 104 patients was 47.2 years. The male-female ratio was 1:1.8. The RSI ranged from 5 to 44, with a mean of 22.99 and standard deviation (SD) of 7.43. The RFS ranged from 4 to 22, with a mean of 11.04 and SD of 3.07. Both the parameters showed high correlation (correlation coefficient 0.98). Conclusion The LPR plays an important contributory role in patients with laryngeal complaints. The RFS and RSI can be used as routine parameters in establishing the diagnosis of reflux. How to cite this article Shah RV, Vishwakarma R. Laryngopharyngeal Reflux: Is It the Real Culprit in Patients with Laryngeal Complaints? Int J Phonosurg Laryngol 2017; 7(1):6-9.


Author(s):  
Suganthi S. Ramachandran ◽  
Vijay L. Kumar ◽  
S. N. Dwivedi ◽  
Vishwajeet Singh ◽  
Pooja Gupta

Background: This study aimed to compare the effect of regular coffee and decaffeinated coffee on psychomotor performance in healthy volunteers during post-lunch period.Methods: In this randomized double-blind cross-over study, adult healthy volunteers were given hot coffee (3 g each of regular or decaffeinated coffee) during post-lunch period. Psychomotor functions (critical flicker-fusion frequency (CFF), choice reaction time (CRT) and error count in hand-steadiness test (HST)), blood pressure and heart rate were measured pre-lunch, pre-coffee (1-hour post-lunch) and 1-hour post-coffee consumption. Subjective ratings of sleepiness and mood were also assessed during post-lunch sessions.Results: The mean age of the participants (n=16) was 27.4±2.7 years with a male: female ratio of 7:9. There was no significant deterioration in psychomotor performance post-lunch when compared to pre-lunch on both the days. The mean CFF, CRT, errors committed in HST and cardiovascular parameters did not differ significantly between regular coffee and decaffeinated groups during post-lunch sessions. There was no significant difference in values of cardiovascular parameters as well as subjective ratings of sleep and mood between two groups.Conclusions: In healthy adult individuals’ consumption of both regular coffee and decaffeinated coffee during the post-lunch period did not affect psychomotor performance.


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