The Modified Lateral Approach: Experience of a Single Center using an Alternative Technique to Conventional Transpedicular Percutaneous Vertebroplasty

2019 ◽  
Vol 3 ◽  
pp. 6
Author(s):  
Isabelle Dupuis ◽  
Reza Forghani ◽  
Huy Le

Objective: The objective of this study was to assess whether the placement of a needle more lateral to the pedicle while using a transpedicular approach compared to the conventional technique yields comparable or better vertebral body filling. Methods: Retrospective review of 134 thoracic and lumbar unipedicular vertebroplasties performed by a single radiologist (110 lateral and 24 classic). Vertebral bodies were divided into eight voxels on computed tomography and the percent of coverage was documented. 50% and 75% cement filling thresholds were defined as “efficient.” Complications were retrospectively collected. Chi-square (χ2) was used to compare the filling efficacy and rates of extravertebral cement leakage between the approaches. Bivariate analysis was performed to assess variables potentially influencing the efficacy. Results: There was no significant difference between the two approaches for 50% coverage (classic; n = 21 [87.5%] vs. lateral; n = 98 [89.1%], P = 0.8228). There was more efficient coverage >75% using the lateral approach (classic; n = 4 [16.7%] vs. lateral; n = 46 (41.8%), P = 0.0210). Vertebral body level (50.8% thoracic vs. 26.0% lumbar, P = 0.0031) and fracture type (45.6% pathological vs. 29.2% osteoporotic, P = 0.0444) were associated with 75% coverage. Three classic cases (12.5%) had extravertebral cement leakage versus 34 lateral cases (30.9%), which was not statistically significant (P = 0.0676). Other complications included one asymptomatic lung embolization using both approaches, one pedicular fracture using the classic approach, and one overnight admission for analgesia using the lateral approach. Conclusion: A modified lateral approach proved to be as safe and more effective in achieving 75% or more vertebral filling in treating compression fractures compared to the conventional approach.

2020 ◽  
Vol 6 (1) ◽  
pp. 32-43
Author(s):  
Amanda Almeida Gomes Dantas ◽  
Nayara Priscila Dantas De Oliveira ◽  
Mercês de Fátima dos Santos Silva ◽  
Diego de Sousa Dantas

 Introdução: A saúde do trabalhador é um campo de relevância, mas que ainda está sendo consolidado no âmbito do sistema único de saúde (SUS). Partindo dessa compreensão, esse estudo teve como objetivo avaliar o estado nutricional e as condições de saúde dos agentes comunitários de saúde do município de Currais Novos-RN. Metodologia: Participaram da pesquisa 80 indivíduos de ambos os sexos. A coleta de dados envolveu um questionário padronizado elaborado especificamente para o referido trabalho, baseado na Pesquisa Nacional de Saúde, realizada por o IBGE, para analisar as condições de vida e de saúde. Além disso, foram realizadas aferição de medidas antropométricas como peso, estatura, circunferência abdominal e dobras cutâneas, para analisar o estado nutricional. A análise bivariada foi realizada por meio do teste Qui-quadrado de Pearson ou Exato de Fisher, sendo verificada a magnitude da associação através da razão de prevalência com intervalo de confiança de 95%, por meio do programa estatístico SPSS for Windows versão 22.0. Resultados: De acordo com os resultados, viu-se que 63,8% dos participantes encontram-se com Sobrepeso/Obesidade. Conclusão: Todos os dados antropométricos apresentaram diferença significativa na análise bivariada, demonstrando que essas variáveis exercem influência no estado nutricional desses.   Descritores: Agente Comunitário de Saúde; Saúde do Trabalhador; Condições de Saúde; Estado Nutricional.   ABSTRACTIntroduction:Workers' health is a field of relevance, but it is still being consolidated within the scope of the single health system (SUS). Based on this understanding, this study aimed to evaluate the nutritional status and health conditions of community health agents in the municipality of Currais Novos-RN. Methodology: Participated in the study 80 individuals of both sexes. The data collection involved a standardized questionnaire elaborated specifically for the aforementioned study, based on the National Health Survey, conducted by the IBGE, to analyze the living and health conditions. In addition, anthropometric measures such as weight, height, waist circumference, and skinfolds were performed to analyze the nutritional status.The bivariate analysis was performed using the Pearson's Chi-square test or the Fisher's exact test, and the magnitude of the association was verified through the prevalence ratio with a 95% confidence interval, using the statistical program SPSS for Windows version 22.0. Results: According to the results, it was found that 63.8% of the participants they are Overweight / Obesity. Conclusion: And all anthropometric data presented a significant difference in the bivariate analysis, demonstrating that these variables influence the nutritional status of these.  Descriptors: Community Health; Agent Worker’s Health; Health Conditions; Nutritional Status.


2011 ◽  
Vol 14 (6) ◽  
pp. 734-741 ◽  
Author(s):  
Ahmed Shawky Eid ◽  
Ung-Kyu Chang

Object The posterolateral transpedicular approach (PTA) is a widely used method for the surgical treatment of vertebral body metastases. It is crucial to understand the optimal location of the anterior graft in terms of sound and durable reconstruction following PTA. The purpose of this study was to investigate whether postoperative construct stability is related to the location of anterior grafts. Methods The authors conducted a retrospective review of 45 cases of metastatic spine disease with epidural tumor extension in which patients underwent circumferential decompression and fusion by means of PTA. Mechanical (anterior construct stability), pain (visual analog scale score), and neurological (American Spinal Injury Association scale) outcomes were evaluated and correlated with the anterior graft location (lateral or central) and surgical approach (unilateral or bilateral), number of decompressed levels, types of anterior graft, screw density of posterior fixation (number of screws used divided by the number of pedicles spanned), and kyphotic angle change from the immediate postoperative period to the most recent follow-up. Results Seven of 45 constructs were judged unstable—5 with a lateral location of the anterior graft and 2 with a central location. The anterior graft was located laterally in 31 cases (69%), centrally in 11 (24%), and bilaterally in 3 (7%). A unilateral approach was used in 33 cases and a bilateral approach in 12. Neither the location of the anterior graft nor the approach had a significant effect on the stability of the reconstructed spine (p > 0.05). There was a significant difference in construct stability between the single-level decompression group (33 patients) and the multiple-level decompression group (12 patients) (p = 0.0001). The types of anterior graft, screw density, and kyphotic angle change were not correlated to the mechanical outcome. Conclusions The anterior graft location showed no significant relationship to the final mechanical, pain, and neurological outcomes.


2021 ◽  
Vol 20 ◽  
pp. e211817
Author(s):  
Alessandra Laís Pinho Valente Pires ◽  
Izana Santos Borges Nascimento ◽  
Ana Letícia Marques de Souza Assis ◽  
Sheinaz Farias Hassam ◽  
Jener Gonçalves de Farias

Tumors of the maxillomandibular complex are a heterogeneous group of lesions with a wide spectrum of clinical and histopathological characteristics. Aim: To evaluate the prevalence of odontogenic and non-odontogenic tumors associated with maxillary bones in a Reference Center for Oral Lesions. Methods: A cross-sectional study based on the medical records of a Reference Center for Oral Lesions at the State University of Feira de Santana, from 2006 to 2018. The data was initially analyzed in a descriptive manner. For bivariate analysis, Pearson’s chi-square test was applied. The level of significance was set at 5%, where p≤ 0.05 is considered significant. Results: The prevalence of tumors was 2.27%. The average age of the individuals was 22.2 (± 15.1) years, the majority being up to 39 years (79.59%) and female (69.40%). A statistically significant difference was observed in relation to age (p = 0.00), as well as regarding the location of tumors in the anterior or posterior region (p = 0.02). Odontogenic tumors were benign, with odontoma being most frequent (46.90%), followed by ameloblastoma (16.30%). As for the non-odontogenic, neurofibroma (4.10%) and osteoma (4.10%) were the most common across the benign, while osteosarcoma accounted for 6.10% of cases. Conclusion: Odontogenic tumors were the most frequent in women, with age up to 39 years, odontoma being most common in the posterior region of the mandible. Among nonodontogenic tumors, central neurofibroma and osteoma were the most common. Osteosarcoma was more frequent in men over 40 years old and in the mandible region.


Author(s):  
Yusmahenry Galindra ◽  
Ade Ricky Harahap

Computers and microscopes are tools used by workers at PT. NPCB, in the quality control and screening section. When working using the tool within> 4 hours can cause tension headaches in the muscles. This study aims to determine the comparison of the incidence of muscle tension headaches between computer users and microscopes. This type of research is quantitative and analytic with the cross-sectional approach. Respondents are 33 people who use computers and 34 microscopy users at PT. NPCB Batam City in 2019. Computer users and microscope users are measured on their headache scale using the VAS questionnaire. Data were analyzed univariately and bivariate. Bivariate analysis records the frequency distribution of each variable. Bivariate analysis using the chi-square test. From the chi-square test results showed no significant difference in the incidence of muscle tension headaches between computer users and microscope users with a significance value (Pearson value) of 0.957 (p> 0.05). The comparison of the VAS value of Computer and Microscope users is 4.73: 4.41 with a p-value of 0.523. Based on this study it can be concluded that there is no significant difference in the incidence of muscle tension headaches between computer users and microscopes.


2015 ◽  
Vol 8 (6) ◽  
pp. 636-642 ◽  
Author(s):  
Chris N Gu ◽  
Waleed Brinjikji ◽  
Avery J Evans ◽  
Mohammad H Murad ◽  
David F Kallmes

Background and purposeMany studies demonstrate that both kyphoplasty and vertebroplasty are superior to conservative therapy in the treatment of osteoporotic vertebral body compression fractures. We performed a systematic review and meta-analysis of studies comparing the outcomes of vertebroplasty and kyphoplasty, which included prospective non-randomized, retrospective comparative, and randomized studies.Materials and methodsWe searched MEDLINE, EMBASE, and the Web of Science databases for studies of kyphoplasty versus vertebroplasty from 1 January 1990 to 30 November 2014 and compared the following outcomes: procedure characteristics, pain and disability improvement, complications and anatomic outcomes. A subgroup analysis was performed comparing pain outcomes based on the risk of bias.Results29 studies enrolling 2838 patients (1384 kyphoplasty and 1454 vertebroplasty) were included. 16 prospective non-randomized studies, 10 retrospective comparative studies, and 3 randomized controlled studies were included. No significant differences were found in mean pain scores between the two groups postoperatively (2.9±1.5 kyphoplasty vs 2.9±1.7 vertebroplasty, p=0.39) and at 12 months (2.7±1.8 kyphoplasty vs 3.2±1.8 vertebroplasty, p=0.64). No significant differences were found in disability postoperatively (34.7±7.1 kyphoplasty group vs 36.3±7.8 vertebroplasty group, p=0.74) or at 12 months (28.3±16 kyphoplasty group vs 29.6±13.9 vertebroplasty group, p=0.70). Kyphoplasty was associated with lower odds of new fractures (p=0.06), less extraosseous cement leakage (p<0.01), and greater reduction in kyphotic angle (p<0.01).ConclusionsNo significant difference was found between vertebroplasty and kyphoplasty in short- and long-term pain and disability outcomes. Further studies are needed to better determine if any particular subgroups of patients would benefit more from vertebroplasty or kyphoplasty in the treatment of vertebral body compression fractures.


Author(s):  
Hiroko Miura ◽  
Rumi Tano ◽  
Katsuo Oshima ◽  
Yoshie Usui

The super-aged society of Japan is experiencing an increased demand for dental hygienists, of which there is currently a shortage. This study aimed to investigate the factors related to the working status of dental hygienists in Japan. We conducted a survey by mailing a questionnaire on employment to 1444 dental hygienists and obtained 537 valid responses. We conducted a bivariate analysis using either a chi-square test or t-test as well as a multiple logistic regression analysis to determine the factors related to working status. The overall employment rate was 68.2%, with a significant difference between age groups (p < 0.01). Approximately 80% of respondents considered working hours and human relations at the workplace to be important, and more than 70% of respondents considered wages as important. Finally, the following four variables were found to be significantly associated with employment status: training course attendance, a desire to work full-time, consideration of wages as important, and consideration of working hours as important. These findings suggest that it is necessary to improve working conditions and environments, including wages and working hours, as well as provide a more robust system of continued professional development for dental hygienists to increase the workforce.


Author(s):  
Eka R. Gunardi ◽  
Arresta Suastika

AbstractObjective: To understand the pattern of referral cases (accuracy of referral diagnosis, the accuracy of referral health facility and consistency of referral diagnosis) in obstetrics and gynaecology outpatient clinic before and after the implementation of JKN.Methods: This is an observational cross-sectional study using medical records of patients who were referred to obstetrics and gynaecology outpatient clinic in Dr. Cipto Mangunkusumo General Hospital in 2013 and 2014. Data were analyzed with bivariate analysis with chi-square, consisting of the accuracy of referral cases, accuracy of referral health facility, and consistency of referral cases before and after implementation of JKN.Results: There is a growing number of patients in obstetrics and gynaecology outpatient clinic after the implementation of JKN in 2014, which is 4.311 patients. Subjects were 222 cases, 104 cases from 2013 and 118 cases from 2014. From the analyzed data, the accuracy of referral diagnosis before JKN is 81.7% and after JKN 72.9%. (p=0.118), the accuracy of referral health facility before JKN is 63.5% and after JKN 71.2% (p=0.220), and the consistency of referral diagnosis before JKN is 89.4% and after JKN 84.7% (p=0.302).Conclusion: There is no statistically significant difference between the accuracy of referral diagnosis, the accuracy of referral health facility, and consistency of referral diagnosis before and after the implementation of JKN.Keywords: national health coverage program, obstetrics and gynaecology, outpatient clinic, referral AbstrakTujuan: Untuk memahami pola kasus rujukan (ketepatan diagnosis rujukan, ketepatan asal fasyankes perujuk, dan kesesuaian diagnosis rujukan) di Poliklinik Obstetri dan Ginekologi sebelum dan setelah pelaksanaan JKN.Metode: Penelitian ini adalah observasional potong lintang dengan menggunakan data rekam medis pasien yang dirujuk ke Poliklinik Obstetri dan Ginekologi RSUPN Dr. Cipto Mangunkusumo selama tahun 2013 dan 2014. Analisis dilakukan dengan analisis bivariat dengan chi square untuk membedakan ketepatan diagnosis rujukan, ketepatan asal fasyankes perujuk, dan kesesuaian diagnosis rujukan sebelum dan setelah pelaksanaan JKN.Hasil: Terdapat peningkatan jumlah kunjungan Poliklinik Obstetri dan Ginekologi sejak dilaksanakannya program JKN pada tahun 2014, yaitu sebanyak 4.311 pasien. Jumlah subjek adalah sebanyak 222 subjek, terdiri dari 104 subjek pada tahun 2013 dan 118 subjek pada tahun 2014. Dari analisis data, didapatkan tingkat ketepatan diagnosis sebelum JKN adalah 81,7% dan setelah JKN 72,9% (p=0,118), tingkat ketepatan fasyankes perujuk sebelum JKN adalah 63,5% dan setelah JKN 71,2% (p=0,220), serta tingkat kesesuaian diagnosis sebelum JKN adalah 89,4% dan setelah JKN 84,7% (p=0,302).Kesimpulan: Tidak ada perbedaan yang bermakna secara statistik antara ketepatan diagnosis rujukan, ketepatan fasyankes perujuk, dan kesesuaian diagnosis fasyankes rujukan sebelum dan sesudah pelaksanaan JKN.Kata kunci: jaminan kesehatan nasional, obstetri dan ginekologi, poliklinik, rujukan


Author(s):  
Dea Noviana Pramantik ◽  
Dwi Aryani

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and has become a major health problem worldwide. Inflammation plays a vital role in the pathophysiology of COVID-19. Systemic Immune Inflammation Index (SII) is an index obtained from calculating the platelets counts, neutrophils, and lymphocytes, which can indicate the inflammation status and immunity. This study aimed to determine the potential of SII as a predictor of SARS-CoV-2 infection in suspected COVID-19 subjects. A retrospective study was carried out by obtaining medical record data in June 2020 at Sleman General Hospital. An unpaired T-test or the Mann-Whitney test was used to determine the statistical difference. A Receiver Operating Characteristic (ROC) curve was generated and used to get the cut-off values. Bivariate analysis was performed using Chi-Square. There were 84 subjects consisting of 46 (54.8%) males and 38 (45.2%) females with a mean age of 42.4±16.356 years. There was a significant difference in the neutrophils count (p=0.045), monocytes (p=0.001), and eosinophils (p=0.037) between subjects with positive and negative SARS-CoV-2 PCR. The median SII in the positive and negative SARS-CoV-2 PCR group was 780.12 (301.21-2178.90)x103/µL and 584.14 (117.79-1933.87)x103/µL (p=0.045), respectively. Bivariate analysis showed significant results at SII > 705 x103/µL in suspected COVID-19 patients to obtain a positive SARS-CoV-2 PCR result with Odds Ratio (OR) of 4.00 (95% CI 1.580-10.127), p=0.003. Patients with suspected SARS-CoV-2 infection with high SII levels had a greater risk of a positive SARS-CoV-2 in PCR test


2021 ◽  
Vol 36 (1) ◽  
pp. 71-83
Author(s):  
Andi Thahir ◽  
Sulastri Sulastri ◽  
Siti Zahra Bulantika ◽  
Tiara Novita

The COVID-19 pandemic creates complex problems and in almost all aspects of life, everyone has been anxious, worried, and panicked about survival. Starting with children, young and old, men and women feel anxious about the threat of COVID-19. This study aimed to determine the differences in anxiety levels between male and female students during the COVID-19 period based on the Hamilton Anxiety Rating Scale (Hamilton, 1969). This study used a survey method with a descriptive design. Sampling using accidental sampling, 396 respondents consisted of 99 male and 297 female with age range of 21-23 years was acquired. Data analysis was based on univariate and bivariate analysis using Chi-Square. The results showed that overall respondents were experiencing high levels of anxiety about COVID-19. On the other hand, there was non-significant difference in anxiety levels between male and female students in facing the COVID-19 pandemic; thereby, indicating that gender did not have significant role in emotional reactivity, such as anxiety and fear. Anxiety would arise when there would be environmental pressures that can hinder one's activities of both male and female students.


2021 ◽  
Author(s):  
Jian Huang ◽  
Jun Huang ◽  
Ming Chen ◽  
Zongbo Zhou ◽  
Zhifu Lu ◽  
...  

Abstract Study design: Retrospective cohort study.Objective: To explore the clinical effect of precise injection and staged perfusion of bone cement kyphoplasty in the treatment of osteoporotic vertebral compression fracture.Methods: 110 patients treated with kyphoplasty from January 2020 to June 2021 were selected and divided into experimental group (n = 55) and control group (n = 55) according to different surgical methods. The experimental group was treated with precise injection and staged perfusion of bone cement kyphoplasty, while the control group was treated with traditional kyphoplasty. The operation time,intraoperative blood loss and amount of bone cement injection were recorded. The pain improvement was evaluated by VAS score. The operation effect were evaluated by anterior height of injured vertebral body, middle height of injured vertebral body, wedge angle of injured vertebral body and distribution grade of bone cement. The incidence of surgical complications was evaluated by the number of bone cement leakage.Results: There were no significant difference in the operation time, intraoperative blood loss and the amount of bone cement injection in two groups. There were no significant difference in VAS scores at 2h, 4h and 48h after operation between the two groups (P > 0.05); There were no significant difference in the ratio of anterior height of injured vertebral body between the two groups on the third day after operation and the last follow-up (P > 0.05); There were no significant difference in the ratio of middle height of injured vertebral body between the two groups on the third day after operation and the last follow-up (P > 0.05); There were no significant difference in wedge angle of injured vertebral body between the two groups at the third day after operation and the last follow-up (P > 0.05). There was significant difference in the distribution grade of bone cement between the two groups (P < 0.01); There was significant difference in the number of bone cement leakage between the two groups (P < 0.01), In cases of bone cement leakage, there were 1 case of type C, 1 case of type S in the experimental group, 7 cases of type C and 2 cases of type S in the control group.Conclusion: Precise injection and staged perfusion of bone cement kyphoplasty in the treatment of osteoporotic vertebral compression fracture can effectively reduce surgical complications and improve surgical efficacy.


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