scholarly journals Cervical Spondylosis in Nepalese Porters

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Prakash Bista ◽  
YB Roka

Neck pain with or without radiculopathy and myelopathy is a very common problem in clinicalpractice. The incidence is believed to be higher in subgroups carrying load on their head. It has beenreported in literature that radiographic spondylosis is appreciable in 25% to 50% of population by theage of 50 years and 75% to 85% by the age of 65 years.One hundred and nineteen lateral X-rays of cervical spine were analyzed as case-control studyin patients between 40 and 50 years age with the objective of finding out proportion of cervicalspondylosis in this age group and difference in the prevalence between porters and non-porters.Out of the 119 cases 54 (45.4.2%) were porters and 65 (54.6%) were non-porters. There were 98(82.4%) males and 21 (17.6%) females. The overall prevalence of radiological cervical spondylosiswas 69 (58%). The prevalence of cervical spondylosis was significantly lower (x2 = 14.795, p=0.0001)in porters in comparison to non-porters. The odds ratio was found to be 0.23 (0.10, 0.53) at 95%confidence interval indicating that portering significantly prohibited development of spondylosis.This study concludes that the overall prevalence of cervical spondylosis in the Nepalese populationis slightly higher than in the Caucasian and contrary to other studies there is significantly lowerprevalence of such degeneration among the Nepalese porters.Key words: cervical Spine, cervical spondylosis, head Injury, Nepalese porters

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francisco Félix Caballero ◽  
Ellen A. Struijk ◽  
Alberto Lana ◽  
Antonio Buño ◽  
Fernando Rodríguez-Artalejo ◽  
...  

AbstractElevated concentrations of acylcarnitines have been associated with higher risk of obesity, type 2 diabetes and cardiovascular disease. The aim of the present study was to assess the association between L-carnitine and acylcarnitine profiles, and 2-year risk of incident lower-extremity functional impairment (LEFI). This case–control study is nested in the Seniors-ENRICA cohort of community-dwelling older adults, which included 43 incident cases of LEFI and 86 age- and sex- matched controls. LEFI was assessed with the Short Physical Performance Battery. Plasma L-carnitine and 28 acylcarnitine species were measured. After adjusting for potential confounders, medium-chain acylcarnitines levels were associated with 2-year incidence of LEFI [odds ratio per 1-SD increase: 1.69; 95% confidence interval: 1.08, 2.64; p = 0.02]. Similar results were observed for long-chain acylcarnitines [odds ratio per 1-SD increase: 1.70; 95% confidence interval: 1.03, 2.80; p = 0.04]. Stratified analyses showed a stronger association between medium- and long-chain acylcarnitines and incidence of LEFI among those with body mass index and energy intake below the median value. In conclusion, higher plasma concentrations of medium- and long-chain acylcarnitines were associated with higher risk of LEFI. Given the role of these molecules on mitochondrial transport of fatty acids, our results suggest that bioenergetics dysbalance contributes to LEFI.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Felicitas Schulz ◽  
Ekkehart Jenetzky ◽  
Nadine Zwink ◽  
Charlotte Bendixen ◽  
Florian Kipfmueller ◽  
...  

Abstract Background Evidence for periconceptional or prenatal environmental risk factors for the development of congenital diaphragmatic hernia (CDH) is still scarce. Here, in a case-control study we investigated potential environmental risk factors in 199 CDH patients compared to 597 healthy control newborns. Methods The following data was collected: time of conception and birth, maternal BMI, parental risk factors such as smoking, alcohol or drug intake, use of hairspray, contact to animals and parental chronic diseases. CDH patients were born between 2001 and 2019, all healthy control newborns were born in 2011. Patients and control newborns were matched in the ratio of three to one. Results Presence of CDH was significantly associated with maternal periconceptional alcohol intake (odds ratio = 1.639, 95% confidence interval 1.101–2.440, p = 0.015) and maternal periconceptional use of hairspray (odds ratio = 2.072, 95% confidence interval 1.330–3.229, p = 0.001). Conclusion Our study suggests an association between CDH and periconceptional maternal alcohol intake and periconceptional maternal use of hairspray. Besides the identification of novel and confirmation of previously described parental risk factors, our study underlines the multifactorial background of isolated CDH.


2009 ◽  
Vol 3 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Nicholas AuYong ◽  
Joseph Piatt

Jefferson fractures of the immature spine have received little attention in the study of pediatric spinal trauma. Fractures through synchondroses are a possibility in the immature spine, in addition to fractures through osseous portions of the vertebral ring, and they create opportunities for misinterpretation of diagnostic imaging. The authors describe 3 examples of Jefferson fractures in young children. All 3 cases featured fractures through an anterior synchondrosis in association with persistence of the posterior synchondrosis or a fracture of the posterior arch. The possibility of a Jefferson fracture should be considered for any child presenting with neck pain, cervical muscle spasm, or torticollis following a head injury, despite a seemingly normal cervical spine study. Jefferson fractures in young children are probably much more common than previously recognized.


Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Tae Jung Kim ◽  
Chi Kyung Kim ◽  
Yerim Kim ◽  
Han-Gil Jeong ◽  
Kiwoong Nam ◽  
...  

Introduction: Sleep duration has been regarded as a potential risk factor for cardiovascular disease and stroke. Short sleep duration is linked with higher stroke incidence, and mortality. Moreover, and paradoxically, long sleep duration is also reported to be positively associated with stroke incidence. However, the impact of sleep duration on the intracerebral hemorrhage (ICH) risk remains unclear. Hypothesis: We assessed the relationship between sleep duration and the risk of ICH. Methods: We performed a nationwide, multicenter matched case-control study to investigate the risk factors for hemorrhagic stroke, using patients from 33 hospitals in Korea. We enrolled a total of 490 patients with ICH and 980 age- and sex-matched controls. We obtained information regarding sleep, sociodemographic factors, lifestyle, and medical history before ICH onset, using qualified structured questionnaires. Sleep duration was categorized as ≤5, 6, 7, 8, and ≥9 hours. We chose sleep duration of 7 h as the reference duration. Results: The included patients were mostly male (58.2%) with a mean age of 57 years. The number of subjects with long sleep duration, more than 8 h, was significantly greater in the ICH group than in the control group (≥8 h, 30.4% vs. 22.6%, P = 0.002). Compared to 7 h, long sleep duration participants tended to be older, be more hypertensive, and be more likely to have blue collar jobs, lower education levels, and poorer marital status (i.e., unmarried or divorced/separated). After controlling for confounding factors, we found that longer sleep duration was independently associated with the risk of ICH in a dose-response manner (8 h: Odds ratio, 1.44; confidence interval, 1.01-2.07; ≥9 h: Odds ratio, 2.60; confidence interval, 1.50–4.49). Conclusions: In conclusion, our study suggested that long sleep duration is positively related to ICH risk in a dose-dependent manner. In this context, our data might suggest that sleep duration is a modifiable risk factor for ICH.


Author(s):  
Walter Wiswell ◽  
Bryan McCarty

The chapter on cervical spine controversies in children describes what initial steps need to be taken in assessing a pediatric patient with neck pain after trauma, and discusses the decision-making process that goes into further evaluation and testing. Clinical actions and assessments of the patient on-scene, whether to pursue imaging once in the emergency department setting, and what imaging is most appropriate depending on the patient presentation are discussed. Indications and contraindications for cervical spine immobilization and spinal positioning, including proper techniques based on a patient’s age and whether or not such steps are necessary. It also discusses the pros and cons of x-rays, CT scans, and MRIs in the context of pediatric neck trauma, and current guidelines that should be followed when deciding to order such studies.


2020 ◽  
pp. 219256822090274
Author(s):  
Christopher Huang ◽  
Ralph Mobbs ◽  
Michael Selby ◽  
Kevin Phan ◽  
Prashanth Rao

Study Design: Retrospective case control study. Objectives: Adjacent-level ossification development (ALOD) is a distinct form of adjacent segmental degeneration that has been recognized to occur after anterior cervical discectomy and fusion (ACDF). It is unclear whether ACDF with plate versus standalone has an effect on rates of ALOD. This retrospective case-control study aims to assess the rate of ALOD in a large series of patients undergoing ACDF with and without plate and factors causing ALOD. Methods: Data was collected for patients undergoing ACDF from January 2009 to July 2016. Data collected was from multiple centers and included demographic data, surgical data, radiological imaging at time of surgery, and serial follow-up imaging. The radiology for ALOD was independently reviewed. Cohorts were divided into ACDF with plate (Group P = plate) and ACDF without plate (Groups S = standalone) and outcomes were compared. Results: There were 260 patients with 138 (53%) in Group P and 122 (47%) in Group S. ALOD was observed in 15.3% of patients overall, 29% in group P and 2.8% in group S ( P < .001). Following multivariate adjustment, statistically significant association was found between use of plate and ALOD (odds ratio = 12.8, 95% confidence interval = 3.52-45.45, P < .001). Plate-to-disc distance <5 mm was significantly associated with ALOD (odds ratio = 13.5, 95% confidence interval = 3.83-47.62, P < .001). Conclusion: The use of anterior plate with ACDF was associated with ALOD. Plate-to-disc distance <5 mm was significantly associated with ALOD even after adjustment for confounding factors. We conclude utilization of standalone cages or cages with plate with more than 5 mm distance from adjacent disc to minimize ALOD.


Lupus ◽  
2020 ◽  
Vol 29 (2) ◽  
pp. 176-181
Author(s):  
M Morishita ◽  
K-E Sada ◽  
K Ohashi ◽  
Y Miyawaki ◽  
Y Asano ◽  
...  

Objective The objective of this study was to evaluate the chronic damage associated with pregnancies before and after the diagnosis of systemic lupus erythematosus (SLE). Methods Using childbearing-aged female SLE patient data registered at the Okayama and Showa University Hospitals, a nested case-control analysis was performed to investigate the relationship between pregnancy and chronic damage using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Results Pregnancy occurred in 22 patients before and 13 patients after the diagnosis of SLE in 104 eligible patients. Live births occurred in 82% (33/40) and 50% (9/18) of the pregnancies before and after the diagnosis of SLE, respectively. After matching age and disease duration, 33 case patients with chronic damage (SDI ≥ 1) and 33 control patients without chronic damage (SDI = 0) were selected. Hypertension was more frequent in cases than in controls (48% vs. 24%, p = 0.041). Pregnancies before and after the diagnosis of SLE were comparable between cases and controls (before the diagnosis: nine case patients and eight control patients; after the diagnosis: three case patients and five control patients; p = 1.00). Even after adjusting for hypertension using multivariate analysis, the pregnancies before and after the diagnosis were not significant predictors for chronic damage (odds ratio = 1.48 (95% confidence interval 0.33–6.65)), p = 0.60 of the pregnancy before the diagnosis; odds ratio = 0.78 (95% confidence interval 0.13–4.74), p = 0.78 of the pregnancy after the diagnosis). Conclusion Pregnancies, either before or after the diagnosis of SLE, did not show any differences in chronic damage. Our results help alleviate fears regarding childbearing in female patients with SLE and their families.


2019 ◽  
Vol 26 (3) ◽  
pp. 655-665 ◽  
Author(s):  
Yusuke Noguchi ◽  
Yugo Kawashima ◽  
Megumi Maruyama ◽  
Hiroko Kawara ◽  
Yoko Tokuyama ◽  
...  

Purpose Docetaxel is known to cause eye disorders. In this study, current status of eye disorders caused by docetaxel administration every 3 weeks in Japanese patients was examined. Methods This case-control study targeted patients who were newly administered docetaxel at the Kyoto Okamoto Memorial Hospital between 1 July 2015 and 30 June 2018. Eye disorder occurrence was defined as an event in which the pharmacist confirmed the symptoms in a patient interview and the ophthalmologist diagnosed the disorder. Results Of the 89 subjects, 7 (7.9%) had eye disorders. The symptoms were watering eyes (7.9%), a stye and eye discharge (2.2% each), corneal and conjunctival disorder, visual acuity reduction, and blepharedema (1.1% each). Four patients who presented with watering eyes, eye discharge, or corneal and conjunctival disorder showed improvement with the use of eye drops such as artificial tears. Two patients who presented with a stye showed improvement with the use of oral cefcapene. One patient with mild symptoms showed spontaneous improvement. However, one patient had irreversible visual acuity reduction. The multivariate logistic regression analysis revealed that a cumulative docetaxel dose of ≥300 mg/m2 (odds ratio: 15.50, 95% confidence interval: 1.37–175.00, p = 0.027) and concomitant cyclophosphamide use (odds ratio: 13.20, 95% confidence interval: 1.13–153.00, p = 0.039) were significant risk factors associated with eye disorders. Conclusion In conclusion, it was determined that docetaxel-related eye disorders might be influenced by the cumulative dose of docetaxel and concomitant cyclophosphamide use. In addition, relatively mild symptoms improved with medication.


Blood ◽  
2004 ◽  
Vol 104 (7) ◽  
pp. 2003-2006 ◽  
Author(s):  
Frank P. Mockenhaupt ◽  
Stephan Ehrhardt ◽  
Sabine Gellert ◽  
Rowland N. Otchwemah ◽  
Ekkehart Dietz ◽  
...  

Abstract The high frequency of α+-thalassemia in malaria-endemic regions may reflect natural selection due to protection from potentially fatal severe malaria. In Africa, bearing 90% of global malaria morbidity and mortality, this has not yet been observed. We tested this hypothesis in an unmatched case-control study among 301 Ghanaian children with severe malaria and 2107 controls (62% parasitemic). In control children, α+-thalassemia affected neither prevalence nor density of Plasmodium falciparum. However, heterozygous α+-thalassemia was observed in 32.6% of controls but in only 26.2% of cases (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.56-0.98). Protection against severe malaria was found to be pronounced comparing severe malaria patients with parasitemic controls (adjusted OR in children &lt; 5 years of age, 0.52; 95% CI, 0.34-0.78) and to wane with age. No protective effect was discernible for homozygous children. Our findings provide evidence for natural selection of α+-thalassemia in Africa due to protection from severe malaria.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1169-1169 ◽  
Author(s):  
Lamiae Grimaldi-Bensouda ◽  
Marc Michel ◽  
Jean-François Viallard ◽  
Daniel Adoue ◽  
Nadine Magy-Bertrand ◽  
...  

Abstract Abstract 1169 Background and objectives Immune thrombocytopenia (ITP) is thought to result from an autoimmune mechanism, and some case-reports have suggested that immunizations could be involved and trigger the autoimmune process. This prospective multicenter case-control study investigated for the first time associations between ITP and vaccination in adults, particularly between ITP and influenza vaccinations. Methods Over a three year period, a network of 15 physicians from hematology and internal medicine referral centers across France recruited newly diagnosed cases of primary ITP in patients aged over 15 years fulfilling the ITP standardized criteria of the American Society of Hematology. Recruiting physicians completed standardized forms for each patient and every patient underwent a standardized 1 hour-interview focused on previous medications and vaccinations in the last 12 months. Incident ITP cases were compared to sex and age-matched controls selected and recruited from general practice settings, also from the same geographically areas of France. The method of referent recruitment has been described elsewhere (Grimaldi-Bensouda et al. 2010 Pharmacoepidemiol Drug Saf 2010;19(6):591–5). Controls were also interviewed in the same standardized way as cases. Cases and control were compared in respect of various descriptive factors and potential risk factors for ITP. Written or other confirmation of vaccinations was sought from both the patient and his/her physician. The time window defining exposure to vaccines was 12 months before the index date. In secondary analysis, the most prevalent vaccines in adults were analyzed. Results Two hundred and twenty four cases fulfilling the inclusion criteria and 4412 were included in the study. Seventy eight of the 224 cases (34.8%) and 1566 of 4412 controls (35.5%) received a vaccination within this time window [adjusted odds ratio 0.97, 95% confidence interval 0.70–1.33]. Twenty percent of the cases and 26% of controls received an influenza vaccine [adjusted odds ratio 0.66, 95% confidence interval 0.45–0.98]. Other prevalent vaccines in adult are currently under study. Conclusions This systematic case-control design is well-suited to study rare disorders such as ITP and few such studies have been conducted. Another advantage was the minimization of recall bias because questions about vaccinations were included in a standardized interview focusing on exposure to all medications. When all vaccines were considered, we found no association between vaccination and the incidence of ITP in either crude or adjusted analyses. Moreover, cases were less likely than controls to have been vaccinated against influenza in the 12 months before the index date. Disclosures: Grimaldi-Bensouda: LA-SER: Employment; INSERM: I was the recipient of a research fellowship from the INSERM (French National Institute for Health and Medical Research) at the time of the study. Leighton:LA-SER Europe Ltd: Employment. Aubrun:LA-SER Europe Ltd: Employment. Abenhaim:LA-SER Europe Ltd: I'm a stock owner and chairman of LA-SER, the company conducting the study.


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