scholarly journals CLINICAL OUTCOME OF THORACOTOMY, ANTERIOR SPINAL DECOMPRESSION AND FIXATION WITH SCREWS AND RODS FOR DORSAL SPINE TUBERCULOSIS

1969 ◽  
Vol 5 (2) ◽  
pp. 671-676
Author(s):  
BAKHT ZAR KHAN ◽  
MUHAMMAD ISHFAQ ◽  
NAEEM UL HAQ ◽  
MUMTAZ ALI ◽  
RAMZAN HUSSAIN ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Status ◽  
Lower Limbs ◽  
Dorsal Spine ◽  
Spinal Decompression ◽  
Transpedicular Approach ◽  
Back Ache ◽  
Spine Tuberculosis ◽  
Age Range ◽  
With Screws

BACKGROUND: The posterolateral or transpedicular approach has been used extensively for themanagement of spinal TB. This approach is a viable and importantly a safe surgical option for ventraldecompression in thoracic spine TB when followed by anti tuberculosis treatment for 18 months andimmobilization in an alkathene shell for 3 months.OBJECTIVE: To determine clinical outcome of thoracotomy, anterior spinal decompression andfixation with screws and rods for dorsal spine TB.MATERIAL AND METHODES: This observational prospective study was conducted inNeurosurgery Department Lady Reading Hospital Peshawar from Mar 2013 to March 2014. All patientsadmitted with dorsal spine tuberculosis and undergone thoracotomy, anterior spinal decompression andfixation with screws & rods were included in the study while those having unstable dorsal spine due tothe metabolic, neoplastic, traumatic pathologies & stable dorsal spine tuberculosis cases were excluded.Patients’ age, sex, addresses, level of dorsal spine tuberculosis, pre operative signs & symptoms, per &post op complications and post op variations in clinical status were recorded on a designed proforma.Minimum 6 months follow up was done. Data was analyzed by SPSS version 17 and expressed in theform of tables and charts.RESULTS: Total 24 patients were included in this study in which males and females were equal innumber. The age range was from 15 to 50 years and mean age was 31.5 ±3.8 years. Backward & hillyareas patients 15(62.5%) were on the top. D7,8,9 levels had highest frequency of involvement 45.83%(11) . Lower limbs weakness was present in all cases (100%) followed by back ache in 23 (95.8 %)while power >3/5,3/5 were noted in 22(75.4 %) followed by gibus formation in 29.3 % cases. Postoperative improvement in pain and power was 100%, 62.5 % while complications occurred in 4 (16.7%) cases having no mortalityCONCLUSIONS: Incidence of dorsal spine tuberculosis is more in backward hilly areas of KPKeffecting lower part of dorsal spine and great improvement in power of lower limbs & pain occurs afterthoracotomy, decompression, bone grafting with cage placement and fixation with screws and rods withacceptable mortality and morbidityKEY WORDS: Dorsal spine tuberculosis, Thoracotomy, Anterior spinal decompression & stabilizationwith screws and rods, clinical outcome.

The role of exudation in chronic subdural hematomas

2007 ◽  
Vol 107 (2) ◽  
pp. 290-295 ◽  
Author(s):  
Mehmet Tokmak ◽  
A. Celal Iplikcioglu ◽  
Sirzat Bek ◽  
Cem Atilla Gökduman ◽  
Mustafa Erdal
Keyword(s):  
Outer Membrane ◽  
Clinical Status ◽  
Ct Scans ◽  
Subdural Hematomas ◽  
The Mean ◽  
Grade 3 ◽  
Age Range ◽  
Exudation Rate

Object Chronic subdural hematomas (SDHs) are a local inflammatory process that causes the formation of a granulation tissue often referred to as the external or outer membrane. This membrane has abnormally permeable macrocapillaries. Therefore, exudation from the macrocapillaries in the outer membrane of chronic SDH may play an important role in the enlargement of chronic SDH. In this study the authors investigated the role of exudation in chronic SDH. Methods The authors examined 24 patients (16 men and eight women; age range 38–86 years [mean age 61.4 years]) with 27 chronic SDHs. The clinical status of the patients was evaluated according to the classification described by Markwalder. The diagnosis was established on computed tomography (CT) scans in all cases. The authors also used the Nomura Classification for judging the lesion's appearance on CT scans. Immediately after the diagnosis, all patients were administered 20 mCi (740 mBq) technetium-99m human serum albumin. Four hours later, blood and SDH samples were taken and radioactivity levels were measured in each. The ratio of activity of the samples taken from chronic SDH to the radioactivity of blood was determined as a percentage and defined as the exudation rate. On the follow-up CT scan obtained on postoperative Day 20, subdural collections thicker than 5 mm were determined to be a reaccumulation. Results The correlations between the exudation rate and age of the patients, clinical grades, CT appearances, and amount of reaccumulation were investigated. In this series the average exudation rate was 13.24% (range 2.05–28.88%). The mean exudation rates according to the clinical grades assigned to patients were as follows: Grade 0, 8.67 ± 5.64% (three patients); Grade 1, 5.07 ± 1.43% (eight patients); Grade 2, 17.87 ± 3.73% (seven patients); and Grade 3, 19.65 ± 7.67% (six patients). Exudation rates in patients with Grades 2 and 3 were significantly higher than those in Grades 0 and 1 (p < 0.05). The mean exudation rates according to the lesion's appearance on CT scans were found as follows: hypodense appearance, 6.55 ± 4.52% (eight patients); isodense appearance, 11.07 ± 6.32% (five patients); hyperdense appearance, 19.47 ± 13.61% (three patients); and mixed-density appearance, 17.40 ± 5.80% (nine patients). The differences among the groups were significant (p < 0.05). The average exudation rate was statistically higher in the patients with reaccumulation (16.30 ± 8.16%) than that in the patients without reaccumulation (9.96 ± 6.84%) (p < 0.05). Conclusions The exudation rate in chronic SDH is correlated with a higher clinical grade (Markwalder Grade 2 or 3), mixed-density CT appearance, and reaccumulation. Therefore, exudation from macrocapillaries in the outer membrane of chronic SDH probably plays an important role in the pathophysiology and the growth of chronic SDH.

Quality of Life of Patients Suffering from Schizophrenia Treated with Clozapine and Risperidone

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Milosavljevic ◽  
D. Lecic-Tosevski ◽  
I. Perunicic
Keyword(s):  
Quality Of Life ◽  
Clinical Outcome ◽  
Social Relationships ◽  
Atypical Antipsychotics ◽  
Clinical Status ◽  
Positive Symptoms ◽  
Significant Difference ◽  
Social Recovery ◽  
Improve Clinical Outcome

Background:Quality of life (QoL) is considered an important outcome in the treatment of schizophrenia and is linked with clinical and social recovery. Until recently treatments of schizophrenia have focused mainly on reducing positive symptoms, often leaving patients with numerous residual difficulties. It's been expected that atypical antipsychotics improve QoL equally as they improve clinical outcome of the patients with schizophrenia.Objectives:To compare clinical improvement and QoL of patients treated with risperidone and clozapine two months after the beginning of treatment.Methods:The sample included 40 patients (17 males and 23 females, mean age 33.1) with diagnosis of schizophrenia according to ICD-X. the patients were treated with either risperidone (n=20) or clozapine (n=20). the PANSS and CGI scales for clinical status were applied at the beginning of the treatment and two months later. the QoL was assessed by the WHOQOL-BREF.Results:Analysis of data has shown a significant difference for all four domains (physical, psychological, social relationships and environment) at WHOQOL-BREF scale for both medications after two months, but no difference between the two antipsychotics. the patients treated with clozapine had significantly higher scores on PANSS at the beginning of treatment. PANSS and CGI applied after two months have not shown differences between the medications.Conclusion:Both clozapine and risperidone had equal and statistically significant effect in reducing the symptoms of schizophrenia measured by PANSS and CGI in two months period, as well as in improving the quality of life. However no difference was found between the two medications.

scholarly journals Ép és mozgásukban korlátozott kajakos sportolók biomechanikai mozgáselemzése és összehasonlító vizsgálata

2019 ◽  
Vol 160 (52) ◽  
pp. 2061-2066
Author(s):  
Bernadett Kertészné Német ◽  
Tamás Terebessy ◽  
Zoltán Bejek
Keyword(s):  
Body Mass ◽  
Mass Range ◽  
Lower Limbs ◽  
Whole Body ◽  
Special Focus ◽  
Upper Limbs ◽  
Height Range ◽  
Flexion Extension ◽  
The Disabled ◽  
Age Range

Abstract: Introduction: During kayaking, the whole body works in a perfect harmony. While the trunk is doing a rotation, flexion-extension helps to the upper limb to create a special cyclic paddle. The purpose of this study was to gain a better understanding of the physical disabled (later disabled) person’s kayaking motions and to probe whether there were any significant differences between disabled and non-disabled kayakers with special focus on the use of footrest. We hypothesised significantly different ranges of motion and muscle activity in lower limbs but no significant differences in those of the upper limbs. Aim: Our goal was to know more about the abled and disbled kayaking and compare the athlete’s kayaking movements. Method: Thirteen (n = 13) elite disabled athletes (age range: 18–40 years, height range: 164–194 cm, body mass range:74–93 kg), eleven (n = 11) elite non-disabled athletes (age range: 18–40 years, height range:172–197 cm, body mass range: 72–96 kg) and nine (n = 9) athletes whose movements were artificially limited to imitate disabled conditions(“imitation disabled” group) (age range: 18–40 years, height range: 172–197 cm, body mass range: 72–96 kg) were measured. Weba sport kayak ergometer, surface electromyography (EMG), and a 3-dimensional Vicon (MX T40) camera system were used to record the data, and a combined Matlab and MS Excel system was used to analyse the results. Results: In line with our basic assumption, range of motion of the upper limbs was not significantly different between disabled athletes and non-disabled athletes (p ≥ 0.05). However, muscle activities were significantly different in the disabled group compared to the non-disabled group (p ≤ 0.05). In the disabled group the knee joint and trunk motions and muscle activities were also significantly different compared to those in the non-disabled group (p ≤ 0.05). The differences in performance force applied to both footrests and force were significant (p ≤ 0.05). Discussion: The assumption that shoulder and elbow ranges of motion were not significantly different in disabled athletes compared to non-disabled athletes was proven. However, muscle activities were significantly different in the disabled group. In the disabled group, knee and trunk motions and muscle activities were also significantly different compared to the non-disabled group. Significant differences were found in performance, force and footrest use. Our results proved our assumption that motions and muscle activities of disabled and non-disabled athletes were significantly different. Orv Hetil. 2019; 160(52): 2061–2066.

scholarly journals Effects of physical therapy in patients with sciatica

2012 ◽  
Vol 18 (4) ◽  
pp. 174-178
Author(s):  
Clipa Adriana ◽  
Moisa Magdalena Nicoleta
Keyword(s):  
Lumbar Spine ◽  
Physical Therapy ◽  
Pain Relief ◽  
Clinical Outcome ◽  
Rehabilitation Hospital ◽  
Age Range

Abstract The aim of this study was to evaluate the clinical outcome of patients with sciatica treated in the Clinical Rehabilitation Hospital of Eforie Nord in the interval of time March 2012-July 2012. The study has been done on a group of 27 patients from which 18 (67%) were male and 9 (33%) were female with an age range of 28-67 years (mean age 48.8 years). The goals of rehabilitation include pain relief, increased mobility for dorsal and lumbar spine and prevention of relapses.

The clinical outcome of the Metha short hip stem: a systematic scoping review

2020 ◽  
pp. 112070002090371 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Purnachandra Tejaswi ◽  
Dimitrios Chytas ◽  
Vikram Kadu ◽  
Dimitrios Karanikas ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Systematic Reviews ◽  
Scoping Review ◽  
Hip Resurfacing ◽  
Long Term Results ◽  
Middle Aged ◽  
Cochrane Database ◽  
Pubmed Database ◽  
Meta Analyses ◽  
Age Range

Introduction: Short femoral stems were designed to bridge the gap between conventional straight design stems and hip resurfacing prostheses in total hip arthroplasty (THA). A number of clinical trials have been recently conducted to assess the clinical and safety profile of the cementless, colarless, tapered Metha short hip stem in young or active middle-aged individuals. Methods: A systematic scoping review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. 4 reviewers independently conducted the search using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “short” AND “hip” AND “stem”. Results: From the initial 773 studies we finally chose 12 studies after applying our inclusion-exclusion criteria. The number of operated hips that were included in these studies was 5048 (mean BMI range: 22.7–35.2, mean age range: 44.4–60.4 years, mean follow-up range: 2–9 years). The mean modified Coleman methodology score was 52.3/100, while it ranged from 31/100 to 63/100. All mean clinical outcome scores that were used in the studies illustrated significant postoperative improvement when compared with the respective initial values. The revision rate of the Metha stem for component-related reasons was 2.5%, while the rate of major complications not requiring revision of the Metha stem was 2.8%. Conclusions: The Metha stem performs well in young or active middle-aged THA patients. Further studies are required for the assessment of the long-term results.

scholarly journals Treatment of Vertebral Artery Origin Stenosis with a Pharos Stent Device: A Single Center Experience

2011 ◽  
Vol 17 (3) ◽  
pp. 316-322 ◽  
Author(s):  
E. Broussalis ◽  
A.B. Kunz ◽  
G. Luthringshausen ◽  
S. Klein ◽  
M.R. McCoy ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Vertebral Artery ◽  
Clinical Status ◽  
Magnetic Resonance Tomography ◽  
Clinical Results ◽  
Stent Restenosis ◽  
Atherosclerotic Stenosis ◽  
One Year ◽  
In Stent Restenosis

Atherosclerotic stenosis of vertebral artery (VA) origin exceeding 70% severity accounts for one third of all vertebrobasilar strokes. For a period of one year the results of endovascular treatment of VA stenosis with the new Pharos stent device were assessed. Twenty-two patients with symptomatic VA stenosis were treated with the Pharos stent. Clinical status and stenosis grade were documented before treatment and 24 hours, one, three and twelve months after treatment via ultrasound and magnetic resonance tomography. All procedures proved to be technically successful without the occurrence of intra-procedural complications. During the observation period of more than one year, 55% of patients were documented with a mean stenosis degree of 60%: two (10%) of these patients showed a residual stenosis after angioplasty and nine patients (45%) an in-stent restenosis, whereas only two patients were documented with a hemodynamically relevant in-stent restenosis of 80%. These two patients were retreated with balloon dilatation. None of the patients showed neurological deterioration or new abnormalities at magnetic resonance tomography examination. Neither VA occlusion nor restenosis of the contralateral VA negatively affected the clinical outcome. An in-stent restenosis was developed by more female than male patients. VA origin stenting with the Pharos stent device is an effective treatment of stenosis. The good clinical results compared to the high restenosis rates have to be examined in further studies. Pin particular, it has to be determined whether the Pharos stent allows the vessel time for collateralization, whether double antiplatelet treatment prevents recurrent cerebrovascular events or whether merely the low restenosis degree is causative for the clinical outcome.

The Transpedicular Approach in the Management of Thoracic Spine Tuberculosis: A Short-Term Follow Up Study

Spine ◽  
2004 ◽  
Vol 29 (17) ◽  
pp. E363-E367 ◽  
Author(s):  
Ari G. Chacko ◽  
Ranjith K. Moorthy ◽  
Mathew J. Chandy
Keyword(s):  
Thoracic Spine ◽  
Short Term ◽  
Follow Up Study ◽  
Transpedicular Approach ◽  
Spine Tuberculosis

scholarly journals Clinical Validation of Kinematic Assessments of Post-Stroke Upper Limb Movements with a Multi-Joint Arm Exoskeleton

2020 ◽  
Author(s):  
Florian Grimm ◽  
Jelena Kraugmann ◽  
Georgios Naros ◽  
Alireza Gharabaghi
Keyword(s):  
Clinical Outcome ◽  
Upper Limb ◽  
Convergent Validity ◽  
Degrees Of Freedom ◽  
Clinical Status ◽  
Multiple Regression Model ◽  
Fine Grained ◽  
Starting Position ◽  
Upper Limb Function ◽  
Upper Limb Movements

Abstract Background: Robotic and gravity-balancing exoskeletons, originally designed for the rehabilitation training of neurological patients, are now being increasingly applied in objective and fine-grained sensor-based assessments of upper limb function. However, gravity compensation, inertia and damping properties of the exoskeleton interfere with the natural sensorimotor interaction, proprioceptive and visual feedback during movement execution. This may endanger the validity of the kinematic assessments in relation to the clinical outcome measures that they were supposed to reflect. Here, we appliedMethods: In a proof of concept study involving nineteen severely impaired chronic stroke patients, we assessed sensor-based kinematic data acquired with a multi-joint arm exoskeleton and compared it to the clinical outcome measure Upper Extremity Fugl-Meyer Assessment (UE-FMA) scale. During this assessment, real-time movement feedback of the system’s seven degrees of freedom was provided with a biomorphic 3D virtual representation of the upper limb, including the proximal component of the arm. To align posture and to minimize the exoskeleton-patient interaction, the same position (neutral zero) with a distance of 90 degrees between forearm and upper arm was taken as the starting position for all assessments. Within self-contained tasks, we assessed separately and subsequently the range of motion/spatial posture of four single joints (i.e., joint angles of wrist, elbow, arm, and shoulder movement) and the closing and opening of the hand with a pressure sensor placed in the handle.Results: A strong correlation was observed between wrist and elbow movements within the kinematic parameters (r > 0.7, p<0.003; Bonferroni corrected). A multiple regression model predicted the UE-FMA significantly (F (5, 13) = 12.22, p < 0.0005, adj. R2 = 0.83). Both shoulder rotation and grip pressure added significantly (p < 0.05) to the prediction with the standardized coefficients β of 0.55 and 0.38, respectively.Conclusions: Exoskeleton-based evaluation of single-joint movements and grip force facilitates the assessment of upper limb kinematics after stroke with high structural and convergent validity. Proximal and distal measures may contribute independently to the prediction of the clinical status.

scholarly journals Lower Limb Varicose Veins's Clinical Profile and Management

2020 ◽  
pp. 1-5
Author(s):  
C. Z. Perdeshi ◽  
Kustub A. Kulkani ◽  
Revendra N. Yadav ◽  
Mayur Nagwakar ◽  
Niten H. Patil
Keyword(s):  
Varicose Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Clinical Profile ◽  
Lower Limbs ◽  
Study Results ◽  
Common Technique ◽  
Age Range ◽  
Made In

The lower limbs’ venous system has the pressure of posture, and blood has to be pushed against gravity into the heart cavity. This issue is generally approached either by a cautious approach or by surgical interference, all of which are constrained. Attempts to study different clinical manifestations of varicose veins are being made in the present study. The overall number of 50 varicose vein patients was analysed and the study results were reported. Varicosity veins of the lower limb is a fairly normal pathological entity. In the 20-50 age range, the condition is more common. The main modality of the procedure is surgery. The most common technique performed is Saphenofemoral flush ligation with stripping. 

scholarly journals Detection of Midline Shift from CT Scans to Predict Outcome in Patients with Head Injuries

2021 ◽  
Vol 11 (1) ◽  
pp. 18-23
Author(s):  
Ikhlas Abdelaziz ◽  
Rowa Aljondi ◽  
Ali Alhailiy ◽  
Mustafa Mahmoud
Keyword(s):  
Clinical Outcome ◽  
Brain Injuries ◽  
Head Injuries ◽  
Clinical Status ◽  
Ct Scans ◽  
Ct Scanner ◽  
Midline Shift ◽  
Medical Systems ◽  
Gcs Score ◽  
The Relationship

Background: The present study aimed to detect the degree of midline shift from CT scans and the clinical status of the patient, to evaluate the relationship between the degree of midline shift found by the CT scan and GCS score as a predictor of clinical outcome in head injury patients. Furthermore, we aimed to assess the relationship between midline shift and age, sex, and causes. Methods and Results: The study included 50 subjects (36 males and 14 females). The age range of the patients in this study was 18–95 years old (mean age of 48.34±17.02 years). The inclusion criteria were patients with traumatic brain injury (TBI) or patients evaluated for level of consciousness by a neurosurgeon. Toshiba 16 Slice CT scanner (Toshiba Medical Systems, Nasu, Japan 2003) was used to scan all patients in the supine, head first position. Contiguous 2 mm slices were obtained using the Toshiba 16-slice machine spiral technique (pitch 1.25–1.5, 0.75 s rotation time, 120 KvP, 2 mm reconstruction interval). The results indicated that the degree of midline shift in patients with brain injuries was statistically significant as a determinant of clinical outcome. It appeared that the probability of poor clinical outcome was higher when there was a combination of midline shift and other types of intracranial hemorrhage, clinical factors, such as sex, age, and GCS score, and associated injuries. The worst outcome was seen in patients with midline shift and subdural hematoma, when compared with other lesions in patients with brain injuries. Conclusion: This study suggests that the degree of midline shift may be predictive of clinical outcome in patients with head injuries.

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